exercise

Data sources: PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, AMED, PEDro, Scopus, ClinicalTrials.gov, ICTRP, and ClinicalTrialsRegister.eu from database inception to August 2024.

Eligibility criteria for selecting studies: Randomised controlled trials comparing different exercise modalities, including aerobic exercise, flexibility exercise, mind-body exercise, neuromotor exercise, strengthening exercise, mixed exercise, and control group for patients with knee osteoarthritis.

Main outcome measures: Primary outcomes included pain, function, gait performance, and quality of life, assessed at short term (four weeks), mid-term (12 weeks), and long term (24 weeks) follow-up. When exact time points were unavailable, data from adjacent time windows were used.

Results: 217 randomised controlled trials involving 15 684 participants were included. Moderate certainty evidence showed that, compared with the control group, aerobic exercise probably results in large improvements in pain at short term (standardised mean difference -1.10, 95% confidence interval -1.68 to -0.52) and mid-term follow-up (-1.19, -1.59 to -0.79), function at mid-term (1.78, 1.05 to 2.51), gait performance at mid-term (0.85, 0.55 to 1.14), and quality of life at short term (1.53, 0.47 to 2.59). Mind-body exercise probably results in a large increase in function at short term follow-up (0.88, 0.03 to 1.73; moderate certainty), while neuromotor exercise probably results in a large increase in gait performance at short term follow-up (1.04, 0.51 to 1.57; moderate certainty). Strengthening (0.86, 0.53 to 1.18) and mixed exercise (1.07, 0.68 to 1.46) probably result in a large increase in function at mid-term follow-up, all with moderate certainty evidence. Regarding long term follow-up, flexibility exercise may result in a large reduction in pain (-0.99, -1.63 to -0.36; low certainty); aerobic exercise may result in a large increase in function (0.87, 0.02 to 1.72, low certainty); and mixed exercise may increase function (0.56, 0.26 to 0.86; low certainty) and probably increases gait performance (0.57, 0.21 to 0.92, moderate certainty). Overall, aerobic exercise consistently showed the highest probability of being the best treatment, as reflected by surface under the cumulative ranking curve values (mean 0.72) across outcomes. The safety outcome was reported in a small proportion of studies (40 studies, 18%), and no clear differences were observed between exercise interventions and control.

Conclusions: In patients with knee osteoarthritis, aerobic exercise is likely the most beneficial exercise modality for improving pain, function, gait performance, and quality of life, with moderate certainty.

Systematic review registration: PROSPERO CRD42023469762.

Author/s:

Lei Yan, Dijun Li, Dan Xing, Zijuan Fan, Guangyuan Du, Jingwei Jiu, Xiaoke Li, Janne Estill, Qi Wang, Ahmed Atef Belal, Chen Tian, Jiao Jiao Li, Songyan Li, Haifeng Liu, Xuanbo Liu, Yijia Ren, Yiqi Yang, Jinxiu Chen, Yihe Hu, Long Ge, Bin Wang

Move more, age well: prescribing physical activity for older adults

Alex Haga — Mon, 03 Feb 2025 23:55:12 +0000

Date Added:

February 3, 2025

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

February 27, 2025

Issue:

Volume:

197

Pages:

E59-E67

URL:

Move more, age well: prescribing physical activity for older adults

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.231336

Keywords

exercise

physical activity

aged

PMID (1):

39870409

MeSH

Evidence-based advice regarding prescribing physical activity for older people. James W. Mold, MD, MPH

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KEY POINTS
Physical activity is a modifiable risk factor for more than 30 chronic conditions relevant to the older adult; 150 minutes per week of moderate physical activity can reduce all-cause mortality by 31% compared with no physical activity.

Physical activity is one of the most important ways to preserve or improve functional independence, including among older adults who are frail or deemed to be at increased risk of falling.

Higher levels of physical activity in older age are associated with improvements in cognition, mental health, and quality of life.

Age, frailty, or existing functional impairments should not be viewed as an absolute contraindication to physical activity but, considering the benefits of physical activity interventions for older adults, a key reason to prescribe exercise.

