The effects of five weeks of climbing training, on and off the wall, on climbing specific strength, performance, and training experience in female climbers-A randomized controlled trial

Recent research has elucidated the effects of strength training on climbing performance. Although local muscular endurance training of the upper-limbs and finger flexors is frequently suggested, there is currently insufficient evidence to support its impact on climbing performance and climbing-specific strength. Furthermore, there is no evidence on climbers' experiences related to training and the likelihood of consistent engagement. In addition, the effects of more climbing-specific strength training on walls with built in lights and adjustable angles have yet to be examined. The low percentage of studies involving female subjects, additionally, demonstrates a significant gap in understanding the specific effects of strength training on women in the context of climbing. The aim of this study was thus to assess the effects of five-week on-, and off-the-wall climbing training on climbing performance, climbing-specific strength, and training experience. Thirty-one female lower-grade to advanced climbers were randomly assigned to either a control group, an off-the-wall training or an on-the-wall training group. Apart from the training regimen, all groups followed their usual climbing and bouldering routine. Subjects trained at least twice a week. Bouldering performance, and maximum strength and muscular endurance of the finger flexors and upper-limbs were assessed before and after the intervention. Furthermore, rate of perceived exertion and discomfort, exercise enjoyment, and exercise pleasure were assessed during the first and last training session, as well as after two and a half weeks of training. Intrinsic training motivation was assessed after the last training session. The results showed trends towards positive effects of off-the-wall training on climbing-specific strength, and on-the-wall training on climbing technique. Furthermore, our finding revealed high exercise enjoyment and intrinsic training motivation for both on- and off-the-wall training. Hence, lower-grade to advanced female climbers should rely on personal training preferences.

Narrative Review of Sex Differences in Muscle Strength, Endurance, Activation, Size, Fiber Type, and Strength Training Participation Rates, Preferences, Motivations, Injuries, and Neuromuscular Adaptations

ABSTRACT

Nuzzo, JL. Narrative review of sex differences in muscle strength, endurance, activation, size, fiber type, and strength training participation rates, preferences, motivations, injuries, and neuromuscular adaptations. J Strength Cond Res 37(2): 494-536, 2023-Biological sex and its relation with exercise participation and sports performance continue to be discussed. Here, the purpose was to inform such discussions by summarizing the literature on sex differences in numerous strength training-related variables and outcomes-muscle strength and endurance, muscle mass and size, muscle fiber type, muscle twitch forces, and voluntary activation; strength training participation rates, motivations, preferences, and practices; and injuries and changes in muscle size and strength with strength training. Male subjects become notably stronger than female subjects around age 15 years. In adults, sex differences in strength are more pronounced in upper-body than lower-body muscles and in concentric than eccentric contractions. Greater male than female strength is not because of higher voluntary activation but to greater muscle mass and type II fiber areas. Men participate in strength training more frequently than women. Men are motivated more by challenge, competition, social recognition, and a desire to increase muscle size and strength. Men also have greater preference for competitive, high-intensity, and upper-body exercise. Women are motivated more by improved attractiveness, muscle "toning," and body mass management. Women have greater preference for supervised and lower-body exercise. Intrasexual competition, mate selection, and the drive for muscularity are likely fundamental causes of exercise behaviors in men and women. Men and women increase muscle size and strength after weeks of strength training, but women experience greater relative strength improvements depending on age and muscle group. Men exhibit higher strength training injury rates. No sex difference exists in strength loss and muscle soreness after muscle-damaging exercise.

