Exercise Activity Levels Research Articles

Relationship of Quality of Life with Perceptions of Physical Fitness and Exercise Activity Level in the Elderly

Aim: The quality of life of any individual is influenced by various determinants. No study evaluated the relationship of quality of life with perceptions of physical fitness and exercise activity level in the elderly Indian population, so the present study aimed to find out the relationship of quality of life with perceptions of physical fitness and exercise activity level in the elderly. Methods: The study had a cross-sectional research design. Eighty- five participants with a mean age of 67 years participated in the study. SF-36 was used to evaluate the quality of life and the Physical Fitness and Exercise Activity of Older Adult’s scale was used to evaluate physical activity perceptions. Karl Pearson correlation coefficient was used to assess correlations and a t-test was used to see any gender differences. Results: Significant but weak to moderate associations were found between the perceived physical fitness, and exercise frequency with the physical functioning component of quality of life in the elderly. The Perceived motivators only mildly affect the social functioning aspect of an individual’s life. The Perceived barriers show moderate correlations with multiple components of the quality of life of an individual. Conclusion: Elderly people’s perception regarding physical fitness and exercise activity level significantly affects their quality of life, especially their physical functioning and exercise frequency. Keywords: Elderly population, Perceived physical fitness and exercise activity level, Physical activity, Quality of life, SF-36

Wearable sensor-based on exercise monitoring system for disabled the individuals using a multi-attribute fuzzy evaluation mode

Recently, there has been a lot of interest in using the wearable sensors for tracking the exercise progress because of the unbiased accuracy and precision they are provided throughout the continual monitoring. For those with physical impairments, the system’s non-intrusive, lightweight ways of the monitoring activity may ease their load and enhance the quality of their decision-making. As a different measuring unit measures the exercise activity levels recorded by the each wearable sensor, it is challenging to assess the monitoring system. Hence, this paper proposes a Hybridized Fuzzy Multi-Attribute for Exercise Monitoring System (HFMA-EMS) to address the uncertainty issues of the wearable sensors. The Triangular Fuzzy membership function is proposed to begin classifying the observed values. Pair-wise attribute comparison and evaluator weighting in a T-spherical uncertain linguistic set setting utilizing the Techniques for Ordering of Preferences by Similarities to Ideal Solutions (TOPSIS). In the suggested method, a utility function is used to assess the merits of a model in which attribute the weights are calculated, followed by an exercise in which the attributes are ordered employing the Measurements of the Alternative and Ranking Compromise Solutions model (MARCOS). The performance is performed to analyze the proposed method’s accuracy, precision, recall, f1-score, and correct and incorrect exercise assessment by an accelerometer, gyroscope, and magnetic field sensor unit. The application scenario of the HFMA-EMS can be used in the clinical applications, healthcare management, and sports injury detection.

Feasibility of a remotely-delivered yoga intervention on cognitive function in breast cancer survivors: a mixed-methods study

BackgroundCancer-related cognitive impairment (CRCI) is a common, persistent quality of life complaint among breast cancer survivors (BCS), however there remain no proven treatments. There is emerging evidence that aerobic exercise and yoga may improve CRCI. There remains limited research on the safety and feasibility of virtually-supervised, remotely-delivered yoga interventions among cancer survivors, and no yoga studies to date have assessed cognitive function as a primary outcome in BCS. The purpose of this study was to explore the feasibility of an 8-week, remotely-delivered yoga intervention and examine its impact on cognitive function, fatigue, and exercise levels in BCS using a concurrent mixed-methods design.MethodsParticipants completed objective and self-report cognitive function measures (NIH Toolbox remote cognitive battery, PsyToolkit Task Switch test, Functional Assessment of Cancer Therapy-Cognitive Function [FACT-Cog3]); fatigue (Revised-Piper Fatigue Scale); and exercise activity level (modified Godin Leisure Time Exercise Questionnaire) before and after the yoga intervention. Semi-structured qualitative interviews were conducted post-intervention to understand participants' experiences with the yoga intervention, CRCI, and fatigue.ResultsThe intervention surpassed a priori feasibility indicators (adherence rate = 83.7%, attrition rate = 5.4%, no adverse events). Participants (n = 18, Mage= 52.2 ± 10.1) had significant improvements in objective memory, fatigue, and weekly minutes of moderate-to-vigorous exercise post-intervention. Qualitative themes indicated that participants found the remote intervention to be enjoyable and beneficial.ConclusionsIn this small proof-of-concept study, remotely-delivered yoga appears safe and effective at improving CRCI. Future randomized controlled trials examining the impact of remotely-delivered yoga interventions on cognitive function in BCS are warranted.

