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Brad Donohue, Yulia Gavrilova, Marina Galante, Elena Gavrilova, Travis Loughran, Jesse Scott, Graig Chow, Christopher P. Plant and Daniel N. Allen

health help-seeking in elite athletes: An exploratory randomized controlled trial . Journal of Medical Internet Research, 14 ( 3 ), 69 . doi:10.2196/jmir.1864 10.2196/jmir.1864 Gulliver , A. , Griffiths , K.M. , Mackinnon , A. , Batterham , P.J. , & Stanimirovic , R. ( 2015 ). The mental

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Bradley M. Wipfli, Chad D. Rethorst and Daniel M. Landers

A meta-analysis was conducted to examine the effects of exercise on anxiety. Because previous meta-analyses in the area included studies of varying quality, only randomized, controlled trials were included in the present analysis. Results from 49 studies show an overall effect size of -0.48, indicating larger reductions in anxiety among exercise groups than no-treatment control groups. Exercise groups also showed greater reductions in anxiety compared with groups that received other forms of anxiety-reducing treatment (effect size = -0.19). Because only randomized, controlled trials were examined, these results provide Level 1, Grade A evidence for using exercise in the treatment of anxiety. In addition, exercise dose data were calculated to examine the relationship between dose of exercise and the corresponding magnitude of effect size.

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George A. Kelley and Kristi S. Kelley

The purpose of this study was to use the meta-analytic approach to examine the effects of exercise on resting systolic and diastolic blood pressure in children and adolescents. Twenty-five studies that included 84 groups (45 exercise, 39 control) and 3,189 subjects (1,885 exercise, 1,304 control) met the criteria for inclusion. Using a random effects model, non-significant decreases of approximately 2% were found for resting systolic (mean – SEM, –2 – 1 mmHg, 95% CI, –4 to 1 mmHg) and diastolic (mean – SEM, –1 – 1 mmHg, 95% CI, –3 to 1 mmHg) blood pressure. Greater decreases in resting systolic blood pressure were found for nonrandomized versus randomized controlled trials (p = 0.001). There was also a statistically significant association between changes in resting systolic blood pressure and initial blood pressure (r = 0.73, p < 0.001) and body weight (r = 0.64, p < 0.001). However, when limited to randomized trials, these results were no longer statistically significant. The results of this study suggest that exercise does not reduce resting systolic and diastolic blood pressure in children and adolescents. However, a need exists for additional randomized controlled trials, especially among hypertensive children and adolescents.

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Susan Williams, Claudia Meyer, Frances Batchelor and Keith Hill

The objective of this study was to determine whether improved balance outcomes achieved in a randomized controlled trial (RCT) using balance screening to identify mild balance dysfunction and home exercises could be translated into community settings. Community-dwelling people aged over 65 who expressed concerns about their balance, had less than two falls in the preceding 12 months, and who had mild balance impairment on screening were given an individualized home-based balance and strengthening exercise program with intermittent home-visit support by a physiotherapist. Of 71 participants assessed (mean age 77.3 years, 76% female), 58 (82%) completed the six-month intervention. Twenty six percent of participants regained balance performance within normal limits—similar to those achieved in the previous RCT. Successful results from a previous RCT were able to be translated into community settings, with a similar magnitude of effect on balance and mobility.

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Thelma J. Mielenz, Michael C. Edwards and Leigh F. Callahan

Benefits of physical activity for those with arthritis are clear, yet physical activity is difficult to initiate and maintain. Self-efficacy is a key modifiable psychosocial determinant of physical activity. This study examined two scales for self-efficacy for exercise behavior (SEEB) to identify their strengths and weaknesses using item response theory (IRT) from community-based randomized controlled trials of physical activity programs in adults with arthritis. The 2 SEEB scales included the 9-item scale by Resnick developed with older adults and the 5-item scale by Marcus developed with employed adults. All IRT analyses were conducted using the graded-response model. IRT assumptions were assessed using both exploratory and confirmatory factor analysis. The IRT analyses indicated that these scales are precise and reliable measures for identifying people with arthritis and low SEEB. The Resnick SEEB scale is slightly more precise at lower levels of self-efficacy in older adults with arthritis.

