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Ramalho RB, Casonato NA, Montilha VB, Chaves TC, Mattiello SM, Selistre LFA. Construct Validity and Responsiveness of Performance-based Tests in Individuals With Knee Osteoarthritis. Arch Phys Med Rehabil 2024; 105:1862-1869. [PMID: 38851556 DOI: 10.1016/j.apmr.2024.05.024] [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: 02/27/2024] [Revised: 04/23/2024] [Accepted: 05/15/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVES To assess the construct validity and responsiveness of 3 performance-based tests in individuals with knee osteoarthritis (KOA). DESIGN This study has a prospective cohort design. SETTING Assessments were administered at the Federal University of São Carlos (Brazil) by 3 different raters. PARTICIPANTS A total of 107 participants with KOA were aged ≥40 years (N=107). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE This study assessed the construct validity and responsiveness of 3 performance-based tests: 40-meter fast-paced walk test (40-m FPWT), 11-step stair climb test (11-step SCT), and 30-second chair stand test (30-s CST). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), sedentary behavior (activPAL), and numeric pain rating scale (NPRS) were used as comparator instruments. Measurements were obtained at baseline and after 6 months. The construct validity and responsiveness were calculated using Spearman correlation coefficient within predefined hypotheses based on a panel comprising 5 experts in the field of outcome measurement in KOA. RESULTS The three performance-based tests showed excellent (ICC>0.9) reliability (intra and inter); however, only the 40-m FPWT and 11-step SCT were considered valid and responsive because both confirmed >75% of the priori hypotheses. The 30-s CST was not considered valid or responsive because it has not confirmed ≥75% of the priori hypotheses. CONCLUSION The 3 performance-based tests are reliable for intra and inter assessments. The 40-m FPWT and 11-step SCT are both valid and responsive for measuring physical function in patients with KOA. The 30-s CST was not considered valid or responsive. Therefore, 40-m FPWT and 11-step SCT can detect changes over time and are indicated for functional assessment in clinical practice.
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Affiliation(s)
- Rebecca B Ramalho
- Physiotherapy Department of the Federal University of São Carlos, São Carlos, Brazil
| | - Natália A Casonato
- Physiotherapy Department of the Federal University of São Carlos, São Carlos, Brazil
| | - Vinicius B Montilha
- Physiotherapy Department of the Federal University of São Carlos, São Carlos, Brazil
| | - Thais C Chaves
- Physiotherapy Department of the Federal University of São Carlos, São Carlos, Brazil
| | - Stela M Mattiello
- Physiotherapy Department of the Federal University of São Carlos, São Carlos, Brazil
| | - Luiz F A Selistre
- Physiotherapy Department of the Federal University of São Carlos, São Carlos, Brazil.
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Letts E, Jakubowski JS, King-Dowling S, Clevenger K, Kobsar D, Obeid J. Accelerometer techniques for capturing human movement validated against direct observation: a scoping review. Physiol Meas 2024; 45:07TR01. [PMID: 38688297 DOI: 10.1088/1361-6579/ad45aa] [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: 08/14/2023] [Accepted: 04/29/2024] [Indexed: 05/02/2024]
Abstract
Objective.Accelerometers are devices commonly used to measure human physical activity and sedentary time. Accelerometer capabilities and analytical techniques have evolved rapidly, making it difficult for researchers to keep track of advances and best practices for data processing and analysis. The objective of this scoping review is to determine the existing methods for analyzing accelerometer data for capturing human movement which have been validated against the criterion measure of direct observation.Approach.This scoping review searched 14 academic and 5 grey databases. Two independent raters screened by title and abstract, then full text. Data were extracted using Microsoft Excel and checked by an independent reviewer.Mainresults.The search yielded 1039 papers and the final analysis included 115 papers. A total of 71 unique accelerometer models were used across a total of 4217 participants. While all studies underwent validation from direct observation, most direct observation occurred live (55%) or using recordings (42%). Analysis techniques included machine learning (ML) approaches (22%), the use of existing cut-points (18%), receiver operating characteristic curves to determine cut-points (14%), and other strategies including regressions and non-ML algorithms (8%).Significance.ML techniques are becoming more prevalent and are often used for activity identification. Cut-point methods are still frequently used. Activity intensity is the most assessed activity outcome; however, both the analyses and outcomes assessed vary by wear location. This scoping review provides a comprehensive overview of accelerometer analysis and validation techniques using direct observation and is a useful tool for researchers using accelerometers.
