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Biomedical subjects

H W Kohl

Publications and source records attributed to H W Kohl.

70 records · Page 4Linked to original sources
PubMed1989

Physical fitness and all-cause mortality. A prospective study of healthy men and women.

We studied physical fitness and risk of all-cause and cause-specific mortality in 10,224 men and 3120 women who were given a preventive medical examination. Physical fitness was measured by a maximal treadmill exercise test. Average follow-up was slightly more than 8 years, for a total of 110,482 person-years of observation. There were 240 deaths in men and 43 deaths in women. Age-adjusted all-cause mortality rates declined across physical fitness quintiles from 64.0 per 10,000 person-years in the least-fit men to 18.6 per 10,000 person-years in the most-fit men (slope, -4.5). Corresponding values for women were 39.5 per 10,000 person-years to 8.5 per 10,000 person-years (slope, -5.5). These trends remained after statistical adjustment for age, smoking habit, cholesterol level, systolic blood pressure, fasting blood glucose level, parental history of coronary heart disease, and follow-up interval. Lower mortality rates in higher fitness categories also were seen for cardiovascular disease and cancer of combined sites. Attributable risk estimates for all-cause mortality indicated that low physical fitness was an important risk factor in both men and women. Higher levels of physical fitness appear to delay all-cause mortality primarily due to lowered rates of cardiovascular disease and cancer.

Adult↗
PubMed1989

Effect of opioid antagonism on the ability to tolerate maximal anaerobic exercise.

The effect of naloxone-induced endogenous opioid antagonism on the ability to tolerate maximal anaerobic exercise was studied in 11 young men. Volume-matched infusions of placebo or naloxone 4 mg were administered in a randomised double-blind crossover trial before a 30-second maximal cycle ergometer test (Wingate test). Mechanical power output was calculated for each 5 seconds of cycling and expressed as peak power (highest output during any 5-second period), average power (average output during the 30 seconds of cycling) and power decline (difference between peak power and the lowest 5-second power output divided by time). Naloxone did not significantly modify (P greater than 0.05) any index of anaerobic power. Similarly, the perception of leg pain during exercise was similar with placebo and naloxone. Therefore, insofar as naloxone may be used to examine the functional role of opioid-mediated mechanisms, these findings are not tenable with the hypothesis that endogenous opioids modulate the ability to tolerate maximal anaerobic exercise.

Adult↗
PubMed1989

The impact of previous athleticism on exercise habits, physical fitness, and coronary heart disease risk factors in middle-aged men.

A longitudinal study was performed to determine differences in physiologic variables, health behaviors, risk factors, or clinical status between former athletes (FA) (N = 345) and nonathletes (NA) (N = 75). The subjects, 420 self-referred white males aged 25-60 years old, were examined for prior athleticism and health. Athleticism was determined through self-reported high school or college athletic history. Baseline physiologic and health behavior characteristics were not different between the two groups. Of those study participants (N = 203 FA, 48 NA) who were sedentary at baseline, 208 (N = 167 FA, 41 NA) voluntarily began an exercise program during the followup period (average followup = 56 months). These numbers correspond to exercise adoption rates of 82 and 85% for FA and NA respectively, and were not statistically different (95% CI FA = 0.76, 0.88, NA = 0.73, 0.97). Repeated measures analysis of covariance was performed to determine if physiologic responses to adoption were different between FA and NA. No statistically significant difference was found between the two groups, time effects were similar in the two, and no significant interaction of time by group was observed. We conclude that prior athleticism has little apparent impact on health and health behaviors, thus suggesting that contemporaneous exercise has more impact on clinical variables.

Adult↗
PubMed1989

Age, physical activity, physical fitness, body composition, and incidence of orthopedic problems.

