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Yoshinori Fujiwara, Shoji Shinkai, Shuichiro Watanabe, Shu Kumagai, Takao Suzuki, Hiroshi Shibata, Tanji Hoshi and Toru Kita

This study investigated the effect of chronic medical conditions on changes in functional capacity in Japanese older adults. Participants comprised 1,518 people aged 65-84 living in an urban and a rural community. They were interviewed to determine the presence of chronic medical conditions and assessed for functional capacity using the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence. Follow-up occurred 4 years later. Statistical analysis revealed that self-reported medical conditions at baseline contributed to declines in the TMIG Index over the 4 years, even after participants’ age, sex, educational attainment, and baseline TMIG level were controlled for. In the urban area, chronic obstructive pulmonary disease, diabetes mellitus, and musculoskeletal disease significantly predicted decline in the index, whereas in the rural area, hypertension and diabetes mellitus were significant predictors. These results indicate the importance of controlling chronic medical conditions in order to prevent further declines in functional capacity in older adults.

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Keith Naugle, Christine Stopka and Jessica Brennan

Column-editor : G. Monique Butcher Mokha

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Keith Naugle, Christine Stopka and Jessica Brennan

Column-editor : G. Monique Mokha

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Keith Naugle, Christine Stopka and Jessica Brennan

Column-editor : G. Monique Butcher Mokha

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Keith Naugle, Christine Stopka and Jessica Brennan

Column-editor : G. Monique Butcher Mokha

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Arya M. Sharma, Donna L. Goodwin and Janice Causgrove Dunn

Dr. Arya M. Sharma challenges the conventional wisdom of relying simply on “lifestyle” approaches involving exercise, diet, and behavioral interventions for managing obesity, suggesting that people living with obesity should receive comprehensive medical interventions similar to the approach taken for other chronic diseases such as Type 2 diabetes or hypertension. He purports that the stigma-inducing focus on self-failing (e.g., coping through food, laziness, lack of self-regulation) does not address biological processes that make obesity a lifelong problem for which there is no easy solution. Interdisciplinary approaches to obesity are advocated, including that of adapted physical activity. Physical activity has multifaceted impacts beyond increasing caloric expenditure, including improved sleep, better mood, increased energy levels, enhanced self-esteem, reduced stress, and an enhanced sense of well-being. The interview with Dr. Sharma, transcribed from a keynote address delivered at the North American Adapted Physical Activity Symposium on September 22, 2016, in Edmonton, AB, Canada, outlines his rationale for approaching obesity as a chronic disease.

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David M. Kahler

The complaint of persistent low back pain in an athlete is usually related to an identifiable structural disorder. As with all other medical conditions, effective treatment relies on an accurate diagnosis. Certain sporting activities are associated with characteristic acquired lesions; this knowledge, when combined with a thorough history and physical examination, will often dictate when the clinician should refer an athlete for further testing. Most causes of back pain in athletes can be treated nonsurgically if they are identified early and treated appropriately. The common congenital abnormalities, acquired conditions, and overuse syndromes causing low back pain in athletes will be discussed, along with appropriate diagnostic tests and treatment regimens.

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Sheila A. Dugan, Susan A. Everson-Rose, Kelly Karavolos, Barbara Sternfeld, Deidre Wesley and Lynda H. Powell

Background:

This study was done to determine whether physical activity at baseline is independently associated with musculoskeletal pain and fulfilling one’s physical role over 3 subsequent years.

Methods:

Our research involved a 3-year longitudinal study of over 2400 community-dwelling, midlife women from the Study of Women’s Health Across the Nation (SWAN). Measurements included baseline physical activity using the Kaiser Permanente Health Plan Activity Survey and SF-36 role-physical and bodily pain indices at each of 3 annual follow-up visits.

Results:

Each 1-point increase on the physical activity score was associated with a 7% greater likelihood of a high role-physical score (95% CI = 1.02– 1.13) and a 10% greater likelihood of a low bodily pain score (95% CI = 1.04–1.17) after adjusting for age, race, menopausal status, educational level, body mass index, depressive symptoms, smoking, and chronic medical conditions. The association between physical activity level and role-physical score was eliminated in the fully adjusted model after adjustment for pain level in post hoc analysis [OR = 1.04 (95% CI = 0.98–1.09)].

Conclusion:

This study demonstrates that women who are more physically active at midlife experience less bodily pain over time regardless of menopausal status, sociodemographics, and medical conditions. Higher physical activity level positively impacts fulfilling one’s physical role; however, this is mediated by pain level.

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Martin E. Block

The effects of Down syndrome (DS) on motor development have been widely reported over the years, particularly with the profusion of research in the past 10 years. Although more research is needed to fully understand the relationship between DS and motor development, there is a need to synthesize the current findings. Henderson (1985, 1986) and Reid (1985) reviewed the literature regarding the motor development of children with DS. While Henderson’s review was extremely well done, certain recent studies can add to our understanding of the motor characteristics of these children. Furthermore, Henderson did not examine factors such as cardiac, anatomical, and sensory deficits that can affect motor development. Therefore this paper reviews the extant literature regarding the motor development of children with DS in terms of health and medical conditions that can affect this development as well as the motor development of infants and all others with DS. Finally, implications for future research and programming are discussed.

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David R. Bassett, Patty S. Freedson and Dinesh John

In recent years, there has been tremendous growth in the use of wearable activity trackers in biomedical research. Activity trackers are also becoming more popular with consumers, who are able to share their data with researchers and practitioners. Steps per day is a useful variable that is estimated from most wearable activity trackers. It has intuitive meaning, is strongly associated with health variables, and has the potential to be standardized across devices. Activity trackers and other wearable medical devices could provide new information on health-related behaviors and their interaction with genetic and environmental variables. If integrated into medical practice, wearable technologies could help motivate patients to change their health behaviors and might eventually be used to diagnose medical conditions. The convergence of wearable medical devices, computer applications, smart phones, and electronic medical records could influence the practice of lifestyle medicine.