Multidimensional Exercise Research Articles

Laughing at northernness: postcolonialism and metafictive irony in the imaginative geography

This paper examines the role played by literature in constructing regional otherness focusing on a case study of Northern Finland. In the case of the Finnish North the direct connections between literary tradition, cultural imaginativeness and spatial otherness have been distinctive. Literary stereotypes concerning northern exoticism and the romantics have formed an imaginary contrast with the southern culture, a homogeneous region without any contradictions, imagined by the southern culture in a manner that meets its own hegemonic needs. The defining of the North exclusively in terms of a binary opposition between nature and culture has implied a multidimensional exercise of power in which culture and civilization have justified their own existence by excluding their opposites. In this article northern literature is perceived as a ‘tool’ not only for constructing otherness but also for deconstructing and decolonizing it. Northern imagination is viewed from a metafictional perspective, and the focus is on how the postmodern northern irony is self-consciously concerned about its own social discursiveness, i.e. northern marginality. In the present case the metafictive approach also stands for a methodological possibility for geographers to view literary discourses of otherness more from above. Attention is focused on the eccentrically obtrusive northern artist Rosa Liksom, the pseudonym of a novelist/visual artist who has transformed her northern irony into an emancipatory project.

Two-Year Improvement in Multidimensional Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index After Nonresectional Lung Volume Reduction Surgery in Awake Patients

This study analyzed the comprehensive 2-year outcome of nonresectional lung volume reduction surgery (LVRS) in awake patients, including calculation of the multidimensional BODE index (body mass index, degree of airflow obstruction assessed by spirometry, modified Medical Research Council dyspnea grade, and 6-minute walking distance), which has proved a useful predictor of survival in patients with chronic obstructive pulmonary disease. The study cohort included 42 patients undergoing LVRS while awake within a staged bilateral program entailing unilateral LVRS, followed by contralateral treatment performed at the reappearance of disabling symptoms. Outcome measures included hospital stay, procedure-related costs, calculation of the multidimensional BODE index, actuarial survival, and freedom from contralateral LVRS. Results were compared with those of a control group undergoing resectional LVRS under general anesthesia. The groups were well matched in demographics and baseline measures. There was no operative mortality. Median hospital stay was significantly shorter in the awake group (6 days versus 9 days, p < 0.0001); median procedure-related costs were significantly lower in the awake group (euro5220 versus euro8580; p < 0.0001). At intergroup comparisons of awake versus control group of clinical results, the BODE index improved postoperatively in both groups (-2.24 +/- 1.0 versus -1.95 +/- 1.0, intergroup p = 0.35) and remained improved for up to 2 years (-1.95 +/- 1.3 versus -1.37 +/- 1.4, intergroup p = 0.1); 2-year survival and freedom from contralateral LVRS rates were 87% versus 91% (p = 0.52) and 74% versus 73% (p = 0.71), respectively. A significant improvement in the BODE index, satisfactory survival, and high rate of freedom from contralateral LVRS occurred both in the awake and control group, although the awake procedure proved more cost-effective.

Validity of multidimensional body mass index (B), airflow obstruction (O), dyspnea (D) and exercise capacity (E), bode index as predictor of hospitalization for COPD

Validity of multidimensional body mass index (B), airflow obstruction (O), dyspnea (D) and exercise capacity (E), bode index as predictor of hospitalization for COPD

Regaining a sense of agency and shared self‐reliance: The experience of advanced disease cancer patients participating in a multidimensional exercise intervention while undergoing chemotherapy – analysis of patient diaries

Evidence is emerging that exercise can reduce psychological distress in cancer patients undergoing treatment. The present study aimed to (qualitatively) explore the experiences of advanced disease cancer patients participating in a 6-week, 9-hours weekly, structured, group-based multidimensional exercise intervention while undergoing chemotherapy. Unstructured diaries from a purposive sample of three females and two males (28-52 years old) who participated in the program served as the database. Data were analyzed using a phenomenological, narrative method. The analysis yielded three themes: shifting position, self-surveillance, and negotiated strength. The intervention highlighted situations making it possible for the participants to negate psychological and physical constraints. The concept of structured exercise contains viable psychotherapeutic potentials by allowing the development of alternative bodily and mental realities complying with cancer patients' demands and abilities to regain autonomy and commitment to discover and adopt a sense of agency and shared self-reliance.

