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Assisted Cycling Therapy (ACT) Improves Mobility in Adults with Down Syndrome

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The purpose of the study was to examine the effectiveness of two modes of exercise on the lower body strength and aerobic capacity in adults with Down syndrome (DS). Six participants randomly completed one of two exercise interventions: 1) Voluntary

The purpose of the study was to examine the effectiveness of two modes of exercise on the lower body strength and aerobic capacity in adults with Down syndrome (DS). Six participants randomly completed one of two exercise interventions: 1) Voluntary Cycling (VC), where participants cycled at their self-selected pedaling rate and 2) Assisted Cycling Therapy (ACT), where the participants' voluntary pedaling rates were augmented by 35% with a motor. In each intervention, the participant completed three, 30-minute cycling sessions each week for a total of eight weeks. The Six-Minute Walk Test (6MWT) was used to evaluate the distance each participant was able to complete in six minutes before and after the intervention. There was a significant increase in the distance and velocity of the participants after the intervention with a greater mean improvement for participants in the ACT group than VC when analyzing total score and t-score. Future research will include a greater sample size and control group to reach significant results as well as try and reveal the mechanisms involved in these physical health improvements found after an acute bout of assisted cycling in adults with DS.

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2015-12

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The Effect of Exercise Therapy on Cognitive Function in Adolescents with Down Syndrome

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This study examines the effect of exercise therapy on a stationary bike on cognitive function, specifically inhibition and set-switching, in adolescents with Down syndrome. 44 participants were randomly divided between the voluntary cycling therapy group (VCT) (i.e., self-selected cadence), assisted

This study examines the effect of exercise therapy on a stationary bike on cognitive function, specifically inhibition and set-switching, in adolescents with Down syndrome. 44 participants were randomly divided between the voluntary cycling therapy group (VCT) (i.e., self-selected cadence), assisted cycling therapy group (ACT) (i.e., 30% faster than self-selected cadence accomplished by a motor), and a control group (NC) in which the participants did not undergo any exercise therapy. Both cycling groups rode a stationary bicycle, for 30 minutes, three times a week, for eight-weeks. At the beginning (i.e., pretest) and end (i.e., posttest) of the eight-week session the participants completed tasks to evaluate their cognitive function. They completed three trials of the card sort test (i.e., set-switching) and three trials of the knock-tap test (i.e, inhibition) before and after eight-weeks of cycling therapy. The scores of these tests were analyzed using one-way ANOVA between groups and paired samples t-tests. The results showed that after eight-weeks of cycling therapy the participants in the VCT group performed worse in the knock-tap test, but improved in two trials of the card sort test. The results also showed that the participants in the ACT group performed worse after eight-weeks of exercise therapy in one trial of the card sort test. No significant changes were seen for the control group. Due to the fact that on average the participants in the VCT group cycled with a higher heart rate, our results suggest exercise that significantly elevates heart rate can improve cognitive function, specifically set-switching, in adolescents with Down syndrome.

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2015-05

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The differences in correlates of physical activity between a sample of non-Hispanic blacks and non-Hispanic whites with arthritis

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Purpose: To examine: (1) whether Non-Hispanic Blacks (NHB) and Non-Hispanic Whites (NHW) with diagnosed arthritis differed in self-reported physical activity (PA) levels, (2) if NHB and NHW with arthritis differed on potential correlates of PA based on the Social Ecological

