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Mikihiro Sato, James Du and Yuhei Inoue

Background:

Although previous studies supported the health benefits of physical activity, these studies were limited to individual-level research designs. Building upon a social-ecological model, we examined the relationship between physical activity and community health—the health status of a defined group of people—while accounting for the potential endogeneity of physical activity to health.

Methods:

We obtained U.S. county-level data from the 2012 Behavioral Risk Factor Surveillance System survey and the 2014 County Health Ranking Database. We first conducted an ordinary least squares (OLS) regression analysis to examine the relationship between the rate of physical activity and community health measured by the average perceived health score for each county. We then conducted a 2-stage least squares (2SLS) regression analysis to investigate this relationship after accounting for potential endogeneity.

Results:

Results from the OLS analysis indicated that the rate of physical activity was positively associated with community health. Results from the 2SLS analysis confirmed that the physical activity rate remained positively associated with community health.

Conclusions:

In line with the social-ecological model, our findings provide the first evidence for the health benefits of county-level physical activity. Our results support extant research that has shown relationships between physical activity and individual-level, health-related outcomes.

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Valéria Cristina Provenza Paschoal and Olga Maria Silverio Amancio

The purpose of this study was to evaluate the body composition, dietary intake, use of nutritional supplements, and biochemical status of 8 Brazilian male elite swimmers, aged 18–21 years, participants at a national swimming competition. Data from the athletes were obtained through a 4-day food record, a fasting blood sample, and anthropometric measurements. The anthropometric results showed that body composition was compatible with sport category. The dietary assessment showed an adequate ingestion of calories, vitamins, and mineral, with the exception of calcium, for which only half of the sample reached the recommendation. The results also indicated low carbohydrate and high protein and cholesterol intakes. Of the swimmers, 62.5% and 25% consumed synthetic aminoacids and antioxidants supplements, respectively. The biochemical indices of the nutritional status were within normal limits in all swimmers, with the exception of creatine-kinase, which was above the recommended level, indicating muscle degradation probably due to poor carbohydrate intake. In conclusion, the results suggest the importance of nutritional education to promote a balanced intake, provide all nutrients in optimal amounts, inhibit unnecessary ingestion of nutritional supplements, maintain ideal performance, and improve the swimmers’ health status.

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Lauren Waters, Marina Reeves, Brianna Fjeldsoe and Elizabeth Eakin

Background:

Several recent physical activity intervention trials have reported physical activity improvements in control group participants. Explanations have been proposed, but not systematically investigated.

Methods:

A systematic review of physical activity intervention trials was conducted to investigate the frequency of meaningful improvements in physical activity among control group participants (increase of ≥ 60 minutes [4 MET·hours] of moderate-to-vigorous physical activity per week, or a 10% increase in the proportion of participants meeting physical activity recommendations), and possible explanatory factors. Explanatory factors include aspects of behavioral measurement, participant characteristics, and control group treatment.

Results:

Eight (28%) of 29 studies reviewed reported meaningful improvements in control group physical activity, most of which were of similar magnitude to improvements observed in the intervention group. A number of factors were related to meaningful control group improvements in physical activity, including the number of assessments, mode of measurement administration, screening to exclude active participants, and preexisting health status.

Conclusions:

Control group improvement in physical activity intervention trials is not uncommon and may be associated with behavioral measurement and participant characteristics. Associations observed in this review should be evaluated empirically in future research. Such studies may inform minimal contact approaches to physical activity promotion.

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Eino Heikkinen

This paper provides a detailed description of the experimental design and chronology of the Evergreen Project, the aims of which were to profile the health and functional capacity of the elderly population of Jyväskylä, Finland, to examine changes in health and functional capacity over time, and to identify the factors related to living conditions and lifestyle that predict changes in functional capacity and health. Residents of Jyväskylä were invited to participate in a series of interviews and laboratory testing sessions. The interviews focused on (a) illnesses, the use of drugs, perceived health, symptoms, and psychosocial well-being, (b) physical and mental capacity and ADL functional capacity, (c) social togetherness and community activity, and (d) living conditions. lifestyle, and life history. The laboratory examinations assessed health status and drug use. anthropometric status, physical performance. sensory functions, perceptual-motor coordination, cognitive capacity and metacognitions. and neuropsychological functioning. A detailed breakdown of the participation and attrition rates, demographic characteristics, and normative data for each age cohort is provided.

