Most people with multiple sclerosis (PwMS) experience progressively worsening disability over a period of decades, thus further knowledge about the long-term changes in different areas of disability is essential.
The aims of this study were to evaluate changes in disability over ten years in PwMS, and to explore the value of personal and disease-specific factors and depressive symptoms in predicting disability. A further aim was to explore the value of these factors as predictors of mortality.
This study was based on a 10-year follow-up of a population-based study in Stockholm (n=166). Home visits were used to collect data on personal and disease-specific factors, walking ability, manual dexterity, cognitive function, mood, activities of daily living (ADL) and social/lifestyle activities.
The proportion of the study population who had disability in cognition, mood and social/lifestyle activities remained stable, while the proportion with disability in walking, manual dexterity and ADL increased. Disease severity predicted an increase in all studied variables of disability except in depressive symptoms. Older age and depressive symptoms were associated with mortality.
This study illustrates the importance of tailored interventions for PwMS and highlights the need for health-care professionals to consider the psychological aspects of the disease. Furthermore, our results indicate that the Expanded Disability Status Scale was a useful tool for predicting future disability.
BACKGROUND AND AIMS: The level of physical functioning (PF) late in life has, in recent years, been shown to be influenced by genetic factors. One of the most extensively studied genetic variants associated with PF and trainability is insertion/deletion (I/D) polymorphism in the gene encoding Angiotensin Converting Enzyme (ACE). However, ACE studies have mainly been conducted among younger persons in excellent physical shape. In this study, we examine whether the level of PF, trainability, or rate-of-change are associated with the ACE genotype among the elderly. METHODS: We used data from 4 randomized training studies of elderly Danes (N = 203). The measures of PF were self-report, maximal oxygen uptake, muscle strength, walking speed, and body composition. RESULTS: Overall, a favorable change in the measures of PF was observed in training groups compared with control groups. However, within groups, neither pre- or post-training/control period levels of PF nor differences in pre- and post-levels were associated with the ACE genotype. CONCLUSIONS: On the basis of our randomized studies, we could not detect any association between the ACE genotype and the level of PF or change, regardless of whether response to physical training or spontaneous changes was studied.
The aims of the study were to describe the stability of active commuting (AC) behavior (i.e., walking and cycling) over 27years and examine the relationship between AC and physical activity (PA) from youth to early midlife.
The mode and distance of travel were assessed using a self-reported questionnaire at five consecutive measurements between 1980 and 2007, when 2072 individuals were followed up from youth (9-18years) to adulthood (30-45years). PA was also measured using a questionnaire.
The prevalence of AC declined sharply with age, particularly after 12years, while AC distances to work or place of study increased substantially. AC was concurrently and prospectively associated with PA in both men and women. Maintained AC, whether walking or cycling and short or long distances, positively predicted adult PA over time. Compared with persistently passive commuters, persistently active commuters had higher adult PA after adjustment for potential covariates. Increasing AC was independently associated with high adult PA, particularly in young adulthood.
Walking and cycling to school/work should be encouraged, as regular AC is associated with higher levels of PA over 27years of follow-up, and thus, may contribute to a healthy and active lifestyle through the various stages of life-course.
The purpose was to describe the patterns of commuting to school in young people and to examine its associations with physical activity (PA) and cardiorespiratory fitness.
The sample comprised 2271 Estonian and Swedish children and adolescents (1218 females) aged 9-10 years and 15-16 years. Data were collected in 1998/99. Mode of commuting to and from school was assessed by questionnaire. Time spent (min/day) in PA and average PA (counts/min) was measured by accelerometry. Cardiorespiratory fitness was assessed by means of a maximal cycle ergometer test.
Sixty-one percent of the participants reported active commuting to school (ACS). Estonian youth showed lower levels of ACS than Swedish (odds ratio, 0.64; 95% confidence interval, 0.53-0.76) and girls reported lower levels than boys (0.74; 0.62-0.88). ACS boys showed higher PA levels than non-ACS boys for moderate, vigorous, MVPA, and average PA levels (all p = 0.01). Participants who cycled to school had higher cardiorespiratory fitness than walkers or passive travellers (p
The objective of this cross-sectional study was to study associations between low back pain (LBP) and modes of transport to school and leisure activities among adolescents. The study population included all adolescents in eighth and ninth grade in two geographic areas in eastern Norway. Eighty-eight adolescents participated (mean age 14.7 years), making the response rate 84%. Data concerning active (walking/bicycling) and passive (bus/car) journeys were obtained from lists and maps from local authorities, and from the pupils, using a questionnaire that also included LBP, activities and wellbeing. Distance walked/bicycled to school was slightly shorter among those reporting LBP in bivariate analyses. Walking/bicycling more than 8 km weekly to regular activities was inversely associated with LBP in multivariate analysis (OR 0.3; 95% confidence interval 0.1-1.0). No associations were found between passive journeys and LBP. The results raise the question for future research of whether lack of active transport may be one cause behind the increase in juvenile LBP.
This study describes temporal and spatial trends in active transportation for school trips in the Greater Toronto Area, Canada's largest city-region.
Proportions of trips by travel mode to and from school were estimated and compared for children (11-13 years) and youth (14-15 years). Data were drawn from the 1986, 1996, 2001, and 2006 versions of the Transportation Tomorrow Survey (TTS).
