Biomedical subjects

Jeffrey A Katula

Publications and source records attributed to Jeffrey A Katula.

8 recordsLinked to original sources

PubMed2006

Older adults' desire for physical competence.

PURPOSE: To develop and provide initial psychometric support for a 16-item measure that assesses a new construct termed desire for physical competence (DPC). METHODS: A total of 157 older adults (aged 60-95) were administered the DPC along with various other questionnaires that assessed demographics, health status, social desirability, desire for control, body satisfaction, and life satisfaction. These data facilitated development and initial psychometric evaluation of the scale. An additional sample of 30 older adults was employed to examine test-retest reliability. RESULTS: Based on the conceptual foundation of DPC and results from an exploratory factor analysis, a single-dimension Rasch model based on response theory was applied to the data. The proposed model fit the data quite well as indicated by the average mean square of both outfit (1.02) and infit (1.04) statistics. The DPC correlated in expected directions with age, r = -0.33 (P < 0.01), and had r values of 0.23, 0.22, 0.25 (all P values <0.01) with desire for control, body satisfaction, and the SF-36, respectively. Older adults with arthritis had lower DPC scores than those without arthritis. The measure was not confounded by social desirability, and test-retest reliability of the measure (>0.90) was excellent. CONCLUSIONS: The DPC provides a tool to assess the incentive value of older adults for being physically competent. As such, it provides a more complete social cognitive foundation for studies examining physical activity behavior and the process of physical disablement.

Activities of Daily Living↗

PubMed2006

Strength training in older adults: an empowering intervention.

PURPOSE: This study evaluated the benefits of adding a psychological empowerment intervention (PEI) to traditional strength training (TST) on social cognitive variables in community-dwelling older adults. METHODS: Thirty-eight participants were randomly assigned to either a PEI or a TST intervention for 6 wk. Before random assignment and following training, participants completed measures of self-efficacy for upper and lower body strength as well as the desire to be able to lift specific amounts of weight. Both treatments involved two sessions per week of center-based training and one session per week of home-based training. The PEI condition also included a group-mediated intervention that was designed to increase self-efficacy for physical strength and the desire for upper and lower body strength. RESULTS: General linear models on difference scores revealed that the two groups experienced differential gains in the desire for upper body strength (P = 0.023, effect size (ES) = 0.79) and were marginally different in gains for upper body strength self-efficacy (P = 0.065, ES = 0.63). On a four-point scale, the adjusted mean (+/-SE) differences for the PEI group on the desire for upper body strength was 0.71 (+/-0.12) as compared to 0.27 (+/-0.13) for the TST group, whereas the PEI group's improvement in self-efficacy for upper body strength was 25.70 (+/-3.02) as compared to 17.18 (+/-3.19) for the TST group. CONCLUSIONS: Empowerment-based exercise programs may be particularly motivating for older adults by creating a more meaningful physical activity experience for them.

Aged↗

PubMed2006

Effect of treadmill and overground walking on function and attitudes in older adults.

PURPOSE: The purpose of this study was to determine whether treadmill walking, as a mode of physical activity for older adults, was comparable with overground walking when considering 1) spatiotemporal gait characteristics (walking velocity, stride length, and stride rate) at a preferred velocity and a prescribed intensity typical of many exercise prescriptions (i.e., RPE of 13); and 2) the effects on physical function (short physical performance battery (SPPB), lateral mobility, 400-m walk) and participants' attitude towards training and level of enjoyment. METHODS: Gait characteristics were measured at each participant's preferred and RPE 13 velocity during treadmill and overground walking (N=23, 74+/-4 yr). Participants were then randomized to either a treadmill or overground progressive intensity and duration walking program of 18 sessions. RESULTS: Both the preferred and RPE 13 walking velocities were significantly slower on the treadmill compared with overground (t(22)=-10.87, P<0.001 and t(22)=-8.54, P<0.001, respectively), as a result of significantly shorter stride lengths and slower stride rates. After training, there were no differences between the groups for RPE 13 velocity, SPPB or lateral mobility. However, following the intervention, the overground group completed the 400-m walk faster (F(1,15)=6.06, P<0.05), had a more favorable attitude towards training, and expressed a more favorable level of enjoyment about the training program than the treadmill group (F(1,16)=7.5; P<0.05). CONCLUSION: An overground walking program appears to offer some advantages over a treadmill walking program in older adults. Using RPE alone to regulate intensity may reduce the benefits of a treadmill walking program in older adults.

Aged↗

PubMed2006

A pilot study to assess the influence of tai chi chuan on functional capacity among breast cancer survivors.

Treatment of breast cancer can significantly diminish functional capacity in patients months and even years after the completion of treatments. Tai chi chuan (TCC) is a moderate form of exercise that may be an effective therapy for improving functional capacity among breast cancer survivors. We sought to provide pilot data comparing the efficacy of TCC and psychosocial therapy (PST; physical activity control) for improving functional capacity among breast cancer survivors post treatment. Twenty-one women who had completed treatment of breast cancer were randomized to receive TCC or PST 3 times/wk for 12 weeks. Functional capacity was assessed at baseline and at 12 weeks. The TCC group demonstrated significant improvement in functional capacity (specifically aerobic capacity, muscular strength, and flexibility) whereas the PST group showed significant improvement in flexibility only. These data suggest that TCC may be an efficacious intervention for enhancing functional capacity among breast cancer survivors and may support the need for larger randomized, controlled clinical trials to further elucidate these relationships.

