Effects of a 12-Month Pedometer-Based Walking Intervention in Women of Low Socioeconomic Status.

This study examined the effects of a 12-month walking intervention in overweight/obese, low socioeconomic women. Forty-six women (48.2 ± 8.0 years) entered the study. Outcomes included weight, waist and hip circumferences, body mass index (BMI), blood pressure, glycosylated hemoglobin, blood lipids, fibrinogen, and high-sensitivity C-reactive protein (hsCRP). Both intention-to-treat analyses in all participants and group analyses in study completers only (3K group = increased steps/day by ≥3,000; No Δ group = did not increase steps/day by ≥3,000) were conducted. Group × time ANOVA was used. In study completers, 3K significantly increased steps/day (6,903 ± 3,328 to 12,323 ± 5,736) compared to No Δ (4,926 ± 3,374 to 5,174 ± 3,095) from baseline to 12 months. There was a significant time effect for weight (P = 0.030), BMI (P = 0.029), and hsCRP (P = 0.044). Low socioeconomic women who adhere to a long-term, pedometer-based walking intervention significantly increased steps/day and may improve body weight, BMI, and hsCRP. This could help reduce health disparities in this population over time.

Effects of a 12-month pedometer walking program on gait, body mass index, and lower extremity function in obese women.

This study evaluated the effects of a self-reported pedometer-walking program on gait, lower extremity function, and Body Mass Index for 33 obese women, ages 31-65 years (M = 48.0, SD = 8.0) and whose initial average Body Mass Index was 40.30 +/- 9.60 kg/m2. During the 12-mo. intervention participants wore pedometers and reported the number of daily steps walked. Body Mass Index, three gait parameters, steps/day, and lower extremity function were taken over 3-mo. intervals. All participants increased in gait velocity, % single-leg support, and lower extremity function, and decreased in Body Mass Index over time. Those whose steps/day increased by 2000 over 6 mo. had significantly faster velocities and longer step lengths than those whose steps/day did not increase. The 1-yr. walking program stimulated changes in gait, Body Mass Index, and lower extremity function for these obese women. Ultimately, these changes may reduce the risk of falls for this group of women.

Pedometer measurement of physical activity and chronic disease risk factors of obese lower socioeconomic status African American women.

BACKGROUND: To evaluate physical activity with pedometers and health markers of chronic disease in obese, lower socioeconomic African American women. METHODS: Thirty-five women (48 +/- 8 years) wore pedometers for 2 weeks. One-way analyses of variances were used to compare age, weight, body mass indices (BMI), and health markers of chronic disease (including blood pressure, cholesterol, triglycerides, glycosylated hemoglobin, fibrinogen, C-reactive protein) between women who were classified by steps per day as sedentary (SED < 5000; 2941 +/- 1161 steps/d) or active (ACT > or = 5000; 7181 +/- 2398 steps/d). RESULTS: ACT had significantly lower BMI (ACT: 37.2 +/- 5.6; SED: 44.4 +/- 7.2 kg/m2) and hip circumferences (ACT: 37.2 +/- 5.6; SED: 44.4 +/- 37.2 cm) and higher total cholesterol (ACT: 230 +/- 53; SED: 191 +/- 32 mg/dL) than SED. There were no differences in health markers of chronic disease between SED and ACT. Pearson product moment correlations showed significant negative correlations between steps/d and weight (r = -.42), BMI (r = -.46), and hip circumference (r = -.47). CONCLUSIONS: Increased levels of physical activity were associated with reduced BMI and hip circumferences but were not associated with lower health markers for chronic disease in obese, lower socioeconomic African American women.

A comparison of physical functional performance and strength in women with fibromyalgia, age- and weight-matched controls, and older women who are healthy.

