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Hawley Chase Almstedt and Zakkoyya H. Lewis


Intermittent pneumatic compression (IPC) is a common therapeutic modality used to reduce swelling after trauma and prevent thrombosis due to postsurgical immobilization. Limited evidence suggests that IPC may decrease the time needed to rehabilitate skeletal fractures and increase bone remodeling.


To establish feasibility and explore the novel use of a common therapeutic modality, IPC, on bone mineral density (BMD) at the hip of noninjured volunteers.


Within-subjects intervention.


University research laboratory.


Noninjured participants (3 male, 6 female) completed IPC treatment on 1 leg 1 h/d, 5 d/wk for 10 wk. Pressure was set to 60 mm Hg when using the PresSsion and Flowtron Hydroven compression units.

Main Outcome Measures:

Dual-energy X-ray absorptiometry was used to assess BMD of the hip in treated and nontreated legs before and after the intervention. Anthropometrics, regular physical activity, and nutrient intake were also assessed.


The average number of completed intervention sessions was 43.4 (± 3.8) at an average duration of 9.6 (± 0.8) wk. Repeated-measures analysis of variance indicated a significant time-by-treatment effect at the femoral neck (P = .023), trochanter (P = .027), and total hip (P = .008). On average, the treated hip increased 0.5–1.0%, while the nontreated hip displayed a 0.7–1.9% decrease, depending on the bone site.


Results of this exploratory investigation suggest that IPC is a therapeutic modality that is safe and feasible for further investigation on its novel use in optimizing bone health.

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Emma E. Sypes, Genevieve Newton, and Zakkoyya H. Lewis

Background: Electronic activity monitor systems (EAMSs) have been readily incorporated into physical activity (PA) and weight-loss interventions to facilitate self-monitoring PA behavior. A comprehensive review is required to better understand their utility as intervention modalities in nonclinical populations. Methods: Medscape, MEDLINE, PsycINFO, and Cochrane databases were searched in February 2017, with a search update in April 2017. Citation screening, risk of bias assessment, and an intensity evaluation were conducted in duplicate by 2 investigators. Results: The search returned 409 unique citations. Of which, 22 citations met the inclusion criteria. Seven studies found significant between-group differences: 3 in weight loss, 3 in PA levels, and 1 in both weight loss and PA levels. Effective interventions lasted 6 weeks to 12 months. Positive health outcomes were demonstrated when users interacted with multiple features of the EAMS and had access to other services, such as personal coaching or environmental reinforcement. Conclusions: When control and intervention groups have access to the same components, such as counseling or group interaction, the addition of an EAMS for self-monitoring within the intervention group may not confer more favorable results. Risk of performance bias and low sample sizes should be addressed in future trials to generate more reliable findings.

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Zakkoyya H. Lewis, Kyriakos S. Markides, Kenneth J. Ottenbacher, and Soham Al Snih

Background: We investigated the association between 10 years of change in physical activity (PA) levels and 7-year all-cause mortality. Methods: Mexican American adults aged 67 and older (N = 803) participating in the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/1996–2012/2013) were included. All-cause mortality was our outcome. Participants were divided into 4 groups based on their difference in overall PA between 1995/1996 and 2005/2006 measured by the Physical Activity Scale for the Elderly. Participants were classified as having unchanged low PA (n = 339), decreased activity (n = 233), unchanged high activity (n = 166), and increased activity (n = 65). Change in the frequency of PA domains was also investigated. PA domains included leisure, household, sedentary, and walking activities. Results:After controlling for all covariates, results from the Cox proportional hazards regression found a 43% lower mortality risk in the increased PA group (hazards ratio = 0.57; 95% confidence interval, 0.34–0.97) compared with the unchanged low PA group. In the entire sample, a significantly lower mortality risk was also present among walking (hazards ratio = 0.88) and household (hazards ratio = 0.88) activities. Conclusion:Our results suggest that, independent of other factors, increasing PA is most protective of mortality among older Mexican Americans.

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Zakkoyya H. Lewis, Kyriakos S. Markides, Kenneth J. Ottenbacher, and Soham Al Snih

We investigated the relationship between physical activity and physical function on the risk of falls over time in a cohort of Mexican-American adults aged 75 and older from the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE). Participants were divided into four groups according to their level of physical activity and physical function: low physical activity and low physical function (n = 453); low physical activity and high physical function (n = 54); high physical activity and low physical function (n = 307); and high physical activity and high physical function (n = 197). Using generalized linear equation estimation, we showed that participants with high physical activity and low physical function had a greater fall risk over time, followed by the high physical activity and high physical function group. Participants seldom took part in activities that improve physical function. To prevent falls, modifications to physical activity should be made for older Mexican Americans.