PubMed Health⌕ Search

Biomedical subjects

H W Kohl

Publications and source records attributed to H W Kohl.

At least 19 recordsLinked to original sources
PubMed2006

Health-related quality of life, BMI and physical activity among US adults (>/=18 years): National Physical Activity and Weight Loss Survey, 2002.

OBJECTIVE: To examine the association between health-related quality of life (HRQOL) and physical activity (PA). METHODS: Cross-sectional data were obtained via a national telephone survey from 9173 respondents (30.9% response rate; 51.4% cooperation rate). Four indicators of HRQOL were measured: self-rated health, physically unhealthy days, mentally unhealthy days and activity limitation days. Prevalence estimates were calculated by body mass index (BMI) category and PA level. Logistic regression evaluated BMI as an effect modifier of the relationship between HRQOL and PA. RESULTS: Inactive adults reported more fair to poor HRQOL than active adults, regardless of BMI category (P<0.001). BMI did not modify the association between PA and any of the four HRQOL indicators. CONCLUSION: Prevalence of low HRQOL is inversely related to PA participation, and the relationship is not altered by BMI status. Regardless of their weight status, adults should be encouraged to engage in PA.

Adolescent↗
PubMed2001

Interactive effects of tunnel dilation on the mechanical properties of hamstring grafts fixed in the tibia with interference screws.

The effect of dilation of the tibial tunnel on the strength of hamstring graft fixation using interference screws was evaluated. In all, 28 RCI screws were tested in male human tibia-hamstring constructs with tibial tunnels reamed or dilated to the respective size of the graft diameter. Dilation of the tibial tunnel failed to significantly enhance hamstring fixation. Grafts secured in dilated tunnels displayed an 11% greater resistance to the initiation of graft slippage (174+/-112 N) compared to their undilated controls (156+/-77 N, P=0.63). Dilation of the tibial tunnel increased the failure load by an average of 4%, independent of screw diameter (dilated specimens: 360+/-120 N, controls: 345+/-88 N, P=0.74). Biomechanical research on the effect of tibial tunnel dilation in hamstring fixation has not provided satisfactory evidence as to the benefits of this additional surgical step during anterior cruciate ligament (ACL) reconstruction.

Anterior Cruciate Ligament↗
PubMed2001

Pelvic fracture among polytrauma decedents. Trauma-based mortality with pelvic fracture--a case series of 74 patients.

Pelvic fractures (PF) sustained from accidents are commonly believed to be a major cause of mortality in polytraumatized patients. The purpose of this paper is to determine whether PF are usually the primary cause or a contributing cause of mortality in these patients. A 10-year retrospective review was performed of all polytrauma patients with PF who were admitted to, and died, at a large, level-I trauma center. The pelvic injury was graded according to Schatzker and Tile into stable (type A), partially stable (type B), and unstable (type C). The injury severity score (ISS), which incorporates associated injuries and their potential impact on mortality, was calculated for all patients. For each patient, a separate subjective designation of the probable cause of death was determined. We identified 74 decedents with PF following deceleration trauma. The pelvic fractures were classified as 12 type A (16%), 36 type B (49%), and 26 type C (35%). The mean ISS was extremely high, 40.6 +/- 1.4 (range 18-75), more than four times the score for simply a severe PF. The ISS was also not significantly different among the three pelvic fracture groups (P = 0.613). The records subjectively identified PF as the precipitating cause of death in only 13% of the patients. In this study, patients who died with PF had an ISS that implicated at least one or two additional major visceral injuries. These data do not support the hypothesis that PF, regardless of its complexity, is the usual primary cause or the major precipitating event of death in the polytraumatized patient. In these patients, mortality appears to be a function of the associated injuries based on the ISS calculation.

Adult↗
PubMed2001

Biomechanical evaluation of the origin of the long head of the biceps tendon.

