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The effects of moderate exercise training on nutrient intake in mildly obese women.

The relationship between moderate exercise training (five 45-minute sessions per week, brisk walking at 62 +/- 2% VO2 max for 15 weeks) and changes in nutrient intake was investigated in a group of 36 sedentary, mildly obese women. The study was conducted using a 2 x 3 factorial design (two groups of subjects: exercise and nonexercise groups; three periods: baseline, 6-week, and 15-week testing sessions). Data were analyzed using repeated measures ANOVA. The pattern of change in caloric intake over time tended to be different between groups (F[2, 68] = 2.50, p = .089); the exercise group experienced a significant decrease in caloric intake by 15 weeks. Significant group x time interactions were found for intakes of carbohydrate, dietary fiber, thiamin, niacin, vitamin B-6, and folate. Intake tended to decrease in the exercise group and to increase in the nonexercise group. Change in intake of each of these nutrients was significantly correlated with change in bread and cereal consumption. The pattern of change in bread and cereal intake over time was significantly different between groups (Pillais Trace = 0.266, F[2, 33] = 5.99, p = .006); the exercise group had significant decreases in intake at 6 and 15 weeks vs baseline values. These data suggest that mildly obese women reduce energy intake subsequent to initiating an exercise program; concomitantly there is a decrease in the quality of nutrient intake from their diets compared with those of sedentary controls.

Adult↗

Physical activity and serum lipids and lipoproteins in elderly women.

OBJECTIVE: The relationship between cardiorespiratory exercise and serum lipid and lipoprotein levels was studied in elderly women. DESIGN: Randomized controlled experimental design with a follow up of 12 weeks; cross-sectional comparison at baseline. SETTING: Community-living elders in university exercise facilities. PARTICIPANTS: Thirty-two apparently healthy, sedentary elderly Caucasian women, 67 to 85 years of age. Ten highly conditioned elderly women, 65 to 84 years of age, who were active in endurance competitions and had been training for 11.2 +/- 1.2 years, were recruited at baseline for cross-sectional comparisons. INTERVENTIONS: Sedentary subjects were randomized to either a walking or calisthenic group. Intervention groups exercised 30 to 40 minutes, 5 days a week for 12 weeks, with the walking group training at 60% heart rate reserve and the calisthenic group engaging in mild range-of-motion and flexibility movements that kept their heart rates close to resting levels. MEASUREMENTS: Serum lipids and lipoproteins, maximal aerobic capacity (VO2 max), four skinfolds, and dietary intake at baseline and after 5 and 12 weeks. RESULTS: When the highly conditioned group and combined group of sedentary subjects were compared at baseline, serum high-density lipoprotein cholesterol (HDL-C; 1.61 +/- 0.14 vs 1.27 +/- 0.05 mmol/L, respectively; P = 0.048) and triglycerides (1.29 +/- 0.15 vs 2.00 +/- 0.15, respectively; P = 0.002), but not total serum cholesterol (5.72 +/- 0.36 vs 5.72 +/- 0.19 mmol/L, respectively) and low-density lipoprotein cholesterol (LDL-C; 3.62 +/- 0.36 vs 3.72 +/- 0.18 mmol/L, respectively), were significantly different. Twelve weeks of moderate cardiorespiratory exercise improved the VO2max of the sedentary subjects 12.6% but did not result in any change in body weight, energy intake, dietary quality, or any of the serum lipids or lipoproteins. CONCLUSION: Highly conditioned and lean elderly women, when compared with their sedentary counterparts, had higher HDL-C and lower triglycerides, but similar total serum cholesterol and LDL-C values. However, twelve weeks of moderate cardiorespiratory exercise were not associated with an improvement in serum lipid or lipoprotein profiles in previously sedentary elderly women.

Aged↗

The influence of a 1-year programme of brisk walking on endurance fitness and body composition in previously sedentary men aged 42-59 years.

