Exercise and physical health: musculoskeletal health and functional capabilities

Factors facilitating and hindering South Asian immigrant adults from engaging in exercise and physical activity - a qualitative systematic review

BACKGROUND

Exercise and physical activity are key components of management in patients with rheumatic musculoskeletal diseases (RMD), but people of the South Asian communities have a lower level of engagement with these activities compared to their Caucasian counterparts. The aim of this qualitative systematic review was to determine the barriers and facilitators of exercise and physical activity in South Asian communities who have migrated and live in western countries, particularly in those who have RMD.

METHODS

Qualitative studies, published in English between 1999 and 2021 and including evaluation of barriers and/or facilitators to exercise or physical activity behaviour in people of South Asian adult communities who have migrated and/or lived in western countries were identified from Embase, MEDLINE, CINAHL, PsycINFO, Google Scholar and manual searches. The studies were appraised using the CASP checklist. Inductive thematic synthesis was used to identify common and global themes.

RESULTS

A total of 32 studies that discussed barriers and facilitators of physical activity in South Asian communities who have migrated and lived in western countries were used for this review but there were no studies identified that focussed specifically on those with RMD. Following appraisal of the reporting of the studies, 30 studies were included in the pooling of the results. The facilitators and barriers to physical activities were broadly categorized into 'extrinsic' and 'intrinsic' factors. Extrinsic factors such as 'opportunity' included environmental factors such as weather and safety; socioeconomic factors such as education, language and literacy, and support in the form of social, psychological and resources. Intrinsic factors included cultural factors, such as life stages and family influence, beliefs and knowledge, which impacted attitudes and skills.

CONCLUSIONS

This review has synthesised evidence of barriers or facilitators and identified potentially modifiable factors influencing physical activity and exercise engagement, which could form the basis of evidence-based interventions to promote participation in healthy behaviour change. Provision of a safe, comfortable and culturally acceptable environment together with culturally-aligned cognitive strategies to facilitate acquisition of exercise-efficacy skills could help engagement.

REGISTRATION

The systematic review was registered on PROSPERO, registration no. 289,235.

Cardiovascular Disease Risk Factors, Musculoskeletal Health, Physical Fitness, and Occupational Performance in Firefighters: A Narrative Review

Introduction

Firefighting is a strenuous occupation that requires firefighters to be in peak physical condition. However, many firefighters have risk factors for cardiovascular disease, impaired musculoskeletal health, and are not physically fit for duty, which all negatively impact their occupational performance. Therefore, the aim of this review is to determine the relationship between cardiovascular disease risk factors, musculoskeletal health, physical fitness, and occupational performance in firefighters.

Methods

The electronic databases PubMed, SCOPUS, and Web of Science were searched online via the library portal of the University of the Western Cape. Publications and grey literature between the years 2000 to present were used. In total, 2607 articles were identified; after the removal of duplicates 1188 articles were then screened, and were excluded for not meeting initial screening criteria. The remaining 209 full-text articles were screened based on the inclusion and exclusion criteria, where 163 articles were excluded. Only studies that were quantitative were included. This left 46 articles that were then finally included in the current narrative review.

Results

The current literature indicated that significant relationships existed between cardiovascular risk factors, musculoskeletal health, physical fitness, and occupational performance. The results indicated firefighters who were aged, obese, physically inactive, cigarette smokers, and unfit were at the highest risk for cardiovascular and musculoskeletal health complications, and unsatisfactory occupational performance. Musculoskeletal health complications significantly affected occupational performance and work ability and were related to physical fitness of firefighters. Most cardiovascular risk factors were related to physical fitness, and all physical fitness parameters were related to occupational performance in firefighters.

Conclusion

The overwhelming evidence in the current review established that physical fitness is related to occupational performance. However, the relationship between cardiovascular risk factors and musculoskeletal health in relation to occupational performance is less clear and still understudied. Significant gaps remain in the literature.

At the nuclear envelope of bone mechanobiology

The nuclear envelope and nucleoskeleton are emerging as signaling centers that regulate how physical information from the extracellular matrix is biochemically transduced into the nucleus, affecting chromatin and controlling cell function. Bone is a mechanically driven tissue that relies on physical information to maintain its physiological function and structure. Disorder that present with musculoskeletal and cardiac symptoms, such as Emery-Dreifuss muscular dystrophies and progeria, correlate with mutations in nuclear envelope proteins including Linker of Nucleoskeleton and Cytoskeleton (LINC) complex, Lamin A/C, and emerin. However, the role of nuclear envelope mechanobiology on bone function remains underexplored. The mesenchymal stem cell (MSC) model is perhaps the most studied relationship between bone regulation and nuclear envelope function. MSCs maintain the musculoskeletal system by differentiating into multiple cell types including osteocytes and adipocytes, thus supporting the bone's ability to respond to mechanical challenge. In this review, we will focus on how MSC function is regulated by mechanical challenges both in vitro and in vivo within the context of bone function specifically focusing on integrin, β-catenin and YAP/TAZ signaling. The importance of the nuclear envelope will be explored within the context of musculoskeletal diseases related to nuclear envelope protein mutations and nuclear envelope regulation of signaling pathways relevant to bone mechanobiology in vitro and in vivo.

Health behaviors of German university freshmen during COVID-19 in association with health behaviors of close social ties, living arrangement, and time spent with peers

Objective

The start of university is a critical period for health risk behavior (i.e. eating, physical activity, alcohol use) which can be influenced by expectations and by environmental factors such as living arrangement, health behaviors of close social ties (i.e. parents, partners, peers), and time spent with peers. We investigated associations between environmental factors and current/expected health behaviors of German freshmen during the COVID-19 pandemic.

