Showing papers in "Medicine and Science in Sports and Exercise in 2001"

CHAMPS physical activity questionnaire for older adults: outcomes for interventions.

Abstract: STEWART, A L, K M MILLS, A C KING, W L HASKELL, D GILLIS, and P L RITTER CHAMPS Physical Activity Questionnaire for Older Adults: outcomes for interventions Med Sci Sports Exerc, Vol 33, No 7, 2001, pp 1126–1141PurposeTo evaluate effectively interventions to increase physical act

Is physical activity or physical fitness more important in defining health benefits

Abstract: BLAIR, S. N., Y. CHENG, and J. S. HOLDER. Is physical activity or physical fitness more important in defining health benefits? Med. Sci. Sports Exerc., Vol. 33, No. 6, Suppl., 2001, pp. S379 ‐S399. Purpose: We addressed three questions: 1) Is there a dose-response relation between physical activity and health? 2) Is there a dose-response relation between cardiorespiratory fitness and health? 3) If both activity and fitness have a dose-response relation to health, is it possible to determine which exposure is more important? Methods: We identified articles by PubMed search (restricted from 1/1/90 to 8/25/00) using keywords related to physical activity, physical fitness, and health. An author scanned titles and abstracts of 9831 identified articles. We included for thorough review articles that included three or more categories of activity or fitness and a health outcome and excluded articles on clinical trials, review papers, comments, letters, case reports, and nonhuman studies. We used an evidence-based approach to evaluate the quality of the published data. Results: We summarized results from 67 articles meeting final selection criteria. There is good consensus across studies with most showing an inverse dose-response gradient across both activity and fitness categories for morbidity from coronary heart disease (CHD), stroke, cardiovascular disease (CVD), or cancer; and for CVD, cancer, or all-cause mortality. Conclusions: All studies reviewed were prospective observational investigations; thus, conclusions are based on Evidence Category C. 1) There is a consistent gradient across activity groups indicating greater longevity and reduced risk of CHD, CVD, stroke, and colon cancer in more active individuals. 2) Studies are compelling in the consistency and steepness of the gradient across fitness groups. Most show a curvilinear gradient, with a steep slope at low levels of fitness and an asymptote in the upper part of the fitness distribution. 3) It is not possible to conclude whether activity or fitness is more important for health. Future studies should define more precisely the shape of the dose-response gradient across activity or fitness groups, evaluate the role of musculoskeletal fitness, and investigate additional health outcomes. Key Words: EPIDEMIOLOGY, MORTALITY, CARDIOVASCULAR DISEASE, CANCER, DIABETES, LONGITUDINAL STUDY

Aerobic endurance training improves soccer performance

Abstract: HELGERUD, J., L. C. ENGEN, U. WISLOFF, and J. HOFF. Aerobic endurance training improves soccer performance.Med. Sci. Sports Exerc., Vol. 33, No. 11, 2001, pp. 1925–1931. Purpose: The aim of the present study was to study the effects of aerobic training on performance during soccer match and soccer specific tests. Methods: Nineteen male elite junior soccer players, age 18.1 0.8 yr, randomly assigned to the training group (N 9) and the control group (N 10) participated in the study. The specific aerobic training consisted of interval training, four times 4 min at 90 –95% of maximal heart rate, with a 3-min jog in between, twice per week for 8 wk. Players were monitored by video during two matches, one before and one after training. Results: In the training group: a) maximal oxygen uptake (V u O2max) increased from 58.1 4.5 mL·kg 1 ·min 1 to 64.3 3.9 mL·kg 1 ·min 1 (P 0.01); b) lactate threshold improved from 47.8 5.3 mL·kg 1 ·min 1 to 55.4 4.1 mL·kg 1 ·min 1 (P 0.01); c) running economy was also improved by 6.7% (P 0.05); d) distance covered during a match increased by 20% in the training group (P 0.01); e) number of sprints increased by 100% (P 0.01); f) number of involvements with the ball increased by 24% (P 0.05); g) the average work intensity during a soccer match, measured as percent of maximal heart rate, was enhanced from 82.7 3.4% to 85.6 3.1% (P 0.05); and h) no changes were found in maximal vertical jumping height, strength, speed, kicking velocity, kicking precision, or quality of passes after the training period. The control group showed no changes in any of the tested parameters. Conclusion: Enhanced aerobic endurance in soccer players improved soccer performance by increasing the distance covered, enhancing work intensity, and increasing the number of sprints and involvements with the ball during a match. Key Words: V u O2max, LACTATE THRESHOLD, RUNNING ECONOMY, SKILL