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Affiliation(s)
- Elyse Letts
- Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Josephine S Jakubowski
- Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Canada
- School of Medicine, Queen's University, Kingston, Canada
| | - Sara King-Dowling
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Kimberly Clevenger
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, United States of America
| | - Dylan Kobsar
- Department of Kinesiology, McMaster University, Hamilton, Canada
| | - Joyce Obeid
- Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Canada
- Department of Kinesiology, McMaster University, Hamilton, Canada
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Hong KR, Hwang IW, Kim HJ, Yang SH, Lee JM. Apple Watch 6 vs. Galaxy Watch 4: A Validity Study of Step-Count Estimation in Daily Activities. SENSORS (BASEL, SWITZERLAND) 2024; 24:4658. [PMID: 39066055 PMCID: PMC11281039 DOI: 10.3390/s24144658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/06/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
The purpose of this study was to examine the validity of two wearable smartwatches (the Apple Watch 6 (AW) and the Galaxy Watch 4 (GW)) and smartphone applications (Apple Health for iPhone mobiles and Samsung Health for Android mobiles) for estimating step counts in daily life. A total of 104 healthy adults (36 AW, 25 GW, and 43 smartphone application users) were engaged in daily activities for 24 h while wearing an ActivPAL accelerometer on the thigh and a smartwatch on the wrist. The validities of the smartwatch and smartphone estimates of step counts were evaluated relative to criterion values obtained from an ActivPAL accelerometer. The strongest relationship between the ActivPAL accelerometer and the devices was found for the AW (r = 0.99, p < 0.001), followed by the GW (r = 0.82, p < 0.001), and the smartphone applications (r = 0.93, p < 0.001). For overall group comparisons, the MAPE (Mean Absolute Percentage Error) values (computed as the average absolute value of the group-level errors) were 6.4%, 10.5%, and 29.6% for the AW, GW, and smartphone applications, respectively. The results of the present study indicate that the AW and GW showed strong validity in measuring steps, while the smartphone applications did not provide reliable step counts in free-living conditions.
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Affiliation(s)
- Kyu-Ri Hong
- Department of Physical Education, Graduate School of Education, Kyung Hee University, Yongin-si 17014, Republic of Korea;
| | - In-Whi Hwang
- Department of Sports Medicine and Science, Graduate School of Physical Education, Kyung Hee University, Yongin-si 17014, Republic of Korea;
| | - Ho-Jun Kim
- Department of Physical Education, College of Physical Education, Kyung Hee University, Yongin-si 17014, Republic of Korea;
| | - Seo-Hyung Yang
- School of Global Sport Studies, Korea University, 2511 Sejong-ro, Sejong City 30019, Republic of Korea;
| | - Jung-Min Lee
- Sports Science Research Center, Global Campus, Kyung Hee University, Yongin-si 17014, Republic of Korea
- Department of Physical Education, Kyung Hee University, Yongin-si 17014, Republic of Korea
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Purcell SA, LaMunion SR, Chen KY, Rynders CA, Thomas EA, Melanson EL. The use of accelerometers to improve estimation of the thermic effect of food in whole room calorimetry studies. J Appl Physiol (1985) 2024; 137:1-9. [PMID: 38695352 PMCID: PMC11389891 DOI: 10.1152/japplphysiol.00763.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/11/2024] [Accepted: 04/23/2024] [Indexed: 06/28/2024] Open
Abstract
We tested whether spontaneous physical activity (SPA) from accelerometers could be used in a whole room calorimeter to estimate thermic effect of food (TEF). Eleven healthy participants (n = 7 females; age: 27 ± 4 yr; body mass index: 22.8 ± 2.6 kg/m2) completed two 23-h visits in randomized order: one "fed" with meals provided and one "fasted" with no food. SPA was measured by ActivPAL and Actigraph accelerometers. Criterion TEF was calculated as the difference in total daily energy expenditure (TDEE) between fed and fasted visits and compared with three methods of estimating TEF: 1) SPA-adjusted TEF (adjTEF)-difference in TDEE without SPA between visits, 2) Wakeful TEF-difference in energy expenditure obtained from linear regression and basal metabolic rate during waking hours, 3) 24-h TEF-increase in TDEE above SPA and sleeping metabolic rate. Criterion TEF was 9.4 ± 4.5% of TDEE. AdjTEF (difference in estimated vs. criterion TEF: activPAL: -0.3 ± 3.3%; Actigraph: -1.8 ± 8.0%) and wakeful TEF (activPAL: -0.9 ± 6.1%; Actigraph: -2.8 ± 7.6%) derived from both accelerometers did not differ from criterion TEF (all P > 0.05). ActivPAL-derived 24-h TEF overestimated TEF (6.8 ± 5.4%, P = 0.002), whereas Actigraph-derived 24-h TEF was not significantly different (4.3 ± 9.4%, P = 0.156). TEF estimations using activPAL tended to show better individual-level agreement (i.e., smaller coefficients of variation). Both accelerometers can be used to estimate TEF in a whole room calorimeter; wakeful TEF using activPAL is the most viable option given strong group-level accuracy and reasonable individual agreement.NEW & NOTEWORTHY Two research-grade accelerometers can effectively estimate spontaneous physical activity and improve the estimation of thermic effect of food (TEF) in whole room calorimeters. The activPAL demonstrates strong group-level accuracy and reasonable individual-level agreement in estimating wakeful TEF, whereas a hip-worn Actigraph is an acceptable approach for estimating 24-h TEF. These results highlight the promising potential of accelerometers in advancing energy balance research by improving the assessment of TEF within whole room calorimeters.
