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Background: Exercise promotion interventions for people with Parkinson's disease (PD) are often offered on a face-to-face basis, follow a generic "one-size-fit-all" approach, and are not typically delivered at diagnosis. Considering PD's heterogenous nature, the existing evidence on the merits of exercise on symptom management and the expressed wishes of people living with PD for access to timely and tailored evidence-based information, there is a demand for interventions that are easily accessible, scalable and co-designed with people living with PD. Objective: Evaluate the feasibility and acceptability of a co-designed digital intervention promoting exercise and physical activity, in people newly diagnosed with PD. Methods: Thirty people living with PD for less than one year participated in an assessor-blinded randomized feasibility trial from June 2022 to April 2023. The intervention group received the 8-week Knowledge, Exercise Efficacy and Participation (KEEP) intervention comprising 6 interactive digital modules and 4 online live group discussions facilitated by a specialist physiotherapist. Assessments were performed at baseline, post intervention and at 6-month follow up. Results: Thirty participants were recruited to target with a 64% recruitment rate (30/47). All but one participant completed the 6-month follow-up assessment. There was high retention (97%), module completion (91%), and online discussion attendance (88%). Outcome measure collection was feasible, including accelerometer data with a daily average wear time of 23.9 hours (SD:0.295). Conclusions: The KEEP intervention was feasible and acceptable in people newly diagnosed with PD. A larger trial is needed to assess intervention efficacy and correlation between knowledge, self-efficacy, and activity levels. Plain Language Summary: Exercise and physical activity have been found beneficial in managing both motor and non-motor symptoms in people living with Parkinson's. But there aren't many programs available right after diagnosis that focus on exercise and explain why it's important for managing PD symptoms and how to exercise with PD. Most existing programs use a one-size-fit-all approach and don't give personalized information. In this study, researchers wanted to see if people who were recently diagnosed with PD would join a study promoting exercise through an online program. This program included educational information and live online group discussions with both people living with Parkinson's and a specialist physiotherapist. The program was developed together with people living with Parkinson's and healthcare professionals to ensure that it better suited the needs of people newly diagnosed with PD. Thirty people took part in the study. They were randomly put into two groups: one received the online program, while the other group continued with their usual care. Participants filled out questionnaires and wore a wrist accelerometer for seven days to track their physical activity levels. The researchers found that most participants stayed in the study (97%), completed the program modules (91%), and attended the live discussions (88%) and wore the accelerometers for 23.9 hours a day on average. Overall, the study showed that the program was doable and well-received. Participants said they had a better understanding on the benefits of exercise in PD. However, a larger study is needed to see if the program helps increase activity levels. [ABSTRACT FROM AUTHOR]

This review explores the diverse landscape of integrating nutrition and physical activity education into medical school curricula, focusing on the imperative role of physicians in promoting health through lifestyle changes. By examining global medical education structures, we uncovered disparities in nutrition and physical activity training, and highlighted the need for a shared framework to address international and regional challenges. Despite acknowledging the importance of both nutrition and physical activity, studies have consistently uncovered deficiencies in medical school curricula, especially in skills related to providing lifestyle advice and behavioral counseling. Survey studies among medical students have illuminated various perceptions and knowledge gaps, emphasizing the need for more comprehensive and mandatory nutrition and physical activity training. While acknowledging progress, challenges, such as time constraints, resource availability, and faculty expertise, persist. Integrating lifestyle education results in resistance, a demand for strategic communication, and faculty buy-ins. These findings underscore the importance of a holistic approach that balances theoretical knowledge, practical skills, and confidence that medical students need to promote effective nutrition and physical activity in healthcare. [ABSTRACT FROM AUTHOR]