Purpose: To examine: (1) whether Non-Hispanic Blacks (NHB) and Non-Hispanic Whites (NHW) with diagnosed arthritis differed in self-reported physical activity (PA) levels, (2) if NHB and NHW with arthritis differed on potential correlates of PA based on the Social Ecological Model (Mcleroy et al., 1988), and (3) if PA participation varied by race/ethnicity after controlling for age, gender, education, and BMI. Methods: This study was a secondary data analysis of data collected from 2006-2008 in Chicago, IL as part of the Midwest Roybal Center for Health Promotion. Bivariate analyses were used to assess potential differences between race in meeting either ACR or ACSM PA guidelines. Comparisons by race between potential socio-demographic correlates and meeting physical activity guidelines were assessed using Chi-squares. Potential differences by race in psychosocial, arthritis, and health-related and environmental correlates were assessed using T-tests. Finally, logistic regression analyses were used to examine if race was still associated with PA after controlling for socio-demographic characteristics. Results: A greater proportion of NHW (68.1% and 35.3%) than NHB (46.5% and 20.9%) met both the arthritis-specific and the American College of Sports Medicine (ACSM) recommendations for physical activity, respectively. NHB had significantly lower self-efficacy for exercise and reported greater impairments in physical function compared to NHW. Likewise, NHB reported more crime and less aesthetics within their neighborhood. NHW were 2.56 times more likely to meet arthritis-specific PA guidelines than NHB after controlling for age, gender, education, marital status, and BMI. In contrast, after controlling for sociodemographic characteristics, age and gender were the only significant predictors of meeting ACSM PA guidelines. Discussion: There were significant differences between NHB and NHW individuals with arthritis in meeting PA guidelines. After controlling for age, gender, education, and BMI non-Hispanic White individuals were still significantly more likely to meet PA guidelines. Interventions aimed at promoting higher levels of physical activity among individuals with arthritis need to consider neighborhood aesthetics and crime when designing programs. More arthritis-specific programs are needed in close proximity to neighborhoods in an effort to promote physical activity.

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2013

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Application of methods in physical activity measurement

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It is broadly accepted that physical activity provides substantial health benefits. Despite strong evidence, approximately 60% to 95% of US adults are insufficiently active to obtain these health benefits. This dissertation explored five projects that examined the measurement properties and

It is broadly accepted that physical activity provides substantial health benefits. Despite strong evidence, approximately 60% to 95% of US adults are insufficiently active to obtain these health benefits. This dissertation explored five projects that examined the measurement properties and methodology for a variety of physical activity assessment methods. Project one identified validity evidence for the new MyWellness Key accelerometer in sixteen adults. The MyWellness Key demonstrated acceptable validity evidence when compared to a criterion accelerometer during graded treadmill walking and in free-living settings. This supports the use of the MyWellness Key accelerometer to measure physical activity. Project two evaluated validity (study 1) and test-retest reliability evidence (study 2) of the Global Physical Activity Questionnaire (GPAQ) in a two part study. The GPAQ was compared to direct and indirect criterion measures including object and subjective physical activity instruments. These data provided preliminary validity and reliability evidence for the GPAQ that support its use to assess physical activity. Project three investigated the optimal h.d-1 of accelerometer wear time needed to assess daily physical activity. Using a semi-simulation approach, data from 124 participants were used to compare 10-13 h.d-1 to the criterion 14 h.d-1. This study suggested that a minimum accelerometer wear time of 13 h.d-1 is needed to provide a valid measure of daily physical activity. Project four evaluated validity and reliability evidence of a novel method (Movement and Activity in Physical Space [MAPS] score) that combines accelerometer and GPS data to assess person-environment interactions. Seventy-five healthy adults wore an accelerometer and GPS receiver for three days to provide MAPS scores. This study provided evidence for use of a MAPS score for future research and clinical use. Project five used accelerometer data from 1,000 participants from the 2005-2006 National Health and Nutrition Examination Study. A semi-simulation approach was used to assess the effect of accelerometer wear time (10-14 h.d-1) on physical activity data. These data showed wearing for 12 h.d-1 or less may underestimate time spent in various intensities of physical activity.

