Background: This study investigates whether the Theory of Planned Behaviour is a viable model to predict the intentions of care staff to support adults with a learning disability to take part in physical activity. Previous research has suggested that people with a learning disability take part in less physical activity than those without disabilities. Research also shows that people with a learning disability have additional health needs when compared to the general population. Some conditions affecting people with a learning disability may be prevented or alleviated by increased physical activity. People with learning disabilities are sometimes dependent on their care staff to support them to access activities, therefore it is important to include care staff in planning interventions. The principal hypothesis of this research was that the Theory of Planned Behaviour may be a useful model in predicting the intentions of staff to support service users to engage in physical activity. Method: Seventy-eight individuals who were keyworkers for adults with learning disabilities participated in this study. This study is based on the responses of these individuals as recorded on questionnaires at two distinct times. At time one, the respondents completed an adaptation of the International Physical Activity Questionnaire – Short Form (IPAQ-SF), and two questionnaires relating to the Theory of Planned Behaviour. At time two, the respondents completed a follow-up measure of physical activity using the IPAQ-SF. The questionnaires were distributed in a pencil-and-paper format, and were available online. Data were analysed using path analysis, an extension of multiple regression. Results: A number of significant relationships between variables were demonstrated by the data. Perceived behavioural control was a significant predictor both of care staff intention and of the behaviour of the service user. Attitude was also a significant predictor of care staff intention. The data did not support that intention would mediate the relationship between attitude, subjective norm and perceived behavioural control and behaviour. Perceived behavioural control was the most significant predictor of intention and of behaviour. Discussion: Results indicate that people with a learning disability take part in less physical activity than the recommendations for health. Perceived behavioural control was the most predictive variable in this population. The clinical and theoretical implications of this are discussed.

Long-term excessive positive energy balance results in overweight and obesity, which is caused by adipose tissue deposition. This increases the occurrence of cardiovascular diseases and type 2 diabetes. Adipose tissue plays an active role in the development of these diseases and so it is important to understand how this tissue responds to relevant stimuli such as feeding, fasting and physical activity. The study in Chapter 4 examined the impact of fasting and feeding, on adipose tissue responsiveness to prolonged moderate intensity exercise. Ten healthy overweight men aged 26 ± 5 years (mean ± SD) with a waist circumference of 105 ± 10 cm walked at 60% of maximum oxygen uptake under either fasted (12 h overnight fasting) or fed (70% carbohydrate breakfast) conditions in a randomised, counterbalanced design. Feeding comprised 648 ± 115 kcal 2 h before exercise. The expression of several metabolism-related adipose tissue genes was acutely regulated whilst participants undertook fasted exercise, including up-regulation of lipolytic lipase and transporter (adipose triglyceride lipase, hormone sensitive lipase & fatty acid translocase/CD36), glycolytic inhibitor (pyruvate dehydrogenase 4), insulin singling molecules (glucose transporter type 4 & insulin receptor substrate 2) as well as adipose insulin receptor substrate 2 protein contents (all p ≤ 0.05), compared to exercise in the fed state. The results indicate that adipose tissue responsiveness to prolonged exercise is affected by the dietary conditions. The study in Chapter 5 examined whether adipose tissue would be influenced by more modest changes in accumulated physical activity. Eleven overweight participants (7 men and 4 post-menopausal women) aged 50 ± 5 years (means ± SD) completed two identical mixed meal (~1,700 ± 360 kcal in total) feeding trials (prolonged sitting versus breaking sitting) in a randomised, counterbalanced design. The breaking sitting intervention comprised walking for 2 min every 20 min over 5 h. The results demonstrated that postprandial insulin and glucose concentrations were attenuated (all p ≤ 0.05) while participating in regular small bouts of walking but this did not affect adipose tissue metabolic- and insulin-associated pathways in adipose tissue. The study in Chapter 6 examined the responsiveness to aforementioned different forms of physical activity (a single bout of prolonged exercise versus accumulation of small bout of physical activity) on a challenge imposed by 50% overfeeding. Twenty-four lean, active and healthy men aged 21 ± 3 years were recruited. Participants were randomised to either an overfeeding with restricted physical activity (≤ 4,000 steps per day) group (OVER, n = 8), overfeeding with restricted physical activity (≤ 4,000 steps per day) plus daily 45 min endurance moderate intensity walking group (50% V̇O2max) (OVER + EN, n = 8) or overfeeding with restricted physical activity (≤ 4,000 steps per day) plus intermittent breaking sitting group (OVER + BREAKS, n = 8). All groups achieved the same overfeeding (50% of overfeeding based on their habitual diet). Notably, despite the impairment of insulin sensitivity as a result of the energy surplus, the accumulation of small bouts of physical activity blunted overfeeding induced up-regulation of adipose lipogenetic activity (i.e. the down-regulation of sterol regulatory element binding protein 1c and fatty acid synthase) and circulating inflammation (i.e. no change of white blood cell count) compared to energy surplus with sedentary lifestyle and/or overfeeding plus a single bout of moderate intensity exercise. This could mean that the form of physical activity undertaken could play a key role in lipogenesis activation. Based on the results from this thesis, it appears that energy consumption and physical activity are both capable of acutely and chronically influencing adipose tissue metabolic signalling and regulation.

