Significant Improvements In Physical Activity Research Articles

Behavioural physical activity interventions in participants with lower-limb osteoarthritis: a systematic review with meta-analysis

ObjectiveTo assess effectiveness of osteoarthritis interventions to promote long-term physical activity behaviour change.DesignA systematic review and meta-analysis. Protocol registration PROSPERO CRD4201300444 5 (http://www.crd.york.ac.uk/prospero/).Study selectionRandomised controlled trials (RCTs) comparing physical activity...

"Go Girls!": psychological and behavioral outcomes associated with a group-based healthy lifestyle program for adolescent girls.

The objective of this study was to assess changes in adolescent girls' health-enhancing cognitions and behaviors targeted by the Go Girls! group-based mentorship lifestyle program. Three hundred and ten adolescent girls (nested within 40 Go Girls! groups) completed questionnaires that assessed cognitions (attitudes, self-regulatory efficacy, and intentions) and behaviors (physical activity and dietary) at four time points (two pre-program, one at the end of the program, and one at 7-week follow-up). Hierarchical linear modeling was used to examine changes in the outcome variables among Go Girls! participants (M age = 11.68 years, SD = 0.80). No significant changes occurred in the outcome variables during the baseline comparison period (Time 1-2). When compared to the average of the baseline assessments, 7 weeks after completing the program, girls reported significant improvements in physical activity (M Baseline PAtotal = 3.82, SD = 3.49; M T4 PAtotal = 4.38, SD = 3.75) and healthy eating (M Baseline = 10.71, SD = 1.13; M T4 = 11.35, SD = 1.05) behavior and related cognitions (d values ≥0.65). Findings provide preliminary support for programs that foster belongingness and target health behaviors through mentorship models.

Effectiveness of pre-school- and school-based interventions to impact weight-related behaviours in African American children and youth: a literature review.

This review assessed the effectiveness of pre-school- and school-based obesity prevention and/or treatment interventions targeting healthy eating, physical activity or obesity in African American children and adolescents. Systematic searches were conducted for English-printed research articles published between January 1980 and March 2013. Retained articles included experimental studies conducted in the United States that targeted ≥ 80% African American/black children and adolescents and/or studies whose results were stratified by race/ethnicity, and that were conducted in pre-schools/head start or schools (excluding after-school programmes). Of the 12,270 articles identified, 17 met the inclusion criteria (pre-school, n=2; elementary school, n=7; middle and secondary schools, n=8). Thirteen studies found significant improvements in nutrition (pre-school, n=1; elementary, n=7; secondary, n=5) and three found significant improvements in physical activity (pre-school, n=1; elementary, n=2) variables of interest. Two studies (pre-school, n=1; secondary, n=1) reported significant reductions in obesity in African American children. The evidence available suggests school-based interventions are effective in promoting healthy nutrition behaviours in African American children. Conclusions overall and, particularly, about effects on physical activity and obesity are limited due to the small number of studies, differences in assessment approaches and a lack of follow-up assessments.

The effect of a behaviour change intervention on the diets and physical activity levels of women attending Sure Start Children’s Centres: results from a complex public health intervention

ObjectivesThe UK government's response to the obesity epidemic calls for action in communities to improve people's health behaviour. This study evaluated the effects of a community intervention on dietary quality...

Impact of CPAP on activity patterns and diet in patients with obstructive sleep apnea (OSA).