The incidence of orthopedic problems was examined in 5,582 men and women who attended the Cooper Clinic in Dallas, Texas between 1974 and 1982. The effects of age, physical activity, physical fitness, and body mass index (BMI) on the occurrence of these problems were examined using a proportional hazards approach. The expected risk of orthopedic problems per person-year was 0.045 for men and 0.046 for women. For men, physical fitness, BMI, and physical activity were associated with orthopedic problems, while for women, physical activity was the main predictor. Age was not a factor for either gender. The effect of change in physical fitness, physical activity, and BMI was examined in a subset of 2,325 persons with more than one visit to the clinic. For women, physical activity and a decrease in BMI were associated with orthopedic problems, while for men none of those factors were significant. Again, age was not a factor in either group. The absence of any age effect on the occurrence of problems suggests that with regard to orthopedic problems, moderate amounts of physical activity in generally healthy persons may be recommended without special consideration as to age.

Adolescent↗
PubMed1989

Surrogate measures of physical activity and physical fitness. Evidence for sedentary traits of resting tachycardia, obesity, and low vital capacity.

Studies on physical activity, physical fitness, and health have been hampered because of invalid, unreliable, or impractical measures of physical activity. This report examines the validity of sedentary traits (resting tachycardia, obesity, and low vital capacity) as predictors of physical fitness as assessed by a maximal treadmill exercise test. Study participants were women (n = 3,943) and men (n = 15,627) with at least one visit to the Cooper Clinic in Dallas, Texas. Association of the sedentary traits with physical fitness was examined by multiple regression analyses. Sedentary traits were associated with physical fitness in all age and sex groups, accounting for 12-40% of the variance in treadmill time. When smoking, a simple physical activity index, and sedentary traits were included in a model to predict physical fitness, R2 values ranged from 0.20 to 0.53 in women and 0.45 to 0.61 in men and were significant at p less than 0.0001. These models account for approximately twice as much variance in physical fitness as has been reported previously. The addition of sedentary traits measurements to a simple physical activity index provides a valid estimate of physical fitness in epidemiologic studies.

Adult↗
PubMed1989

The safety of maximal exercise testing.

Previous reports on the safety of exercise testing have been based on surveys from different testing facilities with a variety of testing protocols and patient types. From 1971 through 1987, 71,914 maximal exercise tests conducted in a population with a low prevalence of known coronary heart disease under uniform conditions at a single medical facility resulted in six major cardiac complications including one death. No complications have occurred in the past 10 years in 45,000 maximal tests. The overall cardiac complication rate in men and women is 0.8 complications per 10,000 tests with 95% confidence intervals of 0.3-1.9 complications per 10,000 tests. Maximal exercise testing appears safer than some previously published reports have suggested and seems to be getting safer with time.

Accident Prevention↗
PubMed1988

A mail survey of physical activity habits as related to measured physical fitness.

The associations of self-reported measures of physical activity from a mail survey with an objective measure of physical fitness were investigated. Respondents to a health status survey (n = 12,225), conducted in 1982 by the Institute for Aerobics Research in Dallas, TX, formed the population. From this group, males who also had a clinical examination within 60 days of the return of their questionnaire served as subjects. The study subjects (n = 375, mean age = 47.1 years) completed a maximal physical fitness assessment using a modified Balke protocol. The questionnaire included a section of inquiries concerning leisure time physical activity participation in which subjects were asked to quantitatively recall exercise participation for varying periods of time. Reported exercise participation values were converted to estimates of energy expenditure and combined into overall indices of physical activity participation. Multiple regression analyses were used to determine the individual contributions of the physical activity indices in predicting maximal treadmill performance (physical fitness). Significant predictors of physical fitness were age (beta = -0.34), an index of running, walking, and jogging participation (beta = 0.31), and the response to a question on frequency of sweating (beta = 0.35). The multiple correlation coefficient for these variables in predicting physical fitness was 0.65. These results indicate that exercise behavior can be accurately estimated in large populations by using simple questions in a mail survey.

Adult↗
PubMed1988

Physical activity and cancer. An epidemiological perspective.

