Development of an exercise self-efficacy questionnaire for older Mexican American women

The purpose of this study was to develop a reliable and culturally meaningful exercise self-efficacy questionnaire for older Mexican American women. Items were derived from a 5-item exercise self-efficacy instrument (Laffrey, 2000; Marcus, Selby, Niaura, & Rossi, 1992) and from focus groups with women in the target population. Content validity of the Spanish-language items was supported by three Mexican American professional women and by five Mexican American nurses. A factor analysis of the 11-item questionnaire revealed one major factor. Internal consistency was shown by an alpha reliability coefficient of .86. Item:corrected scale correlation coefficients ranged from .30 to .70. The mean exercise self-efficacy score was significantly higher for 38 regular exercisers than for 37 non-exercisers. The exercise self-efficacy questionnaire can be used in research with older Mexican American women and should be tested with men and with younger men and women to explore its usefulness with these populations.     

Effect of Changes in Weight-Bearing Exercise on Lumbar Bone Mass after Age Fifty

This two year longitudinal study of 40 healthy subjects over age fifty (27 exercisers, 13 non-exercisers) was designed to evaluate the impact of weight-bearing exercise on lumbar bone mineral density as assessed by quantitative computed tomography. In both males and females exercising at moderate levels, a high correlation was found between changes in exercise and changes in bone density (r = 0.78 and 0.91, respectively P < 0.002). For extreme levels of exercise (>300 min/week in females over age fifty, and >200 min/week in males over age seventy) bone density was low, confirming earlier cross-sectional results. Subjects without change in their exercise levels and non-exercisers lost similar amounts of bone. Increasing body mass index was identified as a protective factor with regard to lumbar bone loss. We conclude that in exercisers continuation of weight-bearing exercise is mandatory to prevent excessive bone loss. Extreme levels of exercise may be detrimental to bone density in subjects over age fifty years.     

The role of exercise in the African-American woman with type 2 diabetes mellitus: application of the health belief model

PURPOSE: To determine whether aging African-American women with a diagnosis of type 2 diabetes mellitus who maintain a regular exercise regimen possess different health beliefs and benefit from greater glycemic control than those who do not exercise regularly. DATA SOURCES: A 32-item health belief model diabetes scale was administered to a convenience sample of 31 African-American women with type 2 diabetes. CONCLUSIONS: A group t-test identified statistically significant differences between "exercisers" and "non-exercisers" in perceived benefits and barriers to exercise and glycemic control. IMPLICATIONS FOR PRACTICE: Findings may be utilized in the development of diabetic educational programs and compliance-enhancing treatment interventions that focus on the barriers and benefits of diabetes self-management.     

Effect of changes in weight-bearing exercise on lumbar bone mass after age fifty

This two year longitudinal study of 40 healthy subjects over age fifty (27 exercisers, 13 non-exercisers) was designed to evaluate the impact of weight-bearing exercise on lumbar bone mineral density as assessed by quantitative computed tomography. In both males and females exercising at moderate levels, a high correlation was found between changes in exercise and changes in bone density (r = 0.78 and 0.91, respectively P less than 0.002). For extreme levels of exercise (greater than 300 min/week in females over age fifty, and greater than 200 min/week in males over age seventy) bone density was low, confirming earlier cross-sectional results. Subjects without change in their exercise levels and non-exercisers lost similar amounts of bone. Increasing body mass index was identified as a protective factor with regard to lumbar bone loss. We conclude that in exercisers continuation of weight-bearing exercise is mandatory to prevent excessive bone loss. Extreme levels of exercise may be detrimental to bone density in subjects over age fifty years.     

Lifelong physical activity patterns of sedentary Mexican American women

Increasing physical activity, especially for high-risk groups, is a national priority; yet little is known about the lifelong patterns of physical activity of older Mexican American women. This article describes Mexican American women's current sedentary status by reviewing their physical activity history. Interventions aimed at promoting health in older adults require an understanding of the impact of prior experiences on current health behaviors. Thus, in-depth semistructured interviews were conducted with 71 Mexican American women (aged 50 years or older) recruited from local churches and senior centers. Household, occupational, and leisure activities from age 15 years to present time were reviewed. A lifelong pattern of low occupational and leisure activity and low to moderate household activity were found, with sedentary occupations and no leisure activities predominating. Most believed that current household, occupational and leisure activities provide enough physical activity, thus influencing participation in exercise programs or activities. Attempts to increase physical activity for this group need to begin by teaching them age-appropriate and culturally acceptable physical activities.     