Changes in Flexed Posture, Musculoskeletal Impairments, and Physical Performance After Group Exercise in Community-Dwelling Older Women

Katzman WB, Sellmeyer DE, Stewart AL, Wanek L, Hamel KA. Changes in flexed posture, musculoskeletal impairments, and physical performance after group exercise in community-dwelling older women. Objective To determine whether improvements in flexed posture, strength, range of motion (ROM), and physical performance would be observed after 12 weeks of group exercise in older women who because of age are prone to flexed posture and impaired physical function. Design Pretest-posttest of outcome measures. Setting Outpatient academic medical center. Participants Twenty-one women with thoracic kyphosis of 50° or greater. Intervention Multidimensional group exercise performed 2 times a week for 12 weeks. Main Outcome Measures Primary dependent measures of flexed posture included kyphosis, forward head, and height. Other dependent measures included spinal extensor muscle strength; shoulder, hip, and knee ROM; balance; modified Physical Performance Test (PPT); jug test; and gait speed. Results Baseline kyphosis was 57°±5.0°, and age was 72.0±4.2 years. There were significant improvements in usual (−6°±3°) and best kyphosis (−5°±3°) ( P<.001), spinal extensor muscle strength (21%±13% of peak torque/body weight, P<.001), popliteal angle (right, 7°±7°; left, 9°±10°; P<.001), modified PPT (2±2 points, P<.001), and jug test (−1.4±1.3s, P<.001). Age and modified PPT at baseline correlated with change in kyphosis ( r=0.5, P=.02; r=.42, P=.055, respectively). Conclusions Multidimensional group exercise reduced measured kyphosis and improved strength, ROM, and physical performance. This study provides a promising exercise intervention that may improve posture and physical performance in older women with flexed posture.

Home Balance Training Intervention for People With Multiple Sclerosis

This study investigated the effects of a home balance training intervention on people with multiple sclerosis (MS). This quasi-experimental repeated-measures study involved 14 ambulatory community-dwelling individuals with MS. Subjects were assessed on three separate occasions: before and after a 6-week control period and after a 6-week home exercise program. After the intervention, subjects demonstrated significant improvement in measures of balance, including the Berg Balance Scale and specific components of the Sensory Organization and Limits of Stability Tests. In conclusion, a multidimensional home exercise program can improve certain measures of balance in individuals with MS who have mild to moderate disability. Whether these improvements lead to improved quality of life or a reduction in fall risk is yet to be determined.

The effect of a multidimensional exercise programme on symptoms and side-effects in cancer patients undergoing chemotherapy—The use of semi-structured diaries

The aim of this study was to evaluate the effects of a 6-week intervention with structured physical activity, relaxation, body-awareness techniques and massage on the symptoms/side-effects of cancer patients undergoing chemotherapy. The study was prospective and exploratory, and 54 patients completed assessments for all 6 weeks of the intervention. In order to obtain a continuous record of side-effects, a diary was developed for the patients' use throughout the intervention. The patients scored their symptoms/side-effects on a scale from 0 to 4, using the Common Toxicity Criteria and reported these scores in questionnaires. Twelve possible symptoms/side-effects were registered daily: lack of appetite, nausea, vomiting, diarrhea, paraesthesia, constipation, physical fatigue, mental fatigue, treatment-related fatigue, muscle pain, arthralgia and other pain. During the intervention a decrease in the scoring for 10 out of the 12 side-effects was found. Statistical significance was observed in the pain score (P=0.046) and the arbitrary-derived sum of the scores for symptoms and side-effects (P=0.036) respectively. Patients with evidence of disease (n=26) had significantly higher levels of symptoms/side-effects than patients with no evidence of disease (n=28) (P=0.027). The results indicate that a six weeks multidimensional exercise intervention undertaken by cancer patients with or without residual disease while undergoing chemotherapy can lead to a reduction in treatment-related symptoms.

