Background: Fatigue is common and distressing after stroke. Many stroke survivors say it is their worst or one of their worst symptoms. The frequency of clinically significant fatigue, whether fatigue is likely to be more or less problematic over time, and its aetiology are unknown. There are currently no known treatments. One hypothesis is that fatigue after stroke is triggered by physical deconditioning which sets up a self-perpetuating cycle of fatigue, avoidance of physical activity, further deconditioning and more fatigue. Another theory is that low mood may contribute to fatigue. Aims: This thesis therefore aims to investigate the frequency and natural history of fatigue after stroke and to explore its associations with mood, physical activity and/or fitness. Method: These aims were addressed by carrying out: 1) a systematic review of all longitudinal observational studies which have assessed fatigue on at least two separate time points and reported its frequency, 2) a systematic review of all observational studies which have measured both fatigue poststroke and one or more measures of physical activity and/or fitness at the same time point and 3) a longitudinal cohort study which assessed clinically significant fatigue, mood and physical activity and fitness at one, six and 12 months after stroke. Results: Frequency of fatigue ranged from 30% to 92% at first time point and frequency of fatigue decreased over time in seven of the ten studies identified in the systematic review of longitudinal studies. The second systematic review found that only two of the eight studies identified found a significant direct relationship between fatigue and physical activity and/or fitness poststroke. In the longtidudinal cohort study, clinically significant fatigue was identified in 32.6% of 132 participants at one month and was still present in a fifth of 91 participants at 12 months, two-thirds of participants who had clinically significant fatigue at one month did not have it by six months and that most (60.4%) individuals either reported fatigue at all three time points or that they did not have fatigue at any time point. There were significant associations between daily step count and fatigue at each time point (p= < 0.0001, 0.011, 0.006). Physical activity (p=0.002, 0.006) and anxiety (p= < 0.0001, 0.001) at one month were independent significant predictors of fatigue severity at six and 12 months after stroke. Age, gender, fatigue before stroke, step count and anxiety at one month accounted for 22% and 27% of the variance in fatigue severity at six and 12 months respectively. No significant associations were found between fatigue and measures of physical fitness. Discussion and conclusion: The findings suggest that although fatigue is common and persistent after stroke, it is more likely to become less problematic over time. They also suggest that the de-conditioning hypothesis of the aetiology of fatigue may be too simplistic and that other factors are involved in the development and perpetuation of fatigue after stroke. Implications are that patients should be assessed for fatigue early after stroke and that the development of an intervention which increases activity and/or reduces anxiety may be beneficial.

There is a growing body of literature investigating age-related declines in physical activity (PA) participation among young people and especially girls, who have lower rates of PA than boys throughout the teenage years. Low PA is particularly apparent within the context of the school physical education classes – termed here as the Physical Education (PE) environment. My PhD thesis aims to explore the reasons for some girls disengagement in PE classes. Using a longitudinal qualitative approach the study tracks the experiences of a sample of ‘disengaged girls’ from four case study schools in Scotland taking part in a school-based physical activity programme, Fit for Girls (FfG). My research investigates the impact of the programme on their engagement through recording and analysis of the changes that take place in their attitudes and behaviour over the course of two years. The study involved the design of a questionnaire to identify a cohort of disengaged girls for baseline focus groups. Twelve focus groups (n=41 girls) were carried out during 2008/09 (three in each case study school) to capture girls’ opinions, perceptions and experiences of PE classes. Twenty disengaged girls were then selected across the four schools, based on their willingness to participate and self-disclose PE experiences. The girls were recruited for three phases of longitudinal in-depth interviews, over a one year period. The aim of these was to track changes in girls’ engagement and experiences in the PE environment. My theoretical framework is based on Welks (1999) Youth Physical Activity Promotion model (YPAP), a socioecological approach which divides the influential correlates of physical activity into 1) individual-level predisposing factors, 2) enabling factors, including personal attributes and environmental variables and 3) reinforcing (social) factors. The results indicate that individual predisposing factors, such as perceptions of competence and identity in the PE class along with the social context (peers and teachers) contribute to girls’ disengagement in PE. This suggests that aspects of the wider psychosocial environment in which PE takes place may be more important than the physical activity itself, impacting on levels of participation and enjoyment. There were subtle, as well as clear changes in engagement among many of the girls. However, for others no change was evident. Individual girls’ experiences across time or ‘journeys’ illustrate the importance of the relationships between the individual, social and PE environment in facilitating and sustaining positive change.

