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Gary S. Goldfield

Objective:

To compare liking and other attitudes toward physical activity (PA) and television (TV) viewing versus PA behavior and time viewing TV at baseline as predictors of response to lifestyle intervention in 30, 8 to 12 year old overweight/obese children.

Method:

Secondary analyses from a randomized controlled trial designed to increase PA and reduce sedentary behavior. PA was measured by accelerometers worn by participants every day for 8 weeks. TV viewing at baseline and during intervention was assessed by self-report.

Results:

Multiple regression analyses showed that base rates of PA and TV viewing significantly predicted changes in PA (Beta = .39, P < .05) and TV viewing (Beta = .37, P < .05) during the intervention, even after statistically controlling for child age, gender, body mass index, as well as baseline attitudes and liking of PA and TV viewing. However, self-reported liking of TV viewing and PA, perceived adequacy, and predilection were not predictive of response to intervention.

Conclusions:

Baseline measure of PA and TV viewing behaviors may be better predictors of response to lifestyle intervention than measure of liking and other attitudinal variables of PA. The theoretical and clinical implications of these findings are discussed.

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Saija Karinkanta, Ritva Nupponen, Ari Heinonen, Matti Pasanen, Harri Sievänen, Kirsti Uusi-Rasi, Mikael Fogelholm and Pekka Kannus

This randomized, controlled trial evaluated the effects of exercise on health-related quality of life (HRQoL) and fear of falling (FoF) among 149 home-dwelling older women. The 12-mo exercise program was intended to reduce the risk of falls and fractures. HRQoL was assessed by the RAND-36 Survey, and FoF, with a visual analog scale, at baseline, 12 mo, and 24 mo. On all RAND-36 scales, the scores indicated better health and well-being. The exercise had hardly any effect on HRQoL; only the general health score improved slightly compared with controls at 12 mo (p = .019), but this gain was lost at 24 mo. FoF decreased in both groups during the intervention with no between-groups difference at 12 or 24 mo. In conclusion, despite beneficial physiological changes, the exercise intervention showed rather limited effects on HRQoL and FoF among relatively high-functioning older women. This modest result may be partly because of insufficient responsiveness of the assessment instruments used.

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Leon Mabire, Ramakrishnan Mani, Lizhou Liu, Hilda Mulligan and David Baxter

Background:

Brisk walking is the most popular activity for obesity management for adults. We aimed to identify whether participant age, sex and body mass index (BMI) influenced the effectiveness of brisk walking.

Methods:

A search of 9 databases was conducted for randomized controlled trials (RCTs). Two investigators selected RCTs reporting on change in body weight, BMI, waist circumference, fat mass, fat-free mass, and body fat percentage following a brisk walking intervention in obese adults.

Results:

Of the 5072 studies screened, 22 met the eligibility criteria. The pooled mean differences were: weight loss, –2.13 kg; BMI, –0.96 kg/m2; waist circumference, –2.83 cm; fat mass, –2.59 kg; fat-free mass, 0.29 kg; and body fat percentage, –1.38%. Meta-regression of baseline BMI showed no effect on changes.

Conclusions:

Brisk walking can create a clinically significant reduction in body weight, BMI, waist circumference, and fat mass for obese men and women aged under 50 years. Obese women aged over 50 years can achieve modest losses, but gains in fat-free mass reduce overall change in body weight. Further research is required for men aged over 50 years and on the influence of BMI for all ages and sexes.

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Rachel S. Mark and Ryan E. Rhodes

Background:

Interactive stationary bikes provide positive affective experiences and physiological benefits; however, research is limited.

Methods:

This study compared usage of GameBikes to traditional stationary bikes among families in the home following a 6-week randomized, controlled trial design. Parents completed questionnaires featuring constructs of the theory of planned behavior (TPB). Usage was tracked by all family members and belief elicitation with GameBike families followed the trial.

