This study assessed the feasibility and initial outcomes of an innovative group exercise-based social intervention (So Fit) on the social functioning, ASD-features, and physical performance of autistic children, ages 7-12 years (N = 28). The So Fit manualized intervention (prescribed content and instructional procedures) was delivered to groups of 8-11 autistic children, and it consisted of two 60-minute sessions per week over 10 weeks. Each session included a skills instruction component targeting social and physical performance skills (10-15 min) followed by an exercise-based activity (45-50 min) to promote social interactions, practice social skills, and receive feedback. A behavioral reinforcement system was also implemented to foster skills development and improve ASD-features. Lastly, parents participated in three psychoeducational parent training groups on the program, and strategies for teaching, reinforcing, and generalizing skills/behaviors outside the program setting. Fidelity was high, parent and child satisfaction were good, and there were no adverse events/injuries or withdrawals supporting feasibility. Preposttest comparisons indicated significant improvements in parent-rated social skills and ASDfeatures, and on objective observations/tests of child social performance, social knowledge, and physical performance. Additional testing of So Fit in a randomized trial appears warranted and recommendations are provided.

PURPOSE: This study assessed the feasibility and effectiveness of a 10-wk high intensity exercise program offered after-school for children with autism spectrum disorder (ASD) without intellectual disability. METHODS: Children with ASD (n = 11, M age: 9.53 ± 2.1 yr) engaged in a 1 hr after-school high intensity functional training exercise session, 2 d/wk for 10 wks that targeted social skills, ASD symptoms, and physical performance. Each group exercise session included an instruction period, warm-up, high intensity workout, related game, and cool-down. Social skill and symptom outcome measures included the Adapted Skillstreaming Checklist (ASC) and Social Responsiveness Scale 2nd Edition, School Age Form (SRS-2). Physical performance data (i.e., strength, flexibility, PACER aerobic fitness, power) were also collected. Paired t-tests were used to assess pre to post program performance differences. Participant and parent/guardian satisfaction surveys (7-point Likert scale) were administered following completion of the program. RESULTS: Feasibility and safety were supported in high levels of fidelity (96%), participant and parental satisfaction (4.66, 6.53 out of 7, respectively), and attendance (90% of all sessions), and there were no adverse events or injuries. Pre-post comparisons indicated significant improvements and large effects in social skills (ASC = 87.5 to 118.73; d = 1.95) and ASD symptoms (SRS-2 = 83.6 to 71.36; d = .98) and medium-to-large effects on tests of physical performance (PACER [6.9 to 9.9 laps; d = .86], 60 sec max sit-ups [13.3 to 23.5 reps, d = .58], 60 sec max body weight squats [19.5 to 29.6; d = .61]). CONCLUSION: This after-school high intensity exercise program for children with ASD without intellectual disability was feasible (high fidelity, satisfaction) and improved social functioning, ASD symptoms and physical performance.

The Social Competence Observation Scale (SCOS) is an objective observational measure developed to assess the social performance of children with autism spectrum disorder (ASD). This paper describes development of the SCOS and results of initial testing of reliability and treatment sensitivity for a sample of 12 children, ages 4–6 years, with ASD. Based on observations, the measure can yield three scores including a social impairment severity, change, and responder status score. Results suggested good-to-excellent reliability (inter-observer agreement and test–retest) and the SCOS was treatment sensitive to changes resulting from the intervention (at the social impairment severity score, change score, and responder status levels). Lastly, the effect size based on the SCOS social impairment severity score improvements (baseline-to-post-treatment) for the coders was large and was comparable to parent ratings on a standardized measure of ASD social impairment symptom severity. Implications and suggestions for future study are discussed.

