Introduction: Obesity during pregnancy is linked to many negative health effects for mothers and offspring. The majority of interventions with obese pregnant women based on physical activity have had limited success suggesting alternative approaches are needed. Sedentary behaviour is defined as waking activities that expend very low energy, 1.5 metabolic equivalents or below, while reclining, lying or sitting. Spending too much time sedentary has been identified as a risk factor for health, regardless of physical activity levels. We hypothesised that targeting sedentary behaviour may be a suitable alternative to reduce health risks during gestation among pregnant women who are morbidly obese (defined as body mass index, BMI > 40 Kg/m²). Aim and objectives: The aim was to explore sedentary behaviour among obese pregnant women and to propose an intervention to reduce the time obese pregnant women spend sedentary, through an active sitting exercise intervention. To conduct a systematic review of the literature to determine the proportion of time spent in sedentary behaviour among pregnant women, and the association of sedentary behaviour with pregnancy outcomes in mothers and offspring. To estimate total energy expenditure, and energy expended in sedentary activities in morbidly obese and lean pregnant women. To assess the feasibility of an active sitting exercise intervention for morbidly obese pregnant women, designed using a patient involvement in research method. Systematic Review: A systematic review of the literature reporting sedentary behaviour during pregnancy and its effects on pregnancy outcomes was conducted. Twenty six publications were included in the systematic review up until October 2015, and a further 18 were identified in the update completed in April 2018. Pregnant women spent at least 50% of their time in sedentary activities. Associations between increased time sedentary and higher risk of macrosomia, higher risk of pre-eclampsia, higher risk of developing gestational diabetes mellitus, and larger new-born abdominal circumference were observed, as the main findings. Most of included studies scored an intermediate quality, only two of the 44 studies scored a good quality. Cross-sectional study. A cross-sectional study was conducted, using the Pregnancy Physical Activity Questionnaire (PPAQ), and the Actical accelerometer, to assess energy expenditure, and energy expended in sedentary behaviour. Based on the PPAQ, women who were morbidly obese expended significantly more energy per day, as total expenditure, than lean pregnant women, which was confirmed by the Actical. During sedentary behaviour lean pregnant women expended significantly less energy than morbidly obese pregnant women, based on the PPAQ. No differences were observed between lean and morbidly obese pregnant women in the proportion of time spent in sedentary activities, nor in time sedentary. Exercise Intervention Design A patient involvement in research approach was used to design an active sitting exercise intervention for morbidly obese pregnant women. Twenty three women took part in the design of the intervention, enabling design of a final protocol including six exercises, to be performed in two sets of 10 repetitions. Active sitting exercise intervention An intervention based on active sitting exercises for morbidly obese pregnant women to reduce sedentary time was conducted to assess the feasibility. Thirty morbidly obese pregnant women were recruited of whom 20% completed the exercise intervention. The main reason not to complete the intervention was lack of time. Conclusion: A better understanding of sedentary behaviour is needed for the design of effective interventions to help to reduce the adverse effects of morbid obesity on pregnancy, especially as prevalence is growing. More time spent in light intensity activities rather than in sedentary behaviour may play a role as contributing to reduce those risks associated with obesity during pregnancy, and to reduce time spent sedentary. Participants have shown real interest in helping to design an effective exercise intervention. Involving and empowering participants in how to take care of themselves as part of the intervention helps to increase their commitment. Giving participants the tools to take care of their own health and their babies' should be considered as part of the intervention with very obese pregnant women. Providing the information in how and why exercise might help, and basing the intervention in giving participants easy and realistic tasks that they could do on their own and around their own environment, will help to increase their commitment. This appears to be a feasible and effective strategy.