Cardiac Optimal Point: Identifying high risk patients for an optimal approach

Abstract Funding Acknowledgements Type of funding sources: None. Introduction In recent years it has been proposed the concept of cardiorespiratory optimal point (COP) to best characterize populations who underwent cardiac rehabilitation programmes (CRP). The COP is defined as the minimum ratio between ventilation and oxygen consumption (VE/VO2) obtained during the cardiopulmonary exercise test (CPET) and it has been suggested that COP values > 30 conveyed worse prognosis. Purpose To validate OP as a predictor of events and its correlation with exercise activity and quality of life on the long term. Methods Single center observational study of patients enrolled on CRP - from February 2018 to May 2019 – who did CPET as part of routine evaluation. COP was defined as the lowest point of VE/VO2 ratio. Clinical and laboratorial characteristics were obtained at admission and discharge of CRP. Exercise practice was accessed using IPAQ questionnaire and quality of life was assessed based on a validated inquire - Kansas City Cardiomyopathy Questionnaire (KCCQ-23) – both by phone interview. Results A total of 78 patients (mean age 63.2 ±11.6, 84.6% male) were evaluated and followed for a mean follow-up of 2,68±0,53 years. Main aetiology was ischemic heart disease (86%), followed by dilated cardiomyopathy (5,1%) and valvular heart disease (2,6%). A COP value above 30 correlated with a worse global score in KCC-23 (r =0.283, p = 0.47), and in particular domains such as frequency and severity of symptoms (p = 0.046, r 0.335 and p=0.16, r= 0.4, respectively), quality of life (p=0.039, r= 0.293) and social limitation (p = 0.001, r=0.5). COP also correlated with VO2 peak in basal CPET (p<0.001, r= 0.450) and on follow-up CPET (p= 0.39, r= 0.303). COP failed to predict events or levels of exercise activity on the long term, as evaluated by the IPAQ score. However, COP>30 did seem to correlate with a higher mortality rate on the follow-up although such trend was not statistically significant (possibly due to short follow-up time and sample size). Conclusion COP values > 30 identify patients with worse prognosis, predicting worse quality of life and higher mortality. Although it did not seem to be a good predictor of exercise adherence after CRP.

Associations between meeting exercise guidelines, physical fitness, and health in people with spinal cord injury

Purpose (1) To estimate the proportion of Dutch wheelchair users with spinal cord injury (SCI) who meet different SCI exercise guidelines; (2) to evaluate which demographic and lesion characteristics are associated with meeting these guidelines; (3) whether meeting these guidelines is associated with physical fitness and health. Materials and methods Based on the PASIPD questionnaire items, participants were allocated to meeting two SCI aerobic exercise guidelines, which differ in exercise load. Differences in personal, lesion, fitness, and health characteristics between groups were tested with a one-way ANOVA. Multiple regression analyses were performed to evaluate if meeting guidelines was associated with better fitness and health. Statistical significance was accepted at p < 0.05. Results Of the 358 included participants, 63.1% met at least one aerobic exercise guideline. Being female, older age, having tetraplegia, and lower educational level were associated with a lower likelihood to meet the aerobic exercise guidelines. Meeting aerobic exercise guidelines showed a positive association with all respiratory and exercise capacity parameters. Limited associations were found between meeting exercise guidelines and health. Conclusions Meeting exercise guidelines was associated with better respiratory functions and exercise capacity with additional fitness and some body composition benefits in higher exercise activity levels. IMPLICATIONS FOR REHABILITATION Meeting SCI exercise guidelines are associated with better respiratory functions and exercise capacity with additional fitness and body composition benefits when higher exercising at higher activity levels, emphasizing the value and importance of regular exercise in individuals with SCI.

