Personal health behaviors and role-modeling attitudes of physical therapists and physical therapist students: a cross-sectional study.

BACKGROUND: Physical therapists have been encouraged to engage in health promotion practice. Health professionals who engage in healthy behaviors themselves are more apt to recommend those behaviors, and patients are more motivated to change their behaviors when their health care provider is a credible role model. OBJECTIVE: The purpose of this study was to describe the health behaviors and role-modeling attitudes of physical therapists and physical therapist students. DESIGN: This study was a descriptive cross-sectional survey. METHODS: A national sample of 405 physical therapists and 329 physical therapist students participated in the survey. Participants' attitudes toward role modeling and behaviors related to physical activity, fruit and vegetable consumption, abstention from smoking, and maintenance of a healthy weight were measured. Wilcoxon rank sum tests were used to examine differences in attitudes and behaviors between physical therapists and physical therapist students. RESULTS: A majority of the participants reported that they engage in regular physical activity (80.8%), eat fruits and vegetables (60.3%), do not smoke (99.4%), and maintain a healthy weight (78.7%). Although there were no differences in behaviors, physical therapist students were more likely to believe that role modeling is a powerful teaching tool, physical therapist professionals should "practice what they preach," physical activity is a desirable behavior, and physical therapist professionals should be role models for nonsmoking and maintaining a healthy weight. LIMITATIONS: Limitations of this study include the potential for response bias and social desirability bias. CONCLUSIONS: Physical therapists and physical therapist students engage in health-promoting behaviors at similarly high rates but differ in role-modeling attitudes.

Improving symptoms and quality of life of female cancer survivors: a randomized controlled study.

BACKGROUND: Surgeons, along with the Centers for Disease Control and Prevention, emphasize the importance of managing symptoms and improving the quality of life of cancer survivors. A 2008 meta-analysis of mindfulness-based stress reduction (MBSR) concluded that this technique might improve patients' adjustment to their disease. However, randomized controlled trials using standardized measures for evaluating MBSR are limited. The primary objective of this study was to evaluate, using valid and reliable measures, the effects of a unique, interactive, 8-week cancer recovery and wellness program on symptoms and quality of life of female cancer survivors. METHODS: Sixty-eight female cancer patients were randomized into either an intervention or waitlisted control group. Patients were evaluated using the Symptoms Checklist (SCL-90-R), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-30), and the Symptoms of Stress Inventory (SOSI). RESULTS: Of the participants, 70.6% were breast cancer survivors. Mean age was 57.5 years (treatment group) and 56.4 years (control group). Between-group demographic differences were not significant (P > 0.6). The treatment group improved significantly on the EORTC QLQ-30 (P = 0.005), on six of the eight SOSI subscales (P ≤ 0.049), and on both SCL-90-R subscales (P ≤ 0.023), while the control group did not improve on any of these measures (P > 0.2). CONCLUSION: The MBSR-based cancer recovery and wellness intervention improved the symptoms and quality of life of this largely breast cancer survivor population across a variety of cancer symptoms and quality-of-life measures.

Metabolic syndrome status changes with fitness level change: a retrospective analysis.

BACKGROUND: Cardiorespiratory fitness level is inversely related to the incidence of Metabolic Syndrome (MetS). This study examined the effects of changes in cardiorespiratory fitness level on MetS status. METHODS: Male and female participants in a health enhancement program (n = 212) were clinically examined for changes in their MetS status and estimated aerobic capacity over a 3-year period. Two physical examinations, each including a maximal treadmill stress test, occurred within this time frame. Participants were divided into three groups: Group 1 (n = 103) was composed of individuals who presented with MetS at exam 1 and reversed their MetS disease status by exam 2; Group 2 (n = 75) members presented with MetS at both exams; and Group 3 (n = 34) individuals were MetS-free at exam 1 but acquired MetS by exam 2. The relationships between MetS clinical characteristics at exam 1 and exam 2 and changes in graded exercise test (GXT) duration were contrasted for the three groups. RESULTS: GXT duration, estimated aerobic capacity (VO(2) max), and MetS characteristics improved significantly in Group 1 (P < 0.01). Group 2 individuals also increased GXT duration (P < 0.05) but showed only nonsignificant improvements (P > 0.05) in clinical characteristics. Group 3 members declined in most MetS characteristics and in estimated VO(2) max (P < 0.05). CONCLUSIONS: Increases in GXT duration accompanied MetS reversal while declines in GXT duration occurred with MetS acquisition. On an individual basis, these changes in GXT duration may be an indicator of disease status.

Longitudinal modeling of the relationship between age and maximal heart rate.

PURPOSE: Maximal heart rate (HRmax)-prediction equations based on a person's age are frequently used in prescribing exercise intensity and other clinical applications. Results from various cross-sectional studies have shown a linear decrease in HRmax during exercise with increasing age. However, it is less well established that longitudinal tracking of the same individuals' HRmax as they age exhibits an identical linear relationship. This study examined the longitudinal relationship between age and HRmax during exercise. METHODS: A retrospective analysis of maximal graded exercise test (GXT) results for members participating in a university-based health-assessment/fitness center between 1978 and 2003 was undertaken in 2006. Records were examined from individuals (N = 132) of both sexes who represented a broad range of age and fitness levels and who had multiple GXT (total N = 908) conducted over 25 years. HRmax-prediction equations based on participants' age and HRmax elicited during the tests were developed using a linear mixed-models statistical analysis approach. RESULTS: Clinical measurements obtained during the administration of the GXT included in this longitudinal study resulted in the generation of a univariate prediction model: HRmax = 207 - 0.7 x age. Model parameters were highly statistically significant (P < 0.001). CONCLUSIONS: The relationship between age and HRmax during exercise developed in this longitudinal study has resulted in a prediction equation appreciably different from the conventional HRmax formula (220 - age) often used in exercise prescription, and it confirms findings from recent cross-sectional investigations of HRmax.

Reversal of metabolic syndrome characteristics.

BACKGROUND: Metabolic syndrome (MetS) is a constellation of three or more clinical health abnormalities from a list of five and, therefore, can vary significantly in its profile. Successful intervention strategies for preventing or resolving individuals' MetS may benefit from better understanding how specific risk factor profiles influence improvement in syndrome status. METHODS: A retrospective analysis of clinical records for members participating in a university-based health assessment/fitness center between 1978 and 2003 was undertaken in 2005. First-year and second-year measures of body mass index, triglycerides, high-density lipoproteins, fasting blood glucose, and blood pressure were compared. Prevalence of individual MetS risk markers, as well as deviation from cut-point levels, were compared in members with and without the syndrome and in subgroups of those whose MetS status changed between the two examinations. RESULTS: Of the 878 members analyzed, 133 (15%) presented with metabolic syndrome at first visit. Within 2 years of participating in a health assessment/fitness center, 42% of the members resolved their MetS status. Elevated triglycerides differentially characterized those participants who did not improve their MetS status, since that risk marker was not prevalent in the reversal group, but was 86% prevalent in the nonreversal group. For those who resolved their MetS status, there was a 33% improvement in triglycerides level. CONCLUSIONS: While MetS resolution was achieved within 2 years for many participants in this study, it is likely that customized treatment interventions are necessary for those individuals with elevated triglycerides, the chief abnormality for those who did not resolve.