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Injury rates from walking, gardening, weightlifting, outdoor bicycling, and aerobics

Authors:

Abstract

The objective of this survey was to estimate the frequency of injuries associated with five commonly performed moderately intense activities: walking for exercise, gardening and yard work, weightlifting, aerobic dance, and outdoor bicycling. National estimates were derived from weighted responses of over 5,000 individuals contacted between April 28 and September 18, 1994, via random-digit dialing of U.S. residential telephone numbers. Self-reported participation in these five activities in the late spring and summer of 1994 was common, ranging from an estimated 14.5 +/- 1.2% of the population for aerobics (nearly 30 million people) to 73.0 +/- 1.5% for walking (about 138 million people). Among participants, the activity-specific 30-d prevalence of injury ranged from 0.9 +- 0.5% for outdoor bicycle riding to 2.4 +- 1.3% for weightlifting. The estimated number in the 30 d of people injured in the 30 d before their interview ranged from 330,000 for outdoor bicycle riding to 2.1 million for gardening or yard work. Incidence rates for injury causing reduced participation in activity were 1.1 +/- 0.5x100 participantsx30 d for walking, 1.1 +/- 0.4 for gardening, and 3.3 +/- 1.9 for weightlifting. During walking and gardening, men and women were equally likely to be injured, but younger people (18-44 yr) were more likely to be injured than older people (45 + yr). Injury rates were low, yet large numbers of people were injured because participation rates were high. Most injuries were minor, but injuries may reduce participation in these otherwise beneficial activities. Additional studies to confirm the magnitude of the problem, to identify modifiable risk factors, and to recommend methods to reduce the frequency of such injuries are needed.
Medicine& Science in Sports & Exercise
Issue: Volume 30(8), August 1998, pp 1246-1249
Copyright: (C) Williams & Wilkins 1998. All Rights Reserved.
Publication Type: [Epidemiology]
ISSN: 0195-9131
Accession: 00005768-199808000-00010
Keywords: INJURY RATES, PHYSICAL ACTIVITY
[Epidemiology]
Injury rates from walking, gardening, weightlifting, outdoor bicycling, and aerobics
POWELL, KENNETH E.; HEATH, GREGORY W.; KRESNOW, MARCIE-JO; SACKS,
JEFFREY J.; BRANCHE, CHRISTINE M.
Author Information
National Center for Injury Prevention and Control and the National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
Submitted for publication April 1997.
Accepted for publication July 1997.
The authors thank Jeffrey P. Koplan, Caroline Macera, and Russell R. Pate for their suggestions
on the manuscript.
The following are members of the ICARIS project, which designed and conducted the survey
from which these data were obtained: Principal investigator: Jeffrey J. Sacks, M.D., M.P.H.;
Project core group: Barbara Houston; Marcie-jo Kresnow, M.S.; Joann M. O'Neil, B.A.; and
Suzanne M. Smith, M.D., M.P.H., of NCIPC. James Hersey Ph.D.; Rick Williams Ph.D.; and
Aiman Zeid, M.S., of Battelle. Sherry Marcy, M.P.H., and Deborah J. Zivan, BA of DataStat;
Project associates: Julie Bolen, Ph.D.; Christine M. Branche, Ph.D.; Peter Briss, M.D.; Terence
Chorba, M.D., M.P.H.; Alex Crosby, M.D., M.P.H.; Yvette Davis, V.M.D., M.P.H.; Jennifer
Friday, Ph.D.; Arlene Greenspan, Dr.P.H., PT; James Mercy, Ph.D.; Phil McClain, M.S.; Lloyd
Potter, Ph.D., M.P.H.; and Kenneth E. Powell, M.D., M.P.H. of NCIPC.
Thomas Matte, M.D., M.P.H., of the National Center for Environmental Health.
Address for correspondence: Kenneth E. Powell, M.D., M.P.H., Associate director for Science,
Mailstop K-60, Division of Violence Prevention, National Center for Injury Prevention and
Control, 4770 Buford Highway, Chamblee, GA 30341-3724. E-mail: KEP1@CDC.GOV.