PURPOSE: Lesions of the superior glenoid labrum extending anterior and posterior (SLAP) have recently been recognized as important sources of shoulder pain and dysfunction. Among the 4 described types of SLAP lesions, the type II SLAP involves detachment of the superior labrum from the bony glenoid and destabilization of the origin of the long head of the biceps tendon (LHBT). The purpose of this cadaveric biomechanical study was to evaluate the relative contribution regarding linear stiffness and displacement under load of the 2 origins of the LHBT: the superior glenoid labrum and the supraglenoid tubercle (the biceps anchor). TYPE OF STUDY: Cadaveric biomechanical study. METHODS: Seven pairs of fresh-frozen cadaveric shoulders were dissected free of all soft tissue except for the glenoid labrum and LHBT. Tension from 0 to 55 N was applied to the LHBT while keeping the tendon perpendicular to the face of the glenoid. Each specimen was tested for linear stiffness and biceps tendon displacement in the intact state, after releasing 1 of the LHBT origins, and after releasing the remaining origin. RESULTS: The average stiffness of the LHBT origin was 103 N/mm. Sectioning the anchor alone resulted in a 52% reduction in linear stiffness, whereas only detaching the superior glenoid labrum from the 10 o'clock to the 2 o'clock position resulted in a 15% reduction in linear stiffness. Maximum displacement of the biceps tendon origin in the intact state at the 55 N load averaged 0.99 mm. With a minimum load applied, displacement changed less than 1 mm unless both origins were released. CONCLUSIONS: The results indicate that the biceps anchor is the primary restraint of the LHBT and that the superior labrum is a secondary restraint in regard to linear stiffness. However, disruption of both restraints is required to produce the laxity typically seen in a type II SLAP lesion.

Adult↗
PubMed2001

Field evaluation of energy expenditure from continuous and intermittent walking in women.

RATIONALE: Recent physical activity recommendations suggest that comparable amounts of prescribed physical activity, done as a single continuous bout or as a set of intermittent bouts, will produce equal amounts of energy expenditure (EE) during the prescribed activity as well as throughout the day. HYPOTHESES: In a field setting, we tested two hypotheses: (1) continuous and intermittent walking conditions will result in significantly greater total daily EE than a control condition, and (2) continuous and intermittent walking conditions will result in similar total daily METHODS: Thirty women (mean age [yr] = 43.7+/-5.8; mean body mass index [kg x m(-2)]= 24.7+/-4.0) participated in a repeated-measures design so that each woman participated in three walking conditions on successive days of the week: a single 30-min brisk walk (continuous): three 10-min brisk walks (intermittent); and no activity (control). Throughout the study protocol, women wore a TRITRAC-R3D accelerometer programmed to estimate EE in 2-min intervals. RESULTS: Mean total EE estimates (kcal) for the three walking conditions were as follows: continuous: 2181+/-308; intermittent: 2121+/-305; and control: 1948+/-270. A repeated-measures analysis of variance omnibus test indicated that EE differed significantly by experimental condition [F(2,58) = 40.2, P < 0.001). To test the first hypothesis, contrasts were examined revealing that EE in the continuous and intermittent conditions was significantly greater than EE in the control condition [F(1,29) = 58.2, P < 0.001]. To test the second hypothesis, contrasts revealed that EE in the continuous condition was significantly greater than EE in the intermittent condition [F(1,29) = 7.0, P = 0.013]. CONCLUSION: For the purposes of total EE, selecting a continuous mode of walking may offer additional benefit over an intermittent mode, given the same total prescribed duration.

Adult↗
PubMed2001

Physical activity and cardiovascular disease: evidence for a dose response.

