Effects of recreational soccer on physical fitness and health indices in sedentary healthy and unhealthy subjects Inverse association between physical inactivity and mental health in men and women. Effect of two contrasting types of physical exercise on chronic neck muscle pain. The efficacy of aerobic exercise and resistance training as transdiagnostic interventions for anxiety-related disorders and constructs: A randomized controlled trial. Changes in physical activity are reflected in changes in fitness during late adolescence. A 2-year follow-up study. Low Cardiorespiratory Fitness and Physical Inactivity as Predictors of Mortality in Men with Type 2 Diabetes The effectiveness of two psychomotor therapy programmes on physical fitness and physical self-concept in nonpsychotic psychiatric patients: a randomized controlled trial Changes in Physical Fitness Predict Improvements in Modifiable Cardiovascular Risk Factors Independently of Body Weight Loss in Subjects With Type 2 Diabetes Participating in the Italian Diabetes and Exercise Study (IDES) Problem elicitation to assess patient priorities in ankylosing spondylitis and fibromyalgia. Evaluating the effects of a low volume stairclimbing programme on measures of health-related fitness in sedentary office workers. Effects of Moderate- Versus High-Intensity Exercise Training on Physical Fitness and Physical Function in People With Type 2 Diabetes: A Randomized Clinical Trial Exercise at an onsite facility with or without direct exercise supervision improves health‐related physical fitness and exercise participation: An 8‐week randomised controlled trial with 15‐month follow‐up Low physical fitness in childhood is associated with the development of asthma in young adulthood: the Odense schoolchild study. A multi-modal training programme to improve physical activity, physical fitness and perceived physical ability in obese children Alcohol consumption and cardiorespiratory fitness in five population-based studies Protocol for a randomized controlled trial evaluating the effect of physical activity on delaying the progression of white matter changes on MRI in older adults with memory complaints and mild cognitive impairment: The AIBL Active trial Preliminary efficacy and feasibility of embedding high intensity interval training into the school day: A pilot randomized controlled trial [The influence of the outpatient cardiologic rehabilitation on the physical fitness at patients after a STEMI]. The health benefits of interactive video game exercise. The relationship between health-related fitness and quality of life in postmenopausal women from Southern Taiwan Function and health-related quality of life: results from a randomized controlled trial of leflunomide versus methotrexate or placebo in patients with active rheumatoid arthritis. Leflunomide Rheumatoid Arthritis Investigators Group. The Los Angeles Lift Off: a sociocultural environmental change intervention to integrate physical activity into the workplace. High-intensity aerobic training during a 10 week one-hour physical education cycle: effects on physical fitness of adolescents aged 11 to 16. Randomized controlled trial using bosentan to enhance the impact of exercise training in subjects with type 2 diabetes mellitus. Use of molecular imaging to predict clinical outcome in patients with rectal cancer after preoperative chemotherapy and radiation. The Association between Cardiorespiratory Fitness and Impaired Fasting Glucose and Type 2 Diabetes Mellitus in Men
Recreational soccer ( RS ) is becoming a popular alternative to the classical continuous exercise mode used for the improvement of cardiovascular and metabolic fitness in untrained people . The objective of this paper was to conduct a detailed systematic review of the literature , identifying the physiological responses to RS and the training effects of RS on aerobic fitness and health in untrained healthy individuals and clinical patients . PubMed , Google Scholar and ScienceDirect data bases were search ed using terms related to recreational soccer . Inclusion criteria were r and omized controlled trials ( RCT ) that assessed acute physiological responses to RS or the training effects of RS on physical fitness and health in sedentary , untrained subjects of any age or health status . All studies were assessed for method ological quality using the PEDro scale . Thirty-five articles met the inclusion criteria ; seven examined the acute response to RS , and 28 assessed training effects . Clear evidence was found that RS had positive effects on many health-related indices and variables , including VO2max ( gains of 7 - 16 % ) , blood pressure ( reductions of 6 - 13 mmHg ) , body composition ( decreased fat mass and improved indices of bone health ) , and metabolic and cardiac function . These positive effects were observed in both healthy individuals and clinical patients , irrespective of age or sex . Although this review provides clear evidence of the positive effects of RS on health , most studies had limitations of methodology ( an average PEDro score < 6 ) . Furthermore , many of the training studies were from a small number of research groups . Future studies should be extended to other countries and institutions to ensure generality of the results . Regular RS training leads to significant cardiovascular and muscular adaptations and gains of health both in sedentary individuals and clinical patients at all ages , suggesting that RS is a potentially highly motivational method to enhance population health PURPOSE The Aerobics Center Longitudinal Study ( ACLS ) provides the opportunity to evaluate associations between measures of physical activity and mental health in a large and well-characterized population of men and women . METHODS Participants were 5451 men and 1277 women ( 20 - 88 yr ) who completed a maximal fitness treadmill test and self-report measures of habitual physical activity , depressive symptoms ( Center for Epidemiological Studies Scale for Depression ; CES-D ) and emotional well-being ( General Well-Being Schedule ; GWB ) . To evaluate the dose-response gradient of the association , we classified the sample , separately for men and women , into three levels of relative cardiorespiratory ( CR ) fitness ( low , moderate , high ) on the maximal treadmill test , and four levels on a physical activity index of weekly walking , jogging , and running . RESULTS In both men and women , there was a significant inverse grade d dose-response relationship between maximal CR fitness and the CES-D score ( P < 0.0001 ) , and a significant positive grade d dose-response relationship between CR fitness and the GWB score ( P < 0.0001 ) . We also observed dose-response associations between the level of physical activity and both CES-D and GWB scores ( P < 0.0001 ) that peaked at 11 - 19 miles per week . CONCLUSION Among men and women in the ACLS , relative increases in maximal CR fitness and habitual physical activity are cross-sectionally associated with lower depressive symptomatology and greater emotional well-being . Prospect i ve epidemiological studies and controlled clinical trials are needed to identify the minimal and optimal levels of physical activity and CR fitness associated with various mental health benefits in different segments of the general population OBJECTIVE The prevalence of neck muscle pain has steadily increased and especially pain from the descending part of the trapezius muscle has been associated with monotonous work tasks such as computer work . Physical exercise is generally recommended as treatment , but it is unclear which type of training is most effective . Our objective was to determine the effectiveness of specific strength training of the painful muscle versus general fitness training without direct involvement of the painful muscle ( leg bicycling ) on work-related neck muscle pain . METHODS We conducted a r and omized controlled trial and recruited subjects from 7 workplaces characterized by monotonous jobs ( e.g. , computer-intensive work ) . Forty-eight employed women with chronic neck muscle pain ( defined as a clinical diagnosis of trapezius myalgia ) were r and omly assigned to 10 weeks of specific strength training locally for the affected muscle , general fitness training performed as leg bicycling with relaxed shoulders , or a reference intervention without physical activity . The main outcome measure was an acute and prolonged change in intensity of neck muscle pain ( 100-mm visual analog scale [ VAS ] ) . RESULTS A decrease of 35 mm ( approximately 79 % ; P<0.001 ) in the worst VAS pain score over a 10-week period was seen with specific strength training , whereas an acute and transient decrease in pain ( 5 mm ; P<0.05 ) was found with general fitness training . CONCLUSION Specific strength training had high clinical relevance and led to marked prolonged relief in neck muscle pain .  