Method

A cross-sectional survey design was used. A total of N = 208 students (82.7% female; M age = 20.90, SD = 4.10) completed an online questionnaire assessing health behaviors and environmental factors at the beginning of their first semester.

Results

Current and expected physical activity was associated to that of all social ties, current and expected alcohol use to partner's and peers' alcohol use, while current and expected eating was only associated to peers' eating. The relationship between partner's or peers' and participant's alcohol use was moderated by coresidence, with a greater probability of engaging in these behaviors observed in case of coresidence. Perceived peer encouragement for alcohol consumption moderated the relationship between peer alcohol use and the number of drinks consumed by participants per month. Participants who spend more time with peers were more likely to consume higher amounts of alcohol. No differences were found regarding present and expected behaviors of participants who moved out of their parents' home and those who did not.

Conclusion

Partners and peers significantly influence students' health behaviors, particularly alcohol use. Interventions to prevent health risk behaviors among freshmen should therefore address these social ties' influence.

Low Intensity Vibrations Augment Mesenchymal Stem Cell Proliferation and Differentiation Capacity during in vitro Expansion

A primary component of exercise, mechanical signals, when applied in the form of low intensity vibration (LIV), increases mesenchymal stem cell (MSC) osteogenesis and proliferation. While it is generally accepted that exercise effectively combats the deleterious effects of aging in the musculoskeletal system, how long-term exercise affects stem cell aging, which is typified by reduced proliferative and differentiative capacity, is not well explored. As a first step in understanding the effect of long-term application of mechanical signals on stem cell function, we investigated the effect of LIV during in vitro expansion of MSCs. Primary MSCs were subjected to either a control or to a twice-daily LIV regimen for up to sixty cell passages (P60) under in vitro cell expansion conditions. LIV effects were assessed at both early passage (EP) and late passage (LP). At the end of the experiment, P60 cultures exposed to LIV maintained a 28% increase of cell doubling and a 39% reduction in senescence-associated β-galactosidase activity (p < 0.01) but no changes in telomere lengths and p16^INK4a levels were observed. Prolonged culture-associated decreases in osteogenic and adipogenic capacity were partially protected by LIV in both EP and LP groups (p < 0.05). Mass spectroscopy of late passage MSC indicated a synergistic decrease of actin and microtubule cytoskeleton-associated proteins in both control and LIV groups while LIV induced a recovery of proteins associated with oxidative reductase activity. In summary, our findings show that the application of long-term mechanical challenge (+LIV) during in vitro expansion of MSCs for sixty passages significantly alters MSC proliferation, differentiation and structure. This suggests LIV as a potential tool to investigate the role of physical activity during aging.

Effects of obesity on breast size, thoracic spine structure and function, upper torso musculoskeletal pain and physical activity in women

PURPOSE

This study investigated the effects of obesity on breast size, thoracic spine structure and function, upper torso musculoskeletal pain and physical activity participation in women living independently in the community.

METHODS

A total of 378 women were divided into 3 groups (Not Overweight: body mass index (BMI) = 22.5 ± 0.2 kg/m² (mean ± SE); Overweight: BMI = 27.4 ± 0.3 kg/m²; Obese: BMI = 35.4 ± 0.3 kg/m²). Outcome variables of breast volume (mL), thoracic flexion torque (N·m), thoracic kyphosis (degrees), upper torso musculoskeletal pain (score) and time spent in physical activity (min) were calculated and compared among the 3 groups, adjusting for between-group differences in age.

RESULTS

There was a significant main effect of BMI on all outcome variables. Participants classified as Obese displayed significantly larger breasts, had greater thoracic flexion torques and reported less time participating in physical activity relative to the participants who were classified as Not Overweight and Overweight. Participants in the Obese group also displayed significantly more thoracic kyphosis and reported significantly more upper torso musculoskeletal pain compared to their counterparts who were classified as Not Overweight.

CONCLUSION

This study is the first to demonstrate that increased obesity levels were associated with compromised kyphosis and loading of the thoracic spine, as well as increased symptoms of upper torso musculoskeletal pain and reduced time spent in physical activity in women living in the community. We recommend further research to determine whether evidence-based interventions designed to reduce the flexion torque generated on the thoracic spine can improve these symptoms of upper torso musculoskeletal pain and the ability of women with obesity to participate in physical activity.

Changes in neurovascular coupling during cycling exercise measured by multi-distance fNIRS: a comparison between endurance athletes and physically active controls

It is well known that endurance exercise modulates the cardiovascular, pulmonary, and musculoskeletal system. However, knowledge about its effects on brain function and structure is rather sparse. Hence, the present study aimed to investigate exercise-dependent adaptations in neurovascular coupling to different intensity levels in motor-related brain regions. Moreover, expertise effects between trained endurance athletes (EA) and active control participants (ACP) during a cycling test were investigated using multi-distance functional near-infrared spectroscopy (fNIRS). Initially, participants performed an incremental cycling test (ICT) to assess peak values of power output (PPO) and cardiorespiratory parameters such as oxygen consumption volume (VO2max) and heart rate (HRmax). In a second session, participants cycled individual intensity levels of 20, 40, and 60% of PPO while measuring cardiorespiratory responses and neurovascular coupling. Our results revealed exercise-induced decreases of deoxygenated hemoglobin (HHb), indicating an increased activation in motor-related brain areas such as primary motor cortex (M1) and premotor cortex (PMC). However, we could not find any differential effects in brain activation between EA and ACP. Future studies should extend this approach using whole-brain configurations and systemic physiological augmented fNIRS measurements, which seems to be of pivotal interest in studies aiming to assess neural activation in a sports-related context.

Can breast characteristics predict upper torso musculoskeletal pain?