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Outline
ABSTRACT
METHODS
RESULTS
DISCUSSION
REFERENCES
ABSTRACT
Injury rates from walking, gardening, weightlifting, outdoor bicycling, and aerobics. Med. Sci.
Sports Exerc., Vol. 30, No. 8, pp. 1246-1249, 1998.
Purpose: The objective of this survey was to estimate the frequency of injuries associated with
five commonly performed moderately intense activities: walking for exercise, gardening and
yard work, weightlifting, aerobic dance, and outdoor bicycling.
National estimates were derived from weighted responses of over 5,000 individuals contacted
between April 28 and September 18, 1994, via random-digit dialing of U.S. residential telephone
numbers. Self-reported participation in these five activities in the late spring and summer of 1994
was common, ranging from an estimated 14.5 +/- 1.2% of the population for aerobics (nearly 30
million people) to 73.0 +/- 1.5% for walking (about 138 million people).
Among participants, the activity-specific 30-d prevalence of injury ranged from
0.9 +/- 0.5% for outdoor bicycle riding to 2.4 +/- 1.3% for weightlifting. The estimated number
of people injured in the 30 d before their interview ranged from 330,000 for outdoor bicycle
riding to 2.1 million for gardening or yard work. Incidence rates for injuries causing reduced
participation in activity were 1.1 +/- 0.5[middle dot]100 participants[middle dot]30 d for
walking, 1.1
+/- 0.4 for gardening, and 3.3 +/- 1.9 for weightlifting. During walking
+and
gardening, men and women were equally likely to be injured, but younger people
(18-44 yr) were more likely to be injured than older people (45+ yr). Injury rates were low, yet
large numbers of people were injured because participation rates were high. Most injuries were
minor, but injuries may reduce participation in these otherwise beneficial activities.
Conclusions: Additional studies to confirm the magnitude of the problem, to identify modifiable
risk factors, and to recommend methods to reduce the frequency of such injuries are needed.
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Within the past several years the health benefits of regular physical activity have been affirmed
and summarized in reports from the Surgeon General of the United States (14), a National
Institutes of Health Consensus Development Conference on Physical Activity and
Cardiovascular Health (8), the Centers for Disease Control and Prevention and the American
College of Sports Medicine (10), and the American Heart Association (1). These entities
conclude that regular physical activity is associated with important health benefits: namely,
reduced rates of coronary heart disease, hypertension, non-insulin-dependent diabetes mellitus,
osteoporosis, colon cancer, anxiety, and depression, and improved quality of life. Importantly,
they emphasize that these and probably other health benefits do not require highly strenuous
activity but will accrue from participation in activities of moderate intensity. Further, they
recommend that actions be taken to encourage and facilitate participation by all segments of the
population in physical activity of moderate intensity.
Surprisingly little information is available about the frequency of injuries and other adverse
effects of physical activity among the general population (4,6,9,14). Information is particularly
sparse for injuries related to commonly performed moderately intense activities such as walking
or gardening. Such data would be valuable because injuries are a health burden themselves, and
they may lead to permanent reductions in activity, thereby impeding efforts to promote
widespread participation. For example, among a group of recreational runners, injury was the
most common reason for men and second most common reason for women to stop running (7).
As a first step toward understanding the impact of injuries from moderately intense activities, we
included a few questions in a nationwide telephone survey of risk factors related to injuries. We
sought information about the frequency of injuries resulting from participation in five common
physical activities:
walking for exercise, gardening and yard work, weightlifting, aerobic dance, and outdoor
bicycling.
METHODS
Data for this analysis are from the 1994 Injury Control and Risk Survey (ICARIS). Conducted
between April 28 and September 18, 1994, ICARIS was based on random-digit dialing of U.S.
residential telephone numbers. English-or Spanish-speaking adults (aged 18 yr and older) in all
50 states and the District of Columbia were eligible. Households in exchanges with high
minority representation were oversampled to ensure adequate representation.