This study examined the influence of a 1-year brisk walking programme on endurance fitness and the amount and distribution of body fat in a group of formerly sedentary men. Seventy-two males, aged 42-59 years, body mass index 25.2 (0.3) kg.m-2 [mean (SEM)], were randomly allocated to either a walking group (n = 48) or control group (n = 24). Brisk walking speed was evaluated using a 1.6-km track walk. Changes in endurance fitness were assessed by measuring blood lactate concentration and heart rate during submaximal treadmill walking. Body composition was determined by hydrostatic weighing and anthropometry; energy intake was assessed from 7-day weighed food inventories. Differences in the response of walkers and controls were examined using two-way analyses of variance. Forty-two walkers (87.5%) completed the study and averaged 27.9 (1.4%) min.day-1 of brisk walking (range 11-46). Brisk walking speed averaged 1.95 (0.03) m.s-1 and elicited approximately 68 (1) % of maximum heart rate. Heart rate and blood lactate concentration during submaximal treadmill walking were significantly reduced in the walkers after 3, 6 and 12 months and the oxygen uptake at a reference blood lactate concentration of 2 mmol.l-1 was increased by 3.2 ml.kg-1.min-1 (14.9%) in the walkers at 6 months (P < 0.01). Although skinfold thicknesses at anterior thigh and medial calf sites decreased significantly for the walkers, the response of the two groups did not differ significantly for other body composition variables or for energy intake.

Adult↗

Cardiorespiratory and metabolic responses during forward and backward walking.

Level and incline backward treadmill walking techniques are used in the rehabilitation of certain lower extremity injuries (eg., anterior cruciate ligament reconstruction). Of interest to clinicians is the maintenance of cardiorespiratory fitness resulting from these activities. The purpose of the present study was to determine the cardiorespiratory and metabolic stress of backward walking compared with forward walking. The metabolic cost of backward incline walking above a 1% grade has previously not been reported. Seventeen volunteers (11 males and six females, age = 25 +/- 2 years) underwent a forward maximal running test and four random-ordered 6-minute submaximal walking bouts at 93.8 m/min (3.5 mph). The bouts consisted of forward walking at 0% and 5% elevation and backward walking at 0% and 5% elevation. Measurements taken for each exercise session were oxygen uptake, expired ventilation, heart rate, and rating of perceived exertion. Statistical analysis of these dependent variables indicates that: 1) at a given elevation, backward walking elicited greater cardiorespiratory, metabolic, and perceptual responses than forward walking and 2) backward walking at 5% elevation could provide a sufficient stimulus to maintain cardiorespiratory fitness.

Adult↗

Walking speed on parquetry and carpet after stroke: effect of surface and retest reliability.

OBJECTIVE: At the transition stage from rehabilitation to home this study aimed to (1) investigate the effect of floor surface (carpet and parquetry) on walking speed; (2) investigate whether there was a difference between these surfaces as stroke patients voluntarily increased from comfortable to fast pace; (3) investigate whether walking speed on parquetry was a predictor of walking speed on carpet at the two paces; (4) investigate whether walking speed at a comfortable pace was a predictor of walking speed at a fast pace on the two surfaces; and (5) quantify systematic and random error in repeated measurements for fast-paced walking trials. DESIGN: Subjects walked 10 metres at comfortable and fast paces on carpet and parquetry on two consecutive days. SETTING: Inpatient rehabilitation centre. SUBJECTS: Twenty-four stroke patients. MAIN OUTCOME MEASURE: Walking speed. RESULTS: Two-way analysis of variance confirmed that patients walked more slowly on carpet than parquetry (F(1,23) = 5.3, p <0.05) at both paces; the interaction effect was not significant (p >0.05). Walking speed on parquetry was a strong predictor of walking speed on carpet at a comfortable (r = 0.92), and fast pace (r = 0.97). Walking speed at comfortable pace was a moderately strong predictor of walking speed at fast pace on parquetry (r = 0.84), and on carpet (r = 0.88). Random error in repeated measurements was higher when walking fast on carpet (7.21 m/min) and parquetry (8.32 m/min) than when walking at a comfortable pace on carpet (4.63 m/min) and parquetry (3.48 m/min). Systematic error was negligible (p <0.05). CONCLUSION: Carpet surface was more challenging than parquetry surface, as evidenced by the systematic decrease in walking speed. This may have been due to lack of familiarity. Relative to the wide range of scores in the group, stroke patients showed consistency of walking speed across both surfaces. Likewise, stroke patients retained their relative position in the group as they changed from a comfortable to a fast walking pace. The difference in random error between comfortable and fast-paced trials highlights the need to quantify error in the repeated measurement situation according to specific test conditions.