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John T. Parsons and Alison R. Snyder

Health-related quality of life (HRQOL) is a broad, multidimensional concept that refers to a synthesis of several health domains including the physical, psychological, and social domains, all of which are affected by individual experiences, expectations, beliefs, and perceptions. HRQOL also shares a well-established connection with contemporary disablement models, which enhances its utility for identifying individual experience, expectations, and values, which can also influence the way a person views his or her health status. However, the routine evaluation of HRQOL in clinical research and patient care in the field of sport rehabilitation remains limited. HRQOL has implications for both athletes who suffer sport-related injury (SRI) and those who care for them. The purpose of this article is to help clinicians and researchers understand HRQOL as a primary outcome in sport rehabilitation. First, the article provides a definition of HRQOL and explains its relationship to contemporary disablement models. Next, research demonstrating that HRQOL is sensitive to both athletic participation and to SRI in athletes at both secondary school and college levels is reviewed. Finally, several important clinical tools that can be used to measure HRQOL by both clinicians and clinical researchers are presented. Criteria to be used in selecting these tools are also presented.

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Reinhard Fuchs, Wiebke Goehner and Harald Seelig

Background:

Little is known about the long-term effects of group intervention programs targeting physical exercise. This paper reports on the effectiveness of MoVo-LISA, a theory-based (MoVo-concept) standardized intervention program. Participants are taught cognitive-behavioral strategies of goal-setting, action planning, barrier management, and self-monitoring.

Methods:

N = 220 in-patients of an orthopedic rehabilitation clinic were assigned to the usual care group (UCG) or the intervention group (IG) (quasi-experimental design). Assessments were conducted at 5 time points.

Results:

At 12-month follow-up, level of exercise in the IG was 28.5 min/week higher than in the UCG (P = .05). Moreover, 50% of the IG was exercising for at least 60 min/week, but only 33% of the UCG (P = .01). During the 12 months after clinic discharge, patients of the IG reported the same low pain experience that they had reached at the end of the clinic stay, whereas UCG patients’ pain experience slowly reincreased.

Conclusions:

Results provide evidence that intervention programs based on the MoVo concept lead to long-term improvement in exercise behavior and health status.

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Huong Q. Nguyen, Jerald R. Herting, Ruth Kohen, Cynthia K. Perry, Andrea LaCroix, Lucile Lauren Adams-Campbell, Shirley A.A. Beresford, Charles B. Eaton and Lesley Tinker

Background:

The goals of this study were to examine 1) longitudinal trajectories of energy expenditure from recreational physical activity (PA) in postmenopausal women, 2) whether women who belong to different PA trajectories engage in different types of PA, and 3) whether baseline sociodemographic, health, psychosocial, and lifestyle characteristics predict membership in PA trajectories.

Methods:

Women from the Women’s Health Initiative Observational Study with baseline PA data (n = 92,629) were included. Physical activity, measured via self-report 6 times over 8 years, was converted to MET hr/wk for analysis. Latent growth curve mixture models and latent profile models were used to analyze longitudinal PA trajectories and cross-sectional PA composition, respectively.

Results:

Three distinct, stable PA trajectories (highly, moderately, and minimally active) were identified with nearly 75% of the women classified as minimally active (≤ 8 MET-hr/wk). The majority of women who were at least moderately active engaged in a balanced combination of walking, moderate, and vigorous PA. Sociodemographic characteristics such as income, education, and past vigorous PA were predictive of PA trajectory, as were some health status indicators (eg, body mass index), but not health related quality of life.

Conclusions:

Self-reported PA is largely stable across nearly a decade of follow-up in postmenopausal women.

