Getting children involved in finding ways to become more physically active can not only make them more aware of local recreational opportunities, but can even help increase their own physical activity.

That’s the result of a study examining the role of seven national parks in contributing to the health of today’s youth. The study was conducted by researchers from a variety of disciplines at North Carolina State University and other U.S. universities and funded by the National Park Service.

The researchers developed pilot programs aimed at increasing the awareness of health benefits from participating in recreational activities at national parks and increasing physical activity by park visitors.

Dr. Myron Floyd, professor of parks, recreation and tourism management at NC State, specifically examined the use of Cuyahoga Valley National Park in Ohio by studying area middle-school students.

“We decided early on that engaging the community in activities the park had to offer would be crucial in developing this pilot program,” Floyd said. “We had local 6th and 7th graders actually create the tagline to promote the program: Get Up, Get Out and Go!. The students also helped us determine what types of activities would get them interested enough to head out to the park.”

The program comprised a series of events at Cuyahoga Valley National Park that began with a kickoff event, featured weekly activities such as scavenger hunts and fishing lessons, and concluded with a festival. Advertisements of the program and its events – designed by the students themselves – were placed in local papers, on bus boards and at health fairs.

Floyd’s team compared awareness levels before and after the program and found out that the Get Up, Get Out and Go! worked. The study showed a significant increase in the level of awareness of Cuyahoga Valley National Park and its different offerings – 31 percent before the program was implemented versus 65 percent after the program – among the targeted youth population, with a reported increase in the percentage of participants who intended to visit a national park in the future – 18 percent before the program versus 51 percent after the program. Researchers also reported evidence of an increase in physical activity that was associated with the program’s activities.

“This study was important because it showed that engaging kids early on in the program planning process was important. A lot of the ideas we had for park activities, we quickly found out were not of interest to the children,” Floyd said. “It is imperative that we engage children in finding solutions that get them to be more physically active – whatever environment that may be in.”

In an issue of the British Journal of Sports Medicine, specialists argue that prolonged periods of sitting are truly detrimental. In addition, we should focus on the harms caused by daily inactivity rather than on the lack of regular exercise alone.

The term “sedentary behavior” has come to mean “taking no exercise” according to doctors from the Karolinska Institute and the Swedish School of Sport and Health Sciences in Stockholm, Sweden.

They say it should be more correctly used to describe “muscular inactivity.”

Recent research indicates that prolonged periods of sitting and lack of whole body muscular movement are strongly linked to obesity, diabetes, heart disease, cancer, and an overall higher risk of death. This is regardless of whether moderate to vigorous exercise is taken.

An Australian study suggested that for every additional hour a woman sits in front of the TV, her risk of metabolic syndrome which is a precursor to diabetes and cardiovascular disease, increases by 26 percent. This is irrespective of how much moderate exercise she does.

The authors explain that the health of people who already do too little exercise will suffer even more if combined with extended bouts of sitting.

The researchers remark that further investigation is needed to establish a causal effect between prolonged sitting and ill health. However, some underlying mechanisms have already been identified. These include an enzyme known as lipoprotein lipase. It has an essential role in the regulation of key blood fats.

Consequently, the authors put forward a new model or paradigm of “inactivity physiology”. It establishes that sitting and non-muscular activity may independently boost the risk of ill health, and that sedentary behavior is a separate class of behavior with specific consequences for ill health. These are different than those caused by taking too little exercise.

The authors explain that the molecular and physiological responses of the body provoked by too much sitting cannot simply be eliminated by taking additional exercise.

They add: “In the future, the focus in clinical practice and guidelines should not only be to promote and prescribe exercise, but also to encourage people to maintain their intermittent levels of daily activities [that involve movement]. Climbing the stairs, rather than using elevators and escalators, five minutes of break during sedentary work, or walking to the store rather than taking the car will be as important as exercise.”

If you’ve been looking for a reason to begin an exercise program or get back into working out regularly, the results of two new studies may give you the inspiration you need. Researchers found that people who participated in moderate physical activity in midlife or later had a reduced risk of mild cognitive impairment (MCI) and a six-month high-intensity aerobic exercise program improved the cognitive function of individuals who already had the condition.

Less severe than dementia, MCI is defined as cognitive defects that are evident but do not interfere with daily living, such as slower thinking, reduced ability to learn, and impaired memory. Each year, about 10 to 15 percent of people with MCI progress to dementia, compared with 1 to 2 percent of the general population. As the average life span continues to lengthen, it becomes even more important to find ways to minimize age-related mental decline. Previous research has suggested that exercise may improve cognitive function.

