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Alison R. Snyder, Jessica C. Martinez, R. Curtis Bay, John T. Parsons, Eric L. Sauers and Tamara C. Valovich McLeod

Context:

Patient-oriented outcome measures such as the Medical Outcomes Short Form (SF-36) and the Pediatric Outcomes Data Collection Instrument (PODCI) are important tools for determining the impact of events like sport-related injury on health-related quality of life (HRQoL). Unfortunately, there are no published studies using these instruments that compare adolescent athletes with their nonathlete peers, making interpretations of these measures in this population difficult.

Objective:

To compare HRQoL in adolescent athletes and nonathletes using 2 common instruments.

Design:

Cross-sectional.

Setting:

7 high schools.

Participants:

219 athletes and 106 nonathletes.

Intervention:

None.

Main Outcome Measures:

The SF-36 and the PODCI were completed in a counterbalanced manner during 1 session. Dependent variables included the 8 subscale and 2 composite scores of the SF-36 and the 5 subscale scores and 1 global score of the PODCI.

Results:

On the SF-36, athletes reported higher scores on the physical function, general health, social functioning, and mental health subscales and the mental composite score and lower scores on the bodily pain subscale than nonathletes. On the PODCI, athletes reported higher scores on the sport and physical function and happiness subscales and lower scores on the pain/comfort subscale.

Conclusions:

Athletes reported higher scores on a number of SF-36 and PODCI subscales related to mental, emotional, and physical well-being than nonathletes. Our findings suggest that athletic involvement may be a benefit to the overall health status of adolescents and imply that athletes may be a distinct adolescent group requiring their own normative values when using the SF-36 and PODCI.

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Anners Lerdal, Elin Hannevig Celius and Gunn Pedersen

Background:

Participants who completed a 3-month prescribed individualized exercise program in groups were followed-up prospectively. The aims were to describe the characteristics of the participants, their health-related quality of life (HRQoL) and physical fitness at baseline, at completion and at 12-month follow-up, and to identify predictors of HRQoL and physical fitness at completion and at 12-month follow-up.

Methods:

A 1-group follow-up design was used. Data were collected from records of 163 attendees at a municipality-sponsored health center in Norway. HRQoL was measured by self-report using the COOP/WONCA questionnaire. Physical fitness was estimated from the results of a 2-km walk test.

Results:

Of the 163 participants referred to the clinic, 130 (79.8%) were women and 33 were (20.2%) men. Participants who completed were older than those who dropped out. The participants showed clinical improvement in physical fitness and all health-related quality life domains (d > 0.53) at the completion of the program and in physical functioning, mental health, performance of daily activities, overall health, and perceived improved health after 12 months (d > 0.36).

Conclusions:

Participation in group-based prescribed exercise program for 3 months may improve physical fitness and HRQoL significantly in short and long terms.

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George J. Salem, Sean P. Flanagan, Man-Ying Wang, Joo-Eun Song, Stanley P. Azen and Gail A. Greendale

Stepping activities when wearing a weighted vest may enhance physical function in older persons. Using 3 weighted-vest resistance dosages, this study characterized the lower-extremity joint biomechanics associated with stepping activities in elders. Twenty healthy community-dwelling older adults, ages 74.5 ± 4.5 yrs, performed 3 trials of forward step-up and lateral step-up exercises while wearing a weighted vest which added 0% body weight (BW), 5% BW, or 10% BW. They performed these activities on a force platform while instrumented for biomechanical analysis. Repeated-measures ANOVA was used to evaluate the differences in ankle, knee, and hip maximum joint angles, peak net joint moments, joint powers, and impulses among both steping activities and the 3 loading conditions. Findings indicated that the 5% BW vest increased the kinetic output associated with the exercise activities at all three lower-extremity joints. These increases ranged from 5.9% for peak hip power to 12.5% for knee extensor impulse. The application of an additional 5% BW resistance did not affect peak joint moments or powers, but it did increase the joint impulses by 4–11%. Comparisons between exercise activities, across the 3 loading conditions, indicated that forward stepping preferentially targeted the hip extensors while lateral stepping targeted the plantar flexors; both activities equally targeted the knee extensors. Weighted-vest loads of 5% and 10% BW substantially increased the mechanical demand on the knee extensors, hip extensors (forward stepping), and ankle plantar flexors (lateral stepping).