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2011

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Physical activity counseling knowledge, attitudes, and practices among nurse practitioners and physician assistants

Description

Health care providers (HCPs) are an important source of physical activity (PA) information. Two studies were conducted to qualitatively and quantitatively examine nurse practitioners'(NPs) and physician assistants' current PA counseling practices, knowledge and confidence to provide PA counseling and providers'

Health care providers (HCPs) are an important source of physical activity (PA) information. Two studies were conducted to qualitatively and quantitatively examine nurse practitioners'(NPs) and physician assistants' current PA counseling practices, knowledge and confidence to provide PA counseling and providers' perceptions about their current PA counseling practices. The specific aims for these two studies included quantitatively and qualitatively identifying the prevalence of PA counseling, perceived counseling knowledge and confidence, and educational training related to counseling. In study 1, survey respondents were currently practicing NPs and physician assistants. Participants completed a modified version of the Promotion of Physical Activity by Nurse Practitioners Questionnaire either online or in person during a population specific conference. The majority of both NP and physician assistant respondents reported routinely counseling patients about PA. There were no differences in perceived knowledge or confidence to provide PA counseling between the two populations. Approximately half of all respondents reported receiving training to provide PA counseling as part of their educational preparation for becoming a health practitioner. Nearly three-quarters of respondents reported interest in receiving additional PA counseling training. In study 2, five focus groups (FGs), stratified by practice type, were conducted with NPs and physician assistants. Both NPs and physician assistants reported discussing PA with their patients, particularly those with chronic illness. Participants reported that discussing lifestyle modifications with patients was the most common type of PA counseling provided. Increased confidence to counsel was associated with having PA knowledge and providing simple counseling, such as lifestyle modifications. Barriers to counseling included having more important things to discuss, lack of time during appointments, the current healthcare system, lack of reimbursement and perceived patient financial barriers. PA recommendation knowledge was highly variable, with few participants reporting specific guidelines. FG participants, while not familiar with the American College of Sports Medicines' "Exercise is Medicine" initiative indicated interest in its use and learning more about it. The findings of these two studies indicate that while NPs and physician assistants are knowledgeable, confident and currently providing some amount of PA counseling to patients, additional training in PA counseling is needed and desired.

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Date Created
2011

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Barriers & motivators to physical activity in older Mexican American men

Description

The purpose of this phenomenological study was to explore the cultural, social, environmental, and gender factors that may influence physical activity (PA) in older Mexican American (MA) men living in Tucson, Arizona. The Mexican origin population is the fastest growing

The purpose of this phenomenological study was to explore the cultural, social, environmental, and gender factors that may influence physical activity (PA) in older Mexican American (MA) men living in Tucson, Arizona. The Mexican origin population is the fastest growing Hispanic subgroup in our nation, increasing from 20.6 million in the year 2000 to 31.8 million in 2010. Arizona has the sixth largest Hispanic population in the United States and the Mexican origin population accounts for 91% of Arizona's Hispanics. Despite the fast growing Mexican population, there are a limited number of studies that examine MAs and PA. There are even fewer interventions created to foster PA among older (≥65 years old) MA men. Fourteen individual interviews were conducted with older MA men living in Tucson, Arizona. Data was collected, organized, and analyzed according to the methodologies of Clark Moustakas and the Social Ecology Model for Health Promotion framework. Six themes emerged which reflected the older MA male's perception of health, masculinity, and physical activity: a) Retirement promotes self-care behaviors, b) Women, health care providers, and the Internet are important in promoting health, c) Aging changes physical activity, d) I take care of myself, e) Physical activity is a personal choice and lifestyle, and f) I learn and make adjustments as needed. Themes were used to create textural and structural descriptions of their experiences. Descriptions were formed into the essence of the phenomenon. The results of this study increase our understanding of health, masculinity, and physical activity in older MA men. This research will inform the development of an evidence-based PA intervention to promote cardiovascular (CV) health in older MA men that may be implemented in a variety of community-based settings.

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Date Created
2015

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A Cross-Sectional Examination of the Relationship Between Trait Mindfulness, Behavioral Regulation Toward Exercise, Exercise Intention, Perceived Stress, and Physical Activity in University Undergraduates

Description

Physical inactivity is a continuing public health crisis because of its negative effects on health (e.g. hypertension, cardiovascular disease, type II diabetes). To combat the rising prevalence of these non-communicable diseases, physical activity (PA) promotion is a public health priority.

