Increase In Exercise Frequency Research Articles

Patient-reported predictors of postdischarge mortality after cardiac hospitalization.

Adults hospitalized for cardiovascular events are at high risk for postdischarge mortality. Screening of psychosocial risk is prioritized by the Joint Commission. We tested whether key patient-reported psychosocial and behavioral measures could predict posthospitalization mortality in a cohort of adults hospitalized for a cardiovascular event. We conducted a prospective cohort study to test the prognostic utility of validated patient-reported measures, including health literacy, social support, health behaviors and disease management, and socioeconomic status. Cox survival analyses of mortality were conducted over a median of 3.5 years. Among 2977 adults hospitalized for either acute coronary syndrome or acute decompensated heart failure, the mean age was 53 years, and 60% were male. After adjusting for demographic, clinical, and other psychosocial factors, mortality risk was greatest among patients who reported being unemployed (hazard ratio [HR]:1.99, 95% confidence interval [CI]):1.30-3.06), retired (HR: 2.14, 95% CI: 1.60-2.87), or unable to work due to disability (HR: 2.36, 95% CI: 1.73-3.21), as compared to those who were employed. Patient-reported perceived health competence (PHCS-2) and exercise frequency were also associated with mortality risk after adjusting for all other variables (HR: 0.86, 95% CI: 0.73-1.00 per four-point increase in PHCS-2; HR: 0.86, 95% CI: 0.77-0.96 per 3-day increase in exercise frequency, respectively). Patient-reported measures of employment status, perceived health competence, and exercise frequency independently predict mortality after a cardiac hospitalization. Incorporating these brief, valid measures into hospital-based screening may help with prognostication and targeting patients for resources during post-discharge transitions of care.

Preliminary efficacy of an acceptance-based diabetes education (ACT-DE) programme for people with type 2 diabetes on diabetes distress and self-care behaviours: A pilot randomised controlled trial

BackgroundDiabetes distress is often characterised by aversive feelings about diabetes and avoidance of diabetes self-care, leading to suboptimal blood glucose control, diabetes complications and depression. Evidence from a recent review has indicated the potential efficacy of acceptance-based diabetic self-management programmes for improving blood glucose levels and mental health outcomes by fostering psychological flexibility. MethodsWe conducted a two-arm and assessor-blinded pilot randomised controlled trial (RCT) with 48 participants aged 18–64 with type 2 diabetes and moderate distress levels, in which we compared a 6-week acceptance and commitment therapy and diabetes education (ACT-DE) programme intervention with diabetes education. Diabetes distress (the primary outcome), self-care behaviour, self-efficacy in diabetes management, and psychological inflexibility were measured at baseline and post-intervention. Focus group interviews were conducted to explore the intervention group's perceptions of the benefits and limitations of the intervention. ResultsResults of ANCOVA test showed that the intervention group exhibited significantly greater decrease in diabetes distress (effect size [Cohen's d] = 0.65), and increase in exercise frequency (d = 1.16), and foot-care frequency (d = 0.59) than the diabetes education group. The qualitative feedback of the intervention group revealed that the learnt ACT skills can be effectively applied in self-care and highlighted the utility of some of the intervention's therapeutic components, primarily mindfulness practices, metaphors, and interactive diabetes education. The intervention was well-accepted, with an 87.5% completion rate, but caution is needed due to a low recruitment rate (28.1%) during COVID-19 pandemic peak. ConclusionThis pilot study confirmed that ACT-DE programme is an acceptable intervention for people with type 2 diabetes. It demonstrated preliminary efficacy with medium-to-large effect sizes in alleviating the participants’ diabetes distress and improving their self-care. Recruitment strategies can be improved to enhance the feasibility. Moreover, a full-scale RCT with longer-term follow-up is warranted to examine the intervention effects on diabetes distress, blood glucose control and other health outcomes.

Empirical study on the effectiveness of online groups using a mobile health application for middle-aged and older adults to continue exercising.

