1
|
Liang YT, Wang C, Hsiao CK. Data Analytics in Physical Activity Studies With Accelerometers: Scoping Review. J Med Internet Res 2024; 26:e59497. [PMID: 39259962 PMCID: PMC11425027 DOI: 10.2196/59497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/27/2024] [Accepted: 07/16/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Monitoring free-living physical activity (PA) through wearable devices enables the real-time assessment of activity features associated with health outcomes and provision of treatment recommendations and adjustments. The conclusions of studies on PA and health depend crucially on reliable statistical analyses of digital data. Data analytics, however, are challenging due to the various metrics adopted for measuring PA, different aims of studies, and complex temporal variations within variables. The application, interpretation, and appropriateness of these analytical tools have yet to be summarized. OBJECTIVE This research aimed to review studies that used analytical methods for analyzing PA monitored by accelerometers. Specifically, this review addressed three questions: (1) What metrics are used to describe an individual's free-living daily PA? (2) What are the current analytical tools for analyzing PA data, particularly under the aims of classification, association with health outcomes, and prediction of health events? and (3) What challenges exist in the analyses, and what recommendations for future research are suggested regarding the use of statistical methods in various research tasks? METHODS This scoping review was conducted following an existing framework to map research studies by exploring the information about PA. Three databases, PubMed, IEEE Xplore, and the ACM Digital Library, were searched in February 2024 to identify related publications. Eligible articles were classification, association, or prediction studies involving human PA monitored through wearable accelerometers. RESULTS After screening 1312 articles, 428 (32.62%) eligible studies were identified and categorized into at least 1 of the following 3 thematic categories: classification (75/428, 17.5%), association (342/428, 79.9%), and prediction (32/428, 7.5%). Most articles (414/428, 96.7%) derived PA variables from 3D acceleration, rather than 1D acceleration. All eligible articles (428/428, 100%) considered PA metrics represented in the time domain, while a small fraction (16/428, 3.7%) also considered PA metrics in the frequency domain. The number of studies evaluating the influence of PA on health conditions has increased greatly. Among the studies in our review, regression-type models were the most prevalent (373/428, 87.1%). The machine learning approach for classification research is also gaining popularity (32/75, 43%). In addition to summary statistics of PA, several recent studies used tools to incorporate PA trajectories and account for temporal patterns, including longitudinal data analysis with repeated PA measurements and functional data analysis with PA as a continuum for time-varying association (68/428, 15.9%). CONCLUSIONS Summary metrics can quickly provide descriptions of the strength, frequency, and duration of individuals' overall PA. When the distribution and profile of PA need to be evaluated or detected, considering PA metrics as longitudinal or functional data can provide detailed information and improve the understanding of the role PA plays in health. Depending on the research goal, appropriate analytical tools can ensure the reliability of the scientific findings.
Collapse
Affiliation(s)
- Ya-Ting Liang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Charlotte Wang
- Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan
- Master of Public Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chuhsing Kate Hsiao
- Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan
- Master of Public Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
2
|
Hanson D, Samendinger S, McCulley E. Multidisciplinary understanding of modifiable physical disability risk factors for health professionals: A scoping review protocol. PLoS One 2024; 19:e0306438. [PMID: 38990918 PMCID: PMC11238968 DOI: 10.1371/journal.pone.0306438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 06/18/2024] [Indexed: 07/13/2024] Open
Abstract
INTRODUCTION Physical disability represents a major burden to health and lifespan, particularly as the proportion of older adults within the United States is expected to grow. Prevention efforts for physical disability targets methods and strategies to decrease modifiable risk factors. Potential challenges for health professionals may exist in synthesizing and interpreting this broad spectrum of literature due to the discipline-specific nuance of language used, practice type or specialty, and lack of interdisciplinary resources. This scoping review will map and synthesize the literature across healthcare disciplines to identify modifiable risk factors and the evidence related to their ability to predict physical disability. We will also draw attention to the possibility of modifiable risk factors for physical disability being operationalized as pre-disability in order to strengthen primary and secondary prevention efforts. METHODS A planned search strategy using physical disability terminology will be searched in English across MEDLINE, CINAHL, Health Source, PEDro, and REHABDATA by two reviewers in line with our review objectives and inclusion criteria. Eligibility for inclusion include peer-reviewed primary research published in the English language and have established a relationship between a person-level measurable characteristic that is modifiable by changes in lifestyle behaviors and any of the commonly accepted terms used to categorize or describe physical disability. EXPECTED RESULTS Presentation of results will be using the PRISMA flowchart, with additional mapping and synthesis of evidence for modifiable risk factors for physical disability to clarify divergent terms used in classifying and measuring these factors and their potential for prediction of physical disability. EXPECTED CONCLUSION It is anticipated that this scoping review will identify and highlight a variety of modifiable risk factors for physical disability that may aid primary and secondary prevention efforts for health professionals.