Author/s:

Jane S Thornton, William N Morley, Samir K Sinha

Exercise as a treatment for depression

Erin Blanchette — Tue, 14 May 2024 16:30:32 +0000

Date Added:

May 14, 2024

Journal/Publication:

Canadian Medical Association Journal

Publisher:

Canadian Medical Association

Publication Date:

May 5, 2024

Issue:

Volume:

196

Pages:

E596-E96

URL:

Exercise as a treatment for depression

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.231288

Keywords

PMID (1):

38719220

MeSH

depression

Depressive Disorder

Depressive Disorder / therapy

Depression / therapy

exercise

exercise therapy

Exercise Therapy / methods

Supervised exercise works as well as and more consistently (NNT=2) then antidepressants in adults with depression. James W. Mold, MD, MPH

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Exercise effectively treats depression and may decrease suicide attempts

A 2023 meta-analysis of randomized controlled trials (RCTs) found that supervised, group or non-group, moderate- or vigorous-intensity, aerobic or resistance exercises (excluding mind–body activities such as yoga) decreased depressive symptoms among participants with depression, with a number needed to treat of 2 and an effectiveness comparable to first-line treatments such as psychotherapy and medication. Another 2023 meta-analysis of RCTs found that exercise decreased suicide attempts among people with mental or physical illness.

Author/s:

Carl Zhou, Nicholas Fabiano

Project nature: promoting outdoor physical activity in children via primary care

Erin Blanchette — Tue, 12 Mar 2024 16:22:18 +0000

Date Added:

March 12, 2024

Journal/Publication:

BMC Primary Care

Publisher:

Springer Nature

Publication Date:

February 23, 2024

Issue:

Volume:

Pages:

URL:

Project nature: promoting outdoor physical activity in children via primary care

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1186/s12875-024-02297-5

Keywords

behavior therapy

children

children's health

preschool-age children

PMID (1):

38395776

MeSH

A simple primary care-based intervention to increase the outdoor physical activities of children. James W. Mold, MD, MPH

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Background

Families face a range of barriers in supporting their children’s active play in nature including family circumstances, environmental constraints, and behavioral factors. Evidence-based strategies to address these barriers are needed. We aimed to develop and pilot test a primary care-based family-centered behavioral intervention to promote active outdoor play in 4–10 year-old children.

Methods

Project Nature, a provider-delivered intervention that provides informational resources and an age-appropriate toy for nature play, was initially developed for children ages 0–3. With stakeholder input, we adapted existing materials for 4–10 year-olds and conducted usability testing at an urban clinic serving families from diverse backgrounds. Subsequently, we conducted a mix-methods pilot study to evaluate intervention feasibility and acceptability. Parents of 4–10 year-olds completed pre- and post-surveys (n = 22), and a purposive subset (n = 10) completed qualitative interviews. Post-intervention, pediatric providers (n = 4) were interviewed about their implementation experiences.

Results

The majority (82%) of parents liked the information provided and the remaining (18%) were neutral. Qualitatively, parents reported that: the toy provided a tangible element to help children and parents be active, they did not use the website, and they wished the intervention emphasized strategies for physical activity during cold and wet seasons. Providers felt the materials facilitated discussion about behavior change with families. There were no statistically significant changes in PA and outdoor time pre- and post-intervention.

Conclusions

Project Nature was welcomed by providers and families and may be a practical intervention to promote outdoor active play during well-child visits. Providing an age-appropriate nature toy seemed to be a critical component of the intervention, and may be worth the additional cost, time and storage space required by clinics. Building from these results, Project Nature should be revised to better support active outdoor play during suboptimal weather and evaluated to test its efficacy in a fully-powered trial.

Author/s:

Georgia M Griffin, Carolina Nieto, Kirsten Senturia, Marshall Brown, Kimberly Garrett, Elizabeth Nguyen, Danette Glassy, Emily Kroshus, Pooja Tandon

Health benefits of physical activity: the evidence

Linda Fowler — Fri, 26 Jan 2024 22:06:10 +0000

Date Added:

January 26, 2024

Journal/Publication:

Canadian Medical Association Journal

Publisher:

CMA Impact Inc.

