Development of an aerobic capacity prediction model from one-mile run/walk performance in adolescents aged 13-16 years.

A popular algorithm to predict VO2Peak from the one-mile run/walk test (1MRW) includes body mass index (BMI), which manifests practical issues in school settings. The purpose of this study was to develop an aerobic capacity model from 1MRW in adolescents independent of BMI. Cardiorespiratory endurance data were collected on 90 adolescents aged 13-16 years. The 1MRW was administered on an outside track and a laboratory VO2Peak test was conducted using a maximal treadmill protocol. Multiple linear regression was employed to develop the prediction model. Results yielded the following algorithm: VO2Peak = 7.34 × (1MRW speed in m s(-1)) + 0.23 × (age × sex) + 17.75. The New Model displayed a multiple correlation and prediction error of R = 0.81, standard error of the estimate = 4.78 ml kg(-1) · min(-1), with measured VO2Peak and good criterion-referenced (CR) agreement into FITNESSGRAM's Healthy Fitness Zone (Kappa = 0.62; percentage agreement = 84.4%; Φ = 0.62). The New Model was validated using k-fold cross-validation and showed homoscedastic residuals across the range of predicted scores. The omission of BMI did not compromise accuracy of the model. In conclusion, the New Model displayed good predictive accuracy and good CR agreement with measured VO2Peak in adolescents aged 13-16 years.

The Effects of Frontal- and Sagittal-Plane Plyometrics on Change-of-Direction Speed and Power in Adolescent Female Basketball Players.

UNLABELLED: Plyometrics is a popular training modality for basketball players to improve power and change-of-direction speed. Most plyometric training has used sagittal-plane exercises, but improvements in change-of-direction speed have been greater in multi-direction programs. PURPOSE: To determine the benefits of a 6-wk frontal-plane plyometric (FPP) training program compared with a 6-wk sagittal-plane plyometric (SPP) training program with regard to power and change-of-direction speed. METHODS: Fourteen female varsity high school basketball players participated in the study. Multiple 2 × 2 repeated-measures ANOVAs were used to determine differences for the FPP and SPP groups from preintervention to postintervention on 4 tests of power and 2 tests of change-of-direction speed. RESULTS: There was a group main effect for time in all 6 tests. There was a significant group × time interaction effect in 3 of the 6 tests. The SPP improved performance of the countermovement vertical jump more than the FPP, whereas the FPP improved performance of the lateral hop (left) and lateral-shuffle test (left) more than the SPP. The standing long jump, lateral hop (right), and lateral-shuffle test (right) did not show a significant interaction effect. CONCLUSIONS: These results suggest that basketball players should incorporate plyometric training in all planes to improve power and change-of-direction speed.

Lower Leg Anterior and Lateral Intracompartmental Pressure Changes Before and After Classic Versus Skate Nordic Rollerskiing.

CONTEXT: Chronic exertional compartment syndrome (CECS) is a debilitating condition resulting in loss of function and a decrease in athletic performance. Cases of CECS are increasing among Nordic skiers; therefore, analysis of intracompartmental pressures (ICPs) before and after Nordic skiing is warranted. OBJECTIVE: To determine if lower leg anterior and lateral ICPs and subjective lower leg pain levels increased after a 20-minute Nordic rollerskiing time trial and to examine if differences existed between postexercise ICPs for the 2 Nordic rollerskiing techniques, classic and skate. DESIGN: Crossover study. SETTING: Outdoor paved loop. PATIENTS OR OTHER PARTICIPANTS: Seven healthy Division I Nordic skiers (3 men, 4 women; age = 22.71 ± 1.38 y, height = 175.36 ± 6.33 cm, mass = 70.71 ± 6.58 kg). INTERVENTION(S): Participants completed two 20-minute rollerskiing time trials using the classic and skate technique in random order. The time trials were completed 7 days apart. Anterior and lateral ICPs and lower leg pain scores were obtained at baseline and at minutes 1 and 5 after rollerskiing. MAIN OUTCOME MEASURE(S): Anterior and lateral ICPs (mm Hg) were measured using a Stryker Quic STIC handheld monitor. Subjective measures of lower leg pain were recorded using the 11-point Numeric Rating Scale. RESULTS: Increases in both anterior (P = .000) and lateral compartment (P = .002) ICPs were observed, regardless of rollerskiing technique used. Subjective lower leg pain increased after the classic technique for the men from baseline to 1 minute postexercise and after the skate technique for the women. Significant 3-way interactions (technique × time × sex) were observed for the anterior (P = .002) and lateral (P = .009) compartment ICPs and lower leg pain (P = .005). CONCLUSIONS: Postexercise anterior and lateral ICPs increased compared with preexercise ICPs after both classic and skate rollerskiing techniques. Lower leg pain is a primary symptom of CECS. The subjective lower leg pain 11-point Numeric Rating Scale results indicate that increases in lower leg ICPs sustained during Nordic rollerskiing may increase discomfort during activity. Our results therefore suggest that Nordic rollerskiing contributes to increases in ICPs, which may lead to the development of CECS.