Activities of Daily Living↗

Fractal structure and conformational entropy of protein chain.

The structures of 25 proteins arbitrarily chosen are investigated by fractal geometry, and their fractal dimensions (Df) and conformational entropies S(NO) are calculated by Havlin-Ben Avraham and Monte Carlo method, respectively. Comparison of the Df and S(NO) give the relation: Df = 1.532 - 3.00 x 10(-4) S(NO). The entropy data obtained by Monte Carlo method for the chain of random self-avoiding walks confirm the prediction of renormalization group: S(NO) = 1.544NO + 0.1667 In NO + 0.1570 where NO is the number of residues in a protein chain. Both the Df and S(NO) reflect the conformational properties of a protein molecular chain. The idea resulting from the present communication suggests that the thermodynamic behaviours of proteins may be related to multifractals.

Mathematics↗

RNA mapping: selection of potent oligonucleotide sequences for antisense experiments.

The importance of finding good antisense sequences cannot be underestimated. Poor inhibition of the targeted protein can compromise the final outcome of an antisense experiment, making it difficult to arrive at a definitive understanding of the function of the protein of interest. In antisense therapeutics, identification of potent sequences becomes even more important. RNA mapping greatly increases the odds of finding active sequences. When antisense sequences are selected randomly or by gene walking, a substantial number of the oligonucleotides have little to no activity. In contrast, oligonucleotides selected by RNA mapping typically produce an antisense inhibition of greater than 50%. Oligonucleotides targeted to 60% of the accessible sites in the 5' portion of the multidrug resistance transcript inhibited P-glycoprotein function with high potency. In the angiotensin type 1 receptor system, oligonucleotides to the eight accessible sites examined inhibited AT1 receptor binding by at least 50%, with oligonucleotides to four of the sites producing at least 70% inhibition. The RNA mapping assay, which is based on standard molecular techniques, therefore provides an easy and reliable method for potent antisense sequence selection.

Base Sequence↗

Effects of functional electrostimulation on pain, muscular strength, and functional capacity in patients with osteoarthritis of the knee.

BACKGROUND: Osteoarthritis (OA) of the knee is a common cause of chronic disability in patients with quadriceps muscle weakness. Beneficial effects have been proposed for functional electrostimulation (FES) and exercise at the muscle level. OBJECTIVES: The objective of the study was to begin to compare the effects of both therapeutic modalities on quadriceps muscle strength, pain, and functional capacity in patients with OA of the knee and to prove whether the combination of these modalities provides greater benefits than the use of each therapeutic modality alone. METHODS: This pilot study included 37 patients with OA of the knee who were assessed at baseline and at 8 weeks, accounting for the following variables: body mass index, knee pain (measured using a VAS), WOMAC, quadriceps strength (measured using a dynamometer) and 6-minute walk test. Patients were randomized into 3 groups: (A) 8 patients who received FES 3 times per week; (B) 10 patients recruited into a twice-a-week physical training program; and (C) 8 patients under combined therapy; 29.7% of patients were lost to follow-up due to noncompliance with the treatment plan, leaving a total of 26 patients at 8 weeks. RESULTS: Pain and WOMAC improved in all 3 groups; strength improved significantly in the exercise-only group; the FES + exercise combination improved strength significantly when compared with the individual therapeutic procedures. CONCLUSIONS: FES merits a larger placebo-controlled study as it may prove to be useful patients with OA of the knee; the combination with exercise was helpful in improving muscle strength. This technique may be considered in patients who are unable to carry out physical activity due to health problems or in those who are not interested in physical activity.

Journal Article↗

Rhizobium meliloti swims by unidirectional, intermittent rotation of right-handed flagellar helices.

