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.
George A. Kelley and Kristi S. Kelley
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.
Kathleen Benjamin, Nancy Edwards, Jenny Ploeg and Frances Legault
Despite the benefits of physical activity, residents living in long-term care (LTC) are relatively sedentary. Designing successful physical activity and restorative care programs requires a good understanding of implementation barriers. A database search (2002–2013) yielded seven studies (nine articles) that met our inclusion criteria. We also reviewed 31 randomized controlled trials (RCTs) to determine if the authors explicitly discussed the barriers encountered while implementing their interventions. Eleven RCTs (13 articles) included a discussion of the barriers. Hence, a total of 18 studies (22 articles) were included in this review. Barriers occurred at resident (e.g., health status), environmental (e.g., lack of space for physical activity), and organizational (e.g., staffing and funding constraints) levels. These barriers intersect to adversely affect the physical activity of older people living in LTC. Future studies targeting physical activity interventions for residents living in LTC are needed to address these multiple levels of influence.
Seung-Youn Hong, Susan Hughes and Thomas Prohaska
Many different constructs are used currently in the literature to assess exercise adherence. This study examined whether the same or different variables predict exercise attendance and exercise completion among sedentary older adults.
Thirty-seven randomized control trials were selected from articles published between 1980 and 2000 that tested exercise interventions for sedentary older adults. Block-entry, weighted, hierarchical meta-regression analyses were conducted.
Different factors predicted attendance and completion. Group-based (P < .05) and resistance exercise (P < .1) predicted higher attendance rates than individual-based and aerobic exercise. In contrast, facility-based exercise was associated with higher completion rates than home-based exercise (P < .1).
Results show that completing a program is not synonymous with good attendance. Program designers need to consider different strategies to boost both of these rates that need to be maximized to best benefit program participants.
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.
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.
Fuzhong Li, Edward McAuley, Peter Harmer, Terry E. Duncan and Nigel R. Chaumeton
The article describes a randomized, controlled trial conducted to examine the effects of a Tai Chi intervention program on perceptions of personal efficacy and exercise behavior in older adults. The sample comprised 94 low-active, healthy participants (mean age = 72.8 years. SD = 5.1) randomly assigned to either an experimental (Tai Chi) group or a wait-list control group. The study length was 6 months, with self-efficacy responses (barrier, performance efficacies) assessed at baseline, at Week 12, and at termination (Week 24) of the study. Exercise attendance was recorded as an outcome measure of exercise behavior. Random-effects models revealed that participants in the experimental group experienced significant improvements in self-efficacy over the course of the intervention. Subsequent repeated-measures ANOVA revealed that participants’ changes in efficacy were associated with higher levels of program attendance. The findings suggest that self-efficacy can be enhanced through Tai Chi and that the changes in self-efficacy are likely to improve exercise adherence.
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.
Katherine M. White, Deborah J. Terry, Carolyn Troup, Lynn A. Rempel, Paul Norman, Kerry Mummery, Malcolm Riley, Natasha Posner and Justin Kenardy
A randomized controlled trial evaluated the effectiveness of a 4-wk extended theory of planned behavior (TPB) intervention to promote regular physical activity and healthy eating among older adults diagnosed with Type 2 diabetes or cardiovascular disease (N = 183). Participants completed TPB measures of attitude, subjective norm, perceived behavioral control, and intention, as well as planning and behavior, at preintervention and 1 wk and 6 wk postintervention for each behavior. No significant time-by-condition effects emerged for healthy eating. For physical activity, significant time-by-condition effects were found for behavior, intention, planning, perceived behavioral control, and subjective norm. In particular, compared with control participants, the intervention group showed short-term improvements in physical activity and planning, with further analyses indicating that the effect of the intervention on behavior was mediated by planning. The results indicate that TPB-based interventions including planning strategies may encourage physical activity among older people with diabetes and cardiovascular disease.
Dennis Hamacher, Daniel Hamacher, Kathrin Rehfeld, Anita Hökelmann and Lutz Schega
Dancing is a complex sensorimotor activity involving physical and mental elements which have positive effects on cognitive functions and motor control. The present randomized controlled trial aims to analyze the effects of a dancing program on the performance on a motorcognitive dual task. Data of 35 older adults, who were assigned to a dancing group or a health-related exercise group, are presented in the study. In pretest and posttest, we assessed cognitive performance and variability of minimum foot clearance, stride time, and stride length while walking. Regarding the cognitive performance and the stride-to-stride variability of minimum foot clearance, interaction effects have been found, indicating that dancing lowers gait variability to a higher extent than conventional health-related exercise. The data show that dancing improves minimum foot clearance variability and cognitive performance in a dual-task situation. Multi-task exercises (like dancing) might be a powerful tool to improve motor-cognitive dual-task performance.