Individual differences in response to regular physical activity.

Abstract: BOUCHARD, C., and T. RANKINEN. Individual differences in response to regular physical activity. Med. Sci. Sports Exerc., Vol. 33, No. 6, Suppl., 2001, pp. S446–S451. Purpose:The purpose of this review was to address the question of interindividual variation in responsiveness to regular exercise trai

Physical activity dose-response effects on outcomes of depression and anxiety.

Abstract: Purpose: The purpose of this study was to examine the scientific evidence for a dose-response relation of physical activity with depressive and anxiety disorders. Methods: Computer database searches of MEDLINE, PsychLit, and Internet and personal retrieval systems to locate population studies, randomized controlled trials (RCTs), observational studies, and consensus panel judgments were conducted. Results: Observational studies demonstrate that greater amounts of occupational and leisure time physical activity are generally associated with reduced symptoms of depression. Quasi-experimental studies show that light-, moderate-, and vigorous-intensity exercise can reduce symptoms of depression. However, no RCTs have varied frequency or duration of exercise and controlled for total energy expenditure in studies of depression or anxiety. Quasi-experimental and RCTs demonstrate that both resistance training and aerobic exercise can reduce symptoms of depression. Finally, the relation of exercise dose to changes in cardiorespiratory fitness is equivocal with some studies showing that fitness is associated with reduction of symptoms and others that have demonstrated reduction in symptoms without increases in fitness. Conclusion: All evidence for dose-response effects of physical activity and exercise come from B and C levels of evidence. There is little evidence for dose-response effects, though this is largely because of a lack of studies rather than a lack of evidence. A dose-response relation does, however, remain plausible.

Physical activity and all-cause mortality: what is the dose-response relation?

Abstract: LEE, I-M., and P. J. SKERRETT. Physical activity and all-cause mortality: what is the dose-response relation? Med. Sci. Sports Exerc., Vol. 33, No. 6, Suppl., 2001, pp. S459 ‐S471. Purpose: The purpose of this review is to assess the dose-response relation between physical activity and all-cause mortality. We examined these parameters of physical activity dose: volume, intensity, duration, and frequency. Methods: We used a computer-assisted literature search to identify papers on this topic. After excluding papers examining only two levels of physical activity or fitness, papers investigating specific causes of mortality, reviews, and those not written in English, 44 papers satisfying all criteria were included in this review. Results: There is clear evidence of an inverse linear dose-response relation between volume of physical activity and all-cause mortality rates in men and women, and in younger and older ($60 yr) persons. Minimal adherence to current physical activity guidelines, which yield an energy expenditure of about 1000 kcal·wk -1 (4200 kJ·wk -1 ), is associated with a significant 20-30% reduction in risk of all-cause mortality. Further reductions in risk are observed at higher volumes of energy expenditure. It is unclear whether a volume of ,1000 kcal·wk -1 also may be associated with lower risk; there are some data supporting this. Due to limited data, it is also unclear whether vigorous-intensity activity confers additional benefit beyond its contribution to volume of physical activity when compared with moderate-intensity activity. No data are available on duration and frequency of physical activity in relation to all-cause mortality rates after controlling for volume of physical activity. Conclusions: All studies in this review are observational studies, so conclusions are based on Evidence Category C. There is an inverse linear dose-response relation between volume of physical activity and all-cause mortality. Further research is needed to clarify the