Objective: Assessment of physical activity and exercise prescription has been widely supported by many organizations, yet provision of such services remains limited in the United States. We sought to uncover why such services have not been widely adopted. Design: The American Medical Society for Sports Medicine organized a task force to canvas physicians and survey the American Medical Society for Sports Medicine membership. Setting: Peer-to-peer and telecommunication discussions and webbased questionnaires. Participants: Sports medicine physicians in the United States. Interventions: None. MainOutcome Measures: Percentage of sports medicine physicians who provide exercise management services and mechanisms of billing for exercise management, identify barriers to such services, and identify industry collaborations for promoting physical activity through physicians. Results: Three of 4 sports medicine physicians spend at least 1 min encouraging exercise with patients, using Evaluation and Management codes to bill or receive credit. Exercise counseling is often bundled within other patient care. Few health plans leverage the patient’s relationship with a primary care physician to promote exercise. Most employed sports medicine physicians do not receive incentives to incorporate exercise counseling into practice, and only 1 in 6 have decision-making authority to hire an exercise professional. Major obstacles are the lack of a business model and knowledge about exercise prescription. Conclusion: The existing E&M codes adequately characterize the work, but physicians desire greater payment or credit for providing exercise management services. Physicians desire to do more exercise prescription, but health system bureaucracy, inadequate support, and economic disincentives are barriers to the provision of exercise management services. [ABSTRACT FROM AUTHOR]

People living alone encounter well-being challenges due to unnoticed personal situations. Thus, it is essential to monitor their activities and encourage them to adopt healthy lifestyle habits without imposing a mental burden, aiming to enhance their overall well-being. To realize such a support system, its components should be simple and loosely coupled to handle various internet of things (IoT)-based smart home applications. In this study, we propose an exercise promotion system for individuals living alone to encourage them to adopt good lifestyle habits. The system comprises autonomous IoT devices as agents and is realized using an agent-oriented IoT architecture. It estimates user activity via sensors and offers exercise advice based on recognized conditions, surroundings, and preferences. The proposed system accepts user feedback to improve status estimation accuracy and offers better advice. The proposed system was evaluated from three perspectives through experiments with subjects. Initially, we demonstrated the system's operation through agent cooperation. Then, we showed it adapts to user preferences within two weeks. Third, the users expressed satisfaction with the detection accuracy regarding their stay-at-home status and the relevance of the advice provided. They were also motivated to engage in exercise based on a subjective evaluation, as indicated by preliminary results. [ABSTRACT FROM AUTHOR]

People living alone encounter well-being challenges due to unnoticed personal situations. Thus, it is essential to monitor their activities and encourage them to adopt healthy lifestyle habits without imposing a mental burden, aiming to enhance their overall well-being. To realize such a support system, its components should be simple and loosely coupled to handle various internet of things (IoT)-based smart home applications. In this study, we propose an exercise promotion system for individuals living alone to encourage them to adopt good lifestyle habits. The system comprises autonomous IoT devices as agents and is realized using an agent-oriented IoT architecture. It estimates user activity via sensors and offers exercise advice based on recognized conditions, surroundings, and preferences. The proposed system accepts user feedback to improve status estimation accuracy and offers better advice. The proposed system was evaluated from three perspectives through experiments with subjects. Initially, we demonstrated the system’s operation through agent cooperation. Then, we showed it adapts to user preferences within two weeks. Third, the users expressed satisfaction with the detection accuracy regarding their stay-at-home status and the relevance of the advice provided. They were also motivated to engage in exercise based on a subjective evaluation, as indicated by preliminary results.

Health care providers have highlighted the need for tools and resources that support promotion of exercise behavior within comprehensive multiple sclerosis (MS) care. This study involved a final quality improvement evaluation of exercise promotion models and materials for inclusion within this setting. Our research team distributed a paper-based survey containing Likert scales, open answer questions, and copies of the models for editing. We distributed this survey among health care providers across the United States. We conducted a novel mixed-methods analysis evaluating quantitative, qualitative, and creative data. We received completed surveys from 13 health care providers who strongly rated the clarity and applicability of the models and materials, and reported that no major improvements were necessary. The minor improvements were specific per comprehensive MS care center. The feedback indicated that the "Exercise in Medicine" models and materials are guides such that the processes should be integrated into real world practice by amending roles and responsibilities with the team members and structure per comprehensive MS care center. This paper presents finalized models and materials for exercise promotion within comprehensive MS care that are ready to be tested for feasibility and efficacy in a clinical trial. Health care providers require support to promote exercise within the context of comprehensive MS care. The practice models in this article provide guides regarding how to promote exercise in this context. Implementing these exercise promotion guides can reduce the burden of neurologists, and ensure patients receive exercise support from appropriate providers. These guides should be implemented within the context of each individual care center, and not as an explicit step by step guide as each care center is unique. [ABSTRACT FROM AUTHOR]