Collapse
Affiliation(s)
- Derek Hanson
- Nutrition Science & Wellness Department, State University of New York (SUNY)-Farmingdale, Farmingdale, NY, United States of America
| | - Stephen Samendinger
- Health Sciences Department, Drexel University, Philadelphia, PA, United States of America
| | - Edwin McCulley
- Urban Health Collaborative, Philadelphia, PA, United States of America
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States of America
| |
Collapse
|
3
|
Nie Z, Gao S, Ge S, Jiang Y, Liang W, Yang R. Low adoption of mobility device in later life: Insights from the lens of intersectionality. Geriatr Nurs 2024; 57:140-146. [PMID: 38643734 DOI: 10.1016/j.gerinurse.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 03/17/2024] [Accepted: 04/12/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES To investigate the utilization of mobility device, whether age and gender-related use disparities exist, and whether falls can further explain use disparities over time among Chinese older adults in need of devices. METHODS Community-dwelling older adults who needed mobility devices and completed four waves of the China Health and Retirement Survey 2011-2018 were included (N = 1,302). A categorical variable was created to represent respondents' intersectionality of age (50-64, 65-74, and ≥75 years) and gender (men vs. women). RESULTS The baseline prevalence of device use was 18.2 % (n = 237). Overall, the device use increased over time. Intersectionality-wise, oldest-old women were 1.53 times more likely than youngest-old men to use devices over time. Respondents with falls were more likely to use devices over time. CONCLUSIONS Older adults with mobility impairment, especially the oldest-old women and those with falls, lag in mobility devices utilization, suggesting future tailored interventions to support these populations.
Collapse
Affiliation(s)
- Zuoting Nie
- Nanjing Medical University School of Nursing, Nanjing, Jiangsu 211166, China
| | - Shiying Gao
- Nanjing Medical University School of Nursing, Nanjing, Jiangsu 211166, China
| | - Song Ge
- Department of Natural Sciences, University of Houston-Downtown, Houston 77002, USA
| | - Yun Jiang
- University of Michigan School of Nursing, Ann Arbor, Michigan, 48109, USA
| | - Wei Liang
- Nanjing Medical University School of Nursing, Nanjing, Jiangsu 211166, China
| | - Rumei Yang
- Nanjing Medical University School of Nursing, Nanjing, Jiangsu 211166, China.
| |
Collapse
|
4
|
Huynh TLT, Barstow EA, Motl RW. Feasibility of a theory-based physical activity intervention for persons newly diagnosed with multiple sclerosis. Mult Scler Relat Disord 2024; 83:105446. [PMID: 38262331 DOI: 10.1016/j.msard.2024.105446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/26/2023] [Accepted: 01/13/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Physical activity (PA) is beneficial for rehabilitation and symptom management in multiple sclerosis (MS), yet persons newly diagnosed with MS are insufficiently active and have not been the focus of PA research. This is important as early initiation of lifestyle PA, alongside other disease modifying therapies, might maximize the lasting benefits of this behavior on health outcomes and health-related quality of life (HRQOL) in MS. PURPOSE This single group, pre-post study examined the feasibility and initial efficacy of a 12-week remotely delivered COM-B-based behavior change intervention targeting lifestyle PA in persons newly diagnosed with MS. METHODS Persons newly diagnosed with MS (diagnosis of 2 years or less) were recruited for the study. The intervention was designed based on COM-B and formative research, and included a program manual, newsletters, video coaching calls, pedometer, logbook, and calendar. Feasibility was assessed in four domains: process (e.g., recruitment, retention), resource (e.g., time and costs), management (e.g., data management), and scientific evidence (e.g., safety, treatment effects). RESULTS Thirty-two persons newly diagnosed with MS underwent screening, 17 were eligible, and 14 started the intervention. Twelve participants completed the study (86 % retention rate). All participants in the intervention engaged in 100 % of video coaching calls and participants provided 73 % of online step count entries. Eighty-three percent of participants fully complied with reviewing the newsletters. No relapses were reported during the intervention. There were moderate-to-large increases in PA outcomes, as measured by the Godin Leisure-Time Exercise Questionnaire, International Physical Activity Questionnaire, and accelerometry (light PA) (d ≥ 0.5). There were no significant changes in other accelerometry outcomes, including step counts and moderate-to-vigorous PA (d = 0.2). There were large, positive effects of the intervention on physical and mental health-related quality of life with (d ≥ 1), but the change in fatigue severity was small and not statistically significant among the study participants (d = 0.3). CONCLUSIONS This study provides evidence for feasibility and initial efficacy of a COM-B-based PA intervention for persons newly diagnosed with MS. The results indicate that this intervention was feasible, safe, acceptable, and promising for promoting lifestyle PA in persons newly diagnosed with MS.