BACKGROUND AND PURPOSE: The purpose of this study was to compare functionality and strength among women with fibromyalgia (FM), women without FM, and older women. SUBJECTS: Twenty-nine women with FM (age [X+/-SD]=46+/-7 years), 12 age- and weight-matched women without FM (age=44+/-8 years), and 38 older women who were healthy (age=71+/-7 years) participated. METHODS: The Continuous Scale-Physical Functional Performance Test (CS-PFP) was used to assess functionality. Isokinetic leg strength was measured at 60 degrees/s, and handgrip strength was measured using a handgrip dynamometer. RESULTS: The women without FM had significantly higher functionality scores compared with women with FM and older women. There were no differences in functionality between women with FM and older women. Strength measures for the leg were higher in women without FM compared with women with FM and older women, and both women with and without FM had higher grip strengths compared with older women. DISCUSSION AND CONCLUSION: This study demonstrated that women with FM and older women who are healthy have similar lower-body strength and functionality, potentially enhancing the risk for premature age-associated disability.

The effects of a 12-week strength-training program on strength and functionality in women with fibromyalgia.

OBJECTIVE: To determine whether women with fibromyalgia benefit from strength training. DESIGN: Randomized controlled trial. SETTING: Testing was completed at the university and training was completed at a local community wellness facility. PARTICIPANTS: Twenty-nine women (age range, 18-54 y) with fibromyalgia participated. Subjects were randomly assigned to a control (n=14; wait-listed for exercise) or strength (n=15) group. After the first 4 weeks, 7 (47%) women dropped from the strength group. INTERVENTION: Subjects underwent 12 weeks of training on 11 exercises, 2 times a week, performing 1 set of 8 to 12 repetitions at 40% to 60% of their maximal lifts and were progressed to 60% to 80%. MAIN OUTCOME MEASURES: Subjects were measured for strength, functionality, tender point sensitivity, and fibromyalgia impact. RESULTS: The strength group significantly (P< or =.05) improved upper- (strength, 39+/-11 to 42+/-12 kg; control, 38+/-13 to 38+/-12 kg) and lower- (strength, 68+/-28 to 82+/-25 kg; control, 61+/-25 to 61+/-26 kg) body strength. Upper-body functionality measured by the Continuous-Scale Physical Functional Performance test improved significantly (strength, 44+/-11 to 50+/-16U; control, 51+/-11 to 49+/-13U) after training. Tender point sensitivity and fibromyalgia impact did not change. CONCLUSIONS: Strength training improved strength and some functionality in women with fibromyalgia. Interventions with resistance have important implications on independence and quality of life issues for women with fibromyalgia.

Association between botulinum toxin injection into the arm and changes in gait in adults after stroke.

Botulinum toxin (BTX) is often used to improve arm function in persons with hemiparesis after stroke. Persons injected into the arm sometimes report changes in their gait. The purpose of this open-labeled pilot study was to investigate the association between injecting BTX into the upper limb and ankle and knee range of motion (ROM) and paretic-leg stride-time, defined as the time in seconds required to move the hemiparetic leg from initial contact of the foot to initial contact of the same foot. Gait parameters were recorded before and 4 to 6 weeks after the hemiparetic arm was injected with BTX in 13 adults with hemiparesis secondary to stroke, using a three-dimensional computerized motion analysis system. BTX injection into the paretic arm was associated with a decrease in stride-time of the paretic leg in all participants. Slower striding participants improved knee and ankle ROM in the paretic leg. There was no change in ankle and knee ROM in faster striding participants. Injection of BTX into the upper extremity is associated with a change in hemiparetic leg stride-time and ankle and knee ROM. There is a variability of response, with slow striders improving to a greater extent than fast striders.

The effects of loading and unloading treadmill walking on balance, gait, fall risk, and daily function in Parkinsonism.

Our study aims were: 1) to determine whether assisted weight bearing or additional weight bearing is more beneficial to the improvement of function and increased stability in gait and dynamic balance in patients with Parkinsonism, compared with matched controls (treadmill alone). Twenty-three men and women participants (M +/- SD = 74.5 +/- 9.7 yrs; Males = 19, Females = 4) with Parkinsonism were in the study. Participants staged at 1-7 (M +/- SD = 3.96 +/- 1.07) using the Hoehn & Yahr scale. All participants were tested before, after the intervention (within one week), and four weeks later on: 1) dynamic posturography, 2) Berg Balance scale, 3) United Parkinson's Disease Rating Scale (UPDRS), 4) biomechanical assessment of strength and range of motion, and 5) Gaitrite force sensitive gait mat. Group 1 (treadmill control group), received treadmill training with no loading or unloading. Group 2 (unweighted group), walked on the treadmill assisted by the Biodex Unweighing System at a 25% body weight reduction. Group 3 (weighted group), ambulated wearing a weighted scuba-diving belt, which increased their normal body weight by 5%. All subjects walked on the treadmill for 20 minutes per day for 3 days per week for 6 weeks. Improvements in dynamic posturography, falls during balance testing, Berg Balance, UPDRS (Motor Exam), and gait for all groups lead us to believe that neuromuscular regulation can be facilitated in all Parkinson's individuals no matter what treadmill intervention is employed.

