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Cox NS, Eldridge B, Rawlings S, Dreger J, Corda J, Hauser J, Button BM, Bishop J, Nichols A, Middleton A, Ward N, Dwyer T, Tomlinson OW, Denford S, Barker AR, Williams CA, Kingsley M, O’Halloran P, Holland AE. A web-based intervention to promote physical activity in adolescents and young adults with cystic fibrosis: protocol for a randomized controlled trial. BMC Pulm Med 2019; 19:253. [PMID: 31856791 PMCID: PMC6921562 DOI: 10.1186/s12890-019-0942-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 09/20/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Regular participation in physical activity by people with cystic fibrosis (CF) promotes positive clinical and health outcomes including reduced rate of decline in lung function, fewer hospitalizations and greater wellbeing. However adherence to exercise and activity programs is low, in part due to the substantial daily therapy burden for young people with CF. Strict infection control requirements limit the role of group exercise programs that are commonly used in other clinical groups. Investigation of methods to promote physical activity in this group has been limited. The Active Online Physical Activity in Cystic fibrosis Trial (ActionPACT) is an assessor-blinded, multi-centre, randomized controlled trial designed to compare the efficacy of a novel web-based program (ActivOnline) compared to usual care in promoting physical activity participation in adolescents and young adults with CF. METHODS Adolescents and young adults with CF will be recruited on discharge from hospital for a respiratory exacerbation. Participants randomized to the intervention group will have access to a web-based physical activity platform for the 12-week intervention period. ActivOnline allows users to track their physical activity, set goals, and self-monitor progress. All participants in both groups will be provided with standardised information regarding general physical activity recommendations for adolescents and young adults. Outcomes will be assessed by a blinded assessor at baseline, after completion of the intervention, and at 3-months followup. Healthcare utilization will be assessed at 12 months from intervention completion. The primary outcome is change in moderate-to-vigorous physical activity participation measured objectively by accelerometry. Secondary outcomes include aerobic fitness, health-related quality of life, anxiety and depression and sleep quality. DISCUSSION This trial will establish whether a web-based application can improve physical activity participation more effectively than usual care in the period following hospitalization for a respiratory exacerbation. The web-based application under investigation can be made readily and widely available to all individuals with CF, to support physical activity and exercise participation at a time and location of the user's choosing, regardless of microbiological status. TRIAL REGISTRATION Clinical trial registered on July 13, 2017 with the Australian and New Zealand Clinical Trials Register at (ACTRN12617001009303).
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Affiliation(s)
- Narelle S. Cox
- Monash University, La Trobe University and Institute for Breathing and Sleep, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, Vic 3004 Australia
| | - Beverley Eldridge
- La Trobe University, Level 4, The Alfred Centre, 99 Commercial Road, Melbourne, Vic 3004 Australia
| | - Sarah Rawlings
- Monash Children’s Hospital Monash University and La Trobe University , 246 Clayton Rd, Clayton, Vic 3168 Australia
| | - Julianna Dreger
- Monash University, La Trobe University and Alfred Health, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, Vic 3004 Australia
| | - Jennifer Corda
- Physiotherapy Department Royal Children’s Hospital, 50 Flemington Road Parkville, Victoria, 3052 Australia
| | - Jennifer Hauser
- Tasmanian Adult Cystic Fibrosis Unit, Royal Hobart Hospital, GPO Box 1061, Hobart, Tasmania 7000 Australia
| | - Brenda M. Button
- Departments of Physiotherapy and Respiratory Medicine Alfred Health and Department of Medicine, Nursing and Health Sciences, Monash University, 55 Commercial Road, Melbourne, Vic 3004 Australia
| | - Jennifer Bishop
- Adult Cystic Fibrosis Service, Westmead Hospital, PO Box 533, Wentworthville, NSW 2145 Australia
| | - Amanda Nichols
