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Ungvari Z, Fazekas-Pongor V, Csiszar A, Kunutsor SK. The multifaceted benefits of walking for healthy aging: from Blue Zones to molecular mechanisms. GeroScience 2023; 45:3211-3239. [PMID: 37495893 PMCID: PMC10643563 DOI: 10.1007/s11357-023-00873-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023] Open
Abstract
Physical activity, including walking, has numerous health benefits in older adults, supported by a plethora of observational and interventional studies. Walking decreases the risk or severity of various health outcomes such as cardiovascular and cerebrovascular diseases, type 2 diabetes mellitus, cognitive impairment and dementia, while also improving mental well-being, sleep, and longevity. Dose-response relationships for walking duration and intensity are established for adverse cardiovascular outcomes. Walking's favorable effects on cardiovascular risk factors are attributed to its impact on circulatory, cardiopulmonary, and immune function. Meeting current physical activity guidelines by walking briskly for 30 min per day for 5 days can reduce the risk of several age-associated diseases. Additionally, low-intensity physical exercise, including walking, exerts anti-aging effects and helps prevent age-related diseases, making it a powerful tool for promoting healthy aging. This is exemplified by the lifestyles of individuals in Blue Zones, regions of the world with the highest concentration of centenarians. Walking and other low-intensity physical activities contribute significantly to the longevity of individuals in these regions, with walking being an integral part of their daily lives. Thus, incorporating walking into daily routines and encouraging walking-based physical activity interventions can be an effective strategy for promoting healthy aging and improving health outcomes in all populations. The goal of this review is to provide an overview of the vast and consistent evidence supporting the health benefits of physical activity, with a specific focus on walking, and to discuss the impact of walking on various health outcomes, including the prevention of age-related diseases. Furthermore, this review will delve into the evidence on the impact of walking and low-intensity physical activity on specific molecular and cellular mechanisms of aging, providing insights into the underlying biological mechanisms through which walking exerts its beneficial anti-aging effects.
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Affiliation(s)
- Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary.
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | | | - Anna Csiszar
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Setor K Kunutsor
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4WP, UK.
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Hulteen RM, Marlatt KL, Allerton TD, Lovre D. Detrimental Changes in Health during Menopause: The Role of Physical Activity. Int J Sports Med 2023; 44:389-396. [PMID: 36807278 PMCID: PMC10467628 DOI: 10.1055/a-2003-9406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Midlife women experience changes in cardiometabolic, physical, and psychosocial health during menopause that negatively impacts their overall quality of life. Factors that contribute to these increases in cardiometabolic risk include weight gain as well as increases in fat mass (particularly abdominal adiposity), insulin resistance, and vascular dysfunction. Other deleterious changes in physical health (e. g. reduced sleep health, bone density, and balance) as well as changes in psychosocial health (e. g. mood, anxiety, and depression) often coincide and are linked to these increases in cardiometabolic risk. Physical activity and exercise are important lifestyle components that have been demonstrated to improve cardiometabolic, physical, and psychosocial health, yet physical activity and exercise is known to decline during perimenopause and into the postmenopausal years. In this narrative review, we summarize these changes in overall health during menopause as well as how declining physical activity contributes to these changes. Additionally, we discuss how incorporating physical activity and exercise during menopause can potentially ameliorate health declines. We conclude that there exists a significant, positive impact of physical activity on cardiometabolic, physical, and psychological health among midlife women, particularly if undertaken during the perimenopausal and postmenopausal years.
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Affiliation(s)
- Ryan M. Hulteen
- Kinesiology, Louisiana State University, Baton Rouge, United States
| | - Kara L. Marlatt
- Clinical Science, Pennington Biomedical Research Center, Baton Rouge, United States
| | - Timothy D. Allerton
- Basic Science, Pennington Biomedical Research Center, Baton Rouge, United States
| | - Dragana Lovre
- School of Medicine, Tulane University Health Sciences Center, New Orleans, United States
- Medicine, Southeast Louisiana Veterans Health Care System, New Orleans, United States
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3
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Qian J, Sun S, Wang M, Sun Y, Sun X, Jevitt C, Yu X. The effect of exercise intervention on improving sleep in menopausal women: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1092294. [PMID: 37181372 PMCID: PMC10167708 DOI: 10.3389/fmed.2023.1092294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/30/2023] [Indexed: 05/16/2023] Open
Abstract
Background Sleep disturbance is common in menopausal women and negatively affects their quality of life and could cause increased risks of other menopause-related diseases. Objective This systematic review aims to synthesize evidence regarding the effects of exercise interventions on improving sleep in menopausal women. Methods A comprehensive search in seven electronic databases for randomized controlled trials (RCTs) was performed on June 3, 2022. The systematic review included seventeen trials, ten of which provided data for the meta-analysis. The effects on outcomes were presented as mean differences (MDs) or standard mean differences (SMDs) and their 95% confidence intervals (CI). Cochrane risk-of-bias tool was used in quality assessment. Results The results suggest that exercise intervention significantly reduces insomnia severity (SMD = -0.91, 95% CI = -1.45 to -0.36, Z = 3.27, P = 0.001) and alleviates sleep problems (MD = -0.09, 95% CI = -0.17 to -0.01, Z = 2.20, P = 0.03). For sleep quality, the results showed that insignificant differences were found between the exercise intervention and the control groups (MD = -0.93, 95% CI = -2.73 to 0.87, Z = 1.01, P = 0.31). The results of the subgroup analysis indicated that more apparent effects of exercise intervention were found among women with sleep disorders than among women without sleep disorders. Which exercise intervention duration was more beneficial to sleep outcomes could not be judged. Overall, there was a moderate risk of bias in the primary studies. Conclusion According to this meta-analysis, exercise interventions can be recommended for menopausal women to improve their sleep. High-quality RCTs applying different types of exercise (e.g., walking, yoga, meditative exercise and so on) with different intervention durations as well as subjective and objective sleep assessment are warranted. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022342277, identifier: CRD42022342277.
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Affiliation(s)
- Jialu Qian
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
- Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shiwen Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Man Wang
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Yaping Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiangyu Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Cecilia Jevitt
- Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Xiaoyan Yu
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
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Buis L, Guo H, Rookes T, Frost R, Hamilton FL. Assessing the Acceptability and Effectiveness of Mobile-Based Physical Activity Interventions for Midlife Women During Menopause: Systematic Review of the Literature. JMIR Mhealth Uhealth 2022; 10:e40271. [PMID: 36485026 PMCID: PMC9789501 DOI: 10.2196/40271] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/26/2022] [Accepted: 10/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Midlife women with menopausal symptoms are less likely to meet the recommended level of physical activity (PA). Promoting PA among women in midlife could reduce their risk of cardiovascular diseases and perhaps improve menopausal symptoms. Mobile PA interventions in the form of smartphone apps and wearable activity trackers can potentially encourage users to increase PA levels and address time and resource barriers to PA. However, evidence on the acceptability and effectiveness of these interventions among midlife women is unclear. OBJECTIVE This systematic review evaluated the effectiveness, acceptability, and active behavior change techniques (BCTs) of mobile PA technologies among midlife menopausal women. METHODS A mixed methods systematic review of qualitative and quantitative studies was conducted. MEDLINE (Ovid), Embase, Scopus, CINAHL, Web of Science, SPORTDiscus, CENTRAL, PsycINFO, and the ProQuest Sports Medicine and Education Index were systematically searched. Studies were selected and screened according to predetermined eligibility criteria. In total, 2 reviewers independently assessed the risk of bias using the Mixed Methods Appraisal Tool and completed BCT mapping of the included interventions using the BCT Taxonomy v1. RESULTS A total of 12 studies were included in this review. Overall risk of bias was "Moderate to high" in 58% (7/12) of the included studies and "low" in 42% (5/12) of the studies. Of the 12 studies, 7 (58%) assessed changes in PA levels. The pooled effect size of 2 randomized controlled trials resulted in a small to moderate increase in moderate to vigorous PA of approximately 61.36 weekly minutes among midlife women, at least in the short term (95% CI 17.70-105.01; P=.006). Although a meta-analysis was not feasible because of heterogeneity, positive improvements were also found in a range of menopause-related outcomes such as weight reduction, anxiety management, sleep quality, and menopause-related quality of life. Midlife women perceived mobile PA interventions to be acceptable and potentially helpful in increasing PA and daily steps. The average number of BCTs per mobile PA intervention was 8.8 (range 4-13) according to the BCT Taxonomy v1. "Self-monitoring of behaviour," "Biofeedback," and "Goal setting (behaviour)" were the most frequently described BCTs across the included interventions. CONCLUSIONS This review demonstrated that mobile PA interventions in the form of smartphone apps and wearable trackers are potentially effective for small to moderate increases in moderate to vigorous PA among midlife women with menopausal symptoms. Although menopause is a natural condition affecting half the population worldwide, there is a substantial lack of evidence to support the acceptability and effectiveness of mobile PA interventions on menopause-related outcomes, which needs further investigation. TRIAL REGISTRATION PROSPERO CRD42021273062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273062.
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Affiliation(s)
| | - Haoyue Guo
- UCL Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Tasmin Rookes
- UCL Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Rachael Frost
- UCL Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Fiona L Hamilton
- UCL Research Department of Primary Care and Population Health, University College London, London, United Kingdom
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Psychological and social health outcomes of physical activity around menopause: A scoping review of research. Maturitas 2022; 164:88-97. [DOI: 10.1016/j.maturitas.2022.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/30/2022] [Accepted: 07/27/2022] [Indexed: 12/18/2022]
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Carcelén-Fraile MDC, Hita-Contreras F, Martínez-Amat A, Loureiro VB, Marques de Loureiro NE, Jiménez-García JD, Fábrega-Cuadros R, Aibar-Almazán A. Impact of Qigong exercises on the severity of the menopausal symptoms and health-related quality of life: a randomized controlled trial. Eur J Sport Sci 2022; 23:656-664. [PMID: 35179431 DOI: 10.1080/17461391.2022.2044915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ABSTRACTThe aim of the present study was to analyze the effects of a Qigong exercise program on the severity of the menopausal symptoms and health-related quality of life (HRQoL) of community-dwelling postmenopausal women. This was done by means of a randomized clinical trial with a sample of 125 women who were assigned to either a control (n = 62) or an experimental group (n = 63). The severity of their menopause-related symptoms and HRQoL were assessed through the Menopause Rating Scale (MRS) and the 36-item Short-Form Health Survey (SF-36) respectively, before and after the intervention period. The main findings of our study reveal significant improvement in the severity of menopausal symptoms at the somatic, psychological, and urogenital levels, as well as in the total score of the MRS. Additionally, participants assigned to the Qigong group experienced improvement in the general health, physical functioning, role-physical, bodily pain, vitality, and mental health domains of the 36-item Short-Form Health Survey, as well as in its physical component and mental component summaries. We can therefore conclude that, among Spanish postmenopausal women, a twelve-week Qigong exercise program has beneficial effects on the severity of menopausal symptoms and HRQoL.Trial registration: ClinicalTrials.gov identifier: NCT03989453..