Maximum physical capacity testing in cancer patients undergoing chemotherapy: qualitative findings from an exercise program

Over the past few years there has been a growing interest in the field of physical exercise in rehabilitation of cancer patients, leading to requirements for objective maximum physical capacity measurement (maximum oxygen uptake (VO(2max)) and one-repetition maximum (1RM)) to determine dose-response levels in different cancer diagnoses. To explore the patients' experiences of maximum physical capacity testing while concurrently undergoing chemotherapy and participating in a 6-week, 9 h weekly multidimensional exercise program. Prospective, exploratory study using semi-structured qualitative interviews conducted prior to and at termination of the program. The study included 100 patients (18-65 years, median 42 years) with or without residual disease and with mixed diagnoses. Following the intervention, cancer patients felt significantly safer in performing maximum physical capacity tests as these motivated them through self-perceived competitiveness and set a standard that served to encourage peak performance. The positive attitudes in this sample towards maximum physical capacity open the possibility of introducing physical testing early in the treatment process. However, the patients were self-referred and thus highly motivated and as such are not necessarily representative of the whole population of cancer patients treated with chemotherapy.

Multidimensional exercise for people with Parkinson's disease: A case report

The primary impairments associated with Parkinson's disease occur in combination with the secondary, preventable effects of immobility. A community-based fitness program may help increase activity and maintain function in people in the early or middle stages of the disease. This article describes a unique program designed to reduce fall risk and promote independent exercise for people with Parkinson's disease. Two 66-year-old males, both community ambulators and in early or middle stages of Parkinson's disease, participated in 3 months of various physical activities. Group balance classes were held twice weekly during the first month, participants joined a fitness center and self-directed their exercise program during the second month, and group Tai Chi classes were held twice weekly during the third month. At conclusion of the program, participants were given suggestions for continued physical fitness activities. After the 3-month program, improvements were noted for both individuals in functional reach, Timed Up and Go, and Berg Balance scores. Both participants continued to exercise regularly for at least 8 months following the program. Two individuals with Parkinson's disease demonstrated improvement in their balance test performance over a 3-month period. Perhaps most importantly, these participants independently continued exercising after completing this program.

The impact of a multidimensional exercise program on self-reported anxiety and depression in cancer patients undergoing chemotherapy: A phase II study

Little is known about the role of exercise in improving cancer patients' mood while undergoing chemotherapy. In this phase II study changes in self-reported anxiety and depression and fitness (VO2max) are reported in relation to a 6-week, 9 h weekly, multidimensional exercise program. A total of 91 patients receiving chemotherapy, between 18 and 65 years old, completed a Hospital Anxiety and Depression Scale Questionnaire (HADS; response rate 91%, adherence rate 78%). Anxiety (p < 0.001) and depression (p = 0.042) was significantly reduced. The mean +/- SD of the change was -1.14 +/- 2.91 for anxiety and -0.44 +/- 2.77 for depression. Improvements in fitness were correlated with improvements in depression, chi2(1) = 3.966, p = 0.046, but not with improvements in anxiety, chi2(1) = 0.540, p = 0.462. The research suggests that exercise intervention may have a beneficial impact on psychological distress for cancer patients receiving chemotherapy with low to moderate levels of baseline psychomorbidity. The study furthermore indicates that changes in distress may be associated with disease status and levels of physical activity undertaken during disease. The study is followed up by an ongoing randomized clinical controlled trial to evaluate potential causal effects of exercise intervention on psychological distress and fitness in cancer patients undergoing chemotherapy.

The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy

The aim of the present study was to investigate the impact of a multidimensional exercise intervention focusing on physical capacity; one-repetition maximum (1RM) and maximum oxygen uptake (VO2Max), activity level, general well-being and quality of life in cancer patients undergoing chemotherapy. The intervention comprised resistance and fitness training, massage, relaxation and body-awareness training. Eighty-two cancer patients, with or without evidence of residual disease, were included: 66 patients with 13 different types of solid tumours and 16 patients with 6 types of haematological malignancies. The patients trained in mixed groups for 9 h weekly for 6 weeks. Physical capacity, physical activity level and psychosocial well-being as measured by the Medical Outcomes Study 36-item Short-Form Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 were assessed pre- and post-intervention. Highly significant increases were achieved in muscular strength (p<0.001), physical fitness (p<0.001) and physical activity levels (p<0.001). The patients reported significant reduction in treatment-related symptoms, i.e., fatigue (p=0.006) and pain (p=0.03). Highly significant improvements were observed in physical functioning (p<0.001) and role functioning (p<0.001). Even patients with advanced disease were able to improve their results after 6 weeks. It is concluded that a multidimensional exercise intervention, including resistance training, may be beneficial for cancer patients undergoing chemotherapy. This study indicates significant clinical meaningful improvements. The exact role of the intervention has to be defined in a randomized controlled design. A clinically controlled trial including 250 patients is currently being carried out.