BACKGROUND

Several studies have associated a large breast size with an increased prevalence and severity of musculoskeletal pain, particularly pain in the upper torso. Despite this evidence, no research has explored whether breast size or related characteristics are risk factors for upper torso musculoskeletal pain.

METHODS

A backward multiple regression analysis was performed to identify whether characteristics of the breasts and upper torso, as well as physical factors known to be associated with musculoskeletal pain, could predict musculoskeletal pain among a cohort of 378 Australian women aged 18 years and over who had a wide range of breast sizes.

FINDINGS

The model identified that breast volume, age and nipple-to-nipple distance predicted 23% of the variance in upper torso musculoskeletal pain reported by the participants.

INTERPRETATION

Women with a larger breast volume, lower age and a greater nipple-to-nipple distance were predicted to report a higher upper torso musculoskeletal pain score.

What is the role of lifestyle behaviour change associated with non-communicable disease risk in managing musculoskeletal health conditions with special reference to chronic pain?

Background

Other than activity and exercise, lifestyle practices such as not smoking and healthy nutrition, well established for preventing and managing lifestyle-related non-communicable diseases (i.e., heart disease, cancer, hypertension, stroke, obstructive lung disease, diabetes, and obesity), are less emphasized in the physical therapy guidelines for addressing chronic pain, e.g., back pain. This state-of-the-art review examines the relationships between lifestyle behaviours and musculoskeletal health, with special reference to chronic pain, and their clinical and research implications.

Discussion

A state-of-the-art review was conducted to synthesize evidence related to lifestyle factors (not smoking, healthy diet, healthy weight, optimal sleep and manageable stress, as well as physical activity) and musculoskeletal health, with special reference to chronic pain. The findings support that health behaviour change competencies (examination/assessment and intervention/treatment) may warrant being included in first-line management of chronic pain, either independently or in conjunction with conventional physical therapy interventions. To address knowledge gaps in the literature however three lines of clinical trial research are indicated: 1) to establish the degree to which traditional physical therapy interventions prescribed for chronic pain augment the benefits of lifestyle behaviour change; 2) to establish the degree to which adopting healthier lifestyle practices, avoids or reduces the need for conventional physical therapy; and 3) to establish whether patients/clients with healthier lifestyles and who have chronic pain, respond more favourably to conventional physical therapy interventions than those who have less healthy lifestyles.

Summary

Lifestyle behaviour change is well accepted in addressing lifestyle-related non-communicable diseases. Compelling evidence exists however supporting the need for elucidation of the role of negative lifestyle behaviours on the incidence of chronic pain, and the role of positive lifestyle behaviours on its incidence and effective management. Addressing lifestyle behaviour change in patients/clients with chronic pain, e.g., back pain, as a first-line intervention might not only constitute a novel approach, but also reduce the socioeconomic burden related to chronic pain as well as non-communicable diseases.

Correlations of Physical Activity, Body Mass Index, Shift Duty, and Selected Eating Habits among Nurses in Riyadh, Saudi Arabia

Nurses are the largest group of direct health providers and can serve as role models for their patients. In this cross sectional study we assessed the relationship among physical activity and barriers, shift duty, elevated BMI, and selected eating habits among 362 non-Saudi female nurses in Riyadh, Saudi Arabia. Results showed that 46.7% were either overweight or obese. Marital status, shift duty, education level, and BMI were significant predictors of physical activity. Weather was the most frequently reported barrier to physical activity (88.3%), followed by a lack of transportation (82.6%), and a lack of time (81.3%). Nurses who worked shift duty had significantly (p = 0.004) higher BMIs compared with day shift nurses. Nurses who rarely ate breakfast (p = 0.004) and meals (p = 0.001) and often eat fast food (p = 0.001) were more likely to be overweight or obese. Nurses should be encouraged for a better healthy lifestyles.

Effect of supervised exercise training on musculoskeletal symptoms and function in patients with type 2 diabetes: the Italian Diabetes Exercise Study (IDES)

Musculoskeletal disorders are common in subjects with type 2 diabetes mellitus (T2DM) and may represent a barrier to physical activity (PA). In the Italian Diabetes and Exercise Study, we assessed whether a strategy aimed at minimizing the risk of injury and worsening of musculoskeletal symptoms favors participation in exercise training and results in improvements in joint-specific functional scores, along with amelioration of metabolic profile. Sedentary patients with T2DM (n = 606) from 22 outpatient diabetes clinics were randomized to twice-a-week supervised aerobic and resistance training plus exercise counseling (EXE) versus counseling alone (CON) for 12 months. Musculoskeletal symptoms were evaluated at baseline in the entire cohort by the use of a self-reported questionnaire in order to design tailored exercise programs with exclusion of painful segments, and validated joint-specific scores were calculated at the end of study in a subgroup of CON (n = 65) and EXE subjects (n = 62). Musculoskeletal symptoms were present in more than ¾ of EXE and CON subjects. Yet, volumes of non-supervised PA were high, whereas dropout rates and adverse events were low in both groups. Moreover, in the EXE group, no difference was observed between patients with and without symptoms in session attendance and PA/exercise volume. Scores for symptoms and functional status of limbs and spine were significantly better in EXE than in CON subjects and correlated with PA/exercise volume and improvements in fitness parameters. Preliminary evaluation of musculoskeletal symptoms is useful in favoring compliance with supervised training programs and obtaining significant benefits to the functional status of the involved joints.