Respondents were asked, "During the past 30 days have you participated in any of the following:
outdoor bicycle riding, aerobics or aerobic dance, weightlifting, walking for exercise, or
gardening or yard work?" "Yes" or "no" responses for each activity were recorded. Those who
responded "yes" to an activity were read a series of questions specifically mentioning that
activity. For example, if someone responded that he/she had done weightlifting, he/she was
asked, "In the past 30 days, were you injured while you were weightlifting." If "yes," the
respondent was asked, "During the past 30 days, on how many occasions when you were
weightlifting did you get injured severely enough that you stopped or reduced the amount of time
you spent weightlifting?" Regardless of the answer about stopping or reducing time, he/she was
asked, "During the past 30 days, on how many occasions when you were weightlifting were you
injured severely enough that you went for medical care or missed one-half day or more of work,
housework, or school?"
Data were weighted to generate national estimates. Weights include both a selection probability
weight and a poststratification weight. Selection probability weights were the inverse of the
probability of selecting a particular household type and the number of telephone numbers in the
household.
Poststratification weights were ratio adjustments based on the March 1994 Current Population
Survey number of households and the study estimates by age, race, sex, Census region, and
location within a metropolitan statistical area.
To account for the complex survey design, we used SUDAAN software (12) to generate
weighted estimates, percents, and 95% confidence intervals (CI). If the coefficient of variation
exceeded 35%, the national estimate and 95% CI are not reported. The Pearson chi-square test
was used to assess the association between sex and age-group characteristics of our study
population and participation and injury prevalence.
RESULTS
Of 9,342 answered calls, 3,630 respondents refused participation and 474 interviews were
incomplete. The final sample was 5,238 completed interviews (response rate, 56.1%).
Participation. Participation in the five activities in the late spring and summer of 1994 was
common, ranging from an estimated 14.5% of the population for aerobics (nearly 30 million
people) to 73.0% for walking (about 138 million
people) (Table 1). Men were more likely than women to participate in gardening or yard work,
weightlifting, and outdoor bicycle riding and less than likely than women to walk for exercise or
do aerobics (PP
Self-reported injury. Among participants, the activity-specific 30-day prevalences of injury were
low, ranging from 0.9% for outdoor bicycle riding to 2.4% for weight-lifting (Table 1). The
estimated number of people injured nationwide in the 30 d before their interview ranged from
330,000 for outdoor bicycle riding to 2.1 million for gardening or yard work. Despite the low
injury rates, sex- and age-group-specific injury rates could be calculated for walking and
gardening. Men and women had similar injury rates for walking and for gardening; however, the
prevalence of injuries among younger people was about twice as high as for older people (P
Injuries requiring reduction in activity, time-loss, or treatment. Incidence rates per 100
participants for injuries causing reduced participation in the activity were 1.1 +/- 0.5 per 30 d for
walking, 1.1 +/- 0.4 for gardening, and
3.3+/- 1.9 for weightlifting. There were too few activity-reducing injuries to calculate incidence
rates for outdoor bicycling and aerobics. There were too few time-loss injuries or injuries
requiring treatment to calculate incidence rates for any of the activities.
Many of the reported injuries apparently were slight. Based on unweighted numbers, about half
of the people who reported an injury from walking, gardening, or bicycling said that the injury
required no change in activity, time off, or medical care (Fig. 1). Roughly 30% of these people
reduced or stopped participating in the activity but did not seek care or take time off; about 20%
either sought medical care or missed one-half day or more of work, housework, or school. For
weightlifting and aerobics nearly everyone who reported an injury reduced the level of their
participation, and 25-30% sought medical care or missed one-half day or more of work,
housework, or school.
DISCUSSION
These data suggest that the proportion of participants who suffer an activity-related injury over a
30-d period while walking, gardening, weightlifting, outdoor bicycling, and performing aerobics
is low (0.9% to 2.4%), and that the 30-d incidence of injuries for walking, gardening, and
weightlifting are 1.1, 1.1, and 3.3 per 100 participants, respectively. The data also indicate that
about half of the self-reported injuries for walking, gardening, and bicycling did not require a
reduction in participation, a visit to a medical professional, or loss of at least one-half day from
work, housework, or school. Persons 45 yr or older were significantly less likely to be injured
than younger persons while walking or gardening.