PURPOSE: To summarize and synthesize existing literature providing evidence of a dose-response relation between physical activity and cardiovascular disease endpoints. METHODS: MEDLINE search of indexed English-language literature through August 2000. Findings supplemented by existing consensus documents and other published literature. Only studies with greater than two physical activity exposure categories were included, and studies not focusing on the clinical manifestation of the outcome (incidence or mortality) were excluded. RESULTS: Existing studies were classified by outcome used: all cardiovascular disease (CVD), coronary (ischemic) heart disease (CHD), and stroke. The vast majority of the literature in this area has relied on prospective observational studies and has been conducted in European men or populations of men of primarily European descent. Follow-up intervals ranged from 3 to 26 yr, and most studies related a single initial measure of physical activity to the outcome of interest, sometimes many years in the future. No randomized trials of physical activity and cardiovascular disease as a clinical outcome exist. Taken together, the available evidence indicates that cardiovascular disease incidence and mortality, and specifically ischemic heart disease, are causally related to physical activity in an inverse, dose-response fashion. These findings have been demonstrated in a variety of populations and using a variety of physical activity assessment methods. Contrarily, equivocal evidence for stroke incidence and mortality prohibits a similar conclusion. No strong evidence for dose-response relation between physical activity and stroke as a CVD outcome is available. CONCLUSION: Physical inactivity is prominent in the causal constellation for factors predisposing to cardiovascular disease, particularly ischemic heart disease. Methodologic advances in physical activity assessment; additional studies on changes in the antecedent variable, physical activity, as it relates to the outcome; and more studies among women and ethnically diverse populations are needed to clarify these relations.

Adolescent↗
PubMed2000

Reliability of the Lichtman classification of Kienböck's disease.

The purpose of this study was to establish the interobserver reliability and intraobserver reproducibility of the staging of Kienböck's disease according to Lichtman's classification. Posteroanterior and lateral wrist radiographs of 64 patients with a diagnosis of Kienböck's disease and 10 control subjects were reviewed independently by 4 observers on 2 separate occasions. The reviewers included 3 hand fellowship-trained surgeons and 1 orthopedist who was not fellowship-trained in hand surgery. A stage was assigned to each set of radiographs according to the Lichtman classification. Paired comparisons for reliability among the 4 observers showed an average absolute percentage agreement of 74% and an average paired weighted kappa coefficient of 0.71. Furthermore, all the controls were correctly classified as stage I, which is in accordance with the Lichtman system. With regard to reproducibility, observers duplicated their initial readings 79% of the time with an average weighted kappa coefficient of 0.77. These results indicate substantial reliability and reproducibility of the Lichtman classification for Kienböck's disease.

Carpal Bones↗
PubMed2000

Work ability, physical activity, and cardiorespiratory fitness: 2-year results from Project Active.

An adequate level of physical activity may maintain or promote work ability in aging workers. Project Active is a randomized trial comparing a Lifestyle physical activity program with a Structured exercise program in sedentary but healthy adults aged 35 to 60 years. Subjects in both groups received 6 months of intensive intervention followed by 18 months of active follow-up. The total number of subjects was 235, from which 80 subjects participated in the work ability assessment. Primary outcome measures were energy expenditure (kcal.kg-1.day-1), cardiorespiratory fitness (peak oxygen uptake in ml.min-1.kg-1), and the Work Ability Index. At 6 months, daily energy expenditure had increased significantly over baseline (mean +/- SD, from 33.0 +/- 0.9 to 34.4 +/- 1.8 kcal.kg-1.day-1) and was maintained over baseline at 24 months (34.0 +/- 2.5 kcal.kg-1.day-1). The significant increase in energy expenditure was observed particularly in moderate levels of activity. The average percentage of body fat was significantly higher at baseline compared with 6 months and 24 months. Peak oxygen uptake increased from baseline significantly during the first 6 months (from 29.6 +/- 5.7 to 30.6 +/- 6.3 ml.min-1.kg-1) and decreased to the baseline level (29.1 +/- 5.5 ml.min-1.kg-1) at 24 months. At baseline, the average Work Ability Index was 44.2 +/- 4.0, and it remained unchanged at 6 months (44.4 +/- 3.9) and at 24 months (44.2 +/- 3.1). In conclusion, a 2-year physical activity intervention increased daily energy expenditure, reduced body fat, and maintained peak oxygen uptake in healthy, middle-aged, sedentary subjects. The average Work Ability Index score at baseline was excellent and did not change during the 2-year physical activity interventions.

Adult↗
PubMed2000

Physical training as a substance abuse prevention intervention for youth.

