Characteristics of physical health conditions in middle-aged and elderly joggers

To clarify the characteristics of physical health conditions in middle-aged and elderly joggers who run regularly, they were compared with middle-aged and elderly people who did not exercise routinely. The physical health conditions were investigated by a questionnaire survey sent by mail. The subjects were 316 joggers (230 men and 86 women) and 272 non-joggers (173 men and 99 women). The number of joggers having any illness was lower than that of non-joggers in both men and women. In contrast, there was no significant difference in type of illness between joggers and non-joggers. Concerning symptoms, the number of joggers who complained of lumbar pain and shoulder stiffness was low, but the number of joggers with symptoms including knee joint pain and muscle pain as well as injury was high compared to non-joggers. While the results of this study reconfirm that continuous jogging in middle-aged and elderly people may effectively improve their physical condition, based on the finding that the morbidity was low, it appears that many joggers have knee joint pain, a typical disorder due to running.

Comparison between menopause-related changes in bone mineral density of the lumbar spine and the proximal femur in Japanese female athletes: a long-term longitudinal study using dual-energy X-Ray absorptiometry

This longitudinal study examined whether bone mineral density (BMD) of the lumbar spine and the proximal femur is maintained in pre-, peri-, and postmenopausal women by regular exercise. BMD was measured using dual-energy X-ray absorptiometry (DXA). Twenty-six Japanese women (mean age 47.8 years) were followed 4-5 years. Twenty-two subjects from volleyball or jogging clubs had participated in the same exercise for more than 5 years at the initial BMD measurement. Longitudinally, for these 22 athletes, the rate of change per year in BMD of the lumbar spine was -0.17% in the premenopause group and -2.60% in the perimenopause group. In the proximal femur of the athletes, BMD increased (rate of increase per year 1.80%) in the premenopause group, but decreased (rate of decrease per year 1.07%) in the perimenopause group. In the premenopause group, BMD of the proximal femur increased in all athletes. However, in the proximal femur, the nonexercise group showed a 0.31% decrease, a significant difference (P < 0.05) compared with the athletes. These findings suggest that women can achieve continuous gains in bone mass in the proximal femur before menopause by regular intense exercise. However, continued high-level physical activity in the perimenopausal women was not able to prevent bone loss.

Biomarkers of lung inflammation in recreational joggers exposed to ozone

Humans exhibit an acute inflammatory response in the lungs after controlled laboratory exposure to ozone. The present study was designed to test whether biomarkers of inflammation are detectable in humans exposed to ozone and associated copollutants under natural conditions outdoors. Bronchoscopy with bronchoalveolar lavage (BAL) was carried out on 19 normal volunteer joggers from Governors Island, NY, who exercised in the afternoon during the 1992 summer (S1) season. Fifteen subjects were retested during the following, low ozone, winter season (W). The BAL protocol involved an initial instillation of 20 ml saline followed by four sequential 50-ml saline washes carried out in both the right middle lobe and the lingula. The eight 50-ml samples were pooled as the 'alveolar' sample. Analyses performed on the alveolar lavage samples included cell differentials, release of IL-8, TNF-alpha, and reactive oxygen species (ROS) by pooled cells, and levels of IL-8, protein, LDH, fibronectin, alpha1-antitrypsin (alpha1-AT), complement fragment 3a (C3a), and prostaglandin E2 (PGE2) in lavage fluids. Release of ROS by stimulated BAL cells was lower in S1 than in W (p = 0.03). In contrast, LDH levels in BAL fluids were 2-fold higher in S1 than in W (p = 0.02), as were IL-8 (p = 0.12) and PGE2 (p = 0.06). These results suggest a possible ongoing inflammatory response in the lungs of recreational joggers exposed to ozone and associated copollutants during the summer months.

Exercise in middle-aged adults: self-efficacy and self-presentational outcomes

BACKGROUND

Whereas self-efficacy expectations have been identified as important determinants of exercise participation patterns, little empirical work that examines efficacy expectations as outcomes of exercise participation or their theoretical relationship to other psychological outcomes associated with exercise has been conducted. In the context of middle-aged males and females, the present study attempted to integrate social cognitive and impression management perspectives with respect to anxiety associated with exercise.

METHODS

Formerly sedentary subjects participated in a 5-month exercise program with assessments of physique anxiety, efficacy, outcome expectations, and anthropometric variables prior to and following the program.

RESULTS

Both acute bouts and long-term participation in exercise resulted in significant increases in self-efficacy. In turn, these changes in efficacy and initial positive outcome expectations were significant predictors of reductions in physique anxiety, even when controlling for the influence of gender and reductions in body fat, weight, and circumferences.

