Efficacy of a Student-Led, Community-Based, Multifactorial Fall Prevention Program: Stay in Balance.

BACKGROUND: Falls are a major public health concern in older adults. Recent fall prevention guidelines recommend the use of multifactorial fall prevention programs (FPPs) that include exercise for community-dwelling older adults; however, the availability of sustainable, community-based FPPs is limited. METHODS: We conducted a 24-week quasi-experimental study to evaluate the efficacy of a community-based, multifactorial FPP [Stay in Balance (SIB)] on dynamic and functional balance and muscular strength. The SIB program was delivered by allied health students and included a health education program focused on fall risk factors and a progressive exercise program emphasizing lower-extremity strength and balance. All participants initially received the 12-week SIB program, and participants were non-randomly assigned at baseline to either continue the SIB exercise program at home or as a center-based program for an additional 12 weeks. Adults aged 60 and older (n = 69) who were at-risk of falling (fall history or 2+ fall risk factors) were recruited to participate. Mixed effects repeated measures using Statistical Application Software Proc Mixed were used to examine group, time, and group-by-time effects on dynamic balance (8-Foot Up and Go), functional balance (Berg Balance Scale), and muscular strength (30 s chair stands and 30 s arm curls). Non-normally distributed outcome variables were log-transformed. RESULTS: After adjusting for age, gender, and body mass index, 8-Foot Up and Go scores, improved significantly over time [F(2,173) = 8.92, p = 0.0; T0 - T2 diff = 1.2 (1.0)]. Berg Balance Scores [F(2,173) = 29.0, p < 0.0001; T0 - T2 diff = 4.96 (0.72)], chair stands [F(2,171) = 10.17, p < 0.0001; T0 - T2 diff = 3.1 (0.7)], and arm curls [F(2,171) = 12.7, p < 0.02; T0 - T2 diff = 2.7 (0.6)] also all improved significantly over time. There were no significant group-by-time effects observed for any of the outcomes. CONCLUSION: The SIB program improved dynamic and functional balance and muscular strength in older adults at-risk for falling. Our findings indicate continuing home-based strength and balance exercises at home after completion of a center-based FPP program may be an effective and feasible way to maintain improvements in balance and strength parameters.

Correlates of Physical Activity among Blacks and Whites with Arthritis.

OBJECTIVE: To evaluate the correlates of physical activity (PA) participation among white and black individuals with diagnosed arthritis. METHODS: This study used a cross-sectional design, grounded in the Social Ecological Model. Participants (N = 205) completed a survey regarding PA participation and potential correlates of PA. Bivariate and multivariate analyses were used to examine the correlates of PA. RESULTS: Nearly 30% of the population met the current guidelines for aerobic PA. A greater proportion of Whites (35.3%) than Blacks (20.9%) met current guidelines (χ(2) = 4.98, p = .03). In bivariate analyses, ethnicity, income, body mass index, self-efficacy for exercise, exercise outcome expectations, physical function, physician advice to exercise, and perceived safety from neighborhood crime and traffic were associated with meeting PA guidelines (p < .05). In regression analyses adjusted for socio-demographic characteristics, exercise self-efficacy and physician's advice to exercise were the only significant predictors of PA (p < .05). This finding was confirmed with stepwise forward regression. CONCLUSIONS: PA interventions for people with arthritis should focus on enhancing self-efficacy for exercise and include strategies to optimize communication about PA by healthcare providers.

Sociodemographic correlates of meeting US Department of Health and Human Services muscle strengthening recommendations in middle-aged and older adults.

