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The effects of a community-based physical activity intervention grounded in the Transtheoretical Model were investigated in a sample of older adults. The residents (n = 48, mean age = 78.24 +/- 6.69, 90% female) of an independent living complex completed pre- and postintervention assessments, including physical, mental, and general health; nutrition; bodily pain; and stages of exercise behavior change. The intervention included posters with stage-based pamphlets (for inactive stages) and in-house exercise sessions (for active participants). The intervention resulted in high exercise maintenance and more progression than regression in exercise stage. More maintainers and progressers improved on the measured variables compared to relapsers. The stage model is a promising framework on which to base and evaluate interventions for this population. The overall impact of the intervention was positive, whether by providing the actual opportunity to exercise or by motivating other physical activity. These results also support the potential quality-of-life impact for this type of intervention in older adults. [ABSTRACT FROM AUTHOR]

Limited information exists on the response to maximal exercise testing in female masters level recreational rowers. This study examined cardiorespiratory and physiologic responses to progressive, incremental exercise using a variable resistance rowing ergometer and a cycle ergometer in six experienced female masters level rowers. Maximal oxygen uptake (VO2max:33.8+/-7.3, 33.5+/-6.6 ml x kg-1 x min-1) and minute ventilation (VEmax: 86.1+/-9.6 1 x min-1, 88.7+/-13.8 1 x min-1) were similar during both tests (rower vs cycle). Maximal heart rates were significantly higher on the cycle ergometer (177+/-9 beats/min-1) compared to the rowing ergometer (173+/-11 beats/min-1), while peak power on the rowing ergometer (175+/-22 watts) was lower than the cycle ergometer (187+/-41 watts). Blood lactate levels taken 1 minute following exercise were similar on the rowing ergometer (10.5+/-1.7 mM/I) and cycle ergometer (11.8+/-1.5 mM/I) and indicated maximal effort was achieved in all subjects. Ventilatory threshold levels were significantly different on the rower (2.0+/-0.16) versus the cycle ergometer (1.9+/-0.18) (p=0.38). These data suggest that the cycle and rowing ergometers yield relatively similar results when testing maximal exercise performance in this population. [ABSTRACT FROM AUTHOR]

Purpose: Few studies have explored how relationships of perceived environment and physical activity vary across different activity domains and populations. This question was explored in five physical activity intervention trials funded by the National Institutes of Health Behavior Change Consortium.Design: Observational.Settings: San Francisco peninsula, California (N = 94); Eugene, Oregon (N = 122); Atlanta, Georgia (N = 256); Kingston, Rhode Island (N = 109); Memphis, Tennessee (N = 64).Subjects: Ethnically diverse community adults ages 18 to 85 years.Measures: The Neighborhood Environment Walkability Scale and CHAMPS physical activity questionnaire. Response rate among those invited to complete these measures was 90%.Results: Cross-sectional pooled signal detection analysis indicated that people who reported living in neighborhoods with more attractive scenery and ease of walking were more likely to meet national physical activity recommendations (67%) compared with those without these neighborhood attributes (36%; chi2 = 13.04, p = .0003). Within-site multiple regression identified two additional variables--seeing others when walking and encountering loose dogs that make it difficult to walk--as correlates across multiple sites and activity domains (i.e., minutes of weekly moderate or more vigorous activity, walking for errands, walking leisurely) (incremental R2 = 2.0-7.5; p < .05). Analyses of covariance suggested that traffic safety might be particularly important in facilitating or impeding physical activity in response to a formal intervention (for traffic-arm assignment interactions, F = 3.8-7.0, p < or = .05).Conclusions: Relationships between perceived environments and physical activity may differ depending upon population groups and activity domains and merit investigation by using stronger prospective designs. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined., Objectives: To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform?, Setting: Clinical and academic exercise settings worldwide., Methods: This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model., Results: The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and postoperative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care"., Conclusions: The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare., (Copyright © 2024 American Society for Metabolic and Bariatric Surgery. All rights reserved.)

Purpose: Evaluate perceptions of a 12-week in-person physical activity intervention for endometrial cancer survivors with obesity., Methods: Sixteen endometrial cancer survivors (Age: 64 ± 8 yrs) with obesity (BMI: 34 ± 8 kg·m -2 ) who completed a 12-week comprehensive physical activity program completed semi-structured interviews regarding perceptions of physical activity participation. Transcripts were analyzed using thematic analysis and were confirmed by multiple authors., Results: Emergent themes (and subthemes) were: 1) Routine physical activity (Walking, Chores), 2) Motivations for physical activity (Social, Independence, Health, Family, Weight), 3) Barriers to physical activity (Weather, Pain, Fatigue, Family Stress), 4) Motivation to 12-week program adherence (Social, Fun, Caring, Structure, Shared Experiences), 5) Perceived benefits of the program (Social, Self-efficacy, Activities of Daily Living, Body Composition, Well-being, Health), and 6) Feedback about the 12-week program (Timing, Setting, Exercise Modes, Incentives, Instructor, Learning)., Conclusions: Socioculturally diverse cancer survivors with obesity who were able to complete a 12-week physical activity program emphasized the importance of maintaining independence, and being part of a fun, caring, and social environment for their ability to overcome fatigue, pain, and family stresses to adhere to the program. Participants discussed myriad health and wellness benefits, and wished the program were more robust., Implications for Cancer Survivors: Low-burden exercise programs can confer meaningful health and wellness benefits for cancer survivors. To maintain adherence, programs should emphasize social cohesion and exercises to help maintain independence. Instructors should express caring support while also making classes fun, while emphasizing body composition instead of weight loss., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Background: Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined., Objectives: To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform?, Setting: Clinical and academic exercise settings worldwide., Methods: This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model., Results: The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being: supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and post-operative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care"., Conclusions: The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare., Competing Interests: COMPETING INTERESTS None

