Comparing Class-Based and Home-Based Exercise for Older Adults With Chronic Health Conditions: 12-Month Follow-Up of a Randomized Clinical Trial.

OBJECTIVE: To assess the maintenance of physical activity (PA) and health gains among participants in a class-based (CB) or home-based (HB) PA intervention over a 12-month study period. METHODS: A total of 172 adults aged 50 years and older were randomly allocated to either a CB or an HB intervention, each involving an intensive 3-month phase with a 9-month follow-up period. Measures at baseline, 3, 6, and 12 months included self-reported PA and health, body mass index, waist circumference (WC), blood pressure, cardiovascular endurance (6-min walk test), physical function, and functional fitness (senior fitness test). Outcomes were analyzed using generalized estimating equations. RESULTS: Maximum improvement was typically observed at 3 or 6 months followed by a modest diminution, with no differences between groups. For body mass index, waist circumference, 6-min walk test, and senior fitness test, there was progressive improvement through the study period. Greater improvement was seen in the CB group compared with the HB group on three items on the senior fitness test (lower body strength and endurance [29% vs. 21%, p < .01], lower body flexibility [2.8 cm vs. 0.4 cm, p < .05], and dynamic agility [14% vs. 7%, p < .05]). CONCLUSION: The interventions were largely comparable; thus, availability, preferences, and cost may better guide program choice.

Predictors of Physical Activity Levels in Community-Dwelling Older Adults: A Multivariate Approach Based on a Socio-Ecological Framework.

The purpose of this study was to explore cross-sectional relationships between self-reported physical activity (PA) and personal, social, and environmental factors in community-dwelling adults aged 50 years and older. Accounting for clustering by neighborhood, generalized estimating equations were used to examine associations between selected correlates and the Physical Activity Scale for the Elderly (PASE) score while adjusting for confounders. Data for 601 participants were analyzed: 79% female, 37% married, mean age 76.8 (± 8.7) years, mean PASE score 112.6 (± 64.8). Age, living in seniors' housing, using nursing/home care services, receiving encouragement to be active, and having benches available in the neighborhood were inversely associated with PASE. Self-efficacy, SF-12 score, PA barriers, social support, and the presence of trails showed positive associations. Several personal, social, and environmental factors associated with PA were identified. The inverse association between PA and living in seniors' housing units should be considered when developing PA programs for older adults.

An Investigation of Bilateral Symmetry in Softball Pitchers According to Body Composition.

Introduction: High body fat percentage (bf%) is considered a potential injury risk factor for softball pitchers amidst the already high rates of pitching-related injury. Similarly, research points out that large bilateral asymmetries are another risk factor for softball pitchers. As softball pitching is a highly asymmetric sport and the repetitive nature of the windmill pitch places high stress on the body while pitchers are in unbalanced and asymmetric positions, research examining body composition and asymmetry is necessary. Purpose: The purpose of this study was to compare functional characteristics of softball pitchers with a healthy and a high bf%. Bilateral symmetry was assessed for pitchers' hip and shoulder isometric strength (ISO) and range of motion (ROM) between the following two groups of softball pitchers: (1) those with a high bf% (≥32%) and (2) those with a healthy bf% (<32%). Methods: A total of 41 high school female softball pitchers from the southern United States agreed to participate (1.69 ± 0.07 m, 76.14 ± 17.08 kg, 15.1 ± 1.1 years). Pitchers completed a dual-energy X-ray absorptiometry (DEXA) scan and were grouped into one of the following two categories based on their bf%: healthy (<32 bf%) and high (≥32 bf%). Bilateral symmetry was assessed for pitchers' hip and shoulder ISO and ROM using a handheld dynamometer and inclinometer, respectively. Bilateral arm bone and lean mass was also measured via the DEXA. Results: Mixed analyses of variance revealed a significant interaction between bf% groups and side dominance for internal rotation shoulder ROM, F(1, 39) = 14.383, p < 0.001, η2 p = 0.269. Main effects for side dominance were also observed for shoulder external rotation ISO, F(1, 39) = 8.133, p = 0.007, η2 p = 0.173, hip internal rotation ISO, F(1, 39) = 4.635, p = 0.038, η2 p = 0.106, arm bone mass, F(1, 39) = 38.620, p < 0.001, η2 p = 0.498, and arm lean mass, F(1, 39) = 101.869, p < 0.001, η2 p = 0.723. Conclusion: Asymmetries and slight differences in functional characteristics exist between bf% groups. Altered functional characteristics may influence pitchers' windmill pitch movement and should be acknowledged by support staff to improve softball pitchers' health and longevity. Implications: Insight into asymmetries can help researchers and clinicians understand the implication of excess body fat and further theorize mechanisms of injury among this athlete population.

