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  • Health Indicators Report Cites Improvement in Physical Activity, Stalled Obesity Rates

    According to a recent federal report on the health of Americans, the US is making steady gains in the number of adults who meet guidelines for physical activity, but obesity rates haven't changed much for any population age group—including children.

    The latest findings are included in a progress report (.pdf) on 26 leading health indicators (LHIs) tracked by Healthy People 2020, a federal program that monitors a long list of health objectives. The report compares current LHIs against a baseline as well as goals for the campaign. In the case of adults meeting aerobic physical activity and muscle-strengthening guidelines, the report shows a 2012 rate of 20.6%--up from the 2008 baseline of 18.2% and slightly above the goal of 20.1%.

    The news wasn't as good for obesity rates. For adults, obesity rates have actually increased from a 2005-2008 baseline of 33.9% to 35.3%, well away from the 30.5% goal. Obesity rates among children also rose from 16.1% to 16.9%, drifting further away from the program's goal of 14.5%. The latest news on childhood obesity rates runs counter to earlier reports from the US Centers for Disease Control and Prevention that pointed to a dramatic drop.

    Overall, the report describes the latest data as "generally positive," with 10 of the 26 indicators showing improvement and 8 showing little or no change since the baseline year. The indicators being monitored through the program are related to more broad topics that include access to health services, preventive services, environmental quality, injury and violence, maternal and child health, mental health, nutrition and physical activity, oral health, reproductive health, social determinants, substance abuse, and tobacco use.

    Among other findings in the report:

    • Improvements were cited in adults with hypertension whose blood pressure is under control, total preterm live births, and rates of adult cigarette smokers. Other improvements included reductions in infant mortality, injury deaths, and adolescent alcohol and drug use.
    • In addition to adult activity rates, other indicators that met goals were in air quality, a reduction in childhood exposure to secondhand smoke, and a decrease in homicide rates.
    • Suicide rates and the percentage of adolescents with major depressive episodes were reported as worsening.

    APTA has long supported the promotion of physical activity and the value of physical fitness, and has representatives on the practice committee of Exercise is Medicine and the board of the National Physical Activity Plan Alliance. The association offers several resources on obesity, including continuing education on childhood obesity, and a prevention and wellness webpage that links to podcasts on the harmful effects of inactivity.

    New Review Says Virtual Reality, Gaming for Individuals Poststroke Provide 'Moderate Advantage' Over Conventional Therapy

    In a study they describe as the first to incorporate analyses of International Classification of Functioning, Disability, and Heath (ICF) data, researchers make a cautious assertion that for individuals poststroke, the use of virtual reality—including commercially available video game systems—produces "a significant moderate advantage" in ICF outcomes compared with conventional therapies.

    The findings were the result of an analysis of 26 randomized controlled trials that focused on the use of virtual reality (VR) to augment or replace conventional therapy in populations largely or solely comprising individuals poststroke. Of the studies analyzed, 4 focused on the use of commercially available gaming platforms such as the Nintendo Wii, while the rest used more specialized virtual environment (VE) equipment designed for rehabilitation. The study was published in the March 28, 2014, edition of PLoS ONE.

    Although other systematic reviews have been conducted around the effectiveness of VR in rehabilitation, authors of the study in PLoS ONE included more recent trials (14 in all since the last such review) and incorporated ICF data into the meta-analysis. While the authors didn't find any trials that examined ICF outcomes related to body function and structures or environmental factors, and found only 3 that analyzed participation restrictions, they did note "a moderate but reliable advantage of VR therapy over [conventional therapy] in the components of body function and activity."

    The authors concede the findings are tempered with limitations. While authors found "strong evidence" for the effectiveness of therapies that incorporated VE, they described the evidence around commercial videogame platforms as "promising" but "too small to draw conclusions." Researchers also cited a "high degree of variability" in the trials, and an insufficient number of studies to allow authors to control for stroke severity or the effects of time poststroke on the outcomes of conventional therapy. In fact, they write, future studies should attempt to clearly define “conventional therapy” to make results more useful.

    Research-related stories featured in News Now are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

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    PTNow Blog: Hypertension Guidelines Nearly Silent on Physical Activity

    When it comes to physical activity and its impact on hypertension, absence definitely doesn't make the physical therapist's heart grow fonder. In fact, the lack of serious consideration of lifestyle interventions in recently published hypertension guidelines could point to a bigger issue, according to the latest PTNow blog post.

    The new post recounts the development of 3 sets of blood pressure management guidelines by groups that mostly agree on the use of drug therapy, but disagree on the best way to reach these conclusions.

    For physical therapists, however, the real news is what isn't in the guidelines—namely, any serious consideration of lifestyle interventions.

    Are the guidelines missing important evidence, or is important evidence just ... missing? Check out the blog and join the discussion.