Yoga is a common exercise modality, ranking in the top 20 fitness trends for the last decade. Recent research has suggested that participating in yoga may provide supplemental benefits to muscular strength, when partnered with resistance training, in young adults. However, previous research has methodological limitations that impact the ability to properly understand the effects of yoga on muscular strength. PURPOSE: To determine the effects of a 6-week Hatha yoga intervention on total body muscular strength in healthy, resistance-trained, young adults. METHODS: Resistance-trained adults (n = 18); age: 23.1 ± 2.0 y; 61% females) were randomized to either the yoga intervention (n = 10) or control group (n = 8). The yoga intervention involved 18 Hatha yoga sessions over 6 weeks, while the control group maintained normal activities. Both groups continued their resistance training programs. Muscular strength was assessed pre- and post-intervention using 1-RM for bench press, deadlift, and squat using standard procedures. Data were analyzed using a 2 (time) x 2 (group) repeated measures ANCOVA, controlling for sex, with an alpha level set at 0.05. RESULTS: There was a significant difference in bench press 1-RM due to time (p < 0.001) with an increase in 1-RM following the intervention (pre: 55.4 ± 9.9 kg vs. post: 59.2 ± 10.0 kg). Deadlift 1-RM also increased across the intervention (pre: 96.7 ± 19.0 kg vs. post: 103.0 ± 18.1 kg; p = 0.04). There were no differences in 1-RM for bench press (p = 0.08) or deadlift (p = 0.29) between the two groups. There was a significant increase in squat 1-RM across time (pre: 79.5 ± 15.2 kg vs. post: 86.3 ± 15.4 kg; p < 0.001). Further, the yoga group had a significantly higher squat 1-RM (90.8 ± 15.0 kg) compared to the control group (75.0 ± 15.0 kg; p = 0.04). CONCLUSIONS: A 6-week Hatha yoga intervention does not improve deadlift and bench press 1-RM differently than resistance training alone. However, yoga may provide beneficial improvements to the 1-RM for squat in resistance-trained, young adults. Future research would be beneficial to investigate alternate forms of yoga on muscular strength such as Vinyasa yoga. Research should also aim to determine whether supplementing resistance training with yoga is beneficial in other populations such as older individuals and those with musculoskeletal disorders.

OBJECTIVES:The present research used a continuous measurement approach to extend the evidence that autism is associated with significant struggles in physical health as well as mental health and psychological well-being.METHODS:The relationship of autism characteristics to physical health and psychological well-being was examined in 294 individuals (M age = 70.51, SD age = 8.17, age range = 53-96). The sample is 57.4% female (n = 166) and primarily White (n = 270, 96.8%). The majority of the participants did not identify as having an autism diagnosis (n = 284, 96.6%). Participants completed the Autism-Spectrum Quotient Scale alongside self-report measures of physical health, mental health, and psychological well-being.RESULTS:Autism characteristics correlated strongly with challenges in social engagement due to poor health (r = 0.46), depression (r = 0.39) and anxiety (r = 0.47), limitations due to poor mental health (r = 0.41), satisfaction with life (r = -0.47), and psychological well-being (r = -0.62).DISCUSSION:These findings help shed light on the challenges experienced by individuals aging with elevated autism characteristics. The limitations of this study and prior work on this topic help identify important avenues for future research in this area.

This study examined the psychometric characteristics of the Cambridge-Mindreading Face-Voice Battery for Children (CAM-C) for a sample of 333 children, ages 6–12 years with ASD (with no intellectual disability). Internal consistency was very good for the Total score (0.81 for both Faces and Voices) and respectable for the Complex emotions score (0.72 for Faces and 0.74 for Voices); however, internal consistency was lower for Simple emotions (0.65 for Faces and 0.61 for Voices). Test–retest reliability at 18 and 36 weeks was very good for the faces and voices total (0.76–0.81) and good for simple and complex faces and voices (0.53–0.75). Significant correlations were found between CAM-C Faces and scores on another measure of face-emotion recognition (Diagnostic Analysis of Nonverbal Accuracy-Second Edition), and between Faces and Voices scores and child age, IQ (except perceptual IQ and Simple Voice emotions), and language ability. Parent-reported ASD symptom severity and the Emotion Recognition scale on the SRS-2 were not related to CAM-C scores. Suggestions for future studies and further development of the CAM-C are provided. Facial and vocal emotion recognition are important for social interaction and have been identified as a challenge for individuals with autism spectrum disorder. Emotion recognition is an area frequently targeted by interventions. This study evaluated a measure of emotion recognition (the CAM-C) for its consistency and validity in a large sample of children with autism. The study found the CAM-C showed many strengths needed to accurately measure the change in emotion recognition during intervention.