Cardiovascular (CV) disease (CVD) is the leading cause of global morbidity and mortality, and low levels of physical activity (PA) is a leading independent predictor of poor CV health and associated with an increased prevalence of risk factors that predispose to CVD development. In this review, we evaluate the benefits of exercise on CV health. We discuss the CV adaptations to exercise, focusing on the physiological changes in the heart and vasculature. We review the impact and benefits of exercise on specific CV prevention, including type II diabetes, hypertension, hyperlipidemia, coronary artery disease, and heart failure, in addition to CVD-related and all-cause mortality. Lastly, we evaluate the current PA guidelines and various modes of exercise, assessing the current literature for the effective regimens of PA that improve CVD outcomes., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Physical activity (PA) provides many substantial benefits to help reduce risk for cardiometabolic disease, improve cognitive function, and improve quality of life. Individuals with neuromuscular disorders (NMDs), such as spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD) are characterized by muscular weakness and fatigue, which limits the capacity to reach the recommended guidelines of PA. Measuring PA in these populations can provide insight to participation in daily activities, track disease progression, and monitor efficacy of drug treatments., Objective: The objective of this study was to identify how PA is measured in SMA and DMD using instrumented and self-report methods, and how these methods are employed in ambulatory and non-ambulatory groups., Methods: A scoping review was performed to identify studies that reported PA in these neuromuscular disorders. Inclusion was determined after a multi-stage review process by several reviewers, followed by an in-depth analysis of metrics reported by each tool that was used., Results: A total of nineteen studies were identified and included in this review. Sixteen studies included instrumented measures and four studies utilized self-reported measures, with eleven studies also reporting PA information from a non-ambulatory group. A variety of metrics have been reported using both classes of measurement tools., Conclusion: Although a wide variety of research exists that details both instrumented and self-reported measurement tools, feasibility, cost, and study aims are important factors to consider in addition to testing methodology when selecting which type of tool to use. We recommend using a combination of instrumented and self-report measures to provide context to the PA measured in these populations. Improvements in both instrumented and self-report methodologies will add valuable knowledge about the disease burden and efficacy of treatment and disease management methods in SMA and DMD.

Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder in children, and it's linked to a higher risk of academic failure, interpersonal issues, mental illness, and criminality. Despite several of the comparative and detailed reviews on the effects of ADHD interventions on core symptoms, there is no data summarizing the effects of aerobic exercise (AE) on executive functions (EFs). Therefore, this study aimed to systematically review and determine the relationship between AE (acute and chronic) dosage and EFs (attention, inhibition, set-shifting, and working memory) in youth with ADHD. The consideration of how AE dosage impacts aspects of EFs has not been investigated in detail previously. The study adhered to PRISMA guideline. Sixdatabases were searched without any date restrictions, up to February 2021, for articles relating to AE interventions to influence EFs in youth with ADHD ≤ 18 years old. Quality assessment of the reviewed papers was addressed. Thirteen studies met the inclusion criteria. Improvements in all aspects of EFs were reported after children with ADHD engaged in acute AE lasting 20-30 minutes with at least moderate intensity (65% ≤ 80% HR max ).Furthermore, chronic exercise that lasts at least 45 minutes and in the range of moderate tohigh intensity (i.e., 60% ≤ 75% HR max ), 3 days/week for 6-12, elicits additional benefits in inhibition and set-shifting.Different dosage of AE might differently influence aspects of EFs; however, this finding rests on preliminary evidence at this stage and thus should be treated with caution.It is necessary to establish suitable interventions with regard to the dosage of AE types to improve EFs in young people with ADHD.

Aims: The aim of this study was to explore the feasibility and benefits of a 12-session dance/movement program for intimate partner violence survivors' mental health and PTSD symptoms during the COVID-19 Pandemic. The specific purposes were fourfold: (1) To determine the feasibility of delivering a virtual dance/movement workshop program; (2) to examine the effects of the program on symptoms of PTSD and psychological distress; (3) to determine whether heart rate variability improves; and (4) to describe the individual and shared experiences of a subgroup of participants of the program., Methods: Forty-five women ages 23-48 years were randomized to a 12-session virtual creative dance/movement program or a usual care control group, and completed questionnaires about PTSD and mental health symptoms, general health, physical activity, and underwent a brief measurement of heart rate variability. A subset of the intervention group participated in a semi-structured focus group., Results: The results of the study showed that the female survivors of intimate partner violence who participated in the virtual workshops felt better, and they experienced improved affect and reduced tension. They found new ways to express themselves, attune to their bodies, learn new self-care habits, and build community as they engaged in the workshops. Over the course of the study, the participants' symptoms of PTSD and psychological distress lessened. There were no changes in heart rate variability., Conclusions: This complex study was successfully completed during a global pandemic and resulted in improvements in some mental health symptoms and overall well-being. Given the importance of this work with intimate partner violence survivors, further work exploring dance/movement workshops for participants virtually and in-person is needed., Competing Interests: GG, YÖ, and TB were employed by Gina Gibney Dance, Inc., AR was employed by Sanctuary for Families Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Özümerzifon, Ross, Brinza, Gibney and Garber.)

Background: High volumes of school-based sedentary time may impact academic achievement and executive function negatively. This study evaluated a multimodal classroom program's (POWER) effect on fifth graders' physical activity (PA) and executive function., Methods: Six 5th grade classes (3 = intervention [POW]; 3 = waitlist control [CONT]) in 2 diverse New Jersey schools participated. Data were collected before, during, and post-intervention. PA was assessed via accelerometer, executive function by NIH Toolbox, and academic achievement via standardized math tests. The POW principal, teachers, and select students participated in follow-up interviews. Group comparisons were made by multivariate repeated-measures ANOVA and linear regression., Results: PA decreased in both groups over time, but POW's post-intervention class-time PA was significantly higher than CONT's. POW's NIH Toolbox score increased 3 percentiles more than CONT's. Intervention fidelity was associated with significantly higher scores for one NIH Toolbox test. Student math test scores increased significantly for both schools, but there was no significant main effect for group. POW's feedback was positive, with the principal reporting fewer disciplinary referrals and teachers and students conveying positive growth., Conclusions: Overall, POW's positive changes and the favorable reception of POWER support POWER'S ability to improve children's socioemotional and physical health., (© 2021 American School Health Association.)