The Role of Mechanical Stimulation in Recovery of Bone Loss-High versus Low Magnitude and Frequency of Force

Musculoskeletal pathologies associated with decreased bone mass, including osteoporosis and disuse-induced bone loss, affect millions of Americans annually. Microgravity-induced bone loss presents a similar concern for astronauts during space missions. Many pharmaceutical treatments have slowed osteoporosis, and recent data shows promise for countermeasures for bone loss observed in astronauts. Additionally, high magnitude and low frequency impact such as running has been recognized to increase bone and muscle mass under normal but not microgravity conditions. However, a low magnitude and high frequency (LMHF) mechanical load experienced in activities such as postural control, has also been shown to be anabolic to bone. While several clinical trials have demonstrated that LMHF mechanical loading normalizes bone loss in vivo, the target tissues and cells of the mechanical load and underlying mechanisms mediating the responses are unknown. In this review, we provide an overview of bone adaptation under a variety of loading profiles and the potential for a low magnitude loading as a way to counteract bone loss as experienced by astronauts.

Associations between recreational exercise and chronic pain in the general population: evidence from the HUNT 3 study

The evidence for an association between leisure-time physical activity and prevalence of pain is insufficient. This study investigated associations between frequency, duration, and intensity of recreational exercise and chronic pain in a cross-sectional survey of the adult population of a Norwegian county (the Nord-Trøndelag Health Study; HUNT 3). Of the 94,194 invited to participate, complete data were obtained from 46,533 participants. Separate analyses were performed for the working-age population (20-64 years) and the older population (65 years or more). When defined as pain lasting longer than 6 months, and of at least moderate intensity during the past month, the overall prevalence of chronic pain was 29%. We found that increased frequency, duration, and intensity of exercise were associated with less chronic pain in analyses adjusted for age, education, and smoking. For those aged 20-64 years, the prevalence of chronic pain was 10-12% lower for those exercising 1-3 times a week for at least 30 minutes duration or of moderate intensity, relative to those not exercising. Dependent on the load of exercise, the prevalence of chronic pain was 21-38% lower among older women who exercised, relative to those not exercising. Similar, but somewhat weaker, associations were seen for older men. This study shows consistent and linear associations between frequency, duration, and intensity of recreational exercise and chronic pain for the older population, and associations without an apparent linear shape for the working-age population.

Work-life conflict and musculoskeletal disorders: a cross-sectional study of an unexplored association

Background

The health consequences of work-family or rather work-life conflict (WLC) have been studied by numerous researchers. The work-related causes of musculoskeletal disorders (MSD) are also well explored. And stress (at work) has been found to be a consequence of WLC as well as a cause of MSD. But very little is known about a potential association between WLC and MSD and the possible mediating role of stress in this relationship.

Methods

Survey data collected in 2007 among the workforces of four large companies in Switzerland were used for this study. The study population covered 6091 employees. As the exposure variable and hypothesized risk factor for MSD, WLC was measured by using a 10-item scale based on an established 18-item scale on work-family conflict. The outcome variables used as indicators of MSD were (low) back pain and neck/shoulder pain. Stress as the assumed intervening variable was assessed by a validated single-item measure of general stress perception. Correlation coefficients (r), standardized regression coefficients (β) and multiple adjusted odds ratios (OR) were calculated as measures of association.

Results

WLC was found to be quite strongly associated with MSD (β = .21). This association turned out to be substantially confounded by physical strain at work, workload and job autonomy and was considerably reduced but far from being completely eliminated after adjusting for general stress as another identified risk factor of MSD and a proven strong correlate of WLC (r = .44). A significant and relevant association still remained (β = .10) after having controlled for all considered covariates. This association could be fully attributed to only one direction of WLC, namely the work-to-life conflict. In subsequent analyses, a clear gradient between this WLC direction and both types of MSD was found, and proved to be consistent for both men and women. Employees who were most exposed to such work-to-life conflict were also most at risk and showed a fivefold higher prevalence rate (19%-42%) and also an up to sixfold increased relative risk (OR = 3.8-6.3) of suffering greatly from these types of MSD compared with the least exposed reference group showing very low WLC in this direction. Including stress in the regression models again reduced the strength of the association significantly (OR = 1.9-4.1), giving an indication for a possible indirect effect of WLC on MSD mediated by stress.

Conclusion

Future research and workplace interventions for the prevention of MSD need to consider WLC as an important stressor, and the MSD risk factor identified in this study.

Qualidade de vida em idosos que praticam atividade física - uma revisão sistemática

OBJETIVO: Realizar uma revisão sistematizada da literatura sobre o impacto da prática regular de atividade física na qualidade de vida dos idosos. MÉTODO: Revisão sistemática de estudos publicados até setembro de 2008, nas bases de dados Medline, LILACS e SciELO. Foram excluídos os estudos que possuíam delineamento transversal ou que eram relatos de casos, que avaliavam a qualidade de vida associada a alguma doença específica e aqueles nos quais havia presença de outra intervenção concomitante. RESULTADOS: De acordo com os critérios de inclusão, dos 391 artigos encontrados, apenas três fizeram parte da análise. Foram identificados três tipos de intervenções: 1) exercícios de aquecimento, treino aeróbico, fortalecimento muscular, coordenação e resfriamento; 2) exercícios de fortalecimento muscular, treino funcional; 3) exercícios na água. Os resultados desses estudos sugerem que a qualidade de vida aumenta com a prática de atividade física (intervenções 1 e 3), principalmente se for realizada duas vezes por semana ao invés de somente uma vez. Os benefícios do treino de resistência muscular na qualidade de vida foram limitados e não foi encontrado benefício do treinamento funcional neste desfecho. CONCLUSÃO: O número limitado de artigos encontrados, apenas um único estudo para cada tipo de intervenção, limita as conclusões desta revisão a respeito da eficácia dessas intervenções. Assim, conclui-se que há evidência limitada a respeito dos benefícios da prática de atividade física na qualidade de vida de idosos vivendo na comunidade. Sugere-se que mais estudos longitudinais sejam realizados para que as conclusões a respeito da eficácia destas intervenções sejam mais robustas.