Background: The historical focus on autism as a childhood disorder means that evidence regarding autism in adulthood lags significantly behind research in other age groups. Emerging studies on the relationship of age with autism characteristics do not target older adult samples, which presents a barrier to studying the important variability that exists in life span developmental research. This study aims to further our understanding of the relationship between the Autism-Spectrum Quotient Scale and age in a large adult sample. Methods: The present study examines the relationship of Autism-Spectrum Quotient Scale (AQ) scores with age in 1139 adults, ages 18-97 years. Participants came from three distinct samples-a sample of primarily students, a sample of MTurk participants, and a sample of primarily community dwelling older adults. The majority of the participants did not self-report an autism diagnosis (91%), were female (67%), and identified as White (81%). Participants completed the AQ primarily via online surveys. Researchers scored the AQ following six common scoring practices. Results: Results of preregistered analyses indicate that autism characteristics measured by the AQ are not strongly associated with age (r values from -0.01 to -0.11). Further findings indicate that the measurement of autism characteristics is consistent across age into late life using both multiple groups and local structural equation modeling approaches to measurement invariance (comparative fit indices = 0.82-0.83, root mean square error = 0.06) as well as reliability analysis. Finally, demographic and autism-related variables (sex, race, self-identified autism spectrum disorder diagnosis, and degree of autism characteristics) did not moderate the relationship between age and autism characteristics. Conclusion: These results suggest that self-reports of autism characteristics using the AQ do not vary strongly by age in this large age-representative sample. Findings suggest that the AQ can potentially serve as a useful tool for future research on autism across the life span. Important limitations on what we can learn from these findings point toward critical avenues for future research in this area. Lay summary Why was this study done?: Self-report questionnaires of autism characteristics are a potentially important resource for studying autism in adulthood. This study sought to provide additional information about one of the most commonly used self-report questionnaires, the Autism-Spectrum Quotient Scale (AQ), across adulthood.What was the purpose of this study?: This study intended to determine if there is a relationship between scores on the AQ and age. Researchers also worked to identify which of the multiple different ways of scoring the AQ worked best across adulthood.What did the researchers do?: Researchers collected data from over a thousand participants aged 18-97 years. Participants from three different age groups completed online surveys to self-report their levels of autism characteristics on the AQ. Researchers tested the relationship between AQ scores and age with six different commonly used ways to calculate AQ scores. Researchers used multiple statistical techniques to evaluate various measurement properties of the AQ.What were the results of the study?: The results indicate that autism characteristics measured by the AQ are not strongly associated with age. Along with that, there is evidence that certain approaches to measuring of autism characteristics are consistent across age into late life and do not vary with demographic and autism-related factors.What do these findings add to what was already known?: These results add to the growing evidence that self-reports of autism characteristics using the AQ in general samples are not strongly associated with age across adulthood. These findings also provide guidance about ways of scoring the AQ that work well through late life.What are potential weaknesses in the study?: While the AQ has a degree of relationship with autism diagnoses, this is far from perfect and has not been evaluated in the context of aging research. Therefore, findings from the present research must be carefully interpreted to be about autism characteristics not diagnoses. The sample was also limited in a number of other ways. As in any studies including a broad age range of individuals, the oldest participants are likely quite healthy, engaged individuals. This may particularly be the case given the higher mortality rates and health challenges seen with autism. Similarly, as with any self-report research, this research is limited to those individuals who could answer questions about their autism characteristics. The sample was also predominantly White and nonautistic. Finally, the research was limited to one point in time and so cannot tell us about how autism characteristics may change across adulthood.How will these findings help autistic adults now or in the future?: These findings support the potential for the AQ to be a useful tool for future research on autism in adulthood. For example, researchers can use measures such as the AQ to study how autism characteristics change over time or are associated with aging-related issues such as changes in physical health and memory. Such research may be able to provide a better understanding of how to support autistic individuals across adulthood.

