Improving physical function and blood pressure in older adults through cobblestone mat walking: a randomized trial. Effectiveness of a Walking Group Intervention to Promote Physical Activity and Cardiovascular Health in Predominantly Non-Hispanic Black and Hispanic Urban Neighborhoods The 'Walking for Wellbeing in the West' randomised controlled trial of a pedometer-based walking programme in combination with physical activity consultation with 12 month follow-up: rationale and study design A randomized exercise trial in older women: increased activity over two years and the factors associated with compliance. Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer Heart-to-Heart: Promoting Walking in Rural Women Through Motivational Interviewing and Group Support A community-based walking trial to improve neighborhood quality of life in older adults: a multilevel analysis Walks4Work: assessing the role of the natural environment in a workplace physical activity intervention. Tracking Restoration of Park and Urban Street Settings in Coronary Artery Disease Patients Quantification of Outdoor Mobility by Use of Accelerometer-Measured Physical Behaviour [The Effects of Urban Forest-walking Program on Health Promotion Behavior, Physical Health, Depression, and Quality of Life: A Randomized Controlled Trial of Office-workers]. Using Ecological Momentary Assessment to Understand Where and With Whom Adults’ Physical and Sedentary Activity Occur Effectiveness of a community‐directed ‘healthy lifestyle’ program in a remote Australian Aboriginal community West End Walkers 65+: A randomised controlled trial of a primary care-based walking intervention for older adults: Study rationale and design The effects of a walking exercise program on physical function and emotional state of elderly Korean women. Community walking training program improves walking function and social participation in chronic stroke patients. Assessment of female participation in an employee 20-week walking incentive program at Marshfield Clinic: a large multispecialty group practice.
OBJECTIVES To determine the relative effects of cobblestone mat walking , in comparison with regular walking , on physical function and blood pressure in older adults . DESIGN R and omized trial with allocation to cobblestone mat walking or conventional walking . SETTING General community in Eugene , Oregon . PARTICIPANTS One hundred eight physically inactive community-dwelling adults aged 60 to 92 ( mean age+/-st and ard deviation=77.5+/-5.0 ) free of neurological and mobility-limiting orthopedic conditions . INTERVENTION Participants were r and omized to a cobblestone mat walking condition ( n=54 ) or regular walking comparison condition ( n=54 ) and participated in 60-minute group exercise sessions three times per week for 16 consecutive weeks . MEASUREMENTS Primary endpoint measures were balance ( functional reach , static st and ing ) , physical performance ( chair st and s , 50-foot walk , Up and Go ) , and blood pressure ( systolic , diastolic ) . Secondary endpoint measures were Short Form-12 physical and mental health scores and perceptions of health-related benefits from exercise .  RESULTS At the 16-week posttest , differences between the two exercise groups were found for balance measures ( P=.01 ) , chair st and s ( P<.001 ) , 50-foot walk ( P=.01 ) , and blood pressure ( P=.01 ) but not for the Up and Go test ( P=.14 ) . Although significant within-group changes were observed in both groups for the secondary outcome measures , there were no differences between intervention groups . CONCLUSION Cobblestone mat walking improved physical function and reduced blood pressure to a greater extent than conventional walking in older adults . Additional benefits of this walking program included improved health-related quality of life . This new physical activity may provide a therapeutic and health-enhancing exercise alternative for older adults Objectives . The purpose of this study was to evaluate the effectiveness of the Walk Your Heart to Health ( WYHH ) intervention , one component of the multilevel Community Approaches to Cardiovascular Health : Pathways to Heart Health ( CATCH : PATH ) intervention design ed to promote physical activity and reduce cardiovascular risk among non-Hispanic Black and Hispanic residents of Detroit , Michigan . The study was design ed and implemented using a community-based participatory research approach that actively engaged community residents , health service providers and academic research ers . It was implemented between 2009 and 2012 . Method . WYHH was a 32-week community health promoter – facilitated walking group intervention . Groups met three times per week at community-based or faith-based organizations , and walked for 45 to 90 minutes ( increasing over time ) . The study used a cluster r and omized control design to evaluate effectiveness of WYHH , with participants r and omized into intervention or lagged intervention ( control ) groups . Psychosocial , clinical , and anthropometric data were collected at baseline , 8 , and 32 weeks , and pedometer step data tracked using uploadable peisoelectric pedometers . Results . Participants in the intervention group increased steps significantly more during the initial 8-week intervention period , compared with the control group ( β = 2004.5 , p = .000 ) . Increases in physical activity were associated with reductions in systolic blood pressure , fasting blood glucose , total cholesterol , waist circumference and body mass index at 8 weeks , and maintained at 32 weeks . Conclusion . The WYHH community health promoter – facilitated walking group intervention was associated with