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Cheng-Feng Lin, Hui Liu, William E. Garrett and Bing Yu

Small knee flexion angle during landing has been proposed as a potential risk factor for sustaining noncontact ACL injury. A brace that promotes increased knee flexion and decreased posterior ground reaction force during landing may prove to be advantageous for developing prevention strategies. Forty male and forty female recreational athletes were recruited. Three-dimensional videographic and ground reaction force data in a stop-jump task were collected in three conditions. Knee flexion angle at peak posterior ground reaction force, peak posterior ground reaction force, the horizontal velocity of approach run, the vertical velocity at takeoff, and the knee flexion angle at takeoff were compared among conditions: knee extension constraint brace, nonconstraint brace, and no brace. The knee extension constraint brace significantly increased knee flexion angle at peak posterior ground reaction force. Both knee extension constraint brace and nonconstraint brace significantly decreased peak posterior ground reaction force during landing. The brace and knee extension constraint did not significantly affect the horizontal velocity of approach run, the vertical velocity at takeoff, and the knee flexion angle at takeoff. A knee extension constraint brace exhibits the ability to modify the knee flexion angle at peak posterior ground reaction force and peak posterior ground reaction force during landing.

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Suzie Mudge, Denise Taylor, Oliver Chang and Rosita Wong

Background:

Activity Monitors give an objective measure of usual walking performance. This study aimed to examine the test-retest reliability of the StepWatch Activity Monitor outputs (mean steps/day; peak activity index; sustained activity indices of 1, 5, 20, 30, 60 minutes; steps at high, medium, and low stepping rates).

Methods:

Thirty healthy adults age 18 to 49 years wore the StepWatch for 2 3-day periods at least 1 week apart.

Results:

The intraclass correlation coefficients of the StepWatch outputs ranged from 0.44 to 0.91 over 3 days. The coefficient of variation ranged from 3.0% to 51.3% over the monitoring periods, with higher variation shown for shorter monitoring periods. The most reliable 5 outputs had 95% limits of agreement between 3-day periods that were less than 40%. These were mean steps/day (±39.1%), highest step rate in 1 (±17.3%) and 5 (±37.4%) minutes, peak activity index (±25.6%), and percentage of inactive time (±9.52%).

Conclusions:

Mean steps/day, highest step rate in 1 and 5 minutes, peak activity index, and percentage of inactive time have good test-retest reliability over a 3-day monitoring period, with lower reliability shown by the other StepWatch outputs. Monitoring over 1 or 2 days is less reliable.

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Marj Moodie, Michelle M. Haby, Boyd Swinburn and Robert Carter

Background:

To assess from a societal perspective the cost-effectiveness of a school program to increase active transport in 10- to 11-year-old Australian children as an obesity prevention measure.

Methods:

The TravelSMART Schools Curriculum program was modeled nationally for 2001 in terms of its impact on Body Mass Index (BMI) and Disability-Adjusted Life Years (DALYs) measured against current practice. Cost offsets and DALY benefits were modeled until the eligible cohort reached age 100 or died. The intervention was qualitatively assessed against second stage filter criteria (‘equity,’ ‘strength of evidence,’ ‘acceptability to stakeholders,’ ‘feasibility of implementation,’ ‘sustainability,’ and ‘side-effects’) given their potential impact on funding decisions.

Results:

The modeled intervention reached 267,700 children and cost $AUD13.3M (95% uncertainty interval [UI] $6.9M; $22.8M) per year. It resulted in an incremental saving of 890 (95%UI −540; 2,900) BMI units, which translated to 95 (95% UI −40; 230) DALYs and a net cost per DALY saved of $AUD117,000 (95% UI dominated; $1.06M).

Conclusions:

The intervention was not cost-effective as an obesity prevention measure under base-run modeling assumptions. The attribution of some costs to nonobesity objectives would be justified given the program’s multiple benefits. Cost-effectiveness would be further improved by considering the wider school community impacts.

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Nicholas Gilson, Wendy J. Brown, Guy Faulkner, Jim McKenna, Marie Murphy, Andy Pringle, Karin Proper, Anna Puig-Ribera and Aphroditi Stathi

Background:

This paper aimed to use the Delphi technique to develop a consensus framework for a multinational, workplace walking intervention.