Endothelial dysfunction is a mechanism that may explain the link between prolonged sedentary time and cardiovascular disease. However, the relation between habitual sedentary behavior (SED) and endothelial function has yet to be explored., Purpose: The purpose of this study was to examine the association of accelerometer-measured SED with markers of endothelial cell health., Methods: Healthy adult participants (n=83; 43.4% male; 25.5 ± 5.8 years old) were examined. SED was measured for 7-days by accelerometer. Endothelial function measures included endothelium-dependent vasodilation (EDV); endothelial microparticles (EMPs) [CD62E+ and CD31+/CD42- EMPs]; and endothelial progenitor cells (EPCs) [CD34+/CD133+/KDR+ and CD34+/KDR+EPCs]. Participants were classified as having low or high SED based on a median split., Results: Participants in the low and high SED group spent a mean ± SD of 8.6 ± 1.1 and 11.1 ± 1.0 h/day in SED, respectively. No significant differences between the low and high SED groups were detected in mean [95% confidence interval (CI)] EDV (2.51 [2.21-2.81] vs. 2.36 [2.07-2.64], p =0.50), EMPs (CD62E+: 6.70 [6.55-6.84] vs. 6.56 [6.42-6.69], p =0.20; CD31+/CD42‒: 6.26 [6.10-6.42] vs. 6.18 [6.03-6.33], p =0.50), or EPCs (CD34+/KDR+: 11.91 [9.23-14.48]×10 -2 vs. 14.87 [12.41-17.32]×10 -2 , p =0.13); CD34+/CD133+/KDR+: 1.84 [1.28-2.39]×10 -2 vs. 2.17 [1.64-2.70]×10 -2 , p =0.43)., Conclusions: Among healthy adults, habitual SED was not associated with markers of endothelial cell health., Competing Interests: Disclosure of Interest: The authors report no conflict of interest. The results of the present study do not constitute endorsement by the American College of Sports Medicine.

Background: There has been an explosion in the use of wearable activity trackers (WATs), but we do not fully understand who wears them and why. This study's purpose was to describe the characteristics of WAT users and to compare current and former users., Materials and Methods: A variety of internet-based resources (eg, Craigslist, Facebook) were used to recruit current and former WAT users. Respondents completed a web-based survey, where they provided information on sociodemographic characteristics, health, physical activity behavior, and about their WAT use., Results: Of the 2826 respondents who gave informed consent, 70.8% (n = 2002) met inclusion criteria for this analysis. Respondents ranged from 18 to 81 years old (mean 32.9 ± 12.2 standard deviation) with 73.8% women. Most were current WAT users (68.7%), and the average length of WAT use overall was 9.3 ± 9.7 months. On average, current users wore the device for 3.7 months longer than former users. Compared to current users, former users had a lower body mass index (1.2 kg/m 2 less), reported fewer medical conditions, shared data from their device less often, and received the device as a gift more frequently., Conclusions: Current and former users varied in their reasons for using a WAT and how they used their device. Differences identified between these groups support further exploration of associations between WAT users' profiles and their physical activity behavior.

Background: Insufficient physical activity (PA) may increase the risk of all-cause mortality and cardiovascular disease (CVD) morbidity and mortality among kidney transplant recipients (KTRs), but limited research is available. We examine the relationship between PA and the development of CVD events, CVD death and all-cause mortality among KTRs., Methods: A total of 3050 KTRs enrolled in an international homocysteine-lowering randomized controlled trial were examined (38% female; mean age 51.8 ± 9.4 years; 75% white; 20% with prevalent CVD). PA was measured at baseline using a modified Yale Physical Activity Survey, divided into tertiles (T1, T2 and T3) from lowest to highest PA. Kaplan-Meier survival curves were used to graph the risk of events; Cox proportional hazards regression models examined the association of baseline PA levels with CVD events (e.g. stroke, myocardial infarction), CVD mortality and all-cause mortality over time., Results: Participants were followed up to 2500 days (mean 3.7 ± 1.6 years). The cohort experienced 426 CVD events and 357 deaths. Fully adjusted models revealed that, compared to the lowest tertile of PA, the highest tertile experienced a significantly lower risk of CVD events {hazard ratio [HR] 0.76 [95% confidence interval (CI) 0.59-0.98]}, CVD mortality [HR 0.58 (95% CI 0.35-0.96)] and all-cause mortality [HR 0.76 (95% CI 0.59-0.98)]. Results were similar in unadjusted models., Conclusions: PA was associated with a reduced risk of CVD events and all-cause mortality among KTRs. These observed associations in a large, international sample, even when controlling for traditional CVD risk factors, indicate the potential importance of PA in reducing CVD and death among KTRs., (© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)

Wearable physical activity (PA) monitors are widely promoted as a means to motivate people to be more active, but the motivational profile of users has never been assessed. This study's purpose was to classify adult users by their motivational regulation scores and examine how these profiles were associated with moderate to vigorous PA (MVPA). Current users (N = 320) recruited across the United States completed a Web-based survey. Motivational regulations were measured using the Behavioral Regulation in Exercise Questionnaire, and associations with MVPA were explored using bivariate correlations. MVPA was more highly correlated with autonomous rather than controlling regulations. A cluster analysis was conducted using the respondents' motivational regulation scores. Five motivational profiles emerged from this analysis, and they differed significantly across motivation and MVPA scores. PA monitor users characterized by more autonomous motives presented with higher MVPA. As technology use increases, assessing the multidimensionality of PA monitor users' motivation may add value when researching PA behaviors.

Introduction: The 6-minute walk test (6MWT) is a well-established clinical assessment of functional endurance, validated as a measure of walking ability in spinal muscular atrophy (SMA). The current availability of disease-modifying therapies for SMA indicates a growing need for normative reference data to compare SMA patients with healthy controls., Methods: The literature was searched in two scientific databases. Studies were evaluated and selected based on adherence to American Thoracic Society guidelines for administering the 6MWT. Reference equations from the selected studies were applied to 6MWT data collected from SMA patients to calculate and compare % predicted values., Results: Three pediatric and six adult studies were selected for comparison. The % predicted values using the pediatric and adult equations ranged from 47.7 ± 18.2% to 67.6 ± 26.2% and 43.0 ± 17.9% to 59.5 ± 26.2%, respectively, and were significantly different (P < 0.001)., Discussion: Results suggest significant variability between % predicted values derived from published reference equations in children and adults, despite adherence to 6MWT standardization., (© 2019 Wiley Periodicals, Inc.)

The purpose of this study was to determine the feasibility and validity of using three-dimensional (3D) video data and computer vision to estimate physical activity intensities in young children. Families with children (2-5-years-old) were invited to participate in semi-structured 20-minute play sessions that included a range of indoor play activities. During the play session, children's physical activity (PA) was recorded using a 3D camera. PA video data were analyzed via direct observation, and 3D PA video data were processed and converted into triaxial PA accelerations using computer vision. PA video data from children ( n = 10) were analyzed using direct observation as the ground truth, and the Receiver Operating Characteristic Area Under the Curve (AUC) was calculated in order to determine the classification accuracy of a Classification and Regression Tree (CART) algorithm for estimating PA intensity from video data. A CART algorithm accurately estimated the proportion of time that children spent sedentary (AUC = 0.89) in light PA (AUC = 0.87) and moderate-vigorous PA (AUC = 0.92) during the play session, and there were no significant differences ( p > 0.05) between the directly observed and CART-determined proportions of time spent in each activity intensity. A computer vision algorithm and 3D camera can be used to estimate the proportion of time that children spend in all activity intensities indoors.