General fitness training showed only a small yet statistically significant acute pain reduction Evidence supports exercise as an intervention for many mental health concerns ; however , r and omized controlled investigations of the efficacy of different exercise modalities and predictors of change are lacking . The purpose s of the current trial were to : ( 1 ) quantify the effects of aerobic exercise and resistance training on anxiety-related disorder ( including anxiety disorders , obsessive-compulsive disorder , and posttraumatic stress disorder ) status , symptoms , and constructs , ( 2 ) evaluate whether both modalities of exercise were equivalent , and ( 3 ) to determine whether exercise enjoyment and physical fitness are associated with symptom reduction . A total of 48 individuals with anxiety-related disorders were r and omized to aerobic exercise , resistance training , or a waitlist . Symptoms of anxiety-related disorders , related constructs , and exercise enjoyment were assessed at pre-intervention and weekly during the 4-week intervention . Participants were further assessed 1-week and 1-month post-intervention . Both exercise modalities were efficacious in improving disorder status . As well , aerobic exercise improved general psychological distress and anxiety , while resistance training improved disorder-specific symptoms , anxiety sensitivity , distress tolerance , and intolerance of uncertainty . Physical fitness predicted reductions in general psychological distress for both types of exercise and reductions in stress for aerobic exercise . Results highlight the efficacy of different exercise modalities in uniquely addressing anxiety-related disorder symptoms and constructs The study describe changes over 2 years in different physical fitness measures and the relationship between these changes and changes in physical activity . Maximal aerobic work capacity ( Wattmax ) , functional strength , muscle endurance , agility and flexibility were measured in 259 r and omly selected high school boys and girls 16.5 years of age and followed-up 2 years later , while they still attended school . Most physical fitness measures increased over time in boys , and in girls an increase was found in arm extensor strength and trunk extensor endurance , but Wattmax per kg body mass decreased . Changes in physical performance between 16 and 18 years of age seem to be very similar in different countries , despite differences in physical activity patterns and absolute level of performance . No change was found in time of participation in physical activity or sports activity  in either gender , but fewer girls participated in  leisure-time sports  at the 2nd test ( p < 0.001 ) . Change in physical activity or sports activity  did not relate to change in physical fitness level . The relationships between level of sports participation ( competition , for health or none ) and physical fitness measures at baseline and at the 2nd test were weak or non-significant . Three explanations for the weak relationship between physical activity and fitness are suggested : ( A ) part of the variability in fitness is explained by genetics , ( B ) growth and hormonal changes , especially in boys , override the stimulus of training , and ( C ) the physical fitness level in adolescents is so high that only physical activity at high relative intensity is supposed to have an effect on the fitness level Exercise has become a st and ard therapy for patients with type 2 diabetes ( 1 ) . Regular exercise improves conventional clinical risk factors , cardiorespiratory fitness , and components of the insulin resistance syndrome ( 2 - 6 ) . However , it is unclear whether physical activity improves the prognosis of patients with diabetes . No data are available on the association of physical activity or cardiorespiratory fitness with mortality in patients with diabetes . The overall benefit of exercise for these patients is unclear , and some experts are concerned that macrovascular and microvascular complications may be worsened by an exercise program ( 1 , 7 ) . Some consider exercise only as a supplement to diet therapy ( 8) . Studies have shown repeatedly that low cardiorespiratory fitness and physical inactivity are directly associated with cardiovascular disease and all-cause mortality ( 9 - 14 ) , and our preliminary study with a small number of end points suggested that this association might persist across plasma glucose levels ( 15 ) . In the current study , we evaluated the prospect i ve association of cardiorespiratory fitness and physical inactivity with mortality in men who have type 2 diabetes . Methods The material presented in this report was derived from the Aerobics Center Longitudinal Study ( ACLS ) , a prospect i ve observational study of patients examined at The Cooper Clinic in Dallas , Texas . The study was review ed and approved annually by the institutional review board at The Cooper Institute . Additional details of study methods and study group characteristics of this cohort have been published elsewhere ( 12 , 13 ) . Patients Participants were men with type 2 diabetes who completed a baseline medical evaluation at The Cooper Clinic in Dallas , Texas , during 1970 to 1993 . These men came to The Cooper Clinic for a medical examination and health counseling . Many were sent by their employers for these services , some were referred by their personal physicians , and others were self-referred . More than 92 % of the patients are white , and most are employed in executive or professional occupations ; more than 75 % are college graduates . Study participants come from middle and upper socioeconomic strata , but they are similar to other well-characterized study group-based cohorts in terms of blood pressure , cholesterol level , body weight , and cardiorespiratory fitness ( 6 , 16 , 17 ) . We excluded men taking insulin and those with a history of cancer at baseline . Clinical Examination The baseline evaluation was performed after participants gave informed written consent for the baseline medical examination and registration in the follow-up study . Examinations followed an overnight fast of at least 12 hours and included personal and family health histories , a question naire on demographic characteristics and health habits , a physical examination , a maximal exercise test on a treadmill , anthropometry , electrocardiography , blood chemistry analyses , and blood pressure measurement . Technicians who followed a st and ard manual of operations administered all procedures . Question naire Patients completed an extensive self-report of personal and family medical diseases and conditions . Each clinic physician examines only four or five patients per day and thus has time for thorough additional probing of items on the self-reported question naire . This complete review of the patient 's medical history and the subsequent physical examination are strengths of the ACLS and provide a more thorough evaluation of baseline health status than is possible in many epidemiologic studies . The question naire also featured items on health habits , including current smoking status and smoking history and whether the participant was currently dieting to lose weight or following any other special dietary plan . Physical activity pattern was ascertained by self-report on the question naire . An extensive list of leisure-time physical activities was presented , and participants indicated activities in which they had participated in the 3 months before the examination . In later study years , they gave additional details on the number of times per week and the duration of exercise sessions . Laboratory Evaluations Cardiorespiratory fitness was assessed by using a maximal exercise test that followed a modified version of Balke and Ware 's protocol ( 18 ) . Briefly , the test began with the participant walking on a horizontal treadmill at 88 m/min . After the first minute , the elevation increased to 2 % , and it further increased 1 % each minute up to 25 minutes . For the few patients who were still able to continue , the elevation was held constant after 25 minutes and the speed increased to 5.4 m/min until the participant reached volitional fatigue . Exercise test performance with this protocol correlates highly with measured maximal oxygen uptake ( r=0.92 ) ( 19 ) . Serum sample s were analyzed by using automated techniques in a laboratory that participates in and meets the quality control st and ards of the Centers for Disease Control and Prevention Lipid St and ardization Program . Blood pressure was measured by auscultatory methods with a mercury sphygmomanometer according to American Heart Association guidelines ( 20 ) . The lowest of three blood pressure measurements at the clinic examination was recorded as the baseline blood pressure . Height and weight were measured by using a st and ard beam-balance scale and stadiometer , and body mass index was calculated . Type 2 Diabetes Diabetes was defined according to criteria of the American Diabetes Association : fasting plasma glucose level of 7.0 mmol/L or greater ( 126 mg/dL ) ( 21 ) . Three hundred seventy patients who did not meet this criterion but who gave a history of physician-diagnosed diabetes were considered to have diabetes . Patients were classified as having known diabetes or unknown diabetes according to their diabetes status before the baseline Cooper Clinic examination . Definition of Exposure Variables The principal exposure variables used in our analyses were  cardiorespiratory fitness and self-reported physical activity .  