Increasing levels of physical activity in older adults and fall prevention are key concerns of current UK health policy. Regular physical activity has many positive benefits for older adults, for example in fall prevention. However, sedentary behaviour among older adults is common. Forty per cent of over 50s in the UK report less physical activity than is considered necessary to maintain good health. Sedentary behaviour is even more common in South Asian older people in the UK. The aim of this research was to investigate the attitudes and beliefs that drive or hinder uptake and adherence of physical activity, in general and in relation to fall prevention, among 60-70 year old Caucasian and South Asian community dwellers. An ethnographic method was chosen as the research approach as it provided the framework for facilitating the incorporation of multiple voices. Two main geographical areas were chosen to conduct the study and included eight sites of study. Data collection used multiple methods (participant observation, focus groups and semi-structured interviews). In total 60 hours of participant observation, 15 focus group discussions (n = 87; mean age = 65.74 years) and 40 semi-structured interviews (mean age = 64.83 yrs) were conducted. Data analysis and classification followed a framework approach, comparing and contrasting themes within and across groups. Findings demonstrate that older people do not recognise falls as a risk and are not motivated to perform physical activity on a regular basis purely to help prevent falls. Social support and social benefits of physical activity appear to be key motivators to initiating and maintaining physical activity. Enjoyment, increased self-confidence and developing social networks seem to be important motivators in terms of adherence. Health, although a good motivator for the initiation of physical activity, appears to be a secondary motivator in terms of adherence. Barriers to physical activity include perceived and actual poor physical health, lack of social support, specificity of physical activity messages by health professionals as well as lack of motivation, low mood, fear of harm and domestic and carer issues. These findings suggest that older adults should be assessed individually, to address physical symptoms and possible low mood, and not according to age. The importance of exercise, even in the presence of physical illness needs to be explained. There is a need to promote confidence in older people’s ability to perform an activity, as this appears to be essential in continuing with exercise. Activities that take a ‘one size fits all’ approach, serve as a de-motivating force. Variety in exercise and physical activity is important to maintain motivation in the long-term.

Background: Exercise is recommended as a non-pharmacological intervention for individuals with a bipolar disorder diagnosis (BDD). Although physical activity can be beneficial for reducing depressive symptoms, there is preliminary evidence that high-intensity exercise can exacerbate (hypo)mania-related symptoms. Risks associated with other forms of exercise remain unknown. Method: To investigate the potential risks and benefits of low-intensity exercise, non-clinical participants were asked to either copy repetitive movements (n = 20), copy variable movements (n = 20) or watch variable movements (n = 21), following approach motivation induction. Hypomania-like symptoms, positive affect and approach motivation were measured pre-, during and post-task. Trait behavioural activation system (BAS) sensitivity was measured as a moderating factor. Results: There were no group differences in symptom change over time. BAS sensitivity did not moderate this relationship. Limitations: A predominantly student population with low average trait BAS sensitivity was studied. The reliability and validity of the approach motivation induction, mania measure and physical activity task are uncertain. Conclusions: It is unclear whether different types of low-intensity exercise are of risk or benefit for individuals prone to (hypo)mania. This area requires further investigation.

Proposed associations between social influence strategies (i.e., persuasion, coercion, and relationship referencing), Kelman's (1958; 1961) processes of change (i.e., internalization, identification, and compliance), and types of motivation derived from self-determination theory were examined. Proposed associations between social influence strategies and relationship satisfaction were also examined. A sample of 194 undergraduate students answered various questionnaires to measure relationship satisfaction, motivation to engage in exercise, Kelman's processes, and forms of social influence. Results indicated significant associations between social influence strategies and Kelman's processes, as well as significant associations between Kelman's processes and motivation. Results supported one mediation path (i.e., persuasion is associated with intrinsic motivation via internalization). Results also indicated an association between persuasive influence strategies and relationship satisfaction.