Low magnitude and high frequency mechanical loading prevents decreased bone formation responses of 2T3 preosteoblasts

Bone loss due to osteoporosis or disuse such as in paraplegia or microgravity is a significant health problem. As a treatment for osteoporosis, brief exposure of intact animals or humans to low magnitude and high frequency (LMHF) mechanical loading has been shown to normalize and prevent bone loss. However, the underlying molecular changes and the target cells by which LMHF mechanical loading alleviate bone loss are not known. Here, we hypothesized that direct application of LMHF mechanical loading to osteoblasts alters their cell responses, preventing decreased bone formation induced by disuse or microgravity conditions. To test our hypothesis, preosteoblast 2T3 cells were exposed to a disuse condition using the random positioning machine (RPM) and intervened with an LMHF mechanical load (0.1-0.4 g at 30 Hz for 10-60 min/day). Exposure of 2T3 cells to the RPM decreased bone formation responses as determined by alkaline phosphatase (ALP) activity and mineralization even in the presence of a submaximal dose of BMP4 (20 ng/ml). However, LMHF mechanical loading prevented the RPM-induced decrease in ALP activity and mineralization. Mineralization induced by LMHF mechanical loading was enhanced by treatment with bone morphogenic protein 4 (BMP4) and blocked by the BMP antagonist noggin, suggesting a role for BMPs in this response. In addition, LMHF mechanical loading rescued the RPM-induced decrease in gene expression of ALP, runx2, osteomodulin, parathyroid hormone receptor 1, and osteoglycin. These findings suggest that preosteoblasts may directly respond to LMHF mechanical loading to induce differentiation responses. The mechanosensitive genes identified here provide potential targets for pharmaceutical treatments that may be used in combination with low level mechanical loading to better treat osteoporosis or disuse-induced bone loss.

Greek traditional dances and quality of old people's life

The aim of the present study was to examine the effect of Greek traditional dances on the improvement of old people's quality of life. A hundred and eleven subjects (75 women and 36 men) 60-91 years old, were divided into an experimental group (n=76) which participated in Greek traditional dances and a control group (n=35) which was discussing and watching television, both for 1h. The Subjective Exercise Experiences Scale [McAuley, E., Courneya, K., 1994. The Subjective Exercise Experiences Scale (SEES): development and preliminary validation. Journal of Sport and Exercise Psychology 16, 163-177] was used to measure positive well-being, psychological distress, and fatigue and the State-Trait Anxiety Inventory [Spielberger, C.D., Gorsuch, R., Lushene, R., 1970. Manual for the State-trait Anxiety Inventory. Consulting Psychologists, Palo Alto] to measure state and trait anxiety respectively. Correlational analyses, between the various measures taken postdance, showed that the overall set of relations between the SEES subscales and the SAI-Y1 subscale supports the criterion-related validity of this measure of exercise-induced psychological responses. The independent groups t-tests showed that the control group in comparison to experimental group, at rest as well as on the second measurement, has significantly higher levels of state anxiety (t=-4.45, p<0.001 &t=-6.56, p<0.001), psychological distress (t=-4.30, p<0.001 &t=-5.46, p<0.001), and fatigue (t=-3.16, p<0.01 &t=-3.46, p<0.001), while it has significantly lower levels of positive well-being (t=4.23, p<0.001 &t=6.90, p<0.001). After dancing approximately 63% of maximum heart rate of experimental group was activated, while from paired t-tests significant decreases in state anxiety (t=5.02, p<0.001) and psychological distress (t=3.14, p<0.01) were observed, as well as significant increases in positive well-being (t=-4.44, p<0.001) and fatigue (t=-2.15, p<0.05). On the other hand, no significant difference in control group was observed. Consequently, Greek traditional dances may be used as a functional psycho-physical activity, to produce both physical and mental benefits for elderly individuals.

Quality of life in chronic musculoskeletal pain

This chapter reviews the impact of chronic musculoskeletal pain on patients' health-related quality of life. In addition to the physical health consequences, chronic musculoskeletal pain can have a profound negative impact on an individual's emotional and social well-being. Although efforts in the health sector are obviously of crucial importance in the management of chronic musculoskeletal pain, a high level of patient and societal involvement is key to reducing the burden of this condition. Patients should work in partnership with health-care professionals, actively participating in their care. Family members should encourage their loved ones to be as independent as possible. The employer of a person with chronic musculoskeletal pain has a vital role in returning him or her to work as soon as possible. Removing all barriers to the use of preventive and therapeutic services will help us to reduce the burden of musculoskeletal pain conditions on both patients and society.

Effects of exercise frequency on functional fitness in older adult women

This study evaluated the effects of exercise frequency on functional fitness in older women participating in a 12-week exercise program. Participants (67.8+/-4.6 years) were divided into three different exercise groups (I, II, and III; n=34) and a control group (Group C; n=11). Group I participated in a 90-min exercise program once a week, for 12 weeks, while Group II attended it twice a week, and Group III attended three times a week. The exercise program consisted of a 10-min warm-up, 20 min of walking, 30 min of recreational activities, 20 min of resistance training, and a 10-min cool-down. The following items were measured before and after the program: muscular strength, muscular endurance, dynamic balance, coordination, and cardiorespiratory fitness (6-min walking distance). Comparisons of baseline and post-intervention measures showed significantly greater improvements in body weight, coordination, and cardiorespiratory fitness for Group III compared to the other groups (p<0.05). In addition, the greatest improvements in body fat, muscular endurance, and dynamic balance were also observed in Group III (p<0.05). However, no significant differences were found in muscular strength. Older women who participate in an exercise program three times a week gain greater functional fitness benefits than those who exercise less frequently. In order to improve functional fitness in older women, an exercise frequency of at least three times each week should be recommended.