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Affiliation(s)
- Sarah A Purcell
- Division of Endocrinology Metabolism and Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Biology, Irving K. Barber Faculty of Science, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Samuel R LaMunion
- Diabetes, Endocrinology, and Obesity Branch, Intramural Research Program, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, United States
| | - Kong Y Chen
- Diabetes, Endocrinology, and Obesity Branch, Intramural Research Program, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, United States
| | - Corey A Rynders
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Elizabeth A Thomas
- Division of Endocrinology Metabolism and Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado, United States
| | - Edward L Melanson
- Division of Endocrinology Metabolism and Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
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Stork MJ, Marcotte-Chénard A, Jung ME, Little JP. Exercise in the workplace: examining the receptivity of practical and time-efficient stair-climbing "exercise snacks". Appl Physiol Nutr Metab 2024; 49:30-40. [PMID: 37748202 DOI: 10.1139/apnm-2023-0128] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
In the workplace, people are often sedentary for prolonged time and do not regularly engage in physical activity-two factors independently linked to premature morbidity and mortality. This study aimed to determine the receptivity of incorporating practical stair-climbing "exercise snacks" (Snacks; three isolated bouts of ascending 53-60 stairs performed sporadically throughout the day) into workplace settings compared to more traditional high-intensity interval training (HIIT; performed as three bouts of 53-60 stairs within a structured HIIT workout) and to explore if these exercise strategies could influence sedentary and physical activity behaviour. Fourteen participants (12 women; Mage = 38.9 ± 10.2 years) completed two supervised exercise trials (Snacks and HIIT) followed by 1 week participating in either form of exercise in their workplace. Ratings of perceived exertion (RPE), affective valence, enjoyment, and self-efficacy were measured at the supervised exercise sessions. During the follow-up period, sedentary behaviour and physical activity were measured with an accelerometer. Affective valence was more positive (p = 0.03; η2 p = 0.21) and there was a lower rise in RPE (p = 0.01; η2 p = 0.29) during Snacks than HIIT. Post-exercise enjoyment of, and self-efficacy towards, Snacks and HIIT were high and similar (ps > 0.05). After the supervised trials, 10/14 of the participants preferred Snacks and 4/14 preferred HIIT (p = 0.18). On days when participants chose to perform either exercise modality, the average number of sit-to-stands in a 24 h period was increased (48.3 ± 8.7 to 52.8 ± 7.8; p = 0.03; Hedge's g = 0.73) and moderate-to-vigorous physical activity tended to increase (21.9 ± 18.2 to 38.1 ± 22.1 min; p = 0.06; Hedge's g = 0.60) compared to days when they chose not to exercise. Stair-climbing exercise snacks may be an attractive approach to implement in the workplace setting and has potential to positively impact sedentary behaviour and physical activity metrics.
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Affiliation(s)
- Matthew J Stork
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Alexis Marcotte-Chénard
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, QC J1H 4C4, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Jonathan P Little
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC V1V 1V7, Canada
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Gallagher J, Carr LJ. Internal but Not External Building Design Associated With More Occupational Physical Activity. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:209-223. [PMID: 37551438 DOI: 10.1177/19375867231192117] [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] [Indexed: 08/09/2023]
Abstract
BACKGROUND Few studies have explored the impact of internal building design features on physical activity. The purpose of this study is to determine building design features associate with physical activity and sedentary behaviors. METHODS Full-time workers (n = 114) wore an ActivPal monitor for 4 work days to measure physical activity and sedentary behaviors. Participants completed a 25-item survey about the presence of external, internal, and staircase design features at their worksite. Participants also reported their desk type. General linear models were used to examine relations between the number of features present for each category and physical activity (steps per hour) and sedentary behavior (sitting time per hour). RESULTS Internal design scores were positively associated with occupational physical activity. Each single item increase in facilitating internal design features was associated with +64.5 steps/hr (p = .045) at work. Workers who reported having a desk job walked 538 fewer steps/hr (p < .01) and sat 17 min more/hr at work than workers who reported not having a desk. CONCLUSION These results suggest that internal design features can promote more movement and less sitting at work. Future studies that examine the longitudinal effect of changing internal design features on occupational physical activity and sedentary behaviors are warranted.