Body esteem and mood among sedentary and active breast cancer survivors

OBJECTIVES: To assess mood states and body esteem in 2 groups of breast cancer survivors, regular exercisers and sedentary women, and to examine these variables among younger and older women in each group. PATIENTS AND METHODS: Between 1998 and 2002, we conducted a cross-sectional study among early-stage breast cancer survivors at the Miriam Hospital in Providence, RI, comparing 40 women who reported regular exercise with 79 sedentary women. We used multivariate and univariate analyses to compare the exercisers with sedentary women on fitness, physical activity, and questionnaire measures of body esteem and mood. Analyses were repeated after the 2 groups were subdivided by age (< 50 years vs > or = 50 years). RESULTS: Regular exercisers (mean +/- SD age, 54.57 +/- 9.18 years) reported significantly more positive attitudes toward their physical condition and sexual attractiveness; significantly less confusion, fatigue, depression, and total mood disturbance; and higher vigor than sedentary women (mean +/- SD age, 52.33 +/- 9.11 years). Both younger and older exercisers had higher physical condition scores than their sedentary peers. Older exercisers reported higher vigor and less confusion, anger, fatigue, depression, and total mood disturbance than sedentary women, regardless of age. Younger exercisers reported higher vigor than their sedentary peers and less confusion than older sedentary women. CONCLUSIONS: In this largely white sample of well-educated women, breast cancer survivors who exercised (particularly older women) reported higher body esteem and better mood than sedentary breast cancer survivors.     

Exercise Adoption Among Older,Low‐Income Women at Risk for Cardiovascular Disease

ABSTRACT Using an expanded Social Cognitive Theory (SCT) model, we hypothesized that self‐efficacy, outcome expectations, and exercise self‐definition would predict exercise adoption. This secondary analysis examined data from a prospective single‐group study of low‐income women who received a physician screen and referral to a community‐based, free exercise program. The sample included 190 older, low‐income women with a mean age of 64 years, the majority of whom were African American (66%) and had at least one cardiovascular risk factor (92%). Baseline values of self‐efficacy, outcome expectations, and exercise self‐definition were measured using instruments developed for the study. Exercise adoption was defined as the number of exercise sessions completed over 8 weeks. Our hypothesis was tested using hierarchical multiple regression. The mean number of exercise sessions completed over the 8‐week period was 5.7 out of a recommended 24. Value of Exercise scores, a subscale of the Exercise Self‐Definition scale, predicted exercise adoption. Self‐efficacy and outcome expectations were not predictive. The significance of Value of Exercise scores reinforces the importance of expanding SCT with additional variables such as exercise self‐definition. Future work should emphasize the social and environmental factors that form an important part of SCT.     

Physiological complexity of gait between regular and non-exercisers with Parkinson's disease

BackgroundPhysiological complexity represents overall health of a system and its underlying capacity to adapt to stresses. The primary purpose of this study was to determine if physiological complexity of gait both ON and OFF anti-Parkinson medication differed between regular and non-exercisers with Parkinson's disease.MethodsTwenty participants with idiopathic Parkinson's disease were enrolled in this cross-sectional study (regular exercisers n = 10, non-exercisers n = 10). Two data collection sessions were completed during a single visit, first after a 12-hour overnight withdrawal from anti-Parkinson medications (OFF), and again one-hour after taking anti-Parkinson medications (ON). During each session participants completed a 2-minute walking task at their preferred pace while wearing wireless inertial measurement units on each lower extremity segment (thigh, shank, foot). Multivariate multiscale entropy was calculated from the tri-axial accelerometer signals and converted to a complexity index for analysis.FindingsRegular exercisers demonstrated significantly higher complexity indices ON and OFF anti-Parkinson medications compared to non-exercisers (ON F = 3.84 P = 0.02; OFF F = 3.61, P < 0.03). Regular exercisers did not significantly differ in complexity between OFF and ON states (most affected leg F = 0.15 P = 0.71; least affected leg F = 0.30 P = 0.60), but non-exercisers demonstrated significantly decreased complexity in the least affected leg OFF anti-Parkinson medications (F = 5.17 P < 0.04).InterpretationEnhanced gait complexity in the regular exercisers may indicate that ongoing exercise is a key ingredient contributing to health in persons with Parkinson's disease. Exercising on a regular basis with Parkinson's disease may augment one's ability to adapt to barriers encountered during gait regardless of medication state.     

