The effect of cardiorespiratory fitness assessment in preventive health checks: a randomised controlled trial

Stay True to Your Workout: Does Repeated Physical Testing Boost Exercise Attendance? A One-Year Follow-Up Study

No prospective studies have investigated if repeated testing of physical performance and body composition are associated with exercise attendance or patterns in fitness club members. This study aimed to investigate if repeated physical testing was associated with exercise attendance and patterns in gym members and to report prospective data on use of the fitness club`s facilities and products. Untrained new members were recruited and divided into a test group (n = 125) and as controls (n = 125). All participants answered a survey including exercise involvement, at onset, and after 3, 6, and 12 months follow-up. The test group also measured body composition, maximal oxygen uptake, and maximal muscle strength (onset, and after 3 and 12 months). In total 73.6% answered all surveys, and in the test group, 44.8% completed all physical tests. Regular exercise attendance was defined as ≥2 sessions/week. Repeated testing showed no association with long-term regular exercise attendance (test group: 19.6%, controls: 19.8%; p = 0.638). At 3 months, a lower proportion in the test group reported engagement in resistance exercise (35.3% and 60.2%; p = 0.003) and had lower exercise frequency (2.0 and 2.6 days/week; p = 0.008) than controls. The test group had higher participation in group exercise classes (28.0% and 13.6%; p = 0.040). Exercise frequency decreased from onset to 12 months (from 2.6 to 2.2 days/week; p = 0.025) At 3, 6, and 12 months, 51.8%, 37.6%, and 37.4% reported regular exercise attendance, and 16.9% at all follow-ups. At all time-points, most common workout mode was individual resistance exercise (43.8% to 46.3%). Few attended group exercise classes (7.5% to 13.8%) or used a personal trainer (22.5% to 27.5%). Repeated physical testing did not improve exercise attendance, and we found no changes in members` use of the fitness club`s facilities and products. Only 16.9% reported regular exercise attendance throughout the first year of membership.

Association of Cardiorespiratory Fitness with Achievement Motivation in Physical Education in Adolescents

Cardiorespiratory fitness is an important health marker in adolescents. Thus, examining the relation between cardiorespiratory fitness and motivation should be important to increase health-related behaviors. This study aimed to describe adolescents' cardiorespiratory fitness and motivation by gender and to analyze the association between two cardiorespiratory fitness tests (original and with music) and motivation. A total of 341 adolescents (14.2 ± 1.5 years, 52.2% girls) participated in this study. Cardiorespiratory fitness was assessed using the 20 m shuttle run and its adaptation with music. Motivation was assessed though the "Achievement Motivation towards Physical Education" questionnaire. Boys presented with higher cardiorespiratory fitness and motivation (all, p < 0.05). Yet, when classifying fit and unfit groups, a higher percentage of girls were considered fit compared to boys (85.8% vs. 74.5%). A higher level of cardiorespiratory fitness (stages) and VO₂max were associated with a higher level of motivation (self-perceived competence and compared competence) and lower anxiety (all p < 0.05). These associations with motivation were stronger when the music was present in the test. In this sense, including music in activities focused on cardiorespiratory fitness could increase the cardiorespiratory fitness performance and motivation, especially in girls. It should be important to increase adolescents' cardiorespiratory fitness levels in order to increase motivation in physical education lessons and to include more motivational activities in order to achieve higher performance.

Effects of a motivational, individual and locally anchored exercise intervention (MILE) on cardiorespiratory fitness: a community-based randomised controlled trial

Background

Risk factors for chronic disease, including low cardiorespiratory fitness levels (VO_2max), are often present in middle-aged populations. We aimed to evaluate the efficacy of a motivational, individual, and locally anchored physical activity intervention on increasing VO_2max in 30–49 year-olds with low VO_2max.

Methods

232 adult volunteers with low VO_2max were randomised to intervention (n = 115) or routine care (n = 117). The intervention included four motivational interviews; six months’ free membership to a local sports club; and a GPS-watch/activity monitor for uploading training data to an online platform/community. Routine care was one or two motivational interviews.