Publication Date:

March 14, 2006

Issue:

Volume:

174

Pages:

801-809

URL:

Health benefits of physical activity: the evidence

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.051351

Keywords

PMID (1):

16534088

MeSH

Cardiovascular Diseases / prevention & control*

Diabetes Mellitus / prevention & control*

Neoplasms / prevention & control*

Life Expectancy*

Humans

An evidence-based summary of the health benefits of physical activity. I could imagine putting the most impactful ones on a waiting room poster. James W. Mold, MD, MPH

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The primary purpose of this narrative review was to evaluate the current literature and to provide further insight into the role physical inactivity plays in the development of chronic disease and premature death. We confirm that there is irrefutable evidence of the effectiveness of regular physical activity in the primary and secondary prevention of several chronic diseases (e.g., cardiovascular disease, diabetes, cancer, hypertension, obesity, depression and osteoporosis) and premature death. We also reveal that the current Health Canada physical activity guidelines are sufficient to elicit health benefits, especially in previously sedentary people. There appears to be a linear relation between physical activity and health status, such that a further increase in physical activity and fitness will lead to additional improvements in health status.

Physical inactivity is a modifiable risk factor for cardiovascular disease and a widening variety of other chronic diseases, including diabetes mellitus, cancer (colon and breast), obesity, hypertension, bone and joint diseases (osteoporosis and osteoarthritis), and depression.1–14 The prevalence of physical inactivity (among 51% of adult Canadians) is higher than that of all other modifiable risk factors.15 In this article we review the current evidence relating to physical activity in the primary and secondary prevention of premature death from any cause, cardiovascular disease, diabetes, some cancers and osteoporosis. We also discuss the evidence relating to physical fitness and musculoskeletal fitness and briefly describe the independent effects of frequency and intensity of physical activity. (A glossary of terms related to the topic appears in Appendix 1). In a companion paper, to be published in the Mar. 28 issue, we will review how to evaluate the health-related physical fitness and activity levels of patients and will provide exercise recommendations for health.

Several authors have attempted to summarize the evidence in systematic reviews and meta-analyses. These evaluations are often overlapping (reviewing the same evidence). Some of the most commonly cited cohorts have been described in different studies over time as more data accumulate (see Appendix 2, available online at www.cmaj.ca/cgi/content/full/174/6/801/DC1). In this review, we searched the literature using the key words „physical activity,” „health,” „health status,” „fitness,” „exercise,” „chronic disease,” „mortality” and disease-specific terms (e.g., „cardiovascular disease,” „cancer,” „diabetes” and „osteoporosis”). Using our best judgment, we selected individual studies that were frequently included in systematic reviews, consensus statements and meta-analyses and considered them as examples of the best evidence available. We also have included important new findings regarding the relation between physical activity and fitness and all-cause and cardiovascular-related mortality.

Author/s:

Darren E R Warburton, Crystal Whitney Nicol, Shannon S D Bredin

Food Intake Compared to Exercise Association with Obesity in Children Ages 3–6

Aubrey Delammermore — Sat, 07 Jan 2023 06:00:00 +0000

Date Added:

January 7, 2023

Journal/Publication:

Journal of the American Board of Family Medicine

Publisher:

American Board of Family Medicine

Publication Date:

November 17, 2022

Issue:

Volume:

Pages:

1072-1080

URL:

Food Intake Compared to Exercise Association with Obesity in Children Ages 3–6

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.3122/jabfm.2022.220159R1

Keywords

PMID (1):

36396411

MeSH

child, preschool

Pediatric Obesity* / epidemiology

Pediatric Obesity* / etiology

body mass index

exercise

In preschool children, physical activity level was correlated with BMI, and caloric intake was not. James W. Mold, MD, MPH

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Background: Childhood obesity affects 19.3% of children ages 2 to 19 years in the US, and 25.6% of Hispanic children. Study objectives were to (1) assess the feasibility of monitoring physical activity and daily caloric intake in children ages 3 to 6 years, (2) assess whether known obesity risk factors apply to this age-group, and (3) explore the factors that may contribute to the higher prevalence of obesity in Hispanic preschooler.

Methods: Children ages 3 to 6 years were recruited at well child visits (n = 37, 65% male, 30% Hispanic). Parents completed a questionnaire (child’s physical activity and screen time) along with a detailed dietary assessment. Children were provided with a fitness tracker worn for 5 days. Fisher’s exact test, t test/Wilcoxon rank sum tests were conducted.

Results: Thirty-four (92%) participants produced usable activity data. Baseline dietary recall was completed by 35 (97%) of the parents and 25 (68%) completed the second unassisted dietary recall. Mean body mass index of the study sample was 60th percentile, 12 (32%) classified as overweight/obese. Children with overweight/obesity showed no significant difference in mean daily calories compared with those without (1403.9 vs 1406.1 Kcal/day, P = .980) or daily hours of screen time (1.5 ± 1.1 vs 1.7 ± 0.8, P = .442). Children with overweight/obesity had fewer mean daily steps compared with those without overweight/obesity (8038 ± 2685 vs 10038 ± 2599 P = .051).

