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Andrew T. Kaczynski and Karla A. Henderson

Background:

The purpose of this study was to review reported associations between parks and recreation settings (PRSs) as features of the built environment and various functions and intensities of physical activity (PA).

Methods:

By searching 4 major databases for the years 1998 to 2005, 50 articles were uncovered that reported quantitative relationships between PRSs and PA.

Results:

Most articles showed some significant positive relationships between PRSs and PA. PRSs were more likely to be positively associated with PA for exercise or utilitarian functions than for recreational PA. Mixed results were observed for the associations between PRSs and both moderate and vigorous PA, but PRSs were commonly associated with walking.

Conclusions:

The studies indicated links between PRSs and PA and provided evidence for the contributions parks and recreation makes as part of the “health care” system within communities. Because of the ubiquity of PRSs and their potential contributions to active living, these relationships merit further exploration.

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James F. Sallis and Kevin Patrick

The International Consensus Conference on Physical Activity Guidelines for Adolescents convened to review the effects of physical activity on the health of adolescents, to establish age-appropriate physical activity guidelines, and to consider how these guidelines might be implemented in primary health care settings. Thirty-four invited experts and representatives of scientific, medical, and governmental organizations established two main guidelines. First, all adolescents should be physically active daily or nearly every day as part of their lifestyles. Second, adolescents should engage in three or more sessions per week of activities that last 20 min or more and that require moderate to vigorous levels of exertion. Available data suggest that the vast majority of U.S. adolescents meet the first guideline, but only about two thirds of boys and one half of girls meet the second guideline. Physical activity has important effects on the health of adolescents, and the promotion of regular physical activity should be a priority for physicians and other health professionals.

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Ross E. Andersen and John M. Jakicic

The aim of this review is to provide a scientific update on the current guidelines for both health and weight management. There has been confusion among health professionals as to which physical activity guidelines should be used to help various specific populations adopt more active lifestyles. We first review the history of the physical activity guidelines. Using the physical activity guidelines in clinical practice is also explored. We also describe common barriers to physical that overweight individuals report and we discuss when it is appropriate for a health care professional to seek a referral from an exercise scientist to help sedentary adults increase their levels of activity. It is important for individuals who care for overweight patients and sedentary adults to understand the current physical guidelines and how these guidelines can be worked into clinical practice.

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Troy R. Garrett and Peter J. Neibert

Clinical Scenario:

Injury to the plantar fascia, whether acute or chronic, is common among many populations. A conventional multiple-treatment approach is commonly administered by health care providers, consisting of controlling inflammation, managing pain, and promoting healing. Frequently, the initial treatment for plantar fasciitis is targeted at increasing dorsiflexion range of motion by stretching the gastroc-soleus musculature. It has been theorized that inflexibility of the gastroc-soleus complex can lead to excessive pronation and overcompensation of the plantar fascia at the first metatarsal phalangeal joint, therefore increasing the stress at the medial calcaneal insertion. Therefore, it is deemed that gastrocnemius–soleus stretches are a beneficial treatment in the initial stage of a plantar fasciitis treatment or rehabilitation program.

Focused Clinical Question:

Is a gastrocnemius–soleus stretching program, as a stand-alone treatment variable, effective in the treatment of plantar fasciitis?

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Barbara Resnick, Marcia G. Ory, Kerrie Hora, Michael E. Rogers, Phillip Page, Jane N. Bolin, Roseann M. Lyle, Cody Sipe, Wojtek Chodzko-Zajko and Terry L. Bazzarre

The Exercise Assessment and Screening for You (EASY) is a tool developed to help older individuals, their health care providers, and exercise professionals identify different types of exercise and physical activity regimens that can be tailored to meet the existing health conditions, illnesses, or disabilities of older adults. The EASY tool includes 6 screening questions that were developed based on an expert roundtable and follow-up panel activities. The philosophy behind the EASY is that screening should be a dynamic process in which participants learn to appreciate the importance of engaging in regular exercise, attending to health changes, recognizing a full range of signs and symptoms that might indicate potentially harmful events, and becoming familiar with simple safety tips for initiating and progressively increasing physical activity patterns. Representing a paradigm shift from traditional screening approaches that focus on potential risks of exercising, this tool emphasizes the benefits of exercise and physical activity for all individuals.