This article reviews the existing epidemiological evidence on the association between physical activity and cancer. Relatively little is known about the role that increased physical activity may have in protecting humans from malignancy. Herein, studies are reviewed on the basis of the type of physical activity exposure studied: occupational or leisure time. Results suggest that if any consistencies emerge, there may be a protective effect of increased physical activity exposure upon cancer of the colon, and no effect on cancer of the rectum, in men. Increased physical activity in women during college years may protect against certain reproductive system cancers. Methodological deficiencies in assessment of physical activity (total exposure over lifetime) and in lack of control for other potential explanations block further, more solid conclusions. The fact that an association has been demonstrated in spite of these drawbacks, however, indicates the importance of further study. Suggested directions for future work are presented.

Exercise↗
PubMed1985

Rubella screening and vaccination follow-up by a hospital employee health office.

The data in the present study indicate two major points. One is that the facility under question has an unusually low rate of rubella susceptibility. The other is that the referral of seronegative employees to an outside agency for vaccination (in this case the local CHD) is not nearly as effective, with respect to employee compliance, as an in-house program. Despite the added immediate cost to the hospital for administering the vaccine, the possibility of employee-to-patient transmission of the rubella virus poses the threat of a much higher future cost. It is suggested that facilities that do not currently have an in-house rubella vaccination program should reevaluate the effectiveness of their programs.

Adult↗
PubMedDate not supplied

Reduction in cardiovascular disease risk factors: 6-month results from Project Active.

BACKGROUND: Project Active is a randomized clinical trial that compares a lifestyle physical activity intervention with a traditional structured exercise intervention. The purpose of this paper is to report 6-month results of these interventions on cardiovascular disease (CVD) risk factors among healthy, sedentary, middle-aged men and women, and to examine the psychological strategies used in each group (Lifestyle and Structured) to reach the level of physical activity recommended by the Centers for Disease Control and Prevention (CDC) and American College of Sports Medicine (ACSM) and to achieve changes in these CVD risk factors. METHODS: A total of 116 initially sedentary men (mean +/- SD self-reported physical activity, 33.2 +/- 1.4 kcal.kg-1.day-1) and 119 women (32.9 +/- 1.0 kcal.kg-1.day-1), ages 35-60 years (46.0 +/- 6.7 years) were randomly assigned to a 6-month lifestyle physical activity counseling intervention or a 6-month gymnasium-based structured program. At baseline and 6 months, changes in lipid and lipoprotein-cholesterol concentrations, blood pressure, and body composition and cognitive and behavioral measures of change were assessed. One-way analyses of variance with covariate adjustment were used to test for between-group differences in CVD risk factors. Associations between achieving the CDC/ACSM criterion and changes in cognitive and behavioral measures were assessed with multiple logistic regression models. RESULTS: After 6 months of intervention, 78% of Lifestyle participants and 85% of Structured participants were meeting or exceeding the CDC/ACSM recommendation of accumulating 30 min or more of moderate-intensity physical activity on most, preferably all, days of the week. This was verified by a significant increase in cardiorespiratory fitness in both groups. The adjusted mean increase in maximal METs (VO2peak divided by 3.5 ml.kg-1.min-1) between treadmill tests was 0.4 kcal.kg-1.hr-1 (P < 0.001) for Lifestyle and 1.1 kcal.kg-1.hr-1 (P < 0.001) for Structured. There was a significant difference between intervention groups for this outcome. Both groups had significant reductions in total cholesterol, total cholesterol/HDL-C ratio, diastolic blood pressure, and percentage of body fat. There were no significant between-group differences in changes in these outcomes. Adjusted mean changes in total cholesterol, systolic blood pressure, and percentage of body fat in Lifestyle [in Structured] participants were -0.2 [-0.3] mmol.L-1, -3.2[-1.8] mm Hg, and -1.4 [-1.7] %, respectively. There were significant associations between achieving the CDC/ACSM physical activity criterion and greater use of the cognitive and behavioral strategies of change. Both groups changed self-efficacy and many of the behavioral measures, but there were no significant differences between intervention groups. CONCLUSIONS: These results demonstrate that lifestyle physical activity counseling is as effective as structured exercise programs in increasing physical activity and improving CVD risk factors after 6 months among initially sedentary men and women. Furthermore, specific cognitive and behavioral counseling strategies were increased significantly as a result of the intervention. These strategies are effective and could be used in a wide variety of settings.