significant reductions in multiple indicators of cardiovascular risk among predominantly Hispanic and non-Hispanic Black participants in a low-to-moderate income urban community . Such interventions can contribute to reductions in racial , ethnic , and socioeconomic inequities in cardiovascular mortality Background Scotl and has a policy aim ed at increasing physical activity levels in the population , but evidence on how to achieve this is still developing . Studies that focus on encouraging real world participants to start physical activity in their setting s are needed . The Walking for Well-being in the West study was design ed to assess the effectiveness of a pedometer-based walking programme in combination with physical activity consultation . The study was multi-disciplinary and based in the community . Walking for Well-being in the West investigated whether Scottish men and women , who were not achieving the current physical activity recommendation , increased and maintained walking behaviour over a 12 month period . This paper outlines the rationale and design of this innovative and pragmatic study . Methods Participants were r and omised into two groups : Group 1 : Intervention ( pedometer-based walking programme combined with a series of physical activity consultations ) ; Group 2 : Waiting list control for 12 weeks ( followed by minimal pedometer-based intervention ) . Physical activity ( primary outcome ) was measured using  pedometer step counts ( 7 day ) and the International Physical Activity Question naire ( long version ) . Psychological processes were measured using question naires relating to the Transtheoretical Model of Behaviour Change , mood ( Positive and Negative Affect Schedule ) and quality of life ( Euroqol EQ-5D instrument ) . Physiological measures included anthropometric and metabolic outcomes . Environmental influences were assessed subjectively ( Neighbourhood Quality of Life Survey ) and objective ly ( neighbourhood audit tool and GIS mapping ) . The qualitative evaluation employed observation , semi-structured interviews and focus groups . A supplementary study undertook an economic evaluation . Discussion Data analysis is on-going . Walking for Well-being in the West will demonstrate if a pedometer based walking programme , in combination with physical activity consultation results in a sustainable increase in walking behaviour in this sample of Scottish adults over a 12 month period . The study will examine the complex relationships between behavioural change , health consequences and the role of the environment , in conjunction with the cost effectiveness of this approach and a detailed insight into the participants ' experiences of the intervention . Trial registration Current Controlled Trials IS RCT The health effects of increased physical activity in the prevention or treatment of any disease can only be meaningfully assessed if compliance to the exercise regimen is maintained . The current research examined compliance in a clinical trial investigating the effect of walking on bone loss in 229 postmenopausal women , r and omized into either a walking or a control group . Although at baseline there was no difference in physical activity between the two groups , after a period of 2 yr , the walking group reported significantly greater physical activity as measured by reported mean blocks walked daily and objective activity monitor day readings . Closer examination of the walking group revealed that compliers ( average 7 + miles walked/wk over the 2 yr ) , when compared to non-compliers , tended at baseline to be more active , lighter weight , and non-smokers . However , the variable that best differentiated between the two compliance groups was the frequency of reported illness over the 2-yr period , with compliers cl aim ing significantly less illness The primary purpose of the current study was to determine prospect i ve associations of accelerometer‐assessed physical activity intensity and sedentary time with health‐related quality of life ( HRQOL ) indicators among survivors of breast cancer Background : Walking can significantly increase cardiorespiratory fitness and thereby reduce the incidence of heart disease in women . However , there is a paucity of research aim ed at increasing walking in rural women , a high-risk group for heart disease and one for which exercise strategies may pose particular challenges . Purpose : This study tested Heart-to-Heart ( HTH ) , a 12-week walking program , design ed to increase fitness through walking in rural women . Heart-to-Heart integrated individual-oriented strategies , including motivational interviewing , and group-based strategies , including team building . Methods : Forty-six rural women were r and omized to either HTH or a comparison group . The primary outcome of cardiorespiratory fitness and secondary outcomes of self-efficacy and social support were measured preintervention and postintervention . Group differences were analyzed with repeated- measures analysis of variance . Results : Women in HTH group had a greater improvement in cardiorespiratory fitness ( P = .057 ) and in social support ( P = .004 ) compared with women in the comparison group . Neither group of women experienced a change in exercise self-efficacy ( P = .814 ) . Conclusions : HTH was effective in improving cardiorespiratory fitness in a sample of rural women . Further research is needed to refine HTH and determine the optimal approach in rural women to increase their walking Background : Few studies have considered the neighborhood as a context in which to examine the physical activity and quality of life relationship . Purpose : The goal of this study