128 resultados para group fitness program
Resumo:
BACKGROUND: Understanding how we can prevent childhood obesity in scalable and sustainable ways is imperative. Early RCT interventions focused on the first two years of life have shown promise however, differences in Body Mass Index between intervention and control groups diminish once the interventions cease. Innovative and cost-effective strategies seeking to continue to support parents to engender appropriate energy balance behaviours in young children need to be explored. METHODS/DESIGN: The Infant Feeding Activity and Nutrition Trial (InFANT) Extend Program builds on the early outcomes of the Melbourne InFANT Program. This cluster randomized controlled trial will test the efficacy of an extended (33 versus 15 month) and enhanced (use of web-based materials, and Facebook® engagement), version of the original Melbourne InFANT Program intervention in a new cohort. Outcomes at 36 months of age will be compared against the control group. DISCUSSION: This trial will provide important information regarding capacity and opportunities to maximize early childhood intervention effectiveness over the first three years of life. This study continues to build the evidence base regarding the design of cost-effective, scalable interventions to promote protective energy balance behaviors in early childhood, and in turn, promote improved child weight and health across the life course. TRIAL REGISTRATION: ACTRN12611000386932 . Registered 13 April 2011.
Resumo:
BACKGROUND : The purpose of this study was to determine the efficacy of a clinician referral and exercise program in improving exercise levels and quality of life for men with prostate cancer.
METHODS : This was a multicenter cluster randomized controlled trial in Melbourne, Australia comprising 15 clinicians: 8 clinicians were randomized to refer eligible participants (n = 54) to a 12-week exercise program comprising 2 supervised gym sessions and 1 home-based session per week, and 7 clinicians were randomized to follow usual care (n = 93). The primary outcome was self-reported physical activity; the secondary outcomes were quality of life, anxiety, and symptoms of depression.
RESULTS : A significant intervention effect was observed for vigorous-intensity exercise (effect size: Cohen's d, 0.46; 95% confidence interval [CI], 0.09-0.82; P = .010) but not for combined moderate and vigorous exercise levels (effect size: d, 0.08; 95% CI, −0.28 to 0.45; P = .48). Significant intervention effects were also observed for meeting exercise guidelines (≥150 min/wk; odds ratio, 3.9; 95% CI, 1.9-7.8; P = .002); positive intervention effects were observed in the intervention group for cognitive functioning (effect size: d, 0.34; 95% CI, −0.02 to 0.70; P = .06) and depression symptoms (effect size: d, −0.35; 95% CI, −0.71 to 0.02; P = .06). Eighty percent of participants reported that the clinician's referral influenced their decision to participate in the exercise program.
CONCLUSIONS : The clinician referral and 12-week exercise program significantly improved vigorous exercise levels and had a positive impact on mental health outcomes for men living with prostate cancer. Further research is needed to determine the sustainability of the exercise program and its generalizability to other cancer populations.
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Background
Cardiovascular disease accounts for a large burden of disease, but is amenable to prevention through lifestyle modification. This paper examines patient and practice predictors of referral to a lifestyle modification program (LMP) offered as part of a cluster randomised controlled trial (RCT) of prevention of vascular disease in primary care.
Methods
Data from the intervention arm of a cluster RCT which recruited 36 practices through two rural and three urban primary care organisations were used. In each practice, 160 eligible high risk patients were invited to participate. Practices were randomly allocated to intervention or control groups. Intervention practice staff were trained in screening, motivational interviewing and counselling and encouraged to refer high risk patients to a LMP involving individual and group sessions. Data include patient surveys; clinical audit; practice survey on capacity for preventive care; referral records from the LMP. Predictors of referral were examined using multi-level logistic regression modelling after adjustment for confounding factors.