Appropriate Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults

Abstract: In excess of 55% of adults in the United States are classified as either overweight (body mass index = 25-29.9 kg.m(-2)) or obese (body mass index > or = 30 kg.m(-2)). To address this significant public health problem, the American College of Sports Medicine recommends that the combination of reductions in energy intake and increases in energy expenditure, through structured exercise and other forms of physical activity, be a component of weight loss intervention programs. An energy deficit of 500-1000 kcal.d-1 achieved through reductions in total energy intake is recommended. Moreover, it appears that reducing dietary fat intake to <30% of total energy intake may facilitate weight loss by reducing total energy intake. Although there may be advantages to modifying protein and carbohydrate intake, the optimal doses of these macronutritents for weight loss have not been determined. Significant health benefits can be recognized with participation in a minimum of 150 min (2.5 h) of moderate intensity exercise per week, and overweight and obese adults should progressively increase to this initial exercise goal. However, there may be advantages to progressively increasing exercise to 200-300 min (3.3-5 h) of exercise per week, as recent scientific evidence indicates that this level of exercise facilitates the long-term maintenance of weight loss. The addition of resistance exercise to a weight loss intervention will increase strength and function but may not attenuate the loss of fat-free mass typically observed with reductions in total energy intake and loss of body weight. When medically indicated, pharmacotherapy may be used for weight loss, but pharmacotherapy appears to be most effective when used in combination with modifications of both eating and exercise behaviors. The American College of Sports Medicine recommends that the strategies outlined in this position paper be incorporated into interventions targeting weight loss and the prevention of weight regain for adults.

Response of blood lipids to exercise training alone or combined with dietary intervention.

Abstract: Purpose: The purpose of this study is to review the effects of aerobic exercise training (AET) on blood lipids and assess dose-response relationships and diet interactions. Methods: We reviewed papers published over the past three decades pertaining to intervention trials on the effects of ≥ 12 wk of AET on blood lipids and lipoprotein outcomes in adult men and women. Included were studies with simultaneous dietary and AET interventions, if they had appropriate comparison groups. Studies were classified by the participants' relative weights expressed as mean BMIs. Information was extracted on baseline characteristics of study subjects, including age, sex, and relative baseline cholesterol levels; details on the training programs; and the responses to training of body weight, VO 2max , and blood total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglyceride (TG). Results: We identified 51 studies, 28 of which were randomized controlled trials. AET was generally performed at a moderate to hard intensity, with weekly energy expenditures ranging from 2,090 to >20,000 kJ. A marked inconsistency was observed in responsiveness of blood lipids. The most commonly observed change was an increase in HDL-C (with reductions in TC, LDL-C, and TG less frequently observed). Insufficient data are available to establish dose-response relationships between exercise intensity and volume with lipid changes. The increase in HDL-C with AET was inversely associated with its baseline level (r = -0.462), but no significant associations were found with age, sex, weekly volume of exercise, or with exercise-induced changes in body weight or VO 2max . Conclusion: Moderate- to hard-intensity AET inconsistently results in an improvement in the blood lipid profile, with the data insufficient to establish dose-response relationships.

Physical fitness and activity as separate heart disease risk factors: a meta-analysis

Abstract: WILLIAMS, P. T. Physical fitness and activity as separate heart disease risk factors: a meta-analysis. Med. Sci. Sports Exerc., Vol. 33, No. 5, 2001, pp. 754–761. Objective:Public health policies for physical activity presume that the greatest health benefits are achieved by increasing physical acti

Psychology of Physical Activity: Determinants, Well-being, and Interventions

Abstract: Bargaining with reading habit is no need. Reading is not kind of something sold that you can take or not. It is a thing that will change your life to life better. It is the thing that will give you many things around the world and this universe, in the real world and here after. As what will be given by this psychology of physical activity determinants well being and interventions, how can you bargain with the thing that has many benefits for you?