This study investigated the acute effect of an 18-hole round of golf on serum interleukin-6 (IL-6) and brain-derived neurotropic factor (BDNF) concentration. Nine young, healthy males, unaccustomed to playing golf, completed an 18-hole round of golf (course length: 5,807 m.). Blood samples were collected prior to, immediately after and 1 h following completion of the exercise session. Interleukin-6 and BDNF, as well as creatine kinase (CK) and myoglobin concentrations were analysed in serum, while adrenaline concentrations were assessed in plasma. The participants completed the course in 303 ± 4 min. Serum IL-6 and BDNF concentrations were respectively elevated 8.6 ± 5.4-fold and 1.2 ± 0.3-fold immediately post-exercise (IL-6 p = 0.008; BDNF p = 0.038). Creatine kinase (p = 0.008), myoglobin (p = 0.011) and adrenaline concentrations (p = 0.038) were also acutely elevated following completion of the golf course. Creatine kinase and myoglobin concentrations were significantly correlated with the acute increase in IL-6 concentration post-exercise (r = 0.70 p = 0.034, r = 0.79 p = 0.012, respectively), while no such relationship was found for BDNF concentration. (r = 0.37 p = 0.333, r = 0.08 p = 0.833, respectively). An 18-hole round of golf was found to acutely elevate IL-6 and BDNF concentration in young, healthy males unaccustomed to playing golf. The correlation of CK and myoglobin with the acute IL-6 response suggests that muscle damage may have influenced the acute increase in this marker. Together, this pilot-study indicates that golf may be promoted as an accessible, low-intensity activity to acutely elevate markers suggested to stimulate improvements in metabolic health and cognitive function.

Given the rise in obesity and the positive exercise effects in curbing obesity levels, exercise promoters are expected to use technological applications--social media and fitness applications--in their exercise motivational programs. The purpose of this article is to critique the use of social media and fitness apps as both ineffective and potentially harmful. An alternative approach is proposed where phronesis (practical wisdom) in exercise participation can be achieved via physical and cognitive mastery of the action for its own sake (real techneart, embodiment). Emphasizing exercise outcomes (e.g., energy expenditure) captured by external devices distracts from embodied and phronetic action. Drawing on the philosophies of phronesis, techne, and embodiment, exercise promoters should emphasize embodied exercise experiences via mastery of action, social interactions, and connectedness to nature. They should target real action in real communities, and not emotionless and meaningless online forums about how to become the ultimate virtual fitness buff. [ABSTRACT FROM AUTHOR]

Abstract Background Regular physical activity and exercise provide many health benefits. These health benefits are mediated in large part through cardiorespiratory fitness and muscular strength. As most individuals have not had an assessment of their personal cardiorespiratory fitness or muscular strength we investigated if measurements of cardiorespiratory fitness and muscular strength would influence an individual’s subsequent self-reported exercise and physical activity. Methods Volunteer subjects at a State Fair were randomized in 1:1 parallel fashion to control and intervention groups. The baseline Exercise Vital Sign (EVS) and type of physical activity were obtained from all subjects. The intervention group received estimated maximum oxygen uptake (VO2max) using a step test and muscular strength using a hand grip dynamometer along with age-specific norms for both measurements. All subjects were provided exercise recommendations. Follow up surveys were conducted at 3, 6 and 12 months regarding their EVS and physical activity. Results One thousand three hundred fifteen individuals (656 intervention, 659 control) were randomized with 1 year follow up data obtained from 823 subjects (62.5%). Baseline mean EVS was 213 min/week. No change in EVS was found in either group at follow-up (p = 0.99). Subjects who were less active at baseline (EVS

There is a need to broaden the knowledge of oncology nurses about exercise prescription and recommendations for the improvement of quality of life and physical and mental health of patients with cancer and survivors. In addition, oncology nurses need to have comprehensive knowledge regarding the physiological mechanisms underlying these improvements. Through this mini review, we aimed to describe the level of expertise of nurses in the field of exercise oncology and identify appropriate solutions to improve this knowledge. Articles concerning exercise and oncology nursing practices published between January 1996 and September 2020 were searched in the PubMed electronic database; relevant articles were selected, full-text articles were assessed, and important information was extracted. A standard exercise oncology curriculum needs to be developed and implemented for oncology nursing practitioners and those training in oncology nursing. Oncology nurses should be trained in exercise oncology, rehabilitation, and exercise prescription and follow-up. This could boost the rate of adherence to self-managed/home-based exercise routine among cancer survivors.