Patients with severe OSA consume greater amounts of cholesterol, protein, and fat as well as have greater caloric expenditure. However, it is not known whether their activity levels or diet change after treatment with CPAP. To investigate this issue, serial assessments of activity and dietary intake were performed in the Apnea Positive Pressure Long-term Efficacy Study (APPLES); a 6-month randomized controlled study of CPAP vs. sham CPAP on neurocognitive outcomes. Subjects were recruited into APPLES at 5 sites through clinic encounters or public advertisement. After undergoing a diagnostic polysomnogram, subjects were randomized to CPAP or sham if their AHI was ≥ 10. Adherence was assessed using data cards from the devices. At the Tucson and Walla Walla sites, subjects were asked to complete validated activity and food frequency questionnaires at baseline and their 4-month visit. Activity and diet data were available at baseline and after 4 months treatment with CPAP or sham in up to 231 subjects (117 CPAP, 114 Sham). Mean age, AHI, BMI, and Epworth Sleepiness Score (ESS) for this cohort were 55 ± 13 [SD] years, 44 ± 27 /h, 33 ± 7.8 kg/m(2), and 10 ± 4, respectively. The participants lacking activity and diet data were younger, had lower AHI and arousal index, and had better sleep efficiency (p < 0.05). The BMI was higher among women in both CPAP and Sham groups. However, compared to women, men had higher AHI only in the CPAP group (50 vs. 34). Similarly, the arousal index was higher among men in CPAP group. Level of adherence defined as hours of device usage per night at 4 months was significantly higher among men in CPAP group (4.0 ± 2.9 vs. 2.6 ± 2.6). No changes in consumption of total calories, protein, carbohydrate or fat were noted after 4 months. Except for a modest increase in recreational activity in women (268 ± 85 vs. 170 ± 47 calories, p < 0.05), there also were no changes in activity patterns. Except for a modest increase in recreational activity in women, OSA patients treated with CPAP do not substantially change their diet or physical activity habits after treatment. .

Bi-Directional Relationship Between Self-Regulation and Improved Eating: Temporal Associations With Exercise, Reduced Fatigue, and Weight Loss

ABSTRACT. Severely obese men and women (body mass index ≥ 35 ≤ 55 kg/m2; Mage = 44.8 years, SD = 9.3) were randomly assigned to a 6-month physical activity support treatment paired with either nutrition education (n = 83) or cognitive-behavioral nutrition (n = 82) methods for weight loss. Both groups had significant improvements in physical activity, fatigue, self-regulation for eating, and fruit and vegetable intake. Compared to those in the nutrition education group, participants in the behavioral group demonstrated greater overall increases in fruit and vegetable intake and physical activity. These group differences were associated with changes that occurred after Month 3. Increased physical activity predicted reduced fatigue, β = −.19, p =.01. A reciprocal relationship between the mediators of that relationship, which were changes in self-regulation and fruit and vegetable intake, was identified. There was significantly greater weight loss over six months in the behavioral nutrition group when contrasted with the nutrition education group. Self-regulation for eating and fruit and vegetable intake were significant predictors of weight loss over both three and six months. Findings enabled a better understanding of psychosocial effects on temporal aspects of weight loss and may lead to more effective behavioral treatments for weight loss.

Lifestyle changes with help from Health Profile Assessment in combination with support in individual interventions for persons with acquired brain injury – A pilot study

Little is known about how to support a lifestyle change for persons with acquired brain injury (ABI), who have poor health compared with the rest of the population. This study investigates whether the Health Profile Assessment (HPA) combined with individual support in individually adjusted interventions could affect the lifestyle of persons with ABI. This longitudinal prospective and quasi-experimental study has a before and after design. HPA aims to improve health habits, perceived health and physiological measurements. In addition, this study includes interventions based on individual goals and actions decided on by the participants. The intervention process was supported through various communication methods such as Motivational Interviewing (MI) and Transactional Analyses (TA). The studied group (n = 25) included persons with cognitive impairments due to ABI who were considered for outpatient rehabilitation at a specialized facility at a university hospital in south-eastern Sweden. Results at follow-up showed significant improvements in physical activity, perceived health and diet. Significant improvements were also shown in sagittal abdominal diameter, waist circumference, body mass index (BMI) and physical fitness. Consequently, this study describes a method that successfully supported lifestyle changes in persons with ABI.