Although the proportion of participants reporting injuries is low, on a national scale the high
participation rates yield a large number of injured people over the 30-d period, ranging from an
estimated 330,000 for outdoor bicycling to 2.1 million for gardening or yard work. The number
of people injured annually would, of course, be even higher; however, we chose not to project
annual rates because participation in gardening, outdoor bicycling, and perhaps walking are
likely to be lower from October to March.
The limited number of questions we asked led to three important limitations of our data. First, we
have no information about the amount of participation (i.e., we know only that the respondent
did the activity at least once in the preceding
30 d). Because time spent on activity is one of the most consistently observed risk factors for
injury, injury rate estimates based upon the amount of participation would be more informative.
Second, we have no information about the type and location of the injury. Third, we know
nothing about the causes of the injuries, which may be intrinsic to the activity, equipment-
related, or arise from conditions unrelated to the activity itself. Intrinsic injuries would include
problems arising directly from the movements of the activity and would include acute strains and
tears as well as "overuse" injuries. Equipment injuries would include dropping a weight on one's
foot or falling because of a wet surface. Extrinsic injuries would include dog bites or collisions
with motor vehicles. Rational injury-prevention activities will depend upon more information
about the actual causes of the injuries.
We were surprised by the high participation rates reported for the five activities but found few
data for comparison. A 1991 survey yielded an estimate that about 18% of people over 20 yr of
age had ridden a bicycle (presumably
outdoors) during the preceding 12 months (11); we estimated 20% of people older than 17 had
ridden during the preceding 30 d. For the other four activities, the survey most similar to ours is
the 1991 National Health Interview Survey (NHIS) (14). Comparing the NHIS with ICARIS,
participation rates are lower in NHIS for walking for exercise (44% vs 73%), gardening or yard
work (29% vs 71%), weightlifting (14% vs 21%), and aerobics or aerobic dance (7% vs 14%).
The higher participation rates in our survey may result from a longer time period of inquiry (30 d
vs 2 wk), more clement weather (April through September vs year-round), or attitude changes
between 1991 and 1994 about how much activity justifies a positive response. Generally, self-
reported physical activity data have been found reliable, but high-intensity activities appear to be
more accurately recalled and reported than activities of light or moderate intensity (2,5,15).
We are unaware of similar population-based estimates for activity-specific injury rates for
common physical activities, and confirmation in other studies is needed. Two studies of walkers
reported injury rates of 2.5% and 3.9% when converted to monthly injury rates (3,13), both
higher than our rate of 1.4%. The walkers in those studies walked 3-6 d[middle dot]wk-1, and
the injury rates represent injuries severe enough to stop or reduce participation. Our walkers
probably averaged less walking, and about half of the injuries did not require any reduction in
participation.
The information about the self-reported frequency and severity of injuries associated with five
common physical activities of moderate intensity brings different messages to different groups.
For the public, the message is that injuries associated with these activities are uncommon and
many of them so minor as to require no treatment or activity reduction. This is good news for the
general population. For the medical, research, and health promotion communities there is, in
addition to this primary positive message, a secondary and challenging one. The number of
people doing these activities is large and, hopefully, will get larger. Therefore, although the rates
of injury are low, the number of injured is large. A few of the injuries may be severe, more will
require care or activity reductions, thereby burdening both the health care system and the injured
individuals. Some of the injured will stop participating in physical activities altogether and will
not benefit from a predominantly healthy behavior. Clearly, further study of injuries caused by
commonly performed activities such as walking for exercise or gardening or yard work should be
done. Such research should enable greater understanding of the frequency and risk factors for
such injuries and facilitate the design of prevention efforts.