The recent explosion of wearable technology and the associated concerns prompted the International Federation of Sports Medicine (FIMS) to create a quality assurance standard for wearable devices, which provides commissioned testing of marketing claims and endorsement of commercial wearables that test favorably. An open forum as announced in the conference advertising was held at the Annual Meeting of the New England Regional Chapter of the American College of Sports Medicine (NEACSM) November 7 to 8, 2019, in Providence, Rhode Island, USA for attending NEACSM members to voice their input on the process. Herein, we report the proceedings. The round table participants perceived the quality assurance standard to be important, but identified some practical process challenges that included the broad scope and complexity of the device universe, the need for a multiphase testing pathway, and the associated fees for product evaluation. The participants also supported the evaluation of device data analysis, behavioral influences, and user experience in the overall evaluation. Looking forward, the FIMS quality assurance standard faces the challenge of balancing these broader perspectives with practical constraints of budget, facilities, time, and human resources.

•Rapid urbanization and its environmental impact have led to challenges to health and well-being of residents in BRICS nations.•Physical activity should be a priority public health target for primary and secondary prevention because of the high prevalence of chronic diseases and cardiometabolic risk factors in BRICS nations.•BRICS nations can harness scientific evidence prospectively to promote environmental and policy supports for physical activity.•Physical activity interventions engaging the members of the community and that are culturally relevant are more likely to be effective., (© 2019 Published by Elsevier B.V. on behalf of Shanghai University of Sport.)

More than 30% of U.S. adults are obese or overweight. A program of regular physical activity is recommended as part of an effective lifestyle intervention for weight loss and weight management. However, more than 40% of adults do not engage in sufficient physical activity to realize these beneficial effects on body weight. Physicians may encounter many barriers to counseling physical activity, such as lack of knowledge or self-efficacy for counseling patients about physical activity. Obese individuals may be reluctant to exercise because of weight stigma, physique anxiety, and other factors; therefore, referral to a weight management specialist or clinical exercise physiologist can be helpful in facilitating exercise and assisting in achieving a clinically meaningful weight loss. Exercise has many benefits on physical and mental health and well-being that go well beyond weight loss, and it is for these reasons that exercise is particularly important for overweight and obese individuals.

Purpose: Research examining the relationship between physical activity (PA) and cardiovascular disease (CVD) risk factors among kidney transplant recipients (KTR) is limited. Accordingly, we sought to 1) describe the levels of PA in KTR and 2) analyze the associations between PA levels and CVD risk factors in KTR., Methods: Baseline data from KTR participants in a large multiethnic, multicenter trial (the Folic Acid for Vascular Outcome Reduction in Transplantation) were examined. PA was categorized in tertiles (low, moderate, and high) derived from a modified PA summary score from the Yale Physical Activity Survey. CVD risk factors were examined across levels of PA by ANOVA, Kruskal-Wallis rank test, and hierarchical multiple regression., Results: The 4034 participants were 37% female (mean ± SD = 51.9 ± 9.4 yr of age, 75% White, 97% with stage 2T-4T chronic kidney disease, and 20% with prevalent CVD. Participants in the "high" PA tertile reported more vigorous PA and walking, compared with participants in moderate and low tertiles (both P < 0.001). No differences were observed in daily household, occupational, or sedentary activities across PA tertiles. More participants in the "low" PA tertile were overweight/obese, had a history of prevalent diabetes, and/or had CVD compared with more active participants (all P < 0.001). Hierarchical modeling revealed that younger age (P = 0.002), cadaveric donor source (P = 0.006), shorter transplant vintage (P = 0.025), lower pulse pressure (P < 0.001), and no history of diabetes (P < 0.001) were associated with higher PA scores., Conclusion: The most active KTR engaged in more intentional exercise. Lower levels of PA were positively associated with more CVD risk factors. Higher PA levels were associated with younger age and with more positive KTR outcomes.

Physical activity (PA) and health were compared in younger (YA; 18-44 years), middle-aged (MA; 45-64 years), and older (OA; ≥65 years) adults with disability (PWD), functional limitation (PFL), or without disability (PWoD). Disability occurred in YA (PWD: 2.3%; PFL: 14.3%), MA (PWD: 8.5%; PFL: 23.8%), and OA (PWD: 14.9%; PFL: 26.6%). Not meeting aerobic/muscle-strengthening PA recommendations was frequent in YA (PWD: 50.7%; PFL: 42.5%; PWoD: 35.8%), MA (PWD: 56.7%; PFL: 44.0%; PWoD: 35.6%), and OA (PWD: 57.8%; PFL: 44.1%; PWoD: 33.1%). Among PWD, YA and MA met muscle, strengthening recommendations more frequently than did OA; PFL did more aerobic PA than PWD. The presence of chronic diseases, female gender, White race, lower education, and less income were associated with being PWD or PFL. Those with greater PA were less likely to be PWD or PFL. Results suggest increasing public health efforts to promote healthy lifestyles in MA and OA.

Background: Guidelines recommend exercise for secondary prevention of acute coronary syndrome (ACS), however adherence to guidelines is low. A paucity of data examining factors associated with objectively-measured exercise post-discharge in ACS survivors exists. The purpose of this study was to identify factors associated with exercise during the 5 weeks after ACS discharge., Methods: A sample of 151 ACS patients treated at a university hospital were enrolled into an observational cohort study and wore an accelerometer for 35 days post-discharge. Days on which participants accumulated ≥30 min of moderate-to-vigorous physical activity in bouts ≥10 min were considered exercise days. Participants were categorized as non-exercisers (0 exercise days) or exercisers (≥1 exercise day). A multi-variable logistic regression model was used to examine the association between exercise and socio-demographics, depression, SF-12 physical and mental health scores, disease severity, length of hospitalization, and percutaneous coronary intervention., Results: 39.7% of participants were non-exercisers. Factors associated with non-exercise were age (OR: 1.11; 95% CI: 1.06-1.17, p < 0.001), female sex (OR: 2.76; 95% CI: 1.10-6.95, p = 0.031), and lower SF-12 physical health score (OR: 0.94; 95% CI: 0.90-0.98, p = 0.005)., Conclusion: In ACS patients in whom exercise participation was objectively measured for 5 weeks post-discharge, demographic and poor physical health factors were associated with non-exercise. These findings identify populations (e.g. older adults, women) at especially high risk for being physically inactive in whom more intense intervention may be warranted., (Copyright © 2018 Elsevier B.V. All rights reserved.)