Collapse
Affiliation(s)
- Trinh L T Huynh
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA.
| | - Elizabeth A Barstow
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA
| |
Collapse
|
5
|
Blodgett JM, Ahmadi MN, Atkin AJ, Chastin S, Chan HW, Suorsa K, Bakker EA, Hettiarcachchi P, Johansson PJ, Sherar LB, Rangul V, Pulsford RM, Mishra G, Eijsvogels TMH, Stenholm S, Hughes AD, Teixeira-Pinto AM, Ekelund U, Lee IM, Holtermann A, Koster A, Stamatakis E, Hamer M. Device-measured physical activity and cardiometabolic health: the Prospective Physical Activity, Sitting, and Sleep (ProPASS) consortium. Eur Heart J 2024; 45:458-471. [PMID: 37950859 PMCID: PMC10849343 DOI: 10.1093/eurheartj/ehad717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/06/2023] [Accepted: 10/10/2023] [Indexed: 11/13/2023] Open
Abstract
BACKGROUND AND AIMS Physical inactivity, sedentary behaviour (SB), and inadequate sleep are key behavioural risk factors of cardiometabolic diseases. Each behaviour is mainly considered in isolation, despite clear behavioural and biological interdependencies. The aim of this study was to investigate associations of five-part movement compositions with adiposity and cardiometabolic biomarkers. METHODS Cross-sectional data from six studies (n = 15 253 participants; five countries) from the Prospective Physical Activity, Sitting and Sleep consortium were analysed. Device-measured time spent in sleep, SB, standing, light-intensity physical activity (LIPA), and moderate-vigorous physical activity (MVPA) made up the composition. Outcomes included body mass index (BMI), waist circumference, HDL cholesterol, total:HDL cholesterol ratio, triglycerides, and glycated haemoglobin (HbA1c). Compositional linear regression examined associations between compositions and outcomes, including modelling time reallocation between behaviours. RESULTS The average daily composition of the sample (age: 53.7 ± 9.7 years; 54.7% female) was 7.7 h sleeping, 10.4 h sedentary, 3.1 h standing, 1.5 h LIPA, and 1.3 h MVPA. A greater MVPA proportion and smaller SB proportion were associated with better outcomes. Reallocating time from SB, standing, LIPA, or sleep into MVPA resulted in better scores across all outcomes. For example, replacing 30 min of SB, sleep, standing, or LIPA with MVPA was associated with -0.63 (95% confidence interval -0.48, -0.79), -0.43 (-0.25, -0.59), -0.40 (-0.25, -0.56), and -0.15 (0.05, -0.34) kg/m2 lower BMI, respectively. Greater relative standing time was beneficial, whereas sleep had a detrimental association when replacing LIPA/MVPA and positive association when replacing SB. The minimal displacement of any behaviour into MVPA for improved cardiometabolic health ranged from 3.8 (HbA1c) to 12.7 (triglycerides) min/day. CONCLUSIONS Compositional data analyses revealed a distinct hierarchy of behaviours. Moderate-vigorous physical activity demonstrated the strongest, most time-efficient protective associations with cardiometabolic outcomes. Theoretical benefits from reallocating SB into sleep, standing, or LIPA required substantial changes in daily activity.