- Monash Children’s Hospital/Monash Health CF Service, 246 Clayton Rd, Clayton, Victoria 3168 Australia
| | - Anna Middleton
- Physiotherapy Department, Children’s Hospital at Westmead, Hawkesbury Road, Westmead, NSW 2145 Australia
| | - Nathan Ward
- Physiotherapy and Cystic Fibrosis Services, 8E055.08, Royal Adelaide Hospital, Port Road, Adelaide, SA 5000 Australia
| | - Tiffany Dwyer
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, NSW 1825 Australia
| | - Owen W. Tomlinson
- Children’s Health & Exercise Research Centre (CHERC), Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter, Devon EX1 2LU UK
| | - Sarah Denford
- Children’s Health & Exercise Research Centre (CHERC), Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter, Devon EX1 2LU UK
| | - Alan R. Barker
- Children’s Health & Exercise Research Centre (CHERC), Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter, Devon EX1 2LU UK
| | - Craig A. Williams
- Children’s Health & Exercise Research Centre (CHERC), Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter, Devon EX1 2LU UK
| | - Michael Kingsley
- La Trobe Rural Health School, La Trobe University, Bendigo, Vic 3552 Australia
| | - Paul O’Halloran
- School of Psychology and Public Health, La Trobe University, Bundoora, Vic 3086 Australia
| | - Anne E. Holland
- Monash University La Trobe University, Alfred Health and Institute for Breathing and Sleep, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, Vic 3004 Australia
| | - On behalf of Youth Activity Unlimited – A Strategic Research Centre of the UK Cystic Fibrosis Trust
- Monash University, La Trobe University and Institute for Breathing and Sleep, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, Vic 3004 Australia
- La Trobe University, Level 4, The Alfred Centre, 99 Commercial Road, Melbourne, Vic 3004 Australia
- Monash Children’s Hospital Monash University and La Trobe University , 246 Clayton Rd, Clayton, Vic 3168 Australia
- Monash University, La Trobe University and Alfred Health, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, Vic 3004 Australia
- Physiotherapy Department Royal Children’s Hospital, 50 Flemington Road Parkville, Victoria, 3052 Australia
- Tasmanian Adult Cystic Fibrosis Unit, Royal Hobart Hospital, GPO Box 1061, Hobart, Tasmania 7000 Australia
- Departments of Physiotherapy and Respiratory Medicine Alfred Health and Department of Medicine, Nursing and Health Sciences, Monash University, 55 Commercial Road, Melbourne, Vic 3004 Australia
- Adult Cystic Fibrosis Service, Westmead Hospital, PO Box 533, Wentworthville, NSW 2145 Australia
- Monash Children’s Hospital/Monash Health CF Service, 246 Clayton Rd, Clayton, Victoria 3168 Australia
- Physiotherapy Department, Children’s Hospital at Westmead, Hawkesbury Road, Westmead, NSW 2145 Australia
- Physiotherapy and Cystic Fibrosis Services, 8E055.08, Royal Adelaide Hospital, Port Road, Adelaide, SA 5000 Australia
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, NSW 1825 Australia
- Children’s Health & Exercise Research Centre (CHERC), Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter, Devon EX1 2LU UK
- La Trobe Rural Health School, La Trobe University, Bendigo, Vic 3552 Australia
- School of Psychology and Public Health, La Trobe University, Bundoora, Vic 3086 Australia
- Monash University La Trobe University, Alfred Health and Institute for Breathing and Sleep, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, Vic 3004 Australia
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Jenkins GP, Evenson KR, Herring AH, Hales D, Stevens J. Cardiometabolic Correlates of Physical Activity and Sedentary Patterns in U.S. Youth. Med Sci Sports Exerc 2018; 49:1826-1833. [PMID: 28538259 DOI: 10.1249/mss.0000000000001310] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Daily or weekly averages of physical activity and sedentary behavior could mask patterns of behavior throughout the week that independently affect cardiovascular health. We examined associations between day-to-day physical activity and sedentary behavior latent classes and cardiovascular disease (CVD) risk factors in U.S. youth. METHODS Data were from 3984 youth ages 6-17 yr from the National Health and Nutrition Examination Survey (2003-2006) and from previously published accelerometry latent classes characterizing average counts per minute and percent of wear time in moderate-to-vigorous physical activity (MVPA) and sedentary behavior. Multiple linear regression