Professional Practice in Exercise Science

This article describes the current outlook for professional practice for graduates majoring in exercise science. A review of professional and experimental literature reveals that graduates of undergraduate programmes in exercise science are not as prepared as they should be in order to provide professional and comprehensive advice on exercise and human performance, because of the focused academic and professional requirements of exercise physiology. In contrast to the direction of training in other allied health professions, this trend of narrowing of the exercise science curriculum to focus on exercise physiology, at the expense of other subdisciplines in kinesiology, has contributed to a decreasing scope of practice and lack of uniqueness, and has reduced the effectiveness of exercise science graduates. This review focuses on an accumulating body of evidence indicating that improving the training in biomechanics and motor behaviour could increase the professional expertise of exercise science graduates. Small improvements in the exercise science curriculum in biomechanics and motor behaviour are proposed that would move toward greater balance and integration of the academic disciplines in kinesiology and better professional practice in exercise science. The drift away from a balance and integration of academic preparation in exercise science represents a threat to the acceptance of exercise science graduates as exercise professionals that needs to be corrected for the field to advance.

Group cohesion and social support in exercise classes: results from a danish intervention study

This study examines the formation of group cohesion and social support in exercise classes among former sedentary adults, participating in a Danish community-based intervention. Furthermore, the aim is to analyze the impact of this process on exercise activity among the participants. A multimethod approach was used, analyzing both survey data and 18 personal interviews collected among 87 participants who completed the intervention project. Analysis was performed according to the grounded theory method. The formation of group cohesion was conditioned by the social composition of the group, the teaching ability by the instructors, and the activity by itself. The cohesive group was characterized by an attitude of mutual support toward exercise activities. This mutual support facilitated development of self-efficacy beliefs among the participants improving their mastery expectation regarding exercise. Manipulating group dynamics may be a promising intervention tool in the promotion of leisure-time physical activity.

Aerobic exercise and its impact on musculoskeletal pain in older adults: a 14 year prospective, longitudinal study

We studied the long term impact of running and other aerobic exercise on musculoskeletal pain in a cohort of healthy aging male and female seniors who had been followed for 14 years. We conducted a prospective, longitudinal study in 866 Runners' Association members (n = 492) and community controls (n = 374). Subjects were also categorized as Ever-Runners (n = 565) and Never-Runners (n = 301) to include runners who had stopped running. Pain was the primary outcome measure and was assessed in annual surveys on a double-anchored visual analogue scale (0 to 100; 0 = no pain). Baseline differences between Runners' Association members and community controls and between Ever-Runners versus Never-Runners were compared using chi-square and t-tests. Statistical adjustments for age, body mass index (BMI), gender, health behaviors, history of arthritis and comorbid conditions were performed using generalized estimating equations. Runner's Association members were younger (62 versus 65 years, p < 0.05), had a lower BMI (22.9 versus 24.2, p < 0.05), and less arthritis (35% versus 41%, p > 0.05) than community controls. Runners' Association members averaged far more exercise minutes per week (314 versus 123, p < 0.05) and miles run per week (26 versus 2, p < 0.05) and tended to report more fractures (53% versus 47%, p > 0.05) than controls. Ever-Runners were younger (62 versus 66 years, p < 0.05), had lower BMI (23.0 versus 24.3, p < 0.05), and less arthritis (35% versus 43%, p < 0.05) than Never-Runners. Ever-Runners averaged more exercise minutes per week (291 versus 120, p < 0.05) and miles run per week (23 versus 1, p < 0.05) and reported a few more fractures (52% versus 48%, p > 0.05) than Never-Runners. Exercise was associated with significantly lower pain scores over time in the Runners' Association group after adjusting for gender, baseline BMI, and study attrition (p < 0.01). Similar differences were observed for Ever-Runners versus Never-Runners. Consistent exercise patterns over the long term in physically active seniors are associated with about 25% less musculoskeletal pain than reported by more sedentary controls, either by calendar year or by cumulative area-under-the-curve pain over average ages of 62 to 76 years.

Health and physical activity research as represented in RQES

In the past 75 years, articles in Research Quarterly for Exercise and Sport (RQES) have contributed to the understanding of the role physical activity plays in the health of individuals and populations. Articles have described laboratory and community research studies in humans and animals, presented reviews of topics and conference proceedings, and presented forums for discussion about current topics in physical activity and health. The articles reflect the growth of the profession from basic inquiry, about physiological responses to exercise (and the development of physical fitness methods and standards), to studies of the effects of exercise on physical fitness and health in various population subgroups. This evolution in RQES reflects the well recognized paradigm shift toward public health concerns for physical activity and health outcomes.

Aptidão física relacionada à saúde de idosos: influência da hidroginástica

FUNDAMENTOS E OBJETIVOS: A prática de exercício físico, além de combater o sedentarismo, contribui de maneira significativa para a manutenção da aptidão física do idoso. O objetivo do estudo foi verificar o efeito da prática de hidroginástica sobre a aptidão física do idoso associada à saúde. METODOLOGIA: Foi realizado um ensaio controlado em 74 mulheres idosas, sem atividade física regular. Um grupo de 37 mulheres recebeu duas aulas semanais de hidroginástica durante três meses e outras 37 mulheres serviram como controle. A aptidão física foi avaliada através da bateria de testes de Rikli e Jones (1999), com avaliações de força e resistência de membros inferiores (levantar e sentar na cadeira), força e resistência de membros superiores (flexão do antebraço), flexão de membros inferiores (sentado, alcançar os membros inferiores com as mãos), mobilidade física - velocidade, agilidade e equilíbrio (levanta, caminha 2,44m e volta a sentar), flexibilidade dos membros superiores (alcançar atrás das costas com as mãos) e resistência aeróbica (andar seis minutos). A bateria de testes foi aplicada antes do início das aulas e no fim do programa após três meses. Os grupos foram semelhantes em relação a idade, IMC, renda familiar e anos de escolaridade. RESULTADOS: Ao longo dos três meses, foram acompanhadas 30 mulheres em cada grupo; perda amostral de 18,9%. Observou-se no grupo da hidroginástica um melhor desempenho em todos os pós-testes, quando comparados com os resultados do próprio grupo no pré-teste e com o controle no pós-teste (p < 0,05). CONCLUSÃO: Concluiu-se que a prática de hidroginástica para mulheres idosas sem exercícios físicos regulares contribuiu para a melhoria da aptidão física relacionada à saúde.