'A Lot of People Just Go for Walks, and Don't Do Anything Else': Older Adults in the UK Are Not Aware of the Strength Component Embedded in the Chief Medical Officers' Physical Activity Guidelines-A Qualitative Study

Strength recommendations have been embedded within the UK's Chief Medical Officers' physical activity guidelines since 2011. In 2019, they were given a more prominent position in the accompanying infographic. However, there is limited evidence that these recommendations have been successful in their population-wide dissemination. This study aimed to explore the engagement of community-dwelling older adults with the guidelines to date and to gain a nuanced understanding of the awareness, knowledge, and action that older adults take to fulfil strength recommendations. A total of fifteen older adults living in the UK participated in one online interview. A general inductive approach was used to generate themes from the data. There were four major themes that were found. 1. The strength component of the physical activity guidelines, 2. Barriers, 3. Motivators, and 4. Solutions. No participants were aware of the strength guidelines. When they were asked what activities they used to fulfil the 'build strength on at least two-days-per-week' criteria, walking, yoga, and Pilates were the most common responses. Ageism and strength training misconceptions were major barriers to participation in strengthening exercise. Older adults were much less aware of the benefits of building strength and strength training participation when compared to aerobic activities, so motivators to participation were generally not specific to strength training. Finally, there are several ways that practitioners can overcome the barriers to strength training participation. Solutions to improving the uptake and adherence to strength training participation are likely to be more successful when they include opportunities for social interaction, ability-appropriate challenge, and provide both short- and long-term benefits.

Motivational Factors and Barriers Towards Initiating and Maintaining Strength Training in Women: a Systematic Review and Meta-synthesis

Strength training (ST) or resistance training is important in the development and maintenance of musculoskeletal and cardiovascular health in women of all ages; however, uptake of ST amongst women is low. To improve female musculoskeletal health, it is vital that more women are encouraged to participate in ST to maintain musculoskeletal integrity. This systematic review aimed to identify motivators and barriers to women initiating and maintaining ST. Following protocol registration and systematic search, studies were included if they were primary qualitative or mixed-method studies reporting participant verbatim quotes, included adult women, and focused on motivators and barriers for ST. Searches generated 2534 articles from 3 databases, with 20 studies (N = 402 participants) meeting eligibility criteria. Participant quotes and authors' interpretations were analysed using thematic synthesis. The most frequently observed barriers were gender-based stigmas, discouragement, and negative comments, particularly in women currently engaging in ST. Other factors associated with poor adherence included boredom, poor knowledge of ST, poor gym accessibility, lack of supervision or routine, and difficulty in balancing work and family life. Social support from friends and family, words of affirmation, and accompaniment facilitated ST, particularly in older women. Women who saw expected results such as weight loss were motivated to continue ST. Interventions aimed at increasing participation in ST amongst women should focus on the specific benefits valued by women and the dissemination of accurate information to counter misconceptions and increase knowledge. The adaptation of gym environments to make them more welcoming to women, and reduce gender-focused criticism, is especially important.

Assessment of muscle-strengthening exercise in public health surveillance for adults: A systematic review

There is strong scientific evidence that muscle-strengthening exercise (i.e. use of weight machines, push-ups, sit-ups) is independently associated with a reduced risk of multiple chronic diseases (e.g. diabetes, hypertension, cardiovascular disease). However, prevalence rates for meeting the muscle-strengthening exercise guideline (≥2 times/week) are significantly lower (~20%) than those reported to meet the aerobic physical activity guideline (e.g. walking, jogging, cycling) (~50%). It is therefore important to understand public health surveillance approaches to assess muscle-strengthening exercise. The aim of this review was to describe muscle-strengthening exercise assessment in public health surveillance. Informed by the PRISMA guidelines, an extensive keyword search was undertaken across 7 electronic data bases. We identified 86,672 possible articles and following screening (n = 1140 in full-text) against specific inclusion criteria (adults aged ≥18 years, English, studies containing <1000 participants), extracted data from 156 manuscripts. Fifty-eight different survey systems were identified across 17 countries. Muscle-strengthening exercise frequency (85.3%), duration (23.7%) and intensity (1.3%) were recorded. Muscle-strengthening exercise questions varied significantly, with some (11.5%) requiring a singular 'yes' vs 'no' response, while others (7.7%) sought specific details (e.g. muscle groups targeted). Assessments of duration and intensity were inconsistent. Very few studies measured the validity (0.6%) and reliability (1.3%) of muscle-strengthening exercise questions. Discrepancy exists within the current assessment systems/surveys used to assess muscle-strengthening exercise in public health surveillance. This is likely to impede efforts to identify at risk groups and trends within physical activity surveillance, and to accurately assess associations between muscle-strengthening exercise and health-related outcomes.

