Peter Harmer's research while affiliated with Willamette University and other places

Publications (95)

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Background This study examines the feasibility, acceptability, and safety of a newly developed cognitive-enhancing Tai Ji Quan training intervention, delivered via remote videoconferencing, for older adults with mild cognitive impairment (MCI). Methods In a three-arm feasibility trial, community-dwelling older adults with MCI (N = 69; mean age = 7...
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Objective Exercise prevents falls in the general older population, but evidence is inconclusive for older adults living with cognitive impairment. We performed an updated systematic review and meta-analysis to assess the potential effectiveness of interventions for reducing falls in older persons with cognitive impairment. Methods PubMed, EMBASE,...
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Modern competitive fencing consists of three disciplines, foil, epee, and saber, each open to both men and women and each with unique performance characteristics and injury potential. However, sport-specific injuries in fencing, specifically blade-related such as lacerations and penetrations, are the most obvious shared concern. This has been effec...
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Purpose: This study evaluates the feasibility of delivering a virtual (online) falls prevention intervention for older adults with mild cognitive impairment (MCI). Methods: Community-dwelling older adults with MCI (mean age = 76.2 years, 72% women) were randomized to either a Tai Ji Quan (n = 15) or stretching group (n = 15) and participated in...
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Purpose: To compare the prevalence of falls, physical performance, and dual-task cost during walking between cognitively healthy and impaired older adults at high risk of falling. Methods: A cross-sectional analysis of 670 community-dwelling older adults who were considered at high risk of falling, operationalized as 1) having fallen at least on...
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China is experiencing significant public health challenges related to social and demographic transitions and lifestyle transformations following unprecedented economic reforms four decades ago. Of particular public health concern is the fourfold increase in overweight and obesity rates in the nation’s youth population, coupled with the low prevalen...
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The on-going Coronavirus disease (COVID-19) outbreak in China has become the world's leading health headline and is causing major panic and public concerns. On January 30, 2020, the World Health Organization (WHO) declared that the new coronavirus outbreak is a public health emergency of international concern.1 The virus has already had a direct im...
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The on-going Coronavirus disease (COVID-19) outbreak in China has become the world's leading health headline and is causing major panic and public concerns. On January 30, 2020, the World Health Organization (WHO) declared that the new coronavirus outbreak is a public health emergency of international concern.1 The virus has already had a direct im...
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Purpose: Emerging evidence indicates exercise training improves mobility and cognition and reduces falls in older adults, but underlying mechanisms are not well understood. This study tested the hypothesis that change in dual-task walking capacity mediates the positive effect of Tai Ji Quan and multimodal exercise on physical performance, activity...
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Importance Exercise has been shown to reduce injurious falls in older adults. Evidence, however, is lacking regarding the types of intervention that are most effective in preventing injurious falls among older adults at high risk of falling. Objective To determine the longer-term effectiveness of therapeutic tai ji quan intervention vs multimodal...
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Objectives The study aimed to determine the risk of time-loss injuries in international fencing and to characterise their type, location, severity and mechanism. Variations in risk associated with sex and discipline categories are also examined. Methods Data on participation and withdrawal due to injury from 809 competitions comprising the major e...
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Background Data on the cost-effectiveness of proven fall prevention exercise interventions are limited. We aimed to establish the cost-effectiveness of Tai Ji Quan: Moving for Better Balance (TJQMBB) compared to a conventional exercise intervention for older adults at high risk of falling. Methods We conducted a trial-based cost-effectiveness anal...
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Importance Falls in older adults are a serious public health problem associated with irreversible health consequences and responsible for a substantial economic burden on health care systems. However, identifying optimal choices from among evidence-based fall prevention interventions is challenging as few comparative data for effectiveness are avai...
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Objectives: To evaluate the impact of implementing an evidence-based fall prevention intervention in community senior centers. Methods: We used a single-group design to evaluate the Tai Ji Quan: Moving for Better Balance (TJQMBB) program's adoption, population reach, implementation, effectiveness, and maintenance among 36 senior centers in 4 Ore...
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Falls in older adults are a global public health crisis, but mounting evidence from randomized controlled trials shows that falls can be reduced through exercise. Public health authorities and healthcare professionals endorse the use of evidence-based, exercise-focused fall interventions, but there are major obstacles to translating and disseminati...