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Kristen M. Beavers, Fang-Chi Hsu, Monica C. Serra, Veronica Yank, Marco Pahor and Barbara J. Nicklas

Observational studies show a relationship between elevated serum uric acid (UA) and better physical performance and muscle function. The purpose of this paper was to determine whether regular participation in an exercise intervention, known to improve physical functioning, would result in increased serum UA. For this study, 424 older adults at risk for physical disability were randomized to participate in either a 12-mo moderate-intensity physical activity (PA) or a successful aging (SA) health education intervention. UA was measured at baseline, 6, and 12 mo (n = 368, 341, and 332, respectively). Baseline UA levels were 6.03 ± 1.52 mg/dl and 5.94 ± 1.55 mg/dl in the PA and SA groups, respectively. The adjusted mean UA at month 12 was 4.8% (0.24 mg/dl) higher in the PA compared with the SA group (p = .028). Compared with a health education intervention, a 1-yr PA intervention results in a modest increase in systemic concentration of UA in older adults at risk for mobility disability.

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Matthew P. Ford, Laurie A. Malone, Harrison C. Walker, Ildiko Nyikos, Rama Yelisetty and C. Scott Bickel

Background:

UPDRS and PDQ-39 are reliable and valid assessments of quality of life and physical function in persons with Parkinson’s disease (PD). However, these measures were not designed to track day-to-day or week-to-week changes in community activity in persons with PD.

Methods:

Twelve individuals with PD (stage 1 to 3, Hoehn and Yahr) who were active members of a health and wellness facility were recruited for this study. Investigators collected health history information, asked questions about the amount and frequency of weekly exercise, and assessed motor symptoms and ADL skills using the UPDRS, and provided participants with Step Activity Monitor (SAM). SAM data were collected for a continuous 7-day period.

Results:

Participants averaged 8996 steps/day, had an average of 322 minutes of step activity per day, but were inactive (minIA) 77% of their time per day. On the days that participants visited the health and wellness facility they took an average of 802 more steps with 12 minutes more activity per day.

Conclusions:

A SAM can be used to capture activity levels in persons with PD. These pilot data indicate that persons with mild to moderate PD can achieve step activity levels similar to healthy older adults.

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Patrick J. O’Connor, Amanda L. Caravalho, Eric C. Freese and Kirk J. Cureton

Compounds found in the skins of grapes, including catechins, quercetin, and resveratrol, have been added to the diet of rodents and improved run time to exhaustion, fitness, and skeletal-muscle mitochondrial function. It is unknown if such effects occur in humans. The purpose of this experiment was to investigate whether 6 wk of daily grape consumption influenced maximal oxygen uptake (VO2max), work capacity, mood, perceived health status, inflammation, pain, and arm-function responses to a mild eccentric-exercise-induced arm-muscle injury. Forty recreationally active young adults were randomly assigned to consume a grape or placebo drink for 45 consecutive days. Before and after 42 d of supplementation, assessments were made of treadmill-running VO2max, work capacity (treadmill performance time), mood (Profile of Mood States), and perceived health status (SF-36 Health Survey). The day after posttreatment treadmill tests were completed, 18 high-intensity eccentric actions of the nondominant elbow flexors were performed. Arm-muscle inflammation, pain, and function (isometric strength and range of motion) were measured before and on 2 consecutive days after the eccentric exercise. Mixed-model ANOVA showed no significant effect of grape consumption on any of the outcomes. Six weeks of supplemental grape consumption by recreationally active young adults has no effect on VO2max, work capacity, mood, perceived health status, inflammation, pain, or physical-function responses to a mild injury induced by eccentric exercise.

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Takashi Kamijo and Masami Murakami

Background:

Lifestyle-related diseases among middle-age and elderly people have become serious problems. Underlying causes might be related to the changes in the lifestyle including the absence of regular physical exercise.

Methods:

To clarify the significance of regular physical exercise to prevent lifestyle-related diseases, we studied motor functions and blood chemistry examinations in middle-age and elderly women (over 40 years old) who performed regular physical exercise for 2 years (exercise group) and those who initially did not (control group).