Adaptive Virtual Reality Exergame: Promoting Physical Activity Among Workers

AbstractThis work presents a virtual reality (VR) Exergame application designed to prevent work-related musculoskeletal disorders (WMSDs). Moreover, to help adapt the tasks of the exergame, a machine learning model that predicts users’ exercise intensity level is presented. WMSDs are an important issue that can have a direct economic impact to an organization. Exercise and stretching is one method that can benefit workers and help prevent WMSDs. While several applications have been developed to prevent WMSDs, most of them suffer from a lack of immersivity or they just focus on education and not necessarily on helping workers warm-up or stretch. In light of this, an Exergame application that leverages VR and Depth-sensor technology to help provide users with an immersive first-person experience that engages them in physical activities is introduced in this work. The objective of the Exergame is to motivate users to perform full-body movements in order to pass through a series of obstacles. While in the game, users can visualize their motions by controlling the virtual avatar with their body movements. It is expected that this immersivity will motivate and encourage the users. Initial findings show the positive effects that the base exergame has on individuals’ motivation and physical activity. The results indicate that the application was able to engage individuals in low-intensity exercises that produced significant and consistent increases in their heart rate. Lastly, the results show that the machine learning model predicted users’ exercise activity level with an accuracy of 76.67%.

Direct and Stress-Buffering Effects of COVID-19-Related Changes in Exercise Activity on the Well-Being of German Sport Students.

Maintaining or initiating exercise activity in the COVID-19 pandemic may act as a buffer against the observed stress-related deterioration in well-being, with emotion regulation (ER) discussed as a possible moderator. Therefore, the present study investigated the interaction between stress, exercise activity (EA), and ER on mood. In an online survey, 366 German sports science students (56% women, Mage = 23.04, SD = 2.87) reported their stress levels (general and COVID-19-specific), mood (energy, valence, calmness), EA before and during the pandemic, and use of ER strategies in spring 2020. Pandemic-related change in EA was calculated as residual change. Due to gender differences in mental health and EA, the main and interaction effects were tested in twelve hierarchical regression analyses, separately for men and women. Overall, EA significantly decreased during the pandemic and was positively associated with energy in both men and women. ER was positively associated with women’s energy, but negatively with all three mood dimensions in men. Only one three-way interaction appeared significant: in the case of high stress, low levels of EA and high use of ER were associated with the greatest deteriorations in energy in men. Our findings suggest that EA may buffer deteriorations in energy in men with high stress and difficulties in ER.

Impaired cognitive function and its relationship with menopausal onset and exercise intensity of elderly women

Background: The success of development is the ideals of a nation that can be seen from the improvement in living standards and life expectancy. This also results in a shift in the composition of the population, which will increase the composition of the elderly population. Increased life expectancy must also be accompanied by a good quality of life. During this time the elderly are related with helplessness, dependence, with various health problems such as various cardiovascular diseases, osteoporosis, cognitive impairments such as dementia. This needs to be the concern of all parties. This study aims to determine: 1) the prevalence of elderly women who experience cognitive dysfunction in Buleleng Regency; 2) the relationship between cognitive impairment and the onset of menopause; and 3) and the relationship between cognitive impairment and the level of exercise activities of elderly women in Buleleng Regency.Methods: This research is a descriptive correlational quantitative observational study with a cross sectional study approach. The study sites were in 5 sub-districts in Buleleng Regency with a total sample of 73 people. To find out the relationship between cognitive impairment and the onset of menopause and the pattern of exercise activities in older women, data were analyzed by contingency coefficient correlation test.Results: The results showed that 18.4% of elderly women experience definite cognitive impairment, 23% probale cognitive impairment, and 58.6% normal cognitive function. The relationship between cognitive impairment and the onset of menopause was obtained p value 0.296 which indicates that the correlation between the onset of menopause and cognitive function was not statistically significant. The relationship between cognitive impairment in elderly and level of exercise activity obtained a p value of 0,000 which indicates that the correlation between exercise activity and cognitive function is statistically significant.