The relationship of chronic disease and demographic variables to physical activity in a sample of women aged 65 to 79 years.

This study explored the relationship between physical activity, marital status, income, education, and chronic disease in older women to determine which individuals are at risk of being inactive and to identify potential moderators of physical activity behavior. This was an analysis of cross-sectional data from a convenience sample of 271 community-dwelling women aged 65 to 79 years. Self-reported physical activity was measured using the Physical Activity Scale for the Elderly. Socio-demographic characteristics (including age, gender, marital status, education, employment, and income) and self-reported health were measured using previously validated instruments. To avoid seasonal variations in physical activity, data were collected during the summer months. Physical activity was negatively associated with age and the presence of cardio-respiratory disease and positively associated with income greater than $20,000 (p < 0.05). After controlling for other co-variates, no significant differences were observed in physical activity between married and unmarried individuals. Given the strong association between cardio-respiratory disease and income with physical activity, women 65 years of age and older in lower income brackets and suffering from these health conditions should be targeted for exercise counseling and support. Intervention research is needed to determine the most effective means to decrease inactivity among these women.

Using a naturalistic ecological approach to examine the factors influencing youth physical activity across grades 7 to 12.

High levels of inactivity in youth have led researchers and practitioners to focus on identifying the factors that influence physical activity behaviors in young people. The present study employed a qualitative ecological framework to examine the intrapersonal, social, and environmental factors influencing youth physical activity. In grade-specific focus group settings, 160 youth in grades 7 through 12 (aged 12 to 18) were asked how they would increase the physical activity levels of youth their age. Participants identified eight factors that they felt should be addressed in programs and interventions designed to increase the physical activity behaviors of youth. These factors included the importance of fun, having the time to be physically active, the benefits of activity, being active with friends, the role of adults, and the importance of being able to access facilities in their neighborhood.

Factors that influence physical activity participation among high- and low-SES youth.

Researchers have rarely addressed the relationship between socioeconomic status (SES) and physical activity from the perspective of youth. To illuminate the factors that youth from low and high-SES areas consider important to increase physical activity participation among their peers, 160 youth (12-18 years) participated in small focus group interviews. Guiding questions centered on the general theme, "If you were the one in charge of increasing the physical activity levels of kids your age, what would you do?" Findings show that environmental factors (i.e., proximity, cost, facilities, and safety) are very important for youth living in low-SES areas to ensure participation in physical activity. Results also show that intrapersonal (i.e., perceived skill, competence, time) and social factors (i.e., friends, adult support) must be considered to help improve participation rates among both high- and low-SES youth.

Profile of physical activity levels in community-dwelling older adults.

PURPOSE: To examine relationships between selected sociodemographic, health-related and environmental factors and levels of physical activity in older adults across three age groups. METHODS: Seven hundred sixty-four older adults (mean age = 77.4 +/- 8.6 yr) from a midsize Canadian city completed a self-administered questionnaire under researcher supervision. Level of physical activity was determined using the Physical Activity Scale for the Elderly (PASE). Correlates of physical activity were examined using previously validated questionnaires. The findings pertaining to personal and environmental factors are presented. RESULTS: Overall, significantly higher mean PASE scores were seen in those individuals in the following categories: male (P < 0.001), married or common-law (P < 0.001), not living alone (P < 0.001), not living in senior's housing (P < 0.001), higher levels of education (P < 0.001) and higher incomes (P < 0.001). Better physical health showed significant positive associations (P < 0.001) with PASE score. Individuals reporting at least four or more chronic health conditions had significantly lower PASE scores than those reporting no chronic conditions (P < 0.001). Significantly lower PASE scores were also reported in those using domestic services (P < 0.001). Higher PASE scores were related to the presence of hills, biking and walking trails, street lights, various recreation facilities, seeing others active and unattended dogs (P < 0.001 to P < 0.05). CONCLUSION: An understanding of the factors that influence physical activity behavior in older adults is critical to developing effective intervention strategies that will address the problem of physical inactivity in this population, and in doing so, improve the health status and quality of life of the older adult, while having a significant impact on healthcare expenditures.

Is Self-Reported Physical Activity Participation Associated with Lower Health Services Utilization among Older Adults? Cross-Sectional Evidence from the Canadian Community Health Survey.