Program evaluation data from school and community applications of a physical fitness drug prevention program is presented. A train-the-trainer methodology was applied to install the program in twenty-two settings within the state of Illinois. The physical training program consisted of exercise and educational modules delivered over a twelve-week time period that focused on learning values and life skills through exercise. Complete pre-post data were obtained on 329 participating youth at six school and community based sites. Significant increases were demonstrated in physical activity and physical fitness (cardiovascular endurance, strength, and flexibility). Youth self-report data indicated significant decreases in risk factors such as low self-concept, poor school attendance, anxiety, depression, and number of friends who use alcohol and drugs. There were significant reductions in the percentage of youth who used cigarettes, smokeless tobacco, and alcohol. It was concluded that a strong relationship was demonstrated for increased fitness leading to lowered risk factors and usage patterns. Likewise, the train-the-trainer model was shown to be an effective installation approach to expand fitness programming within prevention settings.

Absenteeism↗
PubMed2000

Effect of quadriceps contraction on tangential patellar radiography.

This study examined whether the addition of quadriceps contraction to standard Merchant views provides additional useful information in the evaluation of patients with extensor mechanism malalignment. Fifteen patients (23 knees) with anterior knee pain due to lateral patellar compression syndrome and 22 control patients (44 knees) underwent standard Merchant views with the quadriceps relaxed and with an isometric isotonic contraction. Congruence and lateral patellar angles were measured for all groups. Although the congruence angle differed significantly between the control and symptomatic groups with the quadriceps contracted (P< or = .001), this difference also was seen without quadriceps contraction. There was also no significant difference within each group on addition of quadriceps contraction. No significant difference existed between the two groups for lateral patellar angle with quadriceps contraction. The addition of a controlled isometric quadriceps contraction did not add to the diagnostic yield of the standard Merchant view in terms of a predictable change in measured radiographic parameters.

Adult↗
PubMed1999

Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial.

CONTEXT: Even though the strong association between physical inactivity and ill health is well documented, 60% of the population is inadequately active or completely inactive. Traditional methods of prescribing exercise have not proven effective for increasing and maintaining a program of regular physical activity. OBJECTIVE: To compare the 24-month intervention effects of a lifestyle physical activity program with traditional structured exercise on improving physical activity, cardiorespiratory fitness, and cardiovascular disease risk factors. DESIGN: Randomized clinical trial conducted from August 1, 1993, through July 31, 1997. PARTICIPANTS: Sedentary men (n = 116) and women (n = 119) with self-reported physical activity of less than 36 and 34 kcal/kg per day, respectively. INTERVENTIONS: Six months of intensive and 18 months of maintenance intervention on either a lifestyle physical activity or a traditional structured exercise program. MAIN OUTCOME MEASURES: Primary outcomes were physical activity assessed by the 7-Day Physical Activity Recall and peak oxygen consumption (VO2peak) by a maximal exercise treadmill test. Secondary outcomes were plasma lipid and lipoprotein cholesterol concentrations, blood pressure, and body composition. All measures were obtained at baseline and at 6 and 24 months. RESULTS: Both the lifestyle and structured activity groups had significant and comparable improvements in physical activity and cardiorespiratory fitness from baseline to 24 months. Adjusted mean changes (95% confidence intervals [CIs]) were 0.84 (95% CI, 0.42-1.25 kcal/kg per day; P<.001) and 0.69 (95% CI, 0.25-1.12 kcal/kg day; P = .002) for activity, and 0.77 (95% CI, 0.18-1.36 mL/kg per minute; P = .01) and 1.34 (95% CI, 0.72-1.96 mL/kg per minute; P<.001) for VO2peak for the lifestyle and structured activity groups, respectively. There were significant and comparable reductions in systolic blood pressure (-3.63 [95% CI, -5.54 to -1.72 mm Hg; P<.001] and -3.26 [95% CI, -5.26 to -1.25 mm Hg; P = .002]) and diastolic blood pressure (-5.38 [95% CI, -6.90 to -3.86 mm Hg; P<.001] and -5.14 [95% CI, -6.73 to -3.54 mm Hg; P<.001) for the lifestyle and structured activity groups, respectively. Neither group significantly changed their weight (-0.05 [95% CI, -1.05 to 0.96 kg; P = .93] and 0.69 [95% CI, -0.37 to 1.74 kg; P = .20]), but each group significantly reduced their percentage of body fat (-2.39% [95% CI, -2.92% to -1.85%; P<.001] and -1.85% [95% CI, -2.41 % to -1.28%; P<.001]) in the lifestyle and structured activity groups, respectively. CONCLUSIONS: In previously sedentary healthy adults, a lifestyle physical activity intervention is as effective as a structured exercise program in improving physical activity, cardiorespiratory fitness, and blood pressure.

