Decline In Exercise Research Articles

Factors Influencing Attitudes Toward Physical Activity and Exercise Education in Pregnant Women

Background: The aim of this study was to report on attitudes of pregnant women regarding exercise and exercise education and to identify factors influencing their interest in receiving exercise education. Methods: A cross-sectional survey was completed by 134 women being evaluated for a routine obstetrical visit. Self-reported information regarding demographics, physical activity participation, confidence in knowledge about pregnancy exercise guidelines, and interest in receiving information about exercise during pregnancy was obtained. Descriptive statistics were used to summarize the data. Multiple logistic regressions were performed to measure associations between patient characteristics and exercise decline, confidence, and interest. Results: Participants had a mean age of 33.6 ± 4.3 years, mean BMI of 27.9 ± 5.0, and a mean gestational age of 26 ± 10 weeks. Reported level of physical activity decreased during pregnancy for 73.9 % of women. A significant association was found between pre-pregnancy physical activity (OR 2.00 (1.21-3.52), p = 0.010) and exercise decline. Significant, independent relationships were identified between increased confidence in exercise education and younger patient age (OR 0.89(0.82-0.98), p = 0.015), previous pregnancies (OR 0.43 (0.21-0.86), p = 0.060), higher level of pre-pregnancy exercise (OR 1.73 (1.19-2.53), p = 0.004), and more education received from physicians (OR 1.94 (1.54-2.49), p < 0.001). Interest in education was associated with higher level of physical activity before pregnancy (OR 1.75(1.21-2.57), p = 0.004) and lower amount of education received from physicians (OR 0.78(0.63-0.97), p = 0.025). Conclusions: Women commonly report a decline in exercise during pregnancy, particularly among women with high levels of physical activity prior to pregnancy. Attitudes toward pregnancy exercise education were found to be correlated with patient characteristics including age, nulliparity, level of physical activity before pregnancy, and education received from physicians. These associations can be used to identify target populations for future interventions.

Effect of exercise on sleep and cardiopulmonary parameters in patients with pulmonary artery hypertension.

Pulmonary arterial hypertension (PAH) is considered to be a rare progressive disease resulting from restricted flow through the pulmonary arterial circulation resulting ultimately in right-sided heart failure. Most patients withPAH suffer from sleep disorders, reduced aerobic fitness, and mortality risk despite optimized medical treatment. This study investigated the effect of 12weeks of aerobic training on sleep quality, sleep efficiency, right ventricular systolic pressure (RVSP), and aerobic fitness in patients with PAH. Thirty patientswith PAH were randomized to two equal groups, training group (A) and control group (B). ThePittsburg sleep quality index (PSQI) questionnaire and a wrist-worn actigraph wereused for the assessment of sleep quality and sleepefficiency respectively. RVSP wasmeasured using echocardiography. Cardiopulmonary exercise testing (CPET) assessed maximal heartrate and VO2max. All were measured before and after the study period for both groups. Exercise training was conducted on a bicycle ergometer as an individually-tailored moderate-intensity aerobic trainingsession (60 to 70% of the maximal heart rate reached during the initial exercise test) for 30 to 45min/day, 3sessions/week for 12weeks (36 sessions). Sleep scores and RVSP showed significant reductions and VO2max-representing the aerobic fitness-showed a significant increase in the group (A) compared with group (B). These results suggest that aerobic training has a positive effect on three risk factors for mortality in patients withPAH, namely sleep quality, decline inexercise capacity, and right ventricular remodeling. Clinical trial registered in ClinicalTrials.gov , ID: NCT04337671.

Temporal trends in results of 9170 myocardial perfusion imaging studies (2004 to 2013).

To assess the frequency of normal and abnormal myocardial perfusion imaging (MPI) in a consecutive cohort of patients from Pakistan over a period of 8.5 years. We assessed 9170 patients who had undergone stress-rest MPI between January 2004 and June 2013. Patients were assessed for change in demographics, risk factors, and frequency of abnormal and normal MPI. Overall mean age and male predominance of studied cohort was ≈ 55 years and ≈ 55:45 (M:F), respectively, with no appreciable decline or rise. Marked decline in exercise as mode of stress (from 71% to 35%, p value significant) was noted during the study period. Regarding the risk factors for CAD, only hypertension was noted to have a significant rising trend during the study period. Trend of MPI results over study period was found non-significant from 2004 till 2006 but from 2007 onward (except 2008), a marginal but significant decline in abnormal MPIs (from 45% to 42%; significant p value) and rise in normal MPI (from 55% to 58%; significant p value) was noted. We conclude that over the past 8.5 years, a marginal but significant decline in abnormal and a rise in normal MPIs trend have been observed. An exorbitant rise in use of vasodilator as a method of stress was also observed. We envisaged a follow-up study to ascertain lower negative predictive value of vasodilator as a possible reason and till than results of this and other such studies must be read cautiously.

