Randomised controlled trial of site specific advice on school travel patterns Determinants of car travel on daily journeys to school: cross sectional survey of primary school children Promoting active transport in a workplace setting: evaluation of a pilot study in Australia. Study protocol: the effectiveness and cost effectiveness of an employer-led intervention to increase walking during the daily commute: the Travel to Work randomised controlled trial Increasing active travel to school: are we on the right track? A cluster randomised controlled trial from Sydney, Australia. Rationale and design: telepsychology service delivery for depressed elderly veterans The Effects of Physical Activity on Health and Quality of Life in Adolescent Cancer Survivors: A Systematic Review Risk activities and pre-travel health seeking practices of notified cases of imported infectious diseases in Australia Benefits of regular walking exercise in advanced pre-dialysis chronic kidney disease. Patterns, predictors and effects of texting intervention on physical activity in CHD – insights from the TEXT ME randomized clinical trial Improving rural cancer patients' outcomes: a group-randomized trial. Effectiveness analysis on the physical activity and the health benefit of a community population based program. Effects of sleep hygiene and artificial bright light interventions on recovery from simulated international air travel Prevalence of physical inactivity in nine rural INDEPTH Health and Demographic Surveillance Systems in five Asian countries Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts Physical Activity Across Adulthood and Physical Performance in Midlife The John Insall Award: No Benefit of Minimally Invasive TKA on Gait and Strength Outcomes: A Randomized Controlled Trial
Aims : To evaluate the effect of site specific advice from a school travel coordinator  on school travel patterns . Methods : Cluster r and omised controlled trial of children attending 21 primary schools in the London boroughs of Camden and Islington . A post-intervention survey measured the proportion of children walking , cycling , or using public transport for travel to school , and the proportion of parents/carers very or quite worried about traffic and abduction . The proportion of schools that developed and implemented travel plans was assessed . Results : One year post-intervention , nine of 11 intervention schools and none of 10 control schools had travel plans . Proportions of children walking , cycling , or using public transport on the school journey were similar in intervention and control schools . The proportion of parents who were very or quite worried about traffic danger was similar in the intervention ( 85 % ) and control groups ( 87 % ) . However , after adjusting for baseline and other potential confounding factors we could not exclude the possibility of a modest reduction in parental concern about traffic danger as a result of the intervention . Conclusions : Having a school travel coordinator increased the production of school travel plans but there was no evidence that this changed travel patterns or reduced parental fears . Given the uncertainty about effectiveness , the policy of providing school travel coordinators should only be implemented within the context of a r and omised controlled trial The annual distance walked by children  has fallen 28 % since 1972 , partly because car travel has replaced walking on many school journeys.1 Increasing car use has been linked with obesity , adverse health effects in later life , limitations on children 's independence , traffic congestion , and pollution . 2 3 To inform the development of strategies to reduce school related car travel , we surveyed the travel patterns of urban primary school children . The survey was conducted in the inner London boroughs of Camden and Islington . The question naire — based partly on published surveys 4 5 and prepared in English , Bengali , Turkish , Greek , and Cantonese ( first language s of 85 % of eligible pupils)—asked about that day 's school journey , children 's independent travel , and parental concerns . From the sampling frame of all primary schools ( excluding pilot , boarding , and special schools ) , 31 of the 100 eligible schools were r and omly selected . We weighted sampling probability by combined class sizes in year 2 ( ages 6 - 7 years ) and year Promoting active transport is an increasingly important focus of recent health promotion initiatives addressing the major public health concerns of car dependence , decreased levels of physical activity and environmental health . Using active transport that relies less on the use of private cars and more on alternatives such as walking , cycling and public transport has the potential to increase population levels of physical activity and to improve the environment . Over 12 months , a combined social and individualized marketing campaign was delivered to a cohort of r and omly selected health service employees ( n = 68 ) working at a health care facility in inner-city Sydney , Australia . Pre- and post-intervention surveys measured changes in mode of transport , awareness of active transport and attitudes towards mode of transport . Following the intervention , we found there was a reduction in the proportion of participants who drove to work 5 days per week and a decrease in trips travelled by car on weekends . In addition , there was high awareness of the intervention amongst participants and their underst and ing of the concept of active transport improved