[Purpose] This study aimed to determine the effects of a mobile health application, and exercise instructions by a physical therapist on exercise frequency, duration, and intensity for middle-aged and older adults. [Participants and Methods] The study included males and females in their 50s to 70s, who provided consent to participate. Thirty-six people who wished to participate in the online group were divided into groups of five or six each, with a physical therapist as group leader. The frequency, intensity, duration of exercise, and group activities were surveyed using questionnaires: before coronavirus disease (COVID-19) (before March 2020, when the novel coronavirus began to spread in Japan), during COVID-19 (after April 2020), after digital versatile disc (DVD) distribution, and after online group initiation (3 weeks after DVD distribution for the control group). [Results] The online group received significantly more frequent instructions by a physiotherapist than the control group. The control group did not show significant changes over time, whereas the online group exercised significantly, more frequently after the intervention. [Conclusion] The online mode and physical therapist intervention resulted in a significant increase in exercise frequency. Exercise advice from professionals and peer presence to continue exercising together were beneficial.

A Survey-Based Assessment of "Matter of Balance" Participant Fall-Related Experience.

Falls are a substantial cause of injury in older adults, which can be attributed to progressive lack of physical activity, associated comorbidities, social isolation, and chronic health conditions. Fall prevention courses are designed to educate participants on fall safety and increase activity levels and social engagement. The purpose of this study was to evaluate the perceived effectiveness of a nationally recognized fall prevention course on self-reported fall frequency and lifestyle habits. This was a single-group pretest-posttest study of a convenience sample of older adults enrolled in a group fall prevention program, A Matter of Balance, in a community setting between March 2019 and March 2020. Questionnaires were distributed at the first and final sessions of the course to evaluate participant perceptions of the program and its impact on their fall history, exercise habits, and social engagement. Comparisons were made using Wilcoxon rank sum tests. A total of 40 class members agreed to participate, with 29 (73%) completing both the presurvey and the postsurvey. Responses indicated no change in the number of falls or participants following an established exercise routine. However, of those who fell prior to the course, 75% reported a reduction in falls. In addition, the participants reported an overall increase in weekly exercise frequency. In those who reported fear of falling, 71% reported a reduction in fear following the course. The participants in this study self-reported a decrease in fall rate, a decrease in fear of falling, and an increase in exercise frequency. The course is not fall protective but can be considered an adjunct to fall prevention measures that include medical, medication, visual, and environmental management.

Physical activity levels and mental health burden of healthcare workers during COVID-19 lockdown.

The outbreak of COVID‐19 has precipitated international lockdown measures to curb disease transmissions. The closure of public activity spaces as well as changes in pandemic workload may disrupt healthcare workers' physical activity and self‐care routines. We sought to examine the association between physical activity levels and mental health burden of healthcare workers during the COVID‐19 lockdown in Singapore. This cross‐sectional study comprised of an multidomain survey that was administered digitally to 707 healthcare workers between 17 May and 18 June 2020. Exercise frequency, duration and intensity of these healthcare workers had reduced significantly during the lockdown compared to pre‐lockdown. 25.3%, 37.2%, and 11.9% had screened positive for moderate‐to‐extremely‐severe depression, anxiety and stress respectively. Reductions in exercise duration was a significant risk factor for mild stress and moderate‐to‐severe depression while increase in exercise frequency was found to be a protective factor against depressed mood. Our study revealed that a short‐term reduction in physical activity levels during lockdown was associated with poorer psychological outcomes. Given the protection that exercise confers on depression, physical activity should be promoted at the workplace and at home to support healthcare workers to cope through this protracted health crisis.

Surgical Management of the Giant Pannus: Indications, Strategies, and Outcomes.

The obesity pandemic continues to produce an inexorable increase in the number of patients requiring surgical treatment of obesity and obesity-related complications. Along with this growing number of patients, there is a concomitant increase in the complexity of management. One particular example is the treatment of patients with an exceptionally large and morbid pannus. In this report, we detail the management of seven patients suffering from a giant pannus. Medical and surgical variables were assessed. A quality of life questionnaire was administered pre- and postoperatively. All seven patients suffered some obesity-related medical morbidity and six of seven (86%) had local complications of the giant pannus. Each patient underwent giant panniculectomy [resection weight >13. 6kg (30lb)]. The mean resection weight was 20.0kg. Four of seven (57%) patients experienced postoperative complications, with two (29%) requiring re-operation and blood transfusion. Six patients were available for long-term follow-up; 100% of participants indicated an increased quality of life while five (83%) reported additional postoperative weight loss, increase in exercise frequency and walking ability, and improved ability to work. Our results indicate that giant panniculectomy is a challenging and risky procedure, but careful patient selection and intraoperative scrutiny can ameliorate these risks and afford patients a dramatically improved quality of life. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Exercise and quality of life after first-ever ischaemic stroke: a two-year follow-up study