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Affiliation(s)
- Jacob Gallagher
- Behavioral Medicine Laboratory, Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Lucas J Carr
- Behavioral Medicine Laboratory, Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
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Anens E, Ahlström I, Emtner M, Zetterberg L, Nilsagård Y, Hellström K. Validity and reliability of physical activity measures in multiple sclerosis. Physiother Theory Pract 2023; 39:137-153. [PMID: 34738486 DOI: 10.1080/09593985.2021.1996498] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE The purpose was to evaluate the psychometric properties of physical activity measures in persons with multiple sclerosis (PwMS). METHODS Adults with multiple sclerosis were recruited, n = 30 (validation) and n = 57 (test-retest). Steps measured with PiezoRX, Yamax SW200 and ActiGraph GT9X Link (AGlink) and time in different positions measured with AGlink were validated against data from video analysis. Psychometric properties of the Physical Activity and Disability Survey - Revised Swedish version (PADS-R(Sw)) was evaluated. RESULTS The most valid measures were AGlink using the low-frequency extension filter, and PiezoRX with median absolute percentage errors (MeAPEs) of 0.9-3.1% and 1.3-3.3%. The MeAPEs were higher for Yamax SW200 (2.9-21.0%), AGlink display (3.6-44.8%) and AGlink normal filter (8.9-48.9%), indicating low validity. AGlink was not valid in measurements of sitting (MeAPE 12.0-12.5%) or lying (MeAPE 31.0-41.7%). The correlation between PADS-R(Sw) and AGlink steps was r = 0.492 (p = .009). The relative reliability of PADS-R(Sw) was ICC2,1 0.85 (CI 0.76-0.91), and absolute reliability was SEM 0.54. CONCLUSION AGlink and PiezoRX were valid measures of steps in PwMS. The questionnaire PADS-R(Sw) was valid, with high relative reliability, but its absolute reliability was unsatisfactory.
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Affiliation(s)
- Elisabeth Anens
- Department of Neuroscience, Section for Physiotherapy, Uppsala, Sweden
| | - Isabell Ahlström
- Department of Neuroscience, Section for Physiotherapy, Uppsala, Sweden
| | - Margareta Emtner
- Department of Neuroscience, Section for Physiotherapy, Uppsala, Sweden
| | - Lena Zetterberg
- Department of Neuroscience, Section for Physiotherapy, Uppsala, Sweden
| | - Ylva Nilsagård
- Department of Health Care Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Region Örebro County, University Research Health Care Centre, Sweden
| | - Karin Hellström
- Department of Neuroscience, Section for Physiotherapy, Uppsala, Sweden
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Fanning J, Brooks AK, Ford S, Robison JT, Irby MB, Rejeski WJ. A remote group-mediated daylong physical activity intervention for older adults with chronic pain: Results of the MORPH-II randomized pilot trial. Front Digit Health 2022; 4:1040867. [PMID: 36405417 PMCID: PMC9666366 DOI: 10.3389/fdgth.2022.1040867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/14/2022] [Indexed: 01/24/2023] Open
Abstract
Chronic pain is a debilitating condition that affects many older adults who often have limited access to non-pharmacological pain management strategies. One potentially effective and novel lifestyle medicine for chronic pain involves increasing physical activity through frequent movement across the day, thereby also decreasing the presence of extended sedentary bouts. The MORPH-II pilot randomized controlled refinement trial iterated on the MORPH trial, which was a first-of-its-kind group-mediated daylong physical activity (DPA) intervention for older adults with chronic pain rooted in social cognitive and self-determination theories and supported by an mHealth toolset designed to foster social connection and awareness of physical activity patterns. MORPH-II was delivered fully remotely via videoconference software and supported by a technology kit comprising an iPad, activity monitor, and wireless weight scale. It was also implemented a refined coaching model designed to help participants better understand their own patterns of activity. A total of 44 participants were randomized to receive the 12-week group-mediated DPA intervention or to a low-contact control. Qualitative interviews suggest the program was well-received by participants and that participants developed an understanding of how patterns of physical activity related to their pain symptoms. Participants also highlighted several additional areas for refinement related to the coaching model and feedback provided within the mHealth app. Analyses of covariance, controlling for baseline values, revealed a small effect (η 2 = 0.01) on pain intensity favoring the intervention condition, though both groups improved during the study period. There was a large effect favoring the intervention condition on ActivPAL-assessed average daily steps (η 2 = 0.23) and postural shifts (η 2 = 0.24). Control participants spent less time in short sedentary bouts (η 2 = 0.09), and there was a small effect (η 2 = 0.02) indicating intervention participants spent less time in extended sedentary bouts. Finally, relative to control, intervention participants demonstrated a moderate improvement in autonomy satisfaction (η 2 = 0.05), relatedness frustration (η 2 = 0.05), and competence frustration (η 2 = 0.06), and a large magnitude improvement in competence satisfaction (η 2 = 0.22). These findings indicate that the MORPH-II intervention was feasible and acceptable, and may positively impact steps, postural breaks, and several key domains of basic psychological needs detailed in self-determination theory.