Discussion: Findings indicate that pedometer activity tracking can be used in children 3 to 6 years old and that decreased physical activity correlates more closely to preschool overweight/obesity than caloric intake.

Author/s:

Bedell, D., Sevcik, T., Daly, J. M., Levy, B. T.

Health benefits of physical activity: the evidence

Aubrey Delammermore — Sun, 11 Dec 2022 06:00:00 +0000

Date Added:

December 11, 2022

Journal/Publication:

CMAJ

Publisher:

CMA Impact

Publication Date:

March 14, 2006

Issue:

Volume:

174

Pages:

801-809

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

DOI:10.1503/cmaj.051351

Keywords

PMID (1):

16534088

MeSH

Cardiovascular Diseases / prevention & control*

Diabetes Mellitus / prevention & control*

Life Expectancy*

Neoplasms / prevention & control*

Physical Fitness*

An evidence-based summary of the health benefits of physical activity. Remember, physical activity is a biological requirement. (It’s not optional.) James W. Mold, MD, MPH.

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Author/s:

Warburton, D. E. R., Nicol, C. W., Bredin, S. S. D.

Physical Activity: Home-based Exercise Interventions for Adults Aged 65 years and Older

Aubrey Delammermore — Sat, 12 Nov 2022 06:00:00 +0000

Date Added:

November 12, 2022

Journal/Publication:

The Community Guide

Publisher:

The Guide to Community Preventive Services

Publication Date:

November 8, 2022

URL:

Physical Activity: Home-based Exercise Interventions for Adults Aged 65 years and Older

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

Keywords

MeSH

The CDC’s Community Preventive Services Task Force recommends prescribing home exercise programs for adults age 65 and older and specify most effective ways to achieve adherence and positive results. James W. Mold, MD, MPH

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The Community Preventive Services Task Force (CPSTF) recommends home-based exercise interventions to improve physical fitness (i.e., muscle strength, muscle power, muscle endurance, balance) among adults aged 65 years and older. The Physical Activity Guidelines for Americans, 2nd edition recommends older adults achieve a multicomponent physical activity regimen that combines aerobic activities with physical fitness exercises such as those used in these interventions.

Exercise for dysmenorrhoea

John Bayhi — Fri, 01 Nov 2019 17:23:19 +0000

Date Added:

November 1, 2019

Journal/Publication:

The Cochrane Database of Systematic Reviews

Publisher:

John Wiley & Sons, Inc.

Publication Date:

September 20, 2019

URL:

Exercise for dysmenorrhoea

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1002/14651858.CD004142.pub4

Keywords

alternative therapies

pelvic pain

PMID (1):

31538328

MeSH

Randomized Controlled Trials as Topic

Regular aerobic exercise is associated with reduced menstrual pain. James W. Mold, MD, MPH

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BACKGROUND:

Exercise has a number of health benefits and has been recommended as a treatment for primary dysmenorrhoea (period pain), but the evidence for its effectiveness on primary dysmenorrhoea is unclear. This review examined the available evidence supporting the use of exercise to treat primary dysmenorrhoea.

OBJECTIVES:

To evaluate the effectiveness and safety of exercise for women with primary dysmenorrhoea.

SEARCH METHODS:

We searched the Cochrane Gynaecology and Fertility specialised register, CENTRAL, MEDLINE, Embase, PsycINFO, AMED and CINAHL (from inception to July 2019). We searched two clinical trial databases (inception to March 2019) and handsearched reference lists and previous systematic reviews.

SELECTION CRITERIA:

We included studies if they randomised women with moderate-to-severe primary dysmenorrhoea to receive exercise versus no treatment, attention control, non-steroidal anti-inflammatory drugs (NSAIDs) or the oral contraceptive pill. Cross-over studies and cluster-randomised trials were not eligible for inclusion.

DATA COLLECTION AND ANALYSIS:

Two review authors independently selected the studies, assessed eligible studies for risk of bias, and extracted data from each study. We contacted study authors for missing information. We assessed the quality of the evidence using GRADE. Our primary outcomes were menstrual pain intensity and adverse events. Secondary outcomes included overall menstrual symptoms, usage of rescue analgesic medication, restriction of daily life activities, absence from work or school and quality of life.