Type of activity: resistance, aerobic and leisure versus occupational physical activity.

Abstract: HOWLEY, E. T. Type of activity: resistance, aerobic and leisure versus occupational physical activity. Med. Sci. Sports Exerc., Vol. 33, No. 6, Suppl., 2001, pp. S364 ‐S369. Purpose: To define and describe the essential terminology associated with dose-response issues in physical activity and health. Methods: Recent consensus documents, position stands, and reports were used to provide reference definitions and methods of classifying physical activity and exercise. Results: The two principal categories of physical activity are occupational physical activity (OPA) and leisure-time physical activity (LTPA). OPA is usually referenced to an 8-h d, whereas the duration of LTPA is quite variable. LTPA includes all forms of aerobic activities, structured endurance exercise programs, resistance-training programs, and sports. Energy expenditure associated with aerobic activity can be expressed in absolute terms (kJ·min -1 ), referenced to body mass (METs), or relative to some maximal physiological response (i.e., maximal heart rate (HR) or

Exercise characteristics and the blood pressure response to dynamic physical training.

Abstract: FAGARD, R. H. Exercise characteristics and the blood pressure response to dynamic physical training. Med. Sci. Sports Exerc.,Vol. 33, No. 6, Suppl., pp. S484 ‐S492, 2001. Purpose: The purpose of this study was to assess the influence of the characteristics of the exercise program, particularly exercise intensity, on the blood pressure response to dynamic physical training in otherwise healthy normotensive and hypertensive subjects. Methods: This study is a meta-analysis of randomized controlled intervention trials and a description of studies in which different training regimens have been compared. Results: The weighted net reduction of blood pressure in response to dynamic physical training averaged 3.4/2.4 mm Hg (P , 0.001). Interstudy differences in the changes in pressure were not related to weekly frequency, time per session, or exercise intensity, which ranged from approximately 45‐ 85%; these three characteristics combined explained less than 5% of the variance of the blood pressure response. The response of diastolic blood pressure was not different according to training intensity in studies that randomized patients to training programs with different intensities. Some studies reported a greater reduction of systolic blood pressure when intensity was about 40% than when participants exercised at about 70%, but this finding was not consistent, neither within nor between studies. Conclusion: Training from three to five times per week during 30 ‐ 60 min per session at an intensity of about 40 ‐50% of net maximal exercise performance appears to be effective with regard

Skeletal muscle dysfunction in chronic obstructive pulmonary disease.

Abstract: Chronic obstructive pulmonary disease (COPD) is a major health care problem. Formerly mainly a disease of men, women are increasingly frequently afflicted. In many of these patients, exercise intolerance is the chief complaint. Few effective therapies are available. In recent years, dysfunction of the muscles of ambulation has been identified as a source of a portion of the exercise intolerance these patients experience, and this dysfunction has been shown to be, at least in part, remediable. Mechanisms inducing muscle dysfunction include disuse atrophy, malnutrition, low levels of anabolic steroids, and myopathy from corticosteroid use. Endurance exercise training has been conclusively demonstrated to improve exercise tolerance in COPD. Recent studies suggest that strength training is beneficial as well. A new frontier of therapy for muscle dysfunction in COPD is the use of anabolic hormones. Testosterone supplementation has been shown to increase muscle mass and strength in both hypogonadal and eugonadal healthy men. Low-dose testosterone supplementation is being considered for use in postmenopausal women. Though short-term administration of testosterone in moderate doses seems to be well tolerated in both men and women, further studies are required before safety and effectiveness can be established for routine use in COPD patients.

The acute versus the chronic response to exercise.