CONCLUSIONS

The findings are discussed in terms of the implications for structure and content of exercise environments and the utility of the proposed theoretical integration. Strategies for enhancing beliefs regarding health and fitness outcomes associated with exercise rather than appearance outcomes may be required to maximize reductions in negative body image.

The effects of mild, moderate, and severe exercise on intraocular pressure in glaucoma patients

BACKGROUND

Previous studies have shown a reduction in intraocular pressure (IOP) from many means of exertion, ranging from walking to exhausting exercise in both normal and glaucoma subjects. The variability in their results may be due to several variables that can affect IOP significantly.

PURPOSE

To investigate the effects of common means of exertion on IOP in normal and glaucoma subjects, after elimination of factors that can affect IOP.

SUBJECTS AND METHODS

The effects of walking, jogging, and running fast until exhaustion on IOP were noted in seven normal and seven open-angle glaucoma subjects. Intraocular pressures were measured with the Goldmann applanation tonometer during and after exercise.

RESULTS

The mean differences between before and after walking, jogging, and running exercises were -2.43 +/- 0.30, -3.85 +/- 0.55, and -4.0 +/- 0.37 mmHg in normal subjects. In glaucoma patients these differences were -7.72 +/- 1.25, -10.86 +/- 2.12, and -12.86 +/- 2.05 mmHg, respectively. After 5 min of walking and jogging, in all subjects, IOP decreased significantly (by 56 to 61% of total decreases).

CONCLUSION

Regardless of the means of exertion, in every subject tested there was a drop in intraocular pressure. Glaucoma patients had a greater drop and longer duration of post-exercise recovery as compared to normal subjects. It would seem reasonable, at present, not to discourage patients who have glaucoma from light exercises such as walking; perhaps, on the contrary, it should be encouraged.

Exercise induced anaphylaxis: one more cause for syncope

Syncope is a very common problem. Young people who exercise regularly are considered to be in "good health, " when they complain of passing out during exercise, it must be treated as a serious condition. Exercise Induced Anaphylaxis (EIA) is a well known cause for syncope in sports medicine and allergy literature. A patient's history is critical in making this diagnosis. With the current exercise boom, internists and family practitioners need to be even more aware of EIA when patients complain of syncope with physical activity.

Stepwise analysis of the calibration procedure of an accelerometer-based pacemaker

The rate modulation of Relay 294-03 is individually adjusted during a 3-minute calibration test corresponding to the collection of moderate acceleration signals (MAL), which are related to a programmable moderate pacing rate (PR). Those rate/acceleration values form a calibration point in the flat part of the rate response curve (RRC). To help in a more clinically oriented analysis of this feature, the stimulator was first calibrated while strapped on a volunteer who remained seated (low MAL), walked (medium MAL), or jogged (high MAL). The device was then mechanically submitted to three calibrated to and fro movements corresponding to the sensitivity spectrum of the sensor. Each movement was repeated ten times to test the influence of the slope (1-10).

RESULTS

(1) One-way ANOVA significant effect of the MAL recorded during the calibration test on subsequent rate modulation (P = 0.0001); (2) The sensor amplifier gain was inversely related to the MAL: high MAL induced lower amplifier gain and lower PR for identical accelerations; (3) Lower amplifier gain allowed to discriminate highest acceleration magnitudes before reaching an overflow of the sensor; (4) The maximum achievable PR increased not only with the programmed slope, but also with decreasing MAL (P = 0.0055): a low MAL shifts to the left calibration point located on the part of the RRC and makes the last steep part of the RRC start earlier, thus leading to higher maximum achievable PR. In conclusion the calibration procedure is crucial not only in defining a moderate acceleration intensity but also in determining the sensor amplifier gain and the maximum achievable PR.

Identification of patients at risk during swimming by Holter monitoring

Cardiac arrest during swimming accounts for a considerable number of deaths during physical exercise in patients with coronary artery disease. A link between ST-segment depression and cardiac arrest has been observed in previous studies. In this study, exercise-induced myocardial ischemia was assessed in 23 patients with coronary artery disease by bipolar Holter monitoring during swimming, jogging, and treadmill testing. During treadmill testing, Holter monitoring and standard electrocardiograms were simultaneously recorded. Detection of ST-segment depression during swimming was standardized in a group of normal volunteers (n = 7). All patients with silent myocardial ischemia (n = 8) documented by thallium-201 scintigraphy had ST-segment depression during treadmill testing and swimming when recorded by Holter monitoring, whereas the standard electrocardiogram during treadmill testing was negative in 5 patients. Heart rate at 1 mm ST-segment depression was significantly lower during swimming (110 +/- 11 beats/min) than during treadmill testing (documented by standard electrocardiogram) (133 +/- 23 beats/min, p < 0.002) and jogging (125 +/- 21 beats/min, p < 0.03). However, there was no significant difference in heart rate at onset of angina pectoris in symptomatic patients, suggesting a delayed sensation of ischemic symptoms during swimming. The only clinical event in our group during 8 years of swimming occurred during this study. One patient with silent myocardial ischemia developed ST-segment depression during swimming that degenerated into ventricular fibrillation, requiring resuscitation. Therefore, Holter monitoring can be considered a valuable addition in identifying patients with silent myocardial ischemia during swimming, and thus identifying patients at risk for exertion-related life-threatening ventricular tachyarrhythmias.