Lifestyle diseases: A review

As the developed world contends with high burden of non-communicable diseases (NCDs), developing countries and countries undergoing socioeconomic transition are experiencing a constellation of both communicable and non-communicable diseases.'Lifestyle diseases' or 'diseases of civilization' arising from decline in exercise and activity of daily living caused by availability of technology, safety fears and changes to our living environment and preference for westernized foods are a major contributor to the global upsurge in non-communicable diseases.It is estimated that of the projected 64 million deaths worldwide in 2015, 41 million (64%) will result from chronic or non-communicable diseases.While the world must continue to fight infectious or communicable diseases, it will be disastrous to ignore the NCDs.The reason is that NCDs are implicated in the aetiology of cardiovascular diseases, hypertension, stroke, type-2 diabetes mellitus, osteoarthritis and certain neoplasms. These conditions not only lead to reduced quality of life given their protracted nature but also to premature death. In view of the above attention to lifestyle choices is imperative.

Days of Future Past: Documenting the Future

In the future Britain will not be a nice place to live. By 2014 the growth in the gap between the rich and the poor will have led to a society divided both economically and physically, the ‘underclass’ constantly at war with those with economic clout. The obesity epidemic due to changes in dietary habits and the decline in exercise will, by 2020, have led to a National Health Service stretched to its limits through dealing with the consequences of the nation’s inability to do something as simple as eating properly. This will compound the other primary drain on the NHS budget in 2024: the ageing population requiring expensive long-term care, with the health system being a victim of its success in helping people to live longer. The economic consequences will be dire, with a shrinking working population contemplating violent direct action in their campaign against the exponential tax rises required to fund the elderly and the overweight. At the same time, the country will still be recovering from a range of disasters and terrorist attacks which occurred at the beginning of the twenty-first century and seriously undermined the population’s faith in government, science, politics and all of those whose job it is to ensure our lives are safe. Both the smallpox attack of 2002 and the release of chlorine gas in the London Underground in May 2004 not only claimed many lives, they also demonstrated how easy it was for such things to happen. And the aircraft which crashed into West London in 2003 – a consequence of air traffic control regulations and general inadequacies in Britain’s transport policy – showed how deaths on such a massive scale are not always a result of terrorists. In all, the first quarter of the twenty-first

Home-based cardiac rehabilitation is as effective as centre-based cardiac rehabilitation among elderly with coronary heart disease: results from a randomised clinical trial

participation in centre-based cardiac rehabilitation (CR) is known to reduce morbidity and mortality but participation rates among the elderly are low. Establishing alternative programmes is important, and home-based CR is the predominant alternative. However, no studies have investigated the effect of home-based CR among a group of elderly patients with coronary heart disease with a long-term follow-up. randomised clinical trial comparing home-based CR with comprehensive centre-based CR among patients ≥ 65 years with coronary heart disease. seventy-five patients participated. There were no significant differences in exercise capacity after the intervention between home and centre-based CR. Adjusted mean differences of peak VO₂ = 0.9 ml/kg/min (95% CI -0.7, 2.4) and of 6 min walk test = -18.7 m (95% CI -56.4, 18.9). In addition, no differences were found in the secondary outcomes of systolic blood pressure (-0.6 mmHg, 95% CI -11.3, 10.0), LDL cholesterol (0.3 mmol/l, 95% CI -0.04, 0.7), HDL cholesterol (0.2 mmol/l, 95% CI -0.01, 0.3), body composition, proportion of smokers and health-related quality of life. A group of patients who did not have an effect of either programmes were characterised by higher age, living alone and having COPD. At 12 months of follow-up, both groups had a significant decline in exercise capacity. home-based CR is as effective as centre-based CR in improving exercise capacity, risk factor control and health-related quality of life. However, a group of patients did not improve regardless of the type of intervention. Continued follow-up is essential in order to maintain the gained improvements.

Weight Gain Prevention: Identifying Theory-Based Targets for Health Behavior Change in Young Adults