In one of the recent studies, Dr. Yonas E. Geda and colleagues at Mayo Clinic in Rochester, Minnesota analyzed data on 1,324 individuals without dementia who completed a questionnaire about physical activity between 2006 and 2008 as part of the Mayo Clinic Study of Aging. The participants had an average age of 80 and were classified as having normal cognition (1,126) or MCI (198).

Those who reported performing moderate exercise such as yoga, aerobics, strength training, swimming or brisk walking during midlife were 39 percent less likely to develop MCI, while moderate exercise later in life was associated with a 32 percent reduction. The findings were consistent among men and women. However, light exercise, such as bowling, golfing with a cart or slow dancing, or vigorous exercise, including jogging, racquetball and skiing, were not associated with reduced risk for MCI. “Our findings contribute to the growing body of literature that indicates the potentially beneficial relationship between physical exercise and cognition,” the authors conclude.

The Mayo team says exercise may protect against MCI through production of nerve-protecting compounds, increased blood flow to the brain, improved development and survival of neurons, and decreased risk of heart and blood vessel diseases, but that it may be that physical exercise is simply a marker for a healthy lifestyle. “A subject who engages in regular physical exercise may also show the same type of discipline in dietary habits, accident prevention, adherence to preventive intervention, compliance with medical care and similar health-promoting behaviors.” The researchers conclude that future study is needed to confirm the association between exercise and the decreased risk of MCI and provide additional information on cause and effect relationships.
In another study, Dr. Laura D. Baker, of the University of Washington and Veterans Affairs Puget Sound Health Care System, Seattle, and colleagues conducted a six-month clinical trial involving 33 adults with MCI (17 women, 16 men, and aged 55 to 85). Twenty-three of the participants were randomly assigned to a supervised aerobic exercise group and performed high-intensity workouts for 45-60 minutes per day, four days per week. The remaining 10 participants served as the control group, having the same workout schedule but did supervised stretching exercises and kept their heart rate low. Fitness testing, body fat analysis, blood tests of metabolic markers and cognitive functions were assessed before, during and after the trial.

A total of 29 participants completed the trial. Overall, those in the aerobic exercise group experienced improved cognitive function compared to those in the control group. The effects were more pronounced in women than in men, which the researchers say could be because the metabolic effects of exercise, such as changes to the body’s use and production of insulin, glucose and the stress hormone cortisol, differed in men and women. “Aerobic exercise is a cost-effective practice that is associated with numerous physical benefits. The results of this study suggest that exercise also provides a cognitive benefit for some adults with mild cognitive impairment,” the authors conclude. “Six months of a behavioral intervention involving regular intervals of increased heart rate was sufficient to improve cognitive performance for an at-risk group without the cost and adverse effects associated with most pharmaceutical therapies.”

However, the exercise regimen in the trail proved too intensive for four of the participants who dropped out because of problems like joint or chest pain. Therefore, it might be that not all seniors would be able to participate in this type of program. But we know that regular exercise and physical activity are extremely important and provide long-term health benefits, so it makes sense to stay as active as your health allows. The National Academy of Sciences has recommended that everyone strive for a total of an hour per day of physical activity. This may sound like a lot, but the hour can be made up of several shorter bursts of activity like walking, gardening or even heavy housecleaning done throughout the day.

Researchers participating in the Multidimensional Intervention for Early Osteoarthritis of the Knee (Knee Study) determined that physically inactive, middle-aged people with symptomatic osteoarthritis benefitted equally from strength training regimens, self-management programs, or a combination of the two. Details of this study are available in the January 2010 issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.

Osteoarthritis (OA) is the most common form of arthritis and the second leading cause of disability in the United States. Currently OA is the most prevalent chronic condition among women, afflicting 35-45% of women by the age of 65. A number of studies have compared strength training protocols with self-management programs in older patient populations, but few have examined the potential benefit of using both approaches in conjunction. “We hypothesized that combining the 2 treatments might enhance the outcomes,” said Patrick McKnight, lead author of the Knee Study.

The Knee Study, conducted at the University of Arizona Arthritis Center in Tucson, AZ, was a 24-month unblinded, randomized intervention trial to compare the effects of strength training programs, self-management programs, and a combination of both. The 273 study participants were between the ages of 35 and 65 years, reported pain and disability due to knee pain on most days in one or both knees for a period of no more than 5 years, and had Kellgren/Lawrence classification grade 2 radiographic evidence of knee OA in one or both knees.