Abstract Kozlowski, KF, Ferrentino-DePriest, A, and Cerny, F. Effects of energy gel ingestion on blood glucose, lactate, and performance measures during prolonged cycling. J Strength Cond Res 35(11): 3111–3119, 2021—Endurance athletes have long used carbohydrate supplementation during prolonged exercise (most recently with energy gels) to enhance performance. The purpose of this study was to determine the effect of carbohydrate energy gel ingestion schedules (e.g., manufacturer's recommendations vs. a more frequent ingestion schedule) during 2 hours of steady-state cycling exercise on (a) blood glucose, (b) blood lactate, and (c) performance of a subsequent 15-minute time trial (TT). Ten trained cyclists (5 men and 5 women, mean age = 28.4 ± 3.66 years; body mass = 68.9 ± 10.63 kg; and V̇o2max = 54.57 ± 9.45 mlO2·kg−1·min−1) performed 3 exercise trials in a randomized order. One gel was ingested 15 minutes before exercise during all trials. The 3 experimental trials included gel ingestion every 30 minutes (T1), every 45 minutes (T2) during exercise, and no gel ingested during exercise (T3). Subjects cycled at 70% of V̇o2max for 2 hours, followed by a 15-minute fixed gear TT. The blood glucose level at 60 minutes of exercise was higher during T1 (125.5 ± 30.96 mg·dl−1) and T2 (127.6 ± 14.82 mg·dl−1) compared with T3 (102.8 ± 15.85 mg·dl−1). Time trial distance was significantly greater for T1 (7.56 ± 0.77 km) and T2 (7.16 ± 0.92 km) than T3 (6.69 ± 0.74 km) (p = 0.003) with moderate to strong effect sizes between trials. There were no differences in blood lactate concentrations across trials. Ingestion of energy gels during prolonged cycling elevates blood glucose levels and enhances subsequent performance, whereas a more frequent ingestion elicits additional performance benefits.

ABSTRACT Purpose: Children with autism spectrum disorder (ASD) without intellectual disability (ID) exhibit social and motor impairments and circumscribed interests/behaviors that contribute to lower physical activity (PA) levels. Despite the need for exercise interventions for these children, there is a dearth of evidence-based treatments. This study tested the feasibility of a high-intensity exercise program for children with ASD without ID, and associated changes in physical performance. Method: Fifty-eight children, ages 7–12 with ASD without ID participated. The intervention (5 weeks, 19 sessions, 60 mins ea.) was conducted during the summer. Each session was manualized (operationalized instructional procedure and curriculum) and targeted components of fitness and motor performance using skill development exercises, workouts, and game-related activities. Feasibility was assessed via fidelity (implementation accuracy), satisfaction surveys, attrition, and injuries. Physical performance was tested at baseline and posttest using measures of work production (completed rounds of an exercise circuit) and within-session activity levels (time in moderate-to-vigorous PA), and six exercise tests (sit and reach, push-ups, sit-ups, air squats, long jump, and PACER). Results: Results indicated high levels of fidelity (93.7%) and child and staff satisfaction, and no attrition or injuries, supporting the feasibility, tolerability, and safety of the protocol. Significant increases were found in work production and activity levels (ds 0.83 and 1.05, respectively) and on three exercise tests (sit ups, air squats, and long jump; ds 0.29–0.37). Conclusion: The exercise program was feasible and safe, and completion was associated with significant improvements in multiple areas of performance; a randomized controlled trial appears warranted.

