Background and Intensity of the GALM Physical activity Program

Background: The Groningen Active Living Model (GALM) was developed to stimulate physical activity in sedentary and underactive older adults. The GALM physical activity program was primarily based on an evolutionary–biological play theory and insights from social cognitive theory. The purpose of this study was to assess the intensity of the GALM program. Methods: Data from 15 GALM sessions were obtained by means of heart rate monitors. Results: Data of 97 program participants (mean age: 60.1 y) were analyzed. The overall mean intensity for the GALM program was 73.7% of the predicted heart rate maximum and 6% of the monitored heart rate time could be classified as light, 33% as moderate and 61% as hard. Conclusions: The GALM program met the intensity guidelines to increase cardiorespiratory fitness. The intensity and attractiveness of this physical activity program make it an interesting alternative for stimulating physical activity in sedentary and underactive older adults

The effects of a moderate physical activity intervention on physical fitness and cognition in healthy elderly with low levels of physical activity: a randomized controlled trial

Background Increasing physical activity is one of the most promising and challenging interventions to delay or prevent cognitive decline and dementia. Methods We conducted a randomized controlled trial to assess the effects of a physical activity intervention, aimed at increasing step count, in elderly with low levels of physical activity on measures of strength, balance, aerobic capacity, and cognition. Participants were assigned to 9 months of exercise counseling or active control. Results The intention-to-treat analyses show that the intervention, compared to control, increases the level of physical activity, but has no significant effect on physical fitness and cognition. Those who increased their physical activity with 35% or more show significant improvements in aerobic capacity, gait speed, verbal memory, executive functioning, and global cognition, compared to those who did not achieve a 35% increase. Limitations The number of participants that achieved the intended improvement was lower than expected. Conclusion Responder analyses suggest an improvement of physical fitness and cognition in those who achieved an increase in physical activity of at least 35%

Supplementary Material for: Physical Activity Recommendations in Patients with Chronic Obstructive Pulmonary Disease

Background: Physical activity recommendations are hardly studied in patients with chronic obstructive pulmonary disease (COPD), and specifically recommendations that are individualized to a patient's aerobic fitness level are not studied. Objectives: To compare individualized (relative) and nonindividualized (absolute) physical activity recommendations in patients with COPD and to assess whether there are differences between patients with mild to moderate and (very) severe COPD. Methods: We compared 7 different physical activity recommendations that were described in the literature. Four recommendations were individualized based on the patient's aerobic fitness level measured by a maximal cycle ergometer test. Three recommendations were nonindividualized. The recommendations were measured with an accelerometer, pedometer or questionnaire in 115 patients with mild to very severe COPD (68% male, mean age 65 years, mean FEV1 58% predicted). Results: The percentage of patients that met the different recommendations ranged from 22 to 86% and only 8 patients met all 7 recommendations. The agreement between the different recommendations was poor (intraclass correlation coefficient, 0.28). Individualizing the recommendations resulted in a higher number of patients with severe or very severe COPD meeting the individualized recommendations compared to the nonindividualized recommendations. In contrast, patients with mild to moderate COPD less frequently met the individualized recommendations. Conclusions: Our study showed that applying various physical activity recommendations with small differences in frequency, intensity or time led to large differences in the classification of patients with COPD into being sufficiently physically active or not. Consequently, the used recommendation will highly affect the proposed physical activity advice to the patient

Low Physical Activity and Risk of Cardiovascular and All-Cause Mortality in Renal Transplant Recipients

Background and objectives Low physical activity (PA) is a risk factor for mortality in the general population. This is largely unexplored in renal transplant recipients (RTRs). We studied whether PA is associated with cardiovascular and all-cause mortality in a prospective cohort of RTR. Design, setting, participants, & measurements Between 2001 and 2003, 540 RTRs were studied (age, 51 12 years; 54% male). PA was assessed using validated questionnaires (Tecumseh Occupational Activity Questionnaire and the Minnesota Leisure Time Physical Activity Questionnaire). Cardiovascular and all-cause mortality were recorded until August 2007. Results Independent of age, PA was inversely associated with metabolic syndrome, history of cardiovascular disease, fasting insulin, and triglyceride concentration, and positively associated with kidney function and 24-hour urinary creatinine excretion (i.e., muscle mass). During follow-up for 5.3 years (range, 4.7 to 5.7 years), 81 RTRs died, with 37 cardiovascular deaths. Cardiovascular mortality was 11.7, 7.2, and 1.7%, respectively, according to gender-stratified tertiles of PA (P = 0.001). All-cause mortality was 24.4, 15.0, and 5.6% according to these tertiles (P < 0.001). In Cox regression analyses, adjustment for potential confounders including history of cardiovascular disease, muscle mass, and traditional risk factors for cardiovascular disease did not materially change these associations. Conclusions Low PA is strongly associated with increased risk for cardiovascular and all-cause mortality in RTRs. Intervention studies are necessary to investigate whether PA improves long-term survival after renal transplantation. Clin J Am Soc Nephrol 6: 898-905, 2011. doi: 10.2215/CJN.03340410