Epidemiological studies have demonstrated that, using objective performance measures of physical functioning, disability risk can be predicted in nondisabled older adults. This makes it possible to recruit a nondisabled but at-risk population for clinical trials of disability prevention. Successful disability prevention in this population, for example through an exercise program, would have a major public health impact. To enhance the development of exercise interventions in this group it would be valuable to have additional information not available from existing epidemiologic studies. This report examines the evidence that functional limitations preceding disability can be identified in a community-dwelling population and that it is feasible to recruit these people into studies. It introduces a series of articles examining the characteristics of this population: motivators and barriers to exercise, exercise habits and preferences, the impact of positive and negative affect, and the impact of pain and functional limitations on attitudes toward exercise.
Search Results
Targeting High-Risk Older Adults into Exercise Programs for Disability Prevention
Jack M. Guralnik, Suzanne Leveille, Stefano Volpato, Marcia S. Marx, and Jiska Cohen-Mansfield
Feasibility of a Home-Delivered Internet Obesity Prevention Program for Fourth-Grade Students
Scott Owens, Laurel Lambert, Suzanne McDonough, Kenneth Green, and Mark Loftin
This pilot study examined the feasibility of an interactive obesity prevention program delivered to a class of fourth-grade students utilizing daily e-mail messages sent to the students’ home computers. The study involved a single intact class of 22 students, 17 (77%) of whom submitted parental permission documentation and received e-mail messages each school day over the course of one month. Concerns regarding Internet safety and children’s use of e-mail were addressed fairly easily. Cost/benefit issues for the school did not seem prohibitive. Providing e-mail access to students without a home computer was accomplished by loaning them personal digital assistant (PDA) devices. In larger interventions, loaning PDAs is probably not feasible economically, although cell phones may be an acceptable alternative. It was concluded that this type of interactive obesity prevention program is feasible from most perspectives. Data from a larger scale effectiveness study is still needed.
Community Fall Prevention Programs: Comparing Three InSTEP Models by Level of Intensity
B. Josea Kramer, Beth Creekmur, Michael N. Mitchell, Debra J. Rose, Jon Pynoos, and Laurence Z. Rubenstein
The Fall Prevention Center of Excellence designed three progressive-intensity fall prevention program models, Increasing Stability Through Evaluation and Practice (InSTEP), to reduce risk in community-dwelling older adults. Each model included physical activity, medical risk, and home safety components and was implemented as a 12-week program for small class sizes (12–15 people) in community and senior centers. Change in fall rates and fall risk factors was assessed using a battery of performance tests, self-reports of function, and fall diaries in a 3-group within-subjects (N = 200) design measured at baseline, immediately postintervention, and at 3 and 9 months postintervention. Overall, participants experienced a reduction in falls, improved self-perception of gait and balance, and improved dynamic gait function. The medium-intensity InSTEP model signifcantly (p = .003) reduced self-reported falls in comparison with the other models. InSTEP is a feasible model for addressing fall risk reduction in community-dwelling older adults.
Key Factors Influencing Implementation of Falls Prevention Exercise Programs in the Community
Lesley Day, Margaret J. Trotter, Alex Donaldson, Keith D. Hill, and Caroline F. Finch
The study aim was to evaluate the implementation of group- and home-based exercise falls prevention programs delivered through community health agencies to community-dwelling older people. Interviews with program staff were guided by the Diffusion of Innovations theory. Highly consistent themes emerged for the two types of programs. Both had high overall compatibility, high relative advantage, good observability and high inherent trialability—all factors known to strengthen implementation. The level of complexity and low financial compatibility emerged as the strongest potential inhibitors to program implementation in the context examined. The two main factors contributing to complexity were the need to challenge balance safely across a broad range of capability, and practical considerations associated with program delivery.A range of strategies to provide more technical support for exercise program leaders to tailor balance challenge for exercise program leaders may enhance implementation of falls prevention exercise programs.
Development of a Community-Based Fall Prevention Program: Stay in Balance
Harriet G. Williams and Gerhild Ullmann
Background:
Falls and fall-related injuries are critical issues for older adults; evidence indicates that multidimensional interventions that address modifiable risk factors can be successful in reducing falls. Few evidence-based fall prevention interventions exist due, in part, to complex issues associated with development and implementation. There is a need for a variety of such programs from which older adults may choose. We describe steps, outcomes, and issues involved in developing/implementing an evidenced-based fall prevention program in community settings.
Methods:
The Stay In Balance program (SIB), developed by a team of professionals, local service providers and active older adults, was carried out with total of 135 older adults in several steps: developing objectives and program content, laboratory-based randomized controlled trial (RCT), pilot program in the community, community-based RCT, and implementation at 2 community sites.
Results:
Each step in development provided useful and different insights into needed changes in program content, equipment, support materials, training, and appropriate outcome measures.
Conclusion:
Development of an evidenced-based fall prevention program requires a long term commitment on the part of all partners, University personnel, local service providers, and older adult participants; funding is also critical.
Intrapersonal and Social Environment Correlates of Leisure-Time Physical Activity for Cancer Prevention: A Cross-Sectional Study Among Canadian Adults
Fabiola E. Aparicio-Ting, Christine M. Friedenreich, Karen A. Kopciuk, Ronald C. Plotnikoff, and Heather E. Bryant
Background:
Little is known about the intrapersonal and social factors associated with sufficient physical activity (PA) for cancer prevention, which is greater than for cardiovascular health.
Methods:
1087 and 1684 randomly selected men and women, age 35–64, completed self-administered questionnaires on PA behavior and psycho-social characteristics. Using gender-stratified logistic regression, we investigated correlates of compliance with Canadian Society for Exercise Physiology PA guidelines for general health (150 min/wk), and the American Cancer Society (ACS; 225 min/wk) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AIRC; 420 min/wk) guidelines for cancer prevention.