Physical activity patterns among adults in Georgia: results from the 1990 Behavioral Risk Factor Surveillance System

Regular physical activity increases a person's ability to perform daily activities more efficiently, reduces the risk of specific chronic diseases, including coronary artery disease, and lowers death rates in general. The Healthy People 2000 Physical Activity and Fitness Objectives underscored the importance of monitoring and tracking the prevalence of physical activity and fitness in the United States population for the purpose of planning, implementing, and evaluating efforts to improve the public's physical activity habits. This report examines the prevalence of self-reported leisure-time physical activity (LTPA) among southeastern adults aged 18 years and older living in the state of Georgia. Using data from the 1990 Behavioral Risk Factor Surveillance System (BRFSS) surveys from Georgia, we describe the LTPA patterns of Georgia adults aged 18 years and older. A total of 1,723 adults were interviewed during 1990. Results show the following: women are less active than men, blacks are less active than whites, persons of lower socioeconomic status (SES) are less active than those of higher SES, and older adults are less active than younger adults. These results suggest that a more concerted effort needs to be made in promoting physical activity for women, persons of lower SES, and older adults.

The comparative efficacy of antecedent exercise and methylphenidate: a single-case randomized trial

This study evaluated the comparative efficacy of antecedent exercise, methylphenidate (Ritalin), and placebo in the reduction of hyperactive behaviour in a pre-school boy. A single-case alternating treatments experimental design was employed for a total of 82 days. The dependent variable was the Conners' Abbreviated Symptom Questionnaire. Antecedent exercise failed to reduce hyperactive behaviour. Methylphenidate produced significantly less hyperactive behaviour than both placebo and antecedent exercise (P = 0.0238). Neither methylphenidate nor antecedent exercise produced notable side-effects as measured by the Monitoring of Side-Effects Scale. These data add to a sparse literature on the effects of antecedent exercise and methylphenidate amongst pre-school children.

Tear of the biceps femoris tendon

The clinical and operative findings of an isolated rupture of the biceps femoris tendon are described. The immediate suture and the initial postoperative treatment with a knee brace limiting extension to 20 degrees and flexion to 70 degrees resulted in a free range of motion and full activity of the biceps femoris.

Walk-jog prescription introduced by Toronto centre now a mainstay of cardiac rehabilitation

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Physical activity, fitness, and selected risk factors for CHD in active men and women

The association of physical activity and cardiovascular fitness with risk factors such as blood pressure, body composition, and smoking habits was evaluated in middle-aged men and women active in sports. Data were available for 2009 men and 898 women, all volunteers over 40 yr of age who were active in sports, were available. Physical activity was recorded as sport activity (number and type of sport, frequency, and duration), occupational activity, and the use of the bicycle for transport. Cardiovascular fitness was expressed as maximal power output (Wmax.kg-1) achieved during a progressive maximal cycle ergometer test. Pearson's product moment correlations between cardiovascular fitness and risk factors indicated significantly lower risks among more fit individuals. Except for smoking habits all risk factors showed better associations with fitness in women than in men. The association of physical activity indicators and risk factors was less strong than the fitness-risk factor association in both genders. In both genders, joggers had the most favorable risk profile compared with subjects who were active in one of the other four most popular sports. We conclude that in this relatively active and healthy population comparable associations of physical activity and cardiovascular fitness with risk factors for cardiovascular disease were found as in studies on less active populations.

[Anaphylaxis induced by exertion]

Exercise induced anaphylaxis (EIA) is a relatively new syndrome described in 1980. It is associated with different kinds of exercise, although jogging is the most frequently reported. The clinical manifestations progress from pruritus, erythema and urticaria to some combination of cutaneous angioedema, gastrointestinal and laryngeal symptoms and signs of angioedema and vascular collapse. In the full-blown phase a differential diagnosis must be done with the following syndromes: exercise-induced asthma, idiopathic anaphylaxis, cardiac arrhythmias, carcinoid syndrome. An elevated serum histamine level during experimentally-induced attacks and cutaneous degranulation of mast cells after attacks proved a mast cell participation in the pathogenesis of the syndrome. As predisposing factors, a specific or even aspecific sensitivity to food has been reported and such cases are called "food-dependent EIA". Another precipitating factor includes drug intake; moreover a familial tendency has been reported in some studies. Although the prognosis of this syndrome is not well defined, a reduction of attacks occurs in 45% of patients by means of elimination diets and behavioural changes. Treatment of attacks should include all the manoeuvres efficacious in the management of conventional anaphylactic syndrome, including the epinephrine administration. Prevention of attacks may be achieved by limitation of the exercise program or interruption of the program at the appearance of the first premonitory symptoms. The use of H1 antihistamine-receptor antagonists in maintenance therapy seems to be useful, although no controlled data are available.