Young adults attending college are more vulnerable to weight gain than the general population. We sought to identify health behavior change targets related to weight management in college students. Based on the Social Cognitive Theory model for health behavior change, we investigated the health-related lifestyle behaviors and physiological characteristics of this population. Forty-three college students (18.3±0.1 years) completed a series of quantitative assessments (eg, body weight and composition, cardiorespiratory fitness, and diet and activity habits) and structured qualitative assessments (ie, structured interview or focus group). Participants were predominantly normal weight (mean body mass index 22.2±0.4) and fit (maximal oxygen consumption 50.5±1.5 mL/kg/minute). However, healthful eating and physical activity were not considered high priorities, despite having ample free time, high exercise self-efficacy, positive outcome expectations for exercise, and a desire to exercise more. Participants reported that regularly engaging in exercise was difficult. This may have been due to poor planning/time management, satisfaction with body image, lack of accountability, and feelings of laziness. Dietary patterns generally met recommendations but were low in fruits, vegetables, and whole grains. Social support for exercise and healthful dietary habits were important factors associated with health behaviors. Students reported a decline in exercise and dietary habits relative to high school, which may have contributed to college weight gain. Our results suggest that this population may not have adequate self-regulatory skills, such as planning and self-monitoring, to maintain healthful behaviors in the college environment. Food and nutrition professionals working with young adults attending college may use these findings to guide the behavioral therapy component of their weight management medical nutrition therapy goals and outcomes.

Perceptions of Exercise Stages, Barrier Self-Efficacy, and Decisional Balance for Middle-Level School Students

It is important to examine theoretically the determinants of exercise for middle school children because of the rapid decline in exercise during adolescence. The purpose for this study was to examine the validity of the Stages of Change (SOC) construct of the Transtheoretical Model with 387 middle school children. The students completed an SOC, barrier self-efficacy, and decisional balance questionnaire, as well as objective and self-report measures of exercise behavior/fitness level. Classification by SOC revealed that 236 children were in the maintenance stage, 108 in the action stage, 25 in the preparation stage, and 18 in the contemplation/precontemplation stage. Barrier self-efficacy, 1-mile run/walk, curl-up, and push-up scores improved at each level from the precontemplation through to the maintenance stage. There were no significant differences in decisional balance scores across the SOC. This study provided preliminary cognitive and behavioral support for the use of the SOC construct with middle school children.

Social Inequalities and Exercise during Adulthood: Toward an Ecological Perspective

Grounded in ecological theory, this study examines the association among participation in regular vigorous exercise and social status, aspects of prominent life settings, interactions between life settings, and more proximal individual resources and processes using data from the National Survey of Midlife Development in the United States (N = 3,032). Among women, a higher level of earnings was associated with more vigorous exercise, yet those women with more education had a steeper decline in exercise across adulthood. Among men, those with the lowest level of education had the steepest decline in physical activity across adulthood, and earnings did not affect exercise patterns. Less participation in vigorous exercise among blacks, in contrast to nonblacks, was explained by their tendency to live in less safe neighborhoods and having more functional health problems. Finally, contextual factors from multiple domains were independently associated with participation in regular exercise. Consistent with ecological theory, these results suggest that interventions to promote exercise habits among adults need to consider the independent and interactive effects of multiple contextual factors.

Worst-Rank Score Analysis with Informatively Missing Observations in Clinical Trials

Many randomized clinical trials schedule subjects to undergo some assessment at a fixed time (or times) after the initiation of treatment. Often, these follow-up measurements may be missing for some subjects because a disease-related event occurred prior to the time of the follow-up observation. For example, a study of congestive heart failure may schedule patients to undergo exercise testing at 12 weeks, but this measurement may be missing for those who died of heart disease during the study. In such cases, the measurements are informatively missing because mortality from heart disease and a decline in exercise both indicate progression of the underlying disease. It is inappropriate, therefore, to treat these missing observations as missing-at-random and ignore them in the analysis. In one approach to this problem, investigators have included such patients in the analysis of the follow-up data by assigning a rank that represents a “worst-rank score” relative to those actually observed. Some, however, have criticized this procedure as having the potential to produce biased results. In this paper, we explore the statistical properties of such an analysis. We show under a specific model that the imputation of a worst-rank score for informatively missing observations provides an unbiased test against a restricted alternative. We also describe generalizations that employ the actual times of the informative event. We present an example from a study of congestive heart failure. Last, we discuss the implications of this approach and of other methods. Control Clin Trials 1999;20:408–422

The Effects of Breathing 100 Percent Oxygen during Rest, Heavy Work, and Recovery

Abstract The effects of breathing 100% oxygen on resting, exercise, and recovery oxygen consumptions, pulmonary ventilation volumes, and heart rates were observed on six highly conditioned male athletes. The subjects rode a bicycle ergometer at a heavy work load for five minutes, breathing either normal air or medical oxygen. Ventilation volumes were determined by the open-circuit Douglas bag method, measuring inspired and expired volumes. Gas samples were analyzed for nitrogen and oxygen concentrations on Van Slyke and Beckman gas analyzers, and heart rates were recorded via a telemetry-electrocardiograph system. The results indicated a substantial increase in resting oxygen consumption, a decrease in resting ventilation volume, a marked decline in exercise and recovery ventilation volumes, and an insignificant lowering of the energy cost of exercise during the oxygen experiments. No appreciable differences were noted in heart rates between the oxygen and air experiments.