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Affiliation(s)
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén. Jaén, Spain
| | - Antonio Martínez-Amat
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén. Jaén, Spain
| | | | | | | | - Raquel Fábrega-Cuadros
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén. Jaén, Spain
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén. Jaén, Spain
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Can walking exercise programs improve health for women in menopause transition and postmenopausal? Findings from a scoping review. ACTA ACUST UNITED AC 2021; 27:952-963. [PMID: 32404793 DOI: 10.1097/gme.0000000000001554] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our goal was to explore the range and characteristics of published papers on therapeutic walking programs for menopausal women and to identify program features that resulted in successful outcomes including reduced symptoms and improved long-term wellness. METHODS We searched biomedical and exercise-related databases for articles published up to June 1, 2017, using keywords related to menopause and walking. Data were collected into EndNote X8 reference manager to identify and remove duplicates. The final selection included all articles that studied walking as a health intervention for women in menopause transition or postmenopausal. RESULTS A total of 3,244 papers were collected from the six databases. After removing duplicates and applying inclusion and exclusion criteria, 96 articles were charted, including 77 different walking programs. Walking interventions ranged from 4 weeks to 3 years with an average weekly frequency of 3.8 ± 1.8 and were applied to a variety of symptoms and their biological markers and risk factors. Overall, 91% of the programs showed a beneficial outcome in at least one menopause-related medical issue. Information on menopause-specific symptoms, especially vasomotor symptoms and sleep problems, was scarce. CONCLUSION The scoping review highlights the growing interest in walking programs as therapies for menopause and related symptoms and provides evidence of their possible benefit as a wellness option for women in menopause and beyond. Further research would be recommended to establish the therapeutic value of walking programs for women with specific focus on typical menopause symptoms at different stages of menopause. : Video Summary:http://links.lww.com/MENO/A587.
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8
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Olowokere AE, Tope-Ajayi TO, Komolafe AO, Olajubu AO. Lifestyle practices and menopause-related symptoms among women in rural communities of Ado-Ekiti local government area, Nigeria. Post Reprod Health 2020; 27:66-76. [PMID: 33198561 DOI: 10.1177/2053369120971427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Lifestyle modification is consistently recommended for healthy living during menopause; nonetheless, there is paucity of data on menopausal experiences and lifestyle practices of women in rural communities of Nigeria. This study assessed the lifestyle practices of menopausal women, their experiences of menopause-related symptoms and the influence of lifestyle practices on their experiences of menopause-related symptoms. METHOD A descriptive cross-sectional design was used in this study. Systematic random sampling was used to select 271 menopausal women at household level in rural communities of Ado-Ekiti Local Government Area in Ekiti State, Nigeria. A self-developed structured questionnaire was used to assess lifestyle practices while modified menopause rating scale was used to assess menopausal-related symptoms of the women. Data were analysed using descriptive and inferential statistics in SPSS version 22 at 0.05 level of significance. RESULTS Findings revealed that 58.3% had poor lifestyle, while 41.0% and 0.7% had moderate and good lifestyle, respectively. Findings showed that 66.4% of the women experienced moderate menopause-related symptoms, while 15.5% and 0.4% of the women had severe and very severe menopause-related symptoms respectively. Result of the multiple regression indicated that Exercise (β = 0.22, t = 3.63, p = .01), Nutrition (β = 0.13, t = 2.23, p = .02) and Substance use (β = 0.04, t = 2.25, p = .02) were major predictors of menopause-related symptoms. CONCLUSION The study concluded that positive lifestyle modification could help reduce menopausal-related symptoms.
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Affiliation(s)
- Adekemi Eunice Olowokere
- Department of Nursing Science, Faculty of Basic Medical Sciences, 54715Obafemi Awolowo University, Ile Ife, Nigeria
| | - Titilayo Olubunmi Tope-Ajayi
- Department of Nursing Science, Faculty of Basic Medical Sciences, 54715Obafemi Awolowo University, Ile Ife, Nigeria
| | - Abiola Olubusola Komolafe
- Department of Nursing Science, Faculty of Basic Medical Sciences, 54715Obafemi Awolowo University, Ile Ife, Nigeria
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9
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Javadivala Z, Merghati-Khoei E, Asghari Jafarabadi M, Allahverdipour H, Mirghafourvand M, Nadrian H, Kouzekanani K. Efficacy of pharmacological and non-pharmacological interventions on low sexual interest/arousal of peri- and post-menopausal women: a meta-analysis. SEXUAL AND RELATIONSHIP THERAPY 2018. [DOI: 10.1080/14681994.2018.1446515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Zeinab Javadivala
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Effat Merghati-Khoei
- Iranian National Center of Addiction Studies (INCAS), Institute of Risk Behavior Reduction, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Haidar Nadrian
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamiar Kouzekanani
- College of Education & Human Development, Texas A&M University-Corpus Christi (TAMUCC), Texas, USA
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10
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Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity. Menopause 2018; 23:488-93. [PMID: 26818013 DOI: 10.1097/gme.0000000000000575] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the association between sedentary lifestyle and the severity of menopausal symptoms and obesity in middle-aged women. METHODS The Menopause Rating Scale, the Goldberg Anxiety and Depression Scale, and the Athens Insomnia Scale were administered to 6,079 Latin American women aged 40 to 59 years. Sedentary lifestyle was defined as fewer than three weekly, 30-minute periods of physical activity. RESULTS Sedentary women had more severe menopausal symptoms (total Menopause Rating Scale score: 9.57 ± 6.71 vs 8.01 ± 6.27 points, P < 0.0001) and more depressive symptoms (Goldberg), anxiety (Goldberg), and insomnia (Athens Scale) compared with non-sedentary women. They also had greater mean waist circumference (86.2 ± 12.3 vs 84.3 ± 1.8 cm, P < 0.0001) and a higher prevalence of obesity (20.9% vs 14.3%, P < 0.0001). Logistic regression analysis showed that both obesity (odds ratio [OR] 1.52; 95% CI, 1.32-1.76) and severe menopausal symptoms (OR 1.28; 95% CI, 1.06-1.53), including insomnia and depressive mood, were positively associated with a sedentary lifestyle. Having a stable partner (OR 0.85; 95% CI, 0.76-0.96), using hormone therapy (OR 0.75; 95% CI, 0.64-0.87) and having a higher educational level (OR 0.66; 95% CI, 0.60-0.74) were negatively related to sedentary lifestyle. CONCLUSIONS There was a high prevalence of sedentary lifestyle in this middle-aged Latin American female sample which was associated with more severe menopausal symptoms and obesity.
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Frost R, Levati S, McClurg D, Brady M, Williams B. What Adherence Measures Should Be Used in Trials of Home-Based Rehabilitation Interventions? A Systematic Review of the Validity, Reliability, and Acceptability of Measures. Arch Phys Med Rehabil 2017; 98:1241-1256.e45. [PMID: 27702555 DOI: 10.1016/j.apmr.2016.08.482] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/26/2016] [Accepted: 08/31/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To systematically review methods for measuring adherence used in home-based rehabilitation trials and to evaluate their validity, reliability, and acceptability. DATA SOURCES In phase 1 we searched the CENTRAL database, NHS Economic Evaluation Database, and Health Technology Assessment Database (January 2000 to April 2013) to identify adherence measures used in randomized controlled trials of allied health professional home-based rehabilitation interventions. In phase 2 we searched the databases of MEDLINE, Embase, CINAHL, Allied and Complementary Medicine Database, PsycINFO, CENTRAL, ProQuest Nursing and Allied Health, and Web of Science (inception to April 2015) for measurement property assessments for each measure. STUDY SELECTION Studies assessing the validity, reliability, or acceptability of adherence measures. DATA EXTRACTION Two reviewers independently extracted data on participant and measure characteristics, measurement properties evaluated, evaluation methods, and outcome statistics and assessed study quality using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. DATA SYNTHESIS In phase 1 we included 8 adherence measures (56 trials). In phase 2, from the 222 measurement property assessments identified in 109 studies, 22 high-quality measurement property assessments were narratively synthesized. Low-quality studies were used as supporting data. StepWatch Activity Monitor validly and acceptably measured short-term step count adherence. The Problematic Experiences of Therapy Scale validly and reliably assessed adherence to vestibular rehabilitation exercises. Adherence diaries had moderately high validity and acceptability across limited populations. The Borg 6 to 20 scale, Bassett and Prapavessis scale, and Yamax CW series had insufficient validity. Low-quality evidence supported use of the Joint Protection Behaviour Assessment. Polar A1 series heart monitors were considered acceptable by 1 study. CONCLUSIONS Current rehabilitation adherence measures are limited. Some possess promising validity and acceptability for certain parameters of adherence, situations, and populations and should be used in these situations. Rigorous evaluation of adherence measures in a broader range of populations is needed.