Adult↗
PubMed1999

Detecting bouts of physical activity in a field setting.

The purposes of this study were to assess the TRITRAC and CSA for: (a) interaccelerometer agreement; (b) agreement in detecting patterns of moderate-intensity physical activity; and (c) agreement in detecting walking patterns recorded in a diary. Thirty-one women wore both the TRITRAC and CSA accelerometers for three consecutive days. Interaccelerometer agreement (measured with generalizability coefficients) ranged from .88 to .99. In total, 71.3% of the accelerometers' patterns agreed in length, with CSA patterns being on average significantly longer. Interaccelerometer agreement in detecting patterns of brisk walking, as recorded in a diary, was comparable (69.4%). Interaccelerometer discrepancies may be related in part to the threshold employed by each instrument for classifying moderate intensity patterns.

Adult↗
PubMed1999

Physical fitness and clustering of risk factors associated with the metabolic syndrome.

PURPOSE: The purposes of this study were to 1) assess the prevalence of clustering of metabolic markers of the MS in a defined population and 2) determine the association between CRF and such clustering in a large group of adult men (N = 15,537) and women (N = 3,899). METHODS: Metabolic markers of the MS included systolic blood pressure (BP) > or = 140 mm Hg, serum triglycerides > or = 150 mg x dL(-1), fasting blood glucose > or = 110 mg x dL(-1), and elevated central adiposity (waist circumference > 100 cm). Cardiorespiratory fitness was defined as total time on a maximal treadmill exercise test. The cohort was grouped by the number of metabolic abnormalities and level of CRF. Associations between CRF and the number of metabolic abnormalities were assessed using proportional odds logit models. RESULTS: Among men, the age-adjusted cumulative odds ratio for abnormal markers of the MS was 3.0 (95% C.I. 2.7-3.4; P < 0.001) for the least-fit men when compared with moderately-fit ones, and 10.1 (95% C.I. 9.1-11.2; P < 0.001) when compared with the most-fit men. Among women, the age-adjusted cumulative odds ratio was 2.7 (95% C.I. 2.1-3.5; P < 0.001) for the least-fit women when compared with moderately-fit ones, and 4.9 (95% C.I. 3.8-6.3; P < 0.001) when compared with the most-fit women. CONCLUSIONS: These cross-sectional results suggest that low CRF is associated with an increased clustering of the metabolic abnormalities associated with the MS in both adult men and women and support the need for future prospective analyses.

Adult↗
PubMed1999

Long-term functional and radiographic follow-up of surgically treated isthmic spondylolisthesis.

We studied patients treated surgically for isthmic spondylolisthesis since 1968, with special emphasis on a detailed functional assessment. We followed up 22 patients for an average of 15 years, with a mean age at time of surgery of 18 years. All patients underwent a thorough physical examination and were evaluated with radiographs at baseline and at follow-up. The functional status of patients at the time of follow-up was assessed with 2 self-report pain and function instruments. All surgical procedures included spinal fusion, 12 of which included internal fixation by using Harrington distraction rods with sacral bars. At final follow-up, there was no statistically significant difference in mean slip percentage or mean slip angle compared with baseline radiographs. Functional evaluation was compared with a control group consisting of 52 patients. We conclude that the long-term radiographic and functional outcome is excellent for patients treated surgically for isthmic spondylolisthesis.

Activities of Daily Living↗
PubMed1998

Exaggerated blood pressure response to dynamic exercise and risk of future hypertension.