The 5 to 10 peritrichously inserted complex flagella of Rhizobium meliloti MVII-1 were found to form right-handed flagellar bundles. Bacteria swam at speeds up to 60 microns/s, their random three-dimensional walk consisting of straight runs and quick directional changes (turns) without the vigorous angular motion (tumbling) seen in swimming Escherichia coli cells. Observations of R. meliloti cells tethered by a single flagellar filament revealed that flagellar rotation was exclusively clockwise, interrupted by very brief stops (shorter than 0.1 s), typically every 1 to 2 s. Swimming bacteria responded to chemotactic stimuli by extending their runs, and tethered bacteria responded by prolonged intervals of clockwise rotation. Moreover, the motility tracks of a generally nonchemotactic ("smooth") mutant consisted of long runs without sharp turns, and tethered mutant cells showed continuous clockwise rotation without detectable stops. These observations suggested that the runs of swimming cells correspond to clockwise flagellar rotation, and the turns correspond to the brief rotation stops. We propose that single rotating flagella (depending on their insertion point on the rod-shaped bacterial surface) can reorient a swimming cell whenever the majority of flagellar motors stop.

Chemotaxis↗

The psychological and physiological responses of sedentary individuals to prescribed and preferred intensity exercise.

OBJECTIVES: Affective valence responses to exercise may influence adherence. According to a newly proposed dual-mode model, affective responses have been proposed to vary depending on whether exercise is undertaken above or below the anaerobic threshold. With the model in mind, the study objectives were to explore the impact of an above-lactate, below-lactate, and self-selected exercise condition on acute affective responses in sedentary individuals. DESIGN: Using a repeated measures design, 12 volunteers participated in two prescribed intensity exercise conditions (above and below-lactate threshold) and one self-selected intensity exercise condition. The three conditions were randomized. METHOD: An incremental walking protocol was used to identify exercise intensities that would elicit above- and below-lactate threshold work rates for each participant. The exercise conditions were completed on different days and each lasted for 20 minutes. Physiological and affective responses were recorded pre-exercise, during exercise, and post-exercise. RESULTS: Affective responses were more negative in the above-lactate condition during exercise compared with the below-lactate and self-selected conditions. There were no differences between the conditions post-exercise. Participants exercised around the lactate threshold and at a significantly higher intensity in the self-selected compared with the below-lactate condition. Inter-individual variability in responses was greatest below the lactate threshold, with similar levels of variability in the self-selected and above-lactate conditions. CONCLUSIONS: Data are consistent with the proposals of the dual-mode model and support the use of self-selected intensity with sedentary individuals to promote positive affective responses.

Adult↗

Perception of the symmetrical patterning of human gait by infants.

Two experiments tested 3- and 5-month-old infants' sensitivity to properties of point-light displays of human gait. In Experiment 1, infants were tested for discrimination of point-light displays of a walker and a runner, which, although they differed in many ways, were equivalent with regard to the phasing of limb movements. Results revealed that 3-month-old, but not 5-month-old, infants discriminated these displays. In Experiment 2, the symmetrical phase-patterning of the runner display was perturbed by advancing two of its limbs by 25% of the gait cycle. Both 3- and 5-month-old infants discriminated the walker display from this new phase-shifted runner display. These findings suggest that 3-month-old infants respond to the absolute and relative motions within a single limb, whereas 5-month-old infants respond primarily to the relations between limbs and, in particular, to the bilateral symmetry between the limbs.

Female↗

Dehydration and symptoms of delayed-onset muscle soreness in hyperthermic males.