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Affiliation(s)
- Rachael Frost
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland.
| | - Sara Levati
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland
| | - Doreen McClurg
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland
| | - Marian Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland
| | - Brian Williams
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, Scotland
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Abdulnour J, Stacey D, Dionne IJ, Brochu M, Doucet É, Prud’homme D. Vasomotor symptoms and cardiometabolic risk factors in menopausal women: a MONET Group study. Climacteric 2016; 19:381-6. [DOI: 10.1080/13697137.2016.1191459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- J. Abdulnour
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Institut de recherche de l’Hôpital Montfort, Ottawa, ON, Canada
- Behavioral and Metabolic Research Unit, University of Ottawa, Ottawa, ON, Canada
| | - D. Stacey
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, ON, Canada
| | - I. J. Dionne
- Faculté des sciences de l’activité physique, Université de Sherbrooke, Sherbrooke, QC, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, QC, Canada
| | - M. Brochu
- Faculté des sciences de l’activité physique, Université de Sherbrooke, Sherbrooke, QC, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, QC, Canada
| | - É. Doucet
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Behavioral and Metabolic Research Unit, University of Ottawa, Ottawa, ON, Canada
| | - D. Prud’homme
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Institut de recherche de l’Hôpital Montfort, Ottawa, ON, Canada
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13
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An intensive longitudinal examination of daily physical activity and sleep in midlife women. Sleep Health 2016; 2:42-48. [DOI: 10.1016/j.sleh.2015.12.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 11/30/2015] [Accepted: 12/03/2015] [Indexed: 02/05/2023]
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Dugan SA, Bromberger JT, Segawa E, Avery E, Sternfeld B. Association between physical activity and depressive symptoms: midlife women in SWAN. Med Sci Sports Exerc 2016; 47:335-42. [PMID: 24914519 DOI: 10.1249/mss.0000000000000407] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The relation of physical activity (PA) and positive mood has been the focus of considerable research, which were primarily cross-sectional. This study was done to evaluate the relation between PA and high depressive symptoms across time and to examine whether being physically active attenuates the risk of depressive symptoms in midlife women. METHODS The present study is a longitudinal observational study on the menopausal transition in a multiethnic population. Ten years of data on 2891 women were analyzed. The participants were women from seven geographic areas nationwide, age 42-52 yr at baseline, still menstruating, and not using exogenous reproductive hormones. PA was measured with the Kaiser Permanente Physical Activity Scale. The main outcome measure, depressive symptoms, was assessed with the Center for Epidemiological Studies Depression Scale (CES-D), with primary outcome of CES-D score of 16 or higher. RESULTS In mixed effect logistic regression models adjusted for covariates, compared with inactivity, PA meeting PA guidelines (approximating public health guidelines) and PA below PA guidelines were each associated with lower risk of high depressive symptoms (CES-D score of 16 or higher) (odds ratio, 0.52; 95% confidence interval, 0.40-0.70; and odds ratio, 0.81; 95% confidence interval, 0.67-0.98, respectively] across 10 yr. Being married, Japanese and Hispanic ethnicity, current smoking, reporting very upsetting life events, using antidepressive medications, having hot flashes, and high body mass index were all positively associated with high depressive symptoms, whereas high social support was negatively associated. CONCLUSIONS Higher PA was associated with lower levels of depressive symptoms persistently over 10 yr, independent of potential confounders. Our findings suggest that reaching moderate-intensity PA levels during midlife may be protective against depressive symptoms.
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Affiliation(s)
- Sheila A Dugan
- 1Department of Preventive Medicine, Rush University Medical Center, Chicago, IL; 2Department of Physical Medicine and Rehabilitation, Rush University Medical Center, Chicago, IL; 3Departments of Epidemiology and Psychiatry, University of Pittsburgh, Pittsburgh, PA; and 4Department of Research Science, Kaiser Permanente, Oakland, CA
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Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. Sexual Function and Exercise in Postmenopausal Women Residing in Chalous and Nowshahr, Northern Iran. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e30120. [PMID: 27437131 PMCID: PMC4939225 DOI: 10.5812/ircmj.30120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 06/16/2015] [Accepted: 07/11/2015] [Indexed: 02/05/2023]
Abstract
Background The sexual function of menopausal women is influenced by several factors. Objectives We aimed to investigate the association between exercise and sexual function among postmenopausal women residing in Northern Iran. Patients and Methods Using a multistage, randomized sampling method, 405 postmenopausal women, aged 40 to 65 years, were recruited to participate in this population-based, cross-sectional study. The female sexual function index (FSFI) questionnaire and a researcher-designed questionnaire were completed by every subject. Results Overall, 61% of the women reported having experienced sexual dysfunction, and 53.6% reported that they had not performed any kind of exercise within the last 6 months; among those who did exercise, the most common form was walking (79.8%). The FSFI total scores (P = 0.013), as well as the scores in the lubrication (P = 0.007) and pain (P < 0.001) domains, were significantly lower for the women who performed exercises other than walking compared to those who only walked or who did not exercise at all. The frequency of weekly exercise had a positive correlation with the scores in the lubrication (r = 0.18, P = 0.014) and orgasm (r = 0.146, P = 0.045) domains. The logistic regression analysis demonstrated that the chances of reduced sexual desire were decreased by 80.2% (P = 0.044) with every unit increase in the frequency of weekly exercise. Conclusions More frequent exercise will improve the sexual function of post-menopausal women.
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Affiliation(s)
- Soheila Nazarpour
- Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Masomeh Simbar
- Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Masomeh Simbar, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-212257571, Fax: +98-2188202516, E-mail:
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Tadayon M, Abedi P, Farshadbakht F. Impact of pedometer-based walking on menopausal women’s sleep quality: a randomized controlled trial. Climacteric 2016; 19:364-8. [DOI: 10.3109/13697137.2015.1123240] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- M. Tadayon
- Menopause and Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - P. Abedi
- Menopause and Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - F. Farshadbakht
- Menopause and Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Examining the relationship between subjective sleep disturbance and menopause: a systematic review and meta-analysis. Menopause 2015; 21:1301-18. [PMID: 24800878 DOI: 10.1097/gme.0000000000000240] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to conduct a systematic review and meta-analysis of the relationship between menopausal stages and sleep disturbance reported using subjective methods. Secondary aims included examining the influence of culture/ethnicity on the relationship between menopausal stages and sleep disturbance. METHODS Multiple electronic databases were searched from the first available year to November 2013, and a manual search of the reference lists of review articles identified was also conducted. Twenty-four studies with a total of 63,542 midlife women were identified, coded, and analyzed. RESULTS The crude and adjusted odds of experiencing sleep disturbance were small but statistically significant for perimenopausal and postmenopausal women, using premenopause as the reference group. The ethnicity of the samples influenced effect sizes; Asian and white women both experienced an increased rate of sleep disturbance at the perimenopausal and postmenopausal stages compared with the premenopausal stage, whereas Hispanic women experienced no change in sleep disturbance across the menopausal transition. CONCLUSIONS The prevalence of sleep disturbance is higher in perimenopausal, postmenopausal, and surgical menopausal women than in premenopausal women. There is an independent relationship between menopausal stages and sleep disturbance beyond the effects of aging and other confounders, although the magnitude of the relationship is small. Culture, ethnicity, or both might affect the levels of sleep disturbance at various menopausal stages.
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Young J, Angevaren M, Rusted J, Tabet N. Aerobic exercise to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev 2015; 2015:CD005381. [PMID: 25900537 PMCID: PMC10554155 DOI: 10.1002/14651858.cd005381.pub4] [Citation(s) in RCA: 206] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is increasing evidence that physical activity supports healthy ageing. Exercise is helpful for cardiovascular, respiratory and musculoskeletal systems, among others. Aerobic activity, in particular, improves cardiovascular fitness and, based on recently reported findings, may also have beneficial effects on cognition among older people. OBJECTIVES To assess the effect of aerobic physical activity, aimed at improving cardiorespiratory fitness, on cognitive function in older people without known cognitive impairment. SEARCH METHODS We searched ALOIS - the Cochrane Dementia and Cognitive Improvement Group's Specialized Register, the Cochrane Controlled Trials Register (CENTRAL) (all years to Issue 2 of 4, 2013), MEDLINE (Ovid SP 1946 to August 2013), EMBASE (Ovid SP 1974 to August 2013), PEDro, SPORTDiscus, Web of Science, PsycINFO (Ovid SP 1806 to August 2013), CINAHL (all dates to August 2013), LILACS (all dates to August 2013), World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch), ClinicalTrials.gov (https://clinicaltrials.gov) and Dissertation Abstracts International (DAI) up to 24 August 2013, with no language restrictions. SELECTION CRITERIA We included all published randomised controlled trials (RCTs) comparing the effect on cognitive function of aerobic physical activity programmes with any other active intervention, or no intervention, in cognitively healthy participants aged over 55 years. DATA COLLECTION AND ANALYSIS Two review authors independently extracted the data from included trials. We grouped cognitive outcome measures into eleven categories covering attention, memory, perception, executive functions, cognitive inhibition, cognitive speed and motor function. We used the mean difference (or standardised mean difference) between groups as the measure of the treatment effect and synthesised data using a random-effects model. We conducted separate analyses to compare aerobic exercise interventions with no intervention and with other exercise, social or cognitive interventions. Also, we performed analyses including only trials in which an increase in the cardiovascular fitness of participants had been demonstrated. MAIN RESULTS Twelve trials including 754 participants met our inclusion criteria. Trials were from eight to 26 weeks in duration.We judged all trials to be at moderate or high risk of bias in at least some domains. Reporting of some risk of bias domains was poor.Our analyses comparing aerobic exercise to any active intervention showed no evidence of benefit from aerobic exercise in any cognitive domain. This was also true of our analyses comparing aerobic exercise to no intervention. Analysing only the subgroup of trials in which cardiorespiratory fitness improved in the aerobic exercise group showed that this improvement did not coincide with improvements in any cognitive domains assessed. Our subgroup analyses of aerobic exercise versus flexibility or balance interventions also showed no benefit of aerobic exercise in any cognitive domain.Dropout rates did not differ between aerobic exercise and control groups. No trial reported on adverse effects.Overall none of our analyses showed a cognitive benefit from aerobic exercise even when the intervention was shown to lead to improved cardiorespiratory fitness. AUTHORS' CONCLUSIONS We found no evidence in the available data from RCTs that aerobic physical activities, including those which successfully improve cardiorespiratory fitness, have any cognitive benefit in cognitively healthy older adults. Larger studies examining possible moderators are needed to confirm whether or not aerobic training improves cognition.