was to evaluate the effects of a neighborhood walking program on  quality of life among older adults . It was design ed as a r and omized trial involving a multilevel design with neighborhoods corresponding to primary sampling units and residents to secondary units . Methods : Five hundred eighty-two communitydwelling senior residents ( 65 years of age or older ) in neighborhoods in the northeast metropolitan area of Portl and , Oregon , were recruited through telephone , direct mail , and referrals . The walking intervention was delivered at the neighborhood level . Neighborhoods ( N = 56 ) were r and omly assigned to a 6-month , 3 times per week , leader-led walking group activity ( n = 28 ) or an information-only control group ( n = 28 ) . Primary outcome measures included SF-12 ( Physical , Mental summary scores ) and life satisfaction ( SWLS ) ; the secondary outcome measure was neighborhood walking activity , assessed at baseline , 3 months , and 6 months of the study period . Results : Compared to the control neighborhoods , results from multilevel , longitudinal analyses indicated significant improvements in the primary outcomes of SF-12 Physical ( p < .05 ) , SF-12 Mental ( p < .05 ) summary scores , and SWLS ( p < .05 ) , over the course of the 6-month intervention . A significant increase was also observed in the secondary outcome of walking activity ( p < .05 ) . Conclusions : Implementing a neighborhood-based walking program of low to moderate intensity is feasible and beneficial for promoting quality of life among senior residents at a community level OBJECTIVES The primary aim of this study was to examine the impact of  physical activity ( PA ) in the natural environment ( eg , " green exercise " ) on resting autonomic function in the Walks4Work intervention . A secondary aim was to assess the feasibility of Walks4Work in terms of adherence , change in PA levels , and cardiovascular health parameters . METHODS In an 8-week r and omized control trial , 94 office workers in an international company were allocated to one of three groups : control , nature ( NW ) , or built ( BW ) lunchtime walking route . Both walking groups were required to undertake two lunchtime walks each week . The NW route centered around trees , maintained grass , and public footpaths . In contrast , the BW consisted of pavement routes through housing estates and industrial areas . Data were collected at baseline and following the intervention . To investigate the impact of the intervention , mixed- design analysis of variance ( ANOVA ) were performed . RESULTS A total of 73 participants completed the intervention ( drop-out rate of 22 % ) . No difference was observed in resting autonomic function between the groups . Self-reported mental health improved for the NW group only . PA levels increased at the intervention mid-point for all groups combined but adherence to the intervention was low with rates of 42 % and 43 % within the BW and NW groups , respectively . CONCLUSION Accompanying a guideline of two active lunchtimes per week with low facilitator input appears inadequate for increasing the number of active lunchtimes and modifying cardiovascular health parameters in an office population . However , this population fell within normal ranges for cardiovascular measures and future research should consider investigating at-risk population s , particularly hypertensive individuals The physiological effects of natural and urban environments on the cardiovascular system of coronary artery disease ( CAD ) patients are not fully understood . This controlled field study examines the effects of restorative walking in a park vs. in an urban street environment on CAD patients ’ stress parameters and cardiac function . Methods : Twenty stable CAD patients were r and omly allocated to 7 days controlled walking in a city park or in an urban street environment group . The relationship between different environmental exposures and health effects was analyzed using Wilcoxon signed-rank test and exact Mann-Whitney U test . Results : The mean reduction in cortisol levels and negative effects after the walk on the first day was greater in the city park than in the urban street exposed group , while a reduction in negative effects in the urban group were greater after seven days . The reduction in diastolic blood pressure ( DBP ) in the park group was evident on the seventh day before the walk ( −4 mm Hg , p = 0.031 ) and 60 min after the walk ( −6.00 mm Hg , p = 0.002 ) . The cortisol slope was negatively associated with the DBP changes ( r = −0.514 , p < 0.05 ) . Conclusions : Physical activity in a green environment with noise and air pollution levels lower than in an urban environment has a greater positive effect on CAD patients ’ stress level and hemodynamic parameters . Mitigating green environmental influences may allow urban residents to maintain health and reduce disability Hip fractures in older persons are associated with both low levels of daily physical activity and loss of outdoor mobility . The aim was to investigate if accelerometer-based measures of physical behaviour can be used to determine if people undertake outdoor walking and to provide reference values for physical behaviour outcomes related to outdoor mobility . Older persons ( n = 245 ) , ≥70 years , one year after hip fracture , participated .  