MAIN RESULTS:

We included a total of 12 trials with 854 women in the review, with 10 trials and 754 women in the meta-analysis. Nine of the 10 studies compared exercise with no treatment, and one study compared exercise with NSAIDs. No studies compared exercise with attention control or with the oral contraceptive pill. Studies used low-intensity exercise (stretching, core strengthening or yoga) or high-intensity exercise (Zumba or aerobic training); none of the included studies used resistance training.Exercise versus no treatmentExercise may have a large effect on reducing menstrual pain intensity compared to no exercise (standard mean difference (SMD) -1.86, 95% confidence interval (CI) -2.06 to -1.66; 9 randomised controlled trials (RCTs), n = 632; I2= 91%; low-quality evidence). This SMD corresponds to a 25 mm reduction on a 100 mm visual analogue scale (VAS) and is likely to be clinically significant. We are uncertain if there is any difference in adverse event rates between exercise and no treatment.We are uncertain if exercise reduces overall menstrual symptoms (as measured by the Moos Menstrual Distress Questionnaire (MMDQ)), such as back pain or fatigue compared to no treatment (mean difference (MD) -33.16, 95% CI -40.45 to -25.87; 1 RCT, n = 120; very low-quality evidence), or improves mental quality of life (MD 4.40, 95% CI 1.59 to 7.21; 1 RCT, n = 55; very low-quality evidence) or physical quality of life (as measured by the 12-Item Short Form Health Survey (SF-12)) compared to no exercise (MD 3.40, 95% CI -1.68 to 8.48; 1 RCT, n = 55; very low-quality evidence) when compared to no treatment. No studies reported on any changes in restriction of daily life activities or on absence from work or school.Exercise versus NSAIDsWe are uncertain if exercise, when compared with mefenamic acid, reduced menstrual pain intensity (MD -7.40, 95% CI -8.36 to -6.44; 1 RCT, n = 122; very low-quality evidence), use of rescue analgesic medication (risk ratio (RR) 1.77, 95% CI 1.21 to 2.60; 1 RCT, n = 122; very low-quality evidence) or absence from work or school (RR 1.00, 95% CI 0.49 to 2.03; 1 RCT, n = 122; very low-quality evidence). None of the included studies reported on adverse events, overall menstrual symptoms, restriction of daily life activities or quality of life.

AUTHORS' CONCLUSIONS:

The current low-quality evidence suggests that exercise, performed for about 45 to 60 minutes each time, three times per week or more, regardless of intensity, may provide a clinically significant reduction in menstrual pain intensity of around 25 mm on a 100 mm VAS. All studies used exercise regularly throughout the month, with some studies asking women not to exercise during menstruation. Given the overall health benefits of exercise, and the relatively low risk of side effects reported in the general population, women may consider using exercise, either alone or in conjunction with other modalities, such as NSAIDs, to manage menstrual pain. It is unclear if the benefits of exercise persist after regular exercise has stopped or if they are similar in women over the age of 25. Further research is required, using validated outcome measures, adequate blinding and suitable comparator groups reflecting current best practice or accounting for the extra attention given during exercise.

Author/s:

Armour, M, Ee, CC, Naidoo, D, Ayati, Z, Chalmers, KJ, Steel, KA, de Manincor, MJ, Delshad, E

Sitting Time and Risk of Cardiovascular Disease and Diabetes: A Systematic Review and Meta-Analysis.

Brian Desmarais — Mon, 19 Aug 2019 13:31:30 +0000

Date Added:

August 19, 2019

Journal/Publication:

American Journal of Preventative Medicine

Publication Date:

August 1, 2019

URL:

Sitting Time and Risk of Cardiovascular Disease and Diabetes: A Systematic Review and Meta-Analysis.

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.amepre.2019.04.015

Keywords

physical activity

sitting

exercise

MeSH

cardiovascular diseases

You probably knew this, but perhaps it is time to address sitting behavior and well as physical activity. James W. Mold, MD. MPH

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Whether physical activity attenuates the association of total daily sitting time with cardiovascular disease and diabetes incidence is unclear. This systematic review and meta-analysis examined the association of total daily sitting time with cardiovascular disease and diabetes with and without adjustment for physical activity.

