Week and Weekend Day Cadence Patterns Long-Term Post-Bariatric Surgery

Towards Optimized Care After Bariatric Surgery by Physical Activity and Exercise Intervention: a Review

Although there is growing evidence on the importance of physical activity and exercise intervention after bariatric surgery, it remains to be clarified as to why and how post-operative exercise intervention should be implemented. In this narrative and practically oriented review, it is explained why exercise interventions and physical activity are important after bariatric surgery, how to prescribe exercise and monitor physical activity and how and when physical fitness, muscle strength, fat (-free) mass and bone mineral density could be assessed during follow-up. It is suggested that the inclusion of physical activity and exercise training in the clinical follow-up trajectory could be of great benefit to bariatric surgery patients, since it leads to greater improvements in body composition, bone mineral density, muscle strength and physical fitness.

The Bout Cadence Method Improves the Quantification of Stepping Cadence In Free-Living Conditions

BACKGROUND

Existing analytical approaches used to measure free-living stepping cadence (steps per minute; spm) characterize stepping two-ways: 1) 60 s epochs without considering time spent stepping during the epoch (step accumulation; SA), or 2) a bout-based analysis that considers both number of steps and time spent stepping during stepping bouts (total event cadence; TEC). SA and TEC may incorrectly characterize cadence in epochs that do not consist of continuous stepping or if there are marked changes in cadence within a stepping bout, respectively.

RESEARCH QUESTION

How does a bout-based analytical method that examines each stepping bout individually and considers within-bout changes in stepping cadence during epochs ≥120 s (Bout Cadence; BC) compare to SA and TEC?

METHODS

ActivPAL™-derived data from 122 participants were analyzed (790 total days). SA and TEC were calculated according to previous literature. BC calculated cadence bout-by-bout and stride-by-stride for bouts lasting <120 s and ≥120 s, respectively. Time spent stepping between 0-140 spm (divided into 20 spm bins) or >140 spm were determined for each method. Time spent in slow (0-80 spm), medium (80-120 spm) and fast (>120 spm) cadences for each method were compared via Bland-Altman analyses.

RESULTS

Almost half (43 %) of the total number of 60 s epochs included ≥2 stepping bouts, and 37 % of total stepping time was accumulated in continuous stepping bouts ≥120 s. Compared to TEC, BC identified more daily time spent in the 20-40 spm and >120 spm cadence bins, but less time spent in the 60-120 spm range. Both SA (fixed bias: -11.0 ± 12.4 min/day) and TEC (fixed bias: -10.0 ± 13.6 min/day) underestimated faster stepping cadences compared to BC.

SIGNIFICANCE

Existing analytical approaches largely underestimate faster stepping cadences, resulting in inaccurate measurements of vigorous-intensity stepping activity. The BC better characterizes higher intensity stepping activity, which could have important implications for assessing participants' true habitual stepping activity levels.