S Miilunpalo

UKK Institute, Tammerfors, Province of Western Finland, Finland

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Publications (50)117.37 Total impact

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    ABSTRACT: Evidence of the effect of leisure time physical activity (LTPA) modes on the motor abilities of a mature population is scarce. The purpose of this study was to compare the motor abilities of physically active and inactive men and women and to examine the associations of different exercise modes and former and recent LTPA (R-LTPA) with motor ability and various physical tests. The LTPA of the participants (men n = 69, women n = 79; aged 41-47 yr) was ascertained by a modified Physical Activity Readiness Questionnaire, including questions on the frequency, duration, and intensity of R-LTPA and former LTPA and on exercise modes. Motor abilities in terms of balance, agility, and coordination were assessed with a battery of nine tests supplemented with five physical fitness tests. Multiple statistical methods were used in analyses that were conducted separately for men and women. The MET-hours per week of R-LTPA correlated statistically significantly with the tests of agility and static balance (rs = -0.28, P = 0.022; rs = -0.25, P = 0.043, respectively) among men and with the static balance (rs = 0.41), 2-km walking (rs = 0.36), step squat (rs = 0.36) (P < or = 0.001, respectively), and static back endurance (rs = 0.25, P = 0.024) among women. In the stepwise regression among men, the most frequent statistically significant predictor was the playing of several games. For women, a history of LTPA for more than 3 yr was the strongest predictor for good results in almost all tests. Participants with long-term and regular LTPA had better motor performance, and especially a variety of games improve components of motor ability. Diverse, regular, and long-term exercise including both specific training and general activity develops both motor abilities and physical fitness.
    Medicine and science in sports and exercise 02/2010; 42(9):1760-8. · 4.48 Impact Factor
  • Pauliina Husu, Jaana Suni, Matti Pasanen, Seppo Miilunpalo
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    ABSTRACT: Background: Low levels of physical activity (PA) and poor fitness tend to predict a decline in mobility. The current study investigated whether PA modifies the predictive value of health-related fitness (HRF) tests on difficulty in walking 2 km (WD). PA was assessed by self-reported questionnaires in 1990 and 1996. Subjects age 55 to 69 years and free of self-reported WD participated in assessment of HRF in 1996. Occurrence of WD was assessed by questionnaire in 2002 (n=537). There were no statistically significant interactions between PA and HRF tests; thus, PA and HRF were both independent predictors of WD. Regardless of the PA level, the subjects in the poorest performing third in each HRF test had higher risk of WD than the subjects in the best performing third. PA and HRF seemed to be independent predictors of WD, although the association of PA with WD was weaker than the association of HRF. Thus, PA did not modify the predictive value of HRF on WD.
    Journal of physical activity & health 10/2008; 5(5):732-45. · 1.95 Impact Factor
  • Pauliina Husu, Jaana Suni, Matti Pasanen, Seppo Miilunpalo
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    ABSTRACT: Health-related fitness (HRF) tests are valid predictors of self-reported mobility difficulties among high-functioning older adults. The aim of the present study was to identify optimal cut-off values for HRF tests predicting self-reported difficulties in walking 2 km (WD). Subjects were 55- to 69-year-old men and women who were free of WD at baseline. The HRF assessment in 1996 included seven test items, and postal questionnaires were used to assess occurrence of new WD in 2002. Analysis of covariance and receiver-operating characteristic analysis were used as statistical methods. In a 1-km walk, the sensitivity and specificity at the optimal cut-off 10:15 (min:s) for men were 63% and 75%, and at the cut-off 10:47 for women 70% and 71%. In dynamic back extension, the sensitivity and specificity at the optimal cut-off 16.5 (repetitions) were 67% and 65% in men and 82% and 59% at cut-off 13.5 in women. Correspondingly, in backward walking, the sensitivity and specificity at the optimal cut-off 27.7 (seconds) were 65% and 69% in men and 74% and 61% at cutoff 35.0 in women. The 1-km walk, dynamic back extension and backward walking tests had the best predictive value for WD. These tests, with identified cut-off values, can be used to screen individuals who are at increased risk of WD. Tests can also be used in physical activity counseling to target activity to those components of HRF that indicate poor fitness and are important for good walking ability.