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To address the unusual phenomenon of unbroken blades causing penetrating hand injuries in sabre fencing by applying the van Mechelen model of the 'sequence of prevention'. Cases were collected from three surveillance systems and snowball sampling, and examined for potential aetiological factors. Presumed contributing factors were evaluated against...
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Introduction: Exercise is effective in reducing falls in people with Parkinson disease. However, information on the cost effectiveness of this approach is lacking. We conducted a cost-effectiveness analysis of Tai Ji Quan for reducing falls among patients with mild-to-moderate Parkinson disease. Methods: We used data from a previous intervention...
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Although children and adolescents have been involved in organized sport for more than 120 years, research into the risks and injury characteristics of sports participation for this population has lagged well behind the need. However, interest is growing, with approximately 50 % of the available research literature in this area being produced in the...
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While outdoor physical activity has been shown to promote health and well-being,1 ,2 exercising in environments with high levels of air pollution can increase the risk of health problems ranging from asthma attacks to heart or lung pathologies.3 ,4 The interaction of these two phenomena is of specific significance in China, where outdoor physical a...
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Background Falls are the leading cause of injury death in older adults and present a significant public health problem and a major burden to healthcare. Although there is sufficient evidence from randomized controlled trials to indicate that exercise can prevent falls in older people, few effective, evidence-based fall prevention programs exist in...
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A previous randomized, controlled trial of tai chi showed improvements in objectively measured balance and other motor-related outcomes in patients with Parkinson's disease. This study evaluated whether patient-reported outcomes could be improved through exercise interventions and whether improvements were associated with clinical outcomes and exer...
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This study evaluated whether Tai Ji Quan: Moving for Better Balance (TJQMBB) could improve global cognitive function in older adults with cognitive impairment. Using a nonrandomized control group pretest-posttest design, participants aged ≥65 years who scored between 20 and 25 on the Mini-Mental State Examination (MMSE) were allocated into either a...
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To investigate the dissemination potential of a Tai Ji Quan-based program, previously shown to be efficacious for reducing risk of falls in older adults, through outpatient clinical settings. A single-group pre/post design in which participants attended a twice-weekly Tai Ji Quan training program for 24 weeks. Communities in Lane County, Oregon. In...
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Despite the large number of articles published in the medical literature advocating the use of Tai Ji Quan for a wide variety of health-related outcomes, there has been little systematic broad-scale implementation of these programs. It may be argued that the lack of funding from organizations capable of implementing and overseeing large-scale progr...
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Patients with Parkinson's disease have substantially impaired balance, leading to diminished functional ability and an increased risk of falling. Although exercise is routinely encouraged by health care providers, few programs have been proven effective. We conducted a randomized, controlled trial to determine whether a tailored tai chi program cou...
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The use of anabolic-androgenic steroids (AAS) by young athletes has been a primary concern of sports governing bodies because of the implications for unfair advantage in performance and the potential for adverse side effects. Research over several decades indicated a lifetime prevalence of AAS use for adolescent males of 4-6% and for females of 1.5...
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IntroductionWho Is Affected by Injury?Where Does Injury Occur?When Does Injury Occur?When Does Injury Occur?What Are the Risk Factors?What Are the Inciting Events?Injury PreventionFurther ResearchReferences
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IntroductionWho Is Affected by Injury?Where Does Injury Occur?When Does Injury Occur?What Is the Outcome?What Are the Risk Factors?What Are the Inciting Events?Injury PreventionFurther ResearchReferences
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Grounded in the conceptual framework of the Sport Commitment Model and previous empirical studies conducted in Western countries, this study was designed to (a) test and validate a Thai version of the Athlete Opinion Survey to assess components of the Sport Commitment Model in Thai youth athletes and (b) examine structural relationships among vario...
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Objective: Few studies have examined interaction effects between person and environment, especially for cardiovascular disease (CVD) risk. The purpose of this study was to examine built environment characteristics and resident health behaviors as they relate to change in blood pressure, an important component of CVD. Methods: Participants (N=114...