Study participants were randomly assigned to 1 of 3 treatment groups. The strength training group engaged in a 9-month initial phase designed to improve the core areas of stretching and balance, range of motion and flexibility, and isotonic muscle strength. The second, 15-month phase of this group concentrated on developing independent, long-term exercise habits. The second study group participated in a 2-phase self-management program designed to educate participants and provide one-on-one treatment advice. The combined group participated in both the complete strength training and self-management programs. A total of 201 out of 273 participants completed the 2-year trial, with the self-management group achieving the highest compliance rates.

The study team set out to demonstrate that a combination of OA treatment programs would prove most effective, however, the study failed to uncover significant differences in results among the 3 study participant groups. All 3 groups demonstrated improvements in physical function tests and decreased self-reported pain and disability. “The logic behind the combined treatment was that the different factors addressed in physical and psychological treatments might produce an additive effect if administered together,” said Dr. McKnight. “These results suggest otherwise. Instead, the comparison of the 3 treatment arms showed no difference, suggesting similar benefits for all 3 over a 2-year period.”

Given the higher rate of compliance in the self-management group, the Knee Study researchers suggest that self-management may be a less intrusive and equally effective early treatment for knee OA. The CDC also recommends self-management activities to decrease pain, improve function, stay productive, and lower health care costs, including self-management education programs such as the Arthritis Foundation Self Help Program (AFSHP), or the Chronic Disease Self Management Program (CDSMP) to manage arthritis on a day-to-day basis.

Researchers in the US who compared the effects on hip, knee and ankle joints of running barefoot versus running in modern running shoes, concluded that running in shoes exerted more stress on these joints compared to running barefoot or even walking in high-heeled shoes.

The study was the work of lead author Dr D Casey Kerrigan, of JKM Technologies LLC, in Charlottesville, Virginia and colleagues from the University of Colorado and the University of Virginia, and was published in the December 2009 issue of PM&R: The journal of injury, function and rehabilitation.

Knee osteoarthritis (OA) accounts for more disability in the elderly than any other disease, and although running has been shown to benefit health in many ways, including cardiovascular health, it can stress the joints in the leg, such as the hip, knee, and ankle.

For the study, Kerrigan and colleagues recruited from the general population, 68 healthy young adults (37 women, 31 men) with no history of musculoskeletal injury and who regularly ran at least 15 miles a week in running shoes that are typically available in the shops.

They gave each of the participants a pair of running shoes that was typical of most running footwear, but bore no particular design characteristics and appeared neutral. They then observed the participants running with these shoes on, and also barefoot, on a treadmill, with a motion analysis system. The data was collected after a warm up period and while the runners were running at a pace that was comfortable to them individually.

They observed that, compared with barefoot running, running with running shoes resulted in:

* Increased joint torques at the hip, knee and ankle.

* Disproportionately large increases in the hip internal rotation torque and in the knee flexion and knee varus torques.

* On average these torque increases were: 54 per cent in hip internal rotational, 36 per cent in knee flexion, and 38 per cent in knee varus.

(Joint torque is a measure of the amount of twisting about an axis that goes on at that joint. There are several kinds of torque measure, depending on the joint, which axis is the centre of rotation, and the types of movement through which the attached limbs travel.)

The researchers concluded that while typical running shoes support and protect feet quite well, they increase stress on the hips, knees and ankles, and this is likely to be caused by an elevated heel and extra material under the medial arch.

They also remarked that the 36 to 38 per cent ncreased torque on knee joints observed in the running shoes is even greater than that observed in earlier research on walking in high heeled shoes, which showed a 20 to 26 per increased torque on knee joints.

“Considering that lower extremity joint loading is of a significantly greater magnitude during running than is experienced during walking, the current findings indeed represent substantial biomechanical changes,” said Kerrigan in a press statement, adding that the goal of new footwear design should be to reduce joint torque so it is on a par with barefoot running, while not compromising other functions.

Life is full of hassles, deadlines, frustrations and demands. Stress can take its toll on a woman’s health and spill into the home during the holiday season. In these economic times, tightening budgets during the ‘season to be jolly’ brings additional stress. There is hope on the horizon, as the New Year provides a fresh opportunity for women to resolve to get a handle on stress.

“If time or finances prohibit you from going to the gym, find other ways to stay active such as taking a walk, running and even yard work or gardening.”

“It is very important to set fitness goals and incorporate physical activity into your daily routine to manage stress levels,” says NYC physical therapist Megan Barclay. “If time or finances prohibit you from going to the gym, find other ways to stay active such as taking a walk, running and even yard work or gardening.”