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Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC, United States
| | - Amber K. Brooks
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Sherri Ford
- Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC, United States
| | - Justin T. Robison
- Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC, United States
| | - Megan B. Irby
- Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC, United States
| | - W. Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC, United States
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Jabardo-Camprubí G, Bort-Roig J, Donat-Roca R, Milà-Villarroel R, Sitjà-Rabert M, McKenna J, Puig-Ribera A. A socio-ecological approach to reduce the physical activity drop-out ratio in primary care-based patients with type 2 diabetes: the SENWI study protocol for a randomized control trial. Trials 2022; 23:842. [PMID: 36192800 PMCID: PMC9531392 DOI: 10.1186/s13063-022-06742-7] [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: 06/17/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Physical activity (PA) is a key behaviour for patients with type 2 diabetes (T2DM). However, healthcare professionals’ (HCP) recommendations (walking advice), which are short-term and individually focused, did not reduce the PA drop-out ratio in the long run. Using a socio-ecological model approach may contribute to reducing patient dropout and improving adherence to PA. The aim of this study is threefold: first, to evaluate the effectiveness of a theory-driven Nordic walking intervention using a socio-ecological approach with T2DM patients in Spain; second, to explore the feasibility on the PA adherence process in T2DM patients while participating in the SENWI programme; and third, to understand the HCPs’ opinion regarding its applicability within the Spanish healthcare system. Methods A three-arm randomized control trial (n = 48 each group) will assess the efficacy of two primary care-based PA interventions (Nordic walking vs. Nordic walking plus socio-ecological approach; two sessions per week for twelve weeks) compared to a control group (usual HCPs’ walking advice on PA). Inclusion criteria will include physically inactive patients with T2DM, older than 40 years and without health contraindications to do PA. PA levels and drop-out ratio, quality of life and metabolic and health outcomes will be assessed at baseline, post-intervention and at 9- and 21-month follow-ups. The effect of the different interventions will be assessed by a two-factor analysis of variance: treatment group vs time. Also, a two-factor ANOVA test will be performed with linear mixed models for repeated measures. A qualitative analysis using focus groups will explore the reasons for the (in)effectiveness of the new PA interventions. Qualitative outcomes will be assessed at post-intervention using thematic analysis. Discussion Compared with the general PA walking advice and Nordic walking prescriptions, integrating a socio-ecological approach into Spanish primary care visits could be an effective way to reduce the PA drop-out ratio and increase PA levels in patients with T2DM. Such interventions are necessary to understand the role that multiple socio-complex process in day-to-day PA behaviour has in patients with T2DM in the Spanish context. Trial registration ClinicalTrials.gov NCT05159089. Physical Activity Drop-out Ratio in Patients’ Living with Type 2 Diabetes. Prospectively registered on 15 December 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06742-7.
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Affiliation(s)
- Guillem Jabardo-Camprubí
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain.