Does Dopamine Replacement Medication Affect Postural Sequence Learning in Parkinson's Disease?

Deficits in sequence-specific learning (SSL) may be a product of Parkinson's disease (PD) but this deficit could also be related to dopamine replacement. The purpose of this study was to determine whether dopamine replacement affected acquisition and retention of a standing Continuous Tracking Task in individuals with PD. SSL (difference between random/repeated Root Mean Square Error across trials) was calculated over 2 days of practice and 1 day of retention for 4 groups; 10 healthy young (HY), 10 healthy elders, 10 individuals with PD on, 9 individuals with PD off their usual dosage of dopamine replacement. Improvements in acquisition were observed for all groups; however, only the HY demonstrated retention. Therefore, age appeared to have the largest effect on SSL with no significant effect of medication. Additional research is needed to understand the influence of factors such as practice amount, task difficulty, and dopamine replacement status on SSL deficits during postural tasks.

High school physical educators' and sport coaches' knowledge of resistance training principles and methods.

The purpose of this study was to determine the level of knowledge that current and preservice high school (HS) physical educators and sport coaches possess regarding the principles and methods involved in youth resistance training (RT) and to determine if that knowledge was acceptable based on a predetermined criterion (passing score). A panel of 10 experts in RT or sport pedagogy used a Delphi technique to create a 90-question assessment (examination) that was administered to 287 HS physical educators and sport coaches and 140 university physical education teacher education (PETE) students. An analysis of the results revealed that neither group demonstrated the minimal knowledge necessary to design, implement, and supervise RT programs based on a passing score of 75%: HS physical educators/coaches, mean = 59.30, SD = 14.30, 95% confidence interval (CI) = 57.64-60.96], t(286) = -18.61, p = 0.000; university PETE students, mean = 56.61, SD = 16.59, 95% CI = 53.84-59.38, t(139) = -13.12, p = 0.000. The pass rate for physical educators and sport coaches was 14.3% and for university PETE students it was 20.7%. The results of this study indicate that both current and preservice physical educators and sport coaches need additional education and training specific to the design and implementation of RT programs for HS students. Given that school districts typically require their educators attend in-service training programs, it may be advisable to develop an in-service program that allows both current and preservice HS physical educators and sport coaches to earn an RT certification that specifically addresses the unique physical and psychosocial needs of school-aged youth.

Future Intent to Run and Running Performance of Students Exposed to a Traditional versus an Autonomy Supportive Motivational Running Program.

Background. The study's primary purpose was to investigate whether an autonomy supportive motivational climate in a running program would increase future running intent among high school students. A secondary purpose was to examine whether the program would increase individual performance in the Cooper 12-minute run. Methods. Students participated in a 4-month running intervention program which included four timed runs, one per month, and a future intent questionnaire prior to the start of the timed runs and following the last run. Results. Factorial repeated measures ANOVA revealed significance regarding future intent (P = .026) at both schools. Factorial repeated measures ANOVA indicated differences between the runs at both schools (P < .001). Paired samples t-tests were conducted to look at significance with paired runs. Results revealed significance in two of the six pairs at the treatment school, notably between the first and last timed runs (P = .004). Only one pair was found to be significant (P < .001) with the control school. Conclusion. At both schools, the overall number of laps increased as well as future intent to run scores. The results do not support evidence of a greater effect from the autonomy supportive environment over a traditional environment.

Indices of abdominal adiposity and cardiorespiratory fitness test performance in middle-school students.