    Aging clinical and experimental research 01/2008; 19(6):444-50. · 1.01 Impact Factor
  • Marjo B Rinne, Seppo I Miilunpalo, Ari O Heinonen
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    ABSTRACT: There is a lack of knowledge of the motor abilities required in different exercise modes which are needed when counseling sedentary middle-aged people to start a physically active lifestyle. Nominal group technique was used to establish the consensus statement concerning motor abilities and physical fitness in 31 exercise modes. Walking, running, jogging, and calisthenics were regarded as the most suitable exercise modes for most people with no specific requirements. The most demanding exercise modes of evaluated exercise modes were roller skating, downhill skiing, and martial arts, requiring all five motor abilities. Four abilities were necessary in skating, jazz dance, and ice hockey. When exercising is target-oriented, endurance is trained evidently in 27 out of 31 and muscle strength in 22 out of 31 exercise modes. The consensus statement gives theoretical basis for the components of motor abilities and physical fitness components in different exercise modes. The statement is instructive in order to promote health-enhancing physical activity among sedentary people. This study completes the selection of the exercise modes more detailed than current PA recommendation and guidelines for public health. A variety of exercise modes with one or none motor requirements is available to start. When amount and intensity of exercise is increased the training effects can be found in most components of motor ability and physical fitness.
    Journal of physical activity & health 05/2007; 4(2):203-14. · 1.95 Impact Factor
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    ABSTRACT: In 2001, a collaborative Physical Activity Prescription Programme (PAPP) was started in Finland to increase physical activity (PA) counselling among physicians, especially in primary care. This article describes the initiation, implementation and evaluation of PAPP. Five actions were implemented to reach the programme goal: (i) developing a counselling approach for physicians; (ii) providing easy and open access to counselling material; (iii) facilitating physicians' uptake and adoption of the counselling approach; (iv) disseminating information about the counselling approach to physicians, health and exercise professionals and decision-makers and (v) raising financial resources to cover programme expenses. Evaluation was based on the dimensions of the RE-AIM framework: reach, effectiveness, adoption, implementation and maintenance. Effectiveness and adoption were evaluated with two questions added to the annual survey of the Finnish Medical Association to all practising physicians in the year 2002 (n = 16 692) and 2004 (n = 17 170). The 4-year PAPP was successful in reaching health care units (Reach), accomplishing most of the implementation actions (Implementation) and initiating local projects for institutionalizing the prescription-based counselling approach, 'Prex' (Maintenance). However, at the national level, the programme was not effective in increasing the frequency of asking about patients' PA habits (Effectiveness) or the frequency of using 'Prex' or other written material in PA counselling among physicians (Adoption). To improve the latter two, the duration of the programme would have had to be extended with more effort at strengthening physicians' confidence in PA counselling and knowledge about its effectiveness. Also, a more systematic approach would have been necessary to facilitate inter-sectoral network for adopting 'Prex' as a counselling tool at the local level.
    Health Promotion International 04/2007; 22(1):19-27. · 1.94 Impact Factor
  • P. Oja, S. Miilunpalo, I. Vuori, M. Pasanen, H. Urponen
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    ABSTRACT: The health-related physical activity of Finns was studied during the 1980s by analysing changes in activity in a 10-year follow-up of a representative population cohort aged 20–65 years at the onset of the study. The proportion of apparently healthy people exercising at least twice a week for fitness and health increased from about 40% to over 50%. The increase was particularly large among women and young people. Occupational physical activity, education and marital status did not affect the trends. In contrast, regular vigorous exercise remained unchanged. These findings are consistent with other observations showing a steady increase in health-related physical activity among adult Finns during the past 20 years. However, in terms of the health potential of exercise, a majority of the population remains less than optimally active.