| | - Judit Bort-Roig
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain
| | - Rafel Donat-Roca
- School of Health Science UManresa, Sport Exercise and Human Movement (SEaMH), University of Vic-Central University of Catalonia, Av. Universitaria 4-6, Manresa, Spain
| | - Raimon Milà-Villarroel
- School of Health Science Blanquerna, Ramon Llull University, Padilla, 326-332, Barcelona, Spain
| | - Mercè Sitjà-Rabert
- School of Health Science Blanquerna, Global Research on Wellbeing (GRoW) Research Group, Ramon Llull University, Padilla, 326-332, Barcelona, Spain
| | - Jim McKenna
- School of Sport, Leeds Becket University, Leeds, LS1 3HE, Leeds, England
| | - Anna Puig-Ribera
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain
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Validity of the activPAL monitor to measure stepping activity and activity intensity: A systematic review. Gait Posture 2022; 97:165-173. [PMID: 35964334 DOI: 10.1016/j.gaitpost.2022.08.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/24/2022] [Accepted: 08/04/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Accumulating step counts and engaging in moderate-to-vigorous intensity physical activity is positively associated with numerous health benefits. The activPAL is a thigh-worn monitor that is frequently used to measure physical activity. RESEARCH QUESTION Can the activPAL accurately measure stepping activity and identify physical activity intensity? METHODS We systematically reviewed validation studies examining the accuracy of activPAL physical activity outcomes relative to a criterion measure in adults (>18 years). Citations were not restricted to language or date of publication. Sources were searched up to May 16, 2021 and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier. The study was pre-registered in Prospero (ID# CRD42021248240). Study quality was determined using a modified Hagströmer Bowles checklist. RESULTS Thirty-nine studies (20 laboratory arms, 17 semi-structured arms, 11 uncontrolled protocol arms; 1272 total participants) met the inclusion criteria. Most studies demonstrated a high validity of the activPAL to measure steps across laboratory (12/15 arms), semi-structured (10/13 arms) and uncontrolled conditions (5/7 arms). Studies that demonstrated low validity were generally conducted in unhealthy populations, included slower walking speeds, and/or short walking distances. Few studies indicated that the activPAL accurately measured physical activity intensity across laboratory (0/6 arms), semi-structured (0/5 arms) and uncontrolled conditions (2/5 arms). Using the default settings, the activPAL overestimates light-intensity activity but underestimates moderate-to-vigorous intensity activity. The overall study quality was 11.5 ± 2.0 out of 19. CONCLUSION Despite heterogeneous methodological and statistical approaches, the included studies generally provide supporting evidence that the activPAL can accurately detect stepping activity but not physical activity intensity. Strategies that use alternative data processing methods have been developed to better characterize physical activity intensity, but all methods still underestimate vigorous-intensity activity.
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Validity of the ActivPAL monitor to distinguish postures: A systematic review. Gait Posture 2022; 94:107-113. [PMID: 35276456 DOI: 10.1016/j.gaitpost.2022.03.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/13/2022] [Accepted: 03/03/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Posture has been recently integrated into activity guidelines, advising people to limit their sedentary time and break up sedentary postures with standing/stepping as much as possible. The thigh-worn activPAL is a frequently used objective measure of posture, but its validity has only been investigated by individual studies and has not been systematically reviewed. RESEARCH QUESTION Can the activPAL accurately characterize different postures? METHODS A rigorous systematic review protocol was conducted, including multiple study screeners and determiners of study quality. To be included, validation studies had to examine the accuracy of an activPAL posture outcome relative to a criterion measure (e.g., direct observation) in adults (>18 years). Citations were not restricted to language or date of publication. Sources were searched on May 16, 2021 and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier. The study was pre-registered in Prospero (ID# CRD42021248240). Study quality was determined using a modified Hagströmer Bowles checklist. The results are presented narratively. RESULTS Twenty-four studies (18 semi-structured laboratory arms, 8 uncontrolled protocol arms; 476 participants) met the inclusion criteria. Some studies (5/24) incorporated dual-monitor (trunk: 4/5; shin: 1/5) configurations. While heterogenous statistical procedures were implemented, most studies (n = 22/24) demonstrated a high validity (e.g., percent agreement >90%, no fixed bias, etc.) of the activPAL to measure sedentary and/or upright postures across semi-structured (17/18 arms) and uncontrolled study designs (7/8 arms). Specific experimental protocol factors (i.e., seat height, fidgeting, non-direct observation criterion comparator) likely explain the divergent reports that observed valid versus invalid findings. The study quality was 11.3 (standard deviation: 2.3) out of 19. CONCLUSION Despite heterogeneous methodological and statistical approaches, the included studies generally provide supporting evidence that the activPAL can accurately distinguish between sedentary and standing postures. Multiple activPAL monitor configurations (e.g., thigh and torso) are needed to better characterize sitting versus lying postures.