ABSTRACTBackground: Quality of life (QoL) post-stroke is an important health outcome. Physical deconditioning and physical inactivity are highly prevalent in stroke survivors. This study aimed to assess the long-term trends in QoL and to explore the effect of exercise on the QoL of ischaemic stroke patients. Methods: Data for this prospective study were collected at baseline using face-to-face interviews, and telephone follow-ups were completed every three months from 2010 through 2014. QoL was evaluated with the 12-item Short-Form Health Survey (SF-12). The relationship between changes in exercise and QoL changes was analysed with a multi-level model.Results: Exercise and QoL generally increased during the study period. After adjusting for covariates, the SF-12 Physical Component Summary (PCS) scores increased by 0.60 on average for each unit increase in exercise frequency and by 0.52 for each hour increase in weekly exercise time. For weekly exercise times ≤ 22.73 h, the PCS scores continued to increase with increasing exercise time. The Mental Component Summary scores increased by 0.51 on average for each unit increase in exercise frequency and by 0.35 for each hour increase in weekly exercise time. Furthermore, the standard deviations of exercise frequency and exercise time were inversely associated with changes in the PCS score.Conclusions: Exercise is an important modifiable behaviour. Long-term regular mild exercise should be recommended to improve QoL among stroke survivors.

Impact of cultural factors on the elderly utilization from healthcare services provided by Isfahan University of Medical Sciences' Hospitals - 2014

Aim: As we know, due to the undesirable structural and functional changes arise from aging, old people need more healthcare services than other groups in society. Many factors affect utilization of health services in this age group. Cultural factors can be named as the most important since they play a basic role in determining people's lifestyle and ultimately in the health protection behaviors. Therefore, this paper is aimed at investigation of cultural factors, affecting old people benefit of health services in Isfahan province in 2014. Methods: This study was descriptive analytic, conducted in later 2014. The research population consisted of people aged over 60 years who had been admitted in 12 hospitals affiliated to Isfahan University of Medical Sciences. Two hundred seventy-five people were selected and entered into the research using random sampling method. Data gathering tool was a researcher-made questionnaire in three scopes, and finally the data analyzed at two levels of descriptive level (including frequency, percentage, mean and standard deviation (SD) and inferential level (including statistical tests comparing independent group means, correlation coefficient test, and multivariable regression) in SPSS 22 software. Result: The results showed that the level of utilization for people who had routine exercises and jugging was 0.3 units of SD upper than others. Meanwhile, by increasing exercise frequency, level of religious beliefs and opinions and the having a proper and healthy diet, the utilization of healthcare services decreases by −0.198, −0.150 and −0.196, respectively. In fact, 5.5% of changes in health services utilization variable are explained by the research independent variables. Conclusion: The study showed that doctors' recommendations on physical activities, reasonable increase in exercise frequency, access to rich and healthy food, and religious beliefs can affect old people's utilization of health services; but they cannot explain all variances of it. Therefore, according to complexity of health related issues, other involved variables should be identified and investigated.

The analysis of a group-mediated cognitive-behavioral corporate physical activity intervention

To describe and evaluate the use of a group-mediated cognitive behavioral (GMCB) exercise intervention approach within a corporate environment. Twenty (n(males) = 17, n(females) = 3) employees from two departments within a large Canadian resource company took part in the study. The average age was 43.50 years (SD = 8.60, range = 29 to 60) for males and 49.70 years (SD) = 6.40, range = 45 to 57) for females. A mixed methods case study approach was adopted to assess the response to and effectiveness of the GMCB program within a corporate setting. These included field notes, weekly fitness logs, anthropometric measurements, and end of program focus group sessions. Qualitative measures pointed toward positive outcomes while quantitative results found significant decreases in body mass index, body fat percentage, and waist girth over the duration of the program. Descriptive statistics revealed an increase in exercise frequency and a strong preference for unstructured, group or mixed (i.e., group and individual) based activity during the program. The GMCB protocol can be successful at encouraging physical fitness within a corporate environment with the potential to address other health and wellness issues and to aid in vocational team building.