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Rebecca L. Vivrette, Laurence Z. Rubenstein, Jennifer L. Martin, Karen R. Josephson and B. Josea Kramer

Objective:

To determine seniors’ beliefs about falls and design a fall-risk self-assessment and educational materials to promote early identification of evidence-based fall risks and encourage prevention behaviors.

Methods:

Focus groups with community-dwelling seniors, conducted in two phases to identify perceptions about fall risks and risk reduction and to assess face validity of the fall-risk self-assessment and acceptability of educational materials.

Results:

Lay perception of fall risks was in general concordance with evidence-based research. Maintaining independence and positive tone were perceived as key motivators for fall prevention. Seniors intended to use information in the educational tool to stimulate discussions about falls with health care providers.

Implications:

An evidence-based, educational fall-risk self-assessment acceptable to older adults can build on existing lay knowledge about fall risks and perception that falls are a relevant problem and can educate seniors about their specific risks and how to minimize them.

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the Latest From the Health Care in Action Campaign After the success of NATA’s 2019 Own Your Impact campaign, the association is continuing the conversation in 2020 with the Health Care in Action campaign. Throughout this year-long campaign, NATA will provide resources to members that help them tell

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Roy J. Shephard

The Journal of Physical Activity and Health seems likely to develop as a vehicle for practical, evidence-based answers to problems concerning physical activity and health, issues that have important implications for public health policy. There is strong epidemiological evidence for an association between the regular practice of physical activity and preventive or therapeutic benefit in a wide range of chronic health conditions,1-4 and already many professional groups have been eager to pre¬pare position statements, indicating their assessments of an appropriate minimum weekly dose of physical activity to maintain health.5 Unfortunately, there have been substantial discrepancies between successive recommendations, and uncertainties in the message are one probable factor, limiting its acceptance by both the general public and immediate health-care providers.6,7 The purpose of this brief commentary is to suggest some areas of investigation that would help in formulating a clear and consistent message. Topics discussed include the desired health outcome, the shape of the dose–response relationship, the impact of confounding variables, the quality of the evidence accepted, the basis for shaping the message, and the need for multiple messages.

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Paul Comper, Michael Hutchison, Doug Richards and Lynda Mainwaring

Along with the ever growing awareness among the scientific community and the general public that concussion is a serious health care issue at all levels of sport, with potentially devastating long term health effects, the number of concussion surveillance clinical monitoring programs has significantly increased internationally over the past 10–15 years. An effective concussion program (a “best practice” model) is clinically prudent and evidence-based, one that is an interdisciplinary model involving health professionals who manage, educate, and provide psychosocial support to athletes. The integration of neuropsychological assessment is a component of many present day programs, and therefore, the neuropsychologist is an integral member of the concussion management team. The University of Toronto Concussion Program, operational since 1999, integrates best practices and current evidence into a working model of concussion management for university athletes. The model uses an interdisciplinary approach to monitor and assess athletes with concussions, as well as to educate its athletes, coaches, and administrators. A research component is also integral to the program.

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Carl G. Mattacola and Lori L. Rice

Context:

Dissemination of information regarding the latest research findings in rehabilitative health care is often limited to professional journals.

Objective:

The purpose of the paper is to describe opportunities to better distribute scientific information to wider swaths than normally contained within a readership of a journal, to describe a process to deliver important information via the Cooperative Extension Service, and provide an example of such an informational brochure.

Design:

An interdisciplinary approach was developed to provide access to a larger cohort of individuals the latest research findings regarding heat and hydration.

Data Extraction:

CINAHL, Medline, and Sport Discus were reviewed from 1966 to 2006 using the terms Heat, Hydration, Rhabdomyolysis, Rehabilitation, Heat Exhaustion, Heat Stroke, and Dehydration.

Data Synthesis:

We found substantial information describing recommendations for preventing, recognizing, and treating illness due to variance in heat and hydration. The information was succinctly summarized, converted to a 7th grade reading level, and shared with a larger audience via a unique model available through Cooperative Extension Agencies.

Conclusion:

Providing scientific information via a Cooperative Extension Model enables sharing of information from experts to communities. This methodology increases the distribution of the latest scientific knowledge to broader audiences.