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Key Words: INJURY RATES; PHYSICAL ACTIVITY
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Many individuals do not participate in resistance exercise, with perceived lack of time being a key barrier. Minimal dose strategies, which generally reduce weekly exercise volumes to less than recommended guidelines, might improve muscle strength with minimal time investment. However, minimal dose strategies and their effects on muscle strength are still unclear. Here our aims are to define and characterize minimal dose resistance exercise strategies and summarize their effects on muscle strength in individuals who are not currently engaged in resistance exercise. The minimal dose strategies overviewed were: “Weekend Warrior,” single-set resistance exercise, resistance exercise “snacking,” practicing the strength test, and eccentric minimal doses. “Weekend Warrior,” which minimizes training frequency, is resistance exercise performed in one weekly session. Single-set resistance exercise, which minimizes set number and session duration, is one set of multiple exercises performed multiple times per week. “Snacks,” which minimize exercise number and session duration, are brief bouts (few minutes) of resistance exercise performed once or more daily. Practicing the strength test, which minimizes repetition number and session duration, is one maximal repetition performed in one or more sets, multiple days per week. Eccentric minimal doses, which eliminate or minimize concentric phase muscle actions, are low weekly volumes of submaximal or maximal eccentric-only repetitions. All approaches increase muscle strength, and some approaches improve other outcomes of health and fitness. “Weekend Warrior” and single-set resistance exercise are the approaches most strongly supported by current research, while snacking and eccentric minimal doses are emerging concepts with promising results. Public health programs can promote small volumes of resistance exercise as being better for muscle strength than no resistance exercise at all.
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Zusammenfassung Die Rolle von körperlicher Aktivität in der Prävention und Therapie von Übergewicht und Adipositas, aber auch möglicher Begleit- und Folgeerkrankungen ist heutzutage unbestritten. Die Weltgesundheitsorganisation fordert in den aktuellen Bewegungsempfehlungen für Erwachsene 150–300 Minuten pro Woche moderate oder 75–150 Minuten intensive Bewegungszeit sowie die Reduktion vermeidbarer Sitzzeiten. Für Menschen mit Adipositas gelten nur wenig höhere Umfänge mit 30 bis 60 Minuten Bewegungszeit pro Tag, um eine relevante Gewichtsabnahme zu erzielen. Diese beläuft sich aber meist auf nur 2 bis 3 Kg, die im Interventionszeitraum bis maximal 12 Monate erzielt werden. Wesentlicher sind daher die Effekte von Bewegung auf psychische und physische Faktoren inkl. der Körperkomposition, die auch unabhängig von einer Gewichtsreduktion auftreten. Auch beim Gewichtserhalt, ggf. einer weiteren Gewichtsabnahme über gezielte Maßnahmen hinaus gilt Bewegung als wichtiger Einflussfaktor. Hier werden 200 bis 300 Minuten pro Woche gefordert. Nichtsdestotrotz bleibt die Umsetzung in die Praxis erschwert. Bewährt haben sich eine patientenzentrierte Herangehensweise und eine partizipative Entscheidungsfindung sowie die Vermittlung, dass letztlich jede Bewegungsform einen gesundheitlichen Nutzen hat. Zur Minimierung möglicher Risiken sollte (vorab) eine sportmedizinische Vorsorgeuntersuchung erfolgen.
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Nuzzo, JL. Narrative review of sex differences in muscle strength, endurance, activation, size, fiber type, and strength training participation rates, preferences, motivations, injuries, and neuromuscular adaptations. J Strength Cond Res 37(2): 494-536, 2023-Biological sex and its relation with exercise participation and sports performance continue to be discussed. Here, the purpose was to inform such discussions by summarizing the literature on sex differences in numerous strength training-related variables and outcomes-muscle strength and endurance, muscle mass and size, muscle fiber type, muscle twitch forces, and voluntary activation; strength training participation rates, motivations, preferences, and practices; and injuries and changes in muscle size and strength with strength training. Male subjects become notably stronger than female subjects around age 15 years. In adults, sex differences in strength are more pronounced in upper-body than lower-body muscles and in concentric than eccentric contractions. Greater male than female strength is not because of higher voluntary activation but to greater muscle mass and type II fiber areas. Men participate in strength training more frequently than women. Men are motivated more by challenge, competition, social recognition, and a desire to increase muscle size and strength. Men also have greater preference for competitive, high-intensity, and upper-body exercise. Women are motivated more by improved attractiveness, muscle "toning," and body mass management. Women have greater preference for supervised and lower-body exercise. Intrasexual competition, mate selection, and the drive for muscularity are likely fundamental causes of exercise behaviors in men and women. Men and women increase muscle size and strength after weeks of strength training, but women experience greater relative strength improvements depending on age and muscle group. Men exhibit higher strength training injury rates. No sex difference exists in strength loss and muscle soreness after muscle-damaging exercise.
