Performance enhancement is a multibillion dollar industry, with little known about the efficacy or safety of many practices. Many sport governing bodies have banned certain equipment, supplements, and drugs, yet, some athletes use anyway. This use may pose a danger to the individual user, as well as to other participants, and can challenge the integrity of the sport. We must consider how we, as health care professionals, balance personal autonomy, individual safety, and the integrity of sport in fulfilling our social contract.
Katherine R. Newsham
Ítalo R. Lemes, Rômulo A. Fernandes, Bruna C. Turi-Lynch, Jamile S. Codogno, Luana C. de Morais, Kelly A.K. Koyama and Henrique L. Monteiro
.4, €1.9, and €4.8 million in Germany, Spain, and Italy, respectively. In addition, this estimate is expected to rise by 59%, 179%, and 157% by 2020. 12 Although there are few studies investigating health care expenditures directly related to MetS, several studies have investigated the economic burden
Michelle Y. Martin, M. Paige Powell, Claire Peel, Sha Zhu and Richard Allman
This study examined whether leisure-time physical activity (LTPA) was associated with health-care utilization in a racially diverse sample of rural and urban older adults. Community-dwelling adults (N = 1,000, 75.32 ± 6.72 years old) self-reported participating in LTPA and their use of the health-care system (physician visits, number and length of hospitalizations, and emergency-room visits). After controlling for variables associated with health and health-care utilization, older adults who reported lower levels of LTPA also reported a greater number of nights in the hospital in the preceding year. There was no support, however, for a relationship between LTPA and the other indicators of health-care utilization. Our findings suggest that being physically active might translate to a quicker recovery for older adults who are hospitalized. Being physically active might not only have health benefits for older persons but also lead to lower health-care costs.
Robert H. DuRant and Albert C. Hergenroeder
During the 1993 International Consensus Conference on Physical Activity Guidelines for Adolescents, specific recommendations were made concerning the levels and types of physical activity in which adolescents should be encouraged to engage. This paper addresses the promotion of these guidelines by primary health care providers. Based on social cognitive theory, principles for promoting changes in health behaviors are described. Using the GAPS model (gather information, assess further, problem identification, and self-efficacy and solving barriers), methods of implementing these principles in a physician’s office are presented. Promoting physical activity in other health care settings and situations is also discussed. Primary health care providers can be effective promoters of physical activity to their adolescent patients.
Tatiana Andreyeva and Roland Sturm
Physical activity has clear health benefits but there remains uncertainty about how it affects health care costs.
To examine how physical activity is associated with changes in health expenditure for a national sample age 54 to 69 y, and estimate how this association varies across people with different chronic diseases and health behaviors.
Data were from the Health and Retirement Study, a national longitudinal survey of late middle age Americans.
Correcting for baseline differences in active and inactive groups, physical activity was associated with reduced health care costs of about 7% over 2 y (or $483 annually).
Regular physical activity in late middle age may lower health expenditure over time, and the effect is likely to be more pronounced for the obese, smokers, and individuals with some baseline health problems. While substantially large for the health care system, our estimates are much smaller than health-unadjusted comparisons or cross-sectional effects.
Lena Viktoria Kallings, Matti E. Leijon, Jan Kowalski, Mai-Lis Hellénius and Agneta Ståhle
Physical activity on prescription, as a method for increasing physical activity, has attracted attention in recent years. However, few studies have examined adherence as a primary outcome variable. The aim of this article was to examine self-reported adherence to individualized prescribed physical activity in a routine primary health care setting.
Patients receiving an individualized physical activity on prescription (FaR) for prevention or treatment of disease were recruited from 13 Swedish primary health care units. Self-reported adherence, physical activity level, readiness to change to a more physically active lifestyle, and well-being were measured with questions at baseline and after 6 months in 240 patients (mean age 51, range 12 to 80, 75% women).
At the 6-month follow-up a majority (65%) of the patients reported adherence to the prescription. Partial adherence was reported by 19% and nonadherence by 16%. There was a relationship between adherence and well-being and stages of action or maintenance.
The results demonstrate that adherence to physical activity on prescription is as good as adherence to other treatments for chronic diseases. This is significant because even a small increase in physical activity is important both on an individual level and for public health.
Priscila M. Nakamura, Camila B. Papini, Inaian P. Teixeira, Alberto Chiyoda, Eliete Luciano, Kelly Lynn Cordeira and Eduardo Kokubun
Interventions in primary health care settings have been effective in increasing physical fitness. In 2001, the Programa de Exercício Físico em Unidades de Saúde (Physical Exercise in Health Primary Care Program—PEHPCP) was launched in Rio Claro City, Brazil. The intervention consisted of biweekly, 60-minute group sessions in all primary health care settings in the city. This study evaluated the effect of PEHPCP on physical fitness and on the aging process after a decade of ongoing implementation.
There were 409 women (50 ± 26 y old) and 31 men (64 ± 10 y old) who were eligible for this study. Every 4 months, participants completed the American Alliance for Health, Physical Education, Recreation and Dance standardized tests.
Program participation was associated with a reduced effect, compared with baseline, of the natural decline of physical fitness caused by aging, as represented by changes in the following measures: coordination test time, −0.44 seconds; agility and dynamic balance test time; −1.81 seconds; aerobic capacity test time, 3.57 seconds; and muscle strength exercises, +0.60 repetitions. No significant effect on flexibility was found.
The PEHPCP showed potential in improving muscle strength, coordination, aerobic capacity, and agility and dynamic balance in participants and in maintaining flexibility in participants.
Physical inactivity continues to be a significant public health issue for middle-aged and older adults. This review focuses on physical activity interventions targeting older adults in health care settings. The literature in this area is limited and the results to date disappointing. Much remains to be done to develop effective interventions targeting older adults, especially those from underserved groups. Attention also needs to be paid to maintenance of initial treatment gains and to linking primary-care-based physical activity interventions to community-based resources. Recognition in the social and behavioral sciences of the importance of social-environmental influences on health and health behaviors mandates both a multidisciplinary and a multilevel intervention approach to the problem of physical inactivity.
Brianne L. Foulon, Valérie Lemay, Victoria Ainsworth and Kathleen A. Martin Ginis
The purpose of this study was to determine preferences of people with spinal cord injury (SCI) and health care professionals (HCP) regarding the content and format of a SCI physical activity guide to support recently released SCI physical activity guidelines. Seventy-eight people with SCI and 80 HCP completed a survey questionnaire. Participants with SCI identified desired content items and their preferences for format. HCP rated the helpfulness of content items to prescribe physical activity. All content items were rated favorably by participants with SCI and useful by HCP. The risks and benefits of activity and inactivity, and strategies for becoming more active, were rated high by both samples. Photographs and separate information for those with paraplegia versus tetraplegia were strongly endorsed. These data were used to guide the development of an SCI physical activity guide to enhance the uptake of physical activity guidelines for people with SCI. The guide was publically released November 11, 2011.