Abstract: Purpose: There is strong and consistent evidence that a single exercise session can acutely reduce triglycerides and increase high-density lipoprotein (HDL) cholesterol (HDL-C) reduce blood pressure, and improve insulin sensitivity and glucose homeostasis. Such observations suggest that at least some of the effects on atherosclerotic cardiovascular disease (ASCVD) risk factors attributed to exercise training may be the result of recent exercise. Results: These acute and chronic exercise effects cannot be considered in isolation. Exercise training increases the capacity for exercise, thereby permitting more vigorous and/or more prolonged individual exercise sessions and a more significant acute effect. The intensity, duration, and energy expenditure required to produce these acute exercise effects are not clearly defined. The acute effect of exercise on triglycerides and HDL-C appears to increase with overall energy expenditure possibly because the effect maybe mediated by reductions in intramuscular triglycerides. Prolonged exercise appears necessary for an acute effect of exercise on low-density lipoprotein (LDL) cholesterol (LDL-C) levels. The acute effect of exercise on blood pressure is a low threshold phenomenon and has been observed after energy expenditures requiring only 40% maximal capacity. The acute effect of exercise on glucose metabolism appears to require exercise near 70% maximal, but this issue has not been carefully examined. Conclusions: Exercise has definite acute effects on blood lipids, blood pressure, and glucose homeostasis. Exercise also has acute effects on other factors related to atherosclerosis such as immunological function, vascular reactivity, and hemostasis. Considerable additional research is required to define the threshold of exercise required to produce these putatively beneficial effects.

Relationship of physical activity to fundamental movement skills among adolescents

Abstract: OKELY, A. D., M. L. BOOTH, and J. W. PATTERSON. Relationship of physical activity to fundamental movement skills among adolescents. Med. Sci. Sports Exerc., Vol. 33, No. 11, 2001, pp. 1899–1904. Purpose:To determine the relationship of participation in organized and nonorganized physical activity wi

Risk factors for training-related injuries among men and women in basic combat training.

Abstract: KNAPIK, J. J., M. A. SHARP, M. CANHAM-CHERVAK, K. HAURET, J. F. PATTON, and B. H. JONES. Risk factors for training-related injuries among men and women in basic combat training. Med. Sci. Sports Exerc., Vol. 33, No. 6, 2001, pp. 946–954. Purpose:Past investigations indicate that training-related inj

Longitudinal study of elbow and shoulder pain in youth baseball pitchers.

Abstract: LYMAN, S., G. S. FLEISIG, J. W. WATERBOR, E. M. FUNKHOUSER, L. PULLEY, J. R. ANDREWS, E. D. OSINSKI, and J. M. ROSEMAN. Longitudinal study of elbow and shoulder pain in youth baseball pitchers. Med. Sci. Sports Exerc., Vol. 33, No. 11, 2001, pp. 1803–1810. Purpose:Previous studies among young pitche

Physical activity and cancer risk: dose-response and cancer, all sites and site-specific.

Abstract: THUNE, I., and A. S. FURBERG. Physical activity and cancer risk: dose-response and cancer, all sites and site-specific. Med. Sci. Sports Exerc., Vol. 33, No. 6, Suppl., 2001, pp. S530–S550. Purpose:The association between physical activity and overall and site-specific cancer risk is elaborated in r

External loading of the knee joint during running and cutting maneuvers.

Abstract: BESIER, T. F., D. G. LLOYD, J. L. COCHRANE, and T. R. ACKLAND. External loading of the knee joint during running and cutting maneuvers. Med. Sci. Sports Exerc., Vol. 33, No. 7, 2001, pp. 1168–1175.PurposeTo investigate the external loads applied to the knee joint during dynamic cutting tasks and ass

Human hamstring muscles adapt to eccentric exercise by changing optimum length.

