Walking 10,000 steps daily is associated with beneficial health outcomes. Recent systematic reviews have suggested that pedometers may be an effective motivational tool to promote walking. The aim of this study was to study the effectiveness of a 10-week, pedometer-based walking intervention to improve physical activity, body composition and metabolic health indices in a sample of suburban community-dwelling adults not meeting current physical activity recommendations. After screening, 34 overweight/obese individuals (mean age: 46 ± 8 years, mean BMI: 28.3 ± 4.2 kg/m2 ) were accepted into the walking program conducted by the Health Promotion Community Centre, Bangi. Subjects were instructed to increase their steps by 3000 steps daily above their baseline values for 10 weeks. Daily step count, body weight, BMI, waist circumference, as well as blood pressure, fasting glucose and lipids were evaluated at baseline and following the 10-week intervention. Thirty-one participants completed the program with 100% adherence. The average daily steps recorded during the 10-week intervention was 9693 ± 2196 steps per day. Mean daily steps increased from 8679 ± 2567 steps in Week 1 to 10,766 ± 3200 steps in Week 10 (p=0.040). Overall, there were reductions in body weight (-1.13%, p=0.010), waist circumference (-3.5%, p=0.001) and BMI (-1.41%, p=0.008) as well as fasting blood glucose (-8.5%, p=0.003) and systolic blood pressure (-4.8%, p=0.007) following the intervention. The findings of this study demonstrated that a goal-driven, pedometer-based walking intervention for 10 weeks resulted in a modest reduction in body weight and improved metabolic health outcomes in overweight/obese, community-dwelling adults.

Stress is a common problem among university students and studies showed that involvement in exercise could help in reducing stress. However, information regarding the effect of high intensity progressive resistance training (PRT) using a resistant tube on stress among inactive and moderate active young male university students is limited. Hence, the aim of this study is to examine the effect of high intensity PRT using a resistant tube on psychological stress level, cortisol, DHEA and physical fitness in this population. A total of 30 male university students were participated in this quasi-experiment study. Intervention group (n = 14, age: 21.50 ± 1.37 yr) was participaned to carry out high intensity PRT by using resistant tube 3 times per week for 10 weeks; control group (n = 16, age: 21.29 ± 1.86 yr) was asked to continue their current lifestyle as usual. Before and after 10 weeks of intervention, psychological stress was measured by using PSS and SLSI questionnaires; cortisol and DHEA level were measured by using ELISA method. Timed up-and-go (TUG) used to examine dynamic balance and handgrip strength test used to measure muscle strength. Findings showed that the increased of DHEA level after 10 weeks of intervention was significantly difference between control and intervention groups (p < 0.05). There was no significant group difference in changes over time in anthropometric and body composition measurements, stress scores, cortisol level and physical fitness. High intensity PRT using resistant tube may be beneficial in increasing DHEA level among young male adults, which can act as a stress biochemical indicator.
Stress, Psychological

The paediatric rehabilitation service in Malaysia is shifting from the traditional child-focused approach to a family-centred approach. At present, there is a lack of an evaluation tool to assess to the quality of paediatric rehabilitation services, and whether the services are in line with the principles of the family-centred service. This study was undertaken to assess validity and reliability of the Malay version of the Measure of Processes of Care 20-item (MPOC-20) questionnaire in evaluating family-centered approach in children rehabilitation services in Kuala Lumpur. The original English version of the MPOC-20 was translated into Malay language, before it was administered to 102 parents of children receiving rehabilitation service at the Occupational Therapy Unit, UKM Medical Centre. The component structure of the MPOC-20 Malay version was examined using principal component analysis with Varimax rotation to explore the factor structures after translation. Cronbach’s alpha was calculated to determine the internal consistency reliability of the factors identified in the MPOC-20 Malay version. The resultant four-factor model explained 64 % of the variance in the Malay MPOC-20 responses. All four factors were similar to the five factors described in the original MPOC-20. All the 20 items were retained, with relocation of some items into a new factor. The Malay version of the MPOC-20 showed good internal consistency with Cronbach’s alpha values ranging from 0.75 to 0.90. This study demonstrates that the Malay version of the MPOC-20 is valid and reliable, and is suitable for evaluation of the quality of child rehabilitation services in the Malaysian context.
Early Intervention (Education)