Background: Physical education (PE) can be considered an instrument for active lifestyle promotion, and PE teachers can motivate youths lo continue their studies in the field of Movement Sciences (MS). Methods: To evaluate the role of PE in higher secondary school in promoting physical activity (PA) and MS careers, previous PE experiences and current PA practice were investigated in a sample of Italian freshmen enrolled in different university degree courses. Results: A total of 7033 questionnaires were completed by students from 14 universities (41.3% males, mean age 20 ± 2.76 years). Recreation seemed to be the principal aim (42.2%) pursued during PE lessons, which are based mainly on practical activities (51.7%). Of all respondents, 67.2% were satisfied with the PE received during higher secondary school, and 51.6% participated in extracurricular PA. Current practice of PA was reported by 58.1% of the sample. Extracurricular activities were associated with choice of MS curricula (odds ratio: 2.15; 95% confidence interval, 1.85-2.50) and with current practice of PA (odds ratio: 1.68,95% confidence interval, 1.51-1.87). Geographical differences concerning lessons organization and satisfaction were registered (P < .01). Conclusions: To enhance its role in health promotion, PE teaching should be improved by increasing the time allocated to PE and by strengthening the provision of school-based extracurricular PA. [ABSTRACT FROM AUTHOR]

We undertook a qualitative study that explored exercise participation and exercise promotion in the multiple sclerosis (MS) community who live in regional or remote areas of Australia. By simultaneously gathering views from persons with MS, carers, healthcare providers and healthcare managers we aimed to gather unique perspectives which represented views from across socio-ecological levels of MS healthcare. We used interpretive description methodology, and conducted semi-structured interviews or focus groups with people with MS (n = 28), carers (n = 8), healthcare providers (n = 12) and managers/supervisors of MS healthcare systems (n = 16). Data were analysed using thematic analysis. We identified three themes with 10 subthemes. The first theme was "Factors associated with exercise engagement" for the people with MS, from individual, interpersonal, organisational and community/public policy perspectives. The second theme was "Factors influencing the MS community's promotion of exercise" focusing on carers, healthcare providers and healthcare systems. The third theme was "Motivators to increase exercise promotion" which should be delivered by the MS community across varying socio-ecological levels of healthcare to encourage exercise participation. We identified new evidence on the factors which influence the MS community's promotion of exercise and we now better understand that training on exercise should be provided to the wider MS community, and exercise services should be considered locally and perhaps delivered via teleheath. Cohesive healthcare campaigns, and clinical guidelines based on empirical evidence should be established for symptom management in MS with a focus on the role of exercise. Symptom management strategies should consider the whole MS community, including patients, carers, healthcare professional and healthcare co-ordinators. Internal factors (e.g., emotion and motivation) and broader factors (e.g., funding and location) must be considered when designing exercise interventions in persons with MS. [ABSTRACT FROM AUTHOR]

Background Falls incidence increases with age alongside declines in strength and balance. Clinical trials show that the Falls Management Exercise (FaME) programme improves strength and balance, which can reduce falls and improve physical functioning. Objective To determine if the clinical trial efficacy of FaME translates into effectiveness in non-research settings. Design and setting An implementation study of FaME in 10 local authorities across the East Midlands region of England. Subjects Adults aged 65 and over enrolled on a FaME programme. Method Anonymised outcome data collected by the FaME providers were compared at baseline, end of programme and 6 months follow-up using univariate and multivariate analyses. Results For 348 adults enrolled in programmes and analysed, the mean age was 76.8, 73% were female and 143 (41%) completed ≥75% of classes. Overall confidence in balance, fear of falling, functional reach and timed-up-and-go (all P  < 0.001), and turn 180° (P  = 0.008) improved significantly at programme completion versus baseline, but improvements were not maintained 6 months later. Falls risk (FRAT score) and total minutes of physical activity did not change significantly though minutes of strength and balance activity increased by 55% at programme completion and was maintained at 6 months. The falls incidence rate ratio (IRR) was non-significantly lower at programme completion (IRR 0.76, 95% Confidence Interval (CI) 0.48,1.21) and follow-up (IRR 0.82 95% CI 0.48,1.39) versus baseline. Conclusions There is modest translation of FaME efficacy into effectiveness, but not all effects persist after completion. Strategies to aid adherence and exercise maintenance are important to maximise benefits. [ABSTRACT FROM AUTHOR]