These exposures were determined at the baseline examination . Cardiorespiratory Fitness  We categorized  total time from the maximal exercise test into frequency distributions for specific age groups ( 30 to 39 , 40 to 49 , 50 to 59 , and 60 years ) . The least fit 20 % of the participants in each age group were classified as low fit , the next 40 % of the distribution as moderately fit , and the highest 40 % as high fit . We have used these cut-points to define fitness in previous studies ( 12 , 13 ) , and they are based on our entire cohort rather than on diabetic patients only . We selected these cut-points before undertaking the current analysis . Cardiorespiratory fitness is expressed as maximal metabolic units ( METs ) attained during the exercise test . The METs are calculated as the working metabolic rate divided by the resting metabolic rate , and 1 MET is equivalent to an oxygen uptake of 3.5 mL1 kg 1 . Physical Activity Patients who reported walking , jogging , or participating in aerobic exercise programs in the 3 months before the examination were classified as active , regardless of the frequency and duration of exercise . Otherwise , patients were classified as inactive . In our cohort , more than 76 % of men who reported being active at baseline still reported being active at the second visit after more than 1 year . In comparison , only 34 % of men who reported being inactive at baseline reported being active at the second examination ( P<0.001 ) . Self-reported physical activity status in our cohort is correlated with maximal exercise test performance ( 6 , 22 ) . Baseline or Parental Cardiovascular Disease We defined baseline cardiovascular disease as a personal history of heart attack , stroke , or a revascularization procedure ; an abnormal resting or exercise electrocardiogram ; or the highest heart rate during exercise testing that was less than 85 % of the age-predicted maximal heart rate ( [ 220 age in years ] 0.85 ) . Men who reported a history of cardiovascular disease in either parent were classified as having parental cardiovascular disease . Conventional Cardiovascular Disease Risk Factors We assigned men to risk strata for conventional cardiovascular disease risk factors on the basis of recent recommendations ( 23 ) . We defined high blood pressure as systolic blood pressure of 140 mm Hg or more , diastolic blood pressure of 90 mm Hg or more , or a history of physician-diagnosed hypertension . We classified participants with a total cholesterol level of 6.2 mmol/L ( 240 mg/dL ) or more as having high cholesterol , those with self-reported current smoking as current smokers , those with a self-reported parental history of myocardial infa rct ion or stroke as having a history of parental cardiovascular disease , those with a body mass index less than 25.0 kg/m2 as normal weight , and those with a body mass index of 25.0 kg/m2 or more as overweight . Statistical Analysis Our primary outcome measure was all-cause mortality . We used the National Death Index to identify  decedents in the ACLS . The National Death Index has been shown to be an effective , accurate means of ascertaining deaths in the general population , with a sensitivity of about 96 % and a specificity of 100 % ( 24 ) . We obtained official death certificates from states in which there were ACLS decedents , and we had the certificates coded by a nosologist according to the International Classification of Diseases , Ninth Revision . Only the underlying cause of death was used in analyses for this report . Data were analyzed by using the SAS statistical package ( SAS Institute , Inc. , Cary , North Carolina ) . The analyses assumed that physical activity and fitness were essentially unchanged during the study period . We used survival curves to estimate survival function against time and log [ log ( survival time ) ] to check the proportional hazards model assumption . Log [ log ( survival function ) ] estimates were approximately parallel across exposure Objective : To compare the changes in cardiorespiratory and muscular fitness , and the changes in physical self-concept after participation in one of two psychomotor therapy programmes in a sample group of psychiatric patients . To study the relationship between the changes in physical fitness and the changes in physical self-concept . Design : R and omized controlled parallel-group trial with repeated measures . Setting : Three treatment units of a university psychiatric hospital in Belgium . Subjects : One hundred and ninety-nine patients with severe symptoms of depression and /or anxiety , and /or personality disorders . Interventions : A general programme of psychomotor therapy , consisting of different forms of physical exercises and relaxation training , and a personalized psychomotor fitness programme , consisting of aerobic and resistance training . These programmes were followed three times a week for a period of 16 weeks . Outcome measures : The maximum dynamic strength , the strength endurance , physical work capacity at 60 % and 80 % of the estimated maximal heart rate reserve , and the physical self-concept by means of the Dutch version of the Physical Self-Perception Profile . Results : After eight weeks , both groups exhibited an improvement in muscular fitness ( both p-values < 0.0001 ) , but only the psychomotor fitness group had improved in cardiorespiratory fitness ( p < 0.01 ) . After 16 weeks , the patients in the general programme of psychomotor therapy had not increased in cardiorespiratory fitness . At the end of the 16-week programmes , both groups showed a more positive physical self-concept ( p from 0.01 to < 0.0001 ) . However , these improvements were not related to the progress in physical fitness . Conclusions : The main difference in the effectiveness of the two programmes was the increase in cardiorespiratory fitness in the psychomotor fitness group . The gains in fitness did not play an essential role in the enhancement of physical self-concept OBJECTIVE Physical fitness is inversely related to mortality in the general population and in subjects with type 2 diabetes . Here , we present data concerning the relationship between changes in physical fitness and modifiable cardiovascular risk factors in subjects with type 2 diabetes from the Italian Diabetes and Exercise Study . RESEARCH DESIGN AND METHODS Sedentary patients with type 2 diabetes ( n = 606 ) were enrolled in 22 outpatient diabetes clinics and r and omized to twice-a-week supervised aerobic and resistance training plus exercise counseling versus counseling alone for 12 months . Baseline to end-of- study changes in cardiorespiratory fitness , strength , and flexibility , as assessed by Vo2max estimation , a 5–8 maximal repetition test , and a hip/trunk flexibility test , respectively , were calculated in the whole cohort , and multiple regression analyses were applied to assess the relationship with cardiovascular risk factors . RESULTS Changes in Vo2max , upper and lower body strength , and flexibility were significantly associated with the variation in the volume of physical activity , HbA1c , BMI , waist circumference , high-sensitivity C-reactive protein ( hs-CRP ) , coronary heart disease ( CHD ) risk score , and inversely , HDL cholesterol . Changes in fitness predicted improvements in HbA1c , waist circumference , HDL cholesterol , hs-CRP , and CHD risk score , independent of study arm , BMI , and in case of strength , also waist circumference . CONCLUSIONS Physical activity/exercise-induced increases in fitness , particularly muscular , predict improvements in cardiovascular risk factors in subjects with type 2 diabetes independently of weight loss , thus indicating the need for targeting fitness in these individuals , particularly in subjects who struggle to lose weight OBJECTIVE To elicit patient priorities as outcome