Extension Educators and Volunteer Leaders: Evaluation of Fitness Outcomes Among Participants in Community Strength Training Classes

Volunteer-led strength training classes can expand access, improve exercise adherence, and enhance intervention sustainability for older adults. This study compared participant functional fitness outcomes between volunteer-led and Extension educator-led StrongWomen strength training groups in community settings. Change scores for participants (n = 317) were calculated for six Senior Fitness Test (SFT) measures. A non-parametric analysis of independent samples to determine SFT score differences between participant groups (educator-led and volunteer-led) showed no significant differences. Volunteers and professionals, like Extension educators, may be similarly effective in conducting community-based strength training classes resulting in improved functional fitness outcomes. We offer recommendations for organizations seeking to adopt similar approaches.

Sex Difference in Participation in Muscle-Strengthening Activities

Background

Previous data from the United States Centers for Disease Control and Prevention indicate men are more likely than women to participate in muscle-strengthening activities (e.g., resistance training). However, a recent review by Rhodes et al. concluded there is no reliable sex difference in participation. The purpose of the current paper was to review population-level surveys of participation in muscle-strengthening activities to clarify if a sex difference in participation exists.

Methods

Keyword searches (e.g., "resistance training participation") were performed in PubMed and Google Scholar to identify papers that surveyed a general adult population (N > 1,000) and reported an outcome of the proportion of the population meeting recommendations for "muscle-strengthening activities" (i.e., ≥ 2 times/wk) or participating in resistance training.

Results

Sixteen studies from 6 countries met the inclusion criteria. Irrespective of the measure of participation, population-levels of participation were typically higher in men than women. More men than women met recommendations for muscle-strengthening activities in England (men 34%; women 24%), Finland (men 18.1%; women 16.4%), Northern Ireland (men 25%; women 14%), Scotland (men 30%; women 25%), and the United States (men 34.8%; women 25.8%). For Australia, some studies showed no sex difference in participation, whereas other studies showed greater participation among men.

Conclusion

A sex difference exists in participation in muscle-strengthening activities. Low participation rates in both sexes indicate efforts to encourage participation in men and women are warranted. The results also highlight the need for rigorous definitions of "participation," as the lack of such definitions explains the mixed results reported previously.

Sociodemographic Pattern of Physical Activity in the Northwest of Iran: Results of the Pilot Phase of the Azar Cohort Study

Background:

Sedentary lifestyle plays a key role in the emergence of many noncommunicable diseases. Given the importance of physical activity (PA) in population-based studies, the present study was conducted to investigate the pattern of PA and its correlates in the pilot phase of Azar cohort study.

Methods:

In the pilot phase of Azar cohort study, 1236 individuals aged 35–70 years in Khameneh, a city in East Azarbaijan, Iran, were invited to participate in the study. A total of 952 individuals completed the overall and the PA questionnaire, a response rate of 82%. The PA level was evaluated using the classified PA questionnaire based on the equivalent metabolic activities. The general linear model was used to determine the factors affecting PA.

Results:

The overall mean score of PA was 36.54 (standard deviation = 5.3). In multivariate analysis, after adjustment for sociodemographic variables, total PA score was associated with gender (adjusted β = 0.014, confidence interval [CI] 95% = [0.01–0.82]), occupation (adjusted βs ranged over 0.015–0.059, (CI 95% = 0.01–0.079), level of education (adjusted βs ranged over 0.010–0.018, CI 95% = 0.001–0.026). In other word, sex (mean ranged over 35.49–36.81), educational level (mean ranged over 35.01–36.73) and occupation status (mean ranged over 34.62–39.62) were predictors of PA (all P < 0.05). This variable could also predict 20% of the variance of the PA.

Conclusions:

The current study identifies that gender, occupation and level of education could be factors that influence on PA level in the study population.