Genetic Networks Underlying Natural Variation in Basal and Induced Activity Levels in Drosophila melanogaster.

Exercise is recommended by health professionals across the globe as part of a healthy lifestyle to prevent and/or treat the consequences of obesity. While overall, the health benefits of exercise and an active lifestyle are well understood, very little is known about how genetics impacts an individual’s inclination for and response to exercise. To address this knowledge gap, we investigated the genetic architecture underlying natural variation in activity levels in the model system Drosophila melanogaster. Activity levels were assayed in the Drosophila Genetics Reference Panel fly strains at baseline and in response to a gentle exercise treatment using the Rotational Exercise Quantification System. We found significant, sex-dependent variation in both activity measures and identified over 100 genes that contribute to basal and induced exercise activity levels. This gene set was enriched for genes with functions in the central nervous system and in neuromuscular junctions and included several candidate genes with known activity phenotypes such as flightlessness or uncoordinated movement. Interestingly, there were also several chromatin proteins among the candidate genes, two of which were validated and shown to impact activity levels. Thus, the study described here reveals the complex genetic architecture controlling basal and exercise-induced activity levels in D. melanogaster and provides a resource for exercise biologists.

Rehabilitation Exercises for the Gluteus Minimus Muscle Segments: An Electromyography Study.

The gluteus minimus (GMin) muscle consists of 2 uniquely oriented segments that have potential for independent function and have different responses to pathology and aging. For healthy young adults, it is unknown that which rehabilitation exercises specifically target the individual segments. To quantify segmental GMin activity for 6 common lower-limb rehabilitation exercises in healthy young adults and determine if significant differences exist in segmental activity levels between the exercises. Six common lower-limb rehabilitation exercises were performed by 10 healthy young adults with fine-wire electromyography (EMG) electrodes inserted into the anterior and posterior segments of the GMin muscle. Electromyography signals were recorded, and median normalized exercise activity levels were reported and compared for each GMin segment across the 6 exercises. High activity levels were generated in the anterior segment by the resisted hip abduction-extension exercise (51% maximum voluntary isometric contraction [MVIC]), whereas for the posterior segment, high activity levels were produced by the single-leg bridge (49% MVIC), the side-lie hip abduction (43% MVIC), the resisted hip abduction-extension exercise (43% MVIC), and the single-leg squat (40% MVIC). There were significant differences (P < .05) in the median electromyography activity levels for the anterior GMin segment but not for the posterior GMin segment across some of the exercises with large effect sizes. Targeted rehabilitation exercises graded by exercise intensity can be prescribed specifically for the anterior and posterior GMin segments to aid in restoration of hip function following injury or aging.

Magnetic resonance imaging in exertional compartment syndrome of the forearm: Case-based pictorial review and approach to management.