Evaluation of Active Living Every Day in Adults With Arthritis

Background:Adults with arthritis can benefit from participation in physical activity and may be assisted by organized programs. The purpose of this study was to evaluate the effectiveness of a 20-week behavioral lifestyle intervention, Active Living Every Day (ALED), for improvements in primary outcomes (physical activity levels, aerobic endurance, function, symptoms).Methods:A 20-week randomized controlled community trial was conducted in 354 adults. Outcomes were assessed at baseline and 20 weeks in the intervention and wait-list control groups. The intervention group was also assessed at 6 and 12 months. Mean outcomes were determined by multilevel regression models in the intervention and control groups at follow-up points.Results:At 20 weeks, the intervention group significantly increased participation in physical activity, and improved aerobic endurance, and select measures of function while pain, fatigue and stiffness remained status quo. In the intervention group, significant improvements in physical activity at 20 weeks were maintained at 6 and 12 months, and stiffness decreased.Conclusions:ALED appears to improve participation in physical activity, aerobic endurance, and function without exacerbating disease symptoms in adults with arthritis.

Results of a randomized controlled trial to promote physical activity behaviours in mothers with young children

ObjectiveIncreasing levels of physical activity in mothers have long-term health benefits for the mother and family. The study aimed to evaluate the effect of a six-month, physical activity RCT for mothers of young children. MethodsWomen were recruited via playgroups and randomly assigned to intervention (n=394) or control group (n=322). The intervention group received a six-month multi-strategy programme delivered via playgroups in Perth, Australia. measures were mean minutes per week of moderate (M) and vigorous (V) intensity physical activity (PA), and number of days/week of muscle strength exercises. ResultsThe intervention had a significant effect on mean time for vigorous (p=0.008), moderate (p=0.023) and total physical activity (p=0.001) when compared to the control group. The intervention group increased their vigorous activity by a mean of 24min/week, moderate activity by 23min/week and total physical activity by 72min/week. ConclusionsA relatively minimum home based intervention was able to demonstrate modest but statistically significant improvements in physical activity in a hard to reach group. These changes if maintained over a longer period are likely to improve the health of mothers and have a positive impact on their partners and children. Australian and New Zealand Clinical Trials Registry ACTRN12609000735257.

The effectiveness of a motivational interviewing primary-care based intervention on physical activity and predictors of change in a disadvantaged community

Little research exists on the impact of behavior change interventions in disadvantaged communities. We conducted a prospective study to explore the effectiveness of motivational interviewing on physical activity change within a deprived community and the social- psychological and motivational predictors of change in physical activity including stage of change, self-efficacy, social support, and variables from self-determination theory and the theory of planned behavior. Five motivational interviewing counsellors recruited 207 patients and offered motivational interviewing sessions to support physical activity behavior change. At 6-months there were significant improvements in physical activity, stage of change, and social support. A dose-response relationship was evident; those who attended 2 or more consultations increased their total physical activity, stage of change and family social support more than those who attended just one. Hierarchical regression analyses indicated that number of sessions and change in stage of change predicted 28.4% of the variance in change in total physical activity and, with social support from friends, 21.0% of the variance in change walking time. Change in perceived behavioral control and attitudes, friend social support, and number of sessions predicted 16.8% of the variance in change in vigorous physical activity. Motivational interviewing is an effective approach for promoting physical activity amongst lower socio-economic status groups in the short term. The study demonstrates good translational efficacy, and contributes to a limited number of physical activity interventions targeting low income groups in the UK.

One step beyond, does rehabilitation influence physical activity?