Weight management perceptions and clinical practices among gynaecology providers caring for reproductive-aged patients

OBJECTIVE

Research suggests that patient and provider conversations about healthy eating and physical activity behaviours may lead to patients' increased health behaviours, access to dietary and physical activity resources, and weight management. The American College of Obstetrics and Gynecology (ACOG) has a number of weight management intervention options, but it is unclear if providers have conversations about intervention options with their patients who are of reproductive age. The purpose of this work was to evaluate the degree to which gynaecology healthcare providers offer the weight management intervention options as recommended by ACOG.

METHODS

Cross-sectional study of gynaecology providers in Southwest Virginia utilizing an electronic survey to identify weight management perceptions and current clinical practices. Responses were measured using quantitative methods, and agreeability and frequency responses were measured using a 5-point Likert scale.

RESULTS

Twenty-three of the 31 eligible providers (74.2%) completed the survey. Providers acknowledge that patients need weight management discussions and they feel comfortable and are willing to have these discussions. While physical activity recommendations were consistent among providers, they did not reflect the complete physical activity recommendations for Americans. Consistency in dietary recommendations was lacking. Although providers make recommendations for physical activity and/or diet at least sometimes, they rarely utilize other methods of weight management as outlined in the ACOG recommendations, such as referrals to other providers, programmes or medications.

CONCLUSIONS

Areas for improvement in weight management practices include frequency of counselling, consistency in dietary counselling and frequency of utilization of weight loss medications and referrals to ancillary services. These results can be used to aid the development of methods for targeting these deficiencies.

Low Volume, Home-Based Weighted Step Exercise Training Can Improve Lower Limb Muscle Power and Functional Ability in Community-Dwelling Older Women

Stepping exercise can be used as a scalable form of high intensity exercise to enhance important aspects of physical fitness in older populations. The addition of supplementary weights increases the resistive element of stepping, with the potential for training improvements in muscular strength, power, and functional abilities alongside other fitness outcomes. The aim of this study was to evaluate the effects of a low-volume, home-based weighted step exercise programme on muscular strength, power, and functional ability in previously inactive community-dwelling older women. Eleven participants, aged between 65⁻74 years, independently completed a six-week individualised and progressive step exercise training programme wearing a weighted vest. Knee extensor strength, lower limb power output, and physical function using a battery of functional tests were measured at baseline, following a 6-week control period, and again following the 6-week training programme. Following training, lower limb power output improved by 10⁻11% (p < 0.05) and was accompanied by a corresponding 9% (p < 0.01) improvement in stair climb time and 10% (p < 0.01) improvement in normalised stair climbing power, highlighting the beneficial effects of weighted stepping for transferable improvements in functional fitness. The magnitude of observed training improvements suggest that weighted step training has the potential to prolong independence and prevent age-related health conditions such as sarcopenia.

Is strength training associated with mortality benefits? A 15year cohort study of US older adults

BACKGROUND

The relationship between strength training (ST) behavior and mortality remains understudied in large, national samples, although smaller studies have observed that greater amounts of muscle strength are associated with lower risks of death. We aimed to understand the association between meeting ST guidelines and future mortality in an older US adult population.

METHODS

Data were analyzed from the 1997-2001 National Health Interview Survey (NHIS) linked to death certificate data in the National Death Index. The main independent variable was guideline-concordant ST (i.e. twice each week) and dependent variable was all-cause mortality. Covariates identified in the literature and included in our analysis were demographics, past medical history, and other health behaviors (including other physical activity). Given our aim to understand outcomes in older adults, analyses were limited to adults age 65years and older. Multivariate analysis was conducted using multiple logistic regression analysis.

RESULTS

During the study period, 9.6% of NHIS adults age 65 and older (N=30,162) reported doing guideline-concordant ST and 31.6% died. Older adults who reported guideline-concordant ST had 46% lower odds of all-cause mortality than those who did not (adjusted odds ratio: 0.64; 95% CI: 0.57, 0.70; p<0.001). The association between ST and death remained after adjustment for past medical history and health behaviors.

