The benefits of exercise for women

Use of the preparticipation physical examination form to screen for the female athlete triad in Canadian interuniversity sport universities

OBJECTIVE

The purpose of this study was to survey universities affiliated with Canadian Interuniversity Sport on existing screening protocols for the female athlete triad, and to identify any potential areas for improvement of this system.

DESIGN

Surveys were faxed or e-mailed to Canadian Interuniversity Sport-affiliated universities in Canada, and preparticipation physical examination (PPE)/medical history forms from each institution were analyzed.

SETTING

The Fowler Kennedy Sports Medicine Clinic at the University of Western Ontario.

PARTICIPANTS

In 2000, of the 48 universities, 35 responded (73.0% response rate). In 2002, 39 of 49 universities responded (79.6%).

MAIN OUTCOME MEASUREMENTS

Although the majority of institutions surveyed implement a PPE form (80.0% in 2000, 87.2% in 2002), only 70.6% to 75.0% of these institutions actually conduct a follow-up when deemed necessary. However, the number of forms including a specific female section increased from 46.4% in 2000 to 61.8% in 2002. Also encouraging is the percentage of universities attempting to increase awareness of the triad disorders (33.3% in 2002 vs. 14.3% in 2000). It is interesting to note that in over half of the institutions surveyed both years, the athletic therapist or trainer is responsible for analyzing the completed PPE forms.

CONCLUSIONS

This study has shown substantial improvement from 2000 to 2002 in the development of the PPE across Canada, even in a relatively short period of 2 years. However, this study also demonstrates the lack of uniformity within Canada of the PPE forms. There remains a need to improve the PPE form to target a section of the form specifically to female athletes, or else cases may be missed. The triad is also not found solely in sports where leanness is associated with better performance. Better efforts need to made to increase awareness of the triad and its risks among female athletes, as well as provide educational opportunities for athletic therapists, who are the first line of intervention in many cases.

CLINICAL RELEVANCE

The key to successful prevention and intervention is education. This study demonstrates the need for education for all people directly involved with the athlete, and the need to work together to promote a healthy and realistic body image and increase awareness of the female athlete triad among athletes.

Common musculoskeletal disorders in women

Women are prone to certain orthopedic conditions and may present to their primary care physician for treatment. An appreciation of the physiological and anatomical differences between women and men and the musculoskeletal conditions that commonly affect active women can aid the physician in diagnosis and treatment. We discuss common musculoskeletal conditions of active women including those affecting the low back, knee, shoulder, and foot. We also discuss common stress fractures seen in women. Various treatment and prevention strategies are reviewed and include physical therapy, bracing, medications, and surgery.

The practice and process of healthy exercise: an investigation of the treatment of exercise abuse in women with eating disorders

This study investigates the effectiveness of an exercise program designed to reduce exercise abuse in women who are in residential treatment for eating disorders. One hundred and twenty-seven women who participated in the exercise program were compared to 127 non-participants on weight gain and self-reported obligatory attitudes and beliefs about exercise. The exercise participants were women who were medically cleared and attended at least two exercise groups during treatment. The control group were women who were medically cleared, but did not attend any exercise groups during treatment. Significant group x diagnosis interactions revealed that women in the exercise group who were diagnosed with anorexia nervosa gained more than one-third as much weight as those in the control group. Also, women in the exercise group demonstrated significantly reduced obligatory attitudes toward exercise compared to the control group. These findings suggest that the use of an exercise program that targets exercise abuse in women with eating disorders is feasible during residential treatment and results in positive change without interfering with weight gain. Limitations that result from the lack of random assignment to the exercise and control group are discussed.

A high exercise load is linked to pathological weight control behavior and eating disorders in female fitness instructors

Demographic data, exercise habits, weight control behavior, attitudes towards body shape, eating disorder (ED) experience, and menstrual regularity among female fitness instructors were descriptively assessed. A 60-item questionnaire was sent to 295 female fitness instructors at eight fitness centers. Responders (57%) reported a mean weekly exercise load of 5.5 h week(-1) (SD 2.6), which indicates frequent training, however, less than that of athletes. Overall, 35% reported ED experience (DSM-IV criteria), with an onset at 15-17 years of age. The problems had lasted 5-7 years, and 20% of the entire group reported recovery, however, 11% still had EDs. For the entire group, it was found that a high weekly exercise load was linked to a pathological weight control behavior. Fitness instructors with an active ED exercised more than instructors who never had an ED or who had a past ED. Menstrual irregularity was more common among instructors who did not use contraceptives (14%), compared to those who did (5%). As ED experience and pathological weight control behavior were common in the studied group, the importance of guidelines regarding communication from female fitness instructors about healthy training habits to regular exercisers is discussed in the article.

Promoting health among perimenopausal women through diet and exercise

PURPOSE

To review the literature related to health promotion during the perimenopausal years and suggest methods for integrating those changes into the lifestyles of women in primary care.

DATA SOURCES

Selected scientific literature and guidelines for exercise programs.

CONCLUSIONS

The transition into perimenopause presents an opportunity for addressing health promotion issues, such as diet and exercise. As a woman senses perimenopausal changes, health awareness emerges. Such personal insight motivates the woman to implement lifestyle changes.

IMPLICATIONS FOR PRACTICE

Considering the average women will spend approximately one third of her life past menopause, a concerted effort is needed to ensure her well-being. Diet and exercise represent two modifiable areas of concern for perimenopausal women. Dietary selections of phytoestrogens, calcium, fiber and fat along with exercises plans are relatively simple interventions to begin the process of change.