Despite the commonly known benefits of exercise and physical activity evidence shows that persons Multiple Sclerosis (MS) are relatively inactive yet physical activity may be even more important in a population facing functional deterioration. No exercise is effective if it is not done and people with MS face unique barriers to exercise engagement which need to be overcome. We have developed and pilot tested a Multiple Sclerosis Tailored Exercise Program (MSTEP) and it is ready to be tested against general guidelines for superiority and ultimately for its impact on MS relevant outcomes. The primary research question is to what extent does an MS Tailored Exercise Program (MSTEP) result in greater improvements in exercise capacity and related outcomes over a one year period in comparison to a program based on general guidelines for exercise among people with MS who are sedentary and wish to engage in exercise as part of MS self-management. The proposed study is an assessor-blind, parallel-group, randomized controlled trial (RCT). The duration of the intervention will be one year with follow-up to year two. The targeted outcomes are exercise capacity, functional ambulation, strength, and components of quality of life including frequency and intensity of fatigue symptoms, mood, global physical function, health perception, and objective measures of activity level. Logistic regression will be used to test the main hypothesis related to the superiority of the MSTEP program based on a greater proportion of people making a clinically relevant gain in exercise capacity at 1 year and at 2 years, using an intention-to-treat approach. Sample size will be 240 (120 per group). The MS community is clearly looking for interventions to help alleviate the disabling sequelae of MS and promote health. Exercise is a well-known intervention which has known benefits to all, yet few exercise regularly. For people with MS, the role of exercise in MS management needs to be rigorously assessed to inform people as to how best to use exercise to reduce disability and promote health. Clinical Trials.gov: NCT01611987

Objective To evaluate the precision of the iDXA for total body composition and fat distribution measurements in severely obese patients. Design and Methods Sixty-five severely obese participants with a mean age of 46 ± 11years, BMI of 49 ± 6 kg/m², and a mean body mass of 137.3 ± 20.9 kg took part in this investigation. Two consecutive iDXA scans with repositioning of the total body were conducted for each participant. The coefficient of variation (CV), the root-mean-square (RMS) averages of standard deviations of repeated measurements, the corresponding 95% least significant change, and Intraclass Correlations (ICC) were calculated. Results Precision expressed as % CV, for total body bone mineral content, fat free mass, total body fat, total body lean, and % total body fat were 1.08%, 0.94%, 0.90%, 1.00%, 0.79%, respectively. Precision was 1.44% for gynoid fat distribution and 1.64% for android fat (AF) distribution. The ICCs in all DXA measurements were 0.99 with % AF having the lowest at 0.96. Conclusions The GE Lunar iDXA™ demonstrated excellent precision for total body composition assessments and is the first study to assess reproducibility in severely obese individuals.

Physical inactivity is a risk factor for cardiovascular and other chronic diseases. It has been shown that both physical inactivity and social isolation increase with age, and that these factors are detrimental to physical and mental well‐being. The purpose of the present study was to examine the relationship between physical inactivity and social isolation in older US adults. Using data from a nationally representative cross‐sectional survey, the Third National Health and Nutrition Examination Survey, 1988–1994, we assessed the age‐ and race‐specific prevalence of no leisure‐time physical activity in relation to various forms of social interaction. The prevalence of no leisure‐time physical activity increases with age in both men and women. In non‐Hispanic whites, non‐Hispanic blacks, and Mexican Americans, the prevalence of no leisure‐time physical activity is increased in older US adults who are socially isolated. Social isolation is related to physical inactivity among persons 60 years and older. Longitudinal and intervention studies are needed to establish whether increased social support translates to a more active population of older adults.

Patients. Purpose The purpose of the study was to evaluate the precision of CoreScan for VAT measurements in severely obese adults (body mass index > 40 kg·m−2). Methods A total of 55 obese participants with a mean age of 46 ± 11 yr, body mass index of 49 ± 6 kg·m−2, and body mass of 137.3 ± 21.3 kg took part in this study. Two consecutive iDXA scans with repositioning of the total body were conducted for each participant. The coefficient of variation, the root-mean-square averages of SD of repeated measurements, the corresponding 95% least significant change, and intraclass correlations were calculated. Results Precision error was 8.77% (percent coefficient of variation), with a root-mean-square SD of 0.294 kg and an intraclass correlation of 0.96. Bland–Altman plots demonstrated a mean precision bias of −0.08 ± 0.41 kg, giving a coefficient of repeatability of 0.82 kg and a bias range of −0.890 to 0.725 kg. Conclusions When interpreting VAT results with the iDXA in severely obese populations, clinicians should be aware of the precision error for this important clinical parameter....