Valid and reliable assessments are difficult to administer in PK–12 physical education due to a lack of resources. In this article, we discuss a collaborative model that may mutually benefit students in both the PK–12 and higher education settings. We detail a process with related materials and procedures that should be present for a best-practices model of collaboration used in fitness testing of students in grades PK–12.

Since its development in 2010, the Common Core State Standards (CCSS) have been adopted in over 40 states. While the literature discussing the implications of this initiative is robust, the research examining its effect on K–12 physical education (PE) is limited. Moreover, there is little empirical data on the effect of the CCSS on student physical activity (PA) rates in PE. Thus, this study examined the effect of CCSS instructional integration into PE lessons on PA rates of sixthgrade students and on student and teacher perceptions in a public K–12 school. This study utilized a one-group within-subjects randomized design. Rates of PA were compared between PE classes that integrated the CCSS (i.e., CC+) and PE classes that did not integrate the CCSS (i.e., CC-). Student and teacher perceptions of the lessons were also studied. In addition, the feasibility (i.e., acceptability) of the use of an objective measure of PA intensity (accelerometer) was assessed. A linear mixed model analysis of percentage of time in moderate-to-vigorous PA (MVPA) produced a significant effect for condition, CC+ M = 19.7%, SD = 7.0; CC- M = 33.1%, SD = 10.4, F(1, 24) = 182.82, p < .001, d = 1.46, 95% CI [.88, 2.41]. The mixed-model analysis of total steps per minute also produced a significant difference by condition, CC+ M = 20.99, SD = 9.46; CC- M = 32.76, SD = 9.46, F(1, 21) = 133.45, p < .001, d = 1.48, 95% CI [.90, 2.15]. Linear mixed-model analysis of student and teacher perceptions showed no significant differences on any of the six items, indicating general agreement. Intraclass correlations of the student and teacher reports were 0.70 for the CC- items and 0.68 for the CC+ items, again demonstrating general agreement between students and the teacher. Students reported that the accelerometer was “easy to wear” (4.05 out of 5.0); the teacher report was slightly higher (4.83 out of 5.0). Large effect sizes on both PA dependent measures suggest that CCSS integration tasks may have a significant negative effect on PA levels. Student and teacher reports did not differ between CC+ and CC- lessons on a number of lesson attributes and also suggest that the use of accelerometers to measure PA is acceptable. More research needs to explore whether these results generalize to other settings, teachers, students, and activities and examine the overall effect of the CCSS on fitness across the school year. In addition, future research should examine whether certain types of CCSS integration tasks may be more successful with sustaining MVPA.Subscribe to TPE

PURPOSE: This study assessed the effectiveness of a five-week high intensity exercise program offered over two years for high-functioning children with autism spectrum disorder (HFASD). METHODS: Children with HFASD (n=56, M age: 10.22 ± 1.5 yr) engaged in a 1 hr exercise session, 4 d/wk for 5 weeks. Each session included an instruction period, warm-up, high intensity workout, related game, and cool-down to be completed in either an individual (I) or cooperative (CO) format. Child satisfaction surveys (7-pt. Likert) assessed perceived enjoyment, level of support, physical benefits, etc. Staff satisfaction surveys assessed their enjoyment of running the session(s), and clarity and utility of the training. Fidelity of implementation (accuracy) was assessed in 64.9% of all sessions. Biometric (i.e., height, weight, waist circumference, BMI) and physical performance data (i.e., strength, flexibility, aerobic fitness, power, physical activity intensity) were also collected. Paired t-tests were used to assess pre to post program performance differences. RESULTS: Results indicated that the program was implemented accurately (94%). Satisfaction ratings indicated that the overall feeling about the program was very positive from both the participants (M: 6.4) and staff (n=14, M: 6.93). There was no difference in post-satisfaction ratings between the I and CO formats (I M = 5.81, CO M = 5.45, p =.30). Pre-posttest comparisons yielded statistically significant improvements in sit-ups in 60 sec (M Δ = 3.5 reps, 95%CI = 1.41, 5.59), squats in 60 sec (M Δ = 4.4 reps, 95%CI = 1.67, 7.15), and standing long jump (M Δ = 4.0 in., 95%CI = .79, 7.21). Additionally, the rounds completed on repeated parallel workouts improved significantly (M Δ = 2.3, 95%CI = 1.49, 3.07). Significant improvements in percentage of time in moderate-vigorous activity were observed in both the I and CO exercise formats (I M Δ=4.1%, 95%CI = 3.19, 5.06; CO M Δ = 1.9%, 95%CI =.59, 3.24). The I format produced significantly greater improvement in activity level (% time) than the CO format across the 5-weeks (M Δ = 2.22%, 95%CI =.63, 3.81). There were no significant changes in biometric measures. CONCLUSION: A high intensity exercise program for children with HFASD is feasible (high fidelity, satisfaction) and improves physical performance.