Chronic stress can lead to serious health problems including elevated blood pressure, a suppressed immune system, increased risk of heart attack, contribute to infertility and accelerate the aging process, to name a few. So it is important to recognize when your stress levels are out of control and make a resolution to regain control of your health.

Barclay says, “The most dangerous aspect of stress is how easily it can creep up on you, it can start to feel familiar and even normal. You don’t notice how much of an effect it has on you, even as it takes a heavy burden on your body.”

While well-intentioned, most New Year’s resolutions to get in shape involve beginning a fitness regimen characterized by over-exertion and strenuous exercise, and many women wind up suffering from injuries – most commonly to their knees and ankles. Those trouble areas should be supported, but most women find the braces and supports on the market do not fit well or are uncomfortable. There is a reason for this.

“Men’s and women’s bodies are built differently, so one ankle or knee support product, anatomically, cannot provide adequate protection for both genders simultaneously,” says Barclay.

Wellgate for Women was developed on the premise that women need gender-specific ankle and knee supports that address the unique contours of the female anatomy and better address the issues women can experience during a workout or during daily activities.

Such products can provide everyday support, and assist in relieving discomfort after an injury. This is particularly important for women, who are more prone than men to suffer knee injuries like anterior cruciate ligament tears and patella tracking pain.

Wellgate products will not cost an “arm and a leg” and they can prevent the need to spend excess money on a doctor’s visit. Women seeking a safe and healthy exercise regimen can purchase the Wellgate support they need while shopping in stores like Wal-Mart.

Also, with the growing trend of online shopping, women are spending more time at their computers this season than ever. Wellgate wrist supports help to relieve pain from Carpal Tunnel Syndrome, sprains and strains that can come with extensive typing and clicking of your mouse.

Time and time again, it has been documented that regular exercise has many health benefits including lowering risks associated with the comorbidities of obesity. With only 30% of Americans trying to lose weight meeting the National Institutes of Health exercise guidelines of 300 minutes/week, a study in the January/February 2010 issue of the Journal of Nutrition Education and Behavior explores the paradox that exists – an antidote for obesity and its comorbidities is exercise, but the majority of obese Americans do not exercise. Investigators explore and compare the barriers associated with regular exercise in health clubs between overweight and normal weight individuals.

Researchers at The George Washington University Medical Center examined overweight individuals’ intent to exercise at health clubs by administering an online survey instrument based on Ajzen’s Theory of Planned Behavior. This theory is based on (1) one’s attitude toward the behavior in question, (2) the perceived social pressure (subjective norm) to perform the behavior, and (3) the ease or difficulty with which one can actually perform the behavior (perceived control). Of the 1,552 individuals surveyed, 989 were classified into the overweight category.

The researchers found overweight individuals believed exercise improved appearance and self image more than normal weight individuals. In addition, overweight individuals felt more embarrassed and intimidated about exercising, exercising around young people, exercising around fit people, and about health club salespeople than individuals of normal weight. Overweight and normal weight individuals felt the same about exercising with the opposite sex, complicated exercise equipment, exercise boredom, and intention to exercise. The study interestingly found that the demographics of older age and overweight Caucasians (versus overweight non-Caucasians) had more of an effect on exercise intent than did weight. Most notably, the heavier the subject’s weight, the lower his or her perception of health. In other words, for the overweight, sedentary person, the negative emotions associated with health club exercise may be stronger in controlling regular exercise than the intellectual facts.

Writing in the article, the authors state, “One of the most noteworthy findings of this study was that OW [overweight] and NW [normal weight] subjects did not differ in their overall attitude toward exercising at a health club. This similarity in overall attitude of the OW and NW to club exercise is somewhat surprising, in that it is often assumed that OW people do not exercise as much as NW people because the 2 groups have different attitudes about exercise.

The behavior theories that propose that attitude drives the intent to exercise describe attitude as an evaluation of positive versus negative. If this is the case, then, it is important to minimize the negative and maximize the positive in order to promote the desired behavior. Thus, it would be wise for exercise professionals and commercial health clubs to help OW people feel more comfortable around those who are different from themselves and to minimize the intimidating aspects of the exercise environment, while promoting the benefits of exercise to personal health and wellbeing.

Regardless of which subset of the OW population is the target for increasing health club exercise, the ultimate goal is to increase the number of positive beliefs the individual has concerning exercising in a health club…Accordingly, individual beliefs about health club exercise should be evaluated for each new client. If a plan to increase the positive beliefs and reverse the negative beliefs is constructed and followed, the likelihood of retention of that client will be augmented.”