Exercise-related limb pain poses a management dilemma to the clinician. The term ‘chronic exertional compartment syndrome’ (CECS) (previously known as ‘anterior tibial syndrome’) refers to a condition characterised by exercise-induced pain in one or more muscle groups and is more commonly seen in the lower limbs. Much less has been reported about the upper limbs where the muscular compartments are variably noted to be involved. A high index of clinical suspicion should therefore be maintained to avoid missing the diagnosis. Although commonly noted in athletes, CECS can occur in any age group with any level of exercise activity. In addition, there is no age predilection and the syndrome may be bilateral. The exact prevalence is not known as many athletes modify their training methods, thus delaying or avoiding medical assistance and imaging. The pathophysiology of compartment syndrome is complex. In this review of the syndrome, we describe the cycle of intracellular events leading to CECS and the eventual destruction of muscle. There is considerable overlap with the many possible causes of limb pain. Even the most experienced clinicians experience some difficulty in making this diagnosis of CECS, but with increasing awareness of this entity and availability of good-quality magnetic resonance imaging to confirm the suspicion, upper limb CECS is being more commonly diagnosed and patients more timeously managed.

Self-reported exercise behaviour and perception of its importance to recreational divers.

This study examined self-reported physical activity and perceptions of exercise importance among certified divers in two distinct age groups. Questionnaires were distributed by hand at dive sites in three states of the United States, half to students from an academic programme in scuba diving at a regional university. The survey included questions about health status, dive history, certification levels, structured exercise activity levels and perceived importance of regular exercise to their health, diving ability, and safety. Also included was the Godin-Shephard Leisure-Time Physical Activity Questionnaire, a validated physical activity classification instrument for use among adults. Non-students were older than the students and had greater diving experience. There was no detectable difference between groups in perceived exercise importance to health (p = 0.69), diving ability (p = 0.75), or diving safety (p = 0.25). Fitting age, sex, occupation and number of dives to a generalised linear model to predict Godin-Shephard scores, number of dives was removed first (p = 0.43), followed by student status (p = 0.33). Remaining predictors of Godin-Shephard exercise scores were age (-0.004 per year, p < 0.0001) and sex (males = + 0.11, 95% CI 0.04-0.17, p = 0.0012). Both groups reported similar structured exercise regularity, overall health and perceived importance of regular exercise for health, diving and safety. Despite acknowledging the importance of exercise, Godin-Shephard scores for physical activity decrease with age.

Evaluation of dietary behavior and nutritional status of elementary school students in Jeju using nutrition quotient

Purpose: The aim of this study was to evaluate the food behavior and nutritional status of elementary school students in the Jeju area using Nutrition Quotient (NQ). Methods: The subjects were 440 students (235 boys and 205 girls) in the fifth and sixth grade at four elementary schools located in Jeju. Demographic, lifestyle, and environmental information was collected using a self-reported questionnaire. The food behavior checklist for childrens Nutrition Quotient (NQ), consisting of 19 items, and nutrition education related information were also obtained. Results: The mean score of the childrens NQ was poor, reaching 60.3 points. The percentage distribution of NQ grade was 19.8% (lowest), 18.6% (low), 45.0% (medium), 10.7% (high), and 5.9% (highest) and the factor scores for balance, diversity, abstinence, regularity, and practice were 56.6, 68.4, 71.3, 57.4, and 54.8 points, respectively. Compared with the NQ cut-off points for defining malnutrition (balance; 57, diversity; 87, abstinence; 66, regularity; 69, and practice; 67 point), average score of abstinence factor was only above the cut-off point and scores of the other factors were below the cut-off point. Subjects with higher NQ scores tended to have higher levels of exercise activity (p < 0.001), frequency of family meals (p < 0.01), and fathers educational levels (p < 0.01) compared to those with lower NQ score. NQ score showed positive association with nutrition education experience and practice (p < 0.001). Conclusion: NQ score of elementary school students residing in Jeju was lower than the national average. More opportunities should be provided for participation in nutrition education, which incorporates a range of program strategies, as well as communication and education activities.

