Correlates of 15-Year Maintenance of Physical Activity in Middle-Aged Women

Background

Interventions to increase sustained physical activity are needed and should be based on proven theories.

Purpose

To gain a better understanding of the correlates of sustained physical activity in midlife women, we used longitudinal epidemiologic data to investigate links between sustained physical activity and constructs advocated by three basic behavioral and social science theories: (1) self-determination, (2) social cognitive, and (3) social networks. A random sample of 90 midlife women, stratified by level of physical activity over 15 years, was selected from the Chicago cohort of the Longitudinal Study of Women’s Health Across the Nation (SWAN).

Methods

Using data on self-reported physical activity collected over 15 years, women were categorized into consistently active, sporadically active, and sedentary. New data were collected on theory-relevant constructs, i.e., autonomous motivation (assessed by the Treatment Self-Regulation Questionnaire) and self-efficacy (assessed by the Self-Efficacy and Exercise Habits Survey). Every SWAN woman identified a close female friend who also completed the physical activity questionnaire.

Results

SWAN women with higher autonomous motivation (p?=?0.002) and higher self-efficacy (p?<?0.001) were more likely to be consistently physically active in analyses adjusted for age, race, and socioeconomic status. Sixty-one percent of SWAN women with a history of consistent physical activity had a friend who is currently highly active, versus 38 and 23 % for sporadically active and sedentary women, respectively (test for trend p?=?0.008).

Conclusion

In midlife women, constructs advocated by basic behavioral and social science theories were consistent with long-term patterns of physical activity behavior. Special focus should be given to these basic theories in the design of interventions to promote sustained physical activity in mid-life women.     

Is Laparoscopic Appendectomy an Effective Procedure ?

Aim: To compare the results of open and laparoscopic appendectomy and to determine if the laparoscopic approach might be more effective for some subgroups of patients.

Material and methods: We retrospectively analysed the computerised data of 326 consecutive adult patients operated on for suspected appendicitis between 2001 and 2005. The series consisted of 166 men and 160 women with a mean age of 32 ± 16 years and a mean Body Mass Index (BMI) of 24 ± 4. There were 265 ASA I, 46 ASA II and 5 ASA III patients. According to the surgeon’s preference, 176 patients had an open appendectomy (OA) and 150 a laparoscopic appendectomy (LA).

Results: The mean operative time and hospital stay were equivalent in the two groups: respectively 49 ± 19 min. and 4.1 ± 2.5 days in OA and 50 ± 16 min. and 3.5 ± 1.8 days in LA. However, subgroup analysis revealed that overweight (BMI > 25) patients (n=102) and patients with ectopic appendices (n=86) had an obvious benefit from LA. In cases of OA, operative time and hospital stay were longer in overweight patients than in normal weight patients: respectively 63 ± 20 min. and 5.3 ± 2.9 days versus 44 ± 16 min. (p < 0.01) and 3.7 ± 2.2 days (p < 0.01). On the contrary, no difference was observed in the lA group. Operative time and hospital stay were also longer in patients with ectopic appendices submitted to OA than in patients with an appendix in the normal position: respectively 60 ± 18 min. and 4.7 ± 2.7 days versus 45 ± 18 min. (p < 0.01) and 3.9 ± 2.4 days (p < 0.01). Again, such a difference was not observed in cases of LA. We noted no mortality, but 24 patients (7%) developed an abdominal complication: 18 wound infections and 6 intra-abdominal abscesses. Wound infections were more common in the OA than in the LA group: 7.3% (13/176) versus 3.3% (5/150) (p = 0.1). In the LA group, 4 wound infections were observed in our early experience, at a time where no endoscopic bag was used for the removal of the appendix. The rate of intra-abdominal abscesses was similar: 1.7% (3/176) in the OA group and 2% (3/150) in the LA group.

Conclusions: LA is an effective procedure with a reduced risk of developing wound infection. The laparoscopic approach is particularly effective for overweight patients and/or patients with ectopic appendices as far as shortening the operative time and hospital stay are concerned.     

Reported thresholds of self-motion perception are influenced by testing paradigm

Journal of Neurology - Different testing paradigms have been proposed to investigate perceptual self-motion thresholds. They can differ regarding the amount of possible motions that patients have...     

Determining clinical practice of expert physiotherapy for patients undergoing lumbar spinal fusion: a cross-sectional survey study

Purpose

To determine the content of current Dutch expert hospital physiotherapy practice for patients undergoing lumbar spinal fusion (LSF), to gain insight into expert-based clinical practice.

Methods

At each hospital where LSF is performed, one expert physiotherapist received an e-mailed questionnaire, about pre- and postoperative physiotherapy and discharge after LSF. The level of uniformity in goals and interventions was graded on a scale from no uniformity (50–60 %) to very strong uniformity (91–100 %).

Results

LSF was performed at 34 of the 67 contacted hospitals. From those 34 hospitals, 28 (82 %) expert physiotherapists completed the survey. Twenty-one percent of the respondents saw patients preoperatively, generally to provide information. Stated postoperative goals and administered interventions focused mainly on performing transfers safely and keeping the patient informed. Outcome measures were scarcely used. There was no uniformity regarding advice on the activities of daily living.

Conclusion

Dutch perioperative expert physiotherapy for patients undergoing LSF is variable and lacks structural outcome assessment. Studies evaluating the effectiveness of best-practice physiotherapy are warranted.