CONCLUSIONS

Although a minority of older US adults met ST recommendations, guideline-concordant ST is significantly associated with decreased overall mortality. All-cause mortality may be significantly reduced through the identification of and engagement in guideline-concordant ST interventions by older adults.

Perceived and objectively measured access to strength-training facilities and strength-training behavior

BACKGROUND

The promotion of strength training is a public health priority. Employing both self-reported and objective assessment of environmental factors is helpful for a better understanding of the environmental influences on strength-training behavior.

PURPOSE

This study aims to investigate the associations of perceived and objectively measured access to strength-training facilities with strength-training behavior.

METHODS

A cross-sectional questionnaire survey targeted 3,000 Japanese adults and 1,051 responded validly. Strength-training behavior, perceived access to facilities, and sociodemographic factors were assessed. Objective access to facilities was calculated using a geographic information system. Logistic regression analyses were conducted.

RESULTS

Perceived good access to the facilities was significantly associated with strength-training behavior, whereas objective access to the facilities was not, even when adjusted for sociodemographic factors and other measures of access to strength-training facilities.

CONCLUSIONS

Perceived access to the facilities may be a stronger predictor of strength-training behavior than objective access.

A comparison of training and physical performance of police students at the start and the end of three-year police education

The purpose was to compare male and female police students exercise and physical performances at the beginning and the end of a 3-year police education. Two hundred thirty-five subjects answered the survey about exercise and 85 subjects (58 men: age = 23.7 ± 2.8 years, body mass = 82.1 ± 7.8 kg, height = 1.83 ± 0.06 m; 27 women: age = 24.9 ± 3.1 years, body mass = 66 ± 8.5 kg, height = 1.70 ± 0.09 m) participated in the 4 physical exercises (bench press, pull-ups, standing long jump, and 3,000-m run). It was found that the priority of maximum strength training increased (p < 0.001), whereas the priority of endurance and sprint training decreased during the 3-year period, with no differences between gender (p ≥ 0.28). The performances in the strength-related physical tests, bench press, and pull-ups also increased in the same period. These changes were the same for both genders. Findings showed a discrepancy between what is reported as necessary physical skills in police work and what actually is trained during the police education. This discrepancy was caused by the large focus upon maximal strength in the physical examination program in the police education.

Is exercise used as medicine? Association of meeting strength training guidelines and functional limitations among older US adults

OBJECTIVE

To determine the association between meeting strength training guidelines (≥2 times per week) and the presence of functional limitations among older adults.

METHODS

This cross-sectional study used data from older adult participants (N=6763) of the National Health Interview Survey conducted in 2011 in the United States.

RESULTS

Overall, 16.1% of older adults reported meeting strength training guidelines. For each of nine functional limitations, those with the limitation were less likely to meet strength training recommendations than those without the limitation. For example, 20.0% of those who reported no difficulty walking one-quarter mile met strength training guidelines, versus only 10.1% of those who reported difficulty (p<.001). In sum, 21.7% of those with no limitations (33.7% of sample) met strength training guidelines, versus only 15.9% of those reporting 1-4 limitations (38.5% of sample) and 9.8% of those reporting 5-9 limitations (27.8% of sample) (p<.001).

CONCLUSION

Strength training is uncommon among older adults and even less common among those who need it the most. The potential for strength training to improve the public's health is therefore substantial, as those who have the most to gain from strength training participate the least.

Sources of strength-training information and strength-training behavior among Japanese older adults

The promotion of strength training is now recognized as an important component of public health initiatives for older adults. To develop successful communication strategies to increase strength-training behavior among older adults, the identification of effective communication channels to reach older adults is necessary. This study aimed to identify the information sources about strength training that were associated with strength-training behaviors among Japanese older adults. The participants were 1144 adults (60-74 years old) randomly sampled from the registry of residential addresses. A cross-sectional questionnaire survey was conducted. The independent variables were sources of strength-training information (healthcare providers, friends, families, radio, television, newspapers, newsletters, posters, books, magazines, booklets, the Internet, lectures, other sources), and the dependent variable was regular strength-training behavior. Logistic regression analysis was used to identify potential relationships. After adjusting for demographic factors and all other information sources, strength-training information from healthcare providers, friends, books and the Internet were positively related to regular strength-training behavior. The findings of the present study contribute to a better understanding of strength-training behavior and the means of successful communication directed at increasing strength training among older adults. The results suggest that healthcare providers, friends, books and the Internet are effective methods of communication for increasing strength-training behaviors among older adults.

