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Three brief sessions of high-impact exercise per week implemented over 2 consecutive years within the elementary school curriculum elicited a substantial bone mineral accrual advantage in pubertal girls.

OBJECTIVE-To compare the effectiveness of group resistance and agility training programs in reducing fall risk in community-dwelling older women with low bone mass. DESIGN-A randomized, controlled, single-blinded 25-week prospective study with assessments at baseline, midpoint and trial completion. SETTING-Community centre.PARTICIPANTS-Community-dwelling women aged 75-85 years with low bone mass. INTERVENTION-Participantswere randomly assigned to one of three groups: Resistance Training (n=32), Agility Training (n=34), and Stretching (sham) exercises (n=32). The exercise classes for each study arm were held twice weekly. MEASUREMENTS-The primary outcome measure was fall risk (derived from weighted scores from tests of postural sway, reaction time, strength, proprioception, and vision), as measured by a physiological profile assessment (PPA). Secondary outcome measures were ankle dorsiflexion strength, foot reaction time and the Community Balance and Mobility (CB&M) Scale. CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptRESULTS-Attendance at the exercise sessions for all three groups was excellent: Resistance Training (85.4%), Agility Training (87.3%) and Stretching program (78.8%). At the end of the trial, PPA fall risk scores were reduced by 57.3% and 47.5% in the Resistance and Agility training groups respectively, but by only 20.2% in the Stretching group. In both the Resistance and Agility groups, the reduction in falls risk was mediated primarily by improved postural stability, where sway was reduced by 30.6% and 29.2% respectively. There were no significant differences among the groups for the secondary outcomes measures. Within the Resistance Training group reductions in sway were significantly associated with improved strength as assessed by increased squat load used in the exercise sessions.CONCLUSION-These findings support the implementation of community-based resistance and agility training programs to reduce fall risk in older women with low bone mass. Such programs may have particular public health benefits as it has been shown that this group are at increased risk of falling as well as sustaining fall-related fractures.

Objectives: To examine the effects of a simple and inexpensive physical activity intervention on change in bone mass and structure in school aged children. Methods: Fifty one children (n = 23 boys and 28 girls; mean age 10.1 years) participated in ''Bounce at the Bell'' which consisted of 10 counter-movement jumps 36 per day (total ,3 min/day). Controls were 71 matched children who followed usual school practice. We assessed dietary calcium, physical activity, physical performance, and anthropometry in September and after 8 months of intervention (June). We measured bone mineral content (BMC) and bone area at the lumbar spine, total body, and proximal femur. Proximal femur scans were also analysed for bone geometry and structural strength using the hip structural analysis program. Lean and fat mass (g) were also calculated. Results: Groups were similar at baseline and did not differ in weight, height, total body, lumbar spine, proximal femur, or femoral neck BMC. Control children had a greater increase in adjusted total body BMC (1.4%). Intervention children gained significantly more BMC at the total proximal femur (2%) and the intertrochanteric region (27%). Change in bone structural parameters did not differ between groups. Conclusions: This novel, easily implemented exercise program, took only a few minutes each day and enhanced bone mass at the weight bearing proximal femur in early pubertal children. A large, randomised study of boys and girls should be undertaken powered to test the effectiveness of Bounce at the Bell in children at different stages of maturity, and in boys and girls independently.

Background:

Background: Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods: A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework.

The findings suggest that several risk factors for depressive symptomatology in the immediate postpartum period are consistent with previously identified factors but other factors such as recent immigrant status, feeling unready for hospital discharge, dissatisfaction with their infant feeding method, and pregnancy-induced hypertension should also be examined.