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Hadas Gabizon, Yan Press, Ilia Volkov and Itshak Melzer

Objectives:

To evaluate the effect of a group-based Pilates training program on balance control and health status in healthy older adults.

Design:

A single-blind, randomized, controlled trial.

Setting:

General community.

Participants:

A total of 88 community-dwelling older adults (age 71.15 ± 4.30 years), without evidence of functional balance impairment, were recruited and allocated at random to a Pilates intervention group (n = 44) or a control group (n = 44).

Intervention:

The Pilates intervention group received 36 training sessions over three months (3 sessions a week), while the control group did not receive any intervention.

Outcome measures:

Standing upright postural stability, performance-based measures of balance, and self-reported health status was assessed in both groups at baseline and at the end of the intervention period.

Results:

Compared with the control group, the Pilates intervention did not improve postural stability, baseline functional measures of balance, or health status.

Conclusions:

The results suggest that because Pilates training is not task specific, it does not improve balance control or balance function in independent older adults.

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Joanna Edel McHugh and Brian A. Lawlor

Background:

Perceived health status does not always reflect actual health status. We investigated the association between objective and self-rated measures of health status and hours of exercise per week in older adults.

Method:

As part of the TRIL clinic assessment, we gathered information from 473 community dwelling adults over the age of 65, regarding hours spent per week exercising, depression, personality, perceived health status, and objective health status (in the form of a comorbidity count). Regression analyses were performed on these data to investigate whether perceived health status, objective health status, personality and mood are associated with hours of exercise per week.

Results:

Perceived and objective health status were significantly but weakly correlated. Both perceived and objective health status, as well as depression, were independently associated with hours of exercise per week.

Conclusions:

We conclude that exercise uptake in older adults is contingent on both perceived and objective health status, as well as depression. Perceived health status has a stronger association with exercise uptake in older adults with lower depression levels. The current findings have implications for designing exercise interventions for older adults.

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Sarah Kozey Keadle, Shirley Bluethmann, Charles E. Matthews, Barry I. Graubard and Frank M. Perna

Background:

This paper tested whether a physical activity index (PAI) that integrates PA-related behaviors (ie, moderate-to-vigorous physical activity [MVPA] and TV viewing) and performance measures (ie, cardiorespiratory fitness and muscle strength) improves prediction of health status.

Methods:

Participants were a nationally representative sample of US adults from 2011 to 2012 NHANES. Dependent variables (self-reported health status, multimorbidity, functional limitations, and metabolic syndrome) were dichotomized. Wald-F tests tested whether the model with all PAI components had statistically significantly higher area under the curve (AUC) values than the models with behavior or performance scores alone, adjusting for covariates and complex survey design.

Results:

The AUC (95% CI) for PAI in relation to health status was 0.72 (0.68, 0.76), and PAI-AUC for multimorbidity was 0.72 (0.69, 0.75), which were significantly higher than the behavior or performance scores alone. For functional limitations, the PAI AUC was 0.71 (0.67, 0.74), significantly higher than performance, but not behavior scores, while the PAI AUC for metabolic syndrome was 0.69 (0.66, 0.73), higher than behavior but not performance scores.

Conclusions:

These results provide empirical support that an integrated PAI may improve prediction of health and disease. Future research should examine the clinical utility of a PAI and verify these findings in prospective studies.

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Pablo Antonio Valdés-Badilla, Carlos Gutiérrez-García, Mikel Pérez-Gutiérrez, Rodrigo Vargas-Vitoria and Antonio López-Fuenzalida

) and the other by the Senior Center of the municipality of Berisso, Buenos Aires, Argentina ( Marin et al., 2009 ). Table 1 Characteristics of Studies Examining the Effects of Physical Activity Governmental Programs on Health Status in Independent Older Adults PA volume Study, country (study score) a

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Thomas R. Wójcicki, Amanda N. Szabo, Siobhan M. White, Emily L. Mailey, Arthur F. Kramer and Edward McAuley

Background:

The purpose of this study was to assess the extent to which participation in a 12-month exercise program changed the degree of importance that older adults attached to physical activity. In addition, associations among changes in physical activity importance and health-related and psychosocial outcomes were examined.

Methods:

Community-dwelling older adults (N = 179) were recruited to participate in a 12-month exercise trial examining the association between changes in physical activity and fitness with changes in brain structure and psychological health. Participants were randomly assigned to a walking condition or a flexibility, toning, and balance condition. Physical, psychological, and cognitive assessments were taken at months 0, 6, and 12.

Results:

Involvement in a 12-month exercise program increased the importance that participants placed on physical activity; this positive change was similar across exercise condition and sex. Changes in importance, however, were only associated with changes in physical health status and outcome expectations for exercise midway through the intervention. There were no significant associations at the end of the program.

Conclusions:

Regular participation in physical activity can positively influence the perceived importance of the behavior itself. Yet, the implications of such changes on physical activity-related outcomes remain equivocal and warrant further investigation.

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Zhang Ying, Liu Dong Ning and Liu Xin

Background:

Seldom studies are about the relationship between built environment and physical activity, weight, and health outcome in meso- and microscales.

Methods:

1100 residents aged 46 to 80 were recruited from 80 neighborhoods of 13 selected communities of Shanghai, China. An analysis of the relationship between dependent variables (physical activity, Body Mass Index [BMI], overweight/obesity, weight, and health outcomes) and independent variables (involved a geographic-information-system-derived measure of built environment) was conducted with hierarchical linear models.