Abstract: BROCKETT, C. L., D. L. MORGAN, and U. PROSKE. Human hamstring muscles adapt to eccentric exercise by changing optimum length. Med. Sci. Sports Exerc., Vol. 33, No. 5, 2001, pp. 783‐790. Purpose: It is now established that unaccustomed eccentric exercise leads to muscle fiber damage and to delayed-onset muscle soreness (DOMS) in the days after exercise. However, a second bout of eccentric exercise, a week after the first, produces much less damage and soreness. The purpose of this study was to provide evidence from muscle mechanical properties of a proposed mechanism for this training effect in human hamstring muscles. Methods: The eccentric exercise involved 12 sets of 6 repetition “hamstring lowers,” performed on specially designed equipment. Hamstring angle-torque curves were constructed for each of 10 subjects (8 male and 2 female) while they performed maximum voluntary knee extension and flexion movements on an isokinetic dynamometer. Testing sessions were performed over the week before eccentric exercise, immediately post exercise, and daily, up to 8 d post exercise. Subject soreness ratings and leg girth measurements were also made post exercise. Six subjects performed a second bout of eccentric exercise, 8 d after the first, and measurements were continued up to 10 d beyond that. Results: There was a significant shift in the optimum angle for torque generation (Lo), to longer muscle lengths immediately post exercise (7.7°6 2.1°,P , 0.01), indicating an increase in series compliance within some muscle fibers. Subsequent measurements showed increases in leg girth and some muscle soreness, suggesting muscle damage. The shift in Lo persisted, even after other injury parameters had returned to normal, consistent with a training effect. Subjects also showed fewer signs of muscle damage after the second exercise bout. Conclusion: This is the first study to show a sustained shift in optimum angle of human muscle as a protective strategy against injury from eccentric exercise. Implications of this work for athletes, particularly those prone to hamstring

Knee biomechanics of the dynamic squat exercise.

Abstract: ESCAMILLA, R. F. Knee biomechanics of the dynamic squat exercise. Med. Sci. Sports Exerc., Vol. 33, No. 1, 2001, pp. 127‐141. Purpose: Because a strong and stable knee is paramount to an athlete’s or patient’s success, an understanding of knee biomechanics while performing the squat is helpful to therapists, trainers, sports medicine physicians, researchers, coaches, and athletes who are interested in closed kinetic chain exercises, knee rehabilitation, and training for sport. The purpose of this review was to examine knee biomechanics during the dynamic squat exercise. Methods: Tibiofemoral shear and compressive forces, patellofemoral compressive force, knee muscle activity, and knee stability were reviewed and discussed relative to athletic performance, injury potential, and rehabilitation. Results: Low to moderate posterior shear forces, restrained primarily by the posterior cruciate ligament (PCL), were generated throughout the squat for all knee flexion angles. Low anterior shear forces, restrained primarily by the anterior cruciate ligament (ACL), were generated between 0 and 60° knee flexion. Patellofemoral compressive forces and tibiofemoral compressive and shear forces progressively increased as the knees flexed and decreased as the knees extended, reaching peak values near maximum knee flexion. Hence, training the squat in the functional range between 0 and 50° knee flexion may be appropriate for many knee rehabilitation patients, because knee forces were minimum in the functional range. Quadriceps, hamstrings, and gastrocnemius activity generally increased as knee flexion increased, which supports athletes with healthy knees performing the parallel squat (thighs parallel to ground at maximum knee flexion) between 0 and 100° knee flexion. Furthermore, it was demonstrated that the parallel squat was not injurious to the healthy knee. Conclusions: The squat was shown to be an effective exercise to employ during cruciate ligament or patellofemoral rehabilitation. For athletes with healthy knees, performing the parallel squat is recommended over the deep squat, because injury potential to the menisci and cruciate and collateral ligaments may increase with the deep squat. The squat does not compromise knee stability, and can enhance stability if performed correctly. Finally, the squat can be effective in developing hip, knee, and ankle musculature, because moderate to high quadriceps, hamstrings, and gastrocnemius activity were produced during the squat.