    Scandinavian Journal of Medicine and Science in Sports 01/2007; 4(1):75 - 81. · 3.21 Impact Factor
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    ABSTRACT: Menopause may induce a phase of rapid decreases in bone mineral density, aerobic fitness, muscle strength, and balance, especially in sedentary women. The purpose of this study was to examine the effects and feasibility of an exercise program of 1 or 2 bouts of walking and resistance training on lower-extremity muscle strength (the force-generating capacity of muscle), balance, and walking performance in women who recently went through menopause. The subjects were 134 women who recently went through menopause. The study was a 15-week, randomized, controlled trial with continuous and fractionated exercise groups. The outcomes assessed were lower-extremity muscle strength, balance, and walking time over 2 km. Feasibility was assessed by questionnaires, interviews, and training logs. One hundred twenty-eight women completed the study. Adherence to the study protocol was 92%. Both continuous and fractionated exercise groups improved equally in lower-extremity muscle strength and walking time but not in balance. Almost 70% of the subjects considered the program to be feasible. Two daily walking sessions caused fewer lower-extremity problems than did continuous walking. Brisk walking combined with moderate resistance training is feasible and effective. Fractionating the walking into 2 daily sessions is more feasible than continuous walking.
    Physical Therapy 08/2006; 86(7):912-23. · 2.78 Impact Factor
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    ABSTRACT: The functional independence of elderly populations deteriorates with age. Several tests of physical performance have been developed for screening elderly persons who are at risk of losing their functional independence. The purpose of the present study was to investigate whether several components of health-related fitness (HRF) are valid in predicting the occurrence of self-reported mobility difficulties (MD) among high-functioning older adults. Subjects were community-dwelling men and women, born 1917-1941, who participated in the assessment of HRF [6.1-m (20-ft) walk, one-leg stand, backwards walk, trunk side-bending, dynamic back extension, one-leg squat, 1-km walk] and who were free of MD in 1996 (no difficulties in walking 2- km, n=788; no difficulties in climbing stairs, n=647). Postal questionnaires were used to assess the prevalence of MD in 1996 and the occurrence of new MD in 2002. Logistic regression analysis was used as the statistical method. Both inability to perform the backwards walk and a poorer result in it were associated with risk of walking difficulties in the logistic model, with all the statistically significant single test items included. Results of 1-km walk time and one-leg squat strength test were also associated with risk, although the squat was statistically significant only in two older birth cohorts. Regarding stair-climbing difficulties, poorer results in the 1-km walk, dynamic back extension and one-leg squat tests were associated with increased risk of MD. The backwards walk, one-leg squat, dynamic back extension and 1-km walk tests were the best predictors of MD. These tests are recommended for use in screening high-functioning older people at risk of MD, as well as to target physical activity counseling to those components of HRF that are important for functional independence.
    Aging clinical and experimental research 07/2006; 18(3):218-26. · 1.01 Impact Factor
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    ABSTRACT: The authors investigated the associations of the amount, frequency and intensity, and type of leisure-time physical activity (LTPA) with the risk of self-reported difficulty in walking (WD) and stair climbing (SCD) over 16 years in a population-based cohort age 40-64 years at the onset of the study. Their results indicated that the risk for SCD was highest among men and women with a low amount of weekly LTPA. The risk was high also among women with weekly light LTPA compared with women with weekly vigorous LTPA. The risk for WD was highest among men who engaged in fitness activity once a week compared with men who engaged in fitness activity at least three times a week. A low amount of weekly LTPA, light LTPA twice or more a week, and LTPA for keeping fit and healthy less than three times a week are associated with future risk of mobility difficulties among middle-aged and older adults.
    Journal of aging and physical activity 05/2006; 14(2):133-53. · 1.85 Impact Factor
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    Minna Aittasalo, Seppo Miilunpalo
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    ABSTRACT: Employees participating in worksite physical activity (PA) interventions are mostly the physically active and healthy ones. PA counselling may therefore have an important role in reaching 'at-risk' employees. To examine (i) how PA counselling offered by occupational health care (OHC) providers reaches the target group of physically inactive employees who have intentions to increase PA and (ii) the relations of 12 selected variables to respondents' willingness to participate in PA counselling. Questionnaire survey of employees of client companies of OHC providers. Eight of the 19 OHC providers contacted participated and recruited a total of nine client companies to the study. A questionnaire survey was delivered to all the employees of the companies (n = 1349). Fifty-eight percent of employees (n = 784) responded to the survey and half of them (n = 380) belonged to the target group of being physically inactive and intending to increase PA. Only half of the respondents (n = 201) in the target group were willing to participate in counselling. Respondents in small companies were more interested in counselling than employees in large companies as were white-collar workers compared to blue-collar workers. Earlier PA discussions in OHC and intention to increase leisure-time PA were also positively related to willingness. A counselling offer attached to a survey did not effectively reach the target group of physically inactive employees who were ready to increase their PA. More individually based approaches such as brief conversations during client contacts are needed in OHC to raise the interest in lifestyle issues.
