This systematic review aims to evaluate the efficacy of cognitive and behavioral interventions for improving fall-related psychological concerns. A systematic search yielded eight randomized controlled trials eligible for inclusion. All studies compared a cognitive and behavioral intervention with a control. The meta-analysis showed that cognitive and behavioral treatments had beneficial effects on fear of falling outcomes (lower score better) immediately after treatment (random-effects standardized mean difference [SMD]: −0.3, 95% confidence interval [CI] [−0.50, −0.10]) and at the longer term follow-up (random-effects SMD: −0.29, 95% CI [−0.49, −0.09]). Cognitive and behavioral treatments also showed a positive effect on falls efficacy outcomes (higher score better) immediately after treatment (fixed-effects SMD: 0.19, 95% CI [0.04, 0.34]) and over the longer term (fixed-effects SMD: 0.13, 95% CI [−0.00, 0.25]). However, the clinical significance of these effects on fear of falling and falls efficacy was unclear. Further work is required with best-practice comparators over a longer follow-up period.
Angela Papadimitriou and Mark Perry
Anthony Musto, Kevin Jacobs, Mark Nash, Gianluca DelRossi and Arlette Perry
Pedometer programs can increase physical activity in sedentary individuals, a population that is at risk for developing metabolic syndrome and each of its individual components. Although the popular 10,000 steps/day recommendation has shown to induce many favorable health benefits, it may be out of reach for sedentary individuals. This study observed the effects of incremental increases in steps/day on metabolic syndrome components in sedentary overweight women.
This study was a longitudinal, quasiexperimental design. Participants were recruited from a 12-week work-site pedometer program and grouped as either ‘active’ or ‘control’ after the intervention based on their steps/day improvement. Self-reported physical activity, pedometer assessed physical activity, BMI, resting heart rate, waist circumference, blood pressure, triglycerides, HDLC, and fasting glucose were measured before and after the program.
The active group showed significant within-group improvements in waist circumference and fasting glucose. Significant group differences were observed in resting heart rate, BMI, and systolic blood pressure; however, the changes observed in systolic blood pressure were not independent of weight loss.
Incremental increases in steps/day induced favorable changes in some MetS components suggesting that this approach is a viable starting point for sedentary individuals that may find it difficult to initially accumulate 10,000 steps/day.
Lesley Steinman, Mark Doescher, David Levinger, Cynthia Perry, Louise Carter, Amy Eyler, Semra Aytur, Angie L.I. Cradock, Kelly R. Evenson, Katie Heinrich, Jacqueline Kerr, Jill Litt, Yucel Severcan and Carolyn Voorhees
Recent research demonstrates the importance of targeting the built environment to support individual physical activity, particularly for people experiencing health disparities. Master plans to promote biking and/or pedestrians (BPMPs) are a potential method for environmental change. This descriptive study aims to provide a snapshot of plan attributes and better understand demographic, social and transportation characteristics of communities with BPMPs.
We collected a census sample of BPMPs from 4 states. Population and commuting data were obtained from national statistics.
294 master plans were included, with most plans representing municipalities. 62% of plans targeted biking only, one-fifth targeted biking and walking, and 15% targeted walking only. The sampled locations have a similar demographic profile as the overall U.S. for median age and household income, people of color, high school education, and income inequality. The degree of racial diversity of sampled communities is slightly less than the U.S. average and the percentage of people who walk to work were slightly higher.
Given that communities with master plans have a similar profile as the overall U.S., BPMPs could feasibly be spread to communities throughout the country. Further research is planned to describe BPMPs in detail toward informing future plan development.