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Danielle M. Thiel, Fatima Al Sayah, Jeff Vallance, Steven T. Johnson and Jeffrey A. Johnson

Background:

The objective was to investigate the longitudinal relationship between physical activity and health-related quality of life (HRQL) in adults with type 2 diabetes.

Methods:

Data were from a prospective cohort of adults with type 2 diabetes. Weekly moderate-to-vigorous physical activity (MVPA) was reported using the Godin Leisure-Time Physical Activity Questionnaire, and HRQL was reported using the SF-12 and 5-level EQ-5D. Participants were categorized based on current weekly MVPA recommendations. Multivariable linear regression was used to explore associations between MVPA and HRQL, and multinomial logistic regression was used to assess the direction of change in HRQL after 1 year.

Results:

Mean age of participants (N = 1948) was 64.5 ± 10.8 years and 45% were female. Participants reported a mean of 84.1 ± 172.4 min of MVPA/week, and 21% (n = 416) met weekly MVPA recommendations. MVPA was associated with differences in the physical functioning (b = 5.42; P < .001), general health (b = 2.45; P = .037), and vitality (b = 2.83; P = .016) SF-12 dimensions. Participants who met recommendations were less likely to report a decline (vs. no change) in EQ-5D index score (OR = 0.75; 95% CI [0.57, 0.99]), and SF-12 physical component summary (OR = 0.67; 95% CI [0.50, 0.90]), compared with participants not meeting recommendations.

Conclusions:

Participants who met weekly MVPA recommendations reported better physical functioning and were more likely to maintain their physical and overall HRQL over time.

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Steven T. Johnson, Clark Mundt, Weiyu Qiu, Allison Soprovich, Lisa Wozniak, Ronald C. Plotnikoff and Jeffrey A. Johnson

Objective:

To determine the effectiveness of an exercise specialist led lifestyle program for adults with type 2 diabetes in primary care.

Methods:

Eligible participants from 4 primary care networks in Alberta, Canada were assigned to either a lifestyle program or a control group. The program targeted increased daily walking through individualized daily pedometer step goals for the first 3 months and brisk walking speed, along with substitution of low-relative to high-glycemic index foods over the next 3 months. The outcomes were daily steps, diet, and clinical markers, and were compared using random effects models.

Results:

198 participants were enrolled (102 in the intervention and 96 in the control). For all participants, (51% were women), mean age 59.5 (SD 8.3) years, A1c 6.8% (SD 1.1), BMI 33.6 kg/m2 (SD 6.5), systolic BP 125.6 mmHg (SD 16.2), glycemic index 51.7 (4.6), daily steps 5879 (SD 3130). Daily steps increased for the intervention compared with the control at 3-months (1292 [SD 2698] vs. 418 [SD 2458] and 6-months (1481 [SD 2631] vs. 336 [SD 2712]; adjusted P = .002). No significant differences were observed for diet or clinical outcomes.

Conclusions:

A 6-month lifestyle program delivered in primary care by an exercise specialist can be effective for increasing daily walking among adults with recently diagnosed type 2 diabetes. This short-term increase in daily steps requires longer follow-up to estimate the potential impact on health outcomes.

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Andrea T. White, C. Steven Fehlauer, Rita Hanover, Stephen C. Johnson and Robert E. Dustman

Older individuals arc more likely than younger adults to exhibit symptoms of exercise intolerance at high work rates. The risks of maximal exercise in older adults increase proportionally as the number of health difficulties increase. In this study, the effects of health status, age, and gender on older adults’ ability to attain V̇O2max are examined. Sedentary volunteers (60 women, 45 men), mean age 67 ± 5 years (range 57-78 years), participated in graded maximal exercise tests on a combined arm and leg cycle ergometer. Subjects were classified into three groups based on test termination reason: attainment of V̇O2max (MAX), symptom-limited (SX), or EKG-limited (EKG). Sixty percent of men and 40% of women were classified as MAX, while 48% of women and 27% of men were characterized as SX. Thirteen percent of men and 12% of women had EKG-limited exercise tests. Those in the EKG group reported significantly more diagnoses than subjects in the MAX group (2.7 vs. 1.4. p < .05). The number of medications reported and age of the subjects did not differ across test termination categories.

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Cristina M. Caperchione, Sean Stolp, Joan L. Bottorff, John L. Oliffe, Steven T. Johnson, Cherisse Seaton, Paul Sharp, Margaret Jones-Bricker, Sonia Lamont, Sally Errey, Theresa Healy, Kerensa Medhurst, Holly Christian and Megan Klitch

Background:

The purpose of this study was to examine changes in physical activity and healthy eating knowledge and behaviors associated with the level of exposure to POWERPLAY, a men-centered workplace health promotion program.

Methods:

This study is based on a quasi-experimental prepost design. Using a computer assisted telephone interview survey, data regarding program exposure and physical activity and health eating knowledge and behaviors were collected from men (N = 103) in 4 workplaces.

Results:

Exposure scores were calculated and participants were categorized as having low (n = 54) or high exposure (n = 49) to POWERPLAY. Compared with the low exposure group, those reporting high exposure scored significantly higher on physical activity knowledge (F (1, 99) =14.17, P < .001, eta2 = .125) and health eating knowledge (F (1, 99) =14.37, P = .001, eta2 = .111). The high exposure group also reported significantly more minutes walked place to place (F (2, 206) = 3.91, P = .022, eta2 = .037) and on minutes walked for leisure (F (2, 230) = 3.08, P = .048, eta2 = .026).

Conclusions:

POWERPLAY shows significant promise as a workplace health promotion approach and may have an even greater impact when program exposure is augmented with environmental and policy changes.

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Ronald C. Plotnikoff, Michael A. Pickering, Nicole Glenn, Sandra L. Doze, Melissa L. Reinbold-Matthews, Laura J. McLeod, David C. W. Lau, Gordon H. Fick, Steven T. Johnson and Laura Flaman

Background:

Physical activity (PA) is a cornerstone in the management of type 2 diabetes (T2DM). This pilot investigation explores the effects of a standard diabetes education program compared with a supplemental PA intervention on diabetes-related health outcomes.

Methods:

Using a prospective 2-armed design, 96 adults with T2DM were randomly assigned to either standard care (diabetes education program; n = 49) or standard care supplemented with an 8-week, individualized-counseling and community-based PA component (n = 47). Measurements were taken at baseline, 3, 6, and 12 months. Primary outcomes were changes in PA (self-report) and HbA1c. Between group changes were compared using analysis of covariance (ANCOVA) and changes over time using repeated-measures ANOVA.

Results:

In comparison with standard care, the supplemental group demonstrated an increase in PA (Ps < 0.01) and cardiorespiratory fitness (Ps < 0.05) from baseline to all follow-up time-points. HbA1c levels declined (P < .05) from baseline to all time points in the standard care group. Reduction in cholesterol-ratio (P < .01), increase in HDL (P < .05), and reductions in blood pressure, resting heart rate and BMI (approaching statistical significance Ps < 0.10) were also reported for both groups.

Conclusions:

PA counseling in addition to standard care is effective for promoting PA behavior change and positive health-related outcomes among individuals with T2DM.