measures in ankylosing spondylitis ( AS ) and fibromyalgia ( FM ) ; to relate these measures to other outcomes ; to assess construct validity and sensitivity to change of the problem elicitation technique ( PET ) question naire . METHODS One hundred thirty-four patients with AS were r and omly allocated to weekly sessions of group physical therapy or daily exercises at home , whereas 73 patients with FM were r and omized into one of 3 groups ( low impact fitness , biofeedback , controls ) . The PET question naire was applied by trained interviewers at baseline and at 6 ( FM ) and 9 ( AS ) month followup . A PET score was calculated at each assessment . Construct validity of the PET was assessed by correlation and multiple regression of baseline values with other disease outcomes ( pain , stiffness , patient 's global assessment , Sickness Impact Profile ( SIP ) , Health Assessment Question naire ( HAQ ) , Arthritis Impact Measurement Scale ( AIMS ) , patient utilities ) . Sensitivity to change of PET was assessed against changes in these outcomes and by comparing the efficiency of the PET with other outcomes . RESULTS Patients with FM identified more problems ( mean 6.8 ) than patients with AS ( mean 4.4 ) . Moreover , more patients with AS than with FM were unable to identify any problem at baseline ( 10 % compared to 1 % ) . The  PET score improved from 14.9 to 11.3 ( p = 0.0001 ) in patients with AS but did not change from 21.8 to 21.1 ( p = 0.24 ) in patients with FM . Construct validity testing of the PET score showed statistically significant ( p < 0.05 ) correlations with AIMS , utilities , SIP , HAQ , pain , stiffness , and patient 's global health in both groups of patients ( r varying from 0.22 to 0.66 ) . By multiple regression pain explained 29 % of the variance in PET scores among patients with AS . In FM patient global assessment accounted for 39 % of total variance of PET scores , whereas pain explained another 15 % . Changes in  PET scores correlated significantly ( p < 0.05 ) with changes in AIMS , utilities , pain , stiffness , and patient global health in both AS and FM ( r varying from 0.22 to 0.51 ) . Some 6 % of the variance in changes in  PET scores was explained by changes in pain in patients with AS and 35 % by changes in pain and subjective health in patients with FM . Assessment of sensitivity to change revealed that efficiency of the PET score was 0.6 in patients with AS and 0.09 in those with FM . Compared to other outcomes this was reasonable in patients with AS but low in those with FM . CONCLUSION Obtaining patient priorities was generally feasible . In both groups of patients construct validity of the PET question naire was satisfactory . The PET was much more sensitive to change in patients with AS than in patients with FM Despite its obvious advantages , few studies have examined health outcomes of regular stariclimbing . In this study , we investigated the training effects of eight weeks of stairclimbing on recognised measures of health-related fitness in an occupational setting . Forty-five public sector employees ( 22 male , 23 female ) aged 42.3 ± 9.0 years were r and omly assigned to control ( n = 16 ) or stairclimbing  ( n = 29 ) groups . Stairclimbing training began with 1 bout 5d·wk(-1 ) in week 1 , increasing by one climb per day every two weeks until week 5 , where a maintenance level of 3 climbs per day was reached . Participants climbed on staircases located within an 8 storey office block , consisting of 145 steps . The prescribed exercise intensity involved climbing the 8 flights of stairs at a rate of 75 steps·min(-1 ) . All participants agreed not to change their diet or lifestyle over the experimental period . Relative to controls , the stairclimbing group showed a significant increase of 9.4 % in predicted VO2max ( p < 0 . 05 ) . No significant changes in blood pressure , blood lipid concentrations or body composition were noted . These findings provide evidence that stairclimbing can enhance an important component of health-related fitness , namely cardiovascular fitness . Given that such improvement result ed from less than 30 minutes per week of moderate exercise , stairclimbing in the workplace should be promoted as a health-enhancing physical activity . Key pointsLow volumes of stairclimbing significantly increased a key component of cardiorespiratory fitness , namely VO2max . Stairclimbing can therefore be promoted within the typical urban workplace as a health enhancing activity . Indices of morphological or metabolic fitness may require larger volumes of stairclimbing than as prescribed in the current study Background Exercise training is effective for improving physical fitness and physical function in people with type 2 diabetes . However , limited research has been conducted on the optimal exercise training intensity for this population . Objective The primary study objective was to investigate the effects of moderate- versus high-intensity exercise training on physical fitness and physical function in people with type 2 diabetes . Design This was a r and omized clinical trial . Setting The setting was a university campus . Participants Twenty-one people with type 2 diabetes were r and omly allocated to receive either moderate-intensity training ( MOD group ) or high-intensity training ( HIGH group ) . Intervention The MOD group performed resistance training at an intensity of 75 % of the 8-repetition maximum ( 8-RM ) and aerobic training at an intensity of 30 % to 45 % of the heart rate reserve ( HRR ) . The HIGH group performed resistance training at an intensity of 100 % of the 8-RM and aerobic training at an intensity of 50 % to 65 % of the HRR .  Measurements Muscle strength ( peak torque [ newton-meters ] ) , exercise capacity ( grade d exercise test duration [ minutes ] ) , and physical function ( Patient-Specific Functional Scale question naire ) were measured at baseline and 3 months later . Acute exercise-induced changes in glucose levels were assessed immediately before exercise , immediately after exercise , and 1 hour after exercise during the first exercise training session . Results Although both groups showed improvements in physical fitness and physical function , the between-group effect sizes were not statistically significant ( exercise capacity estimated marginal mean [ EMM ] difference=2.1 , 95 % confidence interval [ 95 % CI]=−0.2 , 4.5 ; muscle strength EMM difference=20.8 , 95 % CI=−23.3 , 65.0 ; and physical function EMM difference=0.1 , 95 % CI=−0.6 , 0.9 ) . Mean percent changes in glucose levels measured immediately before exercise and immediately after exercise , immediately after exercise and 1 hour after exercise , and immediately before exercise and 1 hour after exercise for the MOD group were −11.4 % , −5.0 % , and −15.8 % , respectively ; those for the HIGH group were −21.5 % , 7.9 % , and −15.3 % , respectively . Limitations Sample size , lack of outcome assessor masking , and physical function measurement subjectivity were limitations . Conclusions Moderate- and high-intensity exercise training , as defined in this study , may lead to similar improvements in physical fitness and physical function in people with type 2 diabetes ISSUE ADDRESSED Physical activity and exercise participation is limited by a perceived lack of time , poor access to facilities and low motivation . The aim was to assess whether providing an exercise program to be completed at the workplace with or without direct supervision was effective for promoting health-related physical fitness and exercise participation . METHODS Fifty university employees aged ( Mean ± SD ) 42.5 ± 11.1 years were prescribed a moderate- to vigorous-intensity aerobic and resistance exercise program to be completed at an onsite facility for 8 weeks . Participants were r and omly allocated to receive direct exercise supervision or not . Cardiorespiratory fitness ( V̇O2max ) and maximal muscular strength were assessed at baseline and 8 weeks . Self-report physical activity was assessed at baseline , 8 weeks and 15 months post-intervention . RESULTS Attendance or exercise session volume were not different between groups . Cardiorespiratory fitness ( Mean ± 95 % CI ) ; + 1.9 ± 0.7 mL·kg·min-1 ; P < .001 ) , relative knee flexion ( + 7.4 ± 3.5 Nm·kg-1 % ; P < .001 ) and extension ( + 7.4 ± 4.6 Nm·kg-1 % ; P < .01 ) strength increased , irrespective of intervention group . Self-reported vigorous-intensity physical activity increased over the intervention ( mean ± 95 % CI ; + 450 ± 222 MET·minutes per week ; P < .001 ) , but did not remain elevated at 15 months ( + 192 ± 276 MET·minutes per week ) . CONCLUSION Providing a workplace exercise facility to complete an individually-prescribed 8-week exercise program is sufficient to improve