This study examined the association between an exaggerated blood pressure response to treadmill exercise and the risk of developing hypertension. Subjects were healthy normotensive men (n = 5386) who had a baseline graded maximal exercise test between 1971 and 1982, and completed a mailed follow-up questionnaire. At follow-up in 1986, cases (n = 151) reported physician diagnosed hypertension and controls (n = 201) reported normotension. Those who had developed hypertension at follow-up were more likely to have had an exaggerated blood pressure response to exercise (OR = 2.4, 1.4-4.3). In multiple logistic regression analysis an exaggerated response was significantly associated (OR = 3.0, 1.5-6.1) with future hypertension after controlling for sitting systolic and diastolic blood pressure, weight change from age 21 to follow-up, entry age, family history of hypertension, body mass index, treadmill time, alcohol consumption, and years of follow-up. These results suggest that an exaggerated blood pressure response to exercise is independently associated with increased risk of future hypertension, and therefore, may be an important factor in determining hypertension risk.

Adult↗
PubMed1998

Improvements in cardiorespiratory fitness attenuate age-related weight gain in healthy men and women: the Aerobics Center Longitudinal Study.

OBJECTIVE: To determine the longitudinal relation of change in cardiopulmonary fitness to subsequent change in body weight in a cohort of healthy middle-aged adults. DESIGN: Prospective cohort study. SUBJECTS: Participants were 4599 men and 724 women (43 +/- 9 y) receiving at least three medical examinations between 1970 and 1994. Examinations included assessment of cardiorespiratory fitness by maximal exercise tests and measurement of body weight. MEASUREMENTS: Change in fitness was calculated as the difference in maximal treadmill time between the first and second examination (mean interval, 1.8 y). Weight change was calculated as the difference in body weight between the first and last examination (mean follow-up, 7.5 y). RESULTS: There was a small, yet statistically significant weight gain over the follow-up (0.61 +/- 5.29 kg for men and 1.51 +/- 4.67 kg for women; P << 0.001). Estimates from the multiple linear regression modeling show that each 1 min improvement in treadmill time, significantly attenuated weight gain in both men (b = -0.60; P << 0.001) and women (b = -0.60; P << 0.001), respectively. Moreover, each 1 min improvement in treadmill time, reduced the odds of a > or = 5 kg gain by 14% in men (odds ratios (OR)) = 0.86; 95% confidence interval (CI): 0.83-0.89) and by 9% in women (OR = 0.91; 95% CI:0.83-1.00) and the odds of a > or = 10 kg gain by 21% in both men (OR = 0.79;95% CI:0.75-0.84) and women (OR = 0.79;95% CI:0.67-0.93) CONCLUSIONS: Improvements in fitness, appear important in attenuating age-related weight gain in healthy middle-aged adults. Thus, an active life-style should be promoted early and maintained through adulthood to prevent substantial weight gain and obesity with age.

Adult↗
PubMed1998

A randomized trial of physical activity interventions: design and baseline data from project active.

We report here the design and baseline data from Project Active, a 2-yr randomized trial designed to compare the effectiveness of a Lifestyle physical activity intervention with the traditional Structured exercise prescription approach. Primary outcome measures are energy expenditure in physical activity (estimated by kcal per kilogram of body weight of energy expenditure) and cardiorespiratory fitness (measured by maximal oxygen uptake). The participants, 235 initially sedentary and apparently healthy adults, were randomized into either the Lifestyle or Structured intervention groups. The Lifestyle treatment consists of a personalized approach that accounts for an individual's motivational readiness and preferences for integrating physical activity into daily routines. The Structured approach is the familiar exercise prescription that is based on a frequency, intensity, and duration formula. The primary hypothesis to be tested is that there will be a difference in physical activity and cardiorespiratory fitness measures between the two conditions at the end of 24 months. The secondary hypothesis is that both groups will make significant improvements from baseline in physical activity and cardiorespiratory fitness at the end of 6 months. Six months of active intervention are followed by 18 months of a tapered follow-up maintenance intervention in both groups. Primary outcome measures are measured after 6 and 24 months.

Adult↗