Health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy

8010 Background: Cancer patients frequently experience considerable loss of physical capacity and well-being when diagnosed and treated for the disease. This study aims at evaluating the health benefits of a multidimensional exercise program for cancer patients who are undergoing chemotherapy. Methods: The program includes high and low intensity activities (physical exercise, relaxation, massage and body-awareness training) carried out in groups of 7–9 patients 9 hours weekly for 6 weeks. Ninetythree patients with different cancer diagnosis were included, 82 completed the program of these 39 received adjuvant chemotherapy (2/3 breast cancer patients) while 43 were treated for advanced disease. Maximal oxygen uptake (VO2Max) and repetition maximum strength (RM) were compared prior to and after completion of the program. Psychosocial well being and side effects were evaluated using questionnaires (EORTC, QLQ-36, SF-36,HAD) interviews and patient diaries. Results: VO2 max improved 16%, RM 40% (p<.001). Fatique, insomnia, constipation, diarrhoe and pain improved significantly. All 9 indicators of general well-being (SF-36) improved significantly including physical role (p<.0001) and emotional role (p<.0007), the latter in particular among elderly patients. Conclusions: Cancer patients undergoing chemotherapy can significantly increase muscular strength, physical fitness and physical activity level, actively reduce treatment related side-effects and improve their quality of life by participating in a multidimensional exercise program. No significant financial relationships to disclose.

Effect of Exacerbations of COPD (AE)on the Multidimensional Body Mass Index (B), Airflow Obstruction (O), Dyspnea (D) and Exercise Capacity (E), BODE Index

Effect of Exacerbations of COPD (AE)on the Multidimensional Body Mass Index (B), Airflow Obstruction (O), Dyspnea (D) and Exercise Capacity (E), BODE Index

Transforming the nature of fatigue through exercise: qualitative findings from a multidimensional exercise programme in cancer patients undergoing chemotherapy.

The objective of this study was to explore the nature of fatigue in cancer patients with advanced stages of disease undergoing chemotherapy and concurrently participating in a 6-week multidimensional exercise programme (physical exercise, relaxation, massage and body-awareness training). Semi-structured qualitative interviews were conducted with 23 patients between 18 and 65 years of age prior to, during, and at termination of the programme. The findings endorsed that physical debilitation, fatigue, and uncertainty of physical capacity were the patients' motivation for participation. Throughout the programme the patients experienced exercise-induced fatigue, which they associated with a sense of increased physical strength, improvement in energy and physical well-being. This positive sense of fatigue can be seen as a contrast to the negative chemotherapy-induced fatigue, which is characterized by physical discomfort and uncontrollable exhaustion. The patients learned to manoeuvre through periods of intense fatigue by using exercise as a strategy to adjust their sense of physical debilitation. Visibility of fatigue's qualitative aspects is necessary if patients are to be encouraged to stay active and to set realistic goals. The transformation process of fatigue identified in this study supports the theory of exercise as a beneficial intervention strategy in the treatment of cancer-related fatigue.

Gender Related Study of High Risk of Falls in Elderly Population and Physiotherapy Management

