Identifying and assessing interests and concerns of priority populations for work-site programs to promote physical activity.

The work site has been identified as an ideal context for promoting physical activity. Assessing employee interest, identifying who could most benefit, and understanding impact of work-related barriers on potential participation is key. We conducted focus groups and surveyed the employee population of a large urban hospital. Using the "stages of change" construct, employees were categorized based on their motivation to exercise into exerciser, intender, and nonintender groups. Intenders were significantly more interested in most physical activity programs at work than were exercisers (p < .05). Intenders also found environmental and personal barriers to be more significant deterrents to participation than did exercisers (p < .01). Half of nonintenders reported interest in physical activity programs. Interest in physical activity programs at work is strong for employees who are not currently exercising. Both structural changes to promote safe environments and time allotments through work-related policies may encourage participation, especially for the priority populations of nonexercising employees.

Actual and perceived activity levels in polio survivors and older controls: a longitudinal study.

OBJECTIVE: To examine factors associated with daily step activity, perceived activity, maximum walking speed, and walking speed reserve over time in polio survivors and older adults with no history of polio. DESIGN: Longitudinal study. SETTING: A research clinic and the community. PARTICIPANTS: Polio survivors (n=96; 65 in postpolio syndrome [PPS] group, 31 in non-PPS group) and older adults (n=112) with no history of polio. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Daily step activity, perceived activity, maximum walking speed, and walking speed reserve. RESULTS: Results showed decreases in perceived activity over time in the PPS group. However, there was no change in average daily walking activity. Overall, polio survivors walk less and have a smaller walking speed reserve than controls. Knee strength was positively associated with maximum walking speed and walking speed reserve in all groups. Weight and age were associated with daily step activity in controls but not polio survivors. CONCLUSIONS: Daily walking activity did not change statistically over the 3-year study period, although perceived activity and the walking speed reserve decreased among polio survivors with PPS. On average, polio survivors appear to function with minimal functional reserve, as their preferred walking speed was close to their maximum speed.

A patient registry for cognitive rehabilitation research: a strategy for balancing patients' privacy rights with researchers' need for access.

OBJECTIVE: To describe a consent-based Patient Research Registry designed to improve the quality and efficiency of cognitive rehabilitation research by balancing patients' privacy rights with researchers' need for access to research participants. DESIGN: Description of a protocol for a Patient Research Registry. SETTING: Three rehabilitation hospitals. PARTICIPANTS: Inpatients with stroke or traumatic brain injury (TBI) at the 3 participating hospitals. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Percentages of eligible patients with stroke or TBI who consented to be enrolled in the Registry, were subsequently contacted about a study, and ultimately participated in a study. A survey examined satisfaction with the Registry among researchers who used it for recruitment. RESULTS: After 36 months of operation, 58% of patients approached have consented to be in the Registry (N=1256). Eighty-seven percent of those later identified as potential subjects for research studies expressed interest, and 63% eventually participated. Researchers reported satisfaction with the recruitment opportunities afforded by the Registry. CONCLUSIONS: The Registry succeeded in identifying eligible patients interested in participating in research studies, while safeguarding their privacy rights. We identify its strengths and limitations and characterize the type of facility that would most profit from adopting this recruitment model.

Musculoskeletal pain in polio survivors and strength-matched controls.

OBJECTIVES: To determine whether a significant difference exists between musculoskeletal symptoms of polio survivors and those of older adults with no history of polio, and to determine if activity level and strength predict pain in either group. DESIGN: Matched research design. SETTING: A research laboratory in a rehabilitation setting. PARTICIPANTS: Fifty-four polio survivors and 54 adults with no history of polio were matched for gender, race, and bilateral knee extensor strength and selected from a cohort of 316 subjects who participated in a study on the relation between activity level and health status. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Location and severity of musculoskeletal pain, activity frequency and intensity level, maximum voluntary isometric strength, and physical performance measures. RESULTS: Polio survivors reported significantly more symptoms than the matched controls ( P <.05). Symptom status among the polio survivors was strongly associated with performance strain, perceived exertion, and activity intensity. Although the polio survivors had activity frequencies and habitual walking speeds that were similar to those from the matched controls, there was evidence that they performed activities at higher intensity levels. CONCLUSIONS: Activity level is a factor in the development of musculoskeletal symptoms in polio survivors. Polio survivors who perform at higher intensity levels are more likely to have moderate to severe pain and more mobility difficulties.

A comparison of the effects of exercise and lifestyle modification on the resolution of overuse symptoms of the shoulder in polio survivors: a preliminary study.

OBJECTIVE: To compare the effectiveness of exercise and lifestyle modification therapy in treating shoulder symptoms in polio survivors with lower-extremity weakness. DESIGN: A randomized parallel group study. SETTING: Research laboratory. PARTICIPANTS: Twenty-three subjects recruited from a cohort of 194 polio survivors who had participated in a previous study had bilateral hip-extensor and knee-extensor weakness and reported experiencing shoulder pain on a regular basis with daily activity. INTERVENTIONS: Subjects were randomly assigned to 1 of 3 treatment groups. Members of group 1 were placed on a home exercise program that focused on strengthening their hip and knee extensors. Members of group 2 were instructed in lifestyle modification techniques designed to avoid shoulder overuse. Members of group 3 received both interventions. MAIN OUTCOME MEASURES: Shoulder symptoms were quantified in terms of number and severity. Isometric strength of bilateral hip and knee extensors was measured with a hand-held dynamometer. RESULTS: Symptoms improved in all 3 groups. However, members of the exercise-only group (group 1) were the only ones to show a significant difference in both number and severity of symptoms when pre- and posttreatment values were compared. CONCLUSIONS: Both exercise and lifestyle modification therapies that focus on reducing the stress related to lower-extremity weakness are effective in treating shoulder overuse symptoms in polio survivors. A trend toward greater improvement in shoulder symptoms in subjects who participated in the exercise program and who also showed a trend toward increased knee-extensor strength supports muscle strength and/or endurance as a key factor.