Results:

In study 1, VO2max significantly increased in the exercise group compared with the control group in the under 60 years old groups. In the over 60 years old groups, VO2max, foot balance, and HDL-cholesterol significantly increased. Plasma glucose at 120 minutes after the 75 g oral glucose tolerance test, fasting insulin, homeostasis model assessment (HOMA-R), and high sensitivity C-reactive protein (hsCRP) significantly decreased in the exercise group compared with the control group. In study 2, a 1-year exercise program significantly improved physical functions and biochemical markers in the control group.

Conclusion:

These results suggest that regular physical exercise might help to maintain sound motor functions and decrease insulin resistance and a risk for arteriosclerosis.

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Silvia Aranda-García, Albert Busquets, Antoni Planas, Joan A. Prat-Subirana and Rosa M. Angulo-Barroso

Purpose:

Gait speed is related to physical function in older adults. This cross-sectional study examined the best predictors of maximal gait speed (MGS) among physical abilities, and general factors in healthy, rural community-dwelling older adults.

Methods:

MGS, muscle strength, and postural sway were measured in 55 community-dwelling participants (age, 72.1 ± 6.8, range 61–87 years; 72.7% women). Two stepwise regressions were used to find MGS predictors in two models: physical abilities and global.

Results:

Strength of knee extensors with 60° of knee flexion (KStrength60°) and maximal distance in the anterior-posterior direction with eyes closed explained 50.2% of MGS variance (p < .05) in the physical abilities model. KStrength60°, age, and level of physical activity explained 63.9% of MGS variance (p < .05) in the global model.

Conclusions:

Regardless of the model, KStrength60° was the best predictor of MGS in rural female older adults. Future research should examine the generalization of these findings to rural male older adults.

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NiCole R. Keith, Daniel O. Clark, Timothy E. Stump, Douglas K. Miller and Christopher M. Callahan

Background:

An accurate physical fitness survey could be useful in research and clinical care.

Purpose:

To estimate the validity and reliability of a Self-Reported Fitness (SRFit) survey; an instrument that estimates muscular fitness, flexibility, cardiovascular endurance, BMI, and body composition (BC) in adults ≥ 40 years of age.

Methods:

201 participants completed the SF-36 Physical Function Subscale, International Physical Activity Questionnaire (IPAQ), Older Adults’ Desire for Physical Competence Scale (Rejeski), the SRFit survey, and the Rikli and Jones Senior Fitness Test. BC, height and weight were measured. SRFit survey items described BC, BMI, and Senior Fitness Test movements. Correlations between the Senior Fitness Test and the SRFit survey assessed concurrent validity. Cronbach’s Alpha measured internal consistency within each SRFit domain. SRFit domain scores were compared with SF-36, IPAQ, and Rejeski survey scores to assess construct validity. Intraclass correlations evaluated test-retest reliability.

Results:

Correlations between SRFit and the Senior Fitness Test domains ranged from 0.35 to 0.79. Cronbach’s Alpha scores were .75 to .85. Correlations between SRFit and other survey scores were –0.23 to 0.72 and in the expected direction. Intraclass correlation coefficients were 0.79 to 0.93. All P-values were 0.001.

Conclusion:

Initial evaluation supports the SRFit survey’s validity and reliability.

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William R. Sukala, Rachel Page, Chris Lonsdale, Isabelle Lys, David Rowlands, Jeremy Krebs, Murray Leikis and Birinder Singh Cheema

Background:

To evaluate the differential effect of 2, group-based exercise modalities on quality of life (QoL) in indigenous Polynesian peoples with type 2 diabetes (T2DM) and visceral obesity.

Methods:

Participants were randomized to resistance training or aerobic training performed 3 times per for 16 weeks. The Short-Form 36 was administered at baseline and post intervention to assess 8 domains and physical and mental component scales (PCS and MCS) of QoL.

Results:

With the exception of Mental Health and MCS, all scores were lower at baseline than general population norms. Significant improvements were documented in several QoL scores in each group post intervention. No group × time interactions were noted. Pooled analyses of the total cohort indicated significantly improved Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Role-Emotional, PCS and MCS. Adaptation ranged from 5%−22%, and demonstrated a moderate-to-large effect (Cohen’s d = 0.64−1.29). All measures of QoL increased to near equivalent, or greater than general norms.

Conclusion:

Exercise, regardless of specific modality, can improve many aspects of QoL in this population. Robust trials are required to investigate factors mediating improvements in QoL, and create greater advocacy for exercise as a QoL intervention in this and other indigenous populations with T2DM.