Results
Of 301 eligible patients, 190 (63.1%) were referred to the LMP. Independent predictors of referral were baseline BMI ≥ 25 (OR 2.87 95%CI:1.10, 7.47), physical inactivity (OR 2.90 95%CI:1.36,6.14), contemplation/preparation/action stage of change for physical activity (OR 2.75 95%CI:1.07, 7.03), rural location (OR 12.50 95%CI:1.43, 109.7) and smaller practice size (1–3 GPs) (OR 16.05 95%CI:2.74, 94.24).
Conclusions
Providing a well-structured evidence-based lifestyle intervention, free of charge to patients, with coordination and support for referral processes resulted in over 60% of participating high risk patients being referred for disease prevention. Contrary to expectations, referrals were more frequent from rural and smaller practices suggesting that these practices may be more ready to engage with these programs.
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Despite active videogames' popularity and ability to increase a player's energy expenditure, research indicates their use sharply declines over time, which limits their utility in promoting physical activity. A frequent criticism is that a player's interest is quickly exhausted. At the preconference of the International Society of Behavioral Nutrition and Physical Activity 2014, a group of investigators and videogame developers gathered to share lessons learned from using serious videogames in health behavior change and offer insight to guide future efforts.
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Over the past decade, several Australian universities have offered a double degree in nursing and paramedicine. Mainstream employment models that facilitate integrated graduate practice in both nursing and paramedicine are currently lacking. The aim of the present study was to detail the development of the Interprofessional Graduate Program (IPG), the industrial and professional issues that required solutions, outcomes from the first pilot IPG group and future directions. The IPG was an 18-month program during which participants rotated between graduate nursing experience in emergency nursing at Northern Health, Melbourne, Australia and graduate paramedic experience with Ambulance Victoria. The first IPG with 10 participants ran from January 2011 to August 2012. A survey completed by nine of the 10 participants in March 2014 showed that all nine participants nominated Ambulance Victoria as their main employer and five participants were working casual shifts in nursing. Alternative graduate programs that span two health disciplines are feasible but hampered by rigid industrial relations structures and professional ideologies. Despite a 'purpose built' graduate program that spanned two disciplines, traditional organisational structures still hamper double-degree graduates using all of skills to full capacity, and force the selection of one dominant profession.
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Numerous studies have identified a positive association between fundamental movement skill (FMS) competency and physical activity in children; however, the causal pathways have not been established. The aim of this study is to determine if changes in FMS competency mediated the effect of the Supporting Children's Outcomes using Rewards, Exercise and Skills (SCORES) intervention on physical activity and cardiorespiratory fitness in children. Eight primary schools (25 classes) and 460 children (aged 8.5 ± 0.6, 54% girls) were randomised to the SCORES intervention or control group for the 12-month study. The outcomes were accelerometer-determined moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness. The hypothesised mediators were actual FMS competency and perceived sport competence. Mediation analyses were conducted using multilevel linear analysis in MPlus. From the original sample, 138 (30.0%) and 370 (80.4%) children provided useable physical activity and cardiorespiratory fitness data at post-test assessments. There were significant treatment effects for locomotor skills and overall FMSs. Changes in MVPA were associated with changes in object-control skills, overall FMSs and perceived competence. The overall FMSs had a significant mediating effect on MVPA (AB = 2.09, CI = 0.01-4.55). Overall FMSs (AB = 1.19, CI = 0.002-2.79) and locomotor skills (AB = 0.74, CI = 0.01-1.69) had a significant mediating effect on cardiorespiratory fitness. The results of this study conclude that actual but not perceived movement skill competency mediated the effect of the SCORES intervention on physical activity and cardiorespiratory fitness.
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BACKGROUND: The prevention and treatment of childhood obesity is a key public health challenge. However, certain groups within populations have markedly different risk profiles for obesity and related health behaviours. Well-designed subgroup analysis can identify potential differential effects of obesity interventions, which may be important for reducing health inequalities. The study aim was to evaluate the consistency of the effects of active video games across important subgroups in a randomised controlled trial (RCT).