The progression of knee osteoarthritis (OA), the most common cause of physical disability in older adults, is influenced by muscular and biomechanical factors. Reliability of muscular and biomechanical measures, including knee muscle strength and limb alignment, is critical. Furthermore, conservative interventions that slow the course of OA disease progression and prevent disability are urgently needed. The objectives of this thesis were to: 1) investigate the reliability of measures of knee muscle strength and alignment in persons with knee OA, and 2) determine the influence of an exercise intervention targeting hip muscles on knee joint loading in those with medial knee OA. In the first study reliability of knee muscle strength measures was evaluated within one testing session in 40 persons with knee OA. Isometric and isokinetic peak torque values for the quadriceps and hamstring muscles demonstrated high degrees of intra-session reliability. Reliability of lower limb alignment measures was determined following a bone landmark-based approach with use of a computer program. Excellent reliability coefficients were found which compared favorably with reliability of manual measures from schematics of limb deformities drawn with AutoCAD® software. When the computer method was applied to 100 full-limb radiographs of persons with or at risk for knee OA, alignment measures demonstrated high inter- and intra-reader reliability. Hip muscle weakness may influence loading of the medial knee compartment. Hip abductor strength was evaluated in 40 individuals with medial compartment knee OA in comparison to a control group of 40 healthy older adults. The effect of an 8-week home-based hip abductor strengthening program on the knee adduction moment was also assessed in this group with knee OA, compared with the control group which received no intervention. Following the exercise program the OA group demonstrated improvements in hip abductor strength and functional performance on a sit-to-stand task. There were no changes in the knee adduction moment. Thus, hip muscle strengthening did not influence joint loading, but may improve function in persons with knee OA. Results from this thesis provide increased understanding of knee OA, from muscular and biomechanical perspectives, in the areas of measurement reliability and exercise intervention. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2008-09-25 01:29:13.675

<p>Sarcopenia is the age-associated loss of muscle mass and strength. Studies have shown that combining resistance training with high protein intake increases muscle mass and strength in older adults. Women are at higher risk than men of sarcopenia. Thus, it is essential to find interventions to lessen women’s risk of losing muscle mass with aging. However, limited studies combine a specific higher-protein diet and a resistance training program in older women to determine skeletal muscle responses. This study aimed to assess the impact of a 12-week resistance training program with a high protein lean beef diet on skeletal muscle mass, strength, and quality in older women compared to a normal protein diet or a high protein diet composed of a lesser amount of beef. </p> <p>The study included three diets; a USDA recommended protein diet (0.8 g/kg/day), a high protein lean beef diet (1.4 g/kg/day), and a high protein diet composed of lesser beef (1.4 g/kg/day). Sixteen subjects were included in the study. The resistance training program consisted of leg extension, leg press, leg curl, chest press, and seated row. Muscle strength was determined by one-repetition maximum assessment at weeks one, six, and twelve. In addition, subjects underwent an MRI pre- and post-intervention to assess quadriceps volume and intermuscular adipose tissue (IMAT). Muscle quality was defined as the leg extension one-repetition maximum over the quadriceps volume. </p> <p>Muscle strength, muscle quality, and quadriceps volume increased with training in all three diet groups (P<0.05, main effect of time). No difference in muscle strength, quality, or quadriceps volume was found between the diet groups. IMAT decreased in all diet groups (P<0.05, main effect of time), but no differences were seen between the diet groups. These findings suggest that the 12-weeks of resistance training increased skeletal muscle strength, quality, and mass, independent of the normal protein or high protein diet and the source of protein in the diet.</p>

Thesis title: Physical activity as a means of lifestyle change Thesis objective: The objective of the thesis at hand was to verify effectiveness of the exercise program that leads to a change from predominantly sedentary lifestyle to an active one. Methods applied in the thesis: To find out the effectiveness of the controlled exercise intervention, it was applied, for three months, to a group of four persons (one male and three females, aged 28 to 36). The effectiveness was evaluated by exercise test in a laboratory run by FTVS UK in Prague. Outcome: The first proband managed to reduce the overall weight by 2 kg (i.e.2.65 %), out of which the percentage of body fat decreased by 11.82 % and the weight of fat-free matter increased by 0.2 kg (i.e.0.3 %). The ECM/BCM ratio increased by 0.04 (i.e. 4.7 %). The value of aerobic endurance VO2max increased by 8.9 ml.kg-1 .min-1 (i.e. 23.2 %). The running speed per one kilometre (min.km-1 ) at the anaerobic threshold level fell from the original 4:58 minutes to 4:30 minutes (acceleration of 28 seconds). Probands Nos. 2, 3 and 4 managed, on average, to increase their overall weight by 1.7 kg (i.e. 2.11 %), out of which the percentage of body fat increased by 3.07 % and the weight of fat-free matter increased, on average, by 0.73 kg (i.e. 1.11 %). The ECM/BCM...