EVIDENCE ACQUISITION:

PubMed, Web of Science, BASE, MEDLINE, Academic Search Elite, and ScienceDirect were searched for prospective studies, published between January 1, 1989, and February 15, 2019, examining the association of total daily sitting time with cardiovascular disease or diabetes outcomes. Data extraction and study quality assessments were conducted by 2 independent reviewers. Pooled hazard ratios (HRs) were calculated using a fixed-effects model. The quality assessment and meta-analysis procedures were completed in 2018.

EVIDENCE SYNTHESIS:

Nine studies with 448,285 participants were included. A higher total daily sitting time was associated with a significantly increased risk of cardiovascular disease (HR=1.29, 95% CI=1.27, 1.30, p<0.001) and diabetes (HR=1.13, 95% CI=1.04, 1.22, p<0.001) incidence when not adjusted for physical activity. The increased risk for diabetes was unaffected when adjusting for physical activity (HR=1.11, 95% CI=1.01, 1.19, p<0.001). For cardiovascular disease, the increased risk was attenuated but remained significant (HR=1.14, 95% CI=1.04, 1.23, p<0.001).

CONCLUSIONS:

Higher levels of total daily sitting time are associated with an increased risk of cardiovascular disease and diabetes, independent of physical activity. Reductions in total daily sitting may be recommended in public health guidelines.

Author/s:

Bailey, D.P., Hewson, D.J., Champion, R.B., Sayegh, S.M.

For Mortality, Busting the Myth of 10 000 Steps per Day

Brian Desmarais — Thu, 25 Jul 2019 16:11:06 +0000

Date Added:

July 25, 2019

Journal/Publication:

Journal of the American Medical Association

Publisher:

The American Medical Association

Publication Date:

July 24, 2019

URL:

For Mortality, Busting the Myth of 10 000 Steps per Day

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1001/jama.2019.10042

Keywords

For patients who are counting their daily steps, this new information suggests that 7,500 may be enough. James W. Mold, MD, MPH

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When it comes to living longer, reaching the oft-repeated goal of 10 000 steps per day may not be necessary. Older women who walked more than their peers had lower death rates in a recent observational study in JAMA Internal Medicine, and the mortality benefit was seen with as few as 4400 steps.

Author/s:

Abbasi, J.

Spending at least 120 minutes a week in nature is associated with good health and wellbeing

Brian Desmarais — Wed, 19 Jun 2019 01:06:53 +0000

Date Added:

June 18, 2019

Journal/Publication:

Scientific Reports

Publication Date:

June 13, 2019

URL:

Spending at least 120 minutes a week in nature is associated with good health and wellbeing

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1038/s41598-019-44097-3

Keywords

Recreation

Psychology and behaviour

Epidemiology

exercise

MeSH

Recreation

Residence Characteristics

Surveys and Questionnaires

exercise

Spending at least two hours per week outdoors appears to improve perceived health and well-being. James W. Mold, MD, MPH

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Spending time in natural environments can benefit health and well-being, but exposure-response relationships are under-researched. We examined associations between recreational nature contact in the last seven days and self-reported health and well-being. Participants (n = 19,806) were drawn from the Monitor of Engagement with the Natural Environment Survey (2014/15-2015/16); weighted to be nationally representative. Weekly contact was categorised using 60 min blocks. Analyses controlled for residential greenspace and other neighbourhood and individual factors. Compared to no nature contact last week, the likelihood of reporting good health or high well-being became significantly greater with contact ≥120 mins (e.g. 120-179 mins: ORs [95%CIs]: Health = 1.59 [1.31-1.92]; Well-being = 1.23 [1.08-1.40]). Positive associations peaked between 200-300 mins per week with no further gain. The pattern was consistent across key groups including older adults and those with long-term health issues. It did not matter how 120 mins of contact a week was achieved (e.g. one long vs. several shorter visits/week). Prospective longitudinal and intervention studies are a critical next step in developing possible weekly natureexposure guidelines comparable to those for physical activity.

Author/s:

White, M.P., Alcock, I., Grellier, J, Wheeler, B.W., Hartig, T., Warber, S.L., Bone, A., Depledge, M.H., Fleming, L.E.

Early Subthreshold Aerobic Exercise for Sport-Related Concussion: A Randomized Clinical Trial

Tracy Ashby — Mon, 08 Apr 2019 05:00:00 +0000

Date Added:

April 8, 2019

Journal/Publication:

JAMA Pediatrics

Publisher:

American Medical Association

Publication Date:

February 4, 2019

URL:

Early Subthreshold Aerobic Exercise for Sport-Related Concussion: A Randomized Clinical Trial.