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This study examined neighborhood built environment characteristics (fast-food restaurant density, walkability) and individual eating-out and physical activity behaviors in relation to 1-year change in body weight among adults 50–75 years of age at baseline. The authors surveyed 1,145 residents recruited from 120 neighborhoods in Portland, Oregon. D...
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Examine variation in obesity among older adults relative to the joint influences of density of neighborhood fast food outlets and residents' behavioral, psychosocial, and sociodemographic characteristics. Cross-sectional and multilevel design. Census block groups, used as a proxy for neighborhoods, within the metropolitan region's Urban Growth Boun...
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Modern competitive fencing, consisting of the three disciplines of foil, epee, and sabre, has experienced a rapid growth in participation across all age groups in the USA in the past decade. Unfortunately, because of media sensationalism and a lack of well-designed epidemiological studies, there are significant misconceptions regarding both the inc...
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Few studies have investigated the built environment and its association with health-especially excess adiposity-and physical activity in the immediate pre-Baby Boom/early-Baby Boom generations, soon to be the dominant demographic in the U.S. The purpose of this study was to examine this relationship. This study used a cross-sectional, multilevel de...
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Tai chi--moving for better balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the re-aim framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, a...
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This study was designed to develop an evidence- and community based falls prevention program -- Tai Chi: Moving for Better Balance. A mixed qualitative and quantitative approach was used to develop a package of materials for program implementation and evaluation. The developmental work was conducted in 2 communities in the Pacific Northwest. Partic...
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Pedagogical innovations, ideas, and outcomes designed to enhance student learning in physiology courses are encouraged by our professional organizations and are actively discussed at conferences and in Advance in Physiological Education. Here, we report our experiment with freely available internet-based material as a substitute for the textbook fo...
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To estimate the incidence of time-loss injuries in competitive fencing and to characterize these injuries regarding type and location. A 5-year prospective study. Data were collected at all national events organized by the U.S. Fencing Association (USFA) during the 2001-2006 seasons. A total of 78,223 male and female competitors, ranging in age fro...
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Considerable research evidence has been accumulated since 1990 that practicing Tai Chi can ameliorate multiple characteristics in older adults that place them at increased risk of falling, including poor balance, loss of strength, limited flexibility, and fear of falling. However, relatively few studies have directly examined the influence of Tai C...
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The primary objective of this study was to provide preliminary evaluation of the feasibility, safety, and efficacy of a newly developed Tai Chi-based exercise program for older adults with Parkinson's disease (PD). Using a one-group pretest-posttest design, 17 community-dwelling adults (mean age 71.51 years) with mild to moderate idiopathic PD (Sta...
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To determine the relative effects of cobblestone mat walking, in comparison with regular walking, on physical function and blood pressure in older adults. Randomized trial with allocation to cobblestone mat walking or conventional walking. General community in Eugene, Oregon. One hundred eight physically inactive community-dwelling adults aged 60 t...
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Objective: To identify and quantify, to the best extent possible from the existing literature, injury characteristics and factors (risk; protective) associated with injury in young basketball players. Data sources: Database searches principally involving Medline and SportDiscus. In addition, web-based searching and filtering of the reference lis...
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This study examined the role of falls self-efficacy as a potential mediator of the exercise and fear-of-falling relationship. The study sample involved 256 community-dwelling older adults aged 70–92 years (M = 77.48, SD = 4.95) who were recruited from a local health care system in Portland, Oregon, and participated in either a Tai Chi (n = 125) or...
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Over the past few years, attention has been drawn to the importance of neighborhood influences on physical activity behavior and the need to consider a multilevel analysis involving not only individual-level variables but also social- and physical-environment variables at the neighborhood level in explaining individual differences in physical activ...
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The authors' objective was to evaluate the efficacy of a 6-month Tai Chi intervention for decreasing the number of falls and the risk for falling in older persons. This randomized controlled trial involved a sample of 256 physically inactive, community-dwelling adults aged 70 to 92 (mean age, 77.48 years; standard deviation, 4.95 years) who were re...
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To determine whether improved functional balance through a Tai Chi intervention is related to subsequent reductions in falls among elderly persons. Two hundred fifty-six healthy, physically inactive older adults aged 70-92 (mean age +/- SD = 77.48 +/- 4.95), recruited from a local health system in Portland, OR, participated in a 6-month randomized...