Exercise for Fall Risk Reduction in Community-Dwelling Older Adults: A Systematic Review

Purpose:

To evaluate the influence of exercise on falls and fall risk reduction in community-dwelling older adults and to present an updated synthesis of outcome measures for the assessment of fall risk in community-dwelling older adults.

Method:

A systematic review was performed, considering English-language articles published from 2000 to 2006 and accessible through MEDLINE, CINAHL, PEDro, EMBASE, and/or AMED. Included were randomized controlled clinical trials (RCTs) that used an exercise or physical activity intervention and involved participants over age 50. Screening and methodological quality for internal validity were conducted by two independent reviewers.

Results:

The search retrieved 156 abstracts; 22 articles met the internal validity criteria. Both individualized and group exercise programmes were found to be effective in reducing falls and fall risk. The optimal type, frequency, and dose of exercise to achieve a positive effect have not been determined. A variety of outcome measures have been used to measure fall risk, especially for balance.

Conclusions:

Falls and fall risk can be reduced with exercise interventions in the community-dwelling elderly, although the most effective exercise variables are unknown. Future studies in populations with comorbidities known to increase fall risk will help determine optimal, condition-specific fall-prevention programmes. Poor balance is a key risk factor for falls; therefore, the best measure of this variable should be selected when evaluating patients at risk of falling.     

Self-reported exercise behavior and interpretations of exercise in older adults

Prior exercise experiences may influence interpretations of exercise, ultimately affecting exercise behavior. This study examines differences in interpretations of exercise in older adults based on prior exercise behavior. Older adults who report more exercise behavior were hypothesized to score more positively on measures of interpretations of exercise than older adults reporting less exercise behavior. Two hundred fifteen older adults reported prior-year exercise behavior, and within a 2-week exercise training program reported their episode-specific and general interpretations of exercise. High exercisers reported higher perceptions of energy (p = .021), life enhancement (p = .023), and overall psychological outlook (p = .003) than low exercisers. Several gender differences were also noted. These results support earlier findings that older adults' beliefs and interpretations of exercise activity influence exercise behavior.     

Factors influencing participation of African American elders in exercise behavior

This study was designed to examine factors influencing exercise behavior of older African American adults. Using the Transtheoretical Stages of Change Model and focus group methodology, 103 participants were assigned to gender and stage specific groups of 5 to 12 each. The focus group discussion guide was developed to explore the meaning of health and exercise, and factors that influence exercise behavior for each stage of the model. Responses varied by stage and gender. Men and women alike described health as the ability to remain active and participate in desired activities. The meaning of exercise varied, by stage, from the ability to perform household chores to engaging in aerobic activities. Many factors such as health, social support, efficacy, and motivation influenced the desire and ability to exercise. Women were more likely than men to identify family responsibility as a barrier to participation in exercise activities. Participants identified strategies to recruit and retain African American elders in exercise programs. Findings of the study have implications for health professionals designing exercise health promotion programs for older African American adults in community settings.     

A Randomized Clinical Trial of Aquatic versus Land Exercise to Improve Balance, Function, and Quality of Life in Older Women with Osteoporosis

Purpose:

Despite the decreased gravitational loading that is experienced in an aquatic environment, little research has been conducted on this exercise medium for women with osteoporosis (OP). Aquatic exercise (AE) may improve function and balance, thus ultimately decreasing fall risk and the potential for hip fractures in this high-risk population.

Method:

A total of 68 women with OP, aged 60 years or older, were recruited into a randomized clinical trial evaluating the impact of AE, land exercise (LE), and no exercise (NE) on balance, functional mobility, and quality of life (QOL).

Results:

Only one balance measure (backward tandem walk) significantly improved with AE compared to LE, but this did not translate into a greater improvement in self-report function. There were no significant differences between the exercise interventions and NE, except for in ratings of global change, where participants in the AE group were three times more likely to report improvement than those in the NE group.

Conclusion:

There were no differences in balance, function, or QOL in women with OP who followed an AE or LE programme compared to those in an NE control group. However, the significant differences in backward tandem walk between the AE and LE groups and self-reported global change between the AE and NE groups warrant further investigation. Significant improvements in balance and global change suggest that AE is a viable alternative for older women with OP who have difficulty exercising on land.     