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1001/jamapediatrics.2018.4397

Keywords

PMID (1):

30715132

MeSH

Sub-symptomatic aerobic exercise is good for adolescents recovering from concussion. Makes sense. James W. Mold, MD, MPH

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IMPORTANCE:

Sport-related concussion (SRC) is a significant public health problem without an effective treatment.

OBJECTIVE:

To assess the effectiveness of subsymptom threshold aerobic exercise vs a placebo-like stretching program prescribed to adolescents in the acute phase of recovery from SRC.

DESIGN, SETTING, AND PARTICIPANTS:

This multicenter prospective randomized clinical trialwas conducted at university concussion centers. Male and female adolescent athletes (age 13-18 years) presenting within 10 days of SRC were randomly assigned to aerobic exercise or a placebo-like stretching regimen.

INTERVENTIONS:

After systematic determination of treadmill exercise tolerance on the first visit, participants were randomly assigned to a progressive subsymptom threshold aerobicexercise or a progressive placebo-like stretching program (that would not substantially elevate heart rate). Both forms of exercise were performed approximately 20 minutes per day, and participants reported daily symptoms and compliance with exercise prescription via a website.

MAIN OUTCOMES AND MEASURES:

Days from injury to recovery; recovery was defined as being asymptomatic, having recovery confirmed through an assessment by a physician blinded to treatment group, and returning to normal exercise tolerance on treadmill testing. Participants were also classified as having normal (<30 days) or delayed (≥30 days) recovery.

RESULTS:

A total of 103 participants were included (aerobic exercise: n = 52; 24 female [46%]; stretching, n = 51; 24 female [47%]). Participants in the aerobic exercise group were seen a mean (SD) of 4.9 (2.2) days after the SRC, and those in the stretching group were seen a mean (SD) of 4.8 (2.4) days after the SRC. There were no differences in age, sex, previous concussions, time from injury, initial symptom severity score, or initial exercise treadmill test and physical examination results. Aerobic exercise participants recovered in a median of 13 (interquartile range [IQR], 10-18.5) days, whereas stretching participants recovered in 17 (IQR, 13-23) days (P = .009 by Mann-Whitney test). There was a nonsignificant lower incidence of delayed recovery in the aerobic exercise group (2 participants [4%] in the aerobic group vs 7 [14%] in the placebo group; P = .08).

CONCLUSIONS AND RELEVANCE:

This is, to our knowledge, the first RCT to show that individualized subsymptom threshold aerobic exercise treatment prescribed to adolescents with concussion symptoms during the first week after SRC speeds recovery and may reduce the incidence of delayed recovery.

TRIAL REGISTRATION:

clinicaltrials.gov Identifier: NCT02710123.

Author/s:

Leddy, John J., Haider, Mohammad N., Ellis, Michael J., Mannix, Rebekah, Darling, Scott R., Freitas, Michael S., Suffoletto, Heidi N., Leiter, Jeff, Cordingley, Dean M., Willer, Barry

Replacing sedentary time with physical activity: a 15-year follow-up of mortality in a national cohort

Jeffrey Wilson — Wed, 03 Apr 2019 14:24:42 +0000

Date Added:

April 3, 2019

Journal/Publication:

Clinical Epidemiology

Publisher:

Dovepress

Publication Date:

January 25, 2018

Issue:

Pages:

179-186

URL:

Replacing sedentary time with physical activity: a 15-year follow-up of mortality in a national cohort

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.2147/CLEP.S151613

Keywords

exercise

PMID (1):

29416378

MeSH

sedentary lifestyle

motor activity

exercise

cardiovascular diseases

In this large Canadian cohort, followed for 15 years, among the least active participants (≤17minutes/day mod to vigorous physical activity), the replacement of 30minutes/day sitting with light physical activity (PA) was associated with a 14% mortality risk reduction and replacement with moderate to vigorous PA was associated with a 45% mortality risk reduction. For moderately active participants, light physical activity replacement reduced the mortality rate by 6%, and replacement with moderate to vigorous PA reduced mortality by 17%. James W. Mold, MD, MPH

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BACKGROUND:

Sedentary behavior is associated with health risks in adults. The potential benefits of reducing sedentary time may be dependent not only on decrease per se, but also on the type of activity it replaces. Few longitudinal studies have investigated the effects on mortality when replacing objectively assessed sedentary time with another physical activity (PA) behavior.