FINDINGS: A two-arm, parallel RCT was conducted in overweight or obese children (n=322; aged 10-14 years) to determine the effect of active video games on body composition. Statistically significant overall treatment effects favouring the intervention group were found for body mass index, body mass index z-score and percentage body fat at 24 weeks. For these outcomes, pre-specified subgroup analyses were conducted among important baseline demographic (ethnicity, sex) and prognostic (cardiovascular fitness) groups. No statistically significant interaction effects were found between the treatment and subgroup terms in the main regression model (p=0.36 to 0.93), indicating a consistent treatment effect across these groups.
CONCLUSIONS: Preliminary evidence suggests an active video games intervention had a consistent positive effect on body composition among important subgroups. This may support the use of these games as a pragmatic public health intervention to displace sedentary behaviour with physical activity in young people.
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BACKGROUND: Increased understanding of why and how physical activity impacts on health outcomes is needed to increase the effectiveness of physical activity interventions. A recent randomized controlled trial of an active video game (PlayStation EyeToy™) intervention showed a statistically significant treatment effect on the primary outcome, change from baseline in body mass index (BMI), which favored the intervention group at 24 weeks. In this short paper we evaluate the mediating effects of the secondary outcomes.
OBJECTIVE: To identify mediators of the effect of an active video games intervention on body composition.
METHODS: Data from a two-arm parallel randomized controlled trial of an active video game intervention (n = 322) were analyzed. The primary outcome was change from baseline in BMI. A priori secondary outcomes were considered as potential mediators of the intervention on BMI, including aerobic fitness (VO2Max), time spent in moderate-to-vigorous physical activity (MVPA), and food snacking at 24 weeks.
RESULTS: Only aerobic fitness at 24 weeks met the conditions for mediation, and was a significant mediator of BMI.
CONCLUSION: Playing active video games can have a positive effect on body composition in overweight or obese children and this effect is most likely mediated through improved aerobic fitness. Future trials should examine other potential mediators related to this type of intervention.
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Energy expenditure studies have shown that playing Active Video Games (AVGs) is positively associated with increases in heart rate and oxygen consumption. It is proposed that playing AVGs may be a useful means of addressing inactivity and obesity in children. This study explored children's and parents' perceptions of AVGs and the likely facilitators and barriers to sustained use of AVGs. Data were gathered using focus group interviews: seven with children, four with adults. Both children and parents reported that AVGs offered a way to increase activity and improve fitness. Barriers to sustained engagement, according to parents, were the cost of AVGs and lack of space in the home to play the games. According to children, the likelihood of long-term engagement with AVGs depended on game content and child age, with AVGs being seen as more appropriate for younger children than teenagers. It would appear that there is potential for AVGs to reduce inactivity in young people. However, barriers to widespread, sustainable adoption would need to be addressed if this potential is to be realized.
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The present study proposes and demonstrates a comprehensive framework for evaluation of a universal school-based depression prevention program. Efficacy was evaluated by considering the impact of continuous versus categorical approaches to operationalizing outcome, the effect of the intervention on key change agent variables, and moderation of intervention effects by student symptom severity at baseline. Participants 252 adolescent boys and girls (60 % male), aged 13 to 17 years (M = 13.62 years, SD = 0.60 years) from four schools in the state of Victoria, Australia, who were allocated by school into a waitlist = control (n = 88) or a CBT-based intervention (n = 164) group. The intervention involved six 45-min weekly sessions run during wellbeing classes. While the intervention and control groups did not differ in average improvement in symptoms by post-intervention, further analyses showed that responsiveness was highly variable within the intervention, and those with elevated depressive symptoms benefitted most. The proposed change agents of self-esteem, resilience, body image satisfaction, and perceived social support did not uniquely predict change in depressive symptoms but collectively accounted for substantial variance in this change process. Collectively, this framework provided insights into aspects of the intervention that worked and highlighted areas for improvement, thus providing clear direction for future research.
