Analysis of Variables That Influence the Walkability of School Environments Based on the Delphi Method.

Walkability is determined the presence or absence of factors such as quality sidewalks, pedestrian crossings, traffic, etc. The ability to walk to the school environment may be one of the variables that promotes active commuting levels. The aim of this study was to examine the walkability of school environments using the Delphi method. This study used the Delphi method to measure the walkability. A total of 18 experts were selected. First, a list of variables was designed by the control group and sent three times to the experts. Later, the items were analyzed qualitatively and quantitatively to test the consensus of the experts. The list of variables that influence walkability showed a good consensus among the experts at the end of the process. This list was formed by 48 items and organized in six factors: traffic and safety (eleven items), signage (eight items), sidewalk (ten items), transport consistency (five items), activity (five items), and finally, urban planning (nine items). The experts agreed on the need to analyze the environments of educational centers and measure the variables that affect walkability. This study has identified the most important barriers. In the future, a measurement instrument should be developed that allows centers to be compared with others in terms of their levels of walkability. Moreover, it might be a resource for more policies to be developed with the aim to promote active commuting to school.

Effects of a Home-Based Exercise Program on Health-Related Quality of Life and Physical Fitness in Dementia Caregivers: A Randomized Controlled Trial.

Regular exercise can be an effective health-promotion strategy to improve the physical and mental health of informal caregivers. A randomized controlled trial study was designed to evaluate the effects of a 9-month home-based exercise intervention on health-related quality of life (HRQoL) and physical fitness in female family caregivers of persons with dementia. Fifty-four female caregivers were randomly assigned to two groups for the 9-month study period. Participants of the intervention group (n = 25) performed two 60-min exercise sessions per week at home, under the direct supervision of a personal trainer. Participants in the control group (n = 23) continued their habitual leisure-time activities. HRQoL was assessed using the SF-36 questionnaire, and physical fitness was measured using a battery of appropriate fitness tests. After 9 months, significant improvements were observed in general health, social function, vitality, hand and leg strength, trunk flexor and extensor endurance, and aerobic endurance in the intervention group. The present intervention was highly adherent and safe for the participants, with no dropout related to the intervention. As a home-based exercise program conducted by a personal trainer face to face, it can be considered as a feasible and appropriate method to improve the most deficient HRQoL dimensions and contribute to preserving the functional capacity of female family caregivers of persons with dementia.

Health-related quality of life and multidimensional fitness profile in polio survivors.

PURPOSE: To assess and compare the HRQoL and physical fitness of polio survivors with healthy individuals. METHODS: Thirty-seven polio survivors and 40 healthy individuals were recruited in this cross-sectional study. The Fatigue Severity Scale (FSS) was used to evaluate participant's level of fatigue; Short Form 36 (SF-36) was used for evaluating HRQoL, and hand-grip strength, lumbar trunk muscle endurance, flexibility, balance, and aerobic endurance were used as measures for physical fitness. RESULTS: Polio survivors had lower HRQoL in most of the dimensions of the SF-36, and they showed a lower level of physical fitness than controls. In particular, mobility-related variables were 20-40% lower in people with PP. CONCLUSIONS: Subjects with PP had lower scores for the physical component of the HRQoL questionnaire, reduced physical fitness, increased fatigue, less mobility, and a higher fall risk than controls. The outcomes of the study can be useful to the design of future programs tailored specifically to improve the assessment of the physical fitness of subjects with paralytic polio and to facilitate interventions based on appropriate physical exercise regimens.Implications for rehabilitationPost-polio syndrome is a disabling disease that impacts in fitness, physical and psychological health-related quality of life of polio survivors.Polio survivors should undergo physical activity programs that focus on improving mainly their mobility and physical functioning (walking, self-care, and climbing stairs), thereby reducing fall risk and fatigue.Individual tailored physical exercise programs should be promoted in order to improve HRQoL in this population.