from 17.6 % at baseline to 94.1 % at the follow-up survey ( p < 0.01 ) . There was also a significant shift in attitudes , which suggested increased positive regard for active transport . Our findings suggest that a combined social and individualized marketing campaign in the workplace setting can increase the use of active transport for the journey to work and trips on weekends . However , before these findings are widely applied , the intervention needs to be tested in a controlled study with a larger sample size Background Physical inactivity increases the risk of many chronic diseases including coronary heart disease , type 2 diabetes and some cancers . It is recommended that adults should undertake at least 150 minutes of moderate intensity physical activity throughout the week but many adults do not achieve this . An opportunity for working adults to accumulate the recommended activity levels is through the daily commute . Methods Employees will be recruited from workplaces in south-west Engl and and south Wales . In the intervention arm ,  workplace Walk-to-Work promoters  will be recruited and trained . Participating employees will receive Walk-to-Work material  s and support will be provided through four contacts from the promoters over 10 weeks . Workplaces in the control arm will continue with their usual practice . The intervention will be evaluated by a cluster r and omized controlled trial including economic and process evaluations . The primary outcome is daily minutes of moderate to vigorous physical activity ( MVPA ) . Secondary outcomes are : overall physical activity ; sedentary time ; modal shift away from private car use during the commute ; and physical activity/MVPA during the commute .  Accelerometers , GPS receivers and travel diaries will be used at baseline and one year follow-up . Question naires will be used at baseline , immediately post intervention , and one year follow-up . The process evaluation will examine the context , delivery and response to the intervention from the perspectives of employers , Walk-to-Work promoters and employees using question naires , descriptive statistics , fieldnotes and interviews . A cost-consequence study will include employer , employee and health service costs and outcomes . Time and consumables used in implementing the intervention will be measured . Journey time , household commuting costs and expenses will be recorded using travel diaries to estimate costs to employees . Presenteeism , absenteeism , employee wellbeing and health service use will be recorded . Discussion Compared with other forms of physical activity , walking is a popular , familiar and convenient , and the main option for increasing physical activity in sedentary population s. To our knowledge , this is the first full-scale r and omised controlled trial to objective ly measure ( using accelerometers and GPS receivers ) the effectiveness of a workplace intervention to promote walking during the commute to and from work . Trial registration IS RCT N15009100 ( 10 December 2014 ) OBJECTIVE To evaluate the effectiveness of a program to increase walking to and from school . DESIGN A cluster r and omised controlled trial . SETTING 24 primary public schools in inner west Sydney , Australia . PARTICIPANTS 1996 students aged 10 - 12 years and their parents . INTERVENTION A two-year multi-component program included classroom activities , development of school Travel Access Guides , parent newsletters and improving environments with local councils . MEASURES Two measures were used : a survey completed by students on how they travelled to and from school over five days , and a survey completed by their parents on how their child travelled to and from school in a usual week . RESULTS The percentage of students who walked to and from school increased in both the intervention and control schools . Data from parent surveys found that 28.8 % of students in the intervention group increased their walking , compared with 19 % in the control group ( a net increase of 9.8 % , p=0.05 ) . However this effect was not evident in the student data . CONCLUSION The study produced a mixed result , with a high variation in travel patterns from school to school . Intervention research should address the complexity of multiple factors influencing student travel to school with a focus on changing local environments and parents ' travel to work Background Older adults who live in rural areas experience significant disparities in health status and access to mental health care . " Telepsychology , " ( also referred to as " telepsychiatry , " or " telemental health " ) represents a potential strategy towards addressing this longst and ing problem . Older adults may benefit from telepsychology due to its : ( 1 ) utility to address existing problematic access to care for rural residents ; ( 2 ) capacity to reduce stigma associated with traditional mental health care ; and ( 3 ) utility to overcome significant age-related problems in ambulation and transportation . Moreover , preliminary evidence indicates that telepsychiatry programs are often less expensive for patients , and reduce travel time , travel costs , and time off from work . Thus , telepsychology may provide a cost-efficient solution to access-to-care problems in rural areas . Methods We describe an ongoing four-year prospect i ve , r and omized clinical trial comparing the effectiveness of an empirically supported treatment for major depressive disorder , Behavioral Activation , delivered either via in-home videoconferencing