health-related physical fitness in the short-term independent to the level of supervision provided , but does not influence long-term participation . SO WHAT ? : Lower cost onsite exercise facility supervision is as effective at improving physical health and fitness as directly supervised exercise , however ongoing support may be required for sustained physical activity behaviour change Intense physical activity in  children may either improve fitness and protect against asthma , or may trigger symptoms . The aim of this study was to determine whether physical fitness in childhood has an impact on the development of asthma . In this prospect i ve , community-based study , 757 ( 84 % ) asymptomatic children with an average age at inclusion of 9.7 yrs were followed for 10.5 yrs . In both surveys a maximal progressive exercise test on a bicycle ergometer was used to measure physical fitness ( maximal workload ) and to induce airway narrowing . A methacholine provocation test was performed in the subjects at follow-up . During the 10-yr study period , 51 ( 6.7 % ) of the previously asymptomatic children developed  asthma . These subjects had a lower mean physical fitness in 1985 than their peers : ( 3.63 versus 3.89 W x kg(-1 ) ; p=0.02 ) in boys and ( 3.17 versus 3.33 W x kg(-1 ) ; p=0.02 ) in girls . A weak correlation was found between physical fitness in childhood and airway responsiveness to methacholine at follow-up when adjusted for body mass index , age and sex ( r=0.11 ; p<0.01 ) . In a multiple regression analysis , physical fitness was inversely related to the development of physician diagnosed asthma , odds ratio=0.93 ( 0.87 - 0.99 ) . Thus , the risk for the development of asthma during adolescence is reduced 7 % by increasing the maximal workload 1 W x kg(-1 ) . In conclusion , this study showed that physical fitness in childhood is weakly correlated with the development of asthma during adolescence and that high physical fitness seems to be associated with a reduced risk for the development of asthma Abstract Actual and perceived physical abilities are important correlates of  physical activity ( PA ) and fitness , but little research has explored these relationships over time in obese children . This study was design ed : ( a ) to assess the feasibility of a multi-modal training programme promoting changes in PA , fundamental motor skills and real and perceived physical abilities of obese children ; and ( b ) to explore cross-sectional and longitudinal relationships between real and perceived physical competence in boys and girls . Forty-one participants ( 9.2 ± 1.2 years ) were assessed before and after an 8-month intervention with respect to body composition , physical fitness , self-reported PA and perceived physical ability . After treatment , obese children reported improvements in the body mass index , PA levels , gross motor performance and actual and perceived physical abilities . Real and perceived physical competence was correlated in boys , but not in girls . Results indicate that a multi-modal programme focused on actual and perceived physical competence as associated with the gradual increase in the volume of activity might be an effective strategy to improve adherence of the participants and to increase the lifelong exercise skills of obese children Background Poor cardiorespiratory fitness is a risk factor for cardiovascular morbidity . Alcohol consumption contributes substantially to the burden of disease , but its association with cardiorespiratory fitness is not well described . We examined associations between average alcohol  consumption  , heavy episodic drinking and cardiorespiratory fitness . Design The design of this study was as a cross-sectional population -based r and om sample . Methods We analysed data from five independent population -based studies ( Study of Health in Pomerania ( 2008–2012 ) ; German Health Interview and Examination Survey ( 2008–2011 ) ; US National Health and Nutrition Examination Survey ( NHANES ) 1999–2000 ; NHANES 2001–2002 ; NHANES 2003–2004 ) including 7358 men and women aged 20–85 years , free of lung disease or asthma .  Cardiorespiratory fitness , quantified by  peak oxygen uptake , was assessed using exercise testing . Information regarding average alcohol consumption ( ethanol in grams per day ( g/d ) ) and heavy episodic drinking ( 5 + or 6 + drinks/occasion ) was obtained from self-reports . Fractional polynomial regression models were used to determine the best-fitting dose-response relationship . Results Average alcohol consumption displayed an inverted U-type relation with peak oxygen uptake ( p-value<0.0001 ) , after adjustment for age , sex , education , smoking and physical activity . Compared to individuals consuming 10 g/d ( moderate consumption ) , current abstainers and individuals consuming 50 and 60 g/d had significantly lower peak oxygen uptake values ( ml/kg/min ) ( β coefficients = −1.90 , β = −0.06 , β = −0.31 , respectively ) . Heavy episodic drinking was not associated with peak oxygen uptake . Conclusions Across multiple adult population -based sample s , moderate drinkers displayed better fitness than current abstainers and individuals with higher average alcohol consumption Background Older adults free of dementia but with subjective memory complaints ( SMC ) or mild cognitive impairment ( MCI ) are considered at increased risk of cognitive decline . Vascular risk factors ( VRF ) , including hypertension , heart disease , smoking , hypercholesterolemia and lack of physical activity ( PA ) have been identified as modifiable risk factors contributing to cognitive decline , and white matter hyperintensities ( WMH ) are associated with VRF , SMC and cognitive impairment . Findings from a growing number of clinical trials with older adults are providing strong evidence for the benefits of physical activity for maintaining cognitive function , but few studies are investigating these benefits in high-risk population s. The aim of AIBL Active is to determine whether a 24-month physical activity program can delay the progression of white matter changes on magnetic resonance imaging ( MRI ) . Methods / design This single-blind r and omized controlled trial ( RCT ) is offered to 156 participants , aged 60 and older , in the Melbourne arm of the Australian Imaging Biomarkers and Lifestyle Flagship Study of Aging ( AIBL ) . Participants must have SMC with or without MCI and at least one VRF . The PA intervention is a modification of the intervention previously trialed in older adults with SMC and MCI ( Fitness for the Ageing Brain Study ) . It comprises 24 months of moderate , home-based PA ( 150 minutes per week ) and a behavioral intervention package . The primary outcome measure will be change in WMH after 24 months on MRI . Cognition , quality of life , functional fitness , level of physical activity , plasma biomarkers for cerebrovascular disease and amyloid positron emission tomography ( PET ) imaging comprise secondary measures . Discussion Currently , there is no effective pharmacological treatment available to delay cognitive decline and dementia in older adults at risk . Should our findings show that physical activity can slow down the progression of WMH , this RCT would provide an important proof of concept . Since imbedded in AIBL this RCT will also be able to investigate the interaction between vascular and Alzheimer 's disease pathologies . Trial Registration Australia New Zeal and Clinical Trials Registry Current physical activity and fitness levels among adolescents are low , increasing the risk of chronic disease . Although the efficacy of high intensity interval training ( HIIT ) for improving metabolic health is now well established , it is not known if this type of activity can be effective to improve adolescent health . The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day . A 3-arm pilot r and omized controlled trial was conducted in one secondary school in Newcastle , Australia . Participants ( n = 65 ; mean age = 15.8(0.6 ) years ) were r and omized into one of three conditions : aerobic exercise program ( AEP ) ( n = 21 ) , resistance and aerobic exercise program ( RAP ) ( n = 22 ) and control ( n = 22 ) . The 8-week intervention consisted of three HIIT sessions per week ( 8–10 min/session ) , delivered during physical education ( PE ) lessons or at lunchtime . Assessment s were conducted at baseline and post-intervention to detect changes in cardiorespiratory fitness ( multi-stage shuttle-run ) , muscular fitness ( push-up , st and ing long jump tests ) , body composition ( Body Mass Index ( BMI ) , BMI -z scores , waist circumference ) and physical activity motivation ( question naire ) , by research ers blinded to treatment allocation . Intervention effects for