Cardiorespiratory fitness and risk of disability pension: a prospective population based study in Finnish men

BACKGROUND

Early retiring is a major social problem in many western countries.

AIM

To investigate whether good cardiorespiratory fitness prevents disability pensioning in Finnish middle-aged men.

METHODS

Subjects were a random population based sample of 1307 men who were 42-60 years old at baseline, had not retired before baseline or died during follow up, and had undergone a cycle ergometer test at baseline. Cardiorespiratory fitness was assessed at baseline with a maximal but symptom limited exercise test on an electrically braked cycle ergometer.

RESULTS

During a follow up of 11 years on average, 790 (60.4%) men were awarded a disability pension, only 254 (19.4%) men reached the old-age pension without previous early pension, and 263 (20.1%) men were still working at the end of follow up. After adjustment for age, body mass index, alcohol consumption, smoking, education, occupation, and baseline chronic diseases, an inverse association was observed between cardiorespiratory fitness and the risk of disability pension. Men with VO2max <25.98 ml/kg/min (lowest fifth) had a 3.28-fold (95% CI 1.70 to 6.32) and men with the duration of exercise test <9.54 minutes (lowest fifth) had a 4.66-fold (95% CI 2.43 to 8.92) risk of disability pension due to cardiovascular diseases compared with men in the highest fifths. Men with lowest fitness level also had an increased risk of disability pension due to musculoskeletal disorders, or all reasons combined.

CONCLUSIONS

Physical fitness is inversely associated with the risk of disability pension and especially with the risk of disability due to cardiovascular diseases.

Effects of a physical activity program. The study of selected physical abilities among elderly women

This study evaluated the effects of a 12-week exercise program on the physical abilities of 55 sedentary women ages 60 to 75. The variables tested were dynamic balances, muscular endurance, sit and reach flexibility, and muscular coordination. Participants were grouped into three exercise groups (n = 45) and one control group (n = 10). Exercise was performed for 1 hour, once, twice, and three times a week for the three experimental groups. Participants were pre- and post-tested for the selected variables. Significant differences (p < .05) were found between exercise and non-exercise groups. The main effects of the training program were significant for all four variables examined, indicating that even those who participated in an exercise group once a week had a significantly higher levels of physical abilities than the control group. The improvement of the experimental groups was proportional to the frequency of the training program applied.

Tiredness in daily activities among nondisabled old people as determinant of onset of disability

The purpose of this article was to examine whether self-reported tiredness in daily activities at age 75 is an independent determinant of onset of disability at 5-year follow-up. The investigation is based on two subgroups of nondisabled participants of 75 year olds who survived and participated in the follow-up study 5 years later (n = 510 and 429). Persons who felt tired in their daily activities had a larger risk of becoming disabled in mobility (OR = 3.2, 95% CI = 1.4-7.6) and in daily activities (OR = 2.1, 95% CI = 1.0-4.2) compared to persons without tiredness. In addition, persons with poor cognitive function, little diversity in social relations and no physical activity had an independent risk of onset of disability. The results indicate that it is important to take it seriously when older people complain about tiredness in daily activities, as these people are at higher risk of becoming disabled than others.

Work-related musculoskeletal disorders in physical therapists: prevalence, severity, risks, and responses

BACKGROUND AND PURPOSE

Physical therapists are at risk for work-related musculoskeletal disorders (WMSDs). Little is known of how therapists respond or of what actions they take to prevent injury. The purpose of this study was to investigate the prevalence and severity of WMSDs in physical therapists, contributing risk factors, and their responses to injury.

SUBJECTS

As part of a larger study, a systematic sample of 1 in 4 therapists on a state register (n=824) was surveyed.

METHODS

An 8-page questionnaire was mailed to each subject. Questions investigated musculoskeletal symptoms, specialty areas, tasks and job-related risk factors, injury prevention strategies, and responses to injury.

RESULTS

Lifetime prevalence of WMSDs was 91%, and 1 in 6 physical therapists moved within or left the profession as a result of WMSDs. Younger therapists reported a higher prevalence of WMSDs in most body areas. Use of mobilization and manipulation techniques was related to increased prevalence of thumb symptoms. Risk factors pertaining to workload were related to a higher prevalence of neck and upper-limb symptoms, and postural risk factors were related to a higher prevalence of spinal symptoms.

CONCLUSION AND DISCUSSION

Strategies used to reduce work-related injury in industry may also apply to physical therapists. Increased risk of thumb symptoms associated with mobilization techniques suggests that further research is needed to establish recommendations for practice. The issues for therapists who move within or leave the profession are unknown, and further research is needed to better understand their needs and experiences.