Results:
Only 39% and 19% of men and women met ACS and WCRF/AICR guidelines, respectively. Self-efficacy, scheduling PA and friend social support were positively correlated with recommended PA for cancer prevention. In men, poor self-rated health and perceived negative outcomes were negatively correlated and hypertension was positively correlated with meeting cancer prevention guidelines. For women, not being married and having a companion for PA were positively correlated with meeting cancer prevention guidelines.
Conclusions:
Few adults participate in sufficient PA for cancer risk reduction. Multidimensional public health strategies that incorporate intrapersonal and social factors and are tailored for each gender are needed to promote PA for cancer prevention.
Elastic Bandaging for Orthopedic- and Sports-Injury Prevention and Rehabilitation: A Systematic Review
Konstantinos Fousekis, Evdokia Billis, Charalampos Matzaroglou, Konstantinos Mylonas, Constantinos Koutsojannis, and Elias Tsepis
Context:
Elastic bandages are commonly used in sports to treat and prevent sport injuries.
Objective:
To conduct a systematic review assessing the effectiveness of elastic bandaging in orthopedic- and sports-injury prevention and rehabilitation.
Evidence Acquisition:
The researchers searched the electronic databases MEDLINE, CINAHL, SPORTDiscus, EMBASE, and Physiotherapy Evidence Database (PEDro) with keywords elastic bandaging in combination, respectively, with first aid, sports injuries, orthopedic injuries, and sports injuries prevention and rehabilitation. Research studies were selected based on the use of the term elastic bandaging in the abstract. Final selection was made by applying inclusion and exclusion criteria to the full text. Studies were included if they were peer-reviewed clinical trials written in English on the effects of elastic bandaging for orthopedic-injury prevention and rehabilitation.
Evidence Synthesis:
Twelve studies met the criteria and were included in the final analysis. Data collected included number of participants, condition being treated, treatment used, control group, outcome measures, and results. Studies were critically analyzed using the PEDro scale.
Conclusions:
The studies in this review fell into 2 categories: studies in athletes (n = 2) and nonathletes (n = 10). All included trials had moderate to high quality, scoring ≥5 on the PEDro scale. The PEDro scores for the studies in athletes and nonathletes ranged from 5 to 6 out of 10 and from 5 to 8 out of 10, respectively. The quality of studies was mixed, ranging from higher- to moderate-quality methodological clinical trials. Overall, elastic bandaging can assist proprioceptive function of knee and ankle joint. Because of the moderate methodological quality and insufficient number of clinical trials, further effects of elastic bandaging could not be confirmed.
Exposure and Response Prevention in the Treatment of an Okeanophobic Triathlete
Gary M. Farkas
An in vivo exposure and response prevention procedure consisting of seven treatment and generalization sessions was used to aid a 50-year-old woman with a lifelong fear and avoidance of swimming in the ocean. Subsequent to treatment, the subject, already a competent pool swimmer and an accomplished athlete, swam in the ocean, reduced her swim time by over 50%, and placed second in her age group while competing in a major triathlon. A 1-year follow-up indicated that she was still swimming in the ocean and participating in triathlons. The athlete/sport psychologist relationship is discussed in reference to the athlete’s compliance with treatment recommendations.
Educating Coaches on Their Role in the Prevention of Homophobic Bullying in Adolescent Sport
Lana Jade McCloughan, Emma Louise Mattey, and Stephanie J. Hanrahan
Sporting participation is believed to aid the development of good social skills and promote positive values such as equality, cooperation, and respect. Nevertheless, some people have negative experiences in the sporting environment. The presence of homophobic bullying in sport has been increasingly acknowledged. The purpose of this paper is to critically discuss current views on coaches’ roles in homophobic bullying prevention in adolescent sport and provide an example of a program designed to upskill coaches in this important area. A review of the prevalence of homophobic bullying in sport is provided. The importance of the role of the coach in addressing bullying in adolescent sport is then discussed. Coach education and learning theory are examined and an example of a coach education workshop on homophobic bullying prevention is detailed. A summary of the evaluation completed by the coach participants of the education workshop is provided, with potential modifications to the workshop noted. The need for intervention is linked back to the literature in the conclusion.
Meeting Physical Activity Recommendations for Colon Cancer Prevention Among Japanese Adults: Prevalence and Sociodemographic Correlates
Kaori Ishii, Ai Shibata, and Koichiro Oka
Background:
Although physical activity is associated with a lower risk of colon cancer, few studies have described the physical activity required for colon cancer prevention in various sociodemographic subgroups. The current study examined the prevalence and sociodemographic correlates of attaining the 2 recommended physical activity criteria for colon cancer prevention among Japanese adults.
Methods:
The sample included 5322 Japanese adults aged 20 to 79 years. Seven sociodemographic attributes (eg, gender, age, education level, employment status) and the International Physical Activity Questionnaire were assessed via an Internet-based survey. The odds of meeting each physical activity criterion by sociodemographic variables were calculated.
Results:
Overall, 23.8% of the study population met the criterion of ≥ 420 minutes of moderate-intensity activity, and 6.4% met the criterion of ≥ 210 minutes of vigorous activity. Being male, highly educated, employed, living with another person, being married and having a higher household income were significantly correlated with the attainment of recommendations.
Conclusions:
Participants who met the 2 activity recommendations differed in gender, education level, employment status, marital status, living conditions, and household income. The findings of the current study imply that strategies to promote more intense physical activity in all demographic groups may be necessary.