Postprandial hyperglycemia is independently related to cardiovascular disease. Garlic, ginger, lemon, honey and applecider vinegar are known to have anti-glycemic properties. However, the effectiveness of combination of these naturalproducts on reducing postprandial glycemia is uncertain. The aim of the present study was to investigate the glucoseloweringeffect of a novel mixture consisting of apple cider vinegar, garlic, ginger, lemon, and honey; alone and incombination with exercise in response to a high-carbohydrate meal in non-diabetic individuals. Ten, female subjects (meanage: 25 ± 2.67 years, mean BMI: 22.6 ± 3.5 kg/m2) participated in this randomised, cross-over intervention consisting offour trials: control (CON), mixture only (MIX), exercise only (EX), and exercise + mixture (EX-MIX). All trials involvedconsumption of a high-carbohydrate breakfast, then followed by rest in CON, consumption of natural product mixturein MIX, brisk-walking exercise in EX, and combination of mixture and exercise in EX-MIX. Blood glucose was measuredat fasting, and at 30, 60, 90, 120 minutes post meal. Postprandial glucose response was calculated as area under theglucose curve. Two-way repeated measures ANOVA showed a significant group and time interaction (p < 0.001). Comparedto CON, postprandial glucose responses were 8%, 13% and 15% lower in MIX (p = 0.049), EX (p = 0.001) and EX-MIX(p = 0.005) respectively. Postprandial glucose was 8% lower in EX-MIX compared to MIX (p = 0.002). In conclusion,consuming natural product mixture containing garlic, ginger, lemon, honey and apple cider vinegar reduced postprandialglycemia to a certain extent, however, combining mixture with exercise produced a greater attenuation effect comparedto consuming mixture alone. This finding is indicative of a potential benefit of the novel mixture as a complementarymanagement of hyperglycemia in high-risk individual

Diabetes is often associated with dysfunction in activities of daily living (ADL), especially among older adults.Hospitalisation of older adults is often followed by decline in functional status affecting their quality of life and well-beingafter discharge. The objective of this study was to determine the functional independence in carrying out basic activitiesof daily living, its relationship with quality of life, and the factors influencing the quality of life in hospitalised olderadults with diabetes. This cross sectional study was carried out on 104 diabetic patients (mean age: 67.5 ± 9.2 years) whowere receiving in-patient treatment. Face-to-face interviews were carried out to determine functional independence usingModified Barthel Index (MBI) as well as quality of life using the World Health Organization’s Quality of Life instrument(WHOQOL-BREF). Results showed that only 37.5% (n = 39) respondents were catergorised as being fully-independent.Among the domains in MBI, using the stairs recorded the lowest score followed by mobility. The physical domain in qualityof life also recorded the lowest score compared to other domains of quality of life. There were significant (p < 0.05),positive correlations between the overall MBI scores and all domains of quality of life; physical (rs = 0.70), psychology(rs = 0.50), social (rs = 0.33) and environmental (rs = 0.25). Hierachical multiple regression analysis showed MBI scoreshad significant influence on all domains of quality of life, with the largest influence on the physical domain i.e. 36% [F(1,92) = 82.14, p < 0.01, R2 = .36]. As a conclusion, hospitalisation reduces the functional independence in carrying outbasic activities of daily living as well as the physical aspect of quality life in older adults with diabetes. Therefore, it isimportant to provide rehabilitation in activities of daily living while the elderly diabetics while undergoing in-patienttreatment in order to maintain quality of life after discharge.

Introduction: High-intensity interval training (HIIT) has been found to improve cardiometabolic health outcome as compared to moderate-intensity continuous exercise. However, there is still limited data on the benefits of HIIT on the expression of regulatory proteins that are linked to skeletal muscle metabolism and insulin sensitivity in obese adults. This study investigated the effects of HIIT intervention on expressions of peroxisome proliferatoractivated receptor-γ coactivator 1-α (PGC-1α) and adiponectin receptor-1 (AdipoR1), insulin sensitivity (HOMAIR index), and body composition in overweight/obese individuals. Methods: Fifty overweight/obese individuals aged 22-29 years were assigned to either no-exercise control (n=25) or HIIT (n=25) group. The HIIT group underwent a 12-week intervention, three days/week, with intensity of 65-80% of age-based maximum heart rate. Anthropometric measurements, homeostatic model of insulin resistance (HOMA-IR) and gene expression analysis were conducted at baseline and post intervention. Results: Significant time-by-group interactions (p<0.001) were found for body weight, BMI, waist circumference and body fat percentage. The HIIT group had lower body weight (2.3%, p<0.001), BMI (2.7%, p<0.001), waist circumference (2.4%, p<0.001) and body fat percentage (4.3%, p<0.001) post intervention. Compared to baseline, expressions of PGC-1α and AdipoR1 were increased by approximately three-fold (p=0.019) and two-fold (p=0.003) respectively, along with improved insulin sensitivity (33%, p=0.019) in the HIIT group. Conclusion: Findings suggest that HIIT possibly improved insulin sensitivity through modulation of PGC-1α and AdipoR1. This study also showed that improved metabolic responses can occur despite modest reduction in body weight in overweight/obese individuals undergoing HIIT intervention.