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Affiliation(s)
- Jeremy Young
- University of SussexSchool of PsychologyBrightonUKBN1 9QH
| | - Maaike Angevaren
- University of Applied SciencesResearch Group Lifestyle and HealthBolognalaan 101UtrechtNetherlands3584 CJ
| | | | - Naji Tabet
- Brighton and Sussex Medical SchoolPostgraduate MedicineMayfield House, University of BrightonFalmerBrightonUKBN1 9PH
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Abstract
BACKGROUND Evidence suggests that many perimenopausal and early postmenopausal women will experience menopausal symptoms; hot flushes are the most common. Symptoms caused by fluctuating levels of oestrogen may be alleviated by hormone therapy (HT), but a marked global decline in its use has resulted from concerns about the risks and benefits of HT. Consequently, many women are seeking alternatives. As large numbers of women are choosing not to take HT, it is increasingly important to identify evidence-based lifestyle modifications that have the potential to reduce vasomotor menopausal symptoms. OBJECTIVES To examine the effectiveness of any type of exercise intervention in the management of vasomotor symptoms in symptomatic perimenopausal and postmenopausal women. SEARCH METHODS Searches of the following electronic bibliographic databases were performed to identify randomised controlled trials (RCTs): Cochrane Menstrual Disorders and Subfertility Group Specialised Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Wiley Internet interface), MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), the Science Citation Index and the Social Science Citation Index (Web of Science), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (Ovid) and SPORTDiscus. Searches include findings up to 3 March 2014. SELECTION CRITERIA RCTs in which any type of exercise intervention was compared with no treatment/control or other treatments in the management of menopausal vasomotor symptoms in symptomatic perimenopausal/postmenopausal women. DATA COLLECTION AND ANALYSIS Five studies were deemed eligible for inclusion. Two review authors independently selected the studies, and three review authors independently extracted the data. The primary review outcome was vasomotor symptoms, defined as hot flushes and/or night sweats. We combined data to calculate standardised mean differences (SMDs) with 95% confidence intervals (CIs). Statistical heterogeneity was assessed using the I(2) statistic. We assessed the overall quality of the evidence for main comparisons using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) methods. MAIN RESULTS We included five RCTs (733 women) comparing exercise with no active treatment, exercise with yoga and exercise with HT. The evidence was of low quality: Limitations in study design were noted, along with inconsistency and imprecision. In the comparison of exercise versus no active treatment (three studies, n = 454 women), no evidence was found of a difference between groups in frequency or intensity of vasomotor symptoms (SMD -0.10, 95% CI -0.33 to 0.13, three RCTs, 454 women, I(2) = 30%, low-quality evidence). Nor was any evidence found of a difference between groups in the frequency or intensity of vasomotor symptoms when exercise was compared with yoga (SMD -0.03, 95% CI -0.45 to 0.38, two studies, n = 279 women, I(2) = 61%, low-quality evidence). It was not possible to include one of the trials in the meta-analyses; this trial compared three groups: exercise plus soy milk, soy milk only and control; results favoured exercise relative to the comparators, but study numbers were small. One trial compared exercise with HT, and the HT group reported significantly fewer flushes in 24 hours than the exercise group (mean difference 5.8, 95% CI 3.17 to 8.43, 14 participants). None of the trials found evidence of a difference between groups with respect to adverse effects, but data were very scanty. AUTHORS' CONCLUSIONS Evidence was insufficient to show whether exercise is an effective treatment for vasomotor menopausal symptoms. One small study suggested that HT is more effective than exercise. Evidence was insufficient to show the relative effectiveness of exercise when compared with HT or yoga.
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Affiliation(s)
- Amanda Daley
- College of Medical and Dental Sciences, University of BirminghamPrimary Care Clinical SciencesBirminghamEnglandUKB15 2TT
| | - Helen Stokes‐Lampard
- College of Medical and Dental Sciences, University of BirminghamPrimary Care Clinical SciencesBirminghamEnglandUKB15 2TT
| | - Adèle Thomas
- Macquarie UniversityHigher Degree Research OfficeBalaclava RoadNorth RydeNew South WalesAustralia2109
| | - Christine MacArthur
- College of Medical and Dental Sciences, University of BirminghamPublic Health, Epidemiology and BiostatisticsBirminghamEnglandUKB15 2TT
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Im EO, Teng H, Lee Y, Kang Y, Ham OK, Chee E, Chee W. Physical activities and sleep-related symptoms in 4 major racial/ethnic groups of midlife women. FAMILY & COMMUNITY HEALTH 2014; 37:307-316. [PMID: 25167071 PMCID: PMC7647168 DOI: 10.1097/fch.0000000000000041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to determine racial/ethnic differences in midlife women's sleep-related symptoms, relationships between their physical activity and sleep-related symptoms, and specific factors associated with their sleep-related symptoms in each racial/ethnic group. This was a secondary analysis of the data from 542 midlife women in the United States. The data were analyzed using descriptive statistics, χ tests, analysis of variance, hierarchical multiple linear regression analyses, and logistic regression analyses. The findings indicated that physical activities could improve midlife women's sleep-related symptoms, but the types of physical activities and racially/ethnically different factors associated with sleep-related symptoms need to be considered.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Pennsylvania (Drs Im, Ham, and W. Chee and Mss Teng, Lee, and Kang); Department of Nursing, Inha University, Incheon, South Korea (Dr Ham); and School of Engineering and Applied Science, University of Pennsylvania, Philadelphia (Ms E. Chee)
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Rutanen R, Luoto R, Raitanen J, Mansikkamäki K, Tomás E, Nygård CH. Short- and Long-term Effects of a Physical Exercise Intervention on Work Ability and Work Strain in Symptomatic Menopausal Women. Saf Health Work 2014; 5:186-90. [PMID: 25516810 PMCID: PMC4266772 DOI: 10.1016/j.shaw.2014.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 08/31/2014] [Accepted: 08/31/2014] [Indexed: 10/30/2022] Open
Abstract
BACKGROUND Physical exercise during leisure time is known to increase physical capacity; however, the long-term effects on work ability and work strain are inconclusive. The aim of this study was to investigate the effects of a 6-month physical exercise program on work ability and work strain after 6 months and 30 months, among women with menopausal symptoms at baseline. METHODS A questionnaire including questions on work ability and work strain was mailed in the beginning, at 6 months and after 30 months after the intervention to occupationally active women participating in a randomized controlled study on physical exercise and quality of life. The intervention included aerobic exercise training 4 times per week, 50 minutes per session. Work ability was measured with the Work Ability Index (WAI) and with questions about physical and mental work strain. RESULTS Women aged 47-62 years (N = 89) who were occupationally active at baseline were included in the analyses. The increase in WAI from baseline to the end of the exercise intervention (6 months) was statistically significantly greater among the intervention group than among the control group (regression coefficient 2.08; 95% confidence interval 0.71-3.46). The difference between the groups persisted for 30 months. No significant short- or long-term effects on physical and mental work strain were found. CONCLUSION A 6-month physical exercise intervention among symptomatic menopausal women had positive short-term as well as long-term effects on work ability.
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Affiliation(s)
- Reetta Rutanen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Riitta Luoto
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Jani Raitanen
- School of Health Sciences, University of Tampere, Tampere, Finland ; UKK Institute for Health Promotion Research, Tampere, Finland
| | | | - Eija Tomás
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
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Hachul H, Monson C, Kozasa EH, Oliveira DS, Goto V, Afonso R, Llanas AC, Tufik S. Complementary and alternative therapies for treatment of insomnia in women in postmenopause. Climacteric 2014; 17:645-53. [DOI: 10.3109/13697137.2014.926321] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bryant C, Kleinstäuber M, Judd F. Asptects of mental health care in the gynecological setting. WOMENS HEALTH 2014; 10:237-54. [PMID: 24956291 DOI: 10.2217/whe.14.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Psychological disorders are commonly associated with gynecological conditions, but are frequently undetected and untreated, and may influence the presentation and treatment outcomes of the physical condition. A literature search was conducted in order to provide a narrative review of psychological aspects of menopause, premenstrual syndrome, premenstrual dysphoric disorder, chronic pelvic pain, incontinence and polycystic ovarian syndrome. All the conditions that have been addressed in this review can be associated with an increased risk of psychological symptoms and disorders. Anxiety and depression are common and are associated with significant morbidity. Gynecological conditions, by their nature, are likely to be accompanied by impairments in social, occupational and personal functioning. Greater emphasis should be placed on the mental health aspects of gynecological conditions.
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Affiliation(s)
- Christina Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria 3010 Australia
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Sternfeld B, Guthrie KA, Ensrud KE, LaCroix AZ, Larson JC, Dunn AL, Anderson GL, Seguin RA, Carpenter JS, Newton KM, Reed SD, Freeman EW, Cohen LS, Joffe H, Roberts M, Caan BJ. Efficacy of exercise for menopausal symptoms: a randomized controlled trial. Menopause 2014; 21:330-8. [PMID: 23899828 PMCID: PMC3858421 DOI: 10.1097/gme.0b013e31829e4089] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study aims to determine the efficacy of exercise training for alleviating vasomotor and other menopausal symptoms. METHODS Late perimenopausal and postmenopausal sedentary women with frequent vasomotor symptoms (VMS) participated in a randomized controlled trial conducted in three sites: 106 women randomized to exercise and 142 women randomized to usual activity. The exercise intervention consisted of individual facility-based aerobic exercise training three times per week for 12 weeks. VMS frequency and bother were recorded on daily diaries at baseline and on weeks 6 and 12. Intent-to-treat analyses compared between-group differences in changes in VMS frequency and bother, sleep symptoms (Insomnia Severity Index and Pittsburgh Sleep Quality Index), and mood (Patient Health Questionnaire-8 and Generalized Anxiety Disorder-7 questionnaire). RESULTS At the end of week 12, changes in VMS frequency in the exercise group (mean change, -2.4 VMS/d; 95% CI, -3.0 to -1.7) and VMS bother (mean change on a four-point scale, -0.5; 95% CI, -0.6 to -0.4) were not significantly different from those in the control group (-2.6 VMS/d; 95% CI, -3.2 to -2.0; P = 0.43; -0.5 points; 95% CI, -0.6 to -0.4; P = 0.75). The exercise group reported greater improvement in insomnia symptoms (P = 0.03), subjective sleep quality (P = 0.01), and depressive symptoms (P = 0.04), but differences were small and not statistically significant when P values were adjusted for multiple comparisons. Results were similar when considering treatment-adherent women only. CONCLUSIONS These findings provide strong evidence that 12 weeks of moderate-intensity aerobic exercise do not alleviate VMS but may result in small improvements in sleep quality, insomnia, and depression in midlife sedentary women.