Correlates of resistance training in post-treatment breast cancer survivors

PURPOSE

To explore demographic, health, social-cognitive and behavioural correlates of resistance training among post-treatment breast cancer survivors.

METHODS

A sample of 330 post-treatment breast cancer survivors recruited from across Australia completed a mailed questionnaire. A multivariate logistical regression model was used to test associations between independent variables and meeting the resistance training guidelines.

RESULTS

Less than a quarter of the participants were meeting the resistance training guidelines of at least two sessions of resistance training per week. Higher task self-efficacy for resistance training (p < 0.01) and greater goal-setting behaviour (p < 0.05) were identified as significant predictors of meeting the resistance training guidelines, with a one unit increase in task self-efficacy and goal setting, increasing the odds of meeting the resistance training guidelines by a factor of approximately 1.2 (odds ratio (OR) task self-efficacy = 1.23, 95 % confidence interval (CI) = 1.05-1.43; goal-setting OR = 1.20, 95 % CI = 1.04-1.38). No other variables significantly predicted meeting the resistance training guidelines in the multivariate analysis.

CONCLUSIONS

Strategies targeting task self-efficacy and goal-setting behaviours are likely to be important intervention components in resistance training interventions for breast cancer survivors.

IMPLICATIONS FOR CANCER SURVIVORS

The findings of this study will be useful for informing the development of evidence-based interventions aiming to promote resistance training among this group.

Association between lifting weights and metabolic syndrome among U.S. Adults: 1999-2004 National Health and Nutrition Examination Survey

The purpose of this cross-sectional study was to determine the proportion of U.S. adults who participate in the resistance exercise modality of lifting weights (LWs) by demographic characteristics and to investigate the impact of LWs on the prevalence and risk of metabolic syndrome (MetS) in a national representative sample of U.S. adults. The sample (n = 5,618) in this cross-sectional study included adults aged ≥20 years who participated in the 1999-2004 National Health and Nutrition Examination Survey. Approximately twice as many men (11.2%; 95% confidence interval [CI] 9.5, 13.1) reported LWs as women did (6.3%; 95% CI 5.2, 7.6) with non-Hispanic Whites (9.6%; 95% CI 8.1, 11.4) reporting the highest levels and Mexican Americans reporting the lowest levels (5.6%; 95% CI 4.4, 7.2) of engaging in LWs. Additionally, higher levels of socioeconomic status were associated with greater levels of self-reported LWs. MetS prevalence was found to be significantly lower among U.S. adults reporting LWs (24.6%; 95% CI 19.3, 30.9) compared with adults not reporting LWs (37.3%; 95% CI 35.5, 39.2) with associated risk reductions of 58% (p < 0.001) and 37% (p < 0.01) in the unadjusted model and model adjusted for demographic variables, respectively. These findings suggest that LWs may play a role in reducing the prevalence and risk of MetS among U.S. adults. Therefore, exercise professionals should strongly encourage the activity of LWs among adults of all ages to promote metabolic health and focus programs designed to increase the adoption of LWs among the subgroups who report the lowest levels of LWs.

Muscle-strengthening activities and participation among adults in the United States

PURPOSE

To describe those who reported meeting the 2008 Physical Activity Guidelines for Americans (2008 Guidelines) muscle-strengthening standard of 2 or more days per week, including all seven muscle groups, and to assess the type and location of muscle-strengthening activities performed.