outcomes were examined using linear mixed models , and Cohen 's d effect sizes were reported . Participants in the AEP and RAP groups had moderate intervention effects for waist circumference ( p = 0.024 ) , BMI -z ( p = 0.037 ) and BMI ( not significant ) in comparison to the control group . A small intervention effect was also evident for cardiorespiratory fitness in the RAP group UNLABELLED Myocardial infraction , sudden cardiac death next is one of the most serious clinical demonstrations of ischaemic heart diseases . It is characterized by an irreversible destruction ( necrosis ) of a part of cardiac muscle , caused by severe narrowing or blood clot ( thrombosis ) in the lumen of coronary arteries . The long-term , systematic and individually selected program of the physical rehabilitation has a beneficial effect to the improvement in the physical fitness at patients , after an myocardial infa rct ion . The aim of this work was to examine the influence of the outpatient , cardiological rehabilitation on the physical fitness and the normalization of the arterial pressure at patients after STEMI , treated with methods of invasive cardiology , and determining effects of the rehabilitation . MATERIAL AND METHODS The study included 108 patients ( 93 men and 15 women ) . An average age of patients was 53 . Examined patients were divided into 2 groups : rehabilitated ( 55 people ) and control ( 53 people ) . The program of the cardiologic rehabilitation included 24 forty-minute training sessions , for 2 - 3 times during the week . Every training session spread through 10 minutes of the general keep-fit exercise ( warm-up ) , 24 minutes of the ride on cycloergometer ( intervallic training ) with submaximal load adjusted individually for every patient , under the constant electrocardiographic scrutiny of the action of the heart , and 6 minutes of respiratory exercises . The criterion of intensity of a physical effort was determined on the basis of a Bruce test according to on the level of the 70 % of the maximum limit of the heart rate . The rehabilitation lasted about 3 months . RESULTS Obtained findings show that the outpatient , cardiologic rehabilitation has a beneficial effect for the improvement in the physical fitness and the decrease in value of the rest arterial pressure at patients after STEMI . Examinations show the increase of the maximum load ( max MET 'S ) and longer duration of the exercise test . CONCLUSIONS Above findings confirm the effectiveness of the cardiological rehabilitation , although they are not spectacular . Perhaps if they increase the frequency and intensity and number of training sessions , the results would be more significant The purpose of this study was to evaluate the effectiveness of interactive video games ( combined with stationary cycling ) on health-related physical fitness and exercise adherence in comparison with traditional aerobic training ( stationary cycling alone ) . College-aged males were stratified ( aerobic fitness and body mass ) and then assigned r and omly to experimental ( n = 7 ) or control ( n = 7 ) conditions . Program attendance , health-related physical fitness ( including maximal aerobic power ( VO2 max ) , body composition , muscular strength , muscular power , and flexibility ) , and resting blood pressure were measured before and after training ( 60%-75 % heart rate reserve , 3 d/week for 30 min/d for 6 weeks ) . There was a significant difference in the attendance of the interactive video game and traditional training groups ( 78 % + /- 18 % vs. 48 % + /- 29 % , respectively ) . VO2 max was significantly increased after interactive video game ( 11 % + /- 5 % ) but not traditional ( 3 % + /- 6 % ) training . There was a significantly greater reduction in resting systolic blood pressure after interactive video game ( 132 + /- 6 vs. 123 + /- 6 mmHg ) than traditional ( 131 + /- 7 vs. 128 + /- 8 mmHg ) training . There were no significant changes in body composition after either training program . Attendance mediated the relationships between condition and changes in health outcomes ( including VO2 max , vertical jump , and systolic blood pressure ) . The present investigation indicates that a training program that links interactive video games to cycle exercise results in greater improvements in health-related physical fitness than that seen after traditional cycle exercise training . It appears that greater attendance , and thus a higher volume of physical activity , is the mechanism for the differences in health-related physical fitness Background Health-related fitness has been reported to be associated with improved quality of life ( QoL ) in the elderly . Health-related fitness is comprised of several dimensions that could be enhanced by specific training regimens . It has remained unclear how various dimensions of health-related fitness interact with QoL in postmenopausal women . Objective The purpose of the current study was to investigate the relationship between the dimensions of health-related fitness and QoL in elderly women . Methods A cohort of 408 postmenopausal women in a rural area of Taiwan was prospect ively collected . Dimensions of health-related fitness , consisting of muscular strength , balance , cardiorespiratory endurance , flexibility , muscle endurance , and agility , were assessed .  QoL  was determined using the Short Form Health Survey ( SF-36 ) . Differences between age groups ( stratified by decades ) were calculated using a one-way analysis of variance ( ANOVA ) and multiple comparisons using a Scheffé test . A Spearman ’s correlation analysis was performed to examine differences between QoL and each dimension of fitness . Multiple linear regression with forced-entry procedure was performed to evaluate the effects of health-related fitness . A P-value of < 0.05 was considered statistically significant . Results Age-related decreases in health-related fitness were shown for sit-ups , back strength , grip strength , side steps , trunk extension , and agility ( P<0.05 ) . An age-related decrease in QoL , specifically in physical functioning , role limitation due to physical problems , and physical component score , was also demonstrated ( P<0.05 ) . Multiple linear regression analyses demonstrated that back strength significantly contributed to the physical component of QoL ( adjusted beta of 0.268 [ P<0.05 ] ) . Conclusion Back strength was positively correlated with the physical component of QoL among the examined dimensions of health-related fitness . Health-related fitness , as well as the physical component of QoL , declined with increasing age OBJECTIVE To assess the efficacy of leflunomide or methotrexate compared with placebo in improving function and health-related quality of life in patients with active rheumatoid arthritis ( RA ) , and to examine correlations between response status ( as defined by the American College of Rheumatology [ ACR ] response criteria ) and improvement in these measures . METHODS This 52-week , multicenter , doubleblind , controlled trial compared responses to the Health Assessment Question naire ( HAQ ) , modified Health Assessment Question naire ( MHAQ ) , Problem Elicitation Technique ( PET ) , Medical Outcomes Study Short Form 36 ( SF-36 ) , and questions regarding work productivity among 3 treatment groups ( leflunomide , methotrexate , and placebo ) . Improvement in the PET top 5 and SF-36 scales and component scores were compared with ACR response rates . RESULTS Clinical ly meaningful and statistically significant ( P<0.0001 ) improvement in measures of function and heath-related quality of life ( MHAQ scores , all scales and disability index of the HAQ , weighted top 5 score of the PET , 5 of 8 scales and physical component score of the SF-36 , and work productivity ) was seen during treatment with leflunomide in comparison with placebo . Methotrexate administration result ed in significant improvements ( P<0.05 ) in comparison with placebo in the MHAQ scores , HAQ disability index , weighted top 5 score of the PET , physical component score of the SF-36 , and bodily pain scale . Compared with methotrexate , leflunomide administration result ed in significantly ( P<0.01 ) more improvement in the MHAQ scores , 5 of 8 scales and disability index of the HAQ , weighted top 5 score of the PET , and 2 of 8 scales and physical component score of the SF-36 . Improvements in the PET score , SF-36 physical component score , and work productivity correlated with the ACR responder rates of > or = 20 % and > or = 50 % improvement . CONCLUSION Significant improvements in function and health-related quality of life occurred in patients with RA during treatment with leflunomide or methotrexate . These findings were clinical ly meaningful and correlated with the