Collapse
Affiliation(s)
- Joanna M Blodgett
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Sciences, University College London, London , UK
| | - Matthew N Ahmadi
- Mackenzie Wearables Research Hub, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Andrew J Atkin
- School of Health Sciences and Norwich Epidemiology Centre, University of East Anglia, Norwich, UK
| | - Sebastien Chastin
- School of Health and Life Science Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Hsiu-Wen Chan
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Kristin Suorsa
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Esmee A Bakker
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Department of Medical BioSciences, Exercise Physiology ResearchGroup, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Pasan Hettiarcachchi
- Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Sweden
| | - Peter J Johansson
- Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Sweden
- Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - Vegar Rangul
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Norway
| | | | - Gita Mishra
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Thijs M H Eijsvogels
- Department of Medical BioSciences, Exercise Physiology ResearchGroup, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sari Stenholm
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Research Services, Turku University Hospital and University of Turku, Finland
| | - Alun D Hughes
- MRC Unit for Lifelong Health and Ageing, UCL Institute of Cardiovascular Science, UCL, UK
- UCL BHF Research Accelerator, University College London, London, UK
- University College London Hospitals NIHR Biomedical Research Centre, London, UK
| | | | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Departmentof Chronic Diseases, Norwegian Public Health Institute, Oslo, Norway
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Annemarie Koster
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Emmanuel Stamatakis
- Mackenzie Wearables Research Hub, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Mark Hamer
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Sciences, University College London, London , UK
- University College London Hospitals NIHR Biomedical Research Centre, London, UK
| |
Collapse
|
6
|
Li T, Zong G, Peng P, Wang S, Cheng B. Accelerometer-measured physical activity and sample-based frailty in older women: does pattern really matter? Front Public Health 2024; 11:1304279. [PMID: 38332942 PMCID: PMC10850322 DOI: 10.3389/fpubh.2023.1304279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/29/2023] [Indexed: 02/10/2024] Open
Abstract
Background The relationship between the patterns of physical activity (PA) and frailty, including its various subdomains, remains poorly understood. Therefore, this study aims to investigate the correlations between the patterns of physical activity and frailty and its various subdomains in community-dwelling older women. Methods A cross-sectional study investigated the association between physical activity and frailty in 1,099 women aged between 60 to 70 years. Triaxial accelerometers were used to measure bouted PA (a minimum duration of 10 min) and sporadic PA (a duration of <10 min). Fried's frailty phenotype was utilized to evaluate the status of frailty. Data were analyzed using logistic regression and the receiver operating characteristic (ROC) curve. Results Bouted moderate-to-vigorous PA (MVPA) and sporadic MVPA were associated with decreased odds of being prefrail and frail, and the optimal cutoff values were 6 and 19.7 for the prefrail stage and 6.6 and 19.4 min/day for the frail stage, respectively. Bouted light PA (LPA) was associated with decreased odds of being prefrail, and the optimal cutoff value was 170.2 min/day. Additionally, bouted and sporadic MVPA were associated with decreased odds of being slow and their optimal cutoff values were 5 and 19.1 min/day, respectively. Sporadic MVPA was associated with decreased odds of exhaustion, and the cutoff was 19.7 min/day. Bouted MVPA and LPA were associated with decreased odds of having low PA, and the cutoff values were 4.4 and 163.2 min/day, respectively. Conclusion Any MVPA, regardless of bout duration, could be used as a suitable PA program to improve and prevent frailty in older women, such as bouted MVPA (4-5 times/week) or sporadic MVPA (20 min/day). The improvement effect of bouted and sporadic MVPA on the frailty of older people may not be affected by the subdomain. Additionally, bouted LPA was suitable for the management of prefrailty.
Collapse
Affiliation(s)
- Ting Li
- School of Physical Education, Shandong University, Jinan, China
| | | | - Pan Peng
- Ezhou High School, Ezhou, Hubei, China
| | - Shiqiang Wang
- College of Physical Education, Hunan University of Technology, Zhuzhou, China
- Hunan Key Laboratory of Physical Health and Sports Fitness, Zhuzhou, China
- Hunan Research Centre in Physical Fitness, Health, and Performance Excellence, Hunan University of Technology, Hunan, China
| | - Bin Cheng
- School of Physical Education, Shandong University, Jinan, China
| |
Collapse
|
7
|
Zou J, Lin T, Di C, Bellettiere J, Jankowska MM, Hartman SJ, Sears DD, LaCroix AZ, Rock CL, Natarajan L. A RIEMANN MANIFOLD MODEL FRAMEWORK FOR LONGITUDINAL CHANGES IN PHYSICAL ACTIVITY PATTERNS. Ann Appl Stat 2023; 17:3216-3240. [PMID: 38835721 PMCID: PMC11149895 DOI: 10.1214/23-aoas1758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Physical activity (PA) is significantly associated with many health outcomes. The wide usage of wearable accelerometer-based activity trackers in recent years has provided a unique opportunity for in-depth research on PA and its relations with health outcomes and interventions. Past analysis of activity tracker data relies heavily on aggregating minute-level PA records into day-level summary statistics in which important information of PA temporal/diurnal patterns is lost. In this paper we propose a novel functional data analysis approach based on Riemann manifolds for modeling PA and its longitudinal changes. We model smoothed minute-level PA of a day as one-dimensional Riemann manifolds and longitudinal changes in PA in different visits as deformations between manifolds. The variability in changes of PA among a cohort of subjects is characterized via variability in the deformation. Functional principal component analysis is further adopted to model the deformations, and PC scores are used as a proxy in modeling the relation between changes in PA and health outcomes and/or interventions. We conduct comprehensive analyses on data from two clinical trials: Reach for Health (RfH) and Metabolism, Exercise and Nutrition at UCSD (MENU), focusing on the effect of interventions on longitudinal changes in PA patterns and how different modes of changes in PA influence weight loss, respectively. The proposed approach reveals unique modes of changes, including overall enhanced PA, boosted morning PA, and shifts of active hours specific to each study cohort. The results bring new insights into the study of longitudinal changes in PA and health and have the potential to facilitate designing of effective health interventions and guidelines.