The UK government is urging families to bring back the Christmas day walk to burn off their Christmas dinner calories, and generally be more physically active over the holidays.

A typical Christmas dinner of turkey and pudding clocks up nearly 1,500 calories, which is over half of the recommended daily allowance for a man and three quarters of that recommended for a woman, says the Department of Health for England, in a new push to promote Walk4Life as part of its Change4Life campaign to encourage families to “eat well, move more and live longer”.

If every person in England walked their local streets, fields or beaches after their dinner on Christmas day, this would add up to 50 million miles, they said in a statement.

Public Health Minister Gillian Merron told the press that:

‘Whatever the weather, a traditional festive walk is a great way for families and friends to avoid that sluggish feeling and have a more active Christmas.”

“Being more physically active can make a real difference to your health – taking that extra walk is something we can all enjoy as a family,” she added.

If you eat a typical Christmas dinner you are likely to consume around 1,470 calories, says the British Nutrition Foundation, for example:

2 slices of turkey (with skin) 225 kcal
Sausage meat stuffing 185 kcal
4 small roast potatoes 400 kcal
Serving of sprouts (boiled) 30 kcal
Serving of roast parsnips 100 kcal
Serving of gravy 50 kcal
Portion of Christmas pudding 330 kcal
Tablespoon of double cream 150 kcal
Total 1470 kcal

Walk4Life has teamed up with The Ramblers to get families on their feet and walk at Christmas by releasing their top ten English walks, including one round famous London landmarks, another that goes through the Birmingham bog that Tolkien based the hobbits’ Shire home on, and a wildlife walk in Highfield Country Park, Manchester.

Tom Franklin, The Ramblers Chief Executive, said it was important to:

“Make the best of the short daylight hours by getting out of doors, helping you walk off the mince pies and avoid the post-Christmas blues.”

He said there are over 850 free led walks taking place across Britain between Boxing Day and the 3rd of January.

These include least 300 walks under 5 miles, themed “cake walks, tipsy toddles, and fancy dress strolls”, and over 100 walks for people in their 20s and 30s.

The tragic death of actress Natasha Richardson this past March put a spotlight on the potential risks inherent to skiing, as well as the deadly consequences that can result from head trauma. Richardson died two days after suffering an epidural hematoma and slipping into a coma. What at first appeared to be a minor bump on the head from a fall on a beginner ski slope in Quebec proved fatal. “This tragedy likely could have been prevented by wearing a helmet and receiving timely treatment at a trauma center equipped to handle this type of injury. Hopefully this serves as a warning to all skiers to wear a helmet and to take appropriate precautions before hitting the slopes,” stated AANS President Elect James T. Rutka, MD, PhD, a Toronto neurosurgeon.

And while skiing and snowboarding head injuries tend to me more severe, ice hockey contributes to more head injuries per year than skiing. Concussions related to ice hockey are commonly caused by collisions and hitting one’s head against the boards and ice; of the nearly 5,300 ice hockey head injuries in 2008, 1,950 were concussions. “As a longtime hockey player, I can say that it is a highly enjoyable, but hard-hitting, collision sport. It is important to remember that serious neurological injuries associated with all winter sports can usually be avoided by wearing approved, well-fitting gear and following other safety precautions,” remarked Dr. Rutka.

Injuries severe enough to cause head injury or other trauma often also cause neck fracture or spinal cord injury. Winter sports contribute to a greater number of head injuries than neck injuries, but both head and neck injuries can be devastating. While severe head injuries can result in a host of disabling cognitive and physical health problems, severe neck injuries or spinal cord injuries can result in partial or complete paralysis. The most severe of these injuries can tragically end in death.

Skiing/Snowboarding

According to the National Ski Areas Association, during the 2007/08 season there were 53 fatalities; 44 skiing deaths and nine snowboarding deaths. According to the US Consumer Product Safety Commission (CPSC), 4,562 people were treated at US hospital emergency rooms in 2008 for skiing-related head injuries and 6,841 for snowboarding-related head injuries. Of these totals, children age 14 and younger incurred an estimated 1,143 skiing and 2,258 snowboarding head injuries respectively. Further, in all age groups, there were 938 neck injuries from skiing and 1,390 neck injuries from snowboarding.