BACKGROUND: Previous research suggests that use of BMI as a screening tool to assess health in youth has limitations. Valid alternative measures to assess body composition are needed to accurately identify children who are aerobically fit, which is an indicator of health status. The purpose of this study was to examine the associations between select anthropometric measures and cardiorespiratory fitness test performance in middle-school students. METHODS: Participants included 134 students (65 boys and 69 girls) recruited from the 6th, 7th, and 8th grades. Anthropometric measures consisted of BMI, waist circumference (WC), waist-to-height ratio (WHtR), and percent body fat estimated from two-site skinfolds (%BF-SKF), as well as the hand-held OMRON BIA device (%BF-BIA). Cardiorespiratory fitness tests included the one-mile run and PACER test. Data were collected on four separate testing days during the students' physical education classes. RESULTS: There were statistically significant moderate correlations between the %BF estimations, WHtR, and cardiorespiratory fitness test scores in both genders (P < .001). BMI at best only displayed weak correlations with the cardiorespiratory fitness test scores. CONCLUSIONS: The results suggest that alternative measures such as %BF-SKF, %BF-BIA, and WHtR may be more valid indicators of youth aerobic fitness lending to their preferred use over BMI.

Influence of a health-related physical fitness model on students' physical activity, perceived competence, and enjoyment.

This study was designed to explore the effects of a health-related physical fitness physical education model on students' physical activity, perceived competence, and enjoyment. 61 students (25 boys, 36 girls; M age = 12.6 yr., SD = 0.6) were assigned to two groups (health-related physical fitness physical education group, and traditional physical education group), and participated in one 50-min. weekly basketball class for 6 wk. Students' in-class physical activity was assessed using NL-1000 pedometers. The physical subscale of the Perceived Competence Scale for Children was employed to assess perceived competence, and children's enjoyment was measured using the Sport Enjoyment Scale. The findings suggest that students in the intervention group increased their perceived competence, enjoyment, and physical activity over a 6-wk. intervention, while the comparison group simply increased physical activity over time. Children in the intervention group had significantly greater enjoyment.

Explaining long-term exercise adherence in women who complete a structured exercise program.

The purpose of this study was to qualitatively examine factors related to physical activity adherence to understand why women continue to participate in long-term exercise after completing a structured exercise program. Data were collected from focus groups, interviews, and e-mails, and analysis used grounded theory. The central category related to physical activity adherence was self-worth. Motivation, activity enjoyment, priorities, body image, ability to access support, and self-regulation skills had an impact on the self-worth of nonadherers and adherers. Women must value themselves enough to continue to participate in physical activity once they start. Exercise and fitness professionals are encouraged to use strategies to increase self-worth and long-term adherence to physical activity. Some recommended strategies include (a) increasing motivation and enjoyment relative to activity, (b) making activity a high priority in a woman's life, (c) improving or deemphasizing body image, (d) increasing a woman's ability to access support, and (e) facilitating the use of self-regulation strategies. This study is the first to examine qualitative perspectives of exercise adherence among women who completed a structured exercise program. Several concepts related to adherence presented in the quantitative literature are confirmed and enhanced in this study.

Muscle activation characteristics of tumbling take-offs.

In the floor exercise, a gymnast may receive a general composition score deduction associated with a lack of diverse tumbling sequences. Diversity in tumbling is defined as the ability to tumble both forward and backward, as well as twist and flip. A coach's ability to direct technical and physical training for these skill varieties is enhanced when thorough descriptions of the skills are available. The aim of this study was to describe and compare muscle activation of the lower extremity in various tumbling sequences characterized by differing body orientations. The stretch-shortening cycle actions during the take-off portion of four different tumbling sequences were analysed and the results compared across muscles and type of take-off (forward vs. backward, twisting vs. non-twisting). Thirteen female gymnasts performed three trials each of round-off flic-flac to backward layout and to backward layout with longitudinal axis twist, and front flic-flac to forward layout and to forward layout with longitudinal axis twist. Activation onset was assessed as an increase of the EMG of 200% above noise before initial floor contact. The EMG was normalized to peak values for each muscle bilaterally during each take-off. Results showed that muscle activation characteristics in the pre-activation and impact phase (contact to maximal floor depression) differed between tumbling series. Backward take-offs were characterized by longer contact times, greater relative activity of the gastrocnemius compared with the vastus lateralis during pre-activation, and greater biceps femoris activation during impact compared with forward take-offs. Twisting backward was associated with reduced muscle activity of the twisting limb, while twisting forward was associated with increased muscle activation on the twisting limb. These differential effects related to the specific nature of the take-off indicate that training to enhance the stretch-shortening cycle action in gymnasts must be specific to the orientation requirements of each specific skill.