Collapse
Affiliation(s)
- Jingjing Zou
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
- UC San Diego Moores Cancer Center
| | - Tuo Lin
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | - Chongzhi Di
- Division of Public Health Sciences, Fred Hutchinson Cancer Cente
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | - Marta M. Jankowska
- Department of Population Sciences, Beckman Research Institute, City of Hope
| | - Sheri J. Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
- UC San Diego Moores Cancer Center
| | - Dorothy D. Sears
- College of Health Solutions, Arizona State University
- Department of Family Medicine, University of California, San Diego
- UC San Diego Moores Cancer Center
| | - Andrea Z. LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | - Cheryl L. Rock
- Department of Family Medicine, University of California, San Diego
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
- UC San Diego Moores Cancer Center
| |
Collapse
|
8
|
Lopez P, Fitzgerald DB, McVeigh JA, Badiei A, Muruganandan S, Newton RU, Straker L, Lee YCG, Peddle-McIntyre CJ. Associations of physical activity and quality of life in parapneumonic effusion patients. ERJ Open Res 2023; 9:00209-2023. [PMID: 37753285 PMCID: PMC10518875 DOI: 10.1183/23120541.00209-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/17/2023] [Indexed: 09/28/2023] Open
Abstract
Introduction Little is known about activity behaviours and quality of life (QoL) of patients with parapneumonic pleural effusions (PPE) after hospital discharge. This study is a secondary analysis of a randomised trial (dexamethasone versus placebo) for hospitalised patients with PPE. We: 1) described the patients' activity behaviour patterns and QoL measured at discharge and at 30 days post-discharge; and 2) examined the association between activity behaviours and QoL scores. Methods Activity behaviour (7-day accelerometry; Actigraph GT3X+) and QoL (Medical Outcomes Study Short-Form 36) were assessed. Repeated measures analysis of covariance controlling for baseline values and a series of linear regression models were undertaken. Results 36 out of 53 eligible participants completed accelerometry assessments. Despite modest increases in light physical activity (+7.5%) and some domains of QoL (>2 points) from discharge to 30 days post-discharge, patients had persistently high levels of sedentary behaviour (>65% of waking wear time) and poor QoL (≤50 out of 100 points) irrespective of treatment group (p=0.135-0.903). Increasing moderate-to-vigorous physical activity was associated with higher scores on most QoL domains (p=0.006-0.037). Linear regression indicates that a clinically important difference of 5 points in physical composite QoL score can be achieved by reallocating 16.1 min·day-1 of sedentary time to moderate-to-vigorous physical activity. Conclusion Patients with PPE had low levels of physical activity and QoL at discharge and 30 days post-discharge irrespective of treatment. Moderate-to-vigorous physical activity participation was associated with higher QoL scores. Increasing moderate-to-vigorous physical activity following discharge from the hospital may be associated with improvements in QoL.
Collapse
Affiliation(s)
- Pedro Lopez
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Joint first authors
| | - Deirdre B. Fitzgerald
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
- Joint first authors
| | - Joanne A. McVeigh
- Curtin School of Allied Health, Curtin University, Perth, Australia
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Arash Badiei
- Thoracic Medicine, Royal Adelaide Hospital, Adelaide, Australia
- Adelaide Medical School, Faculty of Health and Medical Science, University of Adelaide, Adelaide, Australia
| | | | - Robert U. Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Leon Straker
- Curtin School of Allied Health, Curtin University, Perth, Australia
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Yun Chor Gary Lee
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
- Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
- Joint senior authors
| | - Carolyn J. Peddle-McIntyre
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Joint senior authors
| |
Collapse
|
9
|
Doré A, Kalo K, Schwab L, Reichel JL, Eisenbarth L, Strepp T, Jacob R, Enders K, Letzel S, Simon P, Dietz P, Kubiak T, Heller S. Videos using different message strategies to promote the interruption of sedentary behavior in university students during online lectures - A pilot study. Front Public Health 2023; 11:1108154. [PMID: 37575097 PMCID: PMC10412984 DOI: 10.3389/fpubh.2023.1108154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/26/2023] [Indexed: 08/15/2023] Open
Abstract
Background Sedentary behavior (SB) is highly prevalent among university students and has increased during COVID-19 pandemic. As SB is associated with negative health outcomes, appropriate prevention measures in the university setting are needed. Objective This pilot study aimed at investigating the effects of videos using different message strategies to interrupt SB in the collective of university students during online lectures. Methods During online lectures, university students (N = 96) were shown one of three videos on the interruption of SB. The videos differed in their message strategies with regard to evidence type (statistical vs. narrative) and vividness (static vs. animated images). Demographics, health variables (SB intentions, SB attitudes) and selected media reception variables (identification, homophily, counterarguing) were examined as possible influence factors on the interruption of SB evoked by watching the video. Results Approximately half of the students interrupted sedentary behavior during watching the videos and students of the older age group (cut-off: median = 22 years) interrupted SB significantly more often (p = 0.046). The interruption of SB was predicted by SB intentions (p < 0.05). Identification with characters significantly predicted the intentions to reduce SB (p < 0.001), with a large effect of the overall regression model (R2corr = 0.47). Conclusion Considering the increased digitalization in general and restrictions due to COVID-19 pandemic, videos seem to be a useful tool to interrupt SB among university students during online lectures. Narrative formats could facilitate the intention to reduce SB, which in turn could have a positive impact on the interruption of SB. However, further research on effective communication and message strategies is needed.