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Joel C. Craddock, Yasmine C. Probst and Gregory E. Peoples

Humans consuming vegetarian-based diets are observed to have reduced relative risk for many chronic diseases. Similarly, regular physical activity has also been shown to assist in preventing, and reducing the severity of these conditions. Many people, including athletes, acknowledge these findings and are adopting a vegetarian-based diet to improve their health status. Furthermore, athletes are incorporating this approach with the specific aim of optimizing physical performance. To examine the evidence for the relationship between consuming a predominately vegetarian-based diet and improved physical performance, a systematic literature review was performed using the SCOPUS database. No date parameters were set. The keywords vegetarian OR vegan AND sport OR athlete OR training OR performance OR endurance were used to identify relevant literature. Included studies (i) directly compared a vegetarian-based diet to an omnivorous/mixed diet, (ii) directly assessed physical performance, not biomarkers of physical performance, and (iii) did not use supplementation emulating a vegetarian diet. Reference lists were hand searched for additional studies. Seven randomized controlled trials and one cross-sectional study met the inclusion criteria. No distinguished differences between vegetarian-based diets and omnivorous mixed diets were identified when physical performance was compared. Consuming a predominately vegetarian-based diet did not improve nor hinder performance in athletes. However, with only 8 studies identified, with substantial variability among the studies’ experimental designs, aims and outcomes, further research is warranted.

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Andrea T. White, C. Steven Fehlauer, Rita Hanover, Stephen C. Johnson and Robert E. Dustman

Older individuals arc more likely than younger adults to exhibit symptoms of exercise intolerance at high work rates. The risks of maximal exercise in older adults increase proportionally as the number of health difficulties increase. In this study, the effects of health status, age, and gender on older adults’ ability to attain V̇O2max are examined. Sedentary volunteers (60 women, 45 men), mean age 67 ± 5 years (range 57-78 years), participated in graded maximal exercise tests on a combined arm and leg cycle ergometer. Subjects were classified into three groups based on test termination reason: attainment of V̇O2max (MAX), symptom-limited (SX), or EKG-limited (EKG). Sixty percent of men and 40% of women were classified as MAX, while 48% of women and 27% of men were characterized as SX. Thirteen percent of men and 12% of women had EKG-limited exercise tests. Those in the EKG group reported significantly more diagnoses than subjects in the MAX group (2.7 vs. 1.4. p < .05). The number of medications reported and age of the subjects did not differ across test termination categories.

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Alison R. Snyder Valier, Elizabeth M. Swank, Kenneth C. Lam, Matthew L. Hansen and Tamara C. Valovich McLeod

Context:

Accurate assessment of health-related quality of life (HRQoL) is important for quality patient care. Evaluation of HRQoL typically occurs with patient self-report, but some instruments, such as the Pediatric Quality of Life Inventory (PedsQL), allow for proxy reporting. Limited information exists comparing patient and proxy reports of HRQoL after sport-related injury in adolescent athletes.

Objective:

To compare patient ratings and parent-proxy ratings of HRQoL in adolescent athletes who suffer musculoskeletal injuries requiring orthopedic consultation. The authors hypothesized poor agreement between patient and parent-proxy ratings of HRQoL.

Design:

Cross-sectional study.

Setting:

Orthopedic practice.

Patients:

Thirteen adolescent patients with a sport-related musculoskeletal injury requiring orthopedic consultation and 1 of their parents participated.

Interventions:

During the initial visit to the physician’s office, each patient was asked to complete the PedsQL, and the patient’s parent was asked to complete the parent-proxy version of the PedsQL.

Main Outcome Measurements:

The PedsQL is a pediatric generic outcome measure that consists of a total score and 4 subscale scores: physical, emotional, social, and school functioning. Means and standard deviations were calculated for all scores, and comparisons between patient-self report and parent-proxy ratings of HRQoL were made for the PedsQL total score and subscale scores using Pearson product–moment correlations (r).

Results:

Pearson product–moment correlations showed little to fair insignificant relationships between patient self-report and parent-proxy report of the PedsQL for the total score (r = −.1) and all subscales (range r = .1 to .4).

Conclusions:

Our results suggest a lack of agreement between patient and parent-proxy ratings of HRQoL, with patients rating their HRQoL lower than their parent. Patient perception of HRQoL may be more accurate than proxy report, which supports the use of patient-rated HRQoL in patient evaluation. Assessments of HRQoL made by proxies, even those close to the patient, may not represent patient health status.