Physical inactivity is a continuing public health crisis because of its negative effects on health (e.g. hypertension, cardiovascular disease, type II diabetes). To combat the rising prevalence of these non-communicable diseases, physical activity (PA) promotion is a public health priority. However, current programs seem to be ineffective in the long-term promotion of PA. Resultingly new, effective interventions are needed. Recent studies have established a link between mindfulness and PA engagement. Based on the current literature, the present study sought to investigate the associations between trait mindfulness, behavioral regulation towards exercise, exercise intention, stress, and self-reported PA. This study also examined whether trait mindfulness was independently associated with meeting weekly, leisure-time, moderate-to-vigorous PA [MVPA] recommendations in university undergraduate students after controlling for demographic characteristics, past PA experience, exercise intention, stress, and motivation.

The study used a cross-sectional design and participants consisted of 180 undergraduate university students (aged 18 to 24 years). Participants completed a one-time survey that assessed demographic characteristics, trait mindfulness, behavioral regulation toward exercise, exercise intention, perceived stress and PA. Bivariate associations between the variables were assessed with Pearson or Spearman correlations. A logistic regression analysis was conducted to determine which variables were independently associated with meeting weekly, leisure-time MVPA guidelines. Results of this study found weak positive associations between the mindfulness domain of acceptance and leisure time MVPA ( = .168, p < .05), no associations between mindfulness and transportation PA, and negative associations between mindfulness (MAAS,  = –.238, p < .01; acceptance,  = –.175, p < .05) and sitting time. Results of logistic regression found that only relative autonomy (OR = 1.085, 95% CI [1.008, 1.168], p = .030) and intention (OR = 2.193, 95% CI [1.533, 3.138], p < .0001) were independently associated with meeting weekly, leisure- time MVPA recommendations. The results of this study show that while there is only a weak direct relationship between trait mindfulness and PA, mindfulness may be related with other factors associated with PA. More research is needed in order to better understand the potential mechanisms behind the results found in this, and past, studies.

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2019

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Implementing the Exercise is MedicineTM solution: a process evaluation conducted in a university-based healthcare system

Description

Background: Exercise is Medicine (EIM) is a health promotion strategy for addressing physical inactivity in healthcare. However, it is unknown how to successfully implement the processes.

Purpose: The purpose of this study was to understand how implementing EIM influenced provider

Background: Exercise is Medicine (EIM) is a health promotion strategy for addressing physical inactivity in healthcare. However, it is unknown how to successfully implement the processes.

Purpose: The purpose of this study was to understand how implementing EIM influenced provider behaviors in a university-based healthcare system, using a process evaluation.

Methods: A multiple baseline, time series design was used. Providers were allocated to three groups. Group 1 (n=11) was exposed to an electronic medical record (EMR) systems change, EIM-related resources, and EIM training session. Group 2 (n=5) received the EMR change and resources but no training. Group 3 (n=6) was only exposed to the systems change. The study was conducted across three phases. Outcomes included asking about patient physical activity (PA) as a vital sign (PAVS), prescribing PA (ExRx), and providing PA resources or referrals. Patient surveys and EMR data were examined. Time series analysis, chi-square, and logistic regression were used.

Results: Patient survey data revealed the systems change increased patient reports of being asked about PA, χ2(4) = 95.47, p < .001 for all groups. There was a significant effect of training and resource dissemination on patients receiving PA advice, χ2(4) = 36.25, p < .001. Patients receiving PA advice was greater during phase 2 (OR = 4.7, 95% CI = 2.0-11.0) and phase 3 (OR = 2.9, 95% CI = 1.2-7.4). Increases were also observed in EMR data for PAVS, χ2(2) = 29.27, p <. 001 during implementation for all groups. Increases in PA advice χ2(2) = 140.90, p < .001 occurred among trained providers only. No statistically significant change was observed for ExRx, PA resources or PA referrals. However, visual analysis showed an upwards trend among trained providers.

Conclusions: An EMR systems change is effective for increasing the collection of the PAVS. Training and resources may influence provider behavior but training alone increased provider documentation. The low levels of documented outcomes for PA advice, ExRx, resources, or referrals may be due to the limitations of the EMR system. This approach was effective for examining the EIM Solution and scaled-up, longer trials may yield more robust results.

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2019