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Purpose The main purpose of this study was to investigate the effects of a 12-week, clinician-referred, community-based exercise training program with supervised and unsupervised sessions for men with prostate cancer. The secondary purpose was to determine whether androgen deprivation therapy (ADT) modified responses to exercise training.
Methods Secondary analysis was undertaken on data from a multicentre cluster randomised controlled trial in which 15 clinicians were randomly assigned to refer eligible patients to an exercise training intervention (n = 8) or to provide usual care (n = 7). Data from 119 patients (intervention n = 53, control n = 66) were available for this analysis. Outcome measures included fitness and physical function, anthropometrics, resting heart rate, and blood pressure.
Results Compared to the control condition, men in the intervention significantly improved their 6-min walk distance (Mdiff = 49.98 m, padj = 0.001), leg strength (Mdiff = 21.82 kg, padj = 0.001), chest strength (Mdiff = 6.91 kg, padj = 0.001), 30-s sit-to-stand result (Mdiff = 3.38 reps, padj = 0.001), and reach distance (Mdiff = 4.8 cm, padj = 0.024). A significant difference (unadjusted for multiplicity) in favour of men in the intervention was also found for resting heart rate (Mdiff = −3.76 beats/min, p = 0.034). ADT did not modify responses to exercise training.
Conclusions Men with prostate cancer who act upon clinician referrals to community-based exercise training programs can improve their strength, physical functioning, and, potentially, cardiovascular health, irrespective of whether or not they are treated with ADT.
Implications for Cancer Survivors Clinicians should inform men with prostate cancer about the benefits of exercise and refer them to appropriately qualified exercise practitioners and suitable community-based programs.
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PURPOSE: To determine the effects of 10 wk of resistance or aerobic exercise training on interleukin-6 (IL-6) and C-reactive protein (CRP). Further, to determine pretraining and posttraining associations between alterations of IL-6 and CRP and alterations of total body fat mass (TB-FM), intra-abdominal fat mass (IA-FM), and total body lean mass (TB-LM). METHODS: A sample of 102 sedentary subjects were assigned to a resistance group (n = 35), an aerobic group (n = 41), or a control group (n = 26). Before and after intervention, subjects were involved in dual-energy x-ray absorptiometry, muscular strength and aerobic fitness, measurements and further provided a resting fasted venous blood sample for measures of IL-6, CRP, cholesterol profile, triglycerides, glucose, insulin, and glycosylated hemoglobin. The resistance and the aerobic groups completed a respective 10-wk supervised and periodized training program, whereas the control group maintained sedentary lifestyle and dietary patterns. RESULTS: Both exercise training programs did not reduce IL-6; however, the resistance and the aerobic groups reduced CRP by 32.8% (P < 0.05) and 16.1% (P = 0.06), respectively. At baseline, CRP was positively correlated with IL-6 (r = 0.35), (TB-FM) (r = 0.36), and IA-FM (r = 0.31) and was inversely correlated with aerobic fitness measures (all r values > or = -0.24). Compared with the resistance and the control groups, the aerobic group exhibited significant (P < 0.05) improvements in all aerobic fitness measures and significant reductions in IA-FM (7.4%) and body mass (1.1%). Compared with the aerobic and the control groups, the resistance group significantly (P < 0.05) improved TB-FM (3.7%) and upper (46.3%) and lower (56.6%) body strength. CONCLUSION: Despite no alteration in baseline IL-6 and significantly smaller reductions in measures of adipose tissue as compared with the aerobic training group, only resistance exercise training resulted in significant attenuation of CRP concentration.