Motives for Exercise in Undergraduate Muslim Women and Men in Oman and Pakistan Compared to the United States

In this study we examined motives for exercise as well as the frequency and amount of time spent in exercising in female and male undergraduates in two Muslim countries [Oman, n = 104 and Pakistan, n = 134] as compared with those of U.S. undergraduates [n = 560]. As predicted, overall levels of exercise activity were found to be lower in undergraduates from Pakistan and Oman than in the U.S. sample, and higher in men than women across all three countries. Muslim women were least likely to exercise with the modal groups for both countries not exercising at all. Gender and country differences were more evident in reports of frequency and duration of exercise than in thinking about exercise. Thoughts about exercise predicted frequency and duration of exercise in all gender by country groups. Improving health was especially important as a reason for exercise for the Omani students, as predicted, although this motive was even higher in the Omani women than men. Pakistani women and men were motivated by wanting to relax (as predicted) and improve their appearance, an unexpected finding. For Spending Time with Others, Oman was highest, followed by Pakistan, and with the U.S. lowest, a result not predicted, although the more communal Muslim cultures may help explain this finding.

Multivariate epidemiologic analysis of type 2 diabetes mellitus risks in the Lebanese population.

BackgroundThe burden of diabetes in Lebanon requires well-targeted interventions for screening type 2 diabetes mellitus (T2DM) and prediabetes and prevention of risk factors. Newly recruited 998 Lebanese individuals, in addition to 7,292 already available, were studied to investigate the prevalence of diabetes, prediabetes and their associated risk factors.MethodsParticipants had fasting blood sugar and glycohemoglobin tests in addition to a lipid profile. Clinical and demographic information were obtained from a detailed questionnaire. The relationship between T2DM, its risk factors, and its complications were tested. Comparisons of these risk factors among diabetics, healthy, and coronary artery disease (CAD) patients were performed.ResultsThe prevalence of T2DM significantly increased with increasing BMI (p < 0.0001). Exercise activity level negatively correlated with the disease (p = 0.002), whereas the prevalence of T2DM (p < 0.0001) and CAD family history (p = 0.006) positively correlated with the affection status. The mean levels of triglycerides and LDL-C were significantly higher in diabetics (1.87; 1.35) compared to individuals with prediabetes (1.63; 1.26) and unaffected controls (1.49; 1.19). People with T2DM showed a significant decrease in HDL-C levels. A strong correlation of overall hyperlipidemia with the diabetes affection status was shown (p < 0.0001). Other comorbid factors such as hypertension (p < 0.0001) and self-reported obesity (p < 0.0001) were highly associated with T2DM and prediabetes. Reproductive health of women showed a strong correlation between giving birth to a baby with a high weight and the occurrence of T2DM and prediabetes later in life (p < 0.0001). Retinopathy and peripheral neuropathy were significantly correlated with diabetes and prediabetes (p < 0.0001).ConclusionsThe present study shows an alarming prevalence of diabetes and prediabetes in the studied subgroups representative of the Lebanese population.Electronic supplementary materialThe online version of this article (doi:10.1186/1758-5996-6-89) contains supplementary material, which is available to authorized users.

Exercise therapy in adults with serious mental illness: a systematic review and meta-analysis.

BackgroundIndividuals with serious mental illness are at a higher risk of physical ill health. Mortality rates are at least twice those of the general population with higher levels of cardiovascular disease, metabolic disease, diabetes, and respiratory illness. Although genetics may have a role in the physical health problems of these patients, lifestyle and environmental factors such as levels of smoking, obesity, poor diet, and low levels of physical activity also play a prominent part.MethodsWe conducted a systematic review and meta-analysis of randomised controlled trials comparing the effect of exercise interventions on individuals with serious mental illness.Searches were made in Ovid MEDLINE, Embase, CINAHL, PsycINFO, Biological s on Ovid, and The Cochrane Library (January 2009, repeated January 2013) through to February 2013.ResultsEight RCTs were identified in the systematic search. Six compared exercise versus usual care. One study assessed the effect of a cycling programme versus muscle strengthening and toning exercises. The final study compared the effect of adding specific exercise advice and motivational skills to a simple walking programme. The review found that exercise improved levels of exercise activity (n = 13, standard mean difference [SMD] 1.81, CI 0.44 to 3.18, p = 0.01). No beneficial effect was found on negative (n = 84, SMD = -0.54, CI -1.79 to 0.71, p = 0.40) or positive symptoms of schizophrenia (n = 84, SMD = -1.66, CI -3.78 to 0.45, p = 0.12). No change was found on body mass index compared with usual care (n = 151, SMD = -0.24, CI -0.56 to 0.08, p = 0.14), or body weight (n = 77, SMD = 0.13, CI -0.32 to 0.58, p = 0.57). No beneficial effect was found on anxiety and depressive symptoms (n = 94, SMD = -0.26, CI -0.91 to 0.39, p = 0.43), or quality of life in respect of physical and mental domains.ConclusionsThis systematic review showed that exercise therapies can lead to a modest increase in levels of exercise activity but overall there was no noticeable change for symptoms of mental health, body mass index, and body weight.