ACR response status PURPOSE To present the development and feasibility testing of a sociocultural environmental change intervention strategy aim ed at integrating physical activity into workplace routine . DESIGN R and omized , controlled , post-test only , intervention trial . Setting . Los Angeles County Department of Health Services ' worksites . PARTICIPANTS Four hundred forty-nine employees , predominantly sedentary , overweight , middle-aged women of color , distributed across 26 meetings . INTERVENTION A single 10-min exercise break during work time involving moderate intensity , low-impact aerobic dance and calisthenic movements to music . MEASURES Primary -level of participation , particularly among sedentary staff ; secondary -self-perceived health status , satisfaction with current fitness level , and mood/affective state . RESULTS More than 90 % of meeting attendees participated in the exercises . Among completely sedentary individuals , intervention participants ' self-perceived health status ratings were significantly lower than controls ' ( OR = 0.17 ; 95 % CI = 0.05 , 0.60 ; P = 0.0003 ) . Among all respondents not regularly physically active , intervention participants ' levels of satisfaction with fitness were more highly correlated with self-ranked physical activity stage of change ( r = 0.588 ) than the control participants ' ( r = 0.376 , z = -2.32 , p = 0.02 ) . Among the completely sedentary , control participants reported significantly higher levels of energy than did intervention participants ( P < 0.01 ) . CONCLUSIONS Captive audiences may be engaged in brief bouts of exercise as a part of the workday , regardless of physical activity level or stage of change . This experience may also appropriately erode sedentary individuals ' self-perception of good health and fitness , providing motivation for adoption of more active lifestyles The aim of this study was to analyse the effects of a high-intensity aerobic training program on different components of physical fitness in adolescents aged 11 to 16 years . The subjects were divided into a  high intensity ( HI ) group ( 243 girls and 260 boys ) and a control ( C ) group ( 21 girls and 27 boys ) . HI and C completed a weekly 3 hour physical education ( PE ) session . Before and after a 10-week period , the two groups performed the European physical fitness test battery ( EUROFIT ) . During these 10 weeks HI spent one hour out of three at a specific PE session . These specific sessions consisted of short intermittent exercises ( 10 seconds ) at 100 to 120 % of maximal aerobic speed . They showed a significant influence on st and ing broad jump ( 2.9 % , P<0.05 , F=4.85 ) , 20 meter shuttle run ( 3.8 % , p0.001 , F=23.21 ) and on the maximal distance covered over 7 min ( 7.6 % , P < 0.001 , F= 14.48 ) . For C there was no improvement in EUROFIT performances . It was concluded that training at high intensity improves not only children 's aerobic fitness but also performance of st and ing broad jump . Well-monitored , adequate intensive training is necessary for a more desirable functional development In type 2 diabetes patients , endothelin ( ET ) receptor blockade may enhance blood flow responses to exercise training . The combination of exercise training and ET receptor blockade may represent a more potent stimulus than training alone to improve vascular function , physical fitness and glucose homeostasis . We assessed the effect of an 8 week exercise training programme combined with either ET blockade or placebo on vasculature , fitness and glucose homeostasis in people with type 2 diabetes . In a double-blind r and omized controlled trial , brachial endothelium-dependent and ‑independent dilatation ( using flow-mediated dilatation and glyceryl trinitrate , respectively ) , glucose homeostasis ( using Homeostasis Model Assessment for Insulin Resistance ( HOMA-IR ) ) and physical fitness ( maximal cycling test ) were assessed in 18 men with type 2 diabetes ( 60 ± 6 years old ) . Subjects underwent an 8 week exercise training programme , with half of the subjects receiving ET receptor blockade ( bosentan ) and the other half a placebo , followed by re assessment of the tests above . Exercise training improved physical fitness to a similar extent in both groups , but we did not detect changes in vascular function in either group . This study suggests that there is no adaptation in brachial and femoral artery endothelial function after 8 weeks of training in type 2 diabetes patients . Endothelin receptor blockade combined with exercise training does not additionally alter conduit artery endothelial function or physical fitness in type 2 diabetes PURPOSE To correlate changes in 2-deoxy-2-[18F]fluoro-d-glucose ( 18-FDG ) positron emission tomography ( PET ) ( 18-FDG-PET ) uptake with response and disease-free survival with combined modality neoadjuvant therapy in patients with locally advanced rectal cancer . METHODS AND MATERIAL S Charts were review ed for consecutive patients with ultrasound-staged T3x to T4Nx or TxN1 rectal adenocarcinoma who underwent preoperative chemoradiation therapy at Fox Chase Cancer Center ( FCCC ) or Robert H. Lurie Comprehensive Cancer Center of Northwestern University with 18-FDG-PET scanning before and after combined-modality neoadjuvant chemoradiation therapy .  The maximum st and ardized uptake value ( SUV ) was measured from the tumor before and 3 to 4 weeks after completion of chemoradiation therapy preoperatively . Logistic regression was used to analyze the association of pretreatment SUV , posttreatment SUV , and % SUV decrease on pathologic complete response ( pCR ) , and a Cox model was fitted to analyze disease-free survival . RESULTS A total of 53 patients ( FCCC , n = 41 , RLCCC , n = 12 ) underwent pre- and postchemoradiation PET scanning  between September 2000 and June 2006 . The pCR rate was 31 % . Univariate analysis revealed that % SUV decrease showed a marginally trend in predicting pCR ( p = 0.08 ) . In the multivariable analysis , posttreatment SUV was shown a predictor of pCR ( p = 0.07 ) , but the test results did not reach statistical significance . None of the investigated variables were predictive of disease-free survival . CONCLUSIONS A trend was observed for % SUV decrease and posttreatment SUV predicting pCR in patients with rectal cancer treated with preoperative chemoradiation therapy .  Further prospect i ve study with a larger sample size is warranted to better characterize the role of 18-FDG-PET for response prediction in patients with rectal cancer Type 2 diabetes is a common disease in industrialized countries . It is a major cause of cardiovascular disease and all-cause mortality ( 1 - 6 ) , and its prevalence has increased continuously over the past few decades ( 1 ) . The American Diabetes Association currently defines impaired fasting glucose as a fasting plasma glucose level from 6.1 to 6.9 mmol/L ( 110 to 125 mg/dL ) and type 2 diabetes as a fasting plasma glucose level of 7.0 mmol/L ( 126 mg/dL ) or more ( 1 ) . Data from several prospect i ve studies show an inverse association between physical activity and diabetes ( 7 - 13 ) . However , these studies are limited by the use of self-reporting of physical activity and presence of type 2 diabetes ( 7 - 12 ) . Self-reporting of physical activity tends to be imprecise , and type 2 diabetes is undiagnosed in about 50 % of the prevalent cases ( 14 ) . This leads to misclassification on both exposure and outcome measures ( 15 ) . These limitations may result in underestimation of the true association between sedentary habits and risk for type 2 diabetes . Impaired fasting glucose is a strong predictor of type 2 diabetes , cardiovascular disease , and other diabetic complications ( 6 , 16 - 18 ) . The underlying cause of impaired fasting glucose is unknown , and no prospect i ve study of the association between physical activity and impaired fasting glucose has been published . We examined the relation of cardiorespiratory fitness , objective ly determined by a maximal exercise test on a treadmill , to the incidence of impaired fasting glucose and type 2 diabetes . Cases of impaired fasting glucose and diabetes at baseline and follow-up were determined by using the American Diabetes Association 's current guidelines ( 1 ) . Methods Patients In our population -based prospect i ve study , we included 8633 men 30 to 79 years of age at baseline ( mean , 43.5 years ) who completed at least two medical evaluations at the Cooper Clinic in Dallas , Texas , from 1970 to 1995 . Patients come to the Cooper Clinic for preventive medical examinations and health promotion counseling . Many are sent by their employers for these services , some are referred by their personal physicians , and others are