CONTEXT: Exercise in the heat produces cellular conditions that may leave skeletal muscle susceptible to exercise-induced microdamage. Delayed-onset muscle soreness (DOMS) is a clinical model of contraction-induced skeletal muscle injury. OBJECTIVE: To determine whether thermoregulation during exercise heat stress adversely affects muscle injury and the accompanying DOMS. DESIGN: Randomized group test-retest design. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: Ten healthy male volunteers were randomly assigned to either the euhydration/hyperthermic or dehydration/hyperthermic group. INTERVENTION(S): Participants were randomly assigned to treadmill walking in a hot, humid environmental chamber (40 degrees C and 75% relative humidity) with either oral rehydration (euhydration/hyperthermic) or fluid restriction (dehydration/hyperthermic). Immediately after heat exposure and while hyperthermic, participants performed an eccentrically biased downhill run to induce DOMS. MAIN OUTCOME MEASURE(S): We measured DOMS characteristics pre-exercise and at 0.5, 24, 48, 72, and 96 hours postexercise. RESULTS: Treadmill exercise and exposure to the hot ambient environment elicited a 0.9% body mass loss for the euhydrated/ hyperthermic (mean rectal temperature after 60 minutes of heat-stress trial = 38.2 +/- 0.4 degrees C) and 3.3% body mass loss for the dehydrated/hyperthermic participants (mean rectal temperature after 60 minutes of heat-stress trial = 38.1 +/- 0.4 degrees C). Quadriceps perceived pain was significantly higher (F(5,40) = 18.717, P <or= .001) than baseline at 24 and 48 hours postexercise, following the classic pattern of DOMS. Overall lower extremity perceived pain was significantly higher for the dehydration/hyperthermia group than the euhydration/hyperthermia group (F(1,8) = 6.713, P = .032). Punctate tenderness of the vastus lateralis for the dehydration/hyperthermic group was 6.9% higher (F(5,40) = 4.462, P = .003) than for the euhydration/ hyperthermic group. No clinically important findings were revealed for passive range of motion for knee flexion. For both groups, quadriceps isometric strength (F(5,40) = 12.924, P <or= .001) was 17.5% and 20.0% lower at 0.5 hours postexercise than at 72 and 96 hours postexercise, respectively. Further, quadriceps isometric strength remained 10.5% reduced at 24 hours postexercise compared with 96 hours postexercise. CONCLUSIONS: Skeletal muscle microdamage, indirectly evidenced by DOMS, was exacerbated in hyperthermic participants dehydrated by exercise in a hot ambient environment. Individuals performing novel exercise, particularly with a significant eccentric component, should use caution when training in a hot, humid environment and implement frequent rest and rehydration breaks.

Journal Article↗

Effects of supplemental oxygen during activity in patients with advanced COPD without severe resting hypoxemia.

STUDY OBJECTIVES: To assess oxygen desaturation during activities and to evaluate the short-term effects of supplemental O(2) use in patients with severe COPD who do not qualify for long-term O(2) therapy. DESIGN: A double-blind, randomized, placebo-controlled trial. SETTING: Outpatients from the pulmonary diseases division of a tertiary-care university hospital. PATIENTS: Twenty patients with stable COPD with FEV(1)/FVC ratios of < 50%, FEV(1) levels < 55% of the predicted normal value, and PaO(2) levels of > 60 mm Hg when resting. INTERVENTIONS: Patients were initially evaluated with pulmonary function tests, blood gas analysis, and Doppler echocardiography, and they underwent the following three 6-min walking tests (WTs) in a random sequence: basal WT (BWT); WT while breathing compressed air (CAWT); and WT while breathing O(2) (O(2)WT). MEASUREMENTS AND RESULTS: The distance walked was recorded in meters. Dyspnea was measured by Borg scale measurement before and after the tests, and arterial oxygen saturation measured by pulse oximetry (SpO(2)) was continuously monitored. Results were analyzed by grouping patients in the following manner: desaturators (DSs) (ie, patients with a drop in SpO(2) of at least 5% and < 90% during the WT) vs nondesaturators (NDSs); and O(2) responders (ie, patients with an increase of at least 10% in the distance walked and/or a decrease of at least 3 points in Borg index score) vs nonresponders. During the BWT, 11 of 20 patients (55%) were defined as desaturators. During the O(2)WT, the SpO(2) remained at > 90% in every patient. The distance walked increased by 22% (p < 0.02), and dyspnea decreased 36% (p < 0.01) in DS patients. In NDS patients, O(2) administration reduced dyspnea by 47% (p < 0.001), but the distance walked did not improve. Responses were markedly different from one patient to another. No significant differences were noticed between the results of the BWT and CAWT in any of the groups. Thirteen O(2) responders did not differ from 7 nonresponders either in basal data or in desaturation measure during the BWT, except that all walking responders (five patients) were above the median of basal left ventricle performance. CONCLUSIONS: Most of the studied COPD patients desaturated during the BWT. O(2) administration avoided desaturation and could increase the distance walked and reduce dyspnea, but these effects were not related to walking desaturation in individual cases. Improvements were not a placebo effect. The therapeutic role of O(2) during activities in some patients with severe COPD needs to be individually assessed.