Prevalence and Severity of Menopausal Symptoms and Related Factors Among Women 40-60 Years in Kashan, Iran

Background: Menopause is a unique event in a woman’s life which has many symptoms. Frequency and severity of these symptoms vary, and they are based on the woman’s epidemiological characteristics. Objectives: The aim of this study was to determine the prevalence and severity of menopausal symptoms and related factors among women, 40-60 years in Kashan, Iran. Patients and Methods: In this cross-sectional study, 700 menopausal women in Kashan City were selected using cluster sampling. Data were collected by the Menopause Quality of Life Questionnaire (MENQOL). In addition, demographic variables including; current age, age of menarche and menopause, marital status, educational level, working status and exercise activity levels, were recorded. Data were analyzed using SPSS software version 16 and socio-demographic characteristics were compared using a chi-square test. A P value < 0.05 was considered significant. Results: The most common symptoms in; vasomotor, psychosocial, physical and sexual domains were; ‘night sweats’, ‘accomplishing less than I used to’, ‘feeling a lack of energy’, and ‘change in sexual desire’, respectively. Moreover, the most severe symptoms in these domains were; ‘night sweats’, ‘feeling anxious or nervous’, ‘aching muscles or joints’, and ‘avoiding intimacy’. There was a statistically significant difference between; the severity of menopausal symptoms and working status (P = 0.017), different educational levels (P = 0.001), exercise activity (P = 0.001), exercise frequency (P = 0.04), and duration of menopause (P = 0.03). Conclusions: The prevalence of menopausal symptoms in our population is similar to most other communities. Employment, higher educational levels, doing physical activity and duration of menopause of more than five years is associated with milder menopausal symptoms.

Physical inactivity in COPD and increased patient perception of dyspnea.

Objective:To study patients’ levels of exercise activity and the clinical characteristics that relate to physical activity and inactivity among patients with chronic obstructive pulmonary disease (COPD).Methods:A postal questionnaire was administered to 719 patients with COPD in 2010; patients were recruited from the Helsinki and Turku University Central Hospitals in Finland and have been followed since 2005. The questionnaire asked participants about their exercise routines and other daily activities, potential restrictions to exercise, health-related quality of life, and subjective sensations of dyspnea upon exertion.Results:A total of 50% of the participants reported exercising > 2 times a week throughout the year. The proportion of the exercise inactive patients increased in parallel with disease progression, but the participants exhibited great variation in the degree of activity as well as in sport choices. Year-round activity was better maintained among patients who exercised both indoors and outdoors. Training activity was significantly correlated with patients’ reported subjective dyspnea (r = 0.32, P < 0.001), health-related quality of life (r = 0.25, P < 0.001), mobility score (r = 0.37, P < 0.001), and bronchial obstruction (r = 0.18, P < 0.001). Active patients did not differ from inactive patients in terms of sex, age, smoking status, somatic comorbidities, or body mass index. Irrespective of the level of severity of patients’ COPD, the most significant barrier to exercising was the subjective sensation of dyspnea.Conclusion:When a patient with COPD suffers from dyspnea and does not have regular exercise routines, the patient will most likely benefit from an exercise program tailored to his or her physical capabilities.