Adult↗

PubMed2005

Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis.

OBJECTIVE: To examine changes in mobility-related self efficacy following exercise and dietary weight loss interventions in overweight and obese older adults with knee osteoarthritis (OA), and to determine if self efficacy and pain mediate the effects of the interventions on mobility task performance. METHODS: The Arthritis, Diet, and Activity Promotion Trial was an 18-month, single-blind, randomized, controlled trial comparing the effects of exercise alone, dietary weight loss alone, a combination of exercise plus dietary weight loss, and a healthy lifestyle control intervention in the treatment of 316 overweight or obese older adults with symptomatic knee OA. Participants completed measures of stair-climb time and 6-minute walk distance, self efficacy for completing each mobility task, and self-reported pain at baseline, 6 months, and 18 months during the trial. RESULTS: Mixed model analyses of covariance of baseline adjusted change in the outcomes demonstrated that the exercise + dietary weight loss intervention produced greater improvements in mobility-related self efficacy (P = 0.0035), stair climb (P = 0.0249) and 6-minute walk performance (P = 0.00031), and pain (P = 0.09) when compared with the healthy lifestyle control intervention. Mediation analyses revealed that self efficacy and pain served as partial mediators of the beneficial effect of exercise + dietary weight loss on stair-climb time. CONCLUSION: Exercise + dietary weight loss results in improved mobility-related self efficacy; changes in these task-specific control beliefs and self-reported pain serve as independent partial mediators of the beneficial effect of exercise + dietary weight loss on stair-climb performance.

Activities of Daily Living↗

PubMed2004

Tai Chi Chuan, health-related quality of life and self-esteem: a randomized trial with breast cancer survivors.

GOALS: Health-related quality of life (HRQL) and self-esteem are often diminished among women diagnosed and treated for breast cancer. Tai Chi is a moderate form of exercise that may be an effective therapy for improving HRQL and self-esteem among these women. We sought to compare the efficacy of Tai Chi Chuan (TCC) and psychosocial support (PST) for improving HRQL and self-esteem among breast cancer survivors. PATIENTS AND METHODS: A group of 21 women diagnosed with breast cancer, who had completed treatment within the last 30 months were randomized to receive 12 weeks of TCC or PST. Participants in both groups met three times a week for 60 minutes. HRQL and self-esteem were assessed at baseline, 6 weeks, and 12 weeks. RESULTS: The TCC group demonstrated significant improvements in HRQL, while the PST group reported declines in HRQL, with the differences between the two groups approaching significance at week 12. Additionally, the TCC group exhibited improvements in self-esteem, while the PST group reported declines in self-esteem, with the differences between groups reaching statistical significance at week 12. These findings, coupled with a visual inspection of the raw change scores, support the plausibility of a dose-response relationship concerning Tai Chi. CONCLUSIONS: In this pilot investigation, the TCC group exhibited improvements in HRQL and self-esteem from baseline to 6 and 12 weeks, while the support group exhibited declines. Randomized, controlled clinical trials with larger sample sizes are needed.

Adult↗

PubMed2004

Perceived difficulty, importance, and satisfaction with physical function in COPD patients.

BACKGROUND: Research suggests that patients' satisfaction with their physical functioning (SPF) is a critical component of HRQL. This study was designed to examine the extent to which perceptions of physical function and the value placed on physical function are related to satisfaction ratings. The sample consisted of older adults suffering from a progressively debilitating disease, chronic obstructive pulmonary disease (COPD). METHODS: During baseline assessments, COPD patients participating in a randomized controlled physical activity trial completed measures of SPF, perceived difficulty, and perceived importance. RESULTS: An ANCOVA controlling for age and gender indicated that perceived difficulty, perceived importance, and their interaction accounted for 43% of the variance in SPF. Additionally, participants were most satisfied with important tasks that they performed with little difficulty. Participants were least satisfied with important tasks that they perceived as highly difficult. CONCLUSION: The results of the present study indicate that not being able to perform valued tasks produces discontent that is reflected in lower rating of satisfaction with physical functioning. Clearly, the significance of loss in function to individual patients is related to the importance of the functional activities that may be compromised. These data have implications for the scope of patient assessment in clinical care and for the conceptual basis of future research in the area of physical functioning.

Activities of Daily Living↗

PubMed2004

Challenges and innovations in enhancing adherence.

Adherence is a complex phenomenon involving interactions among the individual, the environment and the community. In an adherence workshop, a small group of investigators discussed their experiences with challenges and innovations regarding adherence gleaned from clinical research. This article summarizes the information and outcomes of that meeting. Guided by theoretical frameworks for understanding and promoting adherence, challenges in the areas of measurement, community-based research, and interventions were explored and innovations for meeting these challenges suggested. The article concludes with recommendations for enhancing the adherence agenda: (1) adherence research must have a well-defined conceptual and theoretical basis; (2) individual perceptions and social context of behavior must be incorporated; (3) research must be undertaken as a collaborative process involving participants and the community. Looking ahead, it is clear that if we hope to develop a new and integrated model of adherence, we must continue to advance theory through theory testing, with particular attention given to mediators and diverse samples. Moreover, an interdisciplinary agenda is necessary to set the stage for bringing together researchers from various disciplines and backgrounds with both participants and community representatives.

Clinical Trials as Topic↗