Collapse
Affiliation(s)
- Anastasia Doré
- Department of Health Psychology, Institute of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Kristin Kalo
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Lisa Schwab
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jennifer L. Reichel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Laura Eisenbarth
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Tilmann Strepp
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
| | - Robin Jacob
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Kira Enders
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Perikles Simon
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Thomas Kubiak
- Department of Health Psychology, Institute of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sebastian Heller
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| |
Collapse
|
10
|
Peddle-McIntyre CJ, Muruganandan S, McVeigh J, Fitzgerald DB, Straker L, Newton RU, Murray K, Lee YCG. Device assessed activity behaviours in patients with indwelling pleural catheter: A sub-study of the Australasian Malignant PLeural Effusion (AMPLE)-2 randomized trial. Respirology 2023; 28:561-570. [PMID: 36642702 DOI: 10.1111/resp.14451] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/19/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Device-assessed activity behaviours are a novel measure for comparing intervention outcomes in patients with malignant pleural effusion (MPE). Australasian Malignant PLeural Effusion (AMPLE)-2 was a multi-centre clinical trial where participants with MPE treated with an indwelling pleural catheter were randomized to daily (DD) or symptom-guided (SGD) drainage for 60-days. Our aim was to describe activity behaviour patterns in MPE patients, explore the impact of drainage regimen on activity behaviours and examine associations between activity behaviours and quality of life (QoL). METHODS Following randomization to DD or SGD, participants enrolled at the lead site (Perth) completed accelerometry assessment. This was repeated monthly for 5-months. Activity behaviour outcomes were calculated as percent of daily waking-wear time and compared between groups (Mann-Whitney U test; Median [IQR]). Correlations between activity behaviour outcomes and QoL were examined. RESULTS Forty-one (91%) participants provided ≥1 valid accelerometry assessment (DDn = 20, SGD n = 21). Participants spent a large proportion of waking hours sedentary (72%-74% across timepoints), and very little time in moderate-to-vigorous physical activity (<1% across timepoints). Compared to SGD group, DD group had a more favourable sedentary-to-light ratio in the week following randomization (2.4 [2.0-3.4] vs. 3.2 [2.4-6.1]; p = 0.047) and at 60-days (2.0 [1.9-2.9] vs. 2.9 [2.8-6.0]; p = 0.016). Sedentary-to-light ratio was correlated with multiple QoL domains at multiple timepoints. CONCLUSION Patients with MPE are largely sedentary. Preliminary results suggest that even modest differences in activity behaviours favouring the DD group could be meaningful for this clinical population. Accelerometry reflects QoL and is a useful outcome measure in MPE populations.
