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Ikuyo Imayama, Catherine M. Alfano, Caitlin E. Mason, Chiachi Wang, Liren Xiao, Catherine Duggan, Kristin L. Campbell, Karen E. Foster-Schubert, Ching-Yun Wang and Anne McTiernan

Background:

Regular exercise increases exercise self-efficacy and health-related quality of life (HRQOL); however, the mechanisms are unknown. We examined the associations of exercise adherence and physiological improvements with changes in exercise self-efficacy and HRQOL.

Methods:

Middle-aged adults (N = 202) were randomized to 12 months aerobic exercise (360 minutes/week) or control. Weight, waist circumference, percent body fat, cardiopulmonary fitness, HRQOL (SF-36), and exercise self-efficacy were assessed at baseline and 12 months. Adherence was measured in minutes/day from activity logs.

Results:

Exercise adherence was associated with reduced bodily pain, improved general health and vitality, and reduced role-emotional scores (P trend ≤ 0.05). Increased fitness was associated with improved physical functioning, bodily pain and general health scores (P trend ≤ 0.04). Reduced weight and percent body fat were associated with improved physical functioning, general health, and bodily pain scores (P trend < 0.05). Decreased waist circumference was associated with improved bodily pain and general health but with reduced role-emotional scores (Ptrend ≤ 0.05). High exercise adherence, increased cardiopulmonary fitness and reduced weight, waist circumference and percent body fat were associated with increased exercise self-efficacy (P trend < 0.02).

Conclusions:

Monitoring adherence and tailoring exercise programs to induce changes in cardiopulmonary fitness and body composition may lead to greater improvements in HRQOL and self-efficacy that could promote exercise maintenance.

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Ruth E. Taylor-Piliae, Kathryn A. Newell, Rise Cherin, Martin J. Lee, Abby C. King and William L. Haskell

Objective:

To compare the effects of Tai Chi (TC, n = 37) and Western exercise (WE, n = 39) with an attention-control group (C, n = 56) on physical and cognitive functioning in healthy adults age 69 ± 5.8 yr, in a 2-phase randomized trial.

Methods:

TC and WE involved combined class and home-based protocols. Physical functioning included balance, strength, flexibility, and cardiorespiratory endurance. Cognitive functioning included semantic fluency and digit-span tests. Data were analyzed using intention-to-treat analysis.

Results:

At 6 mo, WE had greater improvements in upper body flexibility (F = 4.67, p = .01) than TC and C. TC had greater improvements in balance (F = 3.36, p = .04) and a cognitive-function measure (F = 7.75, p < .001) than WE and C. The differential cognitive-function improvements observed in TC were maintained through 12 mo.

Conclusion:

The TC and WE interventions resulted in differential improvements in physical functioning among generally healthy older adults. TC led to improvement in an indicator of cognitive functioning that was maintained through 12 mo.

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Danielle M. Thiel, Fatima Al Sayah, Jeff Vallance, Steven T. Johnson and Jeffrey A. Johnson

Background:

The objective was to investigate the longitudinal relationship between physical activity and health-related quality of life (HRQL) in adults with type 2 diabetes.

Methods:

Data were from a prospective cohort of adults with type 2 diabetes. Weekly moderate-to-vigorous physical activity (MVPA) was reported using the Godin Leisure-Time Physical Activity Questionnaire, and HRQL was reported using the SF-12 and 5-level EQ-5D. Participants were categorized based on current weekly MVPA recommendations. Multivariable linear regression was used to explore associations between MVPA and HRQL, and multinomial logistic regression was used to assess the direction of change in HRQL after 1 year.

Results:

Mean age of participants (N = 1948) was 64.5 ± 10.8 years and 45% were female. Participants reported a mean of 84.1 ± 172.4 min of MVPA/week, and 21% (n = 416) met weekly MVPA recommendations. MVPA was associated with differences in the physical functioning (b = 5.42; P < .001), general health (b = 2.45; P = .037), and vitality (b = 2.83; P = .016) SF-12 dimensions. Participants who met recommendations were less likely to report a decline (vs. no change) in EQ-5D index score (OR = 0.75; 95% CI [0.57, 0.99]), and SF-12 physical component summary (OR = 0.67; 95% CI [0.50, 0.90]), compared with participants not meeting recommendations.

Conclusions:

Participants who met weekly MVPA recommendations reported better physical functioning and were more likely to maintain their physical and overall HRQL over time.

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Joanna S. Kostka, Jan W. Czernicki and Tomasz J. Kostka

We assessed the relative association of quadriceps muscle strength and power as well as optimal shortening velocity (υopt) to physical functioning in 28 women aged 50–87 years with chronic osteoarthritis participating in a three-week multimodal exercise program. Quadriceps muscle strength, power, υopt, and functional performance using the Activities of Daily Living (ADL) scale, Timed Up & Go (TUG) test, Tinetti test, and 6-Minute Walking Test (6-MWT) were assessed pre- and postrehabilitation. With rehabilitation, patients improved the values of strength, power, and the results of all functional tests. Both at baseline and postrehabilitation, functional status was more strongly related to power and υopt than to strength. Functional gains obtained with rehabilitation were not related to changes in power or υopt, and only very modestly related to changes in strength. Future studies should assess the benefits and feasibility of power- and velocity-oriented training in patients with osteoarthritis.