Six objective measures of physical behaviour collected by an activity monitor were compared with self-reported outdoor mobility assessed with the Nottingham Extended ADL scale . All measures of time and length in upright periods were significantly lower in participants who reported not walking outdoors ( p < 0.001 ) . A set of cut-off points for the different physical behaviour variables was generated . Maximum length of upright events discriminated best between groups , with 31 minutes as a threshold to determine if a person is more likely to report that they walk outdoors ( sensitivity : 0.805 , specificity : 0.704 , and AUC : 0.871 ) or 41 minutes or more to determine if a person is more likely to report outdoor walking on their own ( AUC : 0.891 ) . Physical behaviour  variables from activity monitoring can provide information about patterns of physical behaviour related to outdoor activity performance PURPOSE This study was performed to determine the physical and psychological effects of an urban forest-walking program for office workers . For many workers , sedentary lifestyles can lead to low levels of physical activity causing various health problems despite an increased interest in health promotion . METHODS Fifty four office workers participated in this study . They were assigned to two groups ( experimental group and control group ) in r and om order and the experimental group performed 5 weeks of walking exercise based on Information-Motivation-Behavioral skills Model . The data were collected from October to November 2014 . SPSS 21.0 was used for the statistical analysis . RESULTS The results showed that the urban forest walking program had positive effects on the physical activity level ( U=65.00 , p<.001 ) , health promotion behavior ( t=-2.20 , p=.033 ) , and quality of life ( t=-2.42 , p=.020 ) . However , there were no statistical differences in depression , waist size , body mass index , blood pressure , or bone density between the groups . CONCLUSION The current findings of the study suggest the forest-walking program may have positive effects on improving physical activity , health promotion behavior , and quality of life . The program can be used as an effective and efficient strategy for physical and psychological health promotion for office workers Purpose This study used Ecological Momentary Assessment ( EMA ) , a real-time self-report strategy , to describe the physical and social context s of adults ’ physical activity and sedentary activity during their everyday lives and to determine whether these patterns and relationships differ for men and women . Methods Data from 114 adults were collected through mobile phones across 4 days . Eight electronic EMA surveys were r and omly prompted each day asking about current activities ( e.g. , physical or sedentary activity ) , physical and social context s , and perceived outdoor environmental features ( e.g. , greenness/vegetation , safety , and traffic ) . All participants also wore accelerometers during this period to objective ly measure moderate-to-vigorous physical activity ( MVPA ) and sedentary activity . Results Home was the most common physical context for EMA-reported physical and sedentary activity . Most of these activities occurred when participants were alone . When alone , the most commonly EMA-reported physical activity and sedentary activity was walking and reading/using computer , respectively . When in outdoor home locations ( e.g. , yard and driveway ) women demonstrated higher levels of MVPA , whereas men demonstrated higher levels of MVPA when in outdoor park setting s ( ps < .05 ) . Men but not women demonstrated higher levels of MVPA in setting s with a greater degree of perceived greenness and vegetation ( p < .05 ) . Conclusions The current study shows how EMA via mobile phones and accelerometers can be combined to offer an innovative approach to assess the context s of adults ’ daily physical and sedentary activity . Future studies could consider utilizing this method in more representative sample s to gather context -specific information to inform the development of physical activity interventions Objective : To assess the sustainability and effectiveness of a community‐directed program for primary and secondary prevention of obesity , diabetes and cardiovascular disease in an Aboriginal community in north‐west Western Australia Background In Scotl and , older adults are a key target group for physical activity intervention due to the large proportion who are inactive . The health benefits of an active lifestyle are well established but more research is required on the most effective interventions to increase activity in older adults . The ' West End Walkers 65 + ' r and omised controlled trial aims to examine the feasibility of delivering a pedometer-based walking intervention to adults aged ≥65 years through a primary care setting and to determine the efficacy of this pilot . The study rationale , protocol and recruitment process are discussed in this paper . Methods / Design The intervention consisted of a 12-week pedometer-based graduated walking programme and physical activity consultations .  