This study aimed to characterize daily physical activity (PA) behaviors in 2-year-old girls and boys and their parents, with and without an objective measure of dyadic spatial proximity. Urban-dwelling parent⁻toddler dyads ( N = 110) wore accelerometers for 7 days, and parents completed a sociodemographic questionnaire. Accelerometers were initialized to collect PA and Bluetooth-based proximity data. After applying wear-time algorithms, n = 65 dyads were further analyzed using a dyadic analysis statistical methodology. Toddler⁻parent sedentary and light PA time were respectively interdependent, conditional on child sex and child-parent proximity, but moderate⁻vigorous physical activity (MVPA) time was not. Toddlers were significantly more active on weekdays and weekends than their parents, and no differences were found in daily PA volumes between girls and boys. In dyads with proximity data ( n = 34), analyses of joint (i.e., proximal and mutual) PA time showed that girls participated in significantly more joint PA with their mothers than boys. Children who engaged in ≥60 min of MVPA/day participated in ~2 h of joint PA/day, on average, while children with <60 min of MVPA/day engaged in ~30 min less joint-PA time with their mothers. Boys and girls who participated in higher daily MVPA volumes engaged in joint PA with their mothers across greater relative distances, as compared to less active boys who engaged in joint PA at closer relative distances to their mothers. Toddlers who engaged in ≥60 min of daily MVPA participated in joint PA with their mothers at greater relative distances and for longer durations than less active children. Further research on the dyadic activity⁻proximity relationship is needed across early childhood development., Competing Interests: The authors declare no conflicts of interest.

Purpose: To determine whether theory-based physical activity (PA) interventions for overweight and obese female cancer survivors lead to increased PA and improved health., Methods: This systematic review examined randomized controlled trials analyzing the impact of theory-based PA interventions on overweight and obese female cancer survivors through December 2016. Searches of 5 electronic databases revealed 10 articles that included 1351 participants who met the inclusion criteria., Results: Participants were primarily non-Hispanic white (74%-100%) breast or endometrial cancer survivors. Intervention characteristics and PA assessment tools varied greatly. Adherence (68%-99%) and retention (79%-100%) were relatively high. Social cognitive theory was utilized as the theoretical construct in 9 of the 10 studies. Home-based interventions led to small improvements in PA (Cohen's d range = 0.25-0.31), whereas home-based plus center-based interventions led to moderate to large improvements (Cohen's d range = 0.45-1.02). Only three of the studies assessed psychosocial behavioral processes associated with PA, and the results were mixed. Health-related outcomes included improvements in aerobic fitness (Cohen's d = 0.32-1.1 in 5 studies), large absolute decreases in waist circumferences (>6 cm in 3 of 5 studies; Cohen's d = -0.31 to -1.02), and no change in inflammatory biomarkers (in 2 studies). Only one serious adverse event (pelvic stress fracture) was attributed to the interventions., Conclusions: Theory-based PA interventions are safe and feasible for overweight and obese female cancer survivors. Interventions that include a center-based component showed moderate to large effect sizes for PA. Future studies should evaluate behavioral variables and more health-related clinical outcomes.

Purpose: To conduct an integrated review of the performance and implementation of two physical activity (PA) assessment tools, the exercise vital sign (EVS) and the physical activity vital sign (PAVS), in U.S. primary care practice., Design: An integrative review following Whittemore and Knafl's methodology., Methods: Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched. Search terms were "exercise vital sign" OR "physical activity vital sign" AND "primary care". Additional inclusion criteria were studies conducted in the United States, published in English, in primary care, between 2010 and 2016., Results: Nine studies met inclusion criteria. Five studies reported validity data of the EVS tool, while four studies reported data from the PAVS tool. Compared with the accelerometer, the EVS tool overestimated moderate-vigorous PA, while the PAVS tool demonstrated moderate agreement in identifying those not meeting national PA guidelines. The EVS tool was successfully implemented in large, integrated practices utilizing electronic health record systems. PA documentation increased compared to non-EVS practices. The predictive ability of the PAVS tool for clinical outcomes was shown. Studies of PA assessment tool use in children were not found., Conclusions: Preliminary evidence on the validity of both the EVS and PAVS tools support cautious use of each as a screening tool in primary care. There were no data on reliability, with limited data on tool use in diverse populations or settings. Data in children, older adults, and diverse population subgroups were lacking., Clinical Relevance: Two brief exercise vital signs tools have each shown some initial validity for use by primary care clinicians as measures to identify patients not meeting PA guidelines., (© 2017 Sigma Theta Tau International.)

Physical activity (PA) may improve physical and mental health in people living with HIV (PLWH). However, the associations between PA participation and physical and mental health problems of PLWH in urban settings remain largely unknown. Our objective was to determine the relationships between PA and physical and mental health in urban-dwelling PLWH. There were 289 adult PLWH who responded to an electronic survey including questions on PA and current physical and mental health. The associations between physical and mental health and PA were investigated using linear and logistic regression. A large proportion of participants met recommended volumes of PA. Eighty-three percent of respondents reported symptoms of severe mental distress. Diabetes mellitus was associated with a lower total volume of PA (p = .035). Similarly, depression was negatively associated with muscle-strengthening exercise participation (p = .030). Sufficient amounts of aerobic activity and/or muscle strengthening exercise are associated with better physical and mental health., (Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to describe physical activity-related differences in body composition, quality of life, and behavioral variables among a socioculturally diverse sample of endometrial cancer survivors., Methods: Ambulatory, English-speaking endometrial cancer survivors (6 months to 5 years post-treatment), who were residents of Bronx, NY, were recruited to complete questionnaires about physical activity (PA), quality of life (QoL), and psychosocial characteristics. Body weight and height were obtained from medical records to determine body mass index (BMI). ANOVA and independent sample t tests were used to determine differences between racial/ethnic groups and active versus insufficiently active, respectively., Results: Sixty-two participants enrolled in the study. Recruitment rate was 7% for mailed questionnaires and 92% in clinic. Mean age was 63 ± 10 years. Sixty-five percent of the sample was obese (mean BMI: 34.2 ± 8.6 kg·m -2 ). BMI was significantly higher in non-Hispanic black women (37.8 ± 10.2 kg·m -2 ) than non-Hispanic white women (31.2 ± 7.8 kg·m -2 ; d = 0.73, p = 0.05). Forty-seven percent reported being physically active, with no differences by race/ethnicity. Physically active endometrial cancer survivors had higher QoL scores (d = 0.57, p = 0.02). There was a moderate effect size for BMI for the active (32.4 ± 5.6 kg·m -2 ) compared to the insufficiently active group (35.7 ± 10.2 kg·m -2 ; d = 0.40, p = 0.06). Walking self-efficacy was a significant predictor of physical activity (χ 2  = 13.5, p = 0.02)., Conclusions: Physically active endometrial cancer survivors reported higher QoL, lower BMI, and more positive walking self-efficacy. These data suggest that a physically active lifestyle has a benefit in socioculturally diverse endometrial cancer survivors.