OBJECTIVE:

To investigate the effects of replacing objectively assessed sedentary time with time in light-intensity PA or moderate-vigorous PA (MVPA) on all-cause mortality, cardiovascular disease (CVD) mortality or cancer mortality in a cohort with 15 years follow-up time.

METHODS:

In total, 851 women and men from the population-based Sweden Attitude Behaviour and Change study were included. Time spent sedentary, in light-intensity PA and in MVPA were assessed using an Actigraph 7164 accelerometer. Mortality data were obtained from Swedish registers. Cox proportional hazards models estimated hazard ratios (HR) of mortality with 95% confidence intervals (CI) and isotemporal substitution models were used to estimate the effect of replacing sedentary behavior with PA for the same amount of time.

RESULTS:

Over a follow-up of 14.2 years (SD 1.9) with 12,117 person-years at risk, 79 deaths occurred, 24 deaths from CVD, 27 from cancer, and 28 from other causes. Replacing 30 minutes/day of sedentary time with light-intensity PA was associated with significant reduction in all-cause mortality risk (HR: 0.89, 95% CI: 0.81-0.98) and CVD mortality risk (HR: 0.76, 95% CI: 0.63-0.92). Replacing 10 minutes of sedentary time with MVPA was associated with reduction in CVD mortality risk (HR: 0.62, 95% CI: 0.42-0.91). No statistically significant reductions were found for cancer mortality.

CONCLUSION:

This statistical modelling study suggests that replacing sedentary time with light-intensity PA could have beneficial effect on both all-cause mortality and CVD mortality. Replacing sedentary time with MVPA could reduce CVD mortality.

Author/s:

Dohrn, Ing-Mari, Kwak, Lydia, Oja, Pekka, Sjöström, Michael, Hagströmer, Maria

Effect of a Long Bout Versus Short Bouts of Walking on Weight Loss During a Weight‐Loss Diet: A Randomized Trial

Jeffrey Wilson — Wed, 03 Apr 2019 14:08:01 +0000

Date Added:

April 3, 2019

Journal/Publication:

Obesity

Publisher:

The Obesity Society

Publication Date:

February 9, 2019

Issue:

Volume:

URL:

Effect of a Long Bout Versus Short Bouts of Walking on Weight Loss During a Weight‐Loss Diet: A Randomized Trial

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1002/oby.22416

Keywords

PMID (1):

30737894

MeSH

weight reduction programs

In this RCT involving diet and physical activity, two 25 minute bouts a day of moderate physical activity 6 days per week was associated with significantly more weight loss than one 50 minute bout of moderate physical activity per day 6 days a week. James W. Mold, MD, MPH

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OBJECTIVE:

This study aimed to evaluate the effect of different daily physical activity (PA) frequencies, while maintaining the same daily volume of PA, on weight loss, carbohydrate metabolism, and lipid metabolism in women with overweight or obesity throughout a 24-week intervention.

METHODS:

During their weight-loss plan, 65 women (BMI = 27-35 kg/m2 ; age = 18-40 years) who had a sedentary lifestyle were randomly allocated to the following groups: diet plus a long bout of moderate physical activity (LBP) (one 50-minute bout of moderate-intensity PA) 6 d/wk or diet plus short bouts of moderate physical activity (SBP) (two 25-minute bouts of moderate-intensity PA) 6 d/wk. Anthropometric and blood measurements were taken at baseline and at 24 weeks.

RESULTS:

Compared with the LBP group, the SBP group had a greater decrease in weight (SBP: -8.08 ± 2.20 kg; LBP: -6.39 ± 2.28 kg; P = 0.019), BMI (SBP: -3.11 ± 0.87 kg/m2 ; LBP: -2.47 ± 0.86 kg/m2 ; P = 0.027), and waist circumference (SBP: -8.78 ± 2.62 cm; LBP: -5.76 ± 2.03 cm; P = 0.026). No significant differences were seen in carbohydrate and lipid metabolism characteristics after 24 weeks.

CONCLUSIONS:

PA undertaken in two shorter bouts per day could be more effective for weight loss than PA undertaken in a daily long bout in adult women in a 24-week weight-loss program.

Author/s:

Madjd, Amenah, Taylor, Moira A., Delavari, Alireza,, Reza, Macdonald, Ian A., Farshchi, Hamid R.

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