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Affiliation(s)
| | | | - Kristine E. Ensrud
- University of Minnesota and Minneapolis VA Health Care System,
Minneapolis, MN
| | | | | | | | | | | | | | | | | | - Ellen W. Freeman
- Department of Obstetrics and Gynecology, University of Pennsylvania,
Philadelphia, PA
| | - Lee S. Cohen
- Massachusetts General Hospital, Harvard University, Boston,
MA
| | - Hadine Joffe
- Massachusetts General Hospital, Harvard University, Boston,
MA
| | | | - Bette J. Caan
- Division of Research, Kaiser Permanente, Oakland, CA
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Impact of brisk walking on perceived health evaluated by a novel short questionnaire in sedentary and moderately obese postmenopausal women. Menopause 2014; 20:804-12. [PMID: 23884053 DOI: 10.1097/gme.0b013e31827deebb] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The first objective of this study was to evaluate the impact of brisk walking on moderately obese (body mass index, 29-35 kg/m) postmenopausal women's perceived health, assessed through a novel short perceived health questionnaire (SPHQ), and to verify whether improvements in six items examined were related to cardiorespiratory fitness (CRF) and/or fat mass changes (study 1). The second objective of this study was to test the SPHQ against validated generic instruments (study 2). METHODS From the 270 women included in study 1, 181 participants were subjected to three 45-minute walking sessions per week at 60% of their heart rate reserve, whereas 58 women remained inactive for 4 months. Perceived health assessed through the SPHQ, body composition, and CRF were determined before and after the 4-month study period. Another sample of 20 women was selected to validate the SPHQ (study 2). RESULTS Despite a lack of between-group differences in the amelioration of four perceived health items, ideal weight and stress level were improved in women subjected to our walking program exclusively (P < 0.0001). Improved perceived healthy balanced diet was positively correlated to fat mass reduction in the walking group (r = 0.15; P < 0.05) only (study 1). The SPHQ shows good reproducibility for five of six items (intraclass correlation coefficients ranging from 0.77 to 0.89; P < 0.0001), and three of them were validated against generic tools (0.45 < r < 0.54; P < 0.05; study 2). CONCLUSIONS Additional studies are needed to more accurately determine the relationships between changes in perceived health and changes in body fatness and/or CRF after endurance training and to continue the validation of the SPHQ.
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Gibson C, Matthews K, Thurston R. Daily physical activity and hot flashes in the Study of Women's Health Across the Nation (SWAN) Flashes Study. Fertil Steril 2014; 101:1110-6. [PMID: 24491454 DOI: 10.1016/j.fertnstert.2013.12.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 12/09/2013] [Accepted: 12/13/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine the role of physical activity in menopausal hot flashes. DESIGN Physiologic hot flash monitor and activity monitor over two 48-hour periods, with self-report in an electronic diary. SETTING Community. PATIENT(S) 51 midlife women. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Physiologically detected hot flashes and reported hot flashes with and without physiologic corroboration. RESULT(S) Competing models conceptualize physical activity as a risk or protective factor for hot flashes, but few studies have examined this relationship prospectively using physiologic measures of hot flashes and physical activity. When physiologic hot flashes, reported hot flashes, and reported hot flashes without physiologic corroboration were related to activity changes using hierarchic generalized linear modeling, adjusting for potential confounders, hot flash reports without physiologic corroboration were more likely after activity increases, particularly among women with higher levels of depressive symptoms. No other types of hot flashes were related to physical activity. CONCLUSION(S) Acute increases in physical activity were associated with increased reporting of hot flashes that lacked physiologic corroboration, particularly among women with depressive symptoms. Clinicians should consider the role of symptom perception and reporting in relations between physical activity and hot flashes.
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Affiliation(s)
- Carolyn Gibson
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Karen Matthews
- Departments of Psychiatry, Epidemiology, and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rebecca Thurston
- Departments of Psychiatry, Epidemiology, and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
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To exercise, or, not to exercise, during menopause and beyond. Maturitas 2014; 77:318-23. [PMID: 24548848 DOI: 10.1016/j.maturitas.2014.01.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 01/15/2014] [Accepted: 01/16/2014] [Indexed: 11/22/2022]
Abstract
Menopausal symptoms in women can be severe and disruptive to overall quality of life. Hormone replacement therapy, is known to be effective in ameliorating symptoms, however, reporting of side effects has resulted in alternative treatment options. Exercise has been assessed as an alternative treatment option for alleviating menopausal symptoms, including, psychological, vasomotor, somatic and sexual symptoms. Here we report the effects of physical activity and exercise on menopause symptoms in menopausal women.
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Woods NF, Mitchell ES, Schnall JG, Cray L, Ismail R, Taylor-Swanson L, Thomas A. Effects of mind-body therapies on symptom clusters during the menopausal transition. Climacteric 2013; 17:10-22. [PMID: 23937432 DOI: 10.3109/13697137.2013.828198] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS Although most women experience symptom clusters during the menopausal transition and early postmenopause, investigators reporting clinical trial effects for hot flushes often omit co-occurring symptoms. Our aim was to review controlled clinical trials of mind-body therapies for hot flushes and at least one other co-occurring symptom from these groups: sleep, cognitive function, mood, and pain. METHODS An experienced reference librarian performed an extensive search of PubMed/Medline, CINAHL Plus, PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, AMED, and Alt-Health Watch for randomized controlled trials reported in English between 2004 and July 2011. Of 1193 abstracts identified, 58 trials examining effectiveness of therapies for hot flushes and at least one additional co-occurring symptom of interest were identified. RESULTS Eight trials (ten publications) examined relaxation, yoga, or exercise. Physical activity/exercise trials (six) yielded mixed results; only one significantly reduced hot flushes and mood symptoms. Of two relaxation therapy trials, only mindfulness-based stress reduction training reduced sleep and mood symptoms and had within-group treatment effects on hot flushes. Yoga (one trial) significantly reduced hot flushes and improved cognitive symptoms more than exercise, and also had within-group effects on sleep and pain symptoms. CONCLUSIONS Studies of mind-body therapies for hot flushes increasingly measure multiple symptom outcomes, but few report treatment effects in ways that allow clinicians to consider symptom clusters when prescribing therapies. Future studies need to measure and report results for individual symptoms or group like symptoms together into subscales rather than use subscales with mixed dimensions. Trials with larger numbers of participants are essential to allow evaluation of these therapies on multiple co-occurring symptoms.
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Affiliation(s)
- N F Woods
- * Biobehavioral Nursing, University of Washington
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Kline CE, Irish LA, Krafty RT, Sternfeld B, Kravitz HM, Buysse DJ, Bromberger JT, Dugan SA, Hall MH. Consistently high sports/exercise activity is associated with better sleep quality, continuity and depth in midlife women: the SWAN sleep study. Sleep 2013; 36:1279-88. [PMID: 23997360 DOI: 10.5665/sleep.2946] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To examine relationships between different physical activity (PA) domains and sleep, and the influence of consistent PA on sleep, in midlife women. DESIGN Cross-sectional. SETTING Community-based. PARTICIPANTS 339 women in the Study of Women's Health Across the Nation Sleep Study (52.1 ± 2.1 y). INTERVENTIONS None. MEASUREMENTS AND RESULTS Sleep was examined using questionnaires, diaries and in-home polysomnography (PSG). PA was assessed in three domains (Active Living, Household/Caregiving, Sports/Exercise) using the Kaiser Physical Activity Survey (KPAS) up to 4 times over 6 years preceding the sleep assessments. The association between recent PA and sleep was evaluated using KPAS scores immediately preceding the sleep assessments. The association between the historical PA pattern and sleep was examined by categorizing PA in each KPAS domain according to its pattern over the 6 years preceding sleep assessments (consistently low, inconsistent/consistently moderate, or consistently high). Greater recent Sports/Exercise activity was associated with better sleep quality (diary "restedness" [P < 0.01]), greater sleep continuity (diary sleep efficiency [SE; P = 0.02]) and depth (higher NREM delta electroencephalographic [EEG] power [P = 0.04], lower NREM beta EEG power [P < 0.05]), and lower odds of insomnia diagnosis (P < 0.05). Consistently high Sports/Exercise activity was also associated with better Pittsburgh Sleep Quality Index scores (P = 0.02) and higher PSG-assessed SE (P < 0.01). Few associations between sleep and Active Living or Household/Caregiving activity (either recent or historical pattern) were noted. CONCLUSION Consistently high levels of recreational physical activity, but not lifestyle- or household-related activity, are associated with better sleep in midlife women. Increasing recreational physical activity early in midlife may protect against sleep disturbance in this population.
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Affiliation(s)
- Christopher E Kline
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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Abstract
OBJECTIVE The aim of this study was to assess whether aerobic training affects menopausal symptoms in recently postmenopausal sedentary women. METHODS Symptomatic women aged 45 to 63 years (N = 176; 3-36 months since last menstruation) were randomly assigned to an aerobic training or a control group. The intervention included unsupervised aerobic training for 50 minutes four times weekly for 24 weeks, whereas the control group attended health lectures twice a month. Symptoms were reported twice a day using a mobile phone. The perceived disturbance of menopausal symptoms (night sweats, mood swings, irritability, depressive mood, headache, vaginal dryness, and urinary symptoms) was evaluated on a scale from 1 (low) to 5 (high). Multilevel mixed-effect ordinal regression models were based on 17,000 responses during 24 weeks. RESULTS One hundred fifty-four women continued until the end of the study (88% compliance rate). Baseline prevalence was as follows: night sweats, 50% to 60%; irritability and depression, 20% to 25%; mood swings, 25% to 30%; headache and urinary problems, 15% to 20%; and vaginal dryness, 10% to 15%. The prevalence of all symptoms except vaginal dryness decreased among intervention groups. According to multilevel mixed-effect ordinal regression analysis, night sweats and mood swings (P < 0.001) and disturbance of the mood swings (P < 0.001) and irritability (P < 0.001) were reduced more among the women in the intervention group than in the control group. CONCLUSIONS In sedentary women, aerobic training for 6 months may decrease the typical menopausal symptoms, especially night sweats, mood swings, and irritability.