Introduction: The Six-Minute Walk Test (6MWT) was adopted as a clinical outcome measure for ambulatory spinal muscular atrophy (SMA). However, a systematic review of measurement properties reported significant variation among chronic pediatric conditions. Our purpose was to assess the reliability/validity of the 6MWT in SMA., Methods: Thirty participants performed assessments, including the 6MWT, strength, and function. Reproducibility was evaluated by intraclass correlation coefficients. Criterion/convergent validity were determined using Pearson correlation coefficients., Results: Test-retest reliability was excellent. The 6MWT was associated positively with peak oxygen uptake, Hammersmith Functional Motor Scale Expanded (HFMSE), lower extremity manual muscle testing, knee flexion hand-held dynamometry, and inversely with 10-m walk/run. The 6MWT discriminates between disease severity, unlike the HFMSE., Conclusions: This study documents measurement properties of reproducibility, positive criterion validity, and convergent validity with established clinical assessments and reaffirms the value of the 6MWT as a pivotal outcome measure in SMA clinical trials. Muscle Nerve 54: 836-842, 2016., (© 2016 Wiley Periodicals, Inc.)

Purpose: Determine the feasibility of a 12-week physical activity intervention for obese, socioculturally diverse endometrial cancer survivors and to evaluate whether the intervention improves physical activity behavior, physical function, waist circumference, and quality of life., Methods: Obese endometrial cancer survivors from Bronx, NY were assigned to either a 12-week physical activity intervention of behavioral counseling, physical activity and home-based walking (n=25), or wait-list control group (n=15). Mixed-design ANOVA (2 groups×2 time points) were analyzed to determine differences between the intervention and the control for the Yale Physical Activity Survey, six-minute walk test, 30-second chair stand test, waist circumference, and Functional Assessment of Cancer Therapy-Endometrial questionnaire. Data are presented as mean±standard deviation., Results: The sample was diverse (38% non-Hispanic black, 38% Hispanic, 19% non-Hispanic white). Mean Body Mass Index was 37.3±6.5kg·m(-2). Although recruitment rate was low (20% of 140 contacted), 15 of 25 participants in the intervention group attended 75-100% of scheduled sessions. Participants reported walking 118±79min/week at home. There were large effect sizes for the improvements in the six-minute walk test (22±17m vs. 1±22m, d=1.10), waist circumference (-5.3±5.3cm vs. 2.6±6.7cm, d=-1.32), quality of life (10±12 vs. -1±11, d=0.86) and walking self-efficacy (24±30% vs. 1±55%, d=0.87) compared to the control group., Conclusions: The intervention appeared feasible in this population. The results show promising effects on several outcomes that should be confirmed in a larger randomized control trial, with more robust recruitment strategies., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The purpose of the American College of Sports Medicine's (ACSM) exercise preparticipation health screening process is to identify individuals who may be at elevated risk for exercise-related sudden cardiac death and/or acute myocardial infarction. Recent studies have suggested that using the current ACSM exercise preparticipation health screening guidelines can result in excessive physician referrals, possibly creating a barrier to exercise participation. In addition, there is considerable evidence that exercise is safe for most people and has many associated health and fitness benefits; exercise-related cardiovascular events are often preceded by warning signs/symptoms; and the cardiovascular risks associated with exercise lessen as individuals become more physically active/fit. Consequently, a scientific roundtable was convened by the ACSM in June 2014 to evaluate the current exercise preparticipation health screening recommendations. The roundtable proposed a new evidence-informed model for exercise preparticipation health screening on the basis of three factors: 1) the individual's current level of physical activity, 2) presence of signs or symptoms and/or known cardiovascular, metabolic, or renal disease, and 3) desired exercise intensity, as these variables have been identified as risk modulators of exercise-related cardiovascular events. Identifying cardiovascular disease risk factors remains an important objective of overall disease prevention and management, but risk factor profiling is no longer included in the exercise preparticipation health screening process. The new ACSM exercise preparticipation health screening recommendations reduce possible unnecessary barriers to adopting and maintaining a regular exercise program, a lifestyle of habitual physical activity, or both, and thereby emphasize the important public health message that regular physical activity is important for all individuals.

Background: The benefits of exercise on long-term health and well-being are well established. The possible benefits of exercise in Spinal Muscular Atrophy (SMA) have not been explored in a controlled clinical trial format., Objective: To assess the effects of exercise on measures of function, strength, and exercise capacity in ambulatory SMA patients., Methods: Fourteen participants, ages 10-48 years, were randomized to control and exercise cohorts after a 1 month lead-in period. The exercise group received 6 months of intervention. Thereafter, both groups received the intervention for the remaining 12 months. Participants were monitored for a total of 19 months. Exercise included individualized home-based cycling and strengthening. The primary outcome measure was distance walked during the six-minute walk test (6MWT). Secondary outcomes included strength, function, exercise capacity, quality of life and fatigue., Results: Twelve participants completed the first 7 months of the study, and 9 completed all 19 months. At baseline, the groups were similar on all clinical variables. There were no group changes at any time point in the 6MWT, fatigue, or function. Percent-predicted VO2 max improved 4.9% in all participants in 6 months (p = 0.036) (n = 10)., Conclusion: Daily exercise is safe in ambulatory SMA and should be encouraged. We did not uncover any deleterious effects on strength, function, or fatigue. Our study documented a reduction in oxidative capacity and a blunted conditioning response to exercise possibly representing an important insight into underlying pathophysiological mechanisms. These findings also may be linked causally to mitochondrial depletion in SMA and warrant further study.