Effects of aerobic training in adolescents with Down syndrome

The purpose of this study was to evaluate the effects that aerobic training has on adolescents and young adults with Down syndrome. Fourteen individuals with Down syndrome (mean age = 17.7 yr) participated in a 10-wk walking/jogging exercise training study. A pre- and post-training walking treadmill test was performed to determine the following parameters: peak oxygen uptake (VO2, absolute and relative), minute ventilation (VE, l.min-1), heart rate HR, b.min-1), RER (VCO2/VO2), and time and grade to exhaustion. Following the pre-training evaluations, subjects were assigned to a control group (N = 4) or an exercise group (N = 10). The exercise group underwent a 10-wk walk/jog training program at a frequency of 3 times per week, for a duration of 30 min, and at an intensity of approximately 65-75% peak HR. Following training, both control and experimental groups showed no changes in peak VO2 (absolute and relative), VE, HR, and RER. The exercise group, however, did demonstrate a significant improvement in peak exercise time (and grade). Although the training program did not produce improvements in aerobic capacity, it did produce gains in walking capacity. It was concluded that the adolescents and young adults may not be able to improve their aerobic capacity when performing a walk/jog training program.

Food-dependent exercise-induced anaphylaxis: report of two cases

Exercise-induced anaphylaxis (EIAn) is a rare condition characterized by giant urticaria, angioedema and acute gastrointestinal symptoms that develops on exertion. In the most severe forms it may be associated with acute cardiorespiratory symptoms (laringeal stridor, wheezing), profound hypotension or syncope. In some individuals, EIAn characteristically occurs after a meal suggesting that the anaphylactic reaction is provoked by both exercise and ingestion of a foodstuff to which the patient has become sensitized. Two representative cases of severe food-dependent EIAn are described, which emphasize the need of performing a careful allergological evaluation in sportsmen with unexplained cardiovascular and/or respiratory symptoms during effort, especially when associated with other allergic manifestations and/or occurring in the post-prandial period.

[Estimation of energy expenditure and the validity of pitch counting during walking and jogging by piezoelectric materials]

The purpose of the present study was to assess the validity of Piezo-electric accelerometer for estimating energy expenditure in walking and jogging. Energy consumption by oxygen uptake was determined during steady state level of treadmill walking at the speed of 60, 80 and 100 m/min and jogging at the speed of 100, 120, 140, and 160 m/min for 10 subjects. There was a highly significant correlation between the energy consumption and the estimated energy expenditure by an accelerometer despite the attached position (r = 0.912 at the waist, r = 0.915 at the chest, P < 0.001), which suggests accurate estimating energy expenditure in the field.

Effects of jogging exercise on patients with the pigmentary dispersion syndrome and pigmentary glaucoma

BACKGROUND

Exercise-induced anterior chamber pigment dispersion with intraocular pressure (IOP) elevation has been reported in patients with the pigmentary dispersion syndrome. Marked pigment dispersion with or without elevation of IOP could predispose these patients to visual field loss. The authors designed this study to evaluate the effects of jogging exercise on anterior chamber pigment and IOP in a group of patients with the pigmentary dispersion syndrome or pigmentary glaucoma.

METHODS

Fourteen subjects with the pigmentary dispersion syndrome, 10 subjects with pigmentary glaucoma, and 10 control subjects underwent a 45-minute protocol of jogging exercise. Anterior chamber pigment was graded and IOP was measured before and up to 3 hours after completion of the exercise protocol.

RESULTS

Eyes of experimental subjects were significantly more likely to develop exercise-induced pigment dispersion than were eyes of control subjects. In experimental subjects, eyes treated with pilocarpine at the time of the study were significantly less likely to develop exercise-induced pigment dispersion than eyes not treated with pilocarpine. In two experimental subjects, pre-exercise treatment with pilocarpine appeared to inhibit exercise-induced pigment dispersion.

CONCLUSIONS

The authors do not believe that all patients with the pigmentary dispersion syndrome or pigmentary glaucoma need to avoid exercise. However, for patients with these disorders who regularly engage in jogging or more strenuous or more jarring types of exercise, they suggest an evaluation before and after the type of exercise in question. If marked exercise-induced pigment dispersion occurs, pilocarpine therapy may be an alternative to avoidance of the exercise.