Introduction: There is a gap between evidence-based knowledge of exercise benefits and the translation of these benefits among persons with multiple sclerosis within clinical practice. This study represents the second cycle of a Plan-Do-Study-Act ramp to assess and improve three exercise promotion practice models and a screening process for use by healthcare providers to bridge the knowledge-translation gap within comprehensive multiple sclerosis care. Methods: Using a quality improvement design, our research team created an online survey for evaluating program materials by healthcare providers (i.e., neurologists, nurses, physical therapists, and occupational therapists). Participants provided written comments and suggestions for improvement regarding roles and responsibilities and clarity and relatability of these tools within a realworld setting. Results: Healthcare providers submitted 13 suggestions for improvement. Responses informed four specific improvements regarding program materials (i.e., patient screening, current exercise behavior, referrals, and provider checklists), thereby prompting the research team to adapt and further test the change idea. Conclusions: This article provides a step forward in a line of research focused on developing a systems-based process for integrating exercise promotion as part of comprehensive multiple sclerosis care. [ABSTRACT FROM AUTHOR]

Background: Regular physical activity and exercise provide many health benefits. These health benefits are mediated in large part through cardiorespiratory fitness and muscular strength. As most individuals have not had an assessment of their personal cardiorespiratory fitness or muscular strength we investigated if measurements of cardiorespiratory fitness and muscular strength would influence an individual's subsequent self-reported exercise and physical activity. Methods: Volunteer subjects at a State Fair were randomized in 1:1 parallel fashion to control and intervention groups. The baseline Exercise Vital Sign (EVS) and type of physical activity were obtained from all subjects. The intervention group received estimated maximum oxygen uptake (VO2max) using a step test and muscular strength using a hand grip dynamometer along with age-specific norms for both measurements. All subjects were provided exercise recommendations. Follow up surveys were conducted at 3, 6 and 12 months regarding their EVS and physical activity. Results: One thousand three hundred fifteen individuals (656 intervention, 659 control) were randomized with 1 year follow up data obtained from 823 subjects (62.5%). Baseline mean EVS was 213 min/week. No change in EVS was found in either group at follow-up (p = 0.99). Subjects who were less active at baseline (EVS < 150) did show an increase in EVS (86 to 146) at 6 months (p < 0.05). At 3 months the intervention group increased resistance training (29.1 to 42.8%) compared to controls (26.3 to 31.4%) (p < 0.05). Lifestyle physical activity increased in the intervention group at 3 months (27.7 to 29.1%) and 6 months (25%) whereas it declined in the control group at 3 months (24.4 to 20.1%) and 6 months (18.7%) (p < 0.05). Conclusion: Providing VO2max estimates and grip strength did not produce an increase in overall physical activity. The EVS and exercise recommendations did however produce an increase in physical activity in less active individuals. In a very active population the VO2max estimate and measured grip strength did increase lifestyle activity and resistance training. Wider adoption of these measures could be effective in promoting physical activity and resistance training. Trial registration: clinicaltrials.gov NCT03518931 Registered 05/08/2018 -retrospectively registered. [ABSTRACT FROM AUTHOR]

Based on the Dual-System theory of Thaler and Sunstein, this article discussed the relevant research progress of nudge and its enlightenment to the research and practice of exercise behavior promotion from the perspective of the first nudge strategy and the second nudge strategy. The first type of nudge strategy is mainly based on human unconscious system, which mainly includes changing the behavioral background and increasing the selectivity of exercise; changing the default options to promote active decision-making in exercise; initiating role models to increase the visibility of exercise. The second type of nudge is mainly based on human reflective thinking, allowing people to feel the motivation of behavior and then inspiring human behavior, which includes opening self-commitment to promote the durability of exercise; using descriptive social norms to promote the enthusiasm of exercise; making daily reminders to overcome the laziness of exercise; utilizing the selection framework to increase the availability of exercise; employing social influence strategies to improve something interesting of exercise. Based on those above, three issues needed to be explored in future research were suggested: at first, further testing the effectiveness of exercise nudge strategies; secondly, exploring the long-term effects of nudge intervention; thirdly, conducting joint research on exercise promotion based on Dual-System theory. [ABSTRACT FROM AUTHOR]