Results:

Usage across the trial was significantly different for children in favor of the GameBike group (t 36 = 2.61, P = .01, d = .85). No differences were identified for parents. Significant time effects for parents’ (F 5,48 = 5.07, P < .01; η2 = .35) and children’s (F 5,32 = 8.24, P < .01; η2 = .56) usage were found with declines across 6 weeks. Affective attitude was the only significant TPB variable between groups at both time one (t 57 = 2.53, P = .01; d = .65) and follow-up (t 52 = 2.70, P = .01; d = .74) in favor of the GameBike group. Elicited beliefs were primarily affective- and control-based.

Conclusions:

The results provide support for use of interactive video games to augment current PA initiatives. Larger-scale trials with longer durations are warranted.

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Erja Portegijs, Sanna Read, Inka Pakkala, Mauri Kallinen, Ari Heinonen, Taina Rantanen, Markku Alen, Ilkka Kiviranta, Sanna Sihvonen and Sarianna Sipilä

Our aim was to study the effects of sense of coherence (SOC) on training adherence and interindividual changes in muscle strength, mobility, and balance after resistance training in older people with hip fracture history. These are secondary analyses of a 12-week randomized controlled trial of progressive resistance training in 60- to 85-year-old community-dwelling people 0.5–7 years after hip fracture (n = 45; ISRCTN34271567). Pre- and posttrial assessments included SOC, knee extension strength, walking speed, timed up-and-go (TUG), and Berg Balance Scale (BBS). Group-by-SOC interaction effects (repeated-measures ANOVA) were statistically significant for TUG (p = .005) and BBS (p = .040), but not for knee extension strength or walking speed. Weaker SOC was associated with poorer training adherence (mixed model; p = .009). Thus, more complicated physical tasks did not improve in those with weaker SOC, independently of training adherence. Older people with weaker SOC may need additional psychosocial support in physical rehabilitation programs to optimize training response.

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Kimberlee Bethany Bonura and Gershon Tenenbaum

Background:

The objective of this study was to assess the effect of a yoga intervention on psychological health in older adults.

Method:

A randomized controlled trial study, conducted at 2 North Florida facilities for older adults. Subjects were 98 older adults, ages 65 to 92. Participants were randomly assigned to chair yoga, chair exercise, and control groups and assessed preintervention, postintervention, and 1-month follow-up on the State Anger Expression Inventory, State Anxiety Inventory, Geriatric Depression Scale, Lawton’s PGC Morale Scale, General Self-Efficacy Scale, Chronic Disease Self-Efficacy Scales, and Self- Control Schedule.

Results:

Yoga participants improved more than both exercise and control participants in anger (Cohen’s d = 0.89 for yoga versus exercise, and 0.90 for yoga versus control, pretest to posttest; and d = 0.90 and 0.72, pretest to follow-up), anxiety (d = 0.27, 0.39 and 0.62, 0.63), depression (d = 0.47, 0.49 and 0.53, 0.51), well-being (d = 0.14, 0.49 and 0.25, 0.61), general self-efficacy (d = 0.63, 1.10 and 0.30, 0.85), and self-efficacy for daily living (d = 0.52, 0.81 and 0.27, 0.42). Changes in self-control moderated changes in psychological health.

Conclusions:

Over a 6-week period, our findings indicate yoga’s potential for improving psychological health in older adults.

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Wei Duan-Porter, Remy R. Coeytaux, Jennifer R. McDuffie, Adam P. Goode, Poonam Sharma, Hillary Mennella, Avishek Nagi and John W. Williams Jr.

Background:

This study describes evidence of yoga’s effectiveness for depressive disorders, general anxiety disorder (GAD), panic disorder (PD), and posttraumatic stress disorder (PTSD) in adults. We also address adverse events associated with yoga.

Methods:

We searched multiple electronic databases for systematic reviews (SRs) published between 2008 and July 2014, randomized controlled trials (RCTs) not identified in eligible SRs, and ongoing RCTs registered with ClincalTrials.gov.