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Luoto R, Moilanen J, Heinonen R, Mikkola T, Raitanen J, Tomas E, Ojala K, Mansikkamäki K, Nygård CH. Effect of aerobic training on hot flushes and quality of life--a randomized controlled trial. Ann Med 2012; 44:616-26. [PMID: 21639722 PMCID: PMC3469216 DOI: 10.3109/07853890.2011.583674] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE To estimate whether aerobic training has an effect on frequency of hot flushes or quality of life. DESIGN A randomized controlled trial. PARTICIPANTS AND SETTING Symptomatic, sedentary women (n = 176), 43-63 years, no current use of hormone therapy. INTERVENTION Unsupervised aerobic training for 50 minutes four times per week during 6 months. OUTCOMES Hot flushes as measured with Women's Health Questionnaire (WHQ) and Health-Related Quality of Life (HRQoL, SF-36), daily reported hot flushes on phone-based diary, cardiorespiratory fitness (CRF), and body composition. RESULTS Intervention group had larger decrease in the frequency of night-time hot flushes based on phone diary (P for month × group = 0.012), but not on WHQ scale. Intervention group had less depressed mood (P = 0.01) than control women according to change in WHQ score. Changes in WHQ score in depressed mood (P = 0.03) and menstrual symptoms (P = 0.01) in the intervention group were significantly dependent on frequency of training sessions. HRQoL was improved among the intervention group women in physical functioning (P = 0.049) and physical role limitation (P = 0.017). CRF improved (P = 0.008), and lean muscle mass increased (P = 0.046) significantly in the intervention group as compared to controls. CONCLUSIONS Aerobic training may decrease the frequency of hot flushes and improve quality of life among slightly overweight women.
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Affiliation(s)
- Riitta Luoto
- UKK Institute for Health Promotion Research, Tampere, Finland.
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Sleep quality and aerobic training among menopausal women--a randomized controlled trial. Maturitas 2012; 72:339-45. [PMID: 22673453 DOI: 10.1016/j.maturitas.2012.05.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 05/11/2012] [Accepted: 05/13/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Menopause is associated with poor sleep quality and daytime sleepiness, which may lead to impaired quality of life and impaired functioning in daily activities. OBJECTIVE To study whether exercise training improves sleep quality or decreases the amount of night time hot flushes among menopausal women with vasomotor symptoms. STUDY DESIGN A randomized controlled trial. Sedentary women (N=176) aged 43-63 years with menopausal symptoms were randomized to a six-month unsupervised aerobic training intervention (50 min 4 times per week) or a control group. Both groups attended lectures on physical activity and health once a month. MAIN OUTCOME MEASURES Sleep quality and the amount of hot flushes disturbing sleep. The women reported daily via mobile phone whether hot flushes had disturbed their sleep and how they had slept (scale 1-5). Responses received by mobile phone over the 6-month period totaled on average 125 (5.2 per week) responses per participant. RESULTS At baseline there was no difference between the groups in the demographic variables. Sleep quality improved significantly more in the intervention group than in the control group (OR 1.02; 95% CI=1.0-1.05, p=0.043). The odds for sleep improvement were 2% per week in the intervention group and a decrease of 0.5% per week in the control group. The amount of hot flushes related to sleep diminished (p=0.004) by the end of the intervention. CONCLUSIONS Aerobic training for 6 months may improve sleep quality and reduce hot flushes among symptomatic menopausal women.
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Yeh SCJ, Chang MY. The effect of Qigong on menopausal symptoms and quality of sleep for perimenopausal women: a preliminary observational study. J Altern Complement Med 2012; 18:567-75. [PMID: 22537466 DOI: 10.1089/acm.2011.0133] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The study objectives were to examine the effect of a 12-week 30-minute-a-day Ping Shuai Qigong exercise program on climacteric symptoms and sleep quality in perimenopausal women. DESIGN This was a prospective observational study. SETTINGS/LOCATION The subjects (N=70) from two communities were women aged 45 years and above who were experiencing menopausal symptoms. SUBJECTS Thirty-five (35) women from one community were assigned to a Ping Shuai Qigong intervention group, while 35 women from the other community were assigned to the control group. INTERVENTIONS This was a 12-week, 30-minute-a-day Ping Shuai Qigong program. OUTCOME MEASURES The Greene Climacteric Symptom scale and the Pittsburgh Sleep Quality Index were the outcome measures. METHODS Descriptive analysis and repeated-measures analysis of variance were used. RESULTS Pretest scores at baseline found no significant group differences in climacteric symptoms or sleep quality. Significant improvements in climacteric symptoms were found at 6 weeks and 12 weeks (t=4.07, p<0.001 and t=11.83, p<0.001) in the intervention group. They were also found to have significant improvements in sleep quality in those times (t=5.93, p<0.001 and t=10.58, p<0.001, respectively). CONCLUSIONS Ping Shuai Qigong improved climacteric symptoms and sleep quality in perimenopausal women at 6 weeks and 12 weeks. The longer a person practiced this form of meditative exercise, the greater the improvement in sleeping quality and climacteric symptoms.
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Affiliation(s)
- Shu-Chuan Jennifer Yeh
- Department of Business Management, Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung, Taiwan.
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Sternfeld B, Dugan S. Physical activity and health during the menopausal transition. Obstet Gynecol Clin North Am 2012; 38:537-66. [PMID: 21961719 DOI: 10.1016/j.ogc.2011.05.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The benefits of regular physical activity are well established, but evidence for a protective effect against the adverse health consequences accompanying the menopausal transition is limited. This article reviews that evidence, concluding that more physical activity is generally associated with fewer somatic and mood symptoms. Physical activity seems to minimize weight gain and changes in body composition and fat distribution experienced at midlife and might attenuate the rapid bone density loss that occurs. Given these benefits, clinicians treating perimenopausal women should encourage their patients to follow guidelines for physical activity (≥150 minutes a week of moderate-intensity activity).
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Affiliation(s)
- Barbara Sternfeld
- Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA.
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Abstract
BACKGROUND Evidence suggests that many perimenopausal and early postmenopausal women will experience menopause symptoms, hot flushes being the most common. Symptoms caused by fluctuating levels of oestrogen may be alleviated by HRT but there has been a marked global decline in its use due to concerns about the risks and benefits of HRT; consequently many women are now seeking alternatives. As large numbers of women are choosing not to take HRT, it is increasingly important to identify evidence based lifestyle modification interventions that have potential to reduce vasomotor menopausal symptoms. OBJECTIVES To examine the effectiveness of any type of exercise intervention in the management of vasomotor menopausal symptoms (hot flushes and night sweats) in perimenopausal and postmenopausal women. SEARCH STRATEGY Searches of the following electronic bibliographic databases were performed to identify randomised controlled trials (RCTs): Cochrane Menstrual Disorders and Subfertility Group Specialised trials register; Cochrane Library (CENTRAL) (Wiley Internet interface), MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Science Citation Index and Social Science Citation Index (Web of Science), CINAHL (Ovid) and SPORT Discus. Searches included dates up until 16-24 March 2010. SELECTION CRITERIA RCTs in which any type of exercise intervention were compared no treatment/control or other treatments in the management of menopausal vasomotor symptoms in symptomatic perimenopausal/postmenopausal women. DATA COLLECTION AND ANALYSIS Six studies were deemed eligible for inclusion. Three authors independently extracted data from eligible studies. Three meta-analyses according to comparator the group were performed. MAIN RESULTS In the comparison of exercise versus no treatment/control (three studies), the non-significant effect size Standardised Mean Difference (SMD) for vasomotor symptoms was -0.14 (95% CI: -0.54 to 0.26); SMD was -0.04, -0.25, -0.38. For the analysis of exercise versus HRT (three studies), the non-significant SMD was 0.49 (95% CI: -0.27 to 1.26); SMD across studies was 0.13, 0.19 and 1.52, with all studies favouring HRT. In the comparison of exercise versus yoga (two studies), the non-significant SMD was -0.09 (95%CI:-0.64 to 0.45); SMD was -0.37 and 0.19. All comparisons were based on small samples. One small study reported data that could not be included in the meta-analysis; in this study hot flush scores were significantly lower in the exercise plus soy milk group (83%) than soy milk only group (72%). AUTHORS' CONCLUSIONS The existing studies provided insufficient evidence to determine the effectiveness of exercise as a treatment for vasomotor menopausal symptoms, or whether exercise is more effective than HRT or yoga.
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Affiliation(s)
- Amanda Daley
- Primary Care Clinical Sciences, College of Medicine and Dentistry, Learning Centre Building, Universitiy of Birmingham, Birmingham, England, UK, B15 2TT
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Symptom clusters during the late menopausal transition stage: observations from the Seattle Midlife Women's Health Study. Menopause 2011; 17:972-7. [PMID: 20628322 DOI: 10.1097/gme.0b013e3181dd1f95] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of this study were to identify groups of women in the late menopausal transition stage who experienced the same cluster of symptoms and to identify indicators that predicted membership in these distinct groups. METHODS The sample consisted of a subset of Seattle Midlife Women's Health Study participants who were in the late menopausal transition stage and provided self-report data on symptoms experienced between 1990 and 2005. Latent class analysis (LCA) was used to identify groups of women who experienced similar clusters of the following five symptoms: problem concentrating, hot flashes, joint ache, mood changes, and awakening at night. LCA with multivariate logistic regression was used to identify covariates that predicted membership in each group. RESULTS Four groups of women were identified: (1) low severity for all symptoms except for joint ache, which was moderate (65%); (2) high severity for all symptoms except for hot flashes, which was moderate (13%); (3) high severity for hot flashes, joint ache, and awakening at night (12%); and (4) high severity for problem concentrating and joint ache (10%). A clear delineation between groups based on individual characteristics was not fully elucidated. CONCLUSIONS This analysis demonstrates that LCA may be useful to identify women who may experience poorer outcomes related to a higher propensity for severe symptoms. Shifting the focus from single symptoms to symptom clusters will aid in the identification of phenotypic profiles, thus facilitating symptom management strategies that can be tailored to meet the needs of individual women.