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Jack M. Guralnik, Suzanne Leveille, Stefano Volpato, Marcia S. Marx and Jiska Cohen-Mansfield

Epidemiological studies have demonstrated that, using objective performance measures of physical functioning, disability risk can be predicted in nondisabled older adults. This makes it possible to recruit a nondisabled but at-risk population for clinical trials of disability prevention. Successful disability prevention in this population, for example through an exercise program, would have a major public health impact. To enhance the development of exercise interventions in this group it would be valuable to have additional information not available from existing epidemiologic studies. This report examines the evidence that functional limitations preceding disability can be identified in a community-dwelling population and that it is feasible to recruit these people into studies. It introduces a series of articles examining the characteristics of this population: motivators and barriers to exercise, exercise habits and preferences, the impact of positive and negative affect, and the impact of pain and functional limitations on attitudes toward exercise.

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Kathleen Benjamin, Nancy C. Edwards and Virendra K. Bharti

For seniors, an inactive lifestyle can result in declines in mental and physical functioning, loss of independence, and poorer quality of life. This cross-sectional descriptive study examined theory-of-planned-behavior, health-status, and sociodemographic predictors on exercise intention and behavior among 109 older and physically frail adults. Significant predictors of being a high versus a low active were a strong intention to continue exercising, positive indirect attitudes about exercise, and having been advised by a doctor to exercise. Findings indicate that a strong intention to continue exercising differentiates between those who report low levels and those who report high levels of physical activity. The results also highlight the salience of physician’s advice for seniors to exercise.

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Jennifer J. Heisz and Ana Kovacevic

Age-related changes in the brain can compromise cognitive function. However, in some cases, the brain is able to functionally reorganize to compensate for some of this loss. The present paper reviews the benefits of exercise on executive functions in older adults and discusses a potential mechanism through which exercise may change the way the brain processes information for better cognitive outcomes. Specifically, older adults who are more physically active demonstrate a shift toward local neural processing that is associated with better executive functions. We discuss the use of neural complexity as a sensitive measure of the neural network plasticity that is enhanced through exercise. We conclude by highlighting the future work needed to improve exercise prescriptions that help older adults maintain their cognitive and physical functions for longer into their lifespan.

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L. Jerome Brandon, Lisa W. Boyette, Adreinne Lloyd and Deborah A. Gaasch

The purpose of this study was to evaluate the effects of a 24-month moderate-intensity resistive-training intervention on strength and function in older adults. A repeated-measures experimental research design was employed as a sample of 55 apparently healthy, older, community-dwelling volunteers (30 exercisers—25 women and 5 men; 25 comparisons—16 women and 9 men) were evaluated for strength of 5 muscle groups that influence lower extremity movement and physical function. Strength and function were evaluated at 6-month intervals. The findings from this study indicate that a moderate-intensity resistive-training program increases strength in older adults and that the strength benefits are retained for the duration of the intervention. Furthermore, a long-term strength-training program can increase independent-function skills in older adults and might therefore aid in prolonging functional independence.

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Carrie S. Baker, Jennifer M. Medina McKeon and Ellen L. Usher

Self-efficacy of balance, a psychological characteristic, may provide information regarding psychological risk factors for lower-extremity injury. Validated instruments to assess self-efficacy of balance do not currently exist. The objective of this study was to determine the face and content validity of the Self-Efficacy of Balance Scale (SEBS) for an adolescent population, as well as content validity, construct and convergent validity of the overall instrument. A series of panelists (n = 11) assessed proposed items for face and content validity for self-efficacy of balance. Construct and convergent validity were assessed with active college individuals (n = 74) and female high school basketball athletes (n = 57). Original items were revised to 21 items. Panelists validated both face and content validity of the SEBS. All items were assessed to have the construct of self-efficacy. Evidence of convergent validity supported the proposed construct of self-efficacy, and was found to be relevant to the physical functioning of a young, active population.

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Christopher A. Shields, David M. Paskevich and Lawrence R. Brawley

This article presents three studies representing the development stages of a theoretically driven measure employed to assess the frequency of use of the self-presentational strategy of self-handicapping in exercise contexts (Self-Handicapping Exercise Questionnaire: SHEQ). First a pilot study was conducted to examine the nature of the phenomenology of self-handicaps reported in exercise settings. Study 2 involved item creation, item trimming, and model confirmation. Study 3 concerned factorial validation, cross-validating the self-handicapping measure created in the second study. The outcome was a 20-item measure assessing self-handicapping claims in exercise. The results of both model-testing studies indicated three unique and stable factors addressing self-handicapping claims about making exercise a routine, training in an exercise facility, and healthy physical functioning. Self-handicapping responses were not moderated by gender, age, or exercise setting. Further use and development of the SHEQ is discussed.