Chronic disease accounts for the majority of deaths in the United States and is often attributed to obesity. A sedentary lifestyle and poor nutrition are primary contributing factors to the development of obesity and thus chronic disease. Primary care providers are optimally positioned to prescribe exercise and nutrition (lifestyle medicine) as a treatment for chronic disease. Unfortunately, this opportunity seems to be regularly lost. Primary care providers often rely too heavily on weight loss pharmaceuticals and bariatric surgeries to treat obesity. This treatment approach however also does little to prevent and treat the accumulation of chronic diseases. The purpose of this review was to evaluate the efficacy of conventional medical weight loss treatments and determine why primary care providers may not prescribe exercise and nutrition more frequently. Our findings suggest that some primary care providers may be uncomfortable prescribing lifestyle medicine as they receive little formal education in this field. In conclusion, prescription of exercise and nutrition by primary care providers may elicit greater long-term weight loss than current medical weight management practices. Medical management is most likely effective when combined with lifestyle medicine. We propose that primary care providers be better trained in lifestyle medicine through their formal and clinical education. Rates of chronic disease accumulation may potentially decrease if providers prescribe lifestyle medical treatments more frequently.

Latent growth modeling replicates and extends prior findings from the four cohort Rochester Adult Longitudinal Study (RALS) using a new, fifth wave of data (N = 239 – 647). Specifically, Eriksonian psychosocial concerns generally show a slow, steady increase throughout adulthood with some variability in these trajectories by concern and individuals. Further, gender, cohort, and life history variables including educational attainment, occupational prestige, commitment to a long-term relationship, and parenthood status are tested as potential moderators of trajectories in Eriksonian psychosocial concerns. Finally, variability in trajectories of growth in Eriksonian psychosocial concerns is associated with to physical health, medical conditions, and psychological well-being.