Exercise Frequency As a Determinant of Healthy Lifestyle Characteristics Among U.S. Adults

Individual participation in recommended amounts of regular exercise can improve health and prevent disease. However, little is known about whether exercise can improve a group of healthy lifestyle characteristics (HLC). PURPOSE: The purpose of this study was to determine the relationship between exercise frequency and the prevalence rate of a single healthy lifestyle indicator. METHODS: Researchers used data from the 1998 and 2000 BRFSS. Logistic regression analysis was conducted with covariates (age, gender, race, education, income, and general health) and exercise frequency selected as the predictor variable. The criterion variable (single healthy lifestyle indicator), was calculated by a defining pattern of four HLC (healthy weight, fruit and vegetable consumption, non-smoking, and leisure time physical activity) for each respondent. The covariates and predictor variable were entered as a block of predictor variables. RESULTS: Gender (OR = 2.56, 95% CI = 2.41-2.71, p <.0001), general health (OR = 1.57, 95% CI = 1.52-1.62, p <.0001), and exercise frequency (OR = 1.37, 95% CI = 1.36-1.38, p <.0001) had the largest effect on the single healthy lifestyle indicator. Education (OR = 1.35, 95% CI = 1.30-1.39, p <.0001), race (OR = 1.12, 95% CI = 1.04-1.21, p <.0001), income (OR = 1.06, 95% CI = 1.05-1.08, p <.0001), and age (OR = 1.01, 95% CI = 1.00-1.01) were also statistically significant, but had a smaller effect on the single healthy lifestyle indicator. For every one unit increase in exercise frequency, the odds of meeting the single healthy lifestyle indicator increased by a factor of 1.41 while holding all other variables constant. Based on pseudo-R-squared values, when exercise frequency was excluded from the model, the remaining variables only explained 6% of the variance in the single healthy lifestyle indicator. When exercise frequency was reintroduced, the model accounted for 17% of the variance in the single healthy lifestyle indicator. Exercise frequency was able to exclusively explain 11% of the variance in the single healthy lifestyle indicator. CONCLUSION: An increase in exercise frequency was positively related to an increase in the single healthy lifestyle indicator. Future research should examine causal relationships between exercise frequency and other healthy lifestyle indicators.

Feasibility of an exercise counseling intervention for depressed women smokers

Depressive symptoms negatively impact smoking abstinence. However, few interventions have been targeted to smokers with current depression. Exercise improves mood and may benefit depressed smokers. This pilot study investigated the feasibility of an exercise intervention for depressed female smokers (Center for Epidemiological Studies Depression Scale [CES-D] score > or =16). Participants (M = 41 years, 98% White) were randomized to 10 weeks of individually delivered exercise counseling (n = 30) or a health education contact control condition (n = 30). All participants received nicotine patch therapy and behavioral counseling for smoking cessation. The intervention was feasible as indicated by ability to recruit participants, exercise counseling session attendance (M = 7.6 of 10 sessions attended), and significant increase in exercise frequency and stage of change from baseline to end of treatment (EOT) (Week 10). Participant attrition rate was 35% by Week 10 but did not differ significantly between groups. Smoking abstinence rates at Week 10, using intention-to-treat analysis, were 17% for exercise counseling participants and 23% for health education participants (p = .75). An exercise counseling intervention was found to be feasible for depressed women smokers. More intensive intervention may be needed to increase smoking abstinence rates, and methods should be refined to reduce participant burden and attrition.

Fostering independence in health-promoting exercise

The Integrated Model of Physical Activity and Disability was used to design a strength and aerobic exercise program for adults with intellectual disability participating in Special Olympics. This study examined the extent to which four participants could acquire exercise skills in a face-to-face context and apply these skills at home with indirect support. Adherence to the program, as well as program satisfaction, was examined. Participants were able to acquire the strength skills and most were able to use these skills at home with minimal support. The participants liked the approach, in particular the individualized planning and follow-up via telephone calls. These participants were able to use an exercise DVD independently at home and three of the four participants showed a threefold increase in exercise frequency. The utility of the approach lies in the capacity to extend the reach of face-to-face programs beyond tangible constraints such as facilities and staff availability.

High-Density Lipoprotein-Cholesterol Trajectory Pattern, Associated Lifestyle and Biochemical Factors Among Taiwanese