Physical fitness and physical activity for teacher students at Pedf UK This work describes the issues of physical fitness and physical activity. The teoretical part clarifies the basic concepts movement, physical fitness in global. Special attention will be paid to the definition of physical fitness - its components, significance, monitoring, testing, and measurement. Physical activity and its relationship to physical fitness and health are also elaborated in detail. The main objective of this work is to compare the physical fitness and physical activity of the full-time students of Specialization in Pedagogy, the field of Physical Education and Sport, with a focus on education, and students of Teacher Training for the 1. st. elementary school. The set of tests UNIFITTEST 6-60 is used as a comparison to their physical fitness. Physical activity of the students is assessed using the IPAQ questionnaire. The project of testing and investigation is the subject of the practical part, which introduces proposals, implementations and findings. Keywords IPAQ, movement, physical activity, UNIFITTEST 6-60, physical fitness, health

The diploma thesis deals with the active lifestyle and physical condition of adolescents at the chosen school in the district town of South Bohemia. The research was chosen by the Higher Secondary School of Social Studies and the Secondary School of Education in Prachatice and specifically by 53 students of the third year of secondary pedagogical school. The aim of the work was to monitor the body composition, aerobic capacity, muscle strength and mobility of the students on the basis of the batteries tested by the internet portal Indares. To compute the results, the Statistics program and it's forms of parametric and nonparametric tests were used. It follows from the calculations that, in terms of statistical significance, the students did not show very positive results, however, from the point of view of the subject matter it can be stated that according to the standards their performance was average, in some individuals it was above average. Research questions and hypotheses are partly confirmed at the end, but also partly disproved from what it can be concluded that more respondents would be needed for this research for more authoritative results.

Name: Motor skills of preschool children Objectives: The aim of this thesis was to determine the difference of motor skills of preschool children among children regularly attending free time courses focused on physical activities, led by experienced lecturers, and children in different kindergartens who do not attend these courses or rarely attend them. Methods: 67 children aged 4-6 years participated in the research. These were 9 children from the municipal kindergarten, 30 children from the village kindergarten and 28 children from the sports agency (club). Children were evaluated once by using the following tests: beep test, 4x5 m run, long jump, ball throw with right and left hand, sit and reach test. Results: The results confirm the assumption that children who participate in physical activity in their free time as well as in the kindergarten have better results than children who do physical education only in kindergarten. At the municipal nursery school, the children at the best level managed only the right- and left-hand throw. Statistically significant differences between groups occurred in the 4 x 5 m run, long jump and beep test, most often in favor of the sports agency. There was a significant difference in disciplines running 4 x 5 m, long jump from place and beep test between village...

<p>Chronic diseases of lifestyle (CDL) are on a raising trend in the world regardless of age, economic class or geographical location of a population. The mortality rate associated with CDL is alarmingly among the highest globally. Tanzania is not exempted from this development. Literature indicates that physical activity is a health practice that can prevent CDL. It is recommended that medical practitioners should hold the responsibility of counselling patients on physical activity. Some studies outside Africa found an association between doctors&rsquo / physical activity patterns and their counselling practices on the same. This study therefore sought to establish whether physical inactivity among medical&nbsp / doctors in Tanzania significantly influenced their counselling practices on physical activity. A cross sectional quantitative survey at the Muhimbili National Hospital and Muhimbili Orthopedic Institute was conducted to derive the required information. A self administered structured questionnaire was voluntarily answered by 144 medical doctors. The Statistical Package for Social Sciences (SPSS) version 17 was used for data capturing and analysis. Descriptive statistics were employed to summarize data and was expressed as means, standard deviation, frequencies and percentages. The students&rsquo / t-test was used to compare mean physical activity between different groups. Furthermore students&rsquo / t-test and analysis of variance tests were used to examine association between different variables. Chisquare tests were used to test for associations between categorical variables. Alpha level was set at p&lt / 0.05. Most of the participants in this study were sedentary in their leisure time and only active at work. When their quality of&nbsp / physical activity counselling was assessed, the majority of them were found to be poor physical activity counsellors. A significant association was found between physical activity and age, as well as physical activity and counselling practice (p&lt / 0.05). Participants mostly informed their patients about the intensity and duration of exercising more than any other idea of physical activity such as types of exercises, issuing of a written prescription and planning for a follow up. Lack of knowledge and experience about details of physical activity were reasons offered for failure to counsel. Participants also reported the inconvenience of physical activity facility&rsquo / s schedules, fatigue and tiredness to be their&nbsp / barriers to physical activity participation. Doctors in Tanzania lacked personal initiative to participate in physical activity and consequently lacked the motivation to counsel.&nbsp / Measures around enhancing this health practice should be enhanced by all stakeholders including medical doctors, physiotherapists and patients. The need for short term and&nbsp / long term training in matters related to physical activity are therefore necessary among the practicing doctors and those undergoing training in medical schools. Physiotherapists who are trained in movement science can offer valuable advice/information to medical doctors to ensure that medical doctors acquire physical activity prescription and&nbsp / counselling knowledge. Collaboration between stakeholders in campaigning against sedentary lifestyles should be enhanced. Further reasons for failure to counsel, hindrances to physical activity participation and modern approaches to counselling should be explored.<br /> &nbsp / </p>