Purpose. To examine relationships between leisure time physical activity (LTPA) and health services utilization (H) in a nationally representative sample of community-dwelling older adults. Methods. Cross-sectional data from 56,652 Canadian Community Health Survey respondents aged ≥ 50 years (48% M; 52% F; mean age 63.5 ± 10.2 years) were stratified into three age groups and analysed using multivariate generalized linear modeling techniques. Participants were classified according to PA level based on self-reported daily energy expenditure. Nonleisure PA (NLPA) was categorized into four levels ranging from mostly sitting to mostly lifting objects. Results. Active 50-65-year-old individuals were 27% less likely to report any GP consultations (ORadj = 0.73; P < 0.001) and had 8% fewer GP consultations annually (IRRadj = 0.92; P < 0.01) than their inactive peers. Active persons aged 65-79 years were 18% less likely than inactive respondents to have been hospitalized overnight in the previous year (ORadj = 0.82, P < 0.05). Higher levels of NLPA were significantly associated with lower levels of HSU, across all age groups. Conclusion. Nonleisure PA appeared to be a stronger predictor of all types of HSU, particularly in the two oldest age groups. Considering strategies that focus on reducing time spent in sedentary activities may have a positive impact on reducing the demand for health services.

The relationship of social physique anxiety to risk for developing an eating disorder in young females.

PURPOSE: To examine the relationships of age, social physique anxiety, and body image dissatisfaction to preoccupation with body weight and shape in young females. METHODS: Height, weight, and skinfold measurements were obtained from 77 nonobese females (7 to 16 years). Social physique anxiety, body image, and preoccupation with body weight and shape were assessed from the Social Physique Anxiety Scale (SPAS), a Body Image Questionnaire (BIQ), and the Eating Disorder Inventory (EDI). Data were analyzed using Pearson correlations, Chi-square, and hierarchical and stepwise multiple regression. RESULTS: Social physique anxiety was moderately correlated to body image dissatisfaction and body weight and shape concerns. Young females who were more anxious about their physique preferred a smaller body shape and experienced more body weight and shape concerns than those less anxious. The SPAS was a stronger predictor for the EDI scales Body Dissatisfaction and Drive for Thinness than the BIQ or age. CONCLUSIONS: Social physique anxiety related to a negative body image and risk for developing an eating disorder as assessed by Body Dissatisfaction and Drive for Thinness in young females.

Children with Cerebral Palsy: Caregivers' Nutrition Knowledge, Attitudes and Beliefs.

Knowledge is lacking about the feeding relationship between caregivers and children with cerebral palsy (CP). In this relationship, the child's dependency and the caregiver's influence on the child's nutrition may be magnified. A questionnaire was developed to examine caregivers' nutrition knowledge, attitudes, and beliefs. Reliability and validity were pretested with groups independent of the study. The questionnaire was administered to CP caregivers (n=52, 34% response rate) and a comparison group of non-CP caregivers (n=35). Over half of the children with CP were mildly to moderately affected by physical disability and presented with few oral-motor difficulties. Caregivers' perceptions of children's feeding behaviour did not differ between the two groups (p>0.05). Significant differences were evident in nutrition knowledge, as well as on one of two attitude scales and one of two belief scales measured. Non-CP caregivers scored higher in nutrition knowledge (p<0.001), had a more positive attitude about the importance of nutrition (p<0.05), and had a more positive belief in the relationship between nutrition and health (p<0.05). Results suggest that non-nutritional factors may have a higher priority with those caring for children with CP. Further investigation is warranted to examine the role that nutrition has in the care of children with various degrees of disability from CP. and inflammatory modulation.

Assessment of total and central adiposity in Canadian Aboriginal children and their Caucasian peers.

OBJECTIVE: Although Aboriginal children seem to be more susceptible to developing obesity and metabolic disorders than other ethnic groups in Canada, few studies have examined adiposity comprehensively in this population. The purpose of this study was to assess total and central adiposity in Canadian Aboriginal and Caucasian children matched by age, gender and maturity. METHODS: A total of 212 Aboriginal and 204 Caucasian children (8-17 years) were recruited. Heights, weights and waist circumferences were measured and classified using international standards. Dual energy x-ray absorptiometry (DXA) indicated relative total body and trunk fatness. Age of peak height velocity was predicted from somatic growth. Descriptives with independent t-tests and Chi-square analyses were run to detect ethnic differences. ANCOVA was used to assess differences in total body and trunk fatness (covariates height, chronological age and biological age) in girls and boys separately. RESULTS: Overweight/obesity and central adiposity were more prevalent in Aboriginal children compared with Caucasian children (p < 0.05). Ethnic differences in total body and trunk fatness were also significant, with Aboriginal girls and boys presenting, on average, 5.4% and 6.0% more total body fatness and 7.6% and 8.3% more trunk fatness, than Caucasian girls and boys, respectively (p < 0.01). CONCLUSION: Canadian Aboriginal children have greater prevalence of overweight/obesity and central adiposity, and higher relative total body fatness and trunk fatness than their Caucasian peers, which may predispose them to cardiovascular and metabolic disorders at a very young age. Longitudinal research is needed to confirm the associated health risks in this population.

Examination of physical activity in adolescents over the school year.