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BACKGROUND: High-intensity interval training (HIIT) may be a feasible and efficacious strategy for improving health-related fitness in young people. The objective of this systematic review and meta-analysis was to evaluate the utility of HIIT to improve health-related fitness in adolescents and to identify potential moderators of training effects. METHODS: Studies were considered eligible if they: (1) examined adolescents (13-18 years); (2) examined health-related fitness outcomes; (3) involved an intervention of ≥4 weeks in duration; (4) included a control or moderate intensity comparison group; and (5) prescribed high-intensity activity for the HIIT condition. Meta-analyses were conducted to determine the effect of HIIT on health-related fitness components using Comprehensive Meta-analysis software and potential moderators were explored (ie, study duration, risk of bias and type of comparison group). RESULTS: The effects of HIIT on cardiorespiratory fitness and body composition were large, and medium, respectively. Study duration was a moderator for the effect of HIIT on body fat percentage. Intervention effects for waist circumference and muscular fitness were not statistically significant. CONCLUSIONS: HIIT is a feasible and time-efficient approach for improving cardiorespiratory fitness and body composition in adolescent populations.
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Current physical activity and fitness levels among adolescents are low, increasing the risk of chronic disease. Although the efficacy of high intensity interval training (HIIT) for improving metabolic health is now well established, it is not known if this type of activity can be effective to improve adolescent health. The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day. A 3-arm pilot randomized controlled trial was conducted in one secondary school in Newcastle, Australia. Participants (n = 65; mean age = 15.8(0.6) years) were randomized into one of three conditions: aerobic exercise program (AEP) (n = 21), resistance and aerobic exercise program (RAP) (n = 22) and control (n = 22). The 8-week intervention consisted of three HIIT sessions per week (8-10 min/session), delivered during physical education (PE) lessons or at lunchtime. Assessments were conducted at baseline and post-intervention to detect changes in cardiorespiratory fitness (multi-stage shuttle-run), muscular fitness (push-up, standing long jump tests), body composition (Body Mass Index (BMI), BMI-z scores, waist circumference) and physical activity motivation (questionnaire), by researchers blinded to treatment allocation. Intervention effects for outcomes were examined using linear mixed models, and Cohen's d effect sizes were reported. Participants in the AEP and RAP groups had moderate intervention effects for waist circumference (p = 0.024), BMI-z (p = 0.037) and BMI (not significant) in comparison to the control group. A small intervention effect was also evident for cardiorespiratory fitness in the RAP group.
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PURPOSE: Emerging literature suggests that physical activity and fitness may have a positive impact on cognitive and mental health for adolescents. The purpose of the current study was to evaluate the efficacy of two high intensity interval training (HIIT) protocols for improving cognitive and mental health outcomes (executive function, psychological wellbeing, psychological distress and physical self-concept) in adolescents.
METHODS: Participants (n=65; mean age=15.8±0.6) were randomized to three conditions: aerobic exercise program (AEP; n=21), resistance and aerobic exercise program (RAP; n=22) and control (n=22). HIIT sessions (8-10min/session) were delivered during physical education lessons or at lunchtime three times/week for 8-weeks. Assessments were conducted at baseline and immediate post-intervention to detect changes in executive function (Trail Making Test, TMT), psychological wellbeing, psychological distress and physical self-description, by researchers blinded to treatment allocation. Intervention effects were examined using linear mixed models. Cohen's d effect sizes and clinical inference were also calculated.
RESULTS: Small improvements in executive function (d=-0.32, 95%CI -9.12 to 9.77; p=0.386) and psychological wellbeing (d=0.34, 95%CI -1.73 to 2.37; p=0.252) were evident in the AEP group. Moderate improvements in executive function (d=-0.51, 95% CI -8.92 to 9.73; p=0.171), and small improvements in wellbeing (d=0.35, 95%CI -1.46 to 2.53; p=0.219) and perceived appearance (d=0.35, 95%CI -0.74 to 0.41; p=0.249), were observed for the RAP group. Mean feelings state scores improved from pre-workout to post-post workout in both HIIT conditions, with significant results for the AEP (p=0.001).
CONCLUSIONS: This study highlights the potential of embedding HIIT within the school day for improving cognitive and mental health among adolescents.