    Occupational Medicine 02/2006; 56(1):55-8. · 1.45 Impact Factor
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    ABSTRACT: To examine the effectiveness of prescription-based counseling and self-monitoring in the promotion of physical activity in primary health care. The study was conducted in Finland during 2003-2004. Physicians from 24 health care units (N = 67) were randomized to a prescription or a non-prescription group. The patients (N = 265) were assigned to the groups according to their physician. Every other patient of the non-prescription physicians received a pedometer and a physical activity log (MON) and feedback about their 5-day-recordings, the rest served as controls (CON). PA was assessed prior and 2 and 6 months after the physician's appointment with a questionnaire. The mean increase in weekly overall physical activity at 2 months was 1.0 (95% CI 0.0 to 2.0) session more in the prescription group than in controls. In at least moderate-intensity physical activity, the mean difference in changes was 0.8 (95% CI 0.1 to 1.5) sessions at 2 months and 0.9 (95% CI 0.2 to 1.5) sessions at 6 months for the favor of the prescription group. Compared to controls, self-monitoring increased the weekly duration of overall PA at 2 months on average by 217 min (95% CI 23 to 411). Prescription can be recommended as a tool for primary health care physicians to promote physical activity. Self-monitoring with an expert feedback can be useful in increasing especially the weekly duration of overall physical activity in the short term.
    Preventive Medicine 02/2006; 42(1):40-6. · 3.50 Impact Factor
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    ABSTRACT: Leisure time physical activity (LTPA) has been found to prevent several diseases, but little is known about its protective effect against decline in perceived health. The purpose of the present study is to analyze the protective effect of LTPA against the risk of decline in perceived health in a cohort of 19- to 63-year-old Finnish men (n = 1205) and women (n = 1148) with good perceived health. The incidence rate of decline in perceived health was monitored by self-administered questionnaire data from March 1980 through March 1985 through December 1990. LTPA was assessed by (1) a single-item self-assessment of global LTPA; (2) a compiled intensity-frequency measure of LTPA; (3) a total energy expenditure index of LTPA; and (4) three indexes of LTPA (i.e., commuting, fitness, and sport). The association between LTPA and risk of decline in perceived health was assessed using the Cox proportional hazard regression model. Among men, the multivariate analyses revealed an increased risk of decline in perceived health with no weekly vigorous global LTPA (RR = 1.49; 95% CI 1.12-1.98) and with no monthly sport activity (RR = 1.62; 95% CI 1.12-2.35). Among women, the results only showed an increased risk of decline in perceived health with fitness activity at less than once a week (RR = 1.62; 95% CI 1.06-2.48). The total energy expenditure of weekly LTPA and the index of commuting were not associated with the risk of decline in perceived health. Although energy expenditure of weekly LTPA did not prove to be a protective factor against the risk of decline in perceived health, global level, intensity, and type of weekly LTPA did. Physical activity interventions may need to emphasize the amount, intensity, and type of weekly LTPA, rather than energy expenditure of weekly LTPA, for promoting overall public health among middle-aged and older men and women with good perceived health.
    Preventive Medicine 08/2005; 41(1):141-50. · 3.50 Impact Factor
  • Minna Aittasalo, Seppo Miilunpalo, Jaana Suni
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    ABSTRACT: Voluntary employees (N = 155) from nine different companies were screened by questionnaire for the study. They were randomized into three study groups: counseling (n = 52), counseling + fitness testing (n = 51) and control group (n = 52). The counseling was based on a goal-oriented conversation session for each participant and three follow-up appointments with an occupational nurse over a period of 1 year. The fitness tests were adapted from the UKK Health-related Fitness Test Battery. The outcome measures were the changes in the amount of leisure-time physical activity (LTPA) assessed by diary, pedometer and questionnaire at baseline and at 6 and 12 month follow-up visits. As a result, no statistically significant differences were detected between the three groups at either of the follow-up visits. It seemed, thus, that the two PA counseling methods implemented had no direct mid- or long-term effects on the LTPA of voluntary employees with no specific disease-related indication to increase LTPA.