Lumbar segmental mobility disorders: comparison of two methods of defining abnormal displacement kinematics in a cohort of patients with non-specific mechanical low back pain.

BACKGROUND: Lumbar segmental rigidity (LSR) and lumbar segmental instability (LSI) are believed to be associated with low back pain (LBP), and identification of these disorders is believed to be useful for directing intervention choices. Previous studies have focussed on lumbar segmental rotation and translation, but have used widely varying methodologies. Cut-off points for the diagnosis of LSR & LSI are largely arbitrary. Prevalence of these lumbar segmental mobility disorders (LSMDs) in a non-surgical, primary care LBP population has not been established. METHODS: A cohort of 138 consecutive patients with recurrent or chronic low back pain (RCLBP) were recruited in this prospective, pragmatic, multi-centre study. Consenting patients completed pain and disability rating instruments, and were referred for flexion-extension radiographs. Sagittal angular rotation and sagittal translation of each lumbar spinal motion segment was measured from the radiographs, and compared to a reference range derived from a study of 30 asymptomatic volunteers. In order to define reference intervals for normal motion, and define LSR and LSI, we approached the kinematic data using two different models. The first model used a conventional Gaussian definition, with motion beyond two standard deviations (2sd) from the reference mean at each segment considered diagnostic of rotational LSMD and translational LSMD. The second model used a novel normalised within-subjects approach, based on mean normalised contribution-to-total-lumbar-motion. An LSMD was then defined as present in any segment that contributed motion beyond 2sd from the reference mean contribution-to-normalised-total-lumbar-motion. We described reference intervals for normal segmental mobility, prevalence of LSMDs under each model, and the association of LSMDs with pain and disability. RESULTS: With the exception of the conventional Gaussian definition of rotational LSI, LSMDs were found in statistically significant prevalences in patients with RCLBP. Prevalences at both the segmental and patient level were generally higher using the normalised within-subjects model (2.8 to 16.8% of segments; 23.3 to 35.5% of individuals) compared to the conventional Gaussian model (0 to 15.8%; 4.7 to 19.6%). LSMDs are associated with presence of LBP, however LSMDs do not appear to be strongly associated with higher levels of pain or disability compared to other forms of non-specific LBP. CONCLUSION: LSMDs are a valid means of defining sub-groups within non-specific LBP, in a conservative care population of patients with RCLBP. Prevalence was higher using the normalised within-subjects contribution-to-total-lumbar-motion approach.

An evaluation of the predictive validity and reliability of ventilatory threshold.

PURPOSE: To identify a valid and reliable method to determine 40-km time trial (40K) performance in a laboratory setting. METHODS: Part 1: Ventilatory threshold (VT) and 40K performance were determined on two occasions (February/September) using two subsets of cyclists (N = 15 each; VO(2max) 67.6 +/- 4.2/71.5 +/- 3.0 mL x kg(-1) x min(-1)) to determine the predictive validity of VT assessments. Variables of interest were power output at VT, peak power output (MaxVT(w)), and average power output during 40K (40K(avgwatts)). For VT determination we used: breakpoint of VE/VO2; breakpoint of VE/VCO2; V-slope; RER = 1; and RER = 0.95. In part 2, test-retest reliability of VT and MaxVT(w) were examined in 20 subjects (VO(2max) 64.8 +/- 8.0 mL x kg(-1) x min(-1)) on two occasions, separated by 48 h. RESULTS: Regression analyses between power outputs at VTs and 40K(avgwatts) showed significant predictive validity for (February/September): V-slope (r = 0.79/0.84; SEE 155/13.3W), VE/VO2 (r = 0.80/0.81; SEE 15.2/14.2W), RER0.95 (r = 0.73/0.58; SEE 17.4/21.2W), RER1 (r = 0.75/0.74; SEE 16.8/16.7W), and MaxVT(w) (r = 0.81/0.73; SEE 15.0/17.1W). Paired t-tests between power outputs at VTs and the 40K(avgwatts) indicated that mean power outputs at VE/O2 (261 +/- 29W; P = 0.33) and RER0.95 (274 +/- 55W; P = 0.93) in February and VE/VO2 (274 +/- 37W; P = 0.79) in September were not significantly different from the respective 40K(avgwatts) (277 +/- 30W/281 +/- 30W). Test-retest reliability analysis yielded the following intraclass correlation and relative test-retest errors: V-slope: 0.98, 2.6%; VE/VO2: 0.95, 5.3%; RER0.95: 0.87, 9.8%; RER1: 0.94, 5.7%; VE/VCO2: 0.87, 12.1%; MaxVT(w): 0.98, 2.6%. CONCLUSION: The high test-retest reliability and consistent ability to accurately predict athletes' 40K(avgwatts) across a competitive season indicated that VE/VO2 was superior to the other evaluated methods.