Collapse
Affiliation(s)
- Carolyn J Peddle-McIntyre
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Sanjeevan Muruganandan
- Department of Respiratory Medicine, Northern Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Joanne McVeigh
- School of Allied Health, Curtin University, Bentley, Western Australia, Australia.,Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Deirdre B Fitzgerald
- Respiratory Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Institute for Respiratory Health & Medical School, University of Western Australia, Nedlands, Western Australia, Australia
| | - Leon Straker
- School of Allied Health, Curtin University, Bentley, Western Australia, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Nedlands, Western Australia, Australia
| | - Yun Chor Gary Lee
- Respiratory Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Institute for Respiratory Health & Medical School, University of Western Australia, Nedlands, Western Australia, Australia
| |
Collapse
|
11
|
Oba K, Kagiwada Y, Kamada M, Miki R, Kondo Y, Kamakura T, Yamagami T, Fujita T, Tsuchida Y. Evaluating the feasibility of a remote-based training program supported by information and communications technology in the older adults living at home. BMC Geriatr 2022; 22:574. [PMID: 35831789 PMCID: PMC9277784 DOI: 10.1186/s12877-022-03273-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Exercise has been one of the key strategies for preventing frailty. While training programs for preventing frailty have been mainly developed in person, which have now become difficult to perform due to the coronavirus disease pandemic. It would be worthwhile to explore a feasibility of methods for a remote-based training with information and communications technology (ICT) in the pre-frail/robust older adults living at home. Methods We assessed the feasibility of a remote-based training with ICT device in terms of 1) a measurement accuracy and 2) whether it could be used for remote-based training of different intensities. To evaluate a measurement accuracy of the ICT device, we evaluated an inter-rater reliability between a true score and scores obtaining from the ICT device in 20 participants aged 65 years and older. Intraclass correlation was calculated. To evaluate a feasibility of remote-based training interventions of different intensities, we did a parallel, randomized, active controlled trial. Participants aged 65 years or older were randomly allocated to the two 3-month intervention programs with different intensity of exercise with the ICT (i.e., an Exercise-Intensive program and a Light-load exercise program). The primary outcome was 3-month scores of the 30-s chair-stand test (CS-30), which was compared between two groups using mixed models for repeated measures to account for within-person correlations. Results The ICT device showed a high intraclass correlation of over 0.99 for all outcomes including CS-30. Between Aug and Oct 2020, 70 participants (36 and 34 in the Exercise-Intensive and Light-load exercise programs, respectively) were randomized. After 3 months of intervention, CS-30 scores and other physical function improved in both groups. Difference in the 3-month CS-30 scores between two programs was found to be 0.08 (95% confidence interval: − 2.64, 2.79; p = 0.955), which was not statistically significant. No harmful incidents, such as falls, occurred in either group. Conclusion We showed a remote-based training with ICT device in the older adults living at home was feasible. Further studies are warranted to determine what kind of remote exercise intervention programs is more effective for maintaining a physical performance and, beyond that, preventing frailty. Trial registration number UMIN000041616 (05/09/2020) https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000047504&type=summary&language=E
Collapse
Affiliation(s)
- Koji Oba
- Department of Biostatistics, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan. .,Interfaculty Initiative in Information Studies, the University of Tokyo, Tokyo, Japan.
| | - Yusuke Kagiwada
- Department of Biostatistics, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Masamitsu Kamada
- Department of Health Education and Health Sociology, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryusuke Miki
- Health Planning Division, Public Health Bureau, Kobe City Government, Kobe, Japan
| | | | | | | | | | | |
Collapse
|
12
|
Choudhury R, Park JH, Thiamwong L, Xie R, Stout JR. Objectively Measured Physical Activity Levels and Associated Factors in Older US Women During the COVID-19 Pandemic: A Cross-sectional Study (Preprint). JMIR Aging 2022; 5:e38172. [PMID: 35994346 PMCID: PMC9400844 DOI: 10.2196/38172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/27/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Renoa Choudhury
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, United States
| | - Joon-Hyuk Park
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, United States
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Rui Xie
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL, United States
| | - Jeffrey R Stout
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, United States
| |
Collapse
|
13
|
Ballin M, Antonsson O, Rosenqvist V, Nordström P, Nordström A. Association of dog ownership with accelerometer-measured physical activity and daily steps in 70-year-old individuals: a population-based cross-sectional study. BMC Public Health 2021; 21:2313. [PMID: 34933682 PMCID: PMC8691041 DOI: 10.1186/s12889-021-12401-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background Dog ownership (DO) has been associated with higher levels of self-reported walking and physical activity. However, compared to device-based measures, self-reported measures of physical activity may suffer from bias due to recall and social desirability. They are also incapable of quantifying light-intensity physical activity (LPA) and step volume, both of which may have important health benefits, especially for older adults. In this study, we investigated the association of DO with accelerometer-measured physical activity of different intensities and daily steps in 70-year-old individuals. Methods This was a population-based cross-sectional study including 1406 participants aged 70 years [54.1% female] who participated in a health survey in Umeå, Sweden between February 2017–November 2019. All participants self-reported DO [yes/no]. Daily averages of LPA, moderate-to-vigorous-intensity physical activity (MVPA), and steps per day [steps/d] were measured for 1 week using hip-mounted Actigraph GT3X+ accelerometers. Associations were investigated using linear- and logistic regression models, adjusted for sociodemographic and health-related factors, date of examination, and accelerometer wear time. Results The prevalence of DO was 14.1% [N = 199]. After adjustment for all covariates, DO was associated with 19.2 more minutes/d of LPA [95% CI, 8.8–29.6], 11.4 more minutes/d of MVPA [95% CI, 8.0–14.9] and 1738 more steps/d [95% CI, 1326–2149]. DO was also associated with twice the odds of meeting the physical activity recommendations [OR, 2.07, 95% CI, 1.48–2.90]. Exploratory interaction analyses showed that the association between DO and steps/d was stronger [Pinteraction = 0.030] in female [β = 2165, 95% CI, 1585–2744] than in male [β =1255, 95% CI, 664–1845], with a similar trend for MVPA [Pinteraction = 0.082]. Conclusions In this study of community-dwelling 70-year-old individuals, DO was associated with higher levels of daily LPA, MVPA, and steps. With the limitation of the observational design of the study, these findings add knowledge regarding the beneficial role that DO may play for promoting physical activity in the older population. In turn, these findings could support the development and evaluation of targeted interventions seeking to promote dog-friendly environments and facilitate dog walking in the community. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12401-4.