    Patient Education and Counseling 11/2004; 55(2):193-202. · 2.60 Impact Factor
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    ABSTRACT: Women who pass menopause face many changes that may lead to loss of health-related fitness (HRF), especially if sedentary. Many exercise recommendations are also relevant for early postmenopausal women; however, these may not meet their specific needs because the recommendations are based mainly on studies on men. We conducted a systematic review for randomised, controlled exercise trials on postmenopausal women (aged 50 to 65 years) on components of HRF. HRF consists of morphological fitness (body composition and bone strength), musculoskeletal fitness (muscle strength and endurance, flexibility), motor fitness (postural control), cardiorespiratory fitness (maximal aerobic power, blood pressure) and metabolic fitness (lipid and carbohydrate metabolism). The outcome variables chosen were: bodyweight; proportion of body fat of total bodyweight (F%); bone mineral density (BMD); bone mineral content (BMC); various tests on muscle performance, flexibility, balance and coordination; maximal oxygen consumption (V-dotO(2max)); resting blood pressure (BP); total cholesterol (TC); high-density lipoprotein-cholesterol; low-density lipoprotein-cholesterol; triglycerides; blood glucose and insulin. The feasibility of the exercise programme was assessed from drop-out, attendance and injury rates. Twenty-eight randomised controlled trials with 2646 participants were assessed. In total, 18 studies reported on the effects of exercise on bodyweight and F%, 16 on BMD or BMC, 11 on muscular strength or endurance, five on flexibility, six on balance or coordination, 18 on V-dotO(2max), seven on BP, nine on lipids and two studies on glucose an one on insulin. Based on these studies, early postmenopausal women could benefit from 30 minutes of daily moderate walking in one to three bouts combined with a resistance training programme twice a week. For a sedentary person, walking is feasible and can be incorporated into everyday life. A feasible way to start resistance training is to perform eight to ten repetitions of eight to ten exercises for major muscle groups starting with 40% of one repetition maximum. Resistance training initially requires professional instruction, but can thereafter be performed at home with little or no equipment as an alternative for a gym with weight machines. Warm-up and cool-down with stretching should be a part of every exercise session. The training described above is likely to preserve normal bodyweight, or combined with a weight-reducing diet, preserve BMD and increase muscle strength. Based on limited evidence, such exercise might also improve flexibility, balance and coordination, decrease hypertension and improve dyslipidaemia.
    Sports Medicine 02/2004; 34(11):753-78. · 5.32 Impact Factor
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    ABSTRACT: We studied the fractionization of walking training and searched for the minimum dose to affect coronary risk factors in two randomized controlled trials. Altogether 134 (Study I) and 121 (Study II) healthy, sedentary postmenopausal women started the trials, and 130 (Study I) and 116 (Study II) completed them. In Study I the exercise intensity was 65% of the maximal aerobic power (VO2max) and a total of 300 kcal was expended in one (Group W1) or two (Group W2) daily walking bouts. In Study II the exercise was continuous, and the exercise intensity (% of VO2max) and energy expenditure (kcal session(-1)) were 55% and 300 kcal (Group W3), 45% and 300 kcal (Group W4), 55% and 200 kcal (Group W5) and 45% and 200 kcal (Group W6). All the subjects walked 5 days a week. The outcome measures were blood pressure, serum lipoproteins and blood glucose and plasma insulin in fasting state and also during 2-h oral glucose tolerance test in Study I. There was no change in diastolic pressure in the original study groups, but in the combined exercise group (W1+W2) in Study I, the mean diastolic pressure declined by -3.0 mmHg (95% con-fidence interval (CI) -5.5 to -0.4) (P=0.025) in comparison with that of the controls. The mean blood glucose declined by -0.21 mmol L(-1) (CI -0.33 to -0.09) in Group W1 and -0.13 mmol L(-1) (CI -0.25 to -0.01) in Group W2 compared to controls (P=0.03). Also the 2-h glucose concentration decreased in Groups W1 and W2 compared to controls. Systolic blood pressure, serum lipoproteins and insulin levels did not change in Study I or Study II. We conclude that our training program with the greatest exercise dose, exercise intensity 65% of VO2max and weekly expenditure of 1500 kcal had a minimal, positive effect on diastolic pressure and blood glucose, and the effect was similar in one or two daily exercise session groups. This exercise dose is probably close to the minimum to affect coronary risk factors in healthy postmenopausal women. To get a more pronounced and clinically relevant effect, a greater exercise dose is needed.
