December 6 - 7, 2007 Advisory Committee Meeting
Thursday, December 6, 2:45 p.m.
The meeting proceeded with a general discussion period on the
previous presentations on musculoskeletal health, functional health and adverse
Pre-Participation Physical Examinations
This issue is both important and controversial. Who should do
pre-participation exams and what should be done in the exams. There is very
little data to come to strong conclusions on the benefits of an exam; however,
there is great concern for individuals that have been inactive and suddenly
undertake a fitness program, especially in the area of sudden cardiac events.
Dose-Response Studies as Efficacy Studies
An issue surrounding a majority of the studies used in the work of the
Committee was how to interpret the results of the study if the study was truly
focused on efficacy. If a study prescribed different doses of activity to
different individuals what you are truly testing is the effectiveness of the
activity as well as how effective are people in following the recommendation.
Fracture Risk Studies Using Both Men and Women Subjects and
The results in fracture studies using both men and women subjects differed
substantially from studies that dealt with men only or women only. There are
perhaps two issues at work. One of the explanations in the differing results may
lie in the nature of the tool used to capture activity, i.e., if the same
mechanism is used for both men and women. Another factor may be the lack of a
denominator when measuring activity. What may be vigorous for one individual may
not be for another.
Other Adverse Events
The earlier report on adverse events focused on injuries and cardiovascular
events. Should other events such as decreased immune function or even simple
pain be addressed? Dr. Powell indicated pain typically is categorized with
musculoskeletal injuries. Also, with regards to decreased immune function there
did not seem to be enough literature to support any strong conclusions.
Functional Health in Other Populations
A question was raised whether functional health would be looked outside of
the relation to aging. The focus on the subcommittee was originally more
wide-open; however, with the addition of the special populations subcommittee
which will be dealing with disabilities, severely obese, etc., the Functional
Health Subcommittee will focus on older adults.