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12
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Kalisch T, Theil C, Gosheger G, Ackmann T, Schoenhals I, Moellenbeck B. Measuring sedentary behavior using waist- and thigh-worn accelerometers and inclinometers – are the results comparable? Ther Adv Musculoskelet Dis 2022; 14:1759720X221079256. [PMID: 35310836 PMCID: PMC8928357 DOI: 10.1177/1759720x221079256] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/18/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Objective sensor-based quantification of sedentary behavior is an important tool for planning and evaluating interventions for excessive sedentary behavior in patients with musculoskeletal diseases. Although waist-worn accelerometers are the standard for physical activity (PA) assessment, only thigh-worn inclinometers can clearly distinguish sedentary behavior from any light PA or standing activity. Methods: In this study, 53 adults (ages 20–85 years) wore two ActiGraph wGT3X-BT monitors, each containing an inclinometer and accelerometer (set for acquisition of slow movements in all three planes), attached to the right waist and thigh for a period of about 4 days. Both monitors recorded total sedentary time and continuous sedentary 10-min bouts by synchronous accelerometry and inclinometry. Differences and correlations between methods and wearing positions were evaluated against participant age, body mass index (BMI), and number of steps taken. Thigh-worn inclinometry was used as reference. Results: Data from thigh-worn inclinometry and waist-worn accelerometry were highly correlated for total sedentary time [rho = 0.888; intraclass correlation coefficient (ICC) = 0.937] and time in sedentary bouts (rho = 0.818; ICC = 0.848). Nevertheless, accelerometry at the waist underestimated sedentary time by ≈17% (p < 0.001) and time in sedentary bouts by ≈54% (p < 0.001). A satisfactory concordance thus could be demonstrated only for total sedentary time, based on the Bland–Altmann method (≈96% of data within the limits of agreement). The differences between waist-worn accelerometry and thigh-worn inclinometry did not correlate with age but did correlate with BMI and PA for both sedentary behavior parameters (r ⩾ 0.240, p ⩽ 0.043). Conclusion: A waist-worn accelerometer can be used to determine total sedentary time under free-living conditions with sufficient accuracy if the correct settings are chosen. Further investigations are necessary to investigate why short sedentary bouts cannot be reliably assessed. Trial registration: DRKS00024060 (German Clinical Trials Register)
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Affiliation(s)
- Tobias Kalisch
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Christoph Theil
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Georg Gosheger
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Thomas Ackmann
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Isabell Schoenhals
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Burkhard Moellenbeck
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
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Das SK, Miki AJ, Blanchard CM, Sazonov E, Gilhooly CH, Dey S, Wolk CB, Khoo CSH, Hill JO, Shook RP. Perspective: Opportunities and Challenges of Technology Tools in Dietary and Activity Assessment: Bridging Stakeholder Viewpoints. Adv Nutr 2022; 13:1-15. [PMID: 34545392 PMCID: PMC8803491 DOI: 10.1093/advances/nmab103] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 12/23/2022] Open
Abstract
The science and tools of measuring energy intake and output in humans have rapidly advanced in the last decade. Engineered devices such as wearables and sensors, software applications, and Web-based tools are now ubiquitous in both research and consumer environments. The assessment of energy expenditure in particular has progressed from reliance on self-report instruments to advanced technologies requiring collaboration across multiple disciplines, from optics to accelerometry. In contrast, assessing energy intake still heavily relies on self-report mechanisms. Although these tools have improved, moving from paper-based to online reporting, considerable room for refinement remains in existing tools, and great opportunities exist for novel, transformational tools, including those using spectroscopy and chemo-sensing. This report reviews the state of the science, and the opportunities and challenges in existing and emerging technologies, from the perspectives of 3 key stakeholders: researchers, users, and developers. Each stakeholder approaches these tools with unique requirements: researchers are concerned with validity, accuracy, data detail and abundance, and ethical use; users with ease of use and privacy; and developers with high adherence and utilization, intellectual property, licensing rights, and monetization. Cross-cutting concerns include frequent updating and integration of the food and nutrient databases on which assessments rely, improving accessibility and reducing disparities in use, and maintaining reliable technical assistance. These contextual challenges are discussed in terms of opportunities and further steps in the direction of personalized health.