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Prevalence of menopause symptoms and their association with lifestyle among Finnish middle-aged women. Maturitas 2010; 67:368-74. [PMID: 20869181 DOI: 10.1016/j.maturitas.2010.08.007] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 07/28/2010] [Accepted: 08/21/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIM OF THE STUDY The aim of this study is to report the prevalence of menopausal symptoms by severity among the Finnish female population and the association of their symptoms with lifestyle (smoking, use of alcohol, physical activity) and body mass index (BMI). MATERIAL AND METHODS Health 2000 is a nationally representative population-based study of Finnish adults. Data were collected by home interview, three self-administered questionnaires and a clinical examination by a physician. This study included women aged 45-64 years (n=1427). All symptoms included menopause-specific symptoms. Both univariate analysis and a factor analysis based on symptom factors were performed by menopausal group. Multiple regression analysis included each symptom factor as a dependent variable and confounding and lifestyle factors (age, education, smoking, alcohol use, physical activity, BMI, use of hormonal replacement therapy (HRT) and chronic disease status). RESULTS Over one-third (38%) of the premenopausal, half of the perimenopausal, and 54% of both postmenopausal and hysterectomized women reported bothersome symptoms. The difference between pre- and perimenopausal women was largest and statistically most significant in the case of back pain and hot flushes. Physically active women reported fewer somatic symptoms than did women with a sedentary lifestyle. Smoking was not related to vasomotor symptoms. CONCLUSION Bothersome symptoms are common in midlife, regardless of menopausal status. Inverse association between physical activity and menopausal symptoms needs to be confirmed in randomized trials.
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Abstract
The prevalence of sleep-related complaints and the limited efficacy of pharmacological treatments make nonpharmacological alternatives essential. Physical exercise is one such alternative that is inexpensive and affects numerous health systems simultaneously. This article reviews putative mechanisms that have guided exercise and sleep research, including exercise’s antidepressant effects, restorative functions, and circadian effects, and concludes that a number of mechanisms are plausible and likely active in explaining the effects of exercise on sleep. The empirical literature is reviewed, with special emphasis given to randomized controlled trials and experimental studies that help to inform for whom (eg, age, fitness characteristics), under what conditions (eg, light exposure, time of day), and by what means (eg, type, intensity, duration) exercise optimally affects sleep. The review also includes the emerging research using exercise as a treatment of obstructive sleep apnea and restless legs syndrome. The current literature indicates that moderate amounts of exercise, which can be obtained through a variety of means such as brisk walking and resistance training, are sufficient to improve sleep quality. Additional research is warranted in this area, particularly randomized controlled trials that target subgroups at risk for poor sleep such as older adults and persons with sleep disorders.
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Affiliation(s)
- Matthew P. Buman
- Department of Medicine, Stanford University School of Medicine, Stanford, California,
| | - Abby C. King
- Department of Health Research and Policy Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California
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Impact of walking on eating behaviors and quality of life of premenopausal and early postmenopausal obese women. Menopause 2010; 17:529-38. [DOI: 10.1097/gme.0b013e3181d12361] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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McAndrew LM, Napolitano MA, Albrecht A, Farrell NC, Marcus BH, Whiteley JA. When, why and for whom there is a relationship between physical activity and menopause symptoms. Maturitas 2009; 64:119-25. [PMID: 19781877 DOI: 10.1016/j.maturitas.2009.08.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 08/24/2009] [Accepted: 08/25/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The relationship between enhanced physical activity and decreased menopause symptoms is equivocal. In this study we sought to better understand this relationship by examining the association of physical activity to different symptom domains and by examining mediating and moderating variables. STUDY DESIGN Women participating in a randomized control trial on physical activity were given a menopause symptom measure (MENQOL) at follow-up. Of the 280 women participating, 113 (mean age=52) reported having symptoms they attributed to menopause. Regression analyses were run to examine if change in physical activity predicted fewer symptoms. Exercise self-efficacy was examined as a mediator and depressive symptoms as a moderator. RESULTS An increase in physical activity from baseline was found to be related to reporting fewer total menopause symptoms (beta=-0.22, p=.02). When the total menopause symptoms score was examined by domain, increased physical activity was found to be related to reporting fewer general symptoms attributed to menopause (psychosocial (beta=-0.18, p=.05) and physical (beta=-0.23, p=.01)), but had no effect on specific symptoms of menopause (vasomotor and sexual). Exercise self-efficacy was found to mediate the relationship between increased physical activity and total, physical and psychosocial menopause symptoms. Finally, for individuals with high depressive symptoms, those who increased physical activity the most reported fewer sexual symptoms of menopause. CONCLUSION This study suggests that physical activity participation is associated with lower general symptom reporting as opposed to specifically impacting menopause symptoms. Further, exercise self-efficacy mediates the relationship between physical activity and general menopause symptoms, suggesting a psychological pathway.
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Affiliation(s)
- Lisa M McAndrew
- Dept. of Veterans Affairs NJ Healthcare System, War Related Illness and Injury Center, 385 Tremont Ave #129, East Orange, NJ 07018, United States.
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Luoto R. Hot flushes and quality of life during menopause. BMC WOMENS HEALTH 2009; 9:13. [PMID: 19450250 PMCID: PMC2689180 DOI: 10.1186/1472-6874-9-13] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Accepted: 05/18/2009] [Indexed: 11/10/2022]
Abstract
Menopausal health is important since this stage of life is not to be avoided. A recent article in BMC Women's Health from the Estonian Postmenopausal Hormone Therapy trial has concluded that quality of life is not related to hormonal therapy use. The commentary article discusses this finding and considers other factors related to symptoms and quality of life during menopause. Important factors known to affect hot flushes and quality of life are smoking and high body weight. Since both these factors are modifiable, menopause is a suitable area for health promotion. However, evidence concerning lifestyle changes in symptom relief or increase of quality of life is weak. More trials in this area are needed before women may consider non-pharmacological treatment of symptoms as a reliable option for menopausal symptom cure.
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Affiliation(s)
- Riitta Luoto
- UKK Institute for Health Promotion, Tampere, Finland.
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Finlayson J, Jackson A, Cooper SA, Morrison J, Melville C, Smiley E, Allan L, Mantry D. Understanding Predictors of Low Physical Activity in Adults with Intellectual Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2009. [DOI: 10.1111/j.1468-3148.2008.00433.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lee Y, Kim H. Relationships between menopausal symptoms, depression, and exercise in middle-aged women: a cross-sectional survey. Int J Nurs Stud 2008; 45:1816-22. [PMID: 18692187 DOI: 10.1016/j.ijnurstu.2008.07.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Revised: 07/03/2008] [Accepted: 07/03/2008] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the relationship between the severity of menopausal symptoms and depression in Korean women, 40-60 years of age, and to compare the severity of menopausal symptoms and depression between subjects who exercise regularly and subjects who do not exercise regularly. METHODS Data for this cross-sectional, descriptive study were collected by administering questionnaires eliciting general information, menopausal symptoms, the Beck Depression Index and an exercise history to 648 middle-aged women who participated in a women's health promotion program held in the public health center located in Incheon, Korea. RESULTS There was a significant positive correlation between the severity of menopausal symptoms and depression. The severity of menopausal symptoms and depression in subjects who exercised more than three times a week were significantly lower than in the subjects who did not exercise. Menopausal symptoms differed significantly by education, marital status, economic level, and menopausal status. Economic status was related to education level and marital status. The correlation between body mass index and hot flushes was significant, but the magnitude of the correlation coefficient was small (r=.208, p=.000). CONCLUSIONS Women who were depressed had more menopausal symptoms than women who were not depressed, and women who exercised regularly were less depressed and less symptomatic than women who did not exercise.
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Affiliation(s)
- Youngwhee Lee
- Department of Nursing, Inha University, #253 Younghyun-dong, Nam-gu, Incheon 402-751, Republic of Korea
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Angevaren M, Aufdemkampe G, Verhaar HJJ, Aleman A, Vanhees L. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev 2008:CD005381. [PMID: 18646126 DOI: 10.1002/14651858.cd005381.pub3] [Citation(s) in RCA: 394] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Physical activity is beneficial for healthy ageing. It may also help maintain good cognitive function in older age. Aerobic activity improves cardiovascular fitness, but it is not known whether this sort of fitness is necessary for improved cognitive function. Studies in which activity, fitness and cognition are reported in the same individuals could help to resolve this question. OBJECTIVES To assess the effectiveness of physical activity, aimed at improving cardiorespiratory fitness, on cognitive function in older people without known cognitive impairment. SEARCH STRATEGY We searched MEDLINE, EMBASE, PEDro, SPORTDiscus, PsycINFO, CINAHL, Cochrane Controlled Trials Register (CENTRAL), Dissertation abstracts international and ongoing trials registers on 15 December 2005 with no language restrictions. SELECTION CRITERIA All published randomised controlled trials comparing aerobic physical activity programmes with any other intervention or no intervention with participants older than 55 years of age were eligible for inclusion. DATA COLLECTION AND ANALYSIS Eleven RCTs fulfilling the inclusion criteria are included in this review. Two reviewers independently extracted the data from these included studies. MAIN RESULTS Eight out of 11 studies reported that aerobic exercise interventions resulted in increased cardiorespiratory fitness of the intervention group (an improvement on the maximum oxygen uptake test which is considered to be the single best indicator of the cardiorespiratory system) of approximately 14% and this improvement coincided with improvements in cognitive capacity. The largest effects on cognitive function were found on motor function and auditory attention (effect sizes of 1.17 and 0.50 respectively). Moderate effects were observed for cognitive speed (speed at which information is processed; effect size 0.26) and visual attention (effect size 0.26). AUTHORS' CONCLUSIONS There is evidence that aerobic physical activities which improve cardiorespiratory fitness are beneficial for cognitive function in healthy older adults, with effects observed for motor function, cognitive speed, auditory and visual attention. However, the majority of comparisons yielded no significant results. The data are insufficient to show that the improvements in cognitive function which can be attributed to physical exercise are due to improvements in cardiovascular fitness, although the temporal association suggests that this might be the case. Larger studies are still required to confirm whether the aerobic training component is necessary, or whether the same can be achieved with any type of physical exercise. At the same time, it would be informative to understand why some cognitive functions seem to improve with (aerobic) physical exercise while other functions seem to be insensitive to physical exercise. Clinicians and scientists in the field of neuropsychology should seek mutual agreement on a smaller battery of cognitive tests to use, in order to render research on cognition clinically relevant and transparent and heighten the reproducibility of results for future research.