Little is known about high-density lipoprotein-cholesterol (HDL-C) trajectory patterns among ethnic Chinese in Taiwan, or the effects of lifestyle and biochemical measurements on these trajectory patterns. This longitudinal study was based on 330 adult participants who underwent biochemical measurements annually from 2003 to 2006. As time progressed, HDL-C increased significantly; women had a consistently higher value (10 mg/dl) than men. An increase of 1 kg/m(2) in body mass index was associated with -1.00 +/-0.25 mg/dl HDL-C for women (P=0.0001) and -0.78 +/-0.11 mg/dl for men (P<0.0001). Current smoking was inversely associated with HDL-C in men only. Systolic blood pressure and exercise frequency were positively associated with HDL-C in men only. Compared with non-smokers, participants who smoked had a lower HDL-C level of -8.42 +/-4.90 mg/dl in women (P=0.09) and -3.60 +/-0.94 mg/dl in men (P=0.0001). In contrast, a 1-h increase in exercise frequency every week was related to an increased HDL-C level of 0.38 +/-0.28 mg/dl for women (P=0.18) and 0.53 +/-0.14 mg/dl for men (P=0.0001). An increase in HDL-C was shown over a 4-year period and gender-specific lifestyle factors were associated with HDL-C concentration among ethnic Chinese in Taiwan.

Kennedy Space Center Cardiovascular Disease Risk Reduction Program evaluation.

This program evaluation examined the Kennedy Space Center (KSC) Cardiovascular Disease (CVD) Risk Reduction Program which aims to identify CVD risk factors and reduce these risk factors through health education phone counseling. High risk participants (those having two or more elevated lipid values) are identified from monthly voluntary CVD screenings and counseled. Phone counseling consists of reviewing lab values with the participant, discussing dietary fat intake frequency using an intake questionnaire, and promoting the increase in exercise frequency. The participants are followed-up at two-months and five-months for relevant metrics including blood pressure, weight, body mass index (BMI), total cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, triglycerides, dietary fat intake, and exercise frequency. Data for three years of the KSC CVD Program included 366 participants, average age of 49 years, 75% male, and 25% female. For those with complete two and five month follow-up data, significant baseline to two-month follow-up comparisons included decreases in systolic blood pressure (p = 0.03); diastolic blood pressure (p = 0.002); total cholesterol, LDL cholesterol and dietary fat intake (all three at p < 0.0001) as well as a significant increase in exercise frequency (p = 0.04). Significant baseline to five-month follow-up comparisons included decreases in triglycerides (p = 0.05); and total cholesterol, LDL cholesterol and dietary intake (all three at p < 0.0001). These program evaluation results indicate that providing brief phone health education counseling and information at the worksite to high risk CVD participants may impact CVD risk factors.

The use of implementation intentions and the decision balance sheet in promoting exercise behaviour

Although increasing exercise and fitness has often been associated with positive health outcomes, infrequent exercise participation has remained a problem. Since two distinct motivational and volitional phases to goal pursuit have been proposed, a combined motivational (decision balance sheet, DBS) and volitional (implementation intentions) intervention was predicted to be more effective in increasing exercise behaviour than a control or either strategy alone. A total of 86 students were randomly assigned to one of the four conditions, and were all asked to try to exercise two more times a week than they currently did, over a four week period. Their fitness levels were measured through fitness tests conducted pre- and post-intervention. A priori orthogonal contrasts indicated that the experimental strategies produced a greater increase in exercise frequency and total time spent exercising per week and accordingly showed greater fitness improvements than the control group. Moreover, the volitional groups taken together produced greater increase in time spent exercising and a marginally greater improvement in frequency than the DBS alone. The combined intervention led to improvements in fitness and marginal increases in frequency over the implementation intention alone group. It is proposed that for the combined group the DBS may have aided recall of the implementation intention or increased commitment to it, as remembering and then acting on the plan, in the stated place and time, mediated the implementation intention–behaviour relationship. The combined intervention produced the greatest fitness improvements, indicating that this strategy can lead to important health benefits.

Short-Term Nutrition Intervention Increases Calcium Intake Among 45-54 Year Old Women

The purpose of this study was to investigate selected factors related to calcium and change in calcium intake after an intervention among a self-selected sample of 45-54 year old women. The theoretical bases for the research were the Health Belief Model and the health locus of control. The pre-intervention study consisted of 167 women. A total of 152 (91% return rate) completed and returned use-able post-test questionnaires. According to the multidimensional health locus of control results, this group had high scores for the internal locus of control. Similarly, the participants' attitudes related to the Health Belief Model were highly positive. Prior to the intervention, participants had a mean calcium intake of 1,423 mg/day that increased to 1,614 mg/day after the intervention. Participants reported significant increase in frequency of exercise and a decrease in the consumption of caffeine-containing beverages after the intervention. Based on these findings, it is reasonable to conclude that the educational intervention was likely to have been responsible for changing some of the participants' dietary and lifestyle behaviors.