Methods:

Ideas were gathered and ranked from eight recognized and emerging experts in the fields of physical activity and health, from universities in Australia, Canada, England, the Netherlands, Northern Ireland, and Spain. Members of the panel were asked to consider the key characteristics of a successful campus walking intervention. Consensus was reached by an inductive, content analytic approach, conducted through an anonymous, three-round, e-mail process.

Results:

The resulting framework consisted of three interlinking themes defined as “design, implementation, and evaluation.” Top-ranked subitems in these themes included the need to generate research capacity (design), to respond to group needs through different walking approaches (implementation), and to undertake physical activity assessment (evaluation). Themes were set within an underpinning domain, referred to as the “institution” and sites are currently engaging with subitems in this domain, to provide sustainable interventions that refect the practicalities of local contexts and needs.

Conclusions:

Findings provide a unique framework for designing, implementing, and evaluating walking projects in universities and highlight the value of adopting the Delphi technique for planning international, multisite health initiatives.

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Phillip D. Tomporowski

Physical activity is purported to promote children’s brain health and enhance mental development (1). Three studies were selected for review because of their focus on issues that challenge translational research applications in exercise pediatric science. While some disagreement exists concerning the definition of translational research, most suggest that translational interventions focus on the uptake, implementation, and sustainability of research findings within standard care (2). Translational researchers typically highlight differences that exist between efficacy experiments, which provide evidence that a specific intervention works, and effectiveness experiments, which show that the intervention will reap benefits under real-world conditions. Results obtained from laboratory-based efficacy studies that have examined the relation between exercise and cognition led researchers (3,4) and policy makers to consider the importance of physical activity in school settings. Large-scale studies that assess the impact of various types of school based physical activity intervention on children’s cognitive and academic performance have begun. The initial results have been uneven and suggestive of a lack of benefit for children in authentic school settings. Before drawing such conclusions, however, it will be important for researchers and practitioners to recognize the methodological and measurement issues that challenge attempts to employ laboratory methodologies to academic settings.

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Mitch J. Duncan, Hannah M. Badland and William Kerry Mummery

Background:

The aim of this study was to examine the relationship between occupational category and 3 health-related behaviors: participation in leisure-time physical activity, active transport (AT) and occupational sitting in a sample of employed Australian adults.

Methods:

A random, cross-sectional sample of 592 adults aged 18 to 71 years completed a telephone survey in October/November 2006. Reported occupations were categorized as professional (n = 332, 56.1%), white-collar (n = 181, 30.6%), and blue-collar (n = 79, 13.3%). Relationships between occupational category and AT, sufficient physical activity and occupational sitting were examined using logistic regression.

Results:

White-collar employees (OR = 0.36, 95% CI 0.14−0.95) were less likely to engage in AT and more likely to engage in occupational sitting (OR = 3.10, 95% CI 1.63−5.92) when compared with blue-collar workers. Professionals (OR = 3.04, 95% CI 1.94−4.76) were also more likely to engage in occupational sitting compared with blue-collar workers. No relationship was observed between occupational category and engagement in sufficient physical activity.

Conclusions:

No association between occupational category and sufficient physical activity levels was observed, although white-collar and professionals were likely to engage in high levels of occupational sitting. Innovative and sustainable strategies are required to reduce occupational sitting to improve health.

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Jason Duvall

Background:

This study investigated the effectiveness of enhanced cognitive awareness as a means of encouraging outdoor walking. An intervention using engagement-based strategies was compared with a more traditional walking intervention focused on developing and committing to a personalized walking schedule.

Methods:

117 adults were randomly assigned to 1 of 2 treatments—Standard Care (schedule setting, commitment) or Engagement (awareness plans)—and asked to take at least 3, 30 minute outdoor walks each week for 2 weeks. During the study period, self-report and objective measures were used to collect data on walking behavior.