Collapse
Affiliation(s)
- Marcel Ballin
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 90187, Umeå, Sweden. .,Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
| | - Oskar Antonsson
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 90187, Umeå, Sweden
| | - Viktor Rosenqvist
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 90187, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 90187, Umeå, Sweden
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,School of Sport Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
14
|
Tuominen M, Suorsa K, Pentti J, Koski P, Stenholm S, Leskinen T. The Impact of a 12-Month Activity Tracker Intervention on Activity Behavior Across Body Mass Index Subgroups Among Recent Retirees: Post Hoc Analysis of a Randomized Controlled Trial. J Phys Act Health 2021; 18:1563-1569. [PMID: 34702785 DOI: 10.1123/jpah.2021-0352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/02/2021] [Accepted: 09/02/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study examined the effectiveness of a 12-month activity tracker-based intervention on activity behavior among recent retirees (Enhancing physical ACTivity and healthy aging among recent REtirees [REACT]) in subgroups based on body mass index. METHODS REACT trial randomized 231 participants (mean age 65.2) into intervention and control groups. Main outcomes were accelerometer-measured moderate-to-vigorous (MVPA) and light physical activity (LPA) and sedentary time (SED) measured at baseline and 3-, 6-, and 12-month follow-ups. As a post hoc analysis, the intervention effect was examined among participants with normal weight (n = 77), overweight (n = 89), and obesity (n = 61). RESULTS An intervention effect was observed among participants with obesity in LPA (time × group P = .045) mirrored by a similar, albeit nonsignificant, effect in SED (P = .067), but not in MVPA (P = .92). A transient increase of 41 minutes per day (95% confidence interval, 14 to 68) in LPA was observed at 6 months among the intervention group, with a concomitant decrease of 42 minutes per day (-72 to -12) in SED. However, these changes were not maintained at 12 months. No between-group differences in changes over time were observed among participants with normal or overweight. CONCLUSIONS Activity trackers may be particularly suitable for promoting changes in LPA and SED among older adults with obesity. However, their long-term effectiveness might be limited.
Collapse
|
15
|
The Nutritional Status of Long-Term Institutionalized Older Adults Is Associated with Functional Status, Physical Performance and Activity, and Frailty. Nutrients 2021; 13:nu13113716. [PMID: 34835971 PMCID: PMC8619061 DOI: 10.3390/nu13113716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/15/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
Among older adults living in long-term nursing homes (LTNHs), maintaining an adequate functional status and independence is a challenge. Whilst a poor nutritional status is a potential risk factor for a decreased function in this population, its role is not fully understood. Here, using a transversal multicenter study of 105 older adults living in 13 LTNHs, we analyzed the associations between nutritional status, as measured by the Mini Nutritional Assessment (MNA), and the parameters of functional status, physical performance, physical activity, and frailty as well as comorbidity and body composition. The MNA scores were positively correlated with the Barthel Index, handgrip strength, Short Physical Performance Battery (SPPB) scores, absolute muscle power, and Assessment of Physical Activity in Frail Older People (APAFOP) scores and were negatively correlated with dynamic balance and frailty. In a multiple linear regression model controlling for gender and age, the APAFOP score (β = 0.386), BMI (β = 0.301), and Barthel Index (β = 0.220) explained 31% of the variance in the MNA score. Given the observed close relationship between the MNA score and functional status, physical performance and activity, and frailty, interventions should jointly target improvements in both the nutritional status and functional status of LTNH residents. Strategies designed and implemented by interdisciplinary professional teams may be the most successful in improving these parameters to lead to better health and quality of life.
Collapse
|