v anglickém jazyce Management of physical activities in multiple sclerosis patients The thesis introduces how is possible to organise physical activities in groups of multiple sclerosis patients. First theoretical part of thesis describes the multiple sclerosis as one of the most frequent neurological disease with its typical symptoms and possible farmacologic treatment. There are also few comments about patients attittude to physical activity, their adherence to regular physical activity and how to motivate them for better compliance. Lastly this theoretical part contains international recommendation concerning type, intensity and duration of exercise in multiple sclerosis patients. The second part of thesis is about practical experiences with group exercise management in our organization (MS Center, 1st Faculty of Medicine and General University Hospital in Prague). The experiences from group exercise are analysed from three diffrent points of view: objective measurement of gait parametres, exercise attendance and data gained from patient questionnaire. Final part summarises knowledge from theoretical and practical part. In this part I tried to make some recommendation for management of group exercise in multiple sclerosis patients. Key words: multiple sclerosis - exercise - physical activity -...

Minskad rörelse i vardagen är ett problem som idag blir allt större i världen. Trots att människor idag blir allt mer regelbundet fysiskt aktiva och utför mer planerad träning mer, minskar den rörelse i vardagen som krävs för att upprätthålla en god hälsa och minska risken för att dö i förtid. Någonting som visat sig kunna öka vardagsrörelse är närvaron av parkmiljöer. Forskning har visat på att där färre parker fanns, rörde människor på sig mindre. Syftet med denna studie var att undersöka relationen mellan vardagsrörelse och parkmiljöer utifrån fysiskt aktiva unga vuxnas uppfattning. Metoden som användes var intervjuer av unga vuxna (18 - 30 års ålder). Varför detta urval användes var för att denna åldersgrupp tidigare ansetts ha god hälsa under denna levnadsperiod, men nya rön visar på att människor i dessa åldrar blir allt mer inaktiva i vardagen. Fysiskt aktiva människor valdes var för att se hur deras uppfattningar om rörelse utöver deras normala träning betyder för just dem. Sex stycken aktiva unga vuxna individer rekryterades till studien och intervjuades. Resultatet visade på att unga vuxna förstår innebörden av vilka positiva effekter rörelse ger, men var samtidigt negativt inställda till att besöka parkmiljöer. Den enstaka rörelsen i parker som studiedeltagarna angav var i form av promenader och löpturer. Deltagarna menade på att fler olika typer av verksamheter och gratisaktiviteter (kiosker, utomhusgym, etc.) bör finnas tillgängliga, för att öka besöksnivån i parkmiljöer under längre tid, samt bedriva mer vardagsrörelse där. / Reduced movement in everyday life is a problem that is becoming increasingly common in the world today. Although people today are becoming more and more regularly physically active and conduct more planned exercise, the everyday movement that is needed to maintain a good health and reduce the risk of dying prematurely, is decreasing. Something that has been shown to increase everyday activity is the presence of park environments. Research has shown that where fewer parks existed, people were more sedentary and less active. The aim of this study was to investigate the relationship between everyday movement and park environments based on the view of physically active young adults. The method used in this study consisted of interviewing young adults (18-30 years of age). Why this selection was used was because this group of age were previously considered to have good health during their period of life, but new evidence shows that people of these ages are becoming increasingly inactive in their daily lives. Physically active people were chosen to see how their perceptions of movement in addition to their normal training meant to them. Six active young adults were recruited to the study and interviewed. The results showed that young adults understand the meaning of the positive effects of movement, but at the same time they were negatively motivated to visit park environments. The single movement in parks indicated by the participants was in the form of walks and jogging. Participants suggested that more types of activities (kiosks, outdoor gyms, etc.) should be available to increase the visitor level in park environments for a longer period of time, as well as conduct more daily living there.