The measurement of physical activity has become a ‘hot topic’ in the field of pulmonary rehabilitation, as reflected in the systematic review in this issue. The assessment of physical activity is not new however, and there is an accumulating literature in chronic obstructive pulmonary disease (COPD). The level of activity in COPD seems particularly low in comparison with other significant long-term condition, a comparative review of physical activity revealed that activity for individuals was almost half that of individuals with coronary heart disease or arthritis. More recently Watz et al. described the falling levels of activity associated with increasing disease severity. This interest in physical activity was consolidated by the data obtained from the interaction between physical activity and hospital admissions reported from the Copenhagen Heart Study, although at this time the physical activity was described with data from a questionnaire. More specifically high levels of physical activity seem to protect against subsequent readmissions for COPD, the authors of this article suggested that individuals needed to accumulate 60 min of walking a day to reduce the risk of readmission. Pulmonary rehabilitation would seem the ideal intervention to improve physical activity; supporting behaviour change to enhance physical activity is an implicit aim of the service. It has often been assumed that a meaningful change in exercise tolerance after completing a course of rehabilitation will translate into a significant improvement in physical activity. Until fairly recently it has been difficult to objectively test this assumption, but with the commercial development of activity monitors and increased availability of pedometers some authors have tested this hypothesis. The systematic review aimed to evaluate the impact of exercise training upon physical activity. There were no randomised controlled trials (RCTs), this is perhaps not surprising as the monitors are a fairly recent addition to the repertoire of outcome measures and to conduct an RCT where the control group is no intervention would now be considered unethical. Two RCTs were identified; one study explored the relative value of two different exercise regimes delivered within a rehabilitation programme, one arm being conventional rehabilitation. The second, again used conventional rehabilitation as the control arm, but this time compared the standard programme with the addition of a physical activity counselling programme. There were an additional five observational studies included, all were reasonably small sample sizes, with the exception of the recent study by Steele et al. Overall there was a favourable increase in physical activity observed after a course of rehabilitation but this was felt to be small. There are probably a number of reasons to account for this, most obviously that rehabilitation genuinely failed to provoke a significant increase in physical activity. Changes in domestic activity require a supported and structured approach to supervised and home-based exercise and behaviour techniques should be employed to support increased activity during and after a course of rehabilitation. Rehabilitation practitioners have probably been guilty of not pursuing this aspect of rehabilitation as rigorously as might be required to support behaviour change. The authors of this review suggest that a longer course of rehabilitation might be needed to develop these strategies and reinforce behaviour change.

Cost-effectiveness of exercise on prescription with telephone support among women in general practice over 2 years

AimTo assess the cost-effectiveness of exercise on prescription with ongoing support in general practice.MethodsProspective cost-effectiveness study undertaken as part of the 2-year Women's lifestyle study randomised controlled trial involving 1089...

Relationship between self-efficacy and physical activity among patients with type 2 diabetes

While previous studies indicate a significant relationship between self-efficacy and physical activity, less research has focused on this relationship among patients with type 2 diabetes. The purpose of this investigation was to examine whether self-efficacy mediated the relationship between participation in a 1-month, print-based physical activity intervention and improvements in activity levels. Participants (N = 85; mean age = 57; 73% Caucasian; 69% female) were recruited from a community diabetes center. The intervention was individually-tailored based on theoretical constructs, including self-efficacy. After controlling for age, baseline activity, and baseline self-efficacy, the tailored intervention was associated with significant improvements in physical activity, 95% CI [23.01, 271.68] as well as self-efficacy, CI [0.02, 3.48]. There was an indirect effect of treatment on physical activity through self-efficacy, CI [0.77, 73.11], and the direct effect of treatment on physical activity was no longer significant, CI [-7.33, 253.40], after the influences of self-efficacy change were accounted for in the model. Results supported a mediation effect, such that the treatment effect on physical activity was completely mediated by changes in self-efficacy. Although replication is needed, results support the theoretical rationale for targeting self-efficacy to promote physical activity among patients with type 2 diabetes.

Motivational Interviewing to Affect Behavioral Change in Older Adults

This article reviews and assesses the existing research literature on the efficacy of motivational interviewing (MI) to promote lifestyle changes and improve functioning among older adults confronting serious health challenges. A comprehensive literature review was conducted of intervention studies that tested the use of MI to achieve behavioral change among older adults with acute and chronic illnesses. Although limited in number, the studies revealed a significant improvement in physical activity, diet, cholesterol, blood pressure and glycemic control, and increased smoking cessation following MI. MI and its derivatives can be useful in dealing with a range of health issues faced by older adults. Further research to extend findings and address methodological issues is recommended. The integration of MI into social work courses focused on practice with older adults should be considered.