METHOD

Data from HealthStyles 2009, a cross-sectional, consumer mail-panel survey, was used for analyses (n = 4,271). The prevalence estimates with 95% confidence intervals of those meeting the 2008 Guidelines standards were calculated. Pairwise t-tests were performed to examine differences between estimates, tests for linear trends were performed among age, education, and body mass index (BMI) groups, and differences and trends were considered statistically significant at p < .05.

RESULTS

Overall, 6.0% of participants reported meeting 2008 Guidelines, and there were no significant differences between sex and racial/ethnic groups. A significant linear increase was noted among education groups, with respondents who reported lower levels of educational attainment having lower levels of participation compared with respondents who reported higher levels of educational attainment. A significant linear decrease was noted among each BMI group, with those classified as underweight/normal reporting higher levels of participation, compared with those classified as obese. Free weights and calisthenics were the most common types of activities; the home was the most common location.

CONCLUSIONS

Few adults reported meeting current muscle-strengthening standards. Future public health efforts to increase participation should use the most frequently reported type and location of muscle-strengthening activities outlined in this study to guide interventions and communication campaigns.

American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise

The purpose of this Position Stand is to provide guidance to professionals who counsel and prescribe individualized exercise to apparently healthy adults of all ages. These recommendations also may apply to adults with certain chronic diseases or disabilities, when appropriately evaluated and advised by a health professional. This document supersedes the 1998 American College of Sports Medicine (ACSM) Position Stand, "The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults." The scientific evidence demonstrating the beneficial effects of exercise is indisputable, and the benefits of exercise far outweigh the risks in most adults. A program of regular exercise that includes cardiorespiratory, resistance, flexibility, and neuromotor exercise training beyond activities of daily living to improve and maintain physical fitness and health is essential for most adults. The ACSM recommends that most adults engage in moderate-intensity cardiorespiratory exercise training for ≥30 min·d on ≥5 d·wk for a total of ≥150 min·wk, vigorous-intensity cardiorespiratory exercise training for ≥20 min·d on ≥3 d·wk (≥75 min·wk), or a combination of moderate- and vigorous-intensity exercise to achieve a total energy expenditure of ≥500-1000 MET·min·wk. On 2-3 d·wk, adults should also perform resistance exercises for each of the major muscle groups, and neuromotor exercise involving balance, agility, and coordination. Crucial to maintaining joint range of movement, completing a series of flexibility exercises for each the major muscle-tendon groups (a total of 60 s per exercise) on ≥2 d·wk is recommended. The exercise program should be modified according to an individual's habitual physical activity, physical function, health status, exercise responses, and stated goals. Adults who are unable or unwilling to meet the exercise targets outlined here still can benefit from engaging in amounts of exercise less than recommended. In addition to exercising regularly, there are health benefits in concurrently reducing total time engaged in sedentary pursuits and also by interspersing frequent, short bouts of standing and physical activity between periods of sedentary activity, even in physically active adults. Behaviorally based exercise interventions, the use of behavior change strategies, supervision by an experienced fitness instructor, and exercise that is pleasant and enjoyable can improve adoption and adherence to prescribed exercise programs. Educating adults about and screening for signs and symptoms of CHD and gradual progression of exercise intensity and volume may reduce the risks of exercise. Consultations with a medical professional and diagnostic exercise testing for CHD are useful when clinically indicated but are not recommended for universal screening to enhance the safety of exercise.

Strength-Training Behavior and Perceived Environment Among Japanese Older Adults

The authors examined the relationship between strength-training behavior and perceived environment in older Japanese adults. An Internet-based survey was conducted of 293 adults age 68.2 ± 2.8 yr. The dependent variable was regular strength-training behavior. The IPAQ environment module, access to facilities for strength training, and home equipment for strength training were environmental factors. Logistic-regression analysis was employed. After demographic variables (gender, age, educational background, household income, body-mass index, self-rated health status, smoking habit, and residential area) were adjusted for, home equipment for strength training (OR = 2.14, 95% CI = 1.50–3.06), access to facilities for strength training (OR = 2.53, 95% CI = 1.32–4.85), and observing active people (OR = 2.20, 95% CI = 1.06–4.58) were positively correlated with regular strength-training behavior. In conclusion, environmental factors associated with strength-training behavior were access to facilities for strength training, having home equipment for strength training, and observing active people.