Objective: To determine the physical activity (PA) behavior, needs and preferences for underserved, ethnically diverse women with a history of endometrial cancer (EC)., Methods: Women with a history of EC (41 non-Hispanic black, 40 non-Hispanic white, and 18 Hispanic) completed a needs assessment during their regular follow-up appointments at Montefiore Medical Center in Bronx, NY, USA. An 8-week pilot PA intervention based on the results of the needs assessment was conducted with 5 EC survivors., Results: Mean body mass index (BMI) among the 99 respondents was 34.1±7.6 kg/m², and 66% did not exercise regularly. Self-described weight status was significantly lower than actual BMI category (p<0.001). Of the 86% who were interested in joining an exercise program, 95% were willing to attend at least once weekly. The primary motivations were improving health, losing weight, and feeling better physically. Despite the high interest in participation, volunteer rate was very low (8%). However, adherence to the 8-week pilot PA intervention was high (83%), and there were no adverse events. Body weight decreased in all pilot participants., Conclusion: These data show that ethnically diverse EC survivors have a great need for, and are highly interested in, PA interventions. However, greater care needs to be taken to assess and identify barriers to increase participation in such programs.

Many studies have documented the association between mechanical deviations from normal and the presence or risk of injury. Some runners attempt to change mechanics by increasing running cadence. Previous work documented that increasing running cadence reduces deviations in mechanics tied to injury. The long-term effect of a cadence retraining intervention on running mechanics and energy expenditure is unknown. This study aimed to determine if increasing running cadence by 10% decreases running efficiency and changes kinematics and kinetics to make them less similar to those associated with injury. Additionally, this study aimed to determine if, after 6 weeks of cadence retraining, there would be carryover in kinematic and kinetic changes from an increased cadence state to a runner's preferred running cadence without decreased running efficiency. We measured oxygen uptake, kinematic and kinetic data on six uninjured participants before and after a 6-week intervention. Increasing cadence did not result in decreased running efficiency but did result in decreases in stride length, hip adduction angle and hip abductor moment. Carryover was observed in runners' post-intervention preferred running form as decreased hip adduction angle and vertical loading rate.

Background: Weight status and depressive affect in adolescents are positively related constructs, but the nature of this relationship is not well understood, especially in European populations. The objective of this study was to examine the interplay between body mass index (BMI) and depressive symptoms, while accounting for the possible mediational role of body image, in a sample of older adolescents in Iceland., Method: We utilized data from a population-based cross-sectional sample of 11 388 junior college students (16-20-year-olds) to conduct structural equation modelling to test the relationship between BMI, body image and depressive symptoms while controlling for socioeconomic status and other background variables., Results: Higher levels of BMI are associated with higher depressive symptoms. However, this association was mediated entirely through perceptions of body image. The association is gender dependent, with the relationship between BMI levels and depressive symptoms being significantly stronger among junior college girls than boys., Conclusion: Body image is a key contributor in the relationship between weight status and depressive symptoms among adolescents. Future interventions with adolescents should take this association into account and focus on such factors as physical confidence and self-esteem., (© The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Introduction: The timed "up & go" (TUG) test is a quick measure of balance and mobility. TUG scores correlate with clinical, functional, and strength assessment and decline linearly over time. Reliability and validity have not been tested in spinal muscular atrophy (SMA)., Methods: Fifteen ambulatory SMA participants performed TUG testing and strength, functional, and clinical assessments. Intraclass correlation coefficients quantified test-retest reliability. Convergent validity was determined using Pearson correlation coefficients., Results: Test-retest reliability was excellent for all participants. TUG was associated significantly with total leg and knee flexor strength, as well as the Hammersmith Functional Motor Scale Expanded, the 10-meter walk/run, and 6-minute walk tests. TUG findings were not associated with knee extensor strength, pulmonary function, or fatigue., Conclusions: In SMA, the TUG test is easily administered, reliable, and correlates with established outcome measures. TUG testing is a potentially useful outcome measure for clinical trials and a measure of disability in ambulatory patients with SMA., (Copyright © 2013 Wiley Periodicals, Inc.)

Introduction: Spinal muscular atrophy (SMA) causes muscle weakness and fatigue. Better understanding of the relationship between weakness and fatigue may help identify potential targets for rehabilitation., Methods: Gait and surface electromyography (EMG) from 4 muscle groups were measured during the Six-Minute Walk Test (6MWT) in 10 ambulatory participants, aged 9-49 years. Average root mean square amplitude (RMS) of muscle activity was calculated. Strength was assessed using manual and quantitative methods., Results: RMS, stride length, and velocity decreased during the 6MWT. Knee flexor and hip abductor strength was associated with fatigue-related changes; overall strength correlated with disease duration; and leg strength was associated with 6MWT distance., Conclusions: Clinical measures are valid in assessing fatigue and function in SMA, and these assessments can be enhanced by use of gait analysis and EMG. Disease duration and strength measures may represent further stratification refinements when enrolling patients in clinical trials., (Copyright © 2013 Wiley Periodicals, Inc.)

Purpose: To examine associations between academic performance and moderate-vigorous physical activity, strength training, fruit and vegetable intake, and sleep., Design: Cross-sectional observational study., Setting: Forty U.S. colleges and universities participating in the Fall 2008 National College Health Assessment-II (NCHA-II) (median response, 27%)., Subjects: A total of 16,095 undergraduate students (18-24 years; 70.3% female)., Measures: Self-reported lifestyle variables from the NCHA-II questions were dichotomized as meeting or not meeting public health recommendations. Grade average ranged from 1.00 to 4.00 points., Analysis: Linear regression, adjusting for sociodemographic and health-related variables., Results: The prevalence of meeting public health recommendations was as follows: moderate-vigorous physical activity, 41.9%; strength training, 32.4%; fruit and vegetable intake, 4.6%; and sleep, 23.6 %. Grade average was higher in students meeting moderate-vigorous physical activity, fruit and vegetable intake, and sleep recommendations (p ≤ .019). If moderate-vigorous physical activity was met, grade average was higher by .03 points, .15 points higher when meeting fruit and vegetable intake recommendations, and .06 points higher for sleep. There was no significant change in grade average in those meeting strength-training recommendations., Conclusion: College students who adhere to public health recommendations for lifestyle behaviors have modestly higher grade averages after adjusting for sociodemographic and negative health behaviors.

Background: Gait impairments related to Parkinson's disease (PD) include variable step length and decreased walking velocity, which may result in poorer walking economy. Auditory cueing is a common method used to improve gait mechanics in PD that has been shown to worsen walking economy at set treadmill walking speeds. It is unknown if auditory cueing has the same effects on walking economy at self-selected treadmill walking speeds., Objectives: To determine if auditory cueing will affect walking economy at self-selected treadmill walking speeds and at speeds slightly faster and slower than self-selected., Methods: Twenty-two participants with moderate PD performed three, 6-minute bouts of treadmill walking at three speeds (self-selected and ± 0.22 m·sec-1). One session used cueing and the other without cueing. Energy expenditure was measured and walking economy was calculated (energy expenditure/power)., Results: Poorer walking economy and higher energy expenditure occurred during cued walking at a self-selected and a slightly faster walking speed, but there was no apparent difference at the slightly slower speed., Conclusion: These results suggest that potential gait benefits of auditory cueing may come at an energy cost and poorer walking economy for persons with PD at least at some treadmill walking speeds.