Participants were r and omised into an immediate intervention group ( immediate group  ) or a  12-week waiting list control group (  delayed group ) who then received the intervention . For the pilot element of this study , the primary outcome measure was pedometer step counts . Secondary outcome measures of sedentary time and physical activity ( time spent lying/sitting , st and ing or walking ; activPAL ™ monitor ) , mood ( Positive and Negative Affect Schedule ) , functional ability ( Perceived Motor-Efficacy Scale for Older Adults ) , quality of life ( Short-Form ( 36 ) Health Survey version 2 ) and loneliness ( UCLA Loneliness Scale ) were assessed . Focus groups with participants and semi-structured interviews with the research team captured their experiences of the intervention . The feasibility component of this trial examined recruitment via primary care and retention of participants , appropriateness of the intervention for older adults and the delivery of the intervention by a practice nurse . Discussion West End Walkers 65 + will determine the feasibility and pilot the efficacy of delivering a pedometer-based walking intervention through primary care to Scottish adults aged ≥65 years . The study will also examine the effect of the intervention on the well-being of participants and gain an insight into both participant and research team member experiences of the intervention . Trial registration numberIS RCT N : IS RCT Exercise is an important strategy for preventing chronic diseases and promoting the health of older adults . The purpose of this research was to evaluate the effects of an outdoor walking exercise program on the cardiorespiratory function , the flexibility , and the emotional state of elderly Korean women . A nonequivalent control group , pretest-posttest design was used to measure the effects of the exercise program . The subjects were 27 females between the ages of 60 to 75 years . The intensity of the walking program was 40 - 60 % of the target heart-rate with a duration of 50 - 60 min , 3 times per week at an outdoor track for 8 weeks . The effects of the program were assessed by maximal oxygen uptake ( VO2max ) , resting pulse rate , blood pressure Forced Vital Capacity ( FVC ) , Forced Expiratory Volume per 1 second ( FEV1 ) for cardiorespiratory function , the " sit and reach test " for flexibility , and by the Profile of Mood States ( POMS ) for emotional state . The physical function and the emotional state of the experimental group improved significantly more than that of the control group except FEV1 and the anger factor of POMS . The VO2max and the flexibility of elderly women in the experimental group progressively improved as the duration of the exercise period continued . The results of this study suggest a practical and easy method of exercise to enhance the health of older women Stroke patients live with balance and walking dysfunction .  Walking is the most important factor for independent community activities . The purpose of this study was to investigate the effect of a community walking training program ( CWTP ) within the real environment on walking function and social participation in chronic stroke patients . Twenty-two stroke patients ( 13 male , 50.45 years old , post stroke duration 231.64 days ) were r and omly assigned to either the CWTP group or the control group . All subjects participated in the same st and ard rehabilitation program consisting of physical and occupational therapy for 60 min per day , five times a week , for four weeks . In addition , the CWTP group participated in CWTP for 30 min per day , five times a week , for four weeks . Walking function was assessed using the 10-m walk test ( measurement for 10-meter walking speed ) , 6-min walk assessment ( measurement of gait length for 6-minutes ) , and community gait assessment . Social participation was assessed using a social participation domain of stroke impact scale . In walking function , greater improvement was observed in the CWTP group compared with the control group ( P < 0.05 ) . In addition , social participation improved more in the CWTP group compared with the control group ( P < 0.05 ) . These findings demonstrate the efficacy of  CWTP  on walking function and social participation in chronic stroke patients . Therefore , we suggest that CWTP within the real environment may be an effective method for improving walking function and social participation of chronic stroke patients when added to st and ard rehabilitation OBJECTIVE We evaluated the short-term effect of a worksite-based walking incentive program to promote physical activity and well-being in employees of a private healthcare clinic . DESIGN A prospect i ve , observational follow-up study . SETTING The study was conducted at Marshfield Clinic , a large private multispecialty group practice healthcare institution in Marshfield , Wisconsin , USA . PATIENTS Subjects for this study were Marshfield Clinic physicians and staff . METHODS From March 31 , 2005 to August 20 , 2005 , physical activity level , body mass index ( BMI ) and other well-being characteristics were observed pre- and post-program among 191 female participants from the Marshfield Clinic . A brief Web site-accessible , self-reported survey assessed the effectiveness of the exercise program . RESULTS Our data show a statistically significant ( p < 0.0001 ) increase in participants ' physical activity level , while a significant ( p = 0.021 ) decrease in mean BMI was observed . However , there was no evidence of our incentive program reducing participants ' blood pressure . CONCLUSION Preliminary findings of our study suggest that the goal of worksite programs design ed to support employees in their efforts to improve or maintain their level of wellness is potentially achievable . Continuing research is needed to further assess whether persistent health benefits can be induced by worksite wellness programs
There is evidence that walking groups have wide-ranging health benefits .
The evidence was less clear for other outcomes such as waist circumference fasting glucose , SF-36 ( mental health ) and serum lipids such as high-density lipids .
There were no notable adverse side effects reported in any of the studies .
CONCLUSIONS Walking groups are effective and safe with good adherence and wide-ranging health benefits .
They could be a promising intervention as an adjunct to other healthcare or as a proactive health-promoting activity
OBJECTIVE To assess the health benefits of  outdoor walking groups .