self-referred . More than 97 % of the patients are white , and most are employed in executive or professional occupations . More than 75 % are college graduates . Although study participants came from middle and upper socioeconomic strata , they were similar to other well-characterized population -based cohorts in terms of blood pressure , cholesterol level , body weight , and cardiorespiratory fitness ( 19 ) . The study was review ed and approved annually by the institutional review board at the Cooper Institute for Aerobics Research . Additional details of the study methods and population characteristics of the cohort have been published elsewhere ( 20 , 21 ) . Because clinical or sub clinical heart disease and other conditions associated with type 2 diabetes may alter the level of physical activity and thus cardiorespiratory fitness , we excluded men with an abnormal resting or exercise electrocardiogram or a history of heart attack , stroke , or cancer at the baseline clinical examination ( n=2350 ) . The baseline evaluation was performed after participants gave written informed consent for the initial medical examination and registration in the follow-up study . Examinations were done after patients had fasted for at least 12 hours and included personal and family health histories , a question naire on demographic characteristics and health habits  , a  physical examination  , an  exercise test , anthropometric measurement , electrocardiography , blood chemistry analyses , and blood pressure measurement . Technicians who followed a st and ard manual of operations administered all procedures . Impaired fasting glucose and type 2 diabetes were diagnosed according to American Diabetes Association criteria that define impaired fasting glucose as a fasting plasma glucose level of 6.1 to 6.9 mmol/L ( 110 mg/dL to 125 mg/dL ) and diabetes as a fasting plasma glucose level of 7.0 mmol/L ( 126 mg/dL ) or more ( 1 ) . Patients who did not meet these criteria but who reported a history of diabetes or current therapy with oral antidiabetic agents or insulin were also considered to have diabetes . We excluded patients who had diabetes at baseline according to any of these criteria ( n=377 ) .  Cardiorespiratory fitness was assessed with a maximal exercise test that followed a modified Balke protocol ( 22 ) . Details of treadmill speed and elevation have been described elsewhere ( 20 , 21 ) . Briefly , the test began with the patient walking on a horizontal treadmill at 88 m/min . After the first minute , the elevation increased to 2 % ; the elevation then increased 1 % each minute up to 25 minutes . For the few patients who were still able to continue , the elevation was held constant after 25 minutes and the speed was increased by 5.4 m/min until the patient reached volitional fatigue . Use of this protocol for the exercise test correlates highly ( r=0.92 ) with measured maximal oxygen uptake ( 23 ) . All patients in our study achieved at least 85 % of their age-predicted maximal heart rate ; average maximal heart rates ( SD ) in each age group were 186 11 beats/min for patients 30 to 39 years of age , 179 12 beats/min for those 40 to 49 years of age , 172 13 beats/min for those 50 to 59 years of age , and 162 17 beats/min for those 60 years of age or older .  Average maximal heart rates in each age group exceeded the age-predicted rate ( 220 beats/min age in years ) , which indicates that the exercise test can be considered maximal performance . We defined level of fitness by  total time on the treadmill  at the baseline examination , as in our previous studies ( 20 , 21 ) . Treadmill times were placed in frequency distributions for specific age groups ( 30 to 39 , 40 to 49 , 50 to 59 , or 60 or more years of age ) . The least fit 20 % of the participants in each age group were classified as low fitness , the next 40 % as moderate fitness , and the remaining 40 % as high fitness . The respective cut-points for  total treadmill time  in the low- , moderate- , and high-fitness groups were 945 seconds or less , 946 to 1259 seconds , and 1260 seconds or more for patients 30 to 39 years of age ; 849 seconds or less , 850 to 1020 seconds , and 1021 seconds or more for patients 40 to 49 years of age ; 750 seconds or less , 751 to 1035 seconds , and 1036 seconds or more for patients 50 to 59 years of age ; and 644 seconds or less , 645 to 953 seconds , and 954 seconds or more for patients 60 years of age or older . These cut-points at the 20th and 60th percentiles to define fitness levels were used in previous studies ( 20 , 21 ) and were selected before analysis for our investigation . However , we calculated these cut-points with patients in the current study , from which unhealthy persons were excluded . Therefore , they differ somewhat from the cut-points derived from the entire cohort of the Aerobics Center Longitudinal Study ( 21 ) . For some analyses , such as the models that included change in fitness from baseline to follow-up , cardiorespiratory fitness was expressed as maximal metabolic units ( metabolic equivalents [ METs ] , calculated as the working metabolic rate/resting metabolic rate ; 1 MET is equivalent to an oxygen uptake of 3.5 mL1 kg1 ) achieved on the exercise test . In other analyses , time on the treadmill was used as a continuous variable . Serum sample s were analyzed by using automated techniques in a laboratory that participates in the Centers for Disease Control and Prevention Lipid St and ardization Program . Blood pressure was measured by using auscultatory methods with a mercury sphygmomanometer . We defined high blood pressure as systolic blood pressure of at least 140 mm Hg , diastolic blood pressure of at least 90 mm Hg , or a history of hypertension . Height and weight were measured with a st and ard physician 's scale and stadiometer , and body mass index was calculated as weight in kg/height in m2 . Waist circumference was measured with a st and ard anthropometric tape . Statistical Analysis We used SAS statistical software for data analyses ( 24 ) . The incidence of impaired fasting glucose was calculated for men with normal fasting glucose at baseline , and the incidence of diabetes was based on data from all 8633 patients . For analyses with impaired fasting glucose as the outcome , we excluded 1122 men who had impaired fasting glucose at baseline and an additional 69 men who had normal fasting plasma glucose at baseline but developed diabetes during follow-up . Rates of impaired fasting glucose or diabetes were calculated by dividing the number of incident cases during the study period by the number of person-years over the same period . We defined the study period as the interval between the baseline examination and the last follow-up visit . We used logistic regression to estimate the association between dependent variables and independent variables after adjustment for possible confounding factors . We used general linear models to study the cross-sectional association of fitness level and parental history of diabetes ( 24 , 25 ) . To account for the possible cohort effect of baseline year , we examined the relation between incident cases and baseline year and found no association . We used tests for ordinal linear trend to evaluate the possible relation of higher treadmill time with risk for impaired fasting glucose or diabetes after dividing the sample into the three fitness groups . All P values are two-sided , and those less than 0.05 were considered statistically significant . Role of the Funding Source The funding agencies did not participate in the collection , analysis , or interpretation of data presented in this report or in the decision to su bmi t the manuscript for publication . Results During an average follow-up of 6.1 4.8 years ( range , 1 to 24.8 years ) that included 52 588 person-years , 593 men developed impaired fasting glucose and 149 developed diabetes . Of the men with incident diabetes , 139 ( 93 % ) were not aware of
PET effects on physical fitness in  healthy workers  are moderated by age ( CRF ) and occupation type ( muscular endurance ) .
Further , independently computed subgroup analyses indicated that the training period of the PET programs may play an important role in improving CRF in workers
There is evidence that physical exercise training ( PET ) conducted at the workplace is effective in improving physical fitness and thus health .
However , there is no current systematic review available that provides high-level evidence regarding the effects of PET on physical fitness in the workforce .
To quantify sex- , age- , and occupation type-specific effects of PET on physical fitness and to characterize dose – response relationships of PET modalities that could maximize gains in physical fitness in the working population .