Background: Spinal Muscular Atrophy (SMA) is a recessively-inherited neuromuscular disease characterized by weakness and muscle atrophy. Although anecdotal benefits from exercise have been noted, and despite promising pre-clinical and pilot reports, the effect of exercise has not been addressed in a controlled trial in SMA., Objective: To assess the effects of exercise on measures of function, strength, and exercise capacity in ambulatory SMA patients., Methods/design: An evaluator-blinded, randomized, controlled trial of aerobic and strengthening exercise in 14 ambulatory SMA patients aged 8-50 years. Patients will be randomized to either the exercise or control arm after the 1 month lead in period. During the first 6-months, the exercise group will receive the intervention while the other group serves as a control. After those 6 months, both groups will receive the intervention. The last 6-months of the study are designed to mimic real-world conditions where all participants are encouraged to continue on their own. Participants will be monitored throughout this 19 month study and will have in-person visits every three months. The primary outcome measure is the change in the total distance walked over 6-months on the six minute walk test (6MWT). Secondary outcome measures include maximal oxygen uptake (VO2 max), functional and strength assessments, pulmonary function, fatigue, and quality of life., Discussion: The result of this prospective, single blinded, randomized and controlled clinical trial of exercise on an established functional outcome measure will have impact on clinical practice by providing important guidance to clinical management of SMA patients.

Objective. The purpose of the study was to investigate the effects of a 12-week program of therapeutic Tai Chi on the motor function and physical function of idiopathic Parkinson's disease patients (PDs). Methods. The participants were 22 clinically stable PDs in Hoehn-Yahr stages 1-2 randomly assigned to a therapeutic Tai Chi group (TTC, N = 11) or a control group (CON, N = 9). Two subjects in control group did not complete the study for personal reasons. TTC was performed three days a week (60 min/session). Motor symptoms by the UPDRS were assessed, and tests of physical function were administered before and after the 12-week trial. Results. The TTC group, as compared to the CON group, showed changes in the mentation, behavior, mood, and motor scales of the UPDRS (P < 0.05, P < 0.01, resp.), with no significant main effects on the activities of daily living scale (ADL). However, there was a significant interaction between the time and intervention group on ADL (P < 0.05). There were no significant main effects for any of the physical function variables. There were significant interaction effects in balance and agility (P < 0.05, resp.). Conclusions. This study showed that TTC training had modest positive effects on the functional status of Parkinson's disease patients.

Aims: To investigate whether the secular trend in the increasing prevalence of overweight and obesity among 16- to 20-year-old adolescents in Iceland varied by levels of parental education and family structure., Methods: Odds ratios were calculated from repeated population-based, cross-sectional surveys comprising cohorts of 16- to 20-year-old Icelandic adolescents attending junior colleges in 1992 (n=4,922), 2004 (n=11,031), 2007 (n=11,229), and 2010 (n=11,388). Body mass index (BMI) was calculated from self-reported weight and height and categorised as normal weight or overweight and obese, and examined in relation to parental education level and family structure., Results: The odds of being overweight increased by 2.62 and 1.71 for boys and girls respectively over each of the survey time points. The prevalence of overweight and obesity increased across all three subgroups (low, medium, and high) of parental education level. The probability of overweight across all years were consistently the highest for youths with parents in the low-education category followed by middle-educated and high-educated parental background (p<0.05). The gap in overweight and obesity trends between respondents' parental education backgrounds increased over time and was generally explained more by the fathers' education than by the mothers' education (p<0.05). Family structure was not associated with the prevalence of overweight and obesity in our data., Conclusions: Differences in parental levels of education are associated with accelerating trends in prevalence of overweight and obesity among 16- to 20-year-old adolescents in Iceland.

Background: The goal of this study was to evaluate energy expenditure and dietary intake of nutrients during Taekwondo practice in elite Korean male Taekwondo players., Methods: Elite Korean male high school (high school player: HP; n = 59) and college players (college player: CP; n = 58) wore an accelerometer to measure energy expenditure and recorded their daily dietary intake for nutritional analysis over the course of five days., Results: Nutritional adequacy ratios for total energy (0.82), vitamin C (0.97), calcium (0.78), and folate (0.75) were below recommended levels for all players. When comparing daily nutrient intake and energy expenditure between HP and CP, the HP group had significantly higher total calorie intake (402.7 kcal, p < 0.001), calcium (126.3 mg, p = 0.018), phosphorus (198.0 mg, p = 0.002), iron (1.3 mg, p = 0.002), and vitamin B2 (0.4 mg, p < 0.001) than the CP group. Although there was no significant difference in the estimated energy requirement during Taekwondo practice, the total energy expenditure (151.2 kcal, p = 0.001), total activity counts (130,674 counts, p = 0.038) and energy expenditure during Taekwondo practice (257.7 kcal, p < 0.001) were significantly higher in the HP than in the CP., Conclusion: The results indicate that a sports nutrition program based on energy balance is necessary to achieve optimal health and performance in elite male Taekwondo players.

The purpose of this study was to compare simultaneous measurements of tidal volume (Vt) by optoelectronic plethysmography (OEP) and spirometry during a maximal cycling exercise test to quantify possible differences between methods. Vt measured simultaneously by OEP and spirometry was collected during a maximal exercise test in thirty healthy participants. The two methods were compared by linear regression and Bland-Altman analysis at submaximal and maximal exercise. The average difference between the two methods and the mean percentage discrepancy were calculated. Submaximal exercise (SM) and maximal exercise (M) Vt measured by OEP and spirometry had very good correlation, SM R=0.963 (p<0.001), M R=0.982 (p<0.001) and high degree of common variance, SM R(2)=0.928, M R(2)=0.983. Bland-Altman analysis demonstrated that during SM, OEP could measure exercise Vt as much as 0.134 L above and -0.025 L below that of spirometry. OEP could measure exercise Vt as much as 0.188 L above and -0.017 L below that of spirometry. The discrepancy between measurements was -2.0 ± 7.2% at SM and -2.4 ± 3.9% at M. In conclusion, Vt measurements at during exercise by OEP and spirometry are closely correlated and the difference between measurements was insignificant., (Copyright © 2012 Elsevier B.V. All rights reserved.)