This study compared the long-term effectiveness of three physical activity counseling strategies among sedentary older adults: a 1-contact referral (REFER), a 1-contact individualized walking program (WALK), and multiple-contact, individually tailored, and need-supportive coaching based on the self-determination theory (COACH). Participants (n = 442) completed measurements before (pretest), immediately after (posttest), and 1 yr after (follow-up test) a 10-wk intervention. Linear mixed models demonstrated significant time-by-condition interaction effects from pre- to posttest. More specifically, WALK and COACH yielded larger increases in daily steps and self-reported physical activity than REFER. Similarly, self-reported physical activity increased more from pre- to follow-up test in WALK and COACH compared with REFER. Autonomous motivation mediated the effect of perceived need-support on physical activity, irrespective of counseling strategy. These results demonstrate the long-term effectiveness of both a 1-contact individualized walking program and a more time-consuming, need-supportive coaching, especially in comparison with a standard referral to local opportunities. [ABSTRACT FROM AUTHOR]

Despite significant prevention efforts, the numbers of physically inactive individuals, chronic illnesses, exhaustion syndromes and sick leaves are increasing. A still unresolved problem with exercise promotion is the low participation of sedentary persons. This collective term covers heterogeneous subgroups. Their engagement with movement campaigns and resistance to change are influenced by numerous factors. Our aim was to analyse survey data on health, performance, lifestyle habits and the approachability to physical activity campaigns obtained from the Germany-wide ActIv survey. From 2888 study participants aged 50-60 years, 668 persons were categorised into the subgroups "never-athletes", "sports-dropouts", "always-athletes" and "sports-beginners". Large and significant group differences were found for BMI, assessment of quality of life, health and fitness, risk factors and health problems. In total, 42.5% of "never-athletes" and 32.5% of "sports-dropouts" did not state any barriers to sport. There are substantial disparities between the non-athlete groups in terms of their motivation to exercise. In contrast, there are comparatively minor differences in motivation between "sports-dropouts" and "sports-beginners", whose health and fitness are the primary motivators for sport. Our analyses suggest that (i) negative health and performance trends cannot be compensated for by appeals for voluntary participation in exercise programmes and (ii) powerful incentive systems are required.

This study evaluated "Every Step Counts!"-a 10-wk, structured walking intervention in a community-based senior organization-on promoting physical activity participation, fitness, and well-being among older adults (age ? 55 yr). The intervention prescribed pedometer-defined walks in weekly walking schedules. These were fitness-tailored and structured in walking load (intensity/volume) according to the principles of training progression. This intervention was offered as a social activity at meeting points of a community-based senior organization. Twenty-nine meeting points (n = 432) constituted the intervention condition. Ten meeting points (n = 148) formed the wait-list control condition. Measurements were organized at intervention start (pretest) and end (post-test). Intention-to-treat linear mixed models showed small positive intervention effects on physical activity, fitness, and aspects of well-being. These results confirm the effectiveness of structured walking interventions with systematic training progression and underscore the value of community-based senior organizations as intervention settings for older adults. [ABSTRACT FROM AUTHOR]

Nearly 80% of persons with multiple sclerosis (MS) do not engage in sufficient amounts of exercise for managing symptoms and improving quality of life. We have addressed this problem by developing a systematic line of qualitative research targeting the patient–provider interaction for promotion of exercise within comprehensive MS care. This research resulted in a conceptual model that guides health care providers in promoting exercise among persons with MS. The current study involves a final evaluation of the model based on semistructured interviews with 28 MS health care providers. Providers perceived that the model was a strong conceptualization of practice that reflected the MS illness course and supported exercise behavior change, but more steps were required to translate the model from concept into practice, including improved clarity of the model, and the development of practice models. The evaluation yielded a final conceptual model for exercise promotion in MS through the patient–provider interaction. [ABSTRACT FROM AUTHOR]