    Scandinavian Journal of Medicine and Science in Sports 11/2003; 13(5):284-92. · 3.21 Impact Factor
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    ABSTRACT: To investigate age, period, and cohort effects on functional status. A prospective cohort study with measurements in 1981, 1990, and 1996. Three municipalities in north east Finland. A regionally representative sample of 19 to 63 year old men and women was drawn from the census data in 1979, of which 758 men and 1033 women initially aged 39-63 years entered the study in 1980 and completed the follow up in 1996 (90.9% of the alive cohort). Functional status was determined based on self estimated disabilities (difficulties or not able) to walk 2 km, climb several flights of stairs, and run 100 m. The age adjusted odds of disability in stair climbing and running were lower among the men and the women in 1990 and 1996 than among the men and the women in 1981. There was a declining trend in the odds of disability with succeeding birth cohorts among both the men (odds ratios (OR) 0.79 and 95% confidence intervals (CI) 0.70 to 0.88 for stair climbing and OR 0.88 and 95% CI 0.78 to 0.98 for running) and the women (OR 0.85 and 95% CI 0.77 to 0.93 for stair climbing and OR 0.85 and 95% CI 0.76 to 0.94 for running). No statistically significant differences in walking disability were found between the study periods or the study cohorts. The findings depict an improved time trend in functional status in the study population, with implications for future health and social care planning.
    Journal of Epidemiology &amp Community Health 01/2003; 56(12):905-12. · 3.39 Impact Factor
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    ABSTRACT: The American College of Sports Medicine recommends 20-60 minutes of aerobic exercise three to five days a week at an intensity of 40/50-85% of maximal aerobic power (VO(2)MAX) reserve, expending a total of 700-2000 kcal (2.93-8.36 MJ) a week to improve aerobic power and body composition. To ascertain the minimum effective dose of exercise. Voluntary, healthy, non-obese, sedentary, postmenopausal women (n = 121), 48-63 years of age, were randomised to four low dose walking groups or a control group; 116 subjects completed the study. The exercise groups walked five days a week for 24 weeks with the following intensity (% of VO(2)MAX) and energy expenditure (kcal/week): group W1, 55%/1500 kcal; group W2, 45%/1500 kcal; group W3, 55%/1000 kcal; group W4, 45%/1000 kcal. VO(2)MAX was measured in a direct maximal treadmill test. Submaximal aerobic fitness was estimated as heart rates at submaximal work levels corresponding to 65% and 75% of the baseline VO(2)MAX. The body mass index (BMI) was calculated and percentage of body fat (F%) estimated from skinfolds. The net change (the differences between changes in each exercise group and the control group) in VO(2)MAX was 2.9 ml/min/kg (95% confidence interval (CI) 1.5 to 4.2) in group W1, 2.6 ml/min/kg (95% CI 1.3 to 4.0) in group W2, 2.4 ml/min/kg (95% CI 0.9 to 3.8) in group W3, and 2.2 ml/min/kg (95% CI 0.8 to 3.5) in group W4. The heart rates in standard submaximal work decreased 4 to 8 beats/min in all the groups. There was no change in BMI, but the F% decreased by about 1% unit in all the groups. Walking (for 24 weeks) at moderate intensity 45% to 55% of VO(2)MAX, with a total weekly energy expenditure of 1000-1500 kcal, improves VO(2)MAX and body composition of previously sedentary, non-obese, postmenopausal women. This dose of exercise apparently approaches the minimum effective dose.