Exercise and balance in aged women: a pilot controlled clinical trial

A pilot controlled trial was conducted to determine the feasibility of testing an exercise program as a means of improving balance in aged women. A random sample of 50 women more than 65 years old was recruited from two apartment buildings. The buildings were randomized to serve as exercise and control sites. The 24 exercisers did not differ significantly from the 26 controls except that they were better educated and had better vision. The median compliance was 85% of requested sessions attended by the exercisers. Follow-up measures were obtained in 92% and 81% of the exercise and control groups, respectively. The outcome variables studied were changes in sway (areas and velocity of the center of force as measured using a biomechanics platform) in four stances with eyes open or closed, on two feet, or on one foot. After 16 weeks, in stances on one foot, exercisers had smaller areas compared to controls with eyes open, but larger areas with eyes closed. Subgroup analysis indicated that compliance with the exercise program was a determinant of degree of change in the area measures. The inconsistent effect of exercise on area measures of sway in this study may be due to (a) lack of statistical power to detect between-group differences, (b) inadequate compliance with the exercise program, (c) baseline differences between the two groups at randomization, and (d) ineffective or inadequate duration of the exercise program. We conclude that controlled clinical trials to study the effect of exercise on balance measures in community-dwelling elderly women are feasible.(ABSTRACT TRUNCATED AT 250 WORDS)     

Physical activity among older Mexican American women

Theories of stage of readiness for change and self-efficacy guided this investigation of (a) performance of habitual physical activity (daily activity and leisure/sport activity), (b) preference for leisure Physical activities, and (c) relationships of age, stage of readiness for exercise, and exercise self-efficacy with habitual physical activity. The sample consisted of 71 community-residing Mexican American women aged 60-87 years. Fifty-six women reported performing at least one leisure/sport activity; the most frequent was walking, reported by 47 women. Fifty-three women stated that walking was their preferred leisure activity. Age, self-efficacy, and stage of readiness accounted for 27% of the variance in daily activity and 32% of the variance in leisure/sport activity. These findings suggest that stage of readiness for change and self-efficacy theories are useful for this population.     

Effects of two frequencies of walking on cardiovascular risk factor reduction in Mexican American women.

The beneficial effects of moderate-intensity exercise on cardiorespiratory fitness and body composition are well documented, with the greatest health benefits reported in sedentary individuals who engage in moderate levels of exercise. The published literature contains no quantification of the threshold of lower limits of beneficial exercise or estimates of benefits derived from lower exercise levels. The specific aim of this study was to compare the effects of two walking frequencies, holding intensity and duration constant, on blood lipids, body composition, and exercise maintenance regimens of Mexican American women. A quasi-experimental design, with two treatment groups and one comparison group, was used to explore the dose-response effects of low-intensity exercise on cardiovascular outcomes. Significant interactions were found between walking and total serum cholesterol and skin-fold sums. This study demonstrated the clinical efficacy of a low-intensity exercise regimen on cardiovascular risk factors and exercise adherence.     

太极拳运动对中老年人心理和自主神经功能的影响

目的 了解太极拳运动对中老年人心理、自主神经的影响，以推动太极拳运动的开展。方法 随机抽取中老年太极拳练习者207人，非练拳者166人，采用Zung焦虑自我评定量表(Zung Self-rating Anxiety Scale，Zung-SAS)和Zung抑郁症自我评定量表(Zung Self-rating Depression Scale，Zung-SDS)及自主神经平衡指数进行调查。结果练拳组SAS及SDS评分与对照组比较有显著差异，练拳组的自主神经平衡状况优于对照组；在SAS、SDS评分和自主神经平衡状态方面，练拳组内部无性别差异；练拳时间越长，自主神经平衡状态越好。结论 开展太极拳运动对中老年人的心理和自主神经功能有积极作用。     

Effects of Chinese fitness dancing on lower limb strength and fall risk in middle-aged and older women: A cross-sectional study

This study sought to identify the effect of Chinese fitness dancing on lower limb strength and fall risk in middle-aged and older women. The MicroFET3 portable muscle strength tester, the FreeStep test system, and tests to evaluate fall risk were used to measure the maximum muscle strength, fall risk index, and static balance ability of extensor muscle groups in the lower limbs. Compared with the irregular exercise group, the maximum muscle strength of extensor muscle groups in the lower limb, five sit-to-stand test timings, fall risk index, static balance ability, and lower limb flexibility did not improve significantly in the 1-year regular exercise group (p > 0.01). However, these indicators were significantly improved in the 10-year regular exercise group compared with the 1-year regular exercise group (p < 0.01). Long-term regular participation in Chinese fitness dancing significantly increased muscle strength in the lower limbs and effectively lowered the fall risk index in middle-aged and older women. Thus, long-term regular participation in Chinese fitness dancing can be used as a preventive measure to increase muscle strength in the lower limbs and reduce the risk of falls in middle-aged and older women.