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Schlüter, K, Schneider, J, Rosenberger, F, and Wiskemann, J. Feasibility of high-intensity resistance training sessions in cancer survivors. J Strength Cond Res XX(X): 000-000, 2022-Moderate-intensity resistance training (MIRT) is regarded as safe in cancer survivors (CS), but for high-intensity resistance training (HIRT), evidence is lacking. Hence, in the current exploratory analyses, single sessions of HIRT are compared with MIRT regarding safety and feasibility. Twenty-three of 24 included CS (14 breast and 10 prostate CS, 61.6 ± 9.5 years, body mass index 27.0 ± 4.3 kg·m-2, 6-52 weeks after end of primary therapy) started a 12-week resistance training (RT) with a daily undulating periodization model including HIRT (90% of 1 repetition maximum [1RM]) and MIRT (67% 1RM) sessions. Parameters of safety (adverse events [AEs] and training-related pain), feasibility (physical and mental exhaustion, sensation of effort, enjoyment, and dropout rate), and adherence were assessed. An alpha level of 0.05 was applied for analyses. Nineteen of 23 training starters (83%) completed all sessions. Fourteen minor AEs occurred. A significantly higher increase for physical exhaustion appeared in HIRT (p < 0.001). For 18% (HIRT) and 19% (MIRT) of the sessions, training-related pain was reported with no significant difference between intensities. In total, 34% of HIRT and 35% of MIRT sessions were perceived as overstraining or partly overstraining with no significant difference between intensities, but enjoyment (median and quartiles on a 1-7 scale) was high for both (HIRT = 5 [5;6] and MIRT = 5 [4,6]). Our analysis indicates that HIRT sessions do not differ from MIRT sessions concerning safety or feasibility, but training-related pain should be monitored. RT protocols incorporating high-intensity training loads can be applied safely in breast and prostate CS.
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Objective. —To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention.
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OBJECTIVE--To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention. PARTICIPANTS--A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented. EVIDENCE--The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles. CONSENSUS PROCESS--Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise \"public health message was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine. CONCLUSION--Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the weekType: CONSENSUS DEVELOPMENT CONFERENCEType: JOURNAL ARTICLEType: REVIEWLanguage: Eng
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Background: Several studies have reported that short-term recall measures of physical activity participation have acceptable repeatability, but in most cases employed convenience samples and did not use optimal statistics. In this Australian study repeatability was assessed on participants recall of activity over two different time periods and over the same time period. Methods: Two 14-day recall measures of physical activity participation were administered in two studies to randomly selected population samples of adults in Adelaide, South Australia. Intraclass correlation coefficients (ICC), 80% and 95% limits of agreement and the kappa statistic were calculated. Results: For a continuous measure of energy expenditure the ICC was 0.86 using recall of the same 2-week period (N = 115), and was 0.58 for activity recalled over different 2-week period (N = 116). For categorized energy expenditure (inactive, low, Moderate and Vigorous categories), kappa was 0.76 for recall of the same period and was 0.36 for different recall periods. Similar results were observed for continuous and categorical forms of a measure of physical activity that recorded frequency of participation in vigorous and moderate activities and walking. The 80% limits of agreement were markedly smaller than 95% limits of agreement, but were still large. Conclusions: These data suggest that the variation in repeatability coefficients between recall of the same 2-week time period and activity recalled over different 2-week periods was due to actual variation in physical activity participation over different time periods, and not to poor recall or to poor measurement characteristics. The recall measures appear to have good repeatability for most respondents, but repeatability is poor for a substantial minority of the population.
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While there are large numbers of injuries and deaths involving bicycles every year, little information about the characteristics and use patterns of the general population of bicycle riders has been available. This article describes the results of a comprehensive national survey of U.S. bicycle riders conducted in 1991. The survey was based on the Mitofsky-Waksberg method of random-digit-dialing, a two-stage sampling procedure designed to give all telephone numbers an equal chance of selection. The survey collected information on a representative sample of 1,254 U.S. bicycle riders. The results of the survey provide detailed information on: the number of riders and bicycles in use; the demographic characteristics of rider households; rider characteristics (e.g., age, gender); bicycle use patterns (e.g., where and how much bicycles are used); helmet use patterns; and the types of bicycles in use. Some research implications of the survey results are also discussed.
