Walk well:a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol

Background - Walking interventions have been shown to have a positive impact on physical activity (PA) levels, health and wellbeing for adult and older adult populations. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities. This paper will provide details of the Walk Well intervention, designed for adults with intellectual disabilities, and a randomised controlled trial (RCT) to test its effectiveness. Methods/design - This study will adopt a RCT design, with participants allocated to the walking intervention group or a waiting list control group. The intervention consists of three PA consultations (baseline, six weeks and 12 weeks) and an individualised 12 week walking programme. A range of measures will be completed by participants at baseline, post intervention (three months from baseline) and at follow up (three months post intervention and six months from baseline). All outcome measures will be collected by a researcher who will be blinded to the study groups. The primary outcome will be steps walked per day, measured using accelerometers. Secondary outcome measures will include time spent in PA per day (across various intensity levels), time spent in sedentary behaviour per day, quality of life, self-efficacy and anthropometric measures to monitor weight change. Discussion - Since there are currently no published RCTs of walking interventions for adults with intellectual disabilities, this RCT will examine if a walking intervention can successfully increase PA, health and wellbeing of adults with intellectual disabilities

Exploring common stressors in physical education

Daily stressors, or hassles, refer to the everyday environmental demands that constitute a threat or challenge, or exceed an individual’s biological or psychological capacities (Cohen et al., 1995). Increasing evidence suggests that daily stressors have a significant impact on adolescents’ educational outcomes, for example, performance, wellbeing and negative attitudes toward school, however there is limited research examining the concept of common stressors in PE lessons. As early-adolescence is a developmental period associated with decreased engagement in PE, it is important to identify the environmental stressors that may be associated with increased disengagement. The study comprised 54 secondary school students and six PE teachers from five schools in the English Midlands. Semi-structured focus groups were conducted and a thematic analysis was applied to interview transcripts. Three higher order themes were identified from the data: the social environment, the physical and organisational environment, and the performance environment. Common stressors within the social environment included, interpersonal transactions between peers, differences in effort levels during PE, and working outside one’s peer group. Stressors within the physical and organisational environment consisted of, environmental situations within the changing facilities and the availability of activities. Finally, performance environment stressors included, situations involving the difficult acquisition of physical skills, and situations where physical appearance and physical competencies were exposed. The study extends previous findings by identifying potentially threatening and frustrating, environmental demands that have not been identified in the previous literature. The current study is the first to explore the typical stressors that are experienced by students in PE

Abdominal obesity and metabolic syndrome: exercise as medicine?

Background: Metabolic syndrome is defined as a cluster of at least three out of five clinical risk factors: abdominal (visceral) obesity, hypertension, elevated serum triglycerides, low serum high-density lipoprotein (HDL) and insulin resistance. It is estimated to affect over 20% of the global adult population. Abdominal (visceral) obesity is thought to be the predominant risk factor for metabolic syndrome and as predictions estimate that 50% of adults will be classified as obese by 2030 it is likely that metabolic syndrome will be a significant problem for health services and a drain on health economies.Evidence shows that regular and consistent exercise reduces abdominal obesity and results in favourable changes in body composition. It has therefore been suggested that exercise is a medicine in its own right and should be prescribed as such. Purpose of this review: This review provides a summary of the current evidence on the pathophysiology of dysfunctional adipose tissue (adiposopathy). It describes the relationship of adiposopathy to metabolic syndrome and how exercise may mediate these processes, and evaluates current evidence on the clinical efficacy of exercise in the management of abdominal obesity. The review also discusses the type and dose of exercise needed for optimal improvements in health status in relation to the available evidence and considers the difficulty in achieving adherence to exercise programmes. Conclusion: There is moderate evidence supporting the use of programmes of exercise to reverse metabolic syndrome although at present the optimal dose and type of exercise is unknown. The main challenge for health care professionals is how to motivate individuals to participate and adherence to programmes of exercise used prophylactically and as a treatment for metabolic syndrome

FIRE (facilitating implementation of research evidence) : a study protocol

Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS) framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated) affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids

Development and validation of a physical activity monitor for use on a wheelchair

Study design: Keeping physically active is important for people who mobilize using a wheelchair. However, current tools to measure physical activity in the wheelchair are either not validated or limited in their application. The purpose of this study was to develop and validate a monitoring system to measure wheelchair movement.<p></p> Methods: The system developed consisted of a tri-axial accelerometer placed on the wheel of a wheelchair and an analysis algorithm to interpret the acceleration signals. The two accelerometer outputs in the plane of the wheel were used to calculate the angle of the wheel. From this, outcome measures of wheel revolutions, absolute angle and duration of movement were derived and the direction of movement (forwards or backwards) could be distinguished. Concurrent validity was assessed in comparison with video analysis in 14 people with spinal cord injury using their wheelchair on an indoor track and outdoor wheelchair skills course. Validity was assessed using intraclass correlation coefficients (ICC(2,1)) and Bland–Altman plots.<p></p> Results: The monitoring system demonstrated excellent validity for wheel revolutions, absolute angle and duration of movement (ICC(2,1)>0.999, 0.999, 0.981, respectively) in both manual and powered wheelchairs, when the wheelchair was propelled forwards and backwards, and for movements of various durations.<p></p> Conclusion: This study has found this monitoring system to be an accurate and objective tool for measuring detailed information on wheelchair movement and manoeuvring regardless of the propulsion technique, direction and speed

Non-response bias in physical activity trend estimates

© 2009 Craig et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Metabolic risk factors, physical activity and physical fitness in azorean adolescents: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The prevalence of metabolic syndrome has increased over the last few decades in adolescents and has become an important health challenge worldwide. This study analyzed the relationships between metabolic risk factors (MRF) and physical activity (PA) and physical fitness (PF) in a sample of Azorean adolescents.</p> <p>Methods</p> <p>A cross-sectional school-based study was conducted on 417 adolescents (243 girls) aged 15-18 from the Azorean Islands, Portugal. Height, weight, waist circumference, fasting glucose, HDL-cholesterol, triglycerides, and blood pressure were measured. A sum of MRF was computed, and adolescents were classified into three groups: no MRF, one MRF and two or more MRF. PA was assessed by a sealed pedometer. PF was assessed using five tests from the Fitnessgram Test Battery. Dietary intake was obtained using a semi-quantitative food frequency questionnaire.</p> <p>Results</p> <p>Mean daily steps for girls and boys were 7427 ± 2725 and 7916 ± 3936, respectively. Fifty-nine percent of the adolescents showed at least one MRF and 57.6% were under the healthy zone in the 20 m Shuttle Run Test. Ordinal logistic regression analysis showed that after adjusting for sex, body mass index, socio-economic status and adherence to a Mediterranean diet, adolescents who were in the highest quartile of the pedometer step/counts (≥9423 steps/day) and those who achieved the healthy zone in five tests were less likely to have one or more MRF (OR = 0.56;95%CI:0.33-0.95; OR = 0.55;95%CI:0.31-0.98, respectively).</p> <p>Conclusions</p> <p>Daily step counts and PF levels were negatively associated with having one or more MRF among Azorean adolescents. Our findings emphasize the importance of promoting and increasing regular PA and PF to reduce the public health burden of chronic diseases associated with a sedentary lifestyle.</p