Training with verbal instructional cues results in near-term improvement of gait in people with Parkinson disease.

PURPOSE: To assess immediate and near-term effects of an instructional set on select gait parameters in people living with Parkinson disease (PD). SUBJECTS: Five individuals with early stage PD participated in a within subject design in Part One. Eleven individuals with early stage PD were randomly assigned to a treatment group (n = 5) or a control group (n = 6) in Part Two. METHODS: The treatment consisted of a 10-day training program of walking 1800 feet per day and with the instructions to take long steps. Testing occurred before treatment (baseline), immediately after treatment, one week after treatment, and one month after treatment. Measurements of step length, velocity, and cadence were taken without the use of the instructional set. RESULTS: There was a significant increase in step length and velocity and a significant decrease in cadence between baseline and all post-test measures for part one. For part 2, step length of the treatment group significantly increased between baseline and all 3 post-tests and there was a significant difference between the treatment group and control group at all posttests for step length. CONCLUSIONS: The instructional set was effective in improving parameters of gait for at least 4 weeks. These data support the concept that people with Parkinson disease have a potential for motor learning.

The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson's disease.

OBJECTIVE: To assess immediate and near-term effects of 2 exercise training programs for persons with idiopathic Parkinson's disease (IPD). DESIGN: Randomized control trial. SETTING: Public health facility and medical center. PARTICIPANTS: Fifteen persons with IPD. INTERVENTION: Combined group (balance and resistance training) and balance group (balance training only) underwent 10 weeks of high-intensity resistance training (knee extensors and flexors, ankle plantarflexion) and/or balance training under altered visual and somatosensory sensory conditions, 3 times a week on nonconsecutive days. Groups were assessed before, immediately after training, and 4 weeks later. MAIN OUTCOME MEASURES: Balance was assessed by computerized dynamic posturography, which determined the subject's response to reduced or altered visual and somatosensory orientation cues (Sensory Orientation Test [SOT]). Muscle strength was assessed by measuring the amount of weight a participant could lift, by using a standardized weight-and-pulley system, during a 4-repetition-maximum test of knee extension, knee flexion, and ankle plantarflexion. RESULTS: Both types of training improved SOT performance. This effect was larger in the combined group. Both groups could balance longer before falling, and this effect persisted for at least 4 weeks. Muscle strength increased marginally in the balance group and substantially in the combined group, and this effect persisted for at least 4 weeks. CONCLUSION: Muscle strength and balance can be improved in persons with IPD by high-intensity resistance training and balance training.

Aerobic exercise intervention improves aerobic capacity and movement initiation in Parkinson's disease patients.

Parkinson's Disease (PD) is a progressive neurologic disorder, which includes an inability to activate appropriate muscle activity. Very little research has analyzed aerobic exercise for PD patients. The purpose of this study was to investigate the effect of a 16 week aerobic exercise intervention on aerobic capacity and movement initiation (MI) time for PD patients. With 8 PD subjects (Hoehn & Yahr stage 2), 4 completed the exercise intervention. Peak VO_2scores significantly improved (26%) Choice MI improved from 532 ms to 415 ms, while simple MI improved from 285 ms to 261 ms. The improvement in aerobic capacity suggests that PD patients may benefit from exercise just as much as a normal population. The change in MI indicates that aerobic exercise may reduce the detrimental effects of neuromuscular slowing within PD patients, by improving the subjects' ability to initiate and perform appropriate movement patterns.