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Affiliation(s)
- Maaike Angevaren
- Research Group Lifestyle and Health, University of Applied Sciences, Bolognalaan 101, Utrecht, Netherlands, 3584 CJ.
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Angevaren M, Aufdemkampe G, Verhaar HJJ, Aleman A, Vanhees L. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev 2008:CD005381. [PMID: 18425918 DOI: 10.1002/14651858.cd005381.pub2] [Citation(s) in RCA: 171] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Physical activity is beneficial for healthy ageing. It may also help maintain good cognitive function in older age. Aerobic activity improves cardiovascular fitness, but it is not known whether this sort of fitness is necessary for improved cognitive function. Studies in which activity, fitness and cognition are reported in the same individuals could help to resolve this question. OBJECTIVES To assess the effectiveness of physical activity, aimed at improving cardiorespiratory fitness, on cognitive function in older people without known cognitive impairment. SEARCH STRATEGY We searched MEDLINE, EMBASE, PEDro, SPORTDiscus, PsycINFO, CINAHL, Cochrane Controlled Trials Register (CENTRAL), Dissertation abstracts international and ongoing trials registers on 15 December 2005 with no language restrictions. SELECTION CRITERIA All published randomised controlled trials comparing aerobic physical activity programmes with any other intervention or no intervention with participants older than 55 years of age were eligible for inclusion. DATA COLLECTION AND ANALYSIS Eleven RCTs fulfilling the inclusion criteria are included in this review. Two reviewers independently extracted the data from these included studies. MAIN RESULTS Eight out of 11 studies reported that aerobic exercise interventions resulted in increased cardiorespiratory fitness of the intervention group (an improvement on the maximum oxygen uptake test which is considered to be the single best indicator of the cardiorespiratory system) of approximately 14% and this improvement coincided with improvements in cognitive capacity. The largest effects on cognitive function were found on motor function, auditory attention and delayed memory functions (effect sizes of 1.17, 0.52 and 0.50 respectively). However, the results for delayed memory functions should be interpreted with care since they are based on a single study. Moderate effects were observed for cognitive speed (speed at which information is processed; effect size 0.26) and visual attention (effect size 0.26). AUTHORS' CONCLUSIONS There is evidence that aerobic physical activities which improve cardiorespiratory fitness are beneficial for cognitive function in healthy older adults, with effects observed for motor function, cognitive speed, delayed memory functions and auditory and visual attention. However, the majority of comparisons yielded no significant results. The data are insufficient to show that the improvements in cognitive function which can be attributed to physical exercise are due to improvements in cardiovascular fitness, although the temporal association suggests that this might be the case. Larger studies are still required to confirm whether the aerobic training component is necessary, or whether the same can be achieved with any type of physical exercise. At the same time, it would be informative to understand why some cognitive functions seem to improve with (aerobic) physical exercise while other functions seem to be insensitive to physical exercise. Clinicians and scientists in the field of neuropsychology should seek mutual agreement on a smaller battery of cognitive tests to use, in order to render research on cognition clinically relevant and transparent and heighten the reproducibility of results for future research.
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Affiliation(s)
- M Angevaren
- University of Applied Sciences, Research Group Lifestyle and Health, Bolognalaan 101, Utrecht, Netherlands, 3584 CJ.
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Elavsky S, McAuley E. Exercise and self-esteem in menopausal women: a randomized controlled trial involving walking and yoga. Am J Health Promot 2008; 22:83-92. [PMID: 18019884 DOI: 10.4278/0890-1171-22.2.83] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the effects of walking and yoga on multidimensional self-esteem and roles played by self-efficacy, body composition, and physical activity (PA) in changes in esteem. DESIGN Four-month randomized controlled exercise trial with three arms: walking, yoga, and control. SUBJECTS Previously low-active middle-aged women (n=164; M age = 49.9; SD = 3.6). INTERVENTION Structured and supervised walking program meeting three times per week for I hour and supervised yoga program meeting twice per week for 90 minutes. MEASURES Body composition, fitness assessment, and battery of psychologic measures. ANALYSIS Panel analysis within a structural equation modeling framework using Mplus 3.0. RESULTS The walking and yoga interventions failed to enhance global or physical self-esteem but improved subdomain esteem relative to physical condition and strength (for walking) and body attractiveness (for both walking and yoga). Over time the effects of PA, self-efficacy, and body fat on changes in physical self-esteem and global esteem were mediated by changes in physical condition and body attractiveness subdomain esteem. Women reporting greater levels of self-efficacy and PA with lower body fat also reported greater enhancements in subdomain esteem. CONCLUSION These results provide support for the hierarchic and multidimensional nature of self-esteem and indicate that middle-aged women may enhance certain aspects of physical self-esteem by participating in PA.
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Affiliation(s)
- Steriani Elavsky
- Department of Kinesiology, Pennsylvania State University, 268-B Recreation Building, University Park, PA 16802, USA.
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Abstract
BACKGROUND Evidence suggests that a high proportion of perimenopausal and early postmenopausal women will experience some menopause symptoms, hot flushes being the most common. The effects caused by falling levels of estrogen may be alleviated by hormone replacement therapy (HRT) but there has been a marked global decline in the prescription and use of HRT due to concerns about the risks and benefits of HRT; consequently many women are now seeking alternatives. As large numbers of women are choosing not to take HRT, it is increasingly important to identify evidence based lifestyle modifications, which can have a positive effect on menopausal symptoms. OBJECTIVES To examine the effectiveness of any type of exercise intervention in the management of vasomotor menopausal symptoms (hot flushes and night sweats) in perimenopausal and postmenopausal women. SEARCH STRATEGY Searches of the following electronic bibliographic databases were performed to identify randomised controlled trials: The Cochrane Library (CENTRAL) (Wiley Internet interface) 2006 Issue 2, MEDLINE (Ovid) 1966-May week 4 2006, EMBASE (Ovid) 1980-week 21 2006, PsycINFO (Ovid) 1967-May week 5 2006, Science Citation Index and Social Science Citation Index (Web of Science) 1900-June 2006 and 1956-June 2006 respectively, CINAHL (Ovid) 1982-May week 4 2006, SPORT Discus (ERL WebSPIRS) 1830-2006/04. SELECTION CRITERIA Randomised controlled trials (RCTs) in which any type of exercise intervention was compared to other treatments or no treatment in the management of menopausal vasomotor symptoms in symptomatic perimenopausal and postmenopausal women. DATA COLLECTION AND ANALYSIS Nineteen reports were deemed potentially eligible, but of these only one met the inclusion criteria and three authors independently extracted data from this trial. MAIN RESULTS Only one very small trial, which compared exercise with HRT, was available for inclusion in this review. Based on within-group analyses the study authors concluded that both interventions were effective in reducing vasomotor symptoms. Between-group trial analyses conducted by reviewers showed that the HRT group experienced significantly fewer hot flushes compared to the exercise group at follow-up. AUTHORS' CONCLUSIONS Only one very small trial involving symptomatic women has assessed the effectiveness of exercise in the management of vasomotor menopausal symptoms. Exercise was not as effective as HRT in this trial. We found no evidence from randomised controlled trials on whether exercise is an effective treatment relative to other interventions or no intervention in reducing hot flushes and or night sweats in symptomatic women. No conclusions regarding the effectiveness of exercise as a treatment for vasomotor menopausal symptoms could be made due to a lack of trials.
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Affiliation(s)
- A Daley
- Primary Care and General Practice, University of Birmingham, Edgbaston, Birmingham, UK.
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Abstract
Cardiovascular disease rates are higher in African American women and they have more cardiovascular risk factors than other groups. Although one of the most important cardiovascular risk reduction behaviors is physical activity, few studies have focused on African American women's cardiovascular risk and physical activity. Therefore, the aims of this descriptive pilot study were to describe modifiable cardiovascular risks and to explore physical activity, as measured by pedometer steps, in younger (n = 22; aged 21-45 years) and older (n = 22; aged 46-75 years) community-dwelling African American women. The total number of pedometer steps recorded in 3 days ranged from 1,153 to 52,742. Day 1 steps were significantly different than day 2 and day 3 steps across the sample (F = 5.30, df = 1, P < .05). Risk factors were similar across the age groups. There was no relationship between the 3-day total or average number of daily steps and cardiovascular risks. Thus, interventions may be used in both age groups, with modifications for cohort effects of approach and health status. Given the disparities in cardiovascular disease and the Healthy People 2010 national health objectives, it is important to continue a variety of efforts to assist adult women of all ages to increase their physical activity and to decrease other CVD risks.
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Affiliation(s)
- Patricia B Crane
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC 27402, USA.
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Elavsky S, McAuley E. Physical activity and mental health outcomes during menopause: A randomized controlled trial. Ann Behav Med 2007; 33:132-42. [PMID: 17447865 DOI: 10.1007/bf02879894] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Many women experience detriments in mental health during the menopausal transition. Physical activity may attenuate these adverse outcomes but few studies investigating such effects exist. PURPOSE This study examined the effects of a 4-month randomized controlled exercise trial on mental health outcomes in 164 previously low-active middle-aged women (M age = 49.9; SD = 3.6). METHODS AND RESULTS Participants completed body composition and fitness assessment and a battery of psychological measures at the beginning and end of a 4-month randomized controlled exercise trial with three arms: walking, yoga, control. The results indicated that walking and yoga were effective in enhancing positive affect and menopause-related QOL and reducing negative affect. Women who experienced decreases in menopausal symptoms across the trial also experienced improvements in all positive mental health and QOL outcomes and reductions in negative mental health outcomes. Whether menopausal symptoms increased or decreased across the trial appeared to be determined in part by whether there were increases or decreases in cardiorespiratory fitness. CONCLUSIONS Physical activity appears to enhance mood and menopause-related QOL during menopause, however, other aspects of mental health may be affected only as a result of reduction in menopausal symptoms. Increasing cardiorespiratory fitness could be one way to reduce menopausal symptoms.
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Affiliation(s)
- Steriani Elavsky
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA.
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