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To evaluate the effect of 26 weeks of moderate- and high-intensity walking training on injury rates in the elderly, 68 healthy volunteers (31 men, 37 women) were assigned to moderate intensity (MOD, n = 26) or high-intensity (HI, n = 24) training, or to a control (CONT, n = 18) group. To achieve prescribed training intensity, many subjects walked uphill on a treadmill. Seven of 50 subjects who trained (14%) suffered a training-related orthopedic injury; one subject was injured during treadmill testing. Four training injuries (lower leg and foot) occurred during weeks 1-13; three training injuries (leg and groin) occurred during weeks 14-26. Six of the injuries were to women. Because only one training injury occurred during uphill treadmill walking, injuries appeared related to fast walking and not exercise intensity. The higher incidence of injury in females is consistent with our earlier work, indicating the importance of further research to determine the underlying cause.
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Relatively little is known about the incidence of the risks facing those who exercise regularly. Clinical reports suggest a variety of musculoskeletal ailments, and several pathophysiologic conditions may result from the various aerobic activities most likely to be pursued by large parts of the U.S. population. But adequate epidemiologic data are scarce. Careful epidemiologic studies are needed to develop incidence information.
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To review all bicycle crash-related injuries reported to the Oregon Injury Registry for 1989 to compare patterns of injury and other features in adults vs children and adolescents. A retrospective descriptive study was conducted using data from the Oregon Injury Registry. For 1989, this registry included all injury-related deaths and approximately 75% of hospital admissions of 24 hours or more for injury in the State of Oregon. Deaths, helmet use, neurologic injuries, and concurrent ethanol use were evaluated for all patients and for the two age groups. There were 311 bicycle-related injured patients in the registry for 1989; 122 (40%) were adults (age > or = 21 years) and 189 (60%) were children/adolescents (age < 21 years). Approximately 69% of both age groups were male. All of the 15 deaths involved male patients and most deaths [10/15 (67%)] involved injured adults. Bicycle vs motor vehicle collisions accounted for 14 (93%) deaths and 106 (34%) of all registry entries. While only 19 (15%) of the injured adults had elevated blood alcohol levels, half the adults who died had been intoxicated. Helmet use was rare with only 12 (4%) of all the injured riders known to have been helmeted; no rider who died was known to have been helmeted. Neurologic injuries were common. In children, 27 (14%) had sustained skull fractures, 36 (19%) intracranial injuries, and one (0.5%) a spinal injury. In adults, 13 (10%) had sustained skull fractures, 32 (26%) intracranial injuries, and three (2%) spinal injuries. Although children account for 60% of the serious bicycle injuries in Oregon, adults account for 67% of the deaths. Helmet use is rare, brain injuries are frequent, and alcohol use appears to be a contributing factor in cycling deaths among adults. Public education efforts should be directed to both adult and pediatric populations, emphasizing safe cycling practices and helmet use.
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The reproducibility and validity of self-administered questionnaires on physical activity and inactivity were examined in a random (representative) sample of the Nurses' Health Study II cohort and a random sample of African-American women in that cohort. Repeat questionnaires were administered 2 years apart. Past-week activity recalls and 7-day activity diaries were the referent methods; these instruments were sent to participants four times over a 1-year period. The 2-year test-retest correlation for activity was 0.59 for the representative sample (n = 147) and 0.39 for the African-American sample (n = 84). Correlations between activity reported on recalls and that reported on questionnaire were 0.79 and 0.83 for the representative and African-American samples, respectively. Correlations between activity reported in diaries and that reported on questionnaire were 0.62 and 0.59, respectively. Test-retest coefficients for inactivity were 0.52 and 0.55, respectively. Correlations between inactivity reported in diaries and that reported on questionnaire were 0.41 and 0.44, respectively. The simple, short questionnaires on activity and inactivity used in the Nurses' Health Study II are reasonably valid measures for epidemiological research.