Inclusion criteria were low VO_2max based on the cut off levels: ≤ 39 and ≤ 35 ml O₂/kg/min. For 30–39 and 40–49 year-old men respectively and ≤ 33 and ≤ 31 ml O₂/kg/min for 30–39 and 40–49 year-old women, respectively. The primary outcome was change in VO_2max from baseline to twelve months estimated with a maximal ergometer bicycle test. Secondary outcomes included physical activity, biochemical and anthropometric measures, and health-related quality of life. The primary analyses were based on all available data and sensitivity- and predefined sex analyses were performed. The between-group differences were estimated using independent t-tests and presented with 95% confidence intervals.

Results

No significant between-group differences in primary or secondary outcomes were found at twelve months’ follow-up. The mean VO_2max change from baseline in the intervention- and routine care (ml/kg/min) was 3.8 (95% CI: 2.6; 5.0) and 3.4 (95% CI: 1.7; 5.2), respectively. No changes in physical activity were observed. The mean VO_2max (ml/kg/min) changes from baseline in the intervention- and routine care group in men were: 5.0 (95% CI: 3.5; 6.4) and 3.5 (95% CI: 1.5; 5.4); and in women: 1.5 (95% CI: -0.1; 3.1) and 3.4 (95% CI: -0.1; 7.8), respectively. Significant differences in VO_2max between non-completers (44.2%) and completers were observed, 26.3 (95% CI: 25.1; 27.5) vs 28.2 ml/kg/min (95% CI: 27.1; 29.0; p = 0.02). Sensitivity analyses did not change the main result.

Conclusion

Offering a multi-component physical activity intervention to 30–49 year-olds with low levels of VO_2max had no effect on the change in VO_2max from baseline to twelve months compared with routine care.

Trial registration

ClinicalTrials.gov (no. NCT01801956). Registered 1 March 2013.

General health checks in adults for reducing morbidity and mortality from disease

BACKGROUND

General health checks are common elements of health care in some countries. They aim to detect disease and risk factors for disease with the purpose of reducing morbidity and mortality. Most of the commonly used individual screening tests offered in general health checks have been incompletely studied. Also, screening leads to increased use of diagnostic and therapeutic interventions, which can be harmful as well as beneficial. It is therefore important to assess whether general health checks do more good than harm. This is the first update of the review published in 2012.

OBJECTIVES

To quantify the benefits and harms of general health checks.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, two other databases and two trials registers on 31 January 2018. Two review authors independently screened titles and abstracts, assessed papers for eligibility and read reference lists. One review author used citation tracking (Web of Knowledge) and asked trial authors about additional studies.

SELECTION CRITERIA

We included randomised trials comparing health checks with no health checks in adults unselected for disease or risk factors. We did not include geriatric trials. We defined health checks as screening for more than one disease or risk factor in more than one organ system.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted data and assessed the risk of bias in the trials. We contacted trial authors for additional outcomes or trial details when necessary. When possible, we analysed the results with a random-effects model meta-analysis; otherwise, we did a narrative synthesis.

MAIN RESULTS

We included 17 trials, 15 of which reported outcome data (251,891 participants). Risk of bias was generally low for our primary outcomes. Health checks have little or no effect on total mortality (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.97 to 1.03; 11 trials; 233,298 participants and 21,535 deaths; high-certainty evidence, I² = 0%), or cancer mortality (RR 1.01, 95% CI 0.92 to 1.12; 8 trials; 139,290 participants and 3663 deaths; high-certainty evidence, I² = 33%), and probably have little or no effect on cardiovascular mortality (RR 1.05, 95% CI 0.94 to 1.16; 9 trials; 170,227 participants and 6237 deaths; moderate-certainty evidence; I² = 65%). Health checks have little or no effect on fatal and non-fatal ischaemic heart disease (RR 0.98, 95% CI 0.94 to 1.03; 4 trials; 164,881 persons, 10,325 events; high-certainty evidence; I² = 11%), and probably have little or no effect on fatal and non-fatal stroke (RR 1.05 95% CI 0.95 to 1.17; 3 trials; 107,421 persons, 4543 events; moderate-certainty evidence, I² = 53%).

AUTHORS' CONCLUSIONS

General health checks are unlikely to be beneficial.