technology ( " Telepsychology " ) or traditional face-to-face services ( " Same-Room " ) . Our hypothesis is that in-homeTelepsychology service delivery will be equally effective as the traditional mode ( Same-Room ) . Two-hundred twenty-four ( 224 ) male and female elderly participants will be administered protocol -driven individual Behavioral Activation therapy for depression over an 8-week period ; and subjects will be followed for 12-months to ascertain longer-term effects of the treatment on three outcomes domains : ( 1 ) clinical outcomes ( symptom severity , social functioning ) ; ( 2 ) process variables ( patient satisfaction , treatment credibility , attendance , adherence , dropout ) ; and ( 3 ) economic outcomes ( cost and re source use ) . Discussion Results from the proposed study will provide important insight into whether telepsychology service delivery is as effective as the traditional mode of service delivery , defined in terms of clinical , process , and economic outcomes , for elderly patients with depression residing in rural areas without adequate access to mental health services . Trial registration National Institutes of Health Clinical Trials Registry ( Clinical Trials.gov identifier # NCT00324701 ) Background There are numerous published controlled trials assessing the safety and the benefits of physical activity ( PA ) for child and adult cancer survivors . However , trials exclusively comprised of adolescent cancer survivors aged 13 - 19 years , who may experience different health and quality of life ( QOL ) effects as a function of their developmental status , are lacking . Rather , some trials have included both adolescent and child cancer survivors together . Objective The aim of this systematic review was to synthesize the findings from r and omized controlled trails ( RCTs ) and controlled clinical trials ( CCTs ) investigating the effects of PA on health and QOL outcomes in sample s comprised of > 50 % adolescent cancer survivors to summarize the current state of evidence , identify knowledge gaps , and highlight areas in need of additional research within this population . Methods Using a search strategy developed for this review , 10 electronic data bases were search ed for RCTs and CCTs that reported on the effects of PA on at least 1 health and /or QOL outcome in sample s comprised of > 50 % adolescent cancer survivors . Results From the 2249 articles identified , 2 CCTs met the predetermined eligibility criteria and were included in this review . Combined , 28 adolescents ( of 41 participants ) who were receiving active treatment participated in the 2 studies review ed . A total of 4 health and QOL outcomes ( ie , bone mass , fatigue , grip strength , QOL ) were assessed pre- and post-PA intervention . Conclusions On the basis of the 2 studies review ed , PA appears to be safe and feasible .  PA also shows promise to mitigate reductions in bone mass and might be a viable strategy to improve fatigue , grip strength , and QOL . High- quality controlled trials with larger sample s exclusively comprised of adolescent cancer survivors that assess a wide range of outcomes are needed to determine the effects of PA on health and QOL outcomes in this population Background Travellers are at risk of acquiring infectious diseases during travel , with risks differing by destination , travel and traveller characteristics . A pre-travel health consultation may minimize this risk . However , uptake of pre-travel health advice remains low . We investigated pre-travel health preparations and disease-specific risk behaviours among notified cases of selected travel-associated infectious diseases imported into Australia . Methods Prospect i ve enhanced surveillance of notified cases of typhoid , paratyphoid , measles , hepatitis A , hepatitis E , malaria and chikungunya was conducted in two Australian states between February 2013 and January 2014 . Details of pre-travel health preparation and disease-specific risk behaviours were collected . Results Among 180 cases associated with international travel , 28 % were < 18 years , 65 % were VFR travellers and 22 % were frequent travellers , having travelled ≥5 times in the past 5 years . 25 % had sought pre-travel advice from a healthcare provider , and 16 % reported a pre-travel vaccine . Seeking pre-travel health advice did not differ by immigrant status ( P = 0.22 ) or by reason for travel ( P = 0.13 ) but was more commonly sought by first time travellers ( P = 0.03 ) . Travellers visiting friends and relatives were more likely to report at-risk activities of brushing teeth with tap water ( P < 0.001 ) and eating uncooked food ( P = 0.03 ) during travel compared to other travellers . Conclusions Pre-travel health advice seeking practice s and vaccine uptake was suboptimal among cases of notified disease . The results of this study highlight the need for a better underst and ing of barriers to pre-travel health seeking , particularly among high risk travellers , to reduce the importation of infectious diseases into Australia BACKGROUND There is increasing evidence of the benefit of regular physical exercise in a number of long-term conditions including chronic kidney disease ( CKD ) . In CKD , this evidence has mostly come from studies in end stage patients receiving regular dialysis . There is little evidence in pre-dialysis patients with CKD Stages 4 and 5 . METHODS A prospect i ve study compared the benefits of 6 months regular walking in 40 pre-dialysis patients with CKD Stages 4 and 5 . Twenty of them were the