Introduction: The number of elderly individuals within the population in increasing day by day because of various factors including increased standard of education and healthcare, new therapeutic agents and lifesaving drugs, etc. Projections beyond 2016 made by United Nations have indicated that 21 % of the Indian population will be over the age of 60 by 2050. Falls are a major cause of morbidity and mortality in persons over age 60. They are the leading cause of death from injury, a rate that increases with advancing age. Factors leading to falls include reduced balance, strength and endurance, reduced reflexes, etc. This study was intended to identify the gender differences in respect of falls, the risk factors, which contributes to falls and the effect of a multidimensional exercise program in improving balance, mobility and strength and reduce the likelihood for falls in men and women of geriatric homes. Methods: A total of 163 elderly Men and Women (M: F: 76:87) were assessed from four different Geriatric homes over a period of 16 months from August 2002 to November 2003. Participants were included based on the study criteria and by signing the informed consent form. Pretest scores were collected from all participants after which they were classified into high risk and low risk for fall. Both the high risk and low risk individuals were then randomly allocated to experimental and control groups within themselves, making a total of 4 groups. All the participants were given a prevention of fall program and a usual care whereas the participants in the intervention groups alone were given home-based exercise program for three months. Each individual was visited once in fifteen days. Posttest was assessed after 3 months of study and the data was statistically analyzed. Discussion: Out of 163 subjects studied 47(28.8%) subjects fell and they had 105 falls (mean=2.2). There was only one fall in 60-64 years, 17 falls in 65-74 years, 22 falls in 75-84 years and seven falls in above 85 years. Proportion of women who fell increased with age from about 26.6% in the 65-69 years age group to over 66.6% in those over age of 85 years. Most falls occur during periods of maximum activity in the morning or afternoon, and only about 20% occur between 9 p.m. and 7 a.m. Study identified that 72.5% falls occurred in morning, 17.5% falls in afternoon, 5% in evening and 5% in night. This is because most falls occurs during the activities of daily living and people are more active in the morning and afternoon compared to evening and night. Women were at risk for falls, poor vision, use of medication, chronic condition, use of a walking cane, vertigo, imbalance, fear of falling and falls in the previous months were the significant risk factors for falling. The study found that a program of strength and balance training exercises which could be done at home reduces significantly the number of falls experienced by men and women aged 60 years and older. We have also shown that the individually tailored program is useful in improving balance, gait, strength and ADL. We conclude that the home-based individually tailored program is effective in improving balance, gait and strength as well as reduces no. of falls in elderly.

1172 Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy

1172 Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy

Evaluating recent trends in peacebuilding research

Peacebuilding is a complex and multidimensional exercise that encompasses tasks ranging from the disarming of warring factions to the rebuilding of political, economic, judicial and civil society institutions. It utilizes a variety of actors, ideally, in the construction of a culture of peace to replace a structure of violence. Ever since Johan Galtung coined the term ‘peacebuilding’ back in the 1970s, there have been very few attempts to flesh out the essence of this concept. It is only recently, beginning with Boutros Boutros‐Ghali's use of the term in his An Agenda for Peace and continuing with the efforts by the UN and regional bodies to develop sustainable approaches to reconstructing war‐torn societies that greater attention has been given to this idea. This article critically analyzes broad trends that can be discerned from the literature, in rethinking peacebuilding and in bridging the chasm between the concept and practices undertaken in its name.

Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy.

Cancer patients frequently experience considerable loss of physical capacity and general wellbeing when diagnosed and treated for their disease. The aim of this study was to evaluate the feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients during advanced stages of disease who are undergoing adjuvant or high-dose chemotherapy. The supervised program included high- and low-intensity activities (physical exercise, relaxation, massage, and body-awareness training). A total of 23 patients between 18 and 65 years of age (median 40 years) participated in groups of seven to nine patients for 9 h weekly for 6 weeks. Physical capacity in terms of repetition maximum (RM) and maximal oxygen uptake (VO(2)max), physical activity level and psychosocial wellbeing (EORTC QLQ-C30, SF-36, HAD) were compared prior to and after completion of the program. The program was safe and well tolerated. The completion rate was 85.2%. Highly significant increases in physical capacity (1RM, VO(2)max) and an improved level of physical activity were achieved. Quality of life and general wellbeing assessments indicated improvements in several measures, but without reaching significance. It is concluded that an exercise program, which combines high- and low-intensity physical activities, may be used to prevent and/or minimize physical inactivity, fatigue, muscle wasting and energy loss in cancer patients undergoing chemotherapy.

The effect of a multidimensional exercise program on strength, range of motion, balance and gait in the well elderly

The effect of a multidimensional exercise program on strength, range of motion, balance and gait in the well elderly

Consensual representations of social structure in different age groups

The present study is an exploratory investigation into the development of consensual social representations of Australian society. Thirteen to 14‐year‐old and 16 to 17‐year‐old students from two different schools rated the degree of similarity between 12 social groups in a multidimensional scaling exercise. An adult university sample also completed a similar procedure. The younger samples tended to cluster similar groups together, whereas one 16 to 17‐year‐old sample and the adult sample generated a linear or dimensional structure of the groups. While all samples contained a fair degree of individual variation in their representations of the groups, this variation decreased with increased age, suggesting increased consensual representations of society with increased social development.