Between 1986 and 2006, walking mode share for trips to school declined (53.0%-42.5% for 11-13 year olds, 38.6%-30.7% for 14-15 year olds). Although there has also been a decline in walking home from school, walking rates were higher in the afternoon. In 2006, younger children in the suburbs walked less to school (36.1%-42.3% of trips) than 11-13 year olds in Toronto (48.1%) and Toronto's 14-15 year olds walked less (38.3% of trips) but used transit more (44.8% of trips) than students in the suburbs.
The findings indicate a period of decline (1986-2006) in the use of active modes for journeys to and from school for both age groups. Policies and programs to increase active transportation should acknowledge the spatial, temporal, and demographic heterogeneity of school travel decisions and outcomes.
PURPOSE: Active travel to school provides an opportunity for daily physical activity. Previous studies have shown that walking and cycling to school are associated with higher physical activity levels. The purpose of this study was to investigate whether the way that children and adolescents travel to school is associated with level of cardiovascular fitness. METHODS: Participants were recruited via a proportional, two-stage cluster sample of schools (N = 25) in the region of Odense, Denmark as part of the European Youth Heart Study (EYHS). Nine hundred nineteen participants (529 children, age 9.7 +/- 0.5 yr; 390 adolescents, age 15.5 +/- 0.4 yr) completed a maximal cycle ergometer test to assess cardiorespiratory fitness (Wmax x kg(-1)). Mode of travel to school was investigated by questionnaire. Physical activity was measured in 531 participants using an accelerometer. Regression analyses with robust standard errors and adjustment for confounders (gender, age, body composition (skinfolds), pubertal status, and physical activity) and the cluster sampling procedure were used to compare fitness levels for different travel modes. Multinomial logistic regression was applied to assess the odds for belonging to quartiles of fitness. RESULTS: Children and adolescents who cycled to school were significantly more fit than those who walked or traveled by motorized transport and were nearly five times as likely (OR 4.8; 95% CI 2.8-8.4) to be in the top quartile of fitness. CONCLUSION: Cycling to school may contribute to higher cardiovascular fitness in young people.
Human pregnancy is associated with increased requirements for dietary energy and this increase may be partly offset by reductions in physical activity during gestation. Studies in well-nourished women have shown that the physical activity level (PAL), obtained as the total energy expenditure (TEE) divided by the BMR, decreases in late pregnancy. However, it is not known if this decrease is really caused by reductions in physical activity or if it is the result of decreases in energy expenditure/BMR (the so-called metabolic equivalent, MET) for many activities in late pregnancy. In the present study activity pattern, TEE and BMR were assessed in twenty-three healthy Swedish women before pregnancy as well as in gestational weeks 14 and 32. Activity pattern was assessed using a questionnaire and heart rate recording. TEE was assessed using the doubly labelled water method and BMR was measured by means of indirect calorimetry. When compared to the pre-pregnant value, there was little change in the PAL in gestational week 14 but it was significantly reduced in gestational week 32. Results obtained by means of the questionnaire and by heart rate recording showed that the activity pattern was largely unaffected by pregnancy. The findings support the following conclusion: in a population of well-nourished women where the activity pattern is maintained during pregnancy, the increase in BMR represents approximately the main part of the pregnancy-induced increase in TEE, at least until gestational week 32.
The aim of this study was to describe the activity profile of top-class female soccer referees during competition and to relate it to the position of the ball. Ten matches from the Fédération Internationale de Football Association (FIFA) under-20 female World Championships held in Russia in 2006 were filmed and the kinematical parameters of the female referees (n=10) and the ball were determined using a two-dimensional photogrammetric video system based on direct linear transformation (DLT) algorithms. Total distance covered during a match was 10 km, of which 1.3 km represented high-intensity activities (>13 km/h). The referees' highest mobility was achieved in the initial 15 min of the match, covering greater distance and performing more intense exercise (P
The aim of this study was to characterize Kenyan runners in regard to their oxygen uptake and blood and ammonia responses when running. Untrained Kenyan boys (14.2 +/- 0.2 years) and Scandinavian runners were included for comparison. The studies were performed at altitude (approximately 2.000 m.a.s.l.) and, for several Kenyan and Scandinavian runners, at sea level as well. At altitude sedentary adolescent Kenyan boys had a mean maximal oxygen uptake (VO2max) of 47 (44-51) ml.kg-1.min-1, whereas similarly aged boys regularly walking or running but not training for competition reached above 62 (58-71) ml.kg-1.min-1 in VO2max. Kenyan runners in active training had 68 +/- 1.4 ml.kg-1.min-1 at altitude and 79.9 +/- 1.4 ml.kg-1.min-1 at sea level, with individuals reaching 85 ml.kg-1.min-1. The best Scandinavian runners were not significantly different from the Kenyan runners in VO2max both at altitude and at sea level, but none of the Scandinavians reached as high individual values as observed for some Kenyan runners. The running efficiency, determined as the oxygen cost at a given running speed, was less in the Kenyan runners, and the difference became more pronounced when body weight was expressed in ml.kg-0.75 min-1. Blood lactate concentration was in general lower in the Kenyan than in the Scandinavian runners, and the Kenyans also had extremely low ammonia accumulation in the blood even at very high exercise intensities. It is concluded that it is the physical activity during childhood, combined with intense training as teenagers that brings about the high VO2max observed in some Kenyan runners. Their high aerobic capacity, as well as their good running economy, makes them such superior runners. In addition, their low blood lactate and ammonia accumulation in blood when running may also be contributing factors.