    British Journal of Sports Medicine 07/2002; 36(3):189-94. · 3.67 Impact Factor
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    ABSTRACT: To evaluate the feasibility and health-related content validity of 6 health-related fitness (HRF) and 3 functional performance (FP) tests among middle-aged and older persons. Cross-sectional methodologic study. Field laboratories in 3 communities of northeast Finland. A regionally representative, community-based cohort of 55- to 79-year-old men (n=501) and women (n=632). Not applicable. Health-related test exclusion rates (%) by age groups and odds ratios (ORs) of subjective health outcomes by fitness categories (least 20%, next 40%, most fit 40%). The health-related test exclusion rates increased with age, mainly because of musculoskeletal health limitations among the women and cardiovascular and musculoskeletal health limitations among the men. With the exception of dynamic back extension, 1-leg squat, 1-leg standing balance, and the 1-km walk among the women 75 years and older, 85% or more of the subjects qualified for the HRF tests and 95% or more for the FP tests. Strong and graded associations were found for cardiorespiratory and musculoskeletal fitness and the FP test levels with perceived health and functional ability status among both the men and the women (OR range, 2-31). The motor fitness test level was primarily associated with functional ability status. All the HRF and FP tests showed health-related content validity, and 4 of 6 of the HRF tests and all of the FP tests proved to be safe, with minor health-related test exclusions for middle-aged and older adults. The findings may help to target physical activity intervention toward persons at high risk for declining health and functional ability.
    Archives of Physical Medicine and Rehabilitation 06/2002; 83(5):666-77. · 2.36 Impact Factor
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    ABSTRACT: We compared the effects of one vs two daily bouts of walking on aerobic fitness and body composition in postmenopausal women. One hundred and thirty-four subjects were randomized into exercise groups or a control group and 130 completed the study. The subjects walked 5 d/week for 15 weeks at 65% of their maximal aerobic power expending 300 kcal (1255 kJ) in exercise in one (Group S1) or two daily sessions (Group S2). VO(2max) was measured in a direct maximal treadmill test. Body mass index (BMI) was calculated and the percentage of body fat (fat%) estimated using skinfold measurements. The net change in the VO(2max) was 2.5 mL min/kg (95% CI 1.5, 3.5) (8.7%) in Group S1 and 2.5 mL min/kg (95% CI 1.5, 3.5) (8.8%) in Group S2. The net change in body mass was -1.2 kg (95% CI-1.9, -0.5) in Group S1 and -1.1 kg (95% CI -1.8, -0.4) in Group S2. The net fat% change was -2.1% (95% CI-2.7, -1.4) in Group S1 and -1.7% (95% CI-2.3, -1.0) in Group S2. Exercise improved the maximal aerobic power and body composition equally when walking was performed in one or two daily bouts.
    Scandinavian Journal of Medicine and Science in Sports 05/2002; 12(2):99-105. · 3.21 Impact Factor
  • S Miilunpalo, E Toropainen, P Moisio
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    ABSTRACT: To assess the implementation of guidelines in Finnish primary health care units. A semi-quantitative analysis of a cross-sectional interview survey. All municipal health centres in a selected region in Finland. Head physicians and head nurses of the 31 participating units. Number of guidelines adopted; methods used in the implementation; and the unit's estimated purposefulness in the implementation of guidelines. All health centres had adopted at least one guideline in the defined task areas, but only one-third of the units had implemented several guidelines. The implementation methods utilised were usually directive and passive rather than co-operative and problem-solving. Half of the units used training and methods involving active participation of the personnel, and in one-third a multiprofessional approach was applied. Clients' representatives were hardly ever involved in the adaptation of guidelines. A quarter of the health centres were assessed as purposeful in their policy to implement guidelines, the large units being more goal-oriented than the smaller ones. A minority of health centres are goal-oriented in the adoption of guidelines and use versatile methods to support the implementation; this presents an important managerial challenge for national health care development in Finland.
    Scandinavian Journal of Primary Health Care 01/2002; 19(4):227-31. · 1.91 Impact Factor