exercising group and were compared to 20 patients who were continuing with usual physical activity . In addition , the 40 patients were r and omized to receive additional oral sodium bicarbonate ( target venous bicarbonate 29 mmol/L ) or continue with previous sodium bicarbonate treatment ( target 24 mmol/L ) . RESULTS Improvements noted after 1 month were sustained to 6 months in the 18 of 20 who completed the exercise study . These included improvements in exercise tolerance ( reduced exertion to achieve the same activity ) , weight loss , improved cardiovascular reactivity , avoiding an increase in blood pressure medication and improvements in quality of health and life and uraemic symptom scores assessed by question naire . Sodium bicarbonate supplementation did not produce any significant alterations . CONCLUSIONS This study provides further support for the broad benefits of aerobic physical exercise in CKD . More studies are needed to underst and the mechanisms of these benefits , to study whether resistance exercise will add to the benefit and to evaluate strategies to promote sustained lifestyle changes , that could ensure continued increase in habitual daily physical activity levels Background Mobile phone text message interventions are used to support behaviour change including physical activity , but we have less insight into how these interventions work and what factors predict response . Aims To study the effect of TEXT ME ( Tobacco EXercise and dieT Messages ) text message intervention on physical activity domains , consistency of effects across sub-groups and its additive value in patients that received traditional cardiac rehabilitation programme . Methods This is a secondary analysis of the TEXT ME , a r and omized clinical trial of lifestyle-focused text message intervention compared with usual care in patients with coronary heart disease . A quarter of the messages were design ed specifically to encourage physical activity . Sedentary time and physical activity were assessed using the Global Physical Activity Question naire . Results At baseline , 85 % of the 710 participants reported low physical activity levels . At six months , compared with controls , the intervention arm reported higher recreational physical activity ( 471 vs. 307 metabolic equivalent-min/week , p = 0.001 ) and travel physical activity ( 230 vs. 128 MET-min/week , p = 0.002 ) , similar work-related physical activity and lower sedentary times ( 494 vs. 587 min , p < 0.001 ) . Male gender , high baseline physical activity , cardiac rehabilitation participation and text message intervention predicted physically active status at six months . Subjects that received both cardiac rehabilitation and text messaging intervention were more likely to achieve target physical activity levels compared with cardiac rehabilitation alone ( odds ratio 7.07 vs. 1.80 , p < 0.001 ) . Conclusions The TEXT ME intervention improved recreational and travel physical activity , reduced sedentary times but had no effects on work-related physical activity . It had incremental benefits at achieving target physical activity levels even in patients participating in the traditional cardiac rehabilitation programme CONTEXT Significant barriers exist in the delivery of state-of-the-art cancer care to rural population s. Rural providers ' knowledge and practice s , their rural health care delivery systems , and linkages to cancer specialists are not optimal ; therefore , rural cancer patient outcomes are less than achievable . PURPOSE To test the effects of a strategy targeting rural providers and their practice environment on patient travel for care , satisfaction , economic barriers , and health-related quality of life . METHODS A group-r and omized trial was conducted with 18 rural communities in the north- central United States . Twelve of these communities were included and defined as the unit of analysis for the patient outcomes portion of the study . The intervention targeted rural providers and their practice environment . The subjects were patients with breast , colorectal , lung , and prostate cancers from the rural communities . The main outcomes were patients ' travel to obtain health care , satisfaction with care , perceptions of economic barriers to care , and health-related quality of life . In total , 881 patients were included . RESULTS Group r and omization was balanced . Travel for health care was significantly reduced in the community group exposed to the intervention during months 13 to 24 following cancer diagnosis . The mean miles traveled per patient were 1,326 ( SE = 306 ) for the experimental group and 2,186 ( SE = 347 ) for the control group ( P = 0.03 ) . No significant differences in satisfaction with care , economic barriers to care , or health-related quality of life were found . CONCLUSIONS The intervention significantly reduced  cancer patient travel for health care , which suggests that access to care improved in the experimental group . The results of this study do not allow conclusion that there was no effect on other patient outcomes . The results supported the study 's conceptual framework and many of its hypotheses OBJECTIVE To evaluate the community-based  health promotion  effect of physical activity . METHODS The residents aged 18 and above from two communities in Gongshu District of Hangzhou City , Zhejiang province , were r and omly selected and recruited for the multi- strategy and comprehensive physical activity intervention . Question naire survey , physical check up and blood biochemistry