INTRODUCTION: A growing body of evidence demonstrates the health benefits of muscular strength training. Physical activity recommendations encourage all adults to participate regularly in muscle strengthening activities. The purpose of this study was to examine the prevalence of meeting the US Department of Health and Human Services (DHHS) muscular strengthening recommendations by middle-aged and older adults and the sociodemographic characteristics associated with meeting these recommendations, using data from the 2011 Behavioral Risk Factor Surveillance System (BRFSS). METHODS: Data from the 2011 BRFSS were used to examine the prevalence of meeting the DHHS muscle strengthening recommendations by adults older than 45. Simple and multiple regression analyses were used to examine the sociodemographic characteristics associated with meeting the recommendations. RESULTS: Of respondents to the muscle strengthening question (N = 333,507), 79,029 (23.7%) reported meeting the muscle strengthening recommendations. Respondents who were female (odds ratio [OR] = 0.80; 95% confidence interval [CI] 0.78-0.83), widowed (OR = 0.69; 95% CI, 0.66-0.72), 85 or older (OR = 0.63; 95% CI, 0.58-0.68), Hispanic (OR = 0.73; 95% CI, 0.67-0.78), with a body mass index of 30.0 kg/m(2) or higher (OR = 0.47; 95% CI, 0.45-0.49), and with less than a high school education (OR = 0.32, 95% CI, 0.30-0.35) were less likely to meet the recommendations than their counterparts. CONCLUSION: Sociodemographic characteristics such as sex, age, education, and race/ethnicity are significantly associated with meeting the muscle strengthening recommendations, suggesting a need to create tailored interventions and messages to promote participation in strength training.

An examination of the differences between two methods of estimating energy expenditure in resistance training activities.

To date, few studies have looked at the energy expenditure (EE) of individual resistance training (RT) exercises. The purpose of this study was to evaluate the EE of 4 modes of RT (push-ups, curl-ups, pull-ups, and lunges) using 2 different calculation methods for estimating EE. Twelve healthy men with a minimum of 1 year of RT experience were randomly assigned to an RT circuit. Each circuit contained the 4 RT exercises in a specified order. The participants completed 3 trials of their assigned circuit during one visit to the laboratory. Oxygen consumption was measured continuously throughout the trial using indirect calorimetry. Two different calculation methods were applied to estimate EE. Using the traditional method (TEC), we estimated EE by calculating the average oxygen consumption recorded during each activity. Using the second, nontraditional method (NEC), we estimated EE by calculating the average oxygen consumption recorded during the recovery period. Independent T-tests were used to evaluate mean EE differences between the 2 methods. Estimates of EE obtained from the NEC were significantly higher for all the 4 activities (p < 0.001). Using the NEC, 3 of the 4 activities were classified as vigorous intensity (push-ups: 6.91 metabolic equivalents (METs); lunges: 7.52 METs; and pull-ups: 8.03 METs), whereas none were classified as vigorous using the TEC. Findings suggest that the methods we use to calculate the EE of anaerobic activities significantly affect EE estimates. Using the TEC may underestimate actual EE of anaerobic activities.

The exercise experience in adults with arthritis: a qualitative approach.

OBJECTIVE: To examine perceptions of exercise prior to arthritis, the ways in which arthritis affects exercise behavior, and current exercise behaviors in people with arthritis. METHODS: Qualitative analyses were used to identify themes in 12 focus groups segmented by exercise status, education, and race. RESULTS: Non exercisers identified arthritis as a factor in exercise cessation. Exercisers described making changes in type, duration, intensity, and approach to exercise after diagnosis. Exercisers also described participating in a wide range of activities, whereas nonexercisers primarily cited walking. CONCLUSIONS: Intervention and marketing strategies should focus on different capabilities of exercisers and nonexercisers to modify exercise routines to accommodate arthritis.

Physical activity levels among overweight and obese adults in South Carolina.

BACKGROUND: Obesity in the United States has reached epidemic proportions and is a major cause of morbidity and mortality. METHODS: We describe the activity levels of South Carolina adults on the basis of data derived from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System. RESULTS: Overweight and obese men and women reported less leisure time physical activity than did people of normal weight, with women found to be less active than men. CONCLUSION: Physical inactivity is more prevalent among obese and overweight men and women than among people of normal weight. Visiting the physician's office offers a unique opportunity to educate patients about the health benefits and appropriate amount of physical activity.