Does augmented feedback from pedometers increase adults' walking behavior?

This study investigated whether feedback from pedometers motivated adults to increase their walking behavior. Participants (n =26) were enrolled in one of two 8-wk. "Walking for Fitness" classes. The study used a crossover design, such that Group 1 wore pedometers for the first 3 weeks (Feedback Condition) and sealed "disguised" pedometers for the last 3 weeks (No-feedback Condition). The order of feedback was reversed for Group 2. Analysis indicated that (a) neither group increased their walking behavior significantly over time and, (b) interactions between groups were not significant at Week 3 or 6, indicating that groups did not respond differently to feedback from the pedometers. If a motivational effect from pedometers exists, it may be small, dissipate before 3 wk., only work in combination with goal setting, or only motivate certain types of individuals.

Bone mineral density of olympic-level female winter sport athletes.

PURPOSE: To compare areal bone mineral density (aBMD) of female winter sport athletes to healthy controls of similar age and body mass index (BMI). METHODS: Areal BMD (g x cm(-2)) of the whole body, lumbar spine (L2-L4), and right proximal femur were assessed by dual energy x-ray absorptiometry in athletes (N = 40; age: 26.1 +/- 5.7 yr; ht: 165.6 +/- 0.1 cm; wt: 63.0 +/- 6.5 kg; BMI: 23.0 +/- 1.9 kg x m(-2)) involved in speed skating (N = 9), snowboarding (N = 13), freestyle skiing (N = 3), biathlon (N = 8), bobsleigh, skeleton, luge (N = 7), and controls (N = 21; age: 26.0 +/- 5.1 yr; ht: 165.8 +/- 0.1 cm; wt: 62.8 +/- 5.9 kg; BMI: 22.9 +/- 1.3 kg x m(-2)). RESULTS: Using independent t-tests, athletes had lower fat mass, percent body fat, and higher lean mass than controls (P < 0.001). Areal BMD was higher in athletes than controls for all skeletal sites (P

Effects of home- and university-based programs on physical self-perception in mothers and daughters.

The primary purpose of this study was to compare two mother-daughter interventions designed to increase fitness and activity and improve physical self-perception (PSP).A secondary purpose was to test two of the proposed mechanisms for using physical activity to enhance PSP. Twenty mother-daughter pairs (n = 40) were randomly assigned to a university-based (UB) or home-based (HB) group. Initially, both groups received classroom training designed to improve PSP. Then, the UB group met three times per week, whereas the HB group received information concerning home-based activities. The Fitnessgram activity questionnaire and fitness test battery were used to measure physical activity and fitness level. The Physical Self-Perception Profile (PSPP) was used to detect changes in PSP. Separate 2 (group) x 2 (age) x 2 (time) ANOVAs with repeated measures on the last factor were conducted to examine changes in PSP, physical activity, and fitness. Correlations between physical activity, fitness, and PSP were examined to test the two mechanisms. Perceived sports competence and body attractiveness improved in UB and HB mothers and daughters (p =.002 and.005, respectively). UB and HB mothers and daughters increased their participation in aerobic (p =.000 and.015), muscular strength (p =.001 and.001), and flexibility (p =.000 and.000) activities. Support was not provided for the proposed mechanisms for the relationship between physical activity and PSP. These interventions demonstrate the potential to foster positive short-term changes in PSP and physical activity in mothers and daughters. More research is needed to test mechanisms explaining the relationship between activity and PSP.

Sensory cueing effects on maximal speed gait initiation in persons with Parkinson's disease and healthy elders.

