Heimo Nupponen

Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: a 25 year follow up study

Objective: To examine whether adolescent flexibility, endurance strength, and physical activity can predict the later occurrence of recurrent low back pain, tension neck, or knee injury. Methods: In 1976, 520 men and 605 women participated in a sit and reach test (flexibility) and a 30 second sit up test (endurance strength). In 1976 and 2001 (aged 37 and 42 years) they completed a questionnaire. Lifetime occurrence and risk of self reported low back pain and self reported, physician diagnosed tension neck and knee injury were calculated for subjects divided into tertiles by baseline results of strength and flexibility tests. Results: Men from the highest baseline flexibility tertile were at lower risk of tension neck than those from the lowest tertile (odds ratio (OR) 0.51, 95% confidence interval (CI) 0.28 to 0.93). Women from the highest baseline endurance strength tertile were at lower risk of tension neck than those from the lowest tertile (OR 0.60, 95% CI 0.40 to 0.91). Men from the highest baseline endurance strength tertile were at higher risk of knee injury than those from the lowest tertile (OR 1.96, 95% CI 1.05 to 3.64). Men who at school age participated in physical activity were at lower risk of recurrent low back pain (OR 0.61; 95% CI 0.42 to 0.88) than those who did not. Conclusions: Overall good flexibility in boys and good endurance strength in girls may contribute to a decreased risk of tension neck. High endurance strength in boys may indicate an increased risk of knee injury.

Physical activity among young people in the context of lifestyle

The promotion of a healthy lifestyle is the main goal of physical education in many countries. However, very little is known about the relationship between different life styles and physical activity patterns among young people. The aim of this study was to investigate the relationship between lifestyle and physical activity among 12- and 15-year-old boys and girls in Belgium and Finland. The data came from an extensive comparative study, ‘Sporting Lifestyle, Motor Performance and Olympic Ideals of European Youth’. The subjects in this study were 1439 Belgian and 789 Finnish adoles cents. Using factor and cluster analyses, five ways of spending leisure time repre senting different lifestyles were formulated. Additional descriptors of lifestyle were attitude toward school and Physical Education (PE), the importance of being good academically and in sport, perceived competence, and goal orientation. The results showed that there were significant differences in physical activity between the life style groups and that high physical activity was related to more than one lifestyle group. Those who were only interested in computer games and TV-watching were the most inactive, although many computer game players were also physically active. Perceived physical competence and task orientation were positively related to a phys ically active lifestyle. It was concluded that if the aim of physical education is to enhance an active lifestyle, then a variety of characteristics should be taken into account in teaching.

Adolescent physical fitness and activity as predictors of adulthood activity

Abstract A 25-year population-based study was conducted to determine how physical fitness and participation in leisure-time physical activity in adolescence (age 12–18 years) predict leisure-time physical activity in adulthood (age 37–43 years). In 1976, five field tests were conducted to measure muscular fitness, agility and aerobic capacity, and self-report weekly frequencies of activity were obtained by questionnaire. A modified questionnaire was repeated in 2001, when participants were age 37–43 years (N = 1525). On the basis of the questionnaire, a physical activity index was calculated both in 1976 and 2001. The odds ratios (OR) for being inactive in adulthood among those who were physically very active in adolescence compared with those who were inactive in adolescence was 0.13 for males (95%CI: 0.06–0.31) and 0.28 for females (95%CI: 0.13–0.59). The odds ratio for adult inactivity among males in the highest versus lowest fitness group in adolescence was 0.24 (95%CI: 0.07–0.81). Activity in adolescence predicted activity in adulthood in both males and females. The risk for adult inactivity was significantly lower for those who were physically active in adolescence. In addition, high fitness predicted adult activity among males but not among females.

Secular trends in aerobic fitness performance in 13–18-year-old adolescents from 1976 to 2001

Objective To analyse the secular trends in aerobic fitness performance and some of its determinants (body mass index (BMI) and leisure time physical activity (LTPA)) in adolescents. Design Cross-sectional population-based studies in 1976 and 2001 in Finland. A stratified random sample of Finnish 13–18-year-old adolescents was studied in 1976 (n = 717; 384 boys and 333 girls) and in 2001 (n = 558; 305 boys and 253 girls). The main outcome measure was aerobic fitness, estimated with a 2000 m (for boys) and 1500 m (for girls) running test; the weight and height of participants were also measured. Self-reported weekly frequency of LTPA of at least 30 min duration and regularity of participation in organised sport were obtained by questionnaire. Identical methods were used in 1976 and 2001. Results Running time was longer in 2001 compared to 1976 in boys (56 s, Cohen d = 0.46, medium effect size; p<0.001) and girls (29 s, d = 0.32, small; p<0.01). BMI and participation in LTPA explained more of the variance in aerobic fitness in 2001 than in 1976 in boys and girls. Conclusions Aerobic fitness of school-aged children deteriorated between the measurement points. BMI and organised LTPA were better associated with aerobic fitness in 2001 than in 1976. An increase in overweight and obesity was associated with the decrease in aerobic fitness. Although the importance of organised LTPA to fitness increased, it is possible that the decrease in overall physical activity between 1976 and 2001 contributed most to the decrease in the level of aerobic fitness.