In 2015, 120 main primary schools in Croatia did not have a school gymnasium, and could not carry through the full-time compulsory Physical Education (PE) classes. To ensure regular physical exercise to all children and help teachers, the Croatian Institute of Public Health has implemented the project “Polygon for Physical Activity of School-Aged Children”. This paper aims to present the usability and functionality assessment of the multipurpose kinesiology equipment set used in the Project in the primary schools without gymnasia based on the teachers’ experience and appraisals in three independent assessment waves. Results show that after receiving the set the teachers perceived they had better conditions for teaching PE class and managed to fulfil PE curriculum goals and tasks. Students’ motivation for physical education class also improved in some areas, as well as teachers’ satisfaction with the conditions for and school investments in PE class. Most of the teachers perceived that the multipurpose kinesiology equipment set had the potential to improve the quality of PE class and to be used in other classes as well. According to the obtained data it could be assumed that this multipurpose kinesiology equipment set is a positive innovation in the teaching process and presents a strong potential for alleviating the spatial and material problems teachers in schools without gymnasia are experiencing in their work. [ABSTRACT FROM AUTHOR]

The authors examined factors related to participation in walking, gardening or yard work, and sports or exercise in 686 community-dwelling adults 60-95 years of age from Wave IV of the population-based Americans' Changing Lives Study. Logistic regression revealed that male gender, being married, and better functional health were associated with greater likelihood of participating in gardening or yard work (p < .05). Male gender, better functional health, and lower body-mass index were independently associated with greater likelihood of walking (p < .05). Increasing age, male gender, higher education, and better functional health were associated with greater likelihood of participating in sports or exercise (p < .05). Subsequent analyses yielded an interaction of functional health by gender in sport or exercise participation (p = .06), suggesting a greater association between functional health and participation in men. Gender and functional health appear to be particularly important for physical activity participation, which may be useful in guiding future research. Attention to different subgroups may be needed to promote participation in specific activities. [ABSTRACT FROM AUTHOR]

Individuals with severe mental illness engage in significantly less amounts of physical activity than the general population. A secure mental health setting can exacerbate barriers to exercise, and facilitate physical inactivity and sedentary behaviour. Healthcare assistants are intimately involved in the daily lives of patients and, therefore, should be considered integral to exercise promotion in secure mental health settings. Our aim was to explore healthcare assistants' perceptions of exercise and their attitudes to exercise promotion for adult patients in a secure mental health hospital. Qualitative semi-structured interviews were conducted with 11 healthcare assistants from a large UK-based secure mental health hospital. Topics included healthcare assistants' personal experiences of exercise within a secure facility, their perceptions of exercise as an effective treatment tool for mental health, and their perceived roles and responsibilities for exercise promotion. Thematic analysis was used to analyse the data. Three main themes were identified: (i) exercise is multi-beneficial to patients, (ii) perceived barriers to effective exercise promotion, and (iii) strategies for effectives exercise promotion. Healthcare assistants considered exercise to hold patient benefits. However, core organizational and individual barriers limited healthcare assistants' exercise promotion efforts. An informal approach to exercise promotion was deemed most effective to some, whereas others committed to more formal strategies including compulsory sessions. With education and organizational support, we propose healthcare assistants are well placed to identify individual needs for exercise promotion. Their consultation could lead to more efficacious, person-sensitive interventions. [ABSTRACT FROM AUTHOR]

Objectives To explore factors associated with maintenance of moderate-to-vigorous physical activity (MVPA) in community-dwelling adults aged ≥65 years after completing a 24-week exercise programme. Study design This is a cohort study nested within a randomised controlled trial evaluating group- and home-based exercise programmes for older people in England. Methods MVPA levels and factors potentially associated with physical activity (PA) were self-reported at recruitment, 6, 12, 18 and 24 months after exercise programme. Multilevel logistic regression estimated odds ratios (ORs) for achieving target MVPA level (150 min/week) 6-24 months after exercise programmes ended. Results Older people (OR per year increase: 0.89, 95% confidence interval [CI] 0.86, 0.93) and women (OR 0.47, 95% CI 0.33, 0.67) were less likely to achieve target MVPA. Those physically active at recruitment (OR 11.28, 95% CI 7.95, 16.01), with wider social networks (OR per unit increase in Lubben Social Network Scale: 1.06, 95% CI 1.03, 1.10) and performing more sit-to-stands in 30 s (OR for quartile 3 compared with quartile 1: 1.87, 95% CI 1.12, 3.10), were more likely to achieve target MVPA. Negative exercise expectations increased the odds of achieving target MVPA but only among the less active at recruitment (OR per unit increase in Outcome and Expectation for Exercise negative subscale: 1.90, 95% CI 1.39, 2.60). Associations did not differ significantly across the follow-up period. Conclusion A range of factors are associated with maintenance of PA 6-24 months after exercise programmes. Factors are not more strongly associated with shorter vs longer term PA maintenance. Commissioners and providers should consider targeting maintenance interventions to those least likely to maintain PA. [ABSTRACT FROM AUTHOR]