Regular moderate-vigorous physical activity (MVPA) is associated with significant physiological and psychological health benefits (Department of Health, DoH, 2004). However, many children are not undertaking recommended levels of physical activity (PA) (DoH, 2009). This research examined relationships between physiological health parameters, psychological determinants and PA levels in 10-14 year old schoolchildren (N = 249) and assessed the influence of three school-based PA interventions on these constructs in the context of the Health And Physical activity Promotion in Youth (HAPPY) study. Study 1 revealed that sedentary behaviours, moderate PA (MPA), vigorous PA (VPA) and MVPA levels were higher on weekdays than weekend days (p < .001). However, schoolchildren’s PA is often difficult to measure accurately. The self-report measure utilised in study 2 underestimated total MVPA versus accelerometry for both sexes on weekdays and girls on weekend days (p < .01). However, study 3 highlighted a lack of agreement between two RT3® triaxial accelerometer cut-offs for all activity categories. The importance of VPA for promoting health was highlighted in the updated PA guidelines (DoH, 2011). Study 4 reported that cardiorespiratory fitness (CRF) was positively associated with VPA but not MPA (β = .27, p < .01) and inversely correlated with measures of body composition (% body fat; body mass index; waist circumference) (r = -.74, r = -.60, r = -.39, p < .001). Knowing the health benefits of regular MVPA and VPA, it is important to understand the determinants of PA intentions and behaviours to more effectively promote PA in less active children (studies 5 and 6). An exploratory analysis of the constructs in the Revised Theory of Planned Behaviour and the Modified Social Learning Theory for children predicted PA intentions (R2 = .38, F(5, 171) = 20.19, p < .001; R2 = .13, F(6, 147) = 3.4, p < .01, respectively) but the constructs in either model were unable to predict PA. Recognising the need to promote PA levels, study 7 investigated the effectiveness of three school-based interventions (vs. control) on outcome variables included in studies 1, and 4-6. The Health Education and Psychology Health Promotion conditions produced significant positive change scores between data collection 2 and 3 for CRF (vs. control) whereas the Youth-Led condition produced significant change scores between baseline and data collection 2 for generalised self-efficacy (vs. control). No significant change scores were reported for PA, the RTPB constructs or intentions. In conclusion, this research has emphasised the importance of employing a multidisciplinary approach to aid understanding of schoolchildren’s PA levels. Specific highlights include low weekend day PA as a possible future PA promotion target, although it is vital that accelerometry cut-points are standardised, and the relevance of VPA and body composition in predicting CRF. The psychological models identified some important determinants of PA intentions, but a prominent intention-behaviour gap and a need for more intensive interventions to promote PA levels was apparent.

<p>Chronic diseases of lifestyle (CDL) are on a raising trend in the world regardless of age, economic class or geographical location of a population. The mortality rate associated with CDL is alarmingly among the highest globally. Tanzania is not exempted from this development. Literature indicates that physical activity is a health practice that can prevent CDL. It is recommended that medical practitioners should hold the responsibility of counselling patients on physical activity. Some studies outside Africa found an association between doctors&rsquo / physical activity patterns and their counselling practices on the same. This study therefore sought to establish whether physical inactivity among medical&nbsp / doctors in Tanzania significantly influenced their counselling practices on physical activity. A cross sectional quantitative survey at the Muhimbili National Hospital and Muhimbili Orthopedic Institute was conducted to derive the required information. A self administered structured questionnaire was voluntarily answered by 144 medical doctors. The Statistical Package for Social Sciences (SPSS) version 17 was used for data capturing and analysis. Descriptive statistics were employed to summarize data and was expressed as means, standard deviation, frequencies and percentages. The students&rsquo / t-test was used to compare mean physical activity between different groups. Furthermore students&rsquo / t-test and analysis of variance tests were used to examine association between different variables. Chisquare tests were used to test for associations between categorical variables. Alpha level was set at p&lt / 0.05. Most of the participants in this study were sedentary in their leisure time and only active at work. When their quality of&nbsp / physical activity counselling was assessed, the majority of them were found to be poor physical activity counsellors. A significant association was found between physical activity and age, as well as physical activity and counselling practice (p&lt / 0.05). Participants mostly informed their patients about the intensity and duration of exercising more than any other idea of physical activity such as types of exercises, issuing of a written prescription and planning for a follow up. Lack of knowledge and experience about details of physical activity were reasons offered for failure to counsel. Participants also reported the inconvenience of physical activity facility&rsquo / s schedules, fatigue and tiredness to be their&nbsp / barriers to physical activity participation. Doctors in Tanzania lacked personal initiative to participate in physical activity and consequently lacked the motivation to counsel.&nbsp / Measures around enhancing this health practice should be enhanced by all stakeholders including medical doctors, physiotherapists and patients. The need for short term and&nbsp / long term training in matters related to physical activity are therefore necessary among the practicing doctors and those undergoing training in medical schools. Physiotherapists who are trained in movement science can offer valuable advice/information to medical doctors to ensure that medical doctors acquire physical activity prescription and&nbsp / counselling knowledge. Collaboration between stakeholders in campaigning against sedentary lifestyles should be enhanced. Further reasons for failure to counsel, hindrances to physical activity participation and modern approaches to counselling should be explored.<br /> &nbsp / </p>

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.