Exercise in Children during Health and Sickness

Because of the rapidly increasing prevalence of obesity among children worldwide and the realization that this global epidemic is closely related to changing life style, especially relating to diet and exercise, research in the effects of exercise on children's health and the effects of children's health on their ability to exercise becomes timely and imperative. Promoting scientific researching in the field of exercise medicine in children has therefore been the primary motive behind this special issue of the International Journal of Pediatrics which is dedicated to publishing important works in the field. To the great satisfaction of our team of editors, a great number of good quality research results were submitted to the issue from all four corners of the world which indicates a strong interest in this very important field of medicine worldwide. The first section of this issue contains cross-sectional population studies that provide evidence confirming the strong correlation between obesity and lack of activity in children of different populations and different age groups (the first, second, and third papers). Furthermore, a 12-month interventional study from Sweden showed that longer exercise periods performed by school age boys resulted in more muscle mass and increased muscle strength (the fourth paper). The second section of the issue contains several articles studying the different genetic, environmental, parental, and other psychosocial factors that can potentially affect children's level of exercise activity. These articles collectively provide evidence for the variety and complexity of factors that affect children's predilection or exercise (the fifth, sixth, seventh, and eighth papers). They also identify potential areas for future intervention to promote exercise early in life (the ninth paper). One example of such opportunities involves the use of video gaming. Even though the overuse of video gaming has been largely blamed for the decreasing level of physical activity in children, the case might be completely reversed with the recent advent of interactive video gaming which tends to be preferred by children over conventional video gaming and is associated with higher level of physical activity (the tenth paper). The third section deals with research relating to exercise in children with known chronic illness such as diabetes, cystic fibrosis, neuromuscular diseases, arthritis, and congenital heart diseases with emphasis not only concerning the limitations these illnesses impose on children's ability to exercise and become physically fit but also on how increased fitness in these patients can modulate their disease process and therefore on ways exercise can be performed and promoted (the eleventh, twelfth, thirteenth, fourteenth, fifteenth, and sixteenth papers). The fourth section discusses hemodynamic responses to exercise in children as compared to adults (the seventeenth paper) and explores the hormonal and inflammatory profile of overweight and normal weight children and relates them to cardiovascular fitness (the eighteenth paper). The fifth and final section has one article which evaluates the validity of different accelerometeric measurements used in exercise research to objectively grade level of physical activity as compared to the gold standard of directly measuring energy expenditure (the nineteenth paper). We hope that this special issue will contribute substantially to the existing body of knowledge of this new and growing field of exercise medicine in children and to stimulate further needed research. Mutasim Abu-Hasan Neil Armstrong Lars B. Andersen Miles Weinberger Patricia A. Nixon

Electrocardiographic consequences of a peripatetic lifestyle in gray wolves ( Canis lupus)

Cardiac chamber enlargement and hypertrophy are normal physiologic responses to repetitive endurance exercise activity in human beings and domestic dogs. Whether similar changes occur in wild animals as a consequence of increased activity is unknown. We found that free-ranging gray wolves ( Canis lupus, n=11), the archetypical endurance athlete, have electrocardiographic evidence of cardiac chamber enlargement and hypertrophy relative to sedentary captive gray wolves ( n=20), as demonstrated by significant increases in QRS duration, QT interval, and QT interval corrected for heart rate, a tendency towards increased Q, R, and S wave voltages in all leads, and a significant decrease in heart rate. We conclude that exercise activity level and therefore lifestyle affects physiologic variables in wild animals. An immediate consequence of this finding is that physiologic measurements obtained from a captive wild-animal population with reduced exercise activity level may not accurately reflect the normal physiologic state for free-ranging members of the same species.