Aged↗

Effect of intermittent pneumatic compression of foot and calf on walking distance, hemodynamics, and quality of life in patients with arterial claudication: a prospective randomized controlled study with 1-year follow-up.

SUMMARY BACKGROUND DATA: Perioperative mortality, graft failure, and angioplasty limitations militate against active intervention for claudication. With the exception of exercise programs, conservative treatments yield modest results. Intermittent pneumatic compression [IPC] of the foot used daily for 3 months enhances the walking ability and pressure indices of claudicants. Although IPC applied to the foot and calf together [IPCfoot+calf] is hemodynamically superior to IPC of the foot, its clinical effects in claudicants remain undetermined. OBJECTIVE: This prospective randomized controlled study evaluates the effects of IPCfoot+calf on the walking ability, peripheral hemodynamics, and quality of life [QOL] in patients with arterial claudication. METHODS: Forty-one stable claudicants, meeting stringent inclusion and exclusion criteria, were randomized to receive either IPCfoot+calf and aspirin[75 mg] (Group 1; n = 20), or aspirin[75 mg] alone (Group 2; n = 21), with stratification for diabetes and smoking. Groups matched for age, sex, initial [ICD] and absolute [ACD] claudication distances, pressure indices [ABI], popliteal artery flow, and QOL with the short-form 36 Health Survey Questionnaire (SF-36). IPCfoot+calf (120 mm Hg, inflation 4 seconds x 3 impulses per minute, calf inflate delay 1 second) was used for 5 months, > or =2.5 hours daily. Both groups were advised to exercise unsupervised. Evaluation of patients, after randomization, included the ICD and ACD, ABI, popliteal artery flow with duplex and QOL* at baseline*, 1/12, 2/12, 3/12, 4/12, 5/12* and 17/12. Logbooks allowed compliance control. Wilcoxon and Mann-Whitney corrected[Bonferroni] tests were used. RESULTS: At 5/12 median ICD, ACD, resting and postexercise ABI had increased by 197%, 212%, 17%, and 64%, respectively, in Group 1 (P < 0.001), but had changed little (P > 0.1) in Group 2; Group 1 had better ICD, ACD, and resting and postexercise ABI (P < 0.01) than Group 2. Inter- and intragroup popliteal flow differences at 5/12 were small (P > 0.1). QOL had improved significantly in Group 1 but not in Group 2; QOL in the former was better (P < 0.01) than in Group 2. QOL in Group 1 was better (P < 0.01) than in Group 2 at 5/12. IPC was complication free. IPC compliance (> or =2.5 hours/d) was >82% at 1 month and >85% at 3 and 5 months. ABI and walking benefits in Group 1 were maintained a year after cessation of IPC treatment. CONCLUSIONS: IPCfoot+calf emerged as an effective, high-compliance, complication-free method for improving the walking ability and pressure indices in stable claudication, with a durable outcome. These changes were associated with a significant improvement in all aspects of QOL evaluated with the SF-36. Despite some limited benefit noted in some individuals, unsupervised exercise had a nonsignificant impact overall.

Aged↗

Effects of mellow and frenetic music and stimulating and relaxing scents on walking by seniors.

Previous research has yielded an inconclusive picture of the effects of music and scent on walking. Few laboratory studies have detected a beneficial effect of music; olfactory research has shown performance is positively affected for repetitive tasks but not yet on walking. The influence of these two types of stimuli in efficiency of exercise among seniors was assessed by measuring distance walked on an indoor course. Using a 3 x 3 factorial design [mellow music in 4:4 time, frenetic music in 2:8 time, and white noise by stimulating, relaxing, and control scent conditions], each of 20 volunteers from a senior center received nine randomized, 90-sec. exercise trials. Walking distance was reduced by mellow music but unaffected by stimulating music; there was no effect of scent.

Aged↗

Menopausal status, moderate-intensity walking, and symptoms in midlife women.