An evaluation of three self-report physical activity instruments for older adults.

Abstract: Purpose To assess the known-groups and construct validity of measures from the CHAMPS Physical Activity Questionnaire, Physical Activity Survey for the Elderly (PASE), and the Yale Physical Activity Survey (YPAS). Methods The three questionnaires were administered to a convenience sample of older adults (N = 87) recruited from community centers and retirement homes. Validation measures included the SF-36 measures of physical functioning, general health, mental health, and pain; body mass index; performance-based tests of lower body functioning and endurance; and Mini-Logger activity monitor data from ankle and waist sensors. Validity was estimated by testing hypotheses about associations between physical activity and validation measures. Results As hypothesized, differences in activity levels on all measures were found between older adults in retirement homes (less active) and community centers (more active) (P-values Conclusions The PASE, YPAS, and CHAMPS each demonstrated acceptable validity, as all measures met nearly all hypotheses. Higher validity coefficients were found for subgroups (men, 65-74 yr, retirement home), suggesting that these instruments may perform better for certain segments of the older adult population.

Physical activity assessed by activity monitor and doubly labeled water in children.

Abstract: PURPOSE: To validate the Computer Science and Application's (CSA) activity monitor for assessment of the total amount of physical activity during two school-weeks in 9-yr-old children and to develo ...

Anticipatory effects on knee joint loading during running and cutting maneuvers.

Abstract: BESIER, T F, D G LLOYD, T R ACKLAND, and J L COCHRANE Anticipatory effects on knee joint loading during running and cutting maneuvers Med Sci Sports Exerc, Vol 33, No 7, 2001, pp 1176–1181PurposeTo determine how unanticipated performance of cutting maneuvers in sport affects the ext

Exercise dose-response effects on quality of life and independent living in older adults.

Abstract: Purpose: The purpose of this study was to determine if exercise operates in a dose-response fashion to influence well-being and to postpone dependency. Methods: A computer-assisted search was made by using the following key words: resistance training, strength training, function, exercise, elderly, quality of life, frailty, physical activity, independence, performance, aerobic training, mobility, well-being, and disability. Review articles and personal files were also used, and a critical review of research studies meeting the criteria described in the methods section of the article was conducted. Results: In large sample correlational studies and prospective longitudinal studies, researchers consistently report that measures of physical function in old adults are related to feelings of well-being, and that old adults who are physically active also report higher levels of well-being and physical function, but the results of randomized intervention studies of aerobic and/or resistive strength training do not always support this relationship. Even if changes in well-being and physical function were reported, no evidence was found that levels of intensity operated in a dose-response fashion to influence these changes. Research design problems included ineffective aerobic or strength training treatments, widely varying participation and effort of the research participants, and both treatment and physical function tests that were not appropriate for the physical status of the participants. Conclusion: The most consistent results were that long-term physical activity is related to postponed disability and independent living in the oldest-old subjects. Even in individuals with chronic disease, systematic participation in physical activities enhances physical function.

Prevalence of physical activity during leisure time in the European Union

Abstract: Purpose To estimate the prevalence of physical activity during leisure time in adults from the 15 member states of the European Union and the relationship with sociodemographic variables. Methods A representative sample, with approximately 1000 adults, aged 15 and upward, was selected from each member state to complete a questionnaire on attitudes to physical activity, body weight, and health by a face-to-face interview, summing a total of 15,239 subjects. The amount of leisure-time physical activity was quantified by assigning metabolic equivalents (METs) to each activity. Multiple linear regression models with MET-h.wk(-1) as the dependent variable were fitted. Results Northern European countries showed higher levels of physical activity than southern ones. The highest prevalence (91.9%) was found in Finland, and the lowest (40.7%) in Portugal. A higher percentage of men practiced any leisure-time physical activity and also showed higher mean of MET-h.wk(-1). In both genders, the multivariate models showed a significant trend to higher leisure time activity in participants with higher educational levels and in nonsmokers. Also, an inverse association between body mass index and leisure-time physical activity was found. Conclusion The prevalence of any physical activity during leisure time in the adult European population was similar to the U.S. estimates. Nevertheless, the amount of activity is low, and a wide disparity between countries exists. To our knowledge, this is the first study determining the prevalence and amount of leisure-time physical activity, which is the first step to define strategies to persuade populations to increase their physical activity.