Background There is increasing recognition of the benefits of exercise in individuals with multiple sclerosis (MS), yet the MS population does not engage in sufficient amounts of exercise to accrue health benefits. There has been little qualitative inquiry to establish the preferred format and source for receiving exercise information from health-care providers among persons with MS. Objective We sought to identify the desired and preferred format and source of exercise information for persons with MS that can be delivered through health-care providers. Setting and participants Participants were adults with MS who had mild or moderate disability and participated in a range of exercise levels. All participants lived in the Midwest of the United States. Methods Fifty semi-structured interviews were conducted and analysed using thematic analysis. Results Two themes emerged, (i) approach for receiving exercise promotion and (ii) ideal person for promoting exercise. Persons with MS want to receive exercise information through in-person consultations with health-care providers, print media and electronic media. Persons with MS want to receive exercise promotion from health-care providers with expertise in MS (ie neurologists) and with expertise in exercise (eg physical therapists). Conclusions These data support the importance of understanding how to provide exercise information to persons with MS and identifying that health-care providers including neurologists and physical therapists should be involved in exercise promotion. [ABSTRACT FROM AUTHOR]

Background There is growing recognition of the benefits and safety of exercise and its importance in the comprehensive care of persons with multiple sclerosis ( MS), yet uptake is low. Objective We explored the needs and wants of patients with MS regarding exercise promotion through healthcare providers. Setting and participants Participants were adults with MS who had mild-or-moderate disability and a range of exercise levels. All participants lived in the Midwest of the United States. Methods Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, namely interactions between patients and healthcare providers and needs and wants of patients. Results Analysis of participant accounts illustrate that current exercise promotion by healthcare providers does not meet patient needs and wants. The identified needs and wants of persons with MS involved (i) information and knowledge on the benefits of exercise and exercise prescription, (ii) materials to allow home and community exercise and (iii) tools for initiating and maintaining exercise behaviour. Discussion and conclusion Patients with MS frequently interact with healthcare providers and are generally unsatisfied with exercise promotion during interactions. Healthcare providers can address the low uptake of exercise among persons with MS by acting upon the identified unmet needs involving materials, knowledge and behaviour change strategies for exercise. [ABSTRACT FROM AUTHOR]

Recognizing the undisputed health benefits of exercise, physicians' counseling has been included in the Healthy People Objectives since 2000. To address the paucity of data on such counseling at the national level, we examined changing trends and disparities in receiving physicians' counseling on exercise among the physically-able, non-institutionalized U.S. adult population. Data from the 2000, 2005, and 2010 National Health Interview Surveys (NHIS) were examined using logistic regression that included race/ethnicity, age, gender, education, insurance status, number of physician visits in the past year, and body mass index. In 2000, only 22.9% of NIHS respondents had received counseling on exercise, increasing to 33.6% in 2010. Compared with non-Hispanic Whites, non-Hispanic Blacks were 27% less likely to receive exercise advice in 2000 (adjusted odds ratio [AOR] 0.73, 95% confidence interval [CI] 0.61–0.87). In later years, they were equally likely to receive advice. Although decreased over the years, male respondents were significantly (34% to 23%) less likely to report receipt of exercise counseling than female patients (in 2010: AOR 0.77, CI 0.72–0.83). Uninsured respondents were 35% less likely to report receiving exercise advice from their provider in all study years (2010: AOR 0.64, CI 0.59–0.72). Patients with increasing levels of education were increasingly more likely to report receipt of counseling in each successive survey year. The overall prevalence of physicians' counseling on exercise increased moderately between 2000 and 2010. Some disparities narrowed and even reversed but significant disparities continue to exist across gender, insurance status, and education level. [ABSTRACT FROM AUTHOR]

Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals. [ABSTRACT FROM AUTHOR]