Results:

Street connectivity was positively associated with physical activity (P < .01). River proximity was inversely related with overweight/obesity (P = .0220). Parkland and square proximity have a significant relationship with physical activity (P = .0270, .0010), BMI (P = .0260, .0130), and overweight/obesity (P = .0020, .0470). Land-use mix was positively associated with physical activity (P < .01) and inversely associated with BMI (P = .0240) and overweight/obesity (P = .0440). Green and open spaces were positively related with BMI (P < .01) and health status (P < .01). For residential style, residents living in a village were more likely to have a lower BMI and overweight/obesity than those living in an urban old or newer residential building. The direct effect of square proximity is much stronger than the indirect effect on BMI through physical activity.

Conclusions:

The findings can help planners build more pedestrian-friendly communities. They are also useful for creating interventions that are sensitive to possible environmental barriers to physical activity in older adults.

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Claire Peel, Carolyn Utsey and Jan MacGregor

This study aimed to evaluate the effects of an 8-week supervised exercise program on physiological measurements during treadmill walking, muscle strength, functional performance, and health status in older adults limited in physical function. Twenty-four participants were randomly assigned to an exercise group (EG, N = 13) or a control group (CG, N = 11), and were evaluated before and after the exercise program (EG) or 8-week period (CG). Evaluations included a progressive treadmill lest, strength testing, the Physical Performance Test (PPT), and the SF-36 Health Survey. The exercise program consisted of 3 sessions per week of brisk walking and strengthening exercises. The EG demonstrated increases in cardiorespiratory fitness and increases in treadmill walking time. The EG also demonstrated increases in force production in 3 of the 6 muscle groups that were tested. Both the EG and CG demonstrated improvements in PPT scores and in 2 health concepts on the SF-36 Health Survey.

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Alison R. Snyder, Jessica C. Martinez, R. Curtis Bay, John T. Parsons, Eric L. Sauers and Tamara C. Valovich McLeod

Context:

Patient-oriented outcome measures such as the Medical Outcomes Short Form (SF-36) and the Pediatric Outcomes Data Collection Instrument (PODCI) are important tools for determining the impact of events like sport-related injury on health-related quality of life (HRQoL). Unfortunately, there are no published studies using these instruments that compare adolescent athletes with their nonathlete peers, making interpretations of these measures in this population difficult.

Objective:

To compare HRQoL in adolescent athletes and nonathletes using 2 common instruments.

Design:

Cross-sectional.

Setting:

7 high schools.

Participants:

219 athletes and 106 nonathletes.

Intervention:

None.

Main Outcome Measures:

The SF-36 and the PODCI were completed in a counterbalanced manner during 1 session. Dependent variables included the 8 subscale and 2 composite scores of the SF-36 and the 5 subscale scores and 1 global score of the PODCI.

Results:

On the SF-36, athletes reported higher scores on the physical function, general health, social functioning, and mental health subscales and the mental composite score and lower scores on the bodily pain subscale than nonathletes. On the PODCI, athletes reported higher scores on the sport and physical function and happiness subscales and lower scores on the pain/comfort subscale.

Conclusions:

Athletes reported higher scores on a number of SF-36 and PODCI subscales related to mental, emotional, and physical well-being than nonathletes. Our findings suggest that athletic involvement may be a benefit to the overall health status of adolescents and imply that athletes may be a distinct adolescent group requiring their own normative values when using the SF-36 and PODCI.

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Alain Varray and Alain Varray

The aim of this paper is to show how pertinent pathophysiological bases have been built for physical activity prescription for individuals with obstructive pulmonary disease (asthma and chronic obstructive pulmonary disease). The pathophysiological bases were constructed by taking into account exercise mismatching, which was analyzed in terms of both short- and long-term impact on disease outcome. Specific exercise adaptations based on a keen understanding of the underlying physiological processes provided the key to an adapted intervention with well-defined exercise program aims. The results that were achieved are striking, and one might conclude that sometimes exercise is simply the best way to improve the general well-being of individuals with chronic disease. Since this is a major concern for health professionals and chronically ill individuals, physical activity offers a means to rise to this challenge.

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Robin Puett, Jane Teas, Vanesa España-Romero, Enrique Garcia Artero, Duck-chul Lee, Meghan Baruth, Xuemei Sui, Jessica Montresor-López and Steven N. Blair

Background:

The importance of physical activity for health is well-established. Questions remain whether outdoor exercise additionally benefits overall mental and physical well-being.

Methods:

Using cross-sectional data from the Aerobics Center Longitudinal Study, we examined relationships of physical activity environment (PAE) with reported tension, stress, emotional outlook, and health.

Results:

11,649 participants were included. 18% exercised indoors, 54% outdoors, and 28% in both. Participants who exercised partially or entirely outdoors exercised more. In fully adjusted models, for women combined PAE was protective for worse emotional outlook (OR: 0.72; 95% CI: 0.52–0.98). Combined PAE was also protective for reported poor health (OR for women: 0.63; 95% CI: 0.44–0.91; OR for men: 0.75; 95% CI: 0.61–0.92). Amount of physical activity modified PAE relationships with outcomes. Combined and outdoor PAE were more consistently protective for worse outcomes among high activity participants. Regardless of PAE, better outcomes were observed in active versus inactive participants.

Conclusion:

The current study suggests addition of outdoor PAE may be linked with better stress management, outlook and health perceptions for more active populations, whereas indoor PAE may be more important for low active populations. Further research should examine the order of causation and whether type of outdoor PAE (eg, urban, natural) is important.