Energy requirements and physical activity of older free-living African-Americans: a doubly labeled water study

We examined daily energy requirements and determinants of physical activity in older, free-living African-American women (n = 37; age, 64 +/- 8 yr) and men (n = 28; age, 64 +/- 7 yr). Total daily energy expenditure and its components [i.e. resting metabolic rate (RMR) and physical activity energy expenditure] were determined using doubly labeled water and indirect calorimetry. Body composition from dual energy x-ray absorptiometry, maximal oxygen consumption from a graded treadmill test, and leisure time physical activity from a structured interview were determined. Total daily energy expenditure adjusted for body composition was lower (P < 0.05) for women (2198 +/- 621 kcal/d) than for men (2633 +/- 669 kcal/d) due to a lower RMR (1431 +/- 240 vs. 1576 +/- 259 kcal/d; P = 0.07) and physical activity energy expenditure (548 +/- 559 vs. 794 +/- 603 kcal/d; P = 0.19), respectively. The physical activity level ratio (i.e. total daily energy expenditure/RMR) was not different from Food and Agriculture Organization/World Health Organization/United Nations University recommendations (i.e. 1.51) for women (1.51 +/- 0.25), but was higher for men (1.71 +/- 0.32). The strongest correlates with physical activity energy expenditure were age for women (r = -0.44; P < 0.01) and maximal oxygen consumption for men (r = 0.39; P < 0.05). These data show that daily energy requirements are significantly lower in African-American women compared to men, primarily due to lower levels of physical activity energy expenditure. Furthermore, lower levels of cardiovascular fitness in men and advancing age in women are associated with lower physical activity energy expenditure.

Does physical activity enhance health?

This paper provides the justification of physical activity promotion for health by critically reviewing the recent US Surgeon General's Report. Evidence is summarized of the effects of physical activity on physiological responses, overall mortality, a number of diseases and disabilities, overall functional capacity, and mental health and quality of life. Cumulating evidence suggests that the effects be applicable to both genders and to a wide age range. The adverse effects of physical activity on health are shown to be small and mostly preventable. It is emphasized that substantial health effects can be gained by moderate daily physical activity which does not require high skill level nor specialized equipment or facilities. It is concluded that the health potential of physical activity is substantial due to the high prevalence of inactive lifestyle in the populations, the great number of health conditions being affected by physical activity, and the feasibility and safety of physical activity as a health measure.

Aerobic exercise and lumbar spine bone mineral density in postmenopausal women: a meta-analysis

PURPOSE

To use the meta-analytic approach to examine the effects of aerobic exercise on lumbar spine bone mineral density in postmenopausal women.

DATA SOURCES

Studies were retrieved from computer searches (MEDLINE, Current Contents) as well as cross-referencing from the bibliographies of retrieved studies and review articles.

STUDY SELECTION

A total of 17 effect sizes consisting of 330 subjects (192 exercise, 138 nonexercise) were included from the 10 studies that met the criteria for inclusion: (1) aerobic activity as the only exercise intervention, (2) postmenopausal women as subjects, (3) comparative nonexercise group included, (4) changes in lumbar spine bone mineral density reported, (5) studies published in English-language journals between January 1975 and December 1994.

DATA EXTRACTION

The primary outcome measure of interest was the treatment effect delta3, defined as the percent change in lumbar spine bone mineral density, calculated by subtracting the percent change in the exercise group from the percent change in the nonexercise group.

RESULTS

Using a fixed effects model, bootstrap analysis (10,000 replications) showed that significant changes in lumbar spine bone mineral density occurred (mean +/- SD = 2.83 +/- 0.77%, 95% confidence interval (CI) = 1.33 to 4.35%). This overall average increase was caused primarily by the loss of lumbar spine bone mineral density in the nonexercise group relative to the exercise group (mean +/- SD, exercise = .32 +/- 2.46%, 95% CI = -0.94 to 1.58; nonexercise = -2.51 +/- 2.69%, 95% CI = -4.60 to -0.96).

CONCLUSION

The results of this meta-analysis suggest that aerobic exercise helps to maintain lumbar spine bone mineral density in postmenopausal women.

Effects of physical activity, body weight and composition, and muscular strength on bone density in young women

OBJECTIVE

The purpose of this study was to examine the relationship between body weight and composition, muscular strength, physical activity, and bone mineral density (BMD) in eumenorrheic college-aged women.

METHODS

BMD and bone mineral content (BMC) of the total body, and BMD of the lumbar spine (L2-L4) and femoral neck (via dual energy x-ray absorptiometry), as well as body composition and muscular strength, were measured in 60 college-aged women. The women were divided into three groups: 1) low body weight athletes involved in weight-bearing, collegiate sports (N = 20), 2) matched low body weight and sedentary (N = 20), and 3) average body weight and sedentary (N = 20). All groups were matched for height, age, and age at menarche.

RESULTS

The athletes had significantly greater (P < 0.05) (mean +/- SD) total body BMD (1.164 +/- 0.06 g x cm[-2]), L2-L4 BMD (1.240 +/- 0.13 g x cm[-2]), femoral neck BMD (1.144 +/- 0.13 g x cm[-2]) and total body BMC (2.44 +/- 0.30 kg) than the low body weight, sedentary (LWS) group, but were only greater than the average body weight sedentary group (AWS) for femoral neck BMD. Significant correlations were found between lean body mass (LBM) and all BMD variables (P < 0.001). A significant correlation (P < 0.01) was found between fat mass and all BMD variables in the sedentary subjects alone (N = 40), but with inclusion of the athletes (N = 60), none of the correlations between fat mass and BMD were significant. Arm and leg strength isometric torque values corrected for muscle + bone cross-sectional area (M + B CSA) were not significantly different between the athletes and LWS group, but the athletes were greater (P < 0.05) than the AWS group for both arm and leg strength/M + B CSA. No significant, site-specific correlations were found between strength/M + B and BMD.

CONCLUSIONS

In summary, the athletes had significantly greater BMD, BMC, and LBM than the LWS group and, except for a greater femoral neck BMD, similar BMD, BMC, and LBM as the AWS group. These results suggest that LBM and weight-bearing exercise both enhance BMD in eumenorrheic young adult women.