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To determine the effectiveness of tai chi on self-rated sleep quality and daytime sleepiness in older adults reporting moderate sleep complaints. Randomized, controlled trial with allocation to tai chi or exercise control. General community. One hundred eighteen women and men aged 60 to 92. Participants were randomized into tai chi or low-impact ex...
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This study examined the effect of cobblestone-mat walking on health-related outcomes in older adults. Participants (mean age 72.6, N=40) were randomized into either an 8-week cobblestone-mat walking activity (n = 22) or a control group (n = 18). Cobblestone-mat walking entailed three 45-min sessions per week. Primary outcomes included SF-12 (mental...
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This study examined heterogeneity in response patterns of the participants of the Survey of Activities and Fear of Falling in the Elderly (SAFFE) and their relationships to falls, functional ability, quality of life, and activity restriction measures in a cohort of 256 older people (mean age = 77.5 years). Participants recruited from local primary...
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Low-impact exercise that appeals to elderly adults and can be done almost anywhere provides both societal and individual benefits. One such program is Tai Chi, a traditional Chinese dancelike conditioning exercise. The article presents an easily adopted and adapted 8-form Tai Chi program (Easy Tai Chi) designed for older adults or individuals with...
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This study examined falls self-efficacy and fear of falling to determine whether self-efficacy acts as a mediator between fear of falling and functional ability. Using the Survey of Activities and Fear of Falling in the Elderly as a fear-of-falling measure and the Activities-Specific Balance Confidence Scale for falls self-efficacy, structural rela...
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Through a re-analysis of a Tai Chi intervention data set, the study objective was to determine which, if any, subgroups of the study sample evidenced differential benefits from the intervention. Re-analysis of a Tai Chi intervention study, a randomized controlled trial in Eugene and Springfield, Oregon. Physically inactive participants aged > or =6...
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Using a randomized controlled trial, this study examined whether a 6-month Tai Chi exercise program enhanced elderly individuals' multidimensional, hierarchical physical self-esteem. Participants either continued their daily routine activities or participated in a Tai Chi exercise class performing slow rhythmic movements. Both global and domain-spe...
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Using Tai Chi as an exercise mode, this study examined the association between self-efficacy and physical function. Ninety-four healthy, physically inactive older adults (M age = 72.8 years, SD = 5.1) were randomly assigned to either a 6-month, twice a week, Tai Chi condition or a wait-list control condition. Outcome variables included self-reports...
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The article describes a randomized, controlled trial conducted to examine the effects of a Tai Chi intervention program on perceptions of personal efficacy and exercise behavior in older adults. The sample comprised 94 low-active, healthy participants (mean age = 72.8 years, SD = 5.1) randomly assigned to either an experimental (Tai Chi) group or a...
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This study was designed to determine whether a 6-month Tai Chi exercise program can improve self-reported physical functioning limitations among healthy, physically inactive older individuals. Ninety-four community residents ages 65 to 96 (Mage = 72.8 years, SD = 5.1) volunteered to participate in the study. Participants were randomly assigned to e...
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Using a randomized controlled trial, this study examined whether a Tai Chi exercise program enhanced elderly individuals' psychological well-being. Participants either continued their daily routine activities or participated in a Tai Chi exercise class performing slow rhythmic movements. Psychological well-being measures were assessed at baseline,...
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Objectives: This article provides an example and application of growth curve analysis for modeling individual differences in behavioral rates of change in aging. The latent curve modeling approach to the analysis of change allows researchers to describe change as a continuous process and to address issues related to individual differences in change...
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Although a number of factor analytic studies have been conducted on the factorial validity of the Task and Ego Orientation in Sport Questionnaire (TEOSQ), the results have been equivocal. To further substantiate its evidence of validity, this study cross-validated the measurement model using a rigorous structural equation modeling (SEM) approach. D...
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Data collected from longitudinal designs often have correlated observations arising from repeated measurements on the same subject. Conventional statistical methods (e.g., ordinary least squares linear regression, univariate analysis of variance with repeated measures) that assume independence of observations can be inadequate in providing test sta...