Physical activity and cardiovascular disease: evidence for a dose response.

Abstract: Purpose: To summarize and synthesize existing literature providing evidence of a dose-response relation between physical activity and cardiovascular disease endpoints. Methods: MEDLINE search of indexed English-language literature through August 2000. Findings supplemented by existing consensus documents and other published literature. Only studies with greater than two physical activity exposure categories were included, and studies not focusing on the clinical manifestation of the outcome (incidence or mortality) were excluded. Results: Existing studies were classified by outcome used: all cardiovascular disease (CVD), coronary (ischemic) heart disease (CHD), and stroke. The vast majority of the literature in this area has relied on prospective observational studies and has been conducted in European men or populations of men of primarily European descent. Follow-up intervals ranged from 3 to 26 yr, and most studies related a single initial measure of physical activity to the outcome of interest, sometimes many years in the future. No randomized trials of physical activity and cardiovascular disease as a clinical outcome exist. Taken together, the available evidence indicates that cardiovascular disease incidence and mortality, and specifically ischemic heart disease, are causally related to physical activity in an inverse, dose-response fashion. These findings have been demonstrated in a variety of populations and using a variety of physical activity assessment methods. Contrarily, equivocal evidence for stroke incidence and mortality prohibits a similar conclusion. No strong evidence for dose-response relation between physical activity and stroke as a CVD outcome is available. Conclusion: Physical inactivity is prominent in the causal constellation for factors predisposing to cardiovascular disease, particularly ischemic heart disease. Methodologic advances in physical activity assessment; additional studies on changes in the antecedent variable, physical activity, as it relates to the outcome; and more studies among women and ethnically diverse populations are needed to clarify these relations.

Validity and reliability of combining three methods to determine ventilatory threshold.

Abstract: GASKILL, S. E., B. C. RUBY, A. J. WALKER, O. A. SANCHEZ, R. C. SERFASS, and A. S. LEON. Validity and reliability of combining three methods to determine ventilatory threshold. Med. Sci. Sports Exerc., Vol. 33, No. 11, 2001, pp. 1841–1848. Purpose: This research was undertaken to validate a combination of methodologies to determine ventilatory threshold (VT). Methods: Three methods were used individually and then combined to determine VT as follows: 1) ventilatory equivalencies, 2) excess CO2 production, and 3) a modified V-slope method. Three groups of participants— endurance athletes (N 132), healthy, aerobically active adults ( N 31), and healthy, sedentary/low-active adults (N 22)—were independently evaluated for VT and compared with the criterion standard lactate threshold (LT) defined as the first rise in blood lactate with increasing intensity of exercise. Results: VT and LT were significantly correlated using the combined VT method within each study group (r 0.98, 0.97, and 0.95, respectively; P 0.001). Mean V u O2 values at VT and LT were not significantly different between the three groups (P 0.20). The combined method improved the determination rate of VT and reduced the standard deviation of the LT VT difference by 80 –170% over the individual methods. During test-retest procedures V u O2lt and V u O2vt determined by the combined method met criteria demonstrating further reliability.

A multi-station proprioceptive exercise program in patients with ankle instability

Abstract: EILS, E., and D. ROSENBAUM. A multi-station proprioceptive exercise program in patients with ankle instability. Med. Sci. Sports Exerc., Vol. 33, No. 12, 2001, pp. 1991–1998.PurposeThe aim of the present study was to investigate the effects of a 6-wk multi-station proprioceptive exercise program tha