were conducted . RESULTS After this two-year intervention , the time of the participant spent on weekly physical activity of moderate intensity increased from 464 min to 542 min ( P<0.05 ) , with an average increase of 78 min . Time spent in walking every week increased from 533 min to 678 min ( P<0.05 ) , with an average increase of 145 min . The body weight , waistline , blood pressure and heart rate all reduced significantly ( P<0.05 ) ; the vital capacity increased significantly ( P<0.05 ) ; and the related biochemical indicators were also improved . CONCLUSION Comprehensive and evidence -based physical activity interventions targeting community population can improve the levels of physical activity , related body measurement and biochemical indicators Purpose Despite the reported detrimental effects of international air travel on physical performance , a paucity of interventions have been scientifically tested and confirmed to benefit travelling athletes . Consequently , the aim of the present study was to examine the effects of sleep hygiene and artificial bright light interventions on physical performance following simulated international travel . Methods In a r and omized crossover design , 13 physically active males completed 24 h of simulated international travel with ( INT ) and without ( CON ) the interventions . The mild hypoxia and cramped conditions typically encountered during commercial air travel were simulated in a normobaric , hypoxic room . Physical performance , subjective jet-lag symptoms and mood states were assessed in the morning and evening on the day prior to and for two days post-travel . Sleep quantity and quality were monitored throughout each trial . Results Sleep duration was significantly reduced during travel in both trials ( P < 0.01 ) , though total sleep duration during and following travel was almost significantly greater ( P = 0.06 ) in INT ( 17.0 ( 16.2–17.8 ) h ) compared to CON ( 15.7 ( 14.9–16.5 ) h ) . Maximal-sprint and countermovement jump ( P < 0.05 ) , but not Yo – Yo Intermittent Recovery level 1 test ( P > 0.05 ) performance , were significantly reduced the evening of day 1 and 2 post-travel , with no differences between trials ( P > 0.05 ) . Furthermore , vigour was significantly greater ( P = 0.04 ) the morning of day 2 in INT [ 5.3 ( 3.9–6.7 ) ] compared to CON [ 2.8 ( 1.4–4.2 ) ] , and subjective jet-lag symptoms and mood states were significantly worse on day 2 in CON only ( P < 0.05 ) . Conclusions Whilst reducing travel-induced sleep disruption may attenuate travel fatigue , no improvements in the recovery of physical performance were apparent Background : Physical inactivity leads to higher morbidity and mortality from chronic non-communicable diseases ( NCDs ) such as stroke and heart disease . In high income countries , studies have measured the population level of physical activity , but comparable data are lacking from most low and middle-income countries . Objective : To assess the level of physical inactivity  and its associated factors in selected rural sites in five Asian countries . Methods : The multi-site cross-sectional study was conducted in nine rural Health and Demographic Surveillance System ( HDSS ) sites within the INDEPTH Network in Bangladesh , India , Indonesia , Thail and , and Vietnam . Using the methodology from the WHO STEPwise approach to Surveillance ( STEPS ) , about 2,000 men and women aged 25–64 years were selected r and omly from each HDSS sampling frame .  Physical activity at work and during leisure time , and on travel to and from places , was measured using the Global Physical Activity Question naire version 2 ( GPAQ2 ) . The total activity was calculated as the sum of the time spent in each domain of activities in metabolic equivalent-minutes per week , and was used to determine the level of physical activity . Multivariable logistic regression was used to assess demographic factors associated with a low level of physical activity . Results : The prevalence of physical inactivity ranged from 13 % in Chililab HDSS in Vietnam to 58 % in Filabavi HDSS in Vietnam . The majority of men  were physically active , except in the two sites in Vietnam . Most of the respondents walked or cycled for at least 10 minutes to get from place to place , with some exceptions in the HDSSs in Indonesia and Thail and . The majority of respondents , both men and women , were inactive during their leisure time . Women , older age , and high level of education were significantly associated with physical inactivity . Conclusion : This study showed that over 1/4 men and 1/3 women in Asian HDSSs within the INDEPTH Network are physically inactive . The wide fluctuations between the two HDSS in Vietnam offer an opportunity to explore further urbanisation and environmental impacts on physical activity . Considering the importance of physical activity in improving health and preventing chronic NCDs , efforts need to be made to promote physical activity particularly among women , older people , and high education groups in these setting Background / objectives Walking pace is associated with risk of premature mortality . However , whether this relationship is independent of total volume of physical activity and highest physical activity intensity remains unclear . We examined the associations between  walking pace  and cause-specific mortality , investigating the potential modifying effect of factors such as total physical activity volume , highest physical activity intensity , age , sex and body mass index ( BMI ) . Methods