PURPOSE: Physical activity (PA) has been shown to reduce symptoms of depression and anxiety in various populations. This study was conducted to compare PA levels between children with autism spectrum disorder (ASD) and typically developing children (TD) and to determine whether a relationship exists between PA and depression or anxiety in children with ASD. METHODS: 17 TD and 15 children with ASD (μ: 9.5 ± 1.8 yrs) wore triaxial accelerometers to assess PA across 6 consecutive days except during sleep and water activities. Cut points were assessed for sedentary, light, moderate, and vigorous PA (Evenson, 2008). Moderate and vigorous counts were then combined (MVPA). Each child’s parents completed ratings on their child’s ASD symptom expression and the degree of depression and anxiety symptoms their child exhibited via the Behavior Assessment System for Children, 2nd Ed. (BASC-2). Independent t-tests were used for group differences and Pearson’s correlations were used to identify relationships between variables. RESULTS: TD children recorded a significantly greater average daily wear time than ASD children (791.4 vs. 723.9 min. respectively; p<0.001). There were however, no significant differences between TD and ASD participants across percentage of time spent nor average daily minutes spent in sedentary (489.6 vs. 446.8; p=0.07), light (250.6 vs. 234.1; p=0.32), moderate (35.0 vs. 28.1; p=0.08), or vigorous (16.2 vs. 14.8; p=0.67) PA nor in average total activity counts (126.6 vs. 121.97; p=0.71). Neither group reached minimal recommendations for MVPA in children. ASD participants had significantly higher BASC-2 scores for depression (57.6 ± 10.9 vs. 45.1 ± 6.9; p<0.001) but not anxiety than TD participants. Relationships between PA and BASC-2 scores were not significant in the ASD group. In the TD group, there were significant negative relationships between depression scores and average moderate PA (r=-0.656, p=0.006), vigorous PA (r=-0.656, p=0.006), MVPA (r=-0.735, p<0.001), and average total counts (r=-0.637, p=0.008). CONCLUSIONS: While PA did not differ significantly between groups, a significant negative relationship between PA and depression in TD but not ASD suggests that a greater dose of intentional PA may be required to demonstrate an effect on symptoms of depression in children with ASD.

Spirituality relates to an internal movement towards the sacred, while kinesiology is the science of physical human movement. Strong, user-friendly communication between spiritual directors and retreatants is important to the development of an individualized productive retreat experience. To better facilitate guidance, it is helpful for directors to understand the parallels between spiritual exercises and the expertise of retreatants and for retreatants to understand comparisons between their professional and spiritual lives. The physical activity of St. Ignatius during his pilgrimage across Spain exemplifies the similarities between Ignatian spirituality and the science of human movement. Comparisons between Ignatian spirituality and kinesiology include the need for practice of specific exercises, the underlying structure of the Ignatian spiritual exercises compared to a periodized physical exercise program, and the discernment or analysis of movements involved in both fields. Knowledge of the overlap between kinesiology and spirituality may result in retreatants familiar with the science of human movement and exercise developing a better understanding of their spiritual selves and ultimately a closer relationship to God.

Medical fitness programming in an exercise facility closely coordinated with a medical and physical therapy practice may be an effective means to introduce exercise to an at-risk population. PURPOSE: To assess the effectiveness of a structured exercise program on reducing risk factors in a population of at-risk patients administered at a Medically Oriented Gym (MOG) located in proximity to a primary care practice. METHODS: Participants (n=102) were a convenience sample recruited by a physician (RJ) based on existing comorbidities. Following three enrollment periods, 62 participants (30 female) completed the 12 month exercise intervention with assessments for weight, BMI, waist circumference, body composition and sub-maximal VO2 at baseline and each subsequent three months. Attendance to exercise sessions was also recorded for each quarter. RESULTS: There were no significant differences between those that completed and drop outs for any baseline measures with an overall patient compliance rate of 58.8%. In those that completed the 12 month program there were significant decreases in body weight (4.02 kg, p=0.001), BMI (1.52, p<0.001), waist circumference (4.88 cm, p<0.001) and percent body fat (1.25%, p<0.001) and a significant increase in sub-max VO2 (7.19 ml/kg/min, p<0.001). Significant changes occurred between entry and 6 months in weight, between entry and 3 months in percent body fat and between entry and both 3 and 6 months in BMI, waist circumference, and sub-max VO2. There was no significant change for any measure following the 6 month assessment. While there was no difference in MOG attendance between the first and second quarters (21.6 and 22.7 average visits respectively, p=0.4), attendance significantly dropped from the second to third quarter (18.5 visits, p<0.001) and significantly decreased further across the fourth quarter (15.48 visits, p=0.02). The loss of statistically significant improvement in clinical outcomes corresponded to the decrease in attendance after 6 months. CONCLUSION: Participation in an exercise intervention at a MOG facility can significantly reduce risk factors associated with obesity and chronic disease. This improvement is related to attendance in exercise sessions where both participation and significant improvements appear to decrease after 6 months.