This study monitored the physical activity behavior of adolescent students over a ten month school year. Physical activity was assessed at two month intervals using self-report and objective (Actical accelerometers) measures. Self-report results (n = 547) indicated a decline in physical activity throughout the school year for all grades and genders. The decline was attributed largely to a decrease in organized activity participation. Objective physical activity results (n = 40) revealed a significant decline in activity in the latter half of the school year (February to June). Declining physical activity was attributed to a decrease in vigorous activity which was consistent across grade and gender. Collectively, the results highlight the importance of promoting consistent opportunities for adolescents to be active throughout the school year.

Saskatoon in motion: class- versus home-based exercise intervention for older adults with chronic health conditions.

BACKGROUND: The study aimed to compare the effectiveness of a class-based (CB) and home-based (HB) exercise program for older adults with chronic health conditions. METHODS: 172 sedentary older adults with overweight or obesity, type 2 diabetes, hypertension, dyslipidemia, or osteoarthritis were enrolled in a randomized controlled trial with a 3-month follow-up. RESULTS: A significant increase was seen in the CB group in the Physical Activity Scale for the Elderly (PASE) scores and SF-12 Physical and Mental Health scores. In both groups, significant increases were seen in 6-minute walk distance, Physical Performance Test (PPT), and Functional Fitness Test (FFT), and significant reductions were seen in systolic and diastolic blood pressure but not body mass index or waist circumference. Except for a greater increment in the FFT in the CB group, the degree of improvement was not significantly different between the 2 groups. CONCLUSION: After a 3-month intervention, both the CB and HB program produced comparable significant improvements in outcome measures.

Osteoporosis knowledge, beliefs, and practices among adolescent females.

PURPOSE: To assess knowledge, beliefs, and practices of osteoporosis risk factors (physical activity, smoking, and nutrition) among adolescent girls. METHODS: Questionnaires consisting of items assessing knowledge, beliefs, and practices regarding physical activity, calcium intake, and cigarette smoking were administered to 227 girls aged 12-16 years. The adolescent girls were attending public and separate schools in a small-sized Canadian city. Descriptive statistics, t-tests, and Chi-square tests were used to analyze the data. RESULTS: Female adolescents believed that physical inactivity, smoking, and inadequate calcium were health-risking behaviors and osteoporosis risk factors, however, specific in-depth knowledge regarding these risk factors was lacking. Findings further showed that health-risking behaviors were evident, as 25% were current smokers, 58% consumed less than the adequate intake for calcium, and 52% had scores that reflected low to moderate physical activity levels. CONCLUSION: These results highlight the need for educational interventions to promote specific osteo-protective practices among adolescent girls.

Resting mechanomyography after aerobic exercise.

A number of mechanisms have been proposed for the elevation in oxygen consumption following exercise. Biochemical processes that return muscle to its preexercise state do not account for all the oxygen consumed after exercise. It is possible that mechanical activity in resting muscle, which produces low frequency vibrations (i.e., muscle sounds: mechano-myographic [MMG] activity), could contribute to the excess postexercise oxygen consumption. Therefore the purpose of this study was to determine whether the resting MMG amplitude changes after exercise, and whether the change is related to the elevation in oxygen consumption (VO2). Ten young male subjects (22.9 yrs) performed 30 minutes of exercise on a cycle ergometer at an intensity corresponding to 70% peak VO2. Oxygen consumption was measured by indirect calorimetry, and MMG by an accelerometer placed over the mid-quadriceps before exercise and for 5.5 hours after exercise. MMG activity, expressed as mean absolute acceleration, was significantly elevated for the 5.5 hours of measurement after exercise (p < 0.05). MMG and VO2 decayed exponentially after exercise with time constants of 7.2 minutes and 7.4 minutes, respectively. We conclude that muscle is mechanically active following exercise and that this may contribute to an elevated VO2.

Effect of ceasing creatine supplementation while maintaining resistance training in older men.

The authors previously found that creatine (Cr) combined with 12 weeks of resistance training enhanced muscle strength and endurance and lean tissue mass (LTM) in older men. Their purpose in this study was to assess these variables with cessation of Cr combined with 12 weeks of reduced training (33% lower volume) in a subgroup of these men (n = 8, 73 years old) compared with 5 men (69 years old) who did not receive Cr. Strength (1-repetition maximum [1-RM]), endurance (maximum number of repetitions over 3 sets at 70-80% 1-RM), and LTM (dual-energy X-ray absorptiometry) were assessed before and after 12 weeks of Cr cessation combined with reduced-volume training. No changes in strength or LTM occurred. Muscle endurance was significantly reduced (7-21%; p <.05), with the rate of change similar between groups. Withdrawal from Cr had no effect on the rate of strength, endurance, and loss of lean tissue mass with 12 weeks of reduced-volume training.