Results:

Individuals in both treatment conditions reported significant increases (P < .05) in walking behavior. Participants in both treatments failed to sustain these increases at a follow-up measure 4 weeks later. However, the Engagement condition was particularly effective for those individuals who had less prior experience maintaining a walking routine.

Conclusion:

Overall, the findings suggest it may be beneficial to incorporate engagement-based strategies into existing walking interventions. Results of this study also raise the possibility that efforts to encourage cognitive awareness may make the outdoor walking experience more interesting and enjoyable.

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Dana Sirota, Dodi Meyer, Andres Nieto, Arlen Zamula, Melissa Stockwell and Evelyn Berger-Jenkins

Background:

School-based physical activity programs can reach large populations of at-risk children however evidence for the sustainability of healthy behaviors as a result of these programs is mixed. Healthy Schools Healthy Families (HSHF) is a physical activity and nutrition program for elementary students in a predominantly minority community. The program includes short teacher led classroom-based physical activities, also known as Transition Exercises (TE). Our aim was to assess whether TE was associated with children’s reported recreational physical activity outside of school.

Methods:

We surveyed HSHF students in grade 5 (n = 383) about their recreational physical activity at the start and end of the school year. Multivariable analysis was used to determine what factors including TE contributed to their reported activity.

Results:

Students were predominantly Hispanic with a mean age of 10 ± .03. There was an increase in reported recreational physical activity from the start to the end of the school year (73.6% to 82.4%, P < .05). Students who participated in more TE had a 2.75 times greater odds of reporting participation in recreational activity than students who participated in less TE.

Conclusions:

For students in HSHF, TE was significantly associated with an increase in recreational physical activity.

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Maciej S. Buchowski, Leena Choi, Karen M. Majchrzak, Sari Acra, Charles E. Matthews and Kong Y. Chen

Background:

Environmental factors including seasonal changes are important to guide physical activity (PA) programs to achieve or sustain weight loss. The goal was to determine seasonal variability in the amount and patterns of free-living PA in women.

Methods:

PA was measured in 57 healthy women from metropolitan Nashville, TN, and surrounding counties (age: 20 to 54 years, body mass index: 17 to 48 kg/m2) using an accelerometer for 7 consecutive days during 3 seasons within 1 year. PA counts and energy expenditure (EE) were measured in a whole-room indirect calorimeter and used to model accelerometer output and to calculate daily EE and intensity of PA expressed as metabolic equivalents (METs).

Results:

PA was lower in winter than in summer (131 ± 45 vs. 144 ± 54 × 103 counts/d; P = .025) and in spring/fall (143 ± 48 × 103 counts/d; P = .027). On weekends, PA was lower in winter than in summer by 22,652 counts/d (P = .008). In winter, women spent more time in sedentary activities than in summer (difference 35 min/d; P = .007) and less time in light activities (difference −29 min/d, P = .018) and moderate or vigorous activities (difference −6 min/d, P = .051).

Conclusions:

Women living in the southeastern United States had lower PA levels in winter compared with summer and spring/fall, and the magnitude of this effect was greater on weekends than weekdays.

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Marco E. Cabrera, Marvin D. Lough, Carl F. Doershuk and Georgette A. DeRivera

Cystic fibrosis (CF) patients were studied to investigate the muscles’ ability to produce and sustain high-intensity short-term exercise in this population. The patients, 17 males and 23 females, ranged from 10 to 39 years of age. Each patient performed a pulmonary function test followed by a Wingate Anaerobic Test (WAnT). Based on a pulmonary function scoring system, patients were classified as having severe, moderate, or mild lung dysfunction, or normal lung function. Percent ideal body weight was used to categorize the patients as nourished or malnourished. Two indices of anaerobic performance (peak power and mean power) were determined from the WAnT and normalized by actual weight or by ideal weight. Patients in the severe and moderate groups had lower peak power (PP) and lower mean power (MP) than those in the mild and normal groups. Similarly, malnourished patients showed a lower PP and MP than did nourished patients. These results were similar regardless of whether PP or MP were normalized by weight or ideal weight. It is concluded that the anaerobic performance (muscle power and endurance) of CF patients, as assessed by the WAnT, was related to the degree of severity of the overall disease process.