Title: Effects of short-term parkour training programme on selected components of physical fitness in adolescents Objective: The aim of this work was to assess the influence of parkour on selected components of physical fitness - body composition, muscle fitness, aerobic fitness, flexibility - in a short-term programme. Methods: The ten-week experimental study dealt with the possibilities of using parkour to influence the parameters of physical fitness in boys age 16±2 years (N=10). Subjects went through measurement of bioelectrical analysis of body composition, muscle strength and endurance field tests, cardiopulmonary testing, sit-and-reach test. One-way analysis of variance with repeated measures (ANOVA) was used for statistical analysis. The strength of relationship between dependent and independent variables was expressed as unbiased effect size measure omega squared (ω2 ). Pearson two-tailed correlations were used to determine associations between measured parameters. Results: No significant changes in any body composition variables were observed with the parkour intervention. Fat mass increased by 0.18 %, fat free mass (FFM) decreased by 0.07 kg and the extracellular mass-body cell mass ratio (ECM/BCM) decreased by 0.02. Participants significantly improved standing broad jump distance (p <...

The pediatric population is highly impacted by brain tumours, as they are the most common type of solid tumour affecting children. Medical advances have improved the survival rate of children with brain tumours, but many survivors still experience late effects. In adulthood, 18% of pediatric brain tumour (PBT) survivors have reported cardiovascular issues such as strokes, blood clots, and angina, but little is known about the cardiovascular health of these survivors during childhood. The primary objective of this thesis was to measure the proportion of PBT survivors with values of body mass index (BMI), waist circumference (WC), and aerobic fitness meeting the cut-offs associated with unfavourable cardiovascular health (BMI≥+2 SDs, WC≥90th percentile, and % peak oxygen uptake (VO2peak) predicted<85%). The secondary objective was to observe the effects of 12 weeks of exercise training on the BMI, WC, blood pressure (BP), and aerobic fitness of PBT survivors and describe the feasibility of an exercise training program for this population. In this thesis, 32 PBT survivors who had all received cranial radiation were included (age=12.3±3.4 years, age at diagnosis=7.0±2.5 years, time since treatment completion=4.5±2.8 years, 21/32 male). While WC was measured for 13/32 participants, BMI and aerobic fitness were measured for all. Of the participants, 5/32 children completed a 12-week pilot exercise program consisting of two group and two in-home exercise sessions per week. A control group (n=2, age=14.8±3.6 years, 1/2 male) and an intervention group (n=5, age=15.0±2.3, 3/5 male) had BMI, WC, BP, and aerobic fitness measurements taken pre- and post-training. Of the participants, 15.6% (5/32) had a BMI≥+2 SDs, 30.7% had a WC≥90th percentile, and 86.7% had a %VO2peak predicted<85%. In total, 81% (26/32) of the participants had at least one identified biomarker reflecting unfavourable cardiovascular health. A training effect was only observed in BP (change of +9%). The exercise program was feasible with an adherence rate of 88% (21/24) to the group and in-home sessions. All (5/5) participants completed the program without injuries or adverse events during the training program. Findings from this thesis indicate that 81% brain tumour survivors have at least one biomarker indicating unfavourable cardiovascular health in childhood. This thesis also provides novel information to be considered before implementing exercise as a therapy for improving the cardiovascular health of survivors. Future additional research is required to determine the appropriate duration, frequency, and intensity of aerobic exercise to stimulate a training effect on these cardiovascular biomarkers. / Thesis / Master of Science (MSc)

Title: Effects of short-term parkour training programme on selected components of physical fitness in adolescents Objective: The aim of this work was to assess the influence of parkour on selected components of physical fitness - body composition, muscle fitness, aerobic fitness, flexibility - in a short-term programme. Methods: The ten-week experimental study dealt with the possibilities of using parkour to influence the parameters of physical fitness in boys age 16±2 years (N=10). Subjects went through measurement of bioelectrical analysis of body composition, muscle strength and endurance field tests, cardiopulmonary testing, sit-and-reach test. One-way analysis of variance with repeated measures (ANOVA) was used for statistical analysis. The strength of relationship between dependent and independent variables was expressed as unbiased effect size measure omega squared (ω2 ). Pearson two-tailed correlations were used to determine associations between measured parameters. Results: No significant changes in any body composition variables were observed with the parkour intervention. Fat mass increased by 0.18 %, fat free mass (FFM) decreased by 0.07 kg and the extracellular mass-body cell mass ratio (ECM/BCM) decreased by 0.02. Participants significantly improved standing broad jump distance (p <...