Adult↗
PubMedDate not supplied

Isometry measurements in the knee with the anterior cruciate ligament intact, sectioned, and reconstructed.

When assessing isometry during anterior cruciate ligament surgery, it is assumed that points determined to be isometric remain so after reconstruction. We sought to evaluate if isometric measurements vary with the status of the anterior cruciate ligament. A computerized electronic isometer was used to measure the magnitude and pattern of change in separation distance between a constant point in the tibial insertion of the anterior cruciate ligament and five positions within the femoral insertion with the anterior cruciate ligament intact, sectioned, and reconstructed. For the center position, the magnitude and pattern of the change in separation distance was physiologically isometric in all conditions (maximal length change, 3.0 mm). For the posterior position, the isometry pattern remained physiologic in each condition, and the magnitude of the separation distance was nearly isometric in all conditions (maximal length change, 3.7 mm). The superior and inferior positions had similar isometric measurements in the intact and sectioned conditions but significantly different measurements after anterior cruciate ligament reconstruction. Intraoperative assessment of isometry at positions in the center or posterior portion of the anterior cruciate ligament's femoral insertion provides useful information that is not altered by reconstruction. For superior and inferior positions, however, points found to be isometric in the anterior cruciate ligament-deficient knee did not remain isometric after reconstruction.

Anterior Cruciate Ligament↗
PubMedDate not supplied

Cyclic pull-out strength of hamstring tendon graft fixation with soft tissue interference screws. Influence of screw length.

Blunt-threaded interference screws used for fixation of hamstring tendons in anterior cruciate ligament reconstructions provide aperture fixation and may provide a biomechanically more stable graft than a graft fixed further from the articular surface. It is unknown if soft tissue fixation strength using interference screws is affected by screw length. We compared the cyclic and time-zero pull-out forces of 7 x 25 mm and 7 x 40 mm blunt-threaded metal interference screws for hamstring graft tibial fixation in eight paired human cadaveric specimens. A four-stranded autologous hamstring tendon graft was secured by a blunt-threaded interference screw into a proximal tibial tunnel with a diameter corresponding to the graft width. Eight grafts were secured with a 25-mm length screw while the other eight paired grafts were secured with a 40-mm length screw. During cyclic testing, slippage of the graft occurred as the force of pull became greater with each cycle until the graft-screw complex ultimately failed. All grafts failed at the fixation site, with the tendon being pulled past the screw. There were no measurable differences in the mean cyclic failure strength, pull-out strength, or stiffness between the two sizes of screws. Although use of the longer screw would make removal technically easier should revision surgery be necessary, it did not provide stronger fixation strength than the shorter, standard screw as had been postulated.

Adult↗
PubMedDate not supplied

The relationship between sociodemographic characteristics and recruitment, retention, and health improvements in a worksite health promotion program.

BACKGROUND: Recruitment, retention, and success in a worksite health promotion program was examined among various demographic groups of employees (n = 11,830) of the Dallas, Texas Independent School District. METHODS: Enrolled employees (n = 3,873) were given a health screen consisting of health habit assessment, measurement of clinical variables, physical fitness testing, and a medical examination. RESULTS: Thirty-three percent of employees were successfully recruited into the program. Recruitment rates were virtually identical for men and women (32% and 33%, respectively), but varied across ethnic, age, and education groups. Blacks, younger employees, and noncollege graduates were less likely to be recruited. Sixty-nine percent of the employees were retained in the program, as defined by participation in the second screen, and women were more likely to be retained than men (71% versus 64%, respectively). Retention rates throughout the 10-week program were higher for whites and Hispanics, and were virtually identical for each age group and education level. Overall, participants in the program showed an improvement in physical fitness and general well-being, lost weight, and smoked less. These changes were relatively consistent across the various demographic groups. DISCUSSION: Data suggest demographic characteristics are related to recruitment and retention in a health promotion program.

Adult↗