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Gina Bravo, Pierre Gauthier, Pierre-Michel Roy, Hélène Payette, Marie-France Dubois, Monique Harvey and Philippe Gaulin

A recently completed randomized controlled trial documented the effects of a 1-year group-based exercise program in osteopenic women. The present study concerns the comparison of these effects to those produced by a home-based exercise program tested on the same population. All 63 women who had been randomly assigned to the control group in the previous study were invited to enroll in the home program. Comparison of pre- and posttest scores of home exercisers revealed improvements in agility and well-being. In comparison, women who had participated 1 year earlier in the group-based exercise program had improved on four of the five fitness tests, well-being, and pain intensity. More women in the group-based exercise program showed improvement in self-rated health in comparison to those enrolled in the home program. Results suggest that for osteopenic women, a group-based exercise program is much more effective than a home-based exercise program.

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Carolyn Rabin, Bernardine M. Pinto and Georita M. Frierson

Physical activity (PA) interventions diminish some of the physical and psychosocial sequelae of breast cancer diagnosis and treatment. To increase intervention efficacy and portability, it is necessary to determine the factors mediating intervention effects on physical and psychosocial outcomes. This study presents mediator analyses from a randomized controlled trial of a home-based PA intervention (focused primarily on brisk walking) for breast cancer survivors. Eighty-six survivors were randomized to PA or contact control groups (mean age = 53.42 years, SD = 9.08 and 52.86 years, SD = 10.38 respectively; mean time since diagnosis < 2 years). The PA intervention was based on the transtheoretical model (TTM). Kraemerʼs approach was used to test hypothesized mediators. TTM variables did not mediate intervention effects on PA. Data indicate that increases in moderate-intensity PA and improved fitness may mediate intervention effects on vigor (β = .21; p = .01) and fatigue (β = .24; p = .05) and suggest the value of future research on these potential mediators.

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Marijke Hopman-Rock and Marja H. Westhoff

Edited by Wojtek J. Chodzko-Zajko

The Aging Well and Healthily (AWH) program consists of health education by peers and low-intensity exercise. It was evaluated via a small randomized controlled trial and a community intervention trial involving older adults in the Netherlands. Reasons stated for participation were to exercise (35%), to acquire information about health (28%), and for social reasons (12%). The program was rated 8.2 on a 10-point scale. Twenty-five percent of participants joined exercise groups after the program ended, and 28% intended to do so. The mean physical activity score improved from 2.6 to 4.6 at follow-up (F = 16.9, p = .00) and was for the least active participants significantly different from that of the control group (F = 22.9, p = .02). Four to 6 months later, 60% of respondents reported still doing the exercises regularly at home. It is concluded that AWH is a potentially effective program for older adults.

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Elissa Burton, Gill Lewin and Duncan Boldy

The proportion of older people living in our communities is rising and, to live independently, some require assistance from home care services. Physical activity can improve and maintain function, strength, and balance, which are important for those receiving home care. This study reviewed the evidence on physical activity/exercise interventions trialed with older people receiving a home care service. A systematic review of studies published from January 1982 to September 2012, from five databases, was undertaken. Inclusion criteria were: aged 65+ years; community dwelling; no dementia diagnosis; receiving home care services; and a physical activity/exercise program. Eight articles were included and results show there were few consistencies between intervention types, groups, outcome measures, and follow-up. Study quality was mixed. Future studies should include pragmatic randomized controlled trials involving home care practitioners and their clients to gain “real-world” knowledge of what interventions are effective and can be delivered within this setting.

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Erwin C.P.M. Tak, Jannique G.Z. van Uffelen, Mai J.M. Chin A Paw, Willem van Mechelen and Marijke Hopman-Rock

After a randomized controlled trial showing that improvement on some aspects of cognitive function was related to adherence to an exercise program, determinants of adherence and maintenance were further studied. Older adults with mild cognitive impairment were contacted 6 mo after the end of exercise programs for a telephone interview addressing patterns of adherence and determinants of maintenance. Mean adherence during the trial was 53%. About one third of participants had lapses during the trial but completed, one third had no lapses, and one third dropped out or never started. Practical barriers (time, location) were related to not starting and functional limitations to dropout. After the trial 25% of participants continued the programs, 14% reported intention to continue, and 61% quit. Maintenance was determined by fewer health complaints, higher satisfaction with the programs, and better adherence during the programs. Although maintenance was low, this study identified several reasons and barriers to adherence and maintenance that could be addressed.