Step competition is a type of health-promoting activity in the form of an exercise intervention with a focus on increasing physical activity among employees of an organization. The purpose of the present study is to investigate what employees, who have participated in an exercise intervention initiated by their organization in the form of a step competition, describe as motivation for participating. A total of ten people participated in the study, men and women aged 23–59 years (M=37.7), of which three were men and the remaining seven were women. All interviewees work full-time with sedentary tasks at the same organization and they all have been engaged in various forms of exercise before the study. The present study has used an individual unstructured interview technique. The results were classified into six main themes of motives for participation; reducing sedentary workdays, the desire to move outdoors, competition as exercise, feeling a sense of community, the simplicity of the step competition and the health benefits that come with exercise. Based on the results from the present study, similar interventions are recommended to be implemented at organizations as the study has shown positive benefits such as reducing sedentary time, increasing outdoor time, promoting community, being simple and promoting well-being, and has shown motivation for participation. / Stegtävling är en typ av hälsofrämjande aktivitet i form av motionsintervention med fokus påatt öka fysisk aktivitet hos anställda på en organisation. Syftet med föreliggande studie är attundersöka vad anställda, som har deltagit i en motionsintervention initierad av sinorganisation i form av stegtävling, beskriver för motiv till deltagandet. I studien medverkadetotalt tio personer, män och kvinnor i åldrarna 23–59 år (M=37.7) varav tre var män ochresterande sju var kvinnor. Samtliga intervjupersoner arbetar på heltid med stillasittandeuppgifter på samma organisation samt att alla har ägnat sig till olika former av motion innanstudien. Föreliggande studie har använt sig av en individuellt ostrukturerad intervjuteknik.Resultatet klassificerades in i sex huvudteman av motiv för deltagande; minska stillasittandetunder arbetsdagarna, önskan att röra på sig utomhus, tävling som träning, att kännagemenskap, enkelheten med stegtävlingen och hälsofördelar som kommer med motion.Baserat på resultatet från föreliggande studie rekommenderas liknande interventioner attimplementeras på organisationer då studien har visat positiva fördelar såsom att det minskarstillasittandet, ökad utomhusvistelse, främjar gemenskap, är enkel och främjar välbefinnandesamt att detta visat på motiv för ett deltagande.