Prospect i ve pooled analysis of 11 population -based baseline surveys in Engl and and Scotl and between 1994 and 2008 that were linked with mortality records . Multivariate-adjusted Cox proportional hazards models examined associations between  walking pace  ( slow , average , brisk/fast ) and all-cause , cancer and cardiovascular disease ( CVD ) mortality . Results 50 225 walkers were entered in the core analyses . Among participants who did not experience an event in the first 2 years of follow-up ( n=49 731 ) , walking at an average or brisk/fast pace was associated with a reduced risk of all-cause ( 20 % ( 95 % CI 12 % to 28 % ) and 24 % ( 95 % CI 13 % to 33 % ) , respectively ) and CVD mortality ( 24 % ( 95 % CI 9 % to 36 % ) and 21 % ( 95 % CI 1 % to 38 % ) , respectively ) , compared with reporting walking at a slow pace . In stratified analyses , such associations were evident among those over 50 years , those not meeting the physical activity recommendations and those who did not undertake vigorous-intensity activity . There were no interactions by sex or BMI . No associations were seen between pace and cancer mortality . Conclusion Walking benefits health . Assuming causality , these analyses suggest that increasing walking pace could reduce risk for all-cause and CVD mortality .  Walking pace could be emphasised in public health messages , especially in situations when increase in walking volume or frequency is less feasible Background Evidence , mainly from cross-sectional studies , suggests that physical activity is a potentially important modifiable factor associated with physical performance and strength in older age . It is unclear whether the benefits of physical activity accumulate across life or whether there are sensitive periods when physical activity is more influential . Purpose To examine the associations of leisure-time physical activity across adulthood with physical performance and strength in midlife , and to test whether there are cumulative benefits of physical activity . Methods Using data on approximately 2400 men and women from the UK Medical Research Council National Survey of Health and Development , followed up since birth in March 1946 , the associations of physical activity levels during leisure time self-reported prospect ively at ages 36 , 43 , and 53 years with grip strength , st and ing balance , and chair rise times , assessed by nurses at age 53 years ( in 1999 ) , were examined in 2010 . Results There were independent positive effects of  physical activity at all three ages on chair rise performance , and at ages 43 and 53 years on st and ing balance performance , even after adjusting for covariates . These results were supported by evidence of cumulative effects found when using structured life course models . Physical activity and grip strength were not associated in women and , in men , only physical activity at age 53 years was associated with grip strength . Conclusions There are cumulative benefits of physical activity across adulthood on physical performance in midlife . Increased activity should be promoted early in adulthood to ensure the maintenance of physical performance in later life Background While some clinical reports suggest minimally invasive surgical ( MIS ) techniques improve recovery and reduce pain in the first months after TKA , it is unclear whether it improves gait and thigh muscle strength . Questions / Purpose sWe hypothesized TKA performed through a mini-subvastus approach would improve subjective and objective and subjective function compared to a st and ard medial parapatellar approach 2 months after surgery . Methods We r and omized 40 patients into two groups using either the mini-subvastus approach or st and ard medial parapatellar approach .  Patients were evaluated preoperatively and 2 months after surgery . We assessed subjective functional outcome and quality of life ( QOL ) using routine question naires ( SF-12 , Knee Society Score [ KSS ] , Knee Injury and Osteoarthritis Outcome Score [ KOOS ] , UCLA activity , patient milestone diary of activities ) . We determined isometric strength of the thigh muscles and assessed gait with a three-dimensional ( 3-D ) analysis during level walking and stair climbing . Results We observed improvements from preoperatively to 2 months postoperatively in functional scores , QOL , and knee kinematic and kinetic gait parameters during level and stair walking . Isometric quadriceps strength increased in both groups , although remaining lower when compared to sound limbs . We found no differences between the groups in KSS , SF-12 , KOOS , UCLA activity , patient milestone diary of activities , isometric quadriceps strength , or 3-D gait parameters , except a marginally higher speed of stair ascent in the MIS group . Conclusions Our observations suggest an MIS approach does not confer a substantial advantage in early function after TKA.Level of Evidence Level I , therapeutic study . See Instructions to Authors for a complete description of levels of evidence
Active travel may have positive effects on health outcomes , but there is little robust evidence to date of the effectiveness of active transport interventions for reducing obesity .
BACKGROUND Increasing active travel ( primarily walking and cycling ) has been widely advocated for reducing obesity levels and achieving other population health benefits .
However , the strength of evidence underpinning this strategy is unclear .
This study aim ed to assess the evidence that active travel has significant health benefits .