Associations between self‐estimated and measured physical fitness among 40‐year‐old men and women

The aim was to evaluate whether 40‐year‐old men and women are able to estimate their level of fitness compared with actual measured physical fitness. Twenty‐nine men and 35 women first completed a questionnaire at home and then their physical fitness was measured at laboratory. The index of self‐estimated physical fitness was calculated by summing up the scores of self‐estimated endurance, strength, speed and flexibility. The index of self‐estimated endurance was calculated by summing up the scores of self‐estimated endurance and those of the self‐estimated distance they could run, cycle, ski and walk. The index of measured physical fitness was calculated by summing up the z‐scores of a submaximal bicycle ergometer test, ergojump tests (counter‐movement jump and jumping in 15 s), a 30‐s sit‐up test, hand‐grip tests and a sit‐and‐reach test. The correlation (Spearman) between the indices of self‐estimated and measured physical fitness was 0.54 for both sexes, and that between self‐estimated endurance and measured endurance was 0.53 for both sexes. Maximal oxygen uptake estimated based on submaximal ergometer test was higher among those with longer self‐estimated distance of running, cycling, skiing and walking (P for linear trend <0.001). Our study shows that 40‐year‐old adults can estimate at group level their fitness according to different categories moderately well. They can also estimate at group level their endurance moderately well by estimating the distance they can run, cycle, ski or walk. However, in some individuals self‐estimation of fitness is not in agreement with the results of fitness tests.

Secular trends in muscular fitness among Finnish adolescents

Aim: To investigate secular change over time in health-related muscular fitness and how leisure time physical activity (LTPA), sport club participation, and body mass index are associated with muscular fitness in adolescents. Methods: Two cross-sectional samples of Finnish 13—16-year-old adolescents were studied in 1976 (n = 643; 312 boys and 331 girls) and in 2001 (n = 579; 308 boys and 271 girls). Muscular fitness index was calculated as the sum of age- and sex-specific z-scores of four tests measuring muscular fitness and agility. Height and weight were also measured. Self-reported weekly frequency of LTPA of at least 30-min duration and regularity of participation in organised sport were obtained by questionnaire. Identical methods were used in 1976 and 2001. Results: Muscular fitness index was higher in 2001 than in 1976 in both boys (by 0.77 points, p = 0.008, effect size d = 0.17, small difference) and girls (1.01 points, p = 0.004, d = 0.20, small difference). Sport club participation, body mass index, and participation in LTPA together explained more of the muscular fitness index variance in 2001 than in 1976 in both boys (coefficient of determination from 0.10 to 0.24) and girls (from 0.25 to 0.40). Conclusions: The muscular fitness of 13—16-year old adolescents slightly improved over time. Organised LTPA showed a stronger association with muscular fitness in 2001 than in 1976. Due to increased polarisation in fitness, in health promotion more attention should be paid on adolescents’ health-related fitness and its association to LTPA.

Adolescent physical activity predicts high education and socio-economic position in adulthood

BACKGROUND Based on the knowledge on beneficial effects of physical activity (PA) on health and fitness, we hypothesized that PA in adolescence is related to high education and socio-economic position (SEP) in adulthood. Improved school performance may mediate the hypothesized relationship. METHODS The Adolescent Health and Lifestyle Surveys (AHLS), collected biennially in 1981-89 (baseline) and representing 14- and 16-year-old Finns were individually linked with national registries of the highest educational level and SEP. Of the sample, 10 498 (78%) responded the surveys and were followed till the end of 2001 (age group of 28-38 years). Multinomial logistic regression analysis was used to study the associations between the outcomes (highest attained educational level, SEP) and PA (sports clubs, spontaneous, intensity). RESULTS Participating in sports club or spontaneous PA and practicing with high intensity in adolescence were associated with higher educational levels and SEP in adulthood. Childhood socio-economic background only slightly influenced the associations and largely, PA predicted the outcomes independently of background. Particularly among girls, school performance partly accounted for the associations between PA and the highest educational level and the highest SEP. CONCLUSIONS Participation in PA in adolescence and particularly its high intensity, predicts higher educational levels and SEP in early middle age. School performance to some degree mediates the impact of PA. PA behaviours in adolescence-or possibilities to participate in PA-are a potential mechanism in generating better health of higher socio-economic and educational groups in adult age.

Questionnaire-assessed moderate to vigorous physical activity of the Finnish youth in 1979–2005

The purpose of the study was to investigate the time trend of questionnaire‐assessed moderate to vigorous physical activity (MVPA) among 12–18‐year‐old Finnish boys and girls from 1979 to 2005. The MVPA was defined as “at least moderately breathtaking and sweating in leisure time physical activities more than 3 times week.” Data were based on the Adolescent Health and Lifestyle Survey, which is a biannual, nation‐wide survey on adolescent health and health‐related lifestyle in Finland. The nationally representative samples were drawn from the Finnish Population Register Centre. The numbers of participants varied from 2832 to 8390 and the response rates from 91% (girls, 1981) to 58% (boys, 2005). The main results showed that the participation rate in MVPA increased during the study period. The increase was not continuous, but showed an upward trend during the years 2001–2005. The study also revealed that boys participated in MVPA more than girls. However, the gender difference decreased during the study period. Age differences in MVPA were rather small and they decreased during the study period. However, perceived intensity of physical activity was higher among older than younger groups, whereas participation in MVPA was more frequent in younger than older groups. The results supported the findings of some previous studies that reported that especially in Finland the vigorous physical activity among young people had consistently increased. This study gave more information about this phenomenon because the study period was longer, 26 years, and the sample also included older, 16‐ and 18‐year‐old boys and girls.