The thesis investigated the effect of exercise on endothelial function (measured as flow-mediated dilation (FMD)) and triacylglycerol concentrations following the ingestion of a high-fat breakfast and lunch in adolescent boys. The validity of measuring lipid and lipoprotein concentrations from a capillary blood sample, and the reproducibility of the postprandial FMD and triacylglycerol concentration responses to the high-fat meals, was established. The effects of prior continuous moderate-intensity exercise (60 min walking at 60% V̇O₂peak), repeated very short duration sprints (40 x 6 s maximal effort cycle sprints) and accumulated moderate-intensity exercise (6 x 10 min running at 70% V̇O₂peak) on endothelial function and triacylglycerol concentrations in adolescent boys were then established across three studies, each consisting of two, 2-day main trials (control and exercise). On day 1, participants were either inactive or completed the prescribed exercise. On day 2, FMD and triacylglycerol concentrations were measured prior to, and following, ingestion of a high-fat breakfast and lunch. In each control trial FMD was reduced (signifying endothelial dysfunction), compared to fasting, by 20-32% and 24-33% following the high-fat breakfast and lunch. Following continuous moderate-intensity exercise, repeated very-short duration sprints and accumulated moderate-intensity exercise these reductions were only 8% and 10% (main effect trial, P = 0.002; main effect time, P = 0.023; interaction effect trial x time, P = 0.088), 2% and 5% (main effect trial, P = 0.012; main effect time, P = 0.004; interaction effect trial x time, P = 0.003) and 1% and 3% (main effect trial, P = 0.020; main effect time, P < 0.001; interaction effect trial x time, P = 0.014) respectively. The continuous moderate-intensity exercise and repeated very short duration sprints also significantly reduced the total area under the triacylglycerol concentration versus time curve by 22% (Control vs. Exercise; 12.68 (sem 1.37) vs. 9.84 (sem 0.75) mmol L-1 6.5h, P = 0.018) and 13% (Exercise vs. Control: 8.65 (sem 0.97) vs. 9.92 (sem 1.16) mmol L-1 6.5h, P = 0.023). The accumulated moderate-intensity exercise also reduced the total area under the triacylglycerol concentration versus time curve by 11%, but this reduction was not significant (Control vs. Exercise: 10.71 (sem 0.94) vs. 9.56 (sem 0.67) mmol L-1 6.5h, respectively, P = 0.183). The experimental evidence from these studies emphasise that exercise might offer an acceptable, non-pharmacological means of influencing CHD risk when individuals are young. The results of these studies can help shape future physical activity guidelines.

Bakgrund: Sambandet mellan fysisk aktivitet och psykisk hälsa har under senare åren studerats allt oftare.  Fysisk aktivitet kan förebygga olika sjukdomstillstånd och många rapporter stöder att motion är bra för människan. För att kroppen ska fungera optimalt behövs fysisk aktivitet. Stillasittande yrken och dålig motion är vardag för många. Folk verkar bli ohälsosammare tidigare och fysisk aktivitet skulle kunna vara en del av en lösning i en hälsosammare livsstil. Det finns ett samband med träning och bättre hälsa och förmåga . Enligt min frågeställning tror jag att en regelbunden träning ger en friskare individ i sin vardagliga sysselsättning (arbete/studier). Fler studier på området behövs för att upplysa människor om de förbättringar man själv kan göra för sin hälsa och sitt inre välmående. Syfte: Studiens syfte var att undersöka om den självupplevda effekten av fysisk aktivitet är positiv i form av konkreta hälsoförbättringar.  Metod: Jag har använt en kvalitativ metod med semistrutkurerade intervjuer. Innehålls analys har använts för att analysera det manifesta innehållet i texten. Resultat: Samtliga av testpersonerna beskriver konkreta hälsoförbättringar i både den fysiska vardagen och den psykiska vardagen. Stressnivåerna hade minskat, ryggont hade minimerats och välmåendet hade förbättrats hos samtliga. Glädjen att arbeta och umgås hade höjts och flera av testpersonerna nämnde blodsockernivåerna som en viktig faktor som hade förbättrats. Diskussion: För att behålla en bra hälsa i arbetslivet och på fritiden behövs regelbunden fysisk aktivitet. Konklusion: Fysisk aktivitet borde lyftas fram ännu mer och användas mer i preventionssyfte än vad man gör idag. En bättre fysisk förmåga ger helt enkelt en friskare vardag. / Background: The relationship between physical activity and mental health has in recent years been studied more frequently. Physical activity can help prevent various diseases and many reports supports that exercise is good. For the body to function optimally physical activity is needed. Sedentary occupations and poor exercise is for many a lifestyle. People seem to be more unhealthy . Physical activity could be part of the solution to a healthier lifestyle. There is an connection between exercise and better health and ability. In my question, I think that a regular exercise provides a healthier individual in their everyday jobs (work / studies). More studies in this area is needed to enlighten people about the improvements you can do yourself to their health and inner wellbeing. Objective: Purpose of the study was to investigate whether the self-perceived effect of physical activity is positive in terms of concrete improvements in health. Method: The content analysis was used to analyze the manifest content of the text. Results: All of the participants describe specific health improvements in both the physical and mental everyday everyday life. Stress levels had decreased pain, back pain was minimized and well-being had improved. The joy of working and socializing had been increased and several of the participants mentioned their blood sugar levels was key factor that had improved. Discussion: In order to maintain a good health at work and during leisure regular physical activity is needed. Conclusions: Physical activity should be promoted more and used more in prevention purposes than they do today. A better physical ability simply provides a healthier living. / <p>2013-06-04</p>