There are no state laws mandating helmets for skiing or any winter sports. Aspen ski resorts mandate that skiers under age 12 wear helmets. Other ski resorts are trying to institute such mandates, and in Michigan, statewide. Following the high-profile skiing-related deaths of Michael Kennedy in December 1997, and Sony Bono in January 1998, an increase in the number of skiers wearing helmets was noted in several studies.

Ice Hockey

According to the CPSC, 5,272 people were treated at US hospital emergency rooms in 2008 for ice hockey-related head injuries and 1,357 for neck injuries, respectively. Among children age 9-15, one study showed that body checking accounted for 86 percent of game-time injuries with 23 percent of these injuries affecting the head or neck.

Studies indicate that most hockey injuries occur during a game rather than at practice. It is estimated that direct trauma accounts for 80 percent of all injuries. Most of these injuries are caused by player contact (checking and collision), falls, and contact with the boards, a puck, high stick, and rarely, a skate blade. There is evidence from several studies to indicate that full facial protection reduces the number and risk of overall head and facial injuries in ice hockey compared to both partial facial protection and no facial protection.

The AANS offers these winter sports injury prevention tips:

– Buy and use helmets or protective head gear approved by the American Society for Testing and Materials (ASTM) for specific sports 100 percent of the time. These must fit correctly and be worn properly to be effective.

– For ice hockey, in addition to head gear, protective gear includes a face shield, mouth guard, shoulder and elbow pads, shin guards, cup/supporter, and gloves. Goalies require additional protective gear.

– Wear appropriate clothing for the sport.

– Do not participate in sports when you are ill, very tired, or have consumed alcohol.

– Do not participate in outdoor sports when weather conditions pose a serious hazard.

– Ice skate only in areas designated for skating, and be sure to check the ice for cracks and debris.

– Avoid overly aggressive behavior. Boarding, butt-ending, charging, clipping, contact to the head, cross-checking, elbowing, head-butting, high sticks, holding, kneeing, roughing, slashing, and spearing are all “illegal” moves that incur penalties in ice hockey.

– Use only sleds that can be steered, and never go down a slope head first.

– Follow all posted signs and warnings on ski slopes, sledding hills and ice skating rinks.

– Seek immediate treatment for head and neck injuries.

Physical activity is known to reduce depression and fatigue in people struggling with chronic illness. A new study indicates that this effect may stem from an individual’s sense of mastery over – or belief in his or her ability to achieve – certain physical goals.

The study appears in the journal Psychosomatic Medicine.

“We base our arguments on fatigue being a symptom of depression,” said Edward McAuley, a professor of kinesiology and community health at the University of Illinois and lead author of the study. “Interventions to reduce depression have consistently resulted in reductions in fatigue. The opposite is not always the case.”

Depression and fatigue also are highly susceptible to changes in a person’s sense of his or her own ability to achieve a certain goal. This belief in one’s own abilities is called self-efficacy, McAuley said. The conviction that you can jog down the block or climb several flights of stairs without stopping is an example of self-efficacy.

Previous studies have shown that increases in physical activity also increase self-efficacy. The effect is almost immediate, McAuley said.

“The evidence is monumental that physical activity has some effect on well-being,” McAuley said. “The question is: Why?” He and his colleagues wanted to determine whether self-efficacy plays a role in the sequence that leads from physical activity to reduced depression and fatigue.

“Our argument was that physically active individuals would have higher self-efficacy, which in turn would result in reduced depression and reduced fatigue,” McAuley said.

To test this hypothesis, the researchers reanalyzed data from two previously published studies, the first involving breast-cancer survivors and the second focusing on individuals diagnosed with multiple sclerosis. Both studies included self-report questionnaires, but the second used different measures of health status, physical activity, self-efficacy, depression and fatigue. It also required that participants record their physical activity with an accelerometer worn during waking hours for seven days, and it tested them again on all measures after six months.

A statistical analysis showed that in both groups, higher levels of physical activity corresponded to higher self-efficacy and lower levels of depression and fatigue. But when the researchers controlled for the influence of self-efficacy on depression and fatigue, they found that the effect of physical activity on both depression and fatigue was significantly reduced.

This suggests, McAuley said, that physical activity influences depression and fatigue by increasing self-efficacy.

“What we’re showing is that the relationship between physical activity and reductions in fatigue in breast-cancer survivors and people with MS can be explained in part by the effect of physical activity on mastery experiences,” he said. “That sense of accomplishment, or situation-specific self-confidence, serves to reduce depression, which in turn reduces fatigue.” Increased self-efficacy also has a direct effect on reducing fatigue, he said.