Researchers have suggested that sensory cues can improve gait initiation in persons with Parkinson's disease (PD); however, there is little research that documents the effects of sensory cues on gait initiation. The purpose of this study was to examine the effects of auditory and cutaneous sensory cues on maximal speed gait initiation in person's with PD and healthy elderly. Seven persons with PD of moderate severity (mean age=69 years) and seven age, gender, and height matched healthy elders participated. Temporal, kinematic and center of pressure (COP) data were recorded as participants performed eight trials within four randomly ordered conditions (no cue (NC), a single auditory cue (SA), repetitive auditory cues (RA), and repetitive cutaneous cues (RC)). In each condition, participants were instructed to perform each gait initiation trial at their maximal speed. In all conditions, person's with PD reacted more slowly and moved less far than did the matched elders. Relative to conditions with NCs, sensory cueing resulted in decreased double limb support (DLS), and increased COP displacement and velocity in both groups. However, in both groups, displacements and velocities of the swing limb and sacrum during the sensory-cued conditions were less than those during the NC condition. These results suggest that when movement speed is a primary goal, sensory cues may interfere with swing limb and body movement outcomes during the gait initiation task in both person's with PD and healthy elders.

Quantifying physical activity via pedometry in elementary physical education.

PURPOSE: The objective of this study was to determine a pedometer steps per minute standard for quantifying the lesson time that first- and second-grade physical education students spent in moderate to vigorous physical activity (MVPA). METHODS: The sample was divided into validation (N = 246) and cross-validation (N = 123) samples using the holdout technique. Using the criterion test model, steps per minute cut points were empirically and judgmentally determined. C-SOFIT systematic observation was the criterion instrument and pedometry was the predictor instrument. Data were collected from 45 physical education lessons implemented in six schools. The three-step analytic procedure of computing mastery/nonmastery outcome probabilities, phi coefficients, and error proportions was used to determine the optimal steps per minute cut point for quantifying 33.33% of the physical education lesson time engaged in MVPA within a 30 class. RESULTS: Steps per minute was highly correlated with observation (r = 0.74-0.86, P < 0.0001). Five steps per minute scores that were accurate indicators of 33.33% of the class time engaged in MVPA in the validation sample were accurate indicators of steps per minute in the cross-validation sample. The optimal steps per minute cut point ranged from 60.00 to 63.00, which is equivalent to 1800-1890 steps in a 30-min physical education class. CONCLUSION: Data supports the use of pedometry steps per minute values as an accurate indicator of MVPA. Pedometry demonstrates promise as a viable large-scale surveillance instrument for measuring MVPA in physical education.

Daughters and mothers exercising together: effects of home- and community-based programs.

PURPOSE: This pilot study compares the effectiveness of home- and community-based physical activity interventions that target mothers and daughters to increase physical activity and improve health-related fitness. METHODS: Mothers (45.18 +/- 7.49 yr) and daughters (15.41 +/- 1.33 yr) were randomly assigned to a community-based (CB) (N = 20 participants) or home-based (HB) (N = 14 participants) program. CB participants attended three instructor-led sessions per week for 12 wk. HB participants were asked to participate in 3 sessions per week for 12 wk in a program similar to the CB program. The main difference between the programs was that CB activities were completed at a fitness facility within a university and HB activities were completed in or near the home. Before and after the intervention, changes in health-related fitness and physical activity were assessed. A series of 2 (group assignment) x 2 (time) ANOVAs were conducted to assess changes separately for mothers and daughters. RESULTS: CB participants attended 77% of the sessions, and none of the pairs dropped out. HB participants completed 70% of the recommended sessions, and three pairs dropped out. Mothers and daughters in both groups significantly increased their participation in aerobic, muscular strength, and flexibility activities (P = 0.02 to 0.000). Daughters in both groups significantly improved their muscular endurance (sit-ups,P = 0.000). Mothers in both groups improved their muscular strength (push-ups, P = 0.003), muscular endurance (sit-ups, P = 0.000), flexibility (sit-and-reach, P = 0.008), and aerobic capacity (1-mile walk, P = 0.002). Positive changes in diastolic blood pressure also occurred (P = 0.008). CONCLUSION: Mothers and daughters responded positively to CB and HB physical activity programs. Home-based physical activity programming is a cost-effective means to increase physical activity and improve health-related fitness in these groups.