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Bernardine M. Pinto, Bess H. Marcus, Robert B. Patterson, Mary Roberts, Andrea Colucci, and Christina Braun

Exercise has been shown to improve walking ability in individuals with arterial claudication. This study compared the effects of an on-site supervised exercise program and a home exercise program on quality of life and psychological outcomes in these individuals. Sixty individuals were randomly assigned to a 12-week on-site or a 12-week home-based exercise program. Quality of life, mood and pain symptoms, and walking ability were examined at baseline, posttreatment, and at 6 months follow-up. Individuals in the on-site exercise program showed significantly greater improvements in walking ability. Although sample size limited the ability to detect significant differences between groups on quality of life and psychological measures, both groups were comparable on improvements in quality of life and in mood. These data suggest that a home exercise program with weekly feedback may provide improved quality of life and mood benefits for individuals with arterial claudication but does not provide improvements in walking equivalent to those provided by an on-site exercise program.

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Sharon L. Olson, Shu-Shi Chen, and Ching-Yi Wang

Objective:

To determine exercise efficacy in improving dynamic balance in community-dwelling elderly with a fall history.

Methods:

Thirty-five participants were randomly assigned to a treatment (TG; n = 19, 77 ± 7 yr) or control group (CG; n = 16, 75 ± 8 yr). The TG received an individualized home exercise program, and the CG received phone calls twice per week for 12 weeks. Participants’ dynamic-balance abilities— directional control (DC), endpoint excursion (EE), maximum excursion (ME), reaction time (RT), and movement velocity (MV)—were measured using the Balance Master at 75% limits of stability. Functional reach (FR) was also measured.

Results:

At 12 weeks the TG demonstrated significant improvements in DC (p < .0025), EE (p < .0005), and ME (p < .0005), but the CG did not. No significant group differences were found for MV, RT, or FR.

Conclusions:

Excursion distances and directional control improved but not reaction time, suggesting that exercises requiring quick responses may be needed.

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Eleftherios Paraskevopoulos, Georgios Gioftsos, Georgios Georgoudis, and Maria Papandreou

exercise. Increased motivation has been found to positively affect attendance at rehabilitation sessions, completion of prescribed treatment protocols, self-rated adherence, and self-reported home exercise completion in competitive athletes and RA with musculoskeletal injuries ( Brewer et al., 2000 , 2003

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C. Shanthi Jacob Johnson, Anita M. Myers, Lynn M. Scholey, Elizabeth V. Cyarto, and Nancy A. Ecclestone

The Home Support Exercise Program (HSEP) targets frail older adults. After a 4-hr training workshop, home-support workers (HSWs) encourage clients to do a simple, progressive set of 10 exercises during regular visits. Exercise compliance and functional performance were examined in 60 clients who received the HSEP, compared with 38 clients whose HSWs had not received HSEP training. Both groups were primarily female, average age 82, and many of them used walking aids. The 40 HSEP clients who continued with the program over 4 months showed good compliance and significant improvement on several indicators: timed up-and-go, sit-to-stand, 6-min walk, balance confidence, and well-being. Conversely, the comparison group declined on several measures. The findings support the effectiveness of the HSEP, as well as the importance of regular and ongoing support from HSWs for this population.

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Nicholas L. Lerma, Ann M. Swartz, Taylor W. Rowley, Hotaka Maeda, and Scott J. Strath

Background:

The ill-health effects of sedentary behavior are becoming well-documented, yet older adults spend 70–80% of waking hours sedentary.

Purpose:

To determine if a portable elliptical device increases energy expenditure (EE) while performing popular seated activities.

Methods:

Twenty older adults (68.1 ± 1.4 years) participated to compare the measured EE between seated rest and three randomized seated pedaling activities: computer use, reading, TV viewing. Each pedaling activity included 5-min of self-selected paced/no resistance (SSP) and externally paced/added resistance pedaling (Paced).

Results:

A significant increase in EE existed during SSP (+1.44 ± 0.12 kcal/min) and Paced (+2.19 ± 0.09 kcal/min) pedaling relative to Seated Rest (p < .001). EE during the Paced activities was significantly greater than all SSP activities (p <.01).

Conclusion:

Extrapolating these results, pedaling at a SSP for an hour while performing seated activities is equivalent to the net EE of walking 1.6 miles. Future home-based effectiveness and feasibility should be explored.

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Tim Henwood, Sharon Hetherington, Madeleine Purss, Kevin Rouse, Julie Morrow, and Michele Smith

a low risk of falling. Participation included a baseline and follow-up assessment and regular participation in an in-home exercise program for 18 weeks. Client eligibility was discussed by HCWs with the project manager, an accredited exercise physiologist experienced in working with older people

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Thomas A. Perks

physically “inactive,” 1.5–2.99 kcal as “moderately active,” and 3 or more kilocalories as “active.” 33 Scores above 3 are equivalent to walking, gardening, or doing home exercise for at least 1 hour per day. Statistical Analysis To examine the physical activity trajectories of Canadians over time

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Joseph M. Day, Robert Barry Dale, and Elizabeth Kennedy

, with the rise in health care costs, many patients and rehabilitation specialists are opting to reduce the number of on-site visits and focus on home exercise programs (HEP). As a result, many rehabilitation specialists and patients now depend on HEPs as the primary intervention to treat LE. Focused

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Tania Pizzari, Nicholas F. Taylor, Helen McBurney, and Julian A. Feller

Objective:

To investigate the relationship between adherence to rehabilitation and outcome after reconstructive surgery of the anterior cruciate ligament (ACL).

Design:

A prospective cohort study with adherence to rehabilitation evaluated over 8 weeks correlated with outcomes at 9 and 12 months postsurgery.

Participants:

68 patients who had undergone ACL-reconstructive surgery.

Main Outcome Measures:

Adherence was measured to and during appointments and by a self-report diary of home exercise. Outcomes were measured by 6 knee-function scales and 2 hop tests.

Results:

There was a significant relationship between home-exercise adherence and many outcomes for participants under 30 years of age (r s = .33-.44). For participants age 30 and over there was a negative relationship between home-exercise adherence and outcome. There were no significant relationships between adherence to and during physical therapy appointments and outcome after ACL-reconstructive surgery.

Conclusion:

Participants under 30 years of age who adhered to their home-exercise regimen had better functional outcome, whereas adherent participants age 30 and over experienced worse outcome with better home-exercise adherence.

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Carrie B. Scherzer, Britton W. Brewer, Allen E. Cornelius, Judy L. Van Raalte, Albert J. Petitpas, Joseph H. Sklar, Mark H. Pohlman, Robert J. Krushell, and Terry D. Ditmar

Objective:

To examine the relationship between self-reported use of psychological skills and rehabilitation adherence.

Design:

Prospective correlational design.

Setting:

Outpatient physical-therapy clinic specializing in sports medicine.

Patients:

Fifty-four patients (17 women and 37 men) undergoing rehabilitation after anterior-cruciate-ligament reconstruction.

Main Outcome Measures:

An abbreviated version of the Sports Injury Survey (Ievleva & Orlick, 1991) was administered approximately 5 weeks after surgery to assess use of goal setting, imagery, and positive self-talk. Four adherence measures were obtained during the remainder of rehabilitation: attendance at rehabilitation sessions, practitioner ratings of patient adherence at rehabilitation sessions, patient self-reports of home exercise completion, and patient self-reports of home cryotherapy completion.

Results:

Goal setting was positively associated with home exercise completion and practitioner adherence ratings. Positive self-talk was positively correlated with home exercise completion.

Conclusions:

Use of certain psychological skills might contribute to better adherence to sport-injury rehabilitation protocols.