Motivation of fitness center participants toward resistance training

There is a need to better understand the behavior and sense of motivation of fitness center participants. The purpose of this study was to assess whether or not demographic characteristics and health self-determinism (intrinsic or extrinsic motivation) of fitness center participants were predictive of their levels of resistance training. A cross-sectional design was used; participants were recruited via the Internet to complete an online survey. There were 185 participants (age = 39.1 +/- 11.3 years) in the study. The majority of respondents reported having carried out levels of resistance training that met national health organization recommendations. Regression analysis of the data revealed that health self-determinism predicted quantity of resistance training reported (p = 0.014), whereas demographics did not. Being intrinsically motivated to health self-determinism predicted meeting national resistance training recommendations compared to participants extrinsically motivated (p = 0.007). For those who work with fitness center participants, our findings are useful by identifying participants as a predominantly intrinsically motivated group of people that performs adequate quantities of resistance training; the methodology employed in this study can be used to identify participants in need of increased levels of resistance training and heightened sense of motivation to do so.

Impact of traumatic brain injury on participation in leisure activities

OBJECTIVE

To determine how participation in leisure activities for people with traumatic brain injury (TBI) changes from before injury to 1 year after injury.

DESIGN

Prospective evaluation of leisure participation at 1 year after TBI.

SETTING

Level I trauma center.

PARTICIPANTS

Rehabilitation inpatients (mean age, 35.3 years; 77% male; 77% white) with moderate to severe TBI (N=160).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

Functional Status Examination.

RESULTS

At 1 year after injury, 81% had not returned to preinjury levels of leisure participation. Activities most frequently discontinued included partying, drug and alcohol use, and various sports. The activity most often reported as new after injury was watching television. Of the small fraction who returned to preinjury levels, 70% did so within 4 months of injury. Sixty percent of those who did not return to preinjury levels were moderately to severely bothered by the changes.

CONCLUSIONS

At 1 year after injury, many TBI survivors engage in a reduced number of leisure activities, which are more sedentary and less social, with a substantial fraction dissatisfied with these changes. While discontinuing some activities may be viewed as a positive change, there are few new ones to replace them.

Do as I do: exercise habits of physical therapists, physical therapist assistants, and student physical therapists

BACKGROUND

Physical therapy practitioners are among the many health care professionals who can counsel their patients to address the public health care concern of physical inactivity. Health care providers who are physically active themselves are more likely to counsel patients on the benefits of activity.

OBJECTIVE

The purposes of this study were: (1) to examine the leisure-time physical activity habits of physical therapists, physical therapist assistants, and student physical therapists in the United States using Centers for Disease Control and Prevention and American College of Sports Medicine (CDC-ACSM) recommendations and (2) to compare these habits with those of the general population and other health care professionals.

DESIGN

A cross-sectional survey design was used.

METHODS

There were 2 data sources. A random sample of American Physical Therapy Association members completed an online survey that included questions about physical activity habits worded in same manner as the leisure-time activities section of the 2005 National Health Interview Survey (NHIS). The final study sample comprised 1,238 participants: 923 physical therapists, 210 student physical therapists, and 105 physical therapist assistants. The 2005 NHIS public use data files were the source for the same information about the general US population and for a subset of health care professionals. Rates of participation in vigorous and moderate physical activity were analyzed.

RESULTS

Physical therapists, physical therapist assistants, and student physical therapists exercised at higher rates than adults and health-diagnosing professionals in the 2005 NHIS. Limitations The study may be limited by sampling and response bias.

CONCLUSIONS

This study identified that physical therapists, physical therapist assistants, and student physical therapists are meeting CDC-ACSM physical activity guidelines at higher rates than the US adult population and health-diagnosing professionals. These rates exceed the physical activity targets set for adults in Healthy People 2010.