Results:

We identified 1 SR on depression, 1 for adverse events, and 3 addressing multiple conditions. The high-quality depression SR included 12 RCTs (n = 619) that showed improved short-term depressive symptoms (standardized mean difference, –0.69, 95% confidence interval, –0.99 to –0.39), but there was substantial variability (I2 = 86%) and a high risk of bias for 9 studies. Three SRs addressing multiple conditions identified 4 nonrandomized studies (n = 174) for GAD/PD and 1 RCT (n = 8) and 2 nonrandomized studies (n = 22) for PTSD. We separately found 1 RCT (n = 13) for GAD and 2 RCTs (n = 102) for PTSD. Collectively, these studies were inconclusive for the effectiveness of yoga in treating GAD/PD and PTSD. The high-quality SR for adverse events included 37 primary reports (n = 76) in which inversion postures were most often implicated. We found 5 ongoing trials (3 for PTSD).

Conclusions:

Yoga may improve short-term depressive symptoms, but evidence for GAD, PD, and PTSD remain inconclusive.

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Farnoosh Mafi, Soheil Biglari, Alireza Ghardashi Afousi and Abbas Ali Gaeini

To investigate the effects of resistance training and epicatechin supplementation on muscle strength, follistatin, and myostatin in older adults with sarcopenia, a total of 62 males with sarcopenia (68.63 ± 2.86 years) underwent a supervised 8-week randomized controlled trial. Participants were divided into resistance training (RT), epicatechin (EP), resistance training+epicatechin (RT+EP), and placebo (PL) in a double-blind method. A pretest and posttest measurement was conducted. One-way analysis of variance was used to analyze between-group differences. The significantly greatest increase was observed in follistatin, follistatin/myostatin ratio, leg press, and chest press in RT+EP comparing RT, EP, and PL groups, whereas myostatin decreased significantly only in RT+EP and RT groups. However, appendicular muscle mass index and timed up and go test were enhanced significantly in all experimental groups than the PL group (p ≤ .05). Consequently, by comparing the results between three experimental groups, the greatest improvement was detected in the RT+EP group. Therefore, using two interventions simultaneously seems to have a better impact on improving muscle growth factors and preventing the progression of sarcopenia.

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Jennifer L. Etnier

Alzheimer's disease is a chronic illness characterized by clinical cognitive impairment. A behavioral strategy that is being explored in the prevention of Alzheimer's disease is physical activity. Evidence from randomized controlled trials (RCTs) testing the effects of physical activity for cognitively normal older adults supports that physical activity benefits cognitive performance. Evidence from prospective studies supports a protective effect of physical activity with reductions in the risk of cognitive decline ranging from 28% to 45%. RCTs with cognitively impaired older adults also generally support positive effects with greater benefits evident for aerobic interventions. Research examining the potential moderating role of apolipoprotein E (APOE) has yielded mixed results, but the majority of the studies support that physical activity most benefits those who are at greatest genetic risk of Alzheimer's disease. Future directions for research are considered with an emphasis on the need for additional funding to support this promising area of research.

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Mindy Millard-Stafford, Jeffrey S. Becasen, Michael W. Beets, Allison J. Nihiser, Sarah M. Lee and Janet E. Fulton

A systematic review of literature was conducted to examine the association between changes in health-related fitness (e.g., aerobic capacity and muscular strength/endurance) and chronic disease risk factors in overweight and/or obese youth. Studies published from 2000–2010 were included if the physical activity intervention was a randomized controlled trial and reported changes in fitness and health outcomes by direction and significance (p < .05) of the effect. Aerobic capacity improved in 91% and muscular fitness improved in 82% of measures reported. Nearly all studies (32 of 33) reported improvement in at least one fitness test. Changes in outcomes related to adiposity, cardiovascular, musculoskeletal, metabolic, and mental/emotional health improved in 60%, 32%, 53%, 41%, and 33% of comparisons studied, respectively. In conclusion, overweight and obese youth can improve physical fitness across a variety of test measures. When fitness improves, beneficial health effects are observed in some, but not all chronic disease risk factors.