was used to examine associations of the classes with waist circumference, systolic and diastolic blood pressure, HDL-C and LDL-C, triglycerides, glucose, and insulin. RESULTS Participants spent 50.4% of the day in sedentary behavior and 5.3% of the day in moderate-to-vigorous physical activity. Average counts per minute were 516.4 for a 7-d period. Significant differences in CVD risk factors were between extreme classes with few differences observed in intermediate classes. Youth in latent class 4 (highest average counts per minute) had lower systolic blood pressure (-4.11 mm Hg, 95% confidence interval [CI] = -7.74 to -0.55), lower glucose (-4.25 mg·dL, 95% CI = -7.84 to -0.66]), and lower insulin (-6.83 μU·mL, 95% CI = -8.66 to -4.99]) compared with youth in class 1 (lowest average counts per minute). Waist circumference was lower for the least sedentary class (-2.54 cm, 95% CI = -4.90 to -0.19) compared with the most sedentary class. Some associations were attenuated when classes were adjusted for mean physical activity or sedentary level. CONCLUSIONS There is some indication that patterns, in addition to the total amount of physical activity and sedentary behavior, may be important for cardiovascular health in youth. Longitudinal studies are needed to examine associations between physical activity and sedentary behavior patterns and changes in CVD risk factors.
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Affiliation(s)
- Gabrielle P Jenkins
- 1Department of Epidemiology, Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, Chapel Hill, NC; 2Department of Biostatistics, Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, Chapel Hill, NC; 3Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and 4Department of Nutrition, Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, Chapel Hill, NC
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Evenson KR, Herring AH, Wen F. Accelerometry-Assessed Latent Class Patterns of Physical Activity and Sedentary Behavior With Mortality. Am J Prev Med 2017; 52:135-143. [PMID: 28109457 PMCID: PMC5260614 DOI: 10.1016/j.amepre.2016.10.033] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 09/30/2016] [Accepted: 10/25/2016] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Latent class analysis provides a method for understanding patterns of physical activity and sedentary behavior. This study explored the association of accelerometer-assessed patterns of physical activity/sedentary behavior with all-cause mortality. METHODS The sample included 4,510 U.S. National Health and Nutrition Examination Survey participants aged ≥40 years enrolled in 2003-2006 with mortality follow-up through 2011. Participants used a hip-worn accelerometer for 1 week that provided minute-by-minute information on physical activity/sedentary behavior. Accelerometry patterns were derived using latent class analysis. Cox proportional hazards models provided adjusted hazard ratios with 95% CIs. Analyses were conducted from 2014 to 2016. RESULTS During an average of 6.6 years of follow-up, 513 deaths occurred. For average counts/minute, the more-active classes had a lower risk of mortality compared with the lowest (Class 1). Findings were generally similar for percentage of the day in minutes and bouts of moderate to vigorous physical activity, defined two ways. For percentage of the day in sedentary behavior, generally no associations were identified. However, the class with the highest percentage of the day in sedentary bouts (Class 1) had a higher risk of mortality (adjusted hazard ratio, 2.10; 95% CI=1.11, 3.97) versus the class with fewer sedentary bouts (Class 7). CONCLUSIONS In this national observational study, time spent in physical activity reduced the risk of all-cause mortality and time spent in sedentary bouts increased the risk of all-cause mortality, regardless of how both were accumulated. The latent class analysis contributed to understanding the impact of patterning of physical activity and sedentary behavior on mortality.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina; Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina.
| | - Amy H Herring
- Department of Biostatistics at the Gillings School of Global Public Health, Carolina Population Center, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Fang Wen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
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