Experience Analysis of a Practice-Based, Online Pedometer Program

Approximately one-fourth of chronic disease mortality (e.g., diabetes and heart disease) is linked to a sedentary lifestyle.1 In 2000, it was estimated that physical inactivity cost the United States $76.6 billion in medical expenses alone.2 In contrast, a physically active lifestyle is associated with multiple health benefits, including improvements in obesity, coronary artery disease, hypertension, and all-cause mortality.3–6 Regular physical activity may be especially important for individuals at high risk for developing type 2 diabetes; a 2000 calorie/week increase in energy expenditure is associated with a 24% reduction in the risk of developing the disease.7 Despite the clear benefits of an active lifestyle, > 60% of U.S. adults do not get enough physical activity, and at least 25% are completely inactive during their leisure time.8 Technological advancements and changes in the work environment during the past several decades have contributed to a gradual decline in the need for daily physical activity.9,10 Because of this, many practitioners now recommend a lifestyle approach to physical activity, through which sedentary individuals are encouraged to build more physical activity into their daily routine and leisure time.8,11 An increasingly popular tool that can support lifestyle physical activities is the pedometer. Pedometer-based interventions have produced significant improvements in physical activity, weight management, blood pressure, and lipid profiles.11–14 They have also been effective for increasing walking and improving glucose tolerance or insulin sensitivity among participants with type 2 diabetes.15–19 To date, however, most pedometer studies have had limited external validity because of small or narrowly defined at-risk samples. It is unclear how well a large-scale, commercially available pedometer-based walking program performs in the real world. The purpose of this evaluation was to examine whether an online program titled …

A home-based, transtheoretical change model designed strength training intervention to increase exercise to prevent osteoporosis in Iranian women aged 40-65 years: a randomized controlled trial

Physical activity (PA) helps to prevent osteoporosis, but older women are often sedentary. This study used a pre-post randomized controlled design to evaluate a 12-week exercise education intervention program based on the stages of change (SoC) and processes of change from the transtheoretical change model (TTM) to improve adherence with strength and balance training recommendations at levels sufficient to prevent osteoporosis in Iranian women aged 40-65 years. The home-based exercise prescription consisted of strength and balance training that was progressive, individually tailored and included a walking program. Individuals in the training group (n=61) had a positive, significant progression in psychological SoC (P<0.001), whereas no progression in stages occurred in the control group (n=55). After the intervention, the training group demonstrated significant improvements in PA, lower body muscle strength, static and dynamic balance, with no significant changes in the control group. These results support the applicability of the TTM for a PA intervention and indicate that this training program is very effective in improving balance and lower body strength in older women.

Postdischarge support for elective hip arthroplasty patients

This longitudinal study. n 29/ investigated the nature of provision of support available to postoperative discharge patients experiencing elective primary hip arthroplasty. Patients' expectations of support were investigated prior to discharge and at six weeks and three months postdischarge. The assessment tools used were the SF-36 Health Survey ( UK Acute Version) to measure health concepts, and an open ended qualitative questionnaire to investigate the nature of support provision. Patients were assessed between 5 -7 days while in the hospital and six weeks and three months postsurgical procedure. Results indicated a significant improvement in physical activity. p < 0:01/, pain. p < 0:1/, and social activity. p < 0:01/ over time for both groups; however, the pattern of change was different. Patients without partners or close family demonstrated slower patterns of recovery and different levels of physical and emotional factors affecting social function. Reported levels of pain interfering with daily life were greater at six weeks in patients without partners. p < 0:01/. Levels of perceived support were significantly different between the groups. p < 0:0004/ and levels of actual support were also signifi cantly different. p < 0:025/. This study, although small, suggests that patients without support may be more vulnerable in the early postoperative discharge period.