The purpose of this randomized clinical trial study was to determine the effectiveness of a 24-week, home-based, moderate-intensity, walking intervention in improving symptoms (vasomotor, uro-genital/sexual, sleep, psychological, cognitive, physical) experienced by midlife women. One hundred and seventy-three Caucasian and African American women aged 45 to 65 who were not on hormone therapy, had no major signs or symptoms of cardiovascular disease, and were sedentary in their leisure activity were randomly assigned to the moderate-intensity walking group or the nonexercise control group. The exercise prescription was walking at a frequency of 4 times a week for a duration of 20 to 30 minutes. The symptom impact inventory included the frequency, intensity, and bothersomeness of 33 symptoms collected at baseline and 24 weeks. Adherence was measured with a heart rate monitor and exercise log. Average adherence to frequency of walking was 71.6% of the expected walks. After 24 weeks, there were no differences between the walking and control group on change in symptoms. However, multiple regression revealed that frequency of adherence to walking along with change in physical symptoms and menopausal status were significant predictors of change in sleep symptoms. While walking did not improve most symptoms experienced by midlife women, frequency of walking may improve sleep.

Aged↗

Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction? A prospective randomized study with a two-year follow-up.

BACKGROUND: There are well-known problems with the use of bone-patellar tendon-bone autografts for anterior cruciate ligament reconstruction, especially in terms of donor site morbidity. Hamstring tendon grafts have been increasingly used as an alternative, but there are very few controlled studies comparing the methods. HYPOTHESIS: Use of semitendinosus tendon grafts will cause less donor site morbidity and result in better knee-walking ability. STUDY DESIGN: Prospective randomized clinical trial. METHODS: Seventy-one patients who had a unilateral anterior cruciate ligament rupture underwent arthroscopic reconstruction with interference screw fixation and use of either bone-patellar tendon-bone or semitendinosus tendon graft. Outcome assessment was performed by physiotherapists not involved in the patients' care. RESULTS: At the 2-year follow-up, no differences were found in terms of the Lysholm score, Tegner activity level, KT-1000 arthrometer side-to-side laxity measurement, single-legged hop test, or International Knee Documentation Committee classification results. The knee-walking test was rated difficult or impossible to perform by 53% of the bone-patellar tendon-bone group and by only 23% of the semitendinosus graft patients, a significant difference. CONCLUSIONS: The semitendinosus tendon graft is at least an equivalent option to the bone-patellar tendon-bone graft for anterior cruciate ligament reconstruction, and we recommend its use.

Adolescent↗

Blood pressure rise with swimming versus walking in older women: the Sedentary Women Exercise Adherence Trial 2 (SWEAT 2).

OBJECTIVE: Swimming is often recommended in the prevention and treatment of hypertension. Few studies have investigated the effect of swimming training on blood pressure (BP). Our objective was to evaluate 6 months of supervised moderate swimming or walking on BP in previously sedentary, normotensive, older women. DESIGN: Women aged 50-70 years (n = 116) were randomly assigned to a supervised 6-month swimming or walking programme. They were further randomized to receive usual care or a behavioural intervention package. METHODS: Exercise comprised 3 sessions/week with a warm-up, cool down, and 30-min of moderate intensity walking or swimming. BP was recorded for 20 min supine, and 5 min standing. Assessments were made at 0 and 6 months. RESULTS: At baseline, mean supine BP (+/- SD) was 115.7 +/- 1.3/66.8 +/- 0.7 mmHg. Swimming improved swim distance by 78.1 m (29.3%) [95% confidence interval (CI); 66.7, 89.4] and walk time by 0.58 min (3.8%) (0.41, 0.74). Walking decreased walk time by 1.0 min (6.5%) (0.81, 1.19). After adjustment for initial BP, age, hypertension treatment status and change in weight, swimming increased supine and standing systolic BP relative to walking by 4.4 mmHg (1.2, 7.5) (P = 0.008) and 6.0 mmHg (2.6, 9.5) (P = 0.001), respectively. Supine and standing diastolic BP increased by 1.4 mmHg (-0.14, 3.0) (P = 0.07) and 1.8 mmHg (-0.02, 3.5) (P = 0.05), respectively. CONCLUSION: Relative to moderately paced walking, regular swimming significantly elevates BP in previously sedentary, normotensive, older women. This finding may have important implications for exercise prescription in older subjects.

Aged↗