Background: Developmental Coordination Disorder (DCD) describes children with a difficulty to acquire age-specific motor skills. Although there is a significant body of literature addressing developmental and cognitive issues in children with DCD, few studies have actually examined the associations between DCD, physical activity and physical fitness. Therefore, the aim of the present research work was to assess these associations in a series of four successive studies which were set: a) (study 1) to estimate DCD prevalence rates in Greek children and investigate whether these children exhibit different obesity and cardiorespiratory fitness levels than an overseas sample, b) (study 2) to provide evidence on the association between DCD and physical fitness levels, c) (study 3) examine whether a motor skills and exercise training intervention programme affects motor proficiency in a cohort of elementary school children with and without DCD, and d) (study 4) to test the hypothesis that DCD is associated with CVD risk, identify modes of physical activity that mediate such an association and to evaluate the CSAPPA scale as a potential tool for identifying Greek children for DCD. Methods: The total of 574 Greek (Age: 11.46 ± 1.54 years; BMI: 19.96 ± 3.53) children were assessed for anthropometry, physical fitness (flexibility, hand strength, leg explosive power, speed and cardiorespiratory fitness), motor competence (i.e., short form of the Bruininks-Oseretsky Test of Motor Profiency- BOTMP-sf) and subjected to two self assessments for: i) perception of adequacy for physical activity (CSAPPA scale), and ii) children’s participation in physical activity (Participation Questionnaire - PQ). Results: Study 1: Greek children demonstrated significantly higher DCD prevalence rates (p<0.05), higher body fat (p<0.05) and were inferior in both cardiorespiratory fitness (p<0.05) and motor competence (p<0.05) compared to an overseas sample. Study 2: Greek children with DCD demonstrated significantly higher BMI values (p<0.01) and lower leg explosive power (p<0.01), speed (p<0.01) and hand strength (p<0.01) than those without DCD. Study 3: Results showed a significant main effect of time [F(14, 115) = 3.79, p< 0.001; η2 = 0.32] for motor competence (p<0.001) between children with and without DCD. Significant main effects of group (i.e intervention and control groups) [F(42, 351) = 4.01, p< 0.001; η2 = 0.33] were observed for BMI (p<0.01), motor competence (p<0.01), cardiorespiratory fitness (p<0.01), hand strength (p<0.05), leg explosive power (p<0.05), speed (p<0.01), and free time play activities (p<0.05). Study 4: Chi-square comparisons and ANOVA, revealed significantly increased body mass (p<0.05), BMI (p<0.05) and inactivity (p<0.05), as well as significantly decreased cardiorespiratory fitness (p<0.05), motor competence (p<0.05), CSAPPA indices, and participation in free play (p<0.05) in children with DCD. Furthermore, BMI and cardiorespiratory fitness were significantly associated with motor competence (p<0.05) with inactivity as the mediating factor (p<0.05). ROC curve analyses for CSAPPA indicated an optimal cut-off at 62 points. Conclusions: 1) the relatively high DCD and obesity prevalence rates together with the low cardiorespiratory fitness suggest greater health risk for Greek children with the studied condition, 2) children with DCD tend to perform worse in selected physical fitness parameters compared to their normal peers, 3) motor skills and exercise training interventions for children with DCD may improve health and skills related fitness, and 4) inactivity mediates the relationship between DCD and CVD risk in children with DCD. Finally, the CSAPPA scale may serve as a practical and a cost-effective proxy assessment for identifying Greek children with DCD, however as this is not a standardised test for use with children, its use should be treated with caution until further validation work.

Thesis advisor: Mary E. Duffy / Ten people with tetraplegic spinal cord injuries participated in a nurse-coached exercise intervention/single subject design study over a period of six months. Four pieces of exercise equipment were used: the RT300S Functional Electrical Stimulation Bike, the VIta Glide, the NuStep TRS 4000, and the Easy Stand Evolv Glider. Measurement of variables of the Manual Muscle Test (MMT), Catz-Itzkovich Spinal Cord Independence Measures (CI-SCIM), and Moorong Self-Efficacy Scale (MSES) were collected at baseline, at three months into the exercise intervention, and at six months (at the conclusion of the intervention). Results were determined by visual analysis of graphs, in keeping with single subject design methods, and statistical analysis of combined data. Of those muscles that demonstrated some strength at baseline, 75% experienced increased strength at three and/or six months into the intervention. Of those muscles that demonstrated no strength at baseline and that were adjacent to muscles that demonstrated some strength at baseline, 66% were found to have increased strength at three and/or six months. Nine of ten participants experienced upward trends in CI-SCIM scores overall (p<.0001). The results of the subscales of Self-Care (p<.0001) and Mobility (p<.0001) indicated statistically significant changes over time. The subscale Respiratory and Sphincter Management was not statistically significant (p>.05). Visual analysis of graphs demonstrated that each of ten participants experienced strong improvements in self-efficacy scores from baseline to three months and from three months to six months into the intervention. R-ANOVA (p<.0001) confirmed statistical significance across ten participants. The Sheehy Spinal Cord Injury Functional Improvement Via Exercise (SCI-FIVE) Model was constructed prior to the study and validated throughout the course of the study. The results of the study validated all components of the Model and demonstrated increased muscle strength, increased self-efficacy, and improved quality of life for the ten study participants who participated in a nurse-coached exercise intervention for people with tetraplegic spinal cord injuries. / Thesis (PhD) — Boston College, 2010. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.