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Affiliation(s)
- Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Akari J Miki
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Caroline M Blanchard
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Edward Sazonov
- Department of Electrical and Computer Engineering, University of Alabama, Tuscaloosa, AL, USA
| | - Cheryl H Gilhooly
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Sujit Dey
- Department of Electrical and Computer Engineering, University of California, San Diego, La Jolla, CA, USA
| | - Colton B Wolk
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Chor San H Khoo
- Institute for the Advancement of Food and Nutrition Sciences, Washington, DC, USA
| | - James O Hill
- Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robin P Shook
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
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14
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Germini F, Noronha N, Borg Debono V, Abraham Philip B, Pete D, Navarro T, Keepanasseril A, Parpia S, de Wit K, Iorio A. Accuracy and Acceptability of Wrist-Wearable Activity-Tracking Devices: Systematic Review of the Literature. J Med Internet Res 2022; 24:e30791. [PMID: 35060915 PMCID: PMC8817215 DOI: 10.2196/30791] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/24/2021] [Accepted: 12/06/2021] [Indexed: 01/19/2023] Open
Abstract
Background Numerous wrist-wearable devices to measure physical activity are currently available, but there is a need to unify the evidence on how they compare in terms of acceptability and accuracy. Objective The aim of this study is to perform a systematic review of the literature to assess the accuracy and acceptability (willingness to use the device for the task it is designed to support) of wrist-wearable activity trackers. Methods We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and SPORTDiscus for studies measuring physical activity in the general population using wrist-wearable activity trackers. We screened articles for inclusion and, for the included studies, reported data on the studies’ setting and population, outcome measured, and risk of bias. Results A total of 65 articles were included in our review. Accuracy was assessed for 14 different outcomes, which can be classified in the following categories: count of specific activities (including step counts), time spent being active, intensity of physical activity (including energy expenditure), heart rate, distance, and speed. Substantial clinical heterogeneity did not allow us to perform a meta-analysis of the results. The outcomes assessed most frequently were step counts, heart rate, and energy expenditure. For step counts, the Fitbit Charge (or the Fitbit Charge HR) had a mean absolute percentage error (MAPE) <25% across 20 studies. For heart rate, the Apple Watch had a MAPE <10% in 2 studies. For energy expenditure, the MAPE was >30% for all the brands, showing poor accuracy across devices. Acceptability was most frequently measured through data availability and wearing time. Data availability was ≥75% for the Fitbit Charge HR, Fitbit Flex 2, and Garmin Vivofit. The wearing time was 89% for both the GENEActiv and Nike FuelBand. Conclusions The Fitbit Charge and Fitbit Charge HR were consistently shown to have a good accuracy for step counts and the Apple Watch for measuring heart rate. None of the tested devices proved to be accurate in measuring energy expenditure. Efforts should be made to reduce the heterogeneity among studies.
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Affiliation(s)
- Federico Germini
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Noella Noronha
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- School of Interdisciplinary Sciences, McMaster University, Hamilton, ON, Canada
| | - Victoria Borg Debono
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Binu Abraham Philip
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Drashti Pete
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Tamara Navarro
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Arun Keepanasseril
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Sameer Parpia
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Kerstin de Wit
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Alfonso Iorio
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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15
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Gallagher J, Carr LJ. Leisure but Not Occupational Physical Activity and Sedentary Behavior Associated With Better Health. J Occup Environ Med 2021; 63:e774-e782. [PMID: 34456325 DOI: 10.1097/jom.0000000000002365] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study explores relations between occupational and leisure-time physical activity (OPA, LTPA) and sedentary behavior (OSB, LTSB) and several health outcomes. METHODS A total 114 full-time workers had their body composition, waist circumference, height, weight, resting heart rate, and resting blood pressure measured. ActivPal monitor measured physical activity behaviors. Stress, mood, and pain were measured with ecological momentary assessment. General linear models were used to examine the relationship between high and low OPA, LTPA, OSB, and LTSB with each health outcome while controlling for covariates. RESULTS The high LTPA group had lower body mass index (BMI) (P = 0.04) and better mood (P = 0.007) than the low LTPA group. The high LTSB group had higher systolic blood pressure (P = 0.001), higher diastolic blood pressure (P = 0.01), higher BMI (P = 0.027), higher body fat percentage (P = 0.003), higher waist circumference (P = 0.01), and worse mood (P = 0.032) than the low LTSB group. No differences were found between OPA and OSB groups. CONCLUSIONS These findings suggest there may be differential relations between PA and SB accumulated during leisure versus occupational time.
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Affiliation(s)
- Jacob Gallagher
- Behavioral Medicine Laboratory, Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
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16
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Wagnild JM, Akowuah E, Maier RH, Hancock HC, Kasim A. Impact of prehabilitation on objectively measured physical activity levels in elective surgery patients: a systematic review. BMJ Open 2021; 11:e049202. [PMID: 34493516 PMCID: PMC8424868 DOI: 10.1136/bmjopen-2021-049202] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To systematically review the impact of prehabilitation on objectively measured physical activity (PA) levels in elective surgery patients. DATA SOURCES Articles published in Web of Science Core Collections, PubMed, Embase (Ovid), CINAHL (EBSCOHost), PsycInfo (EBSCOHost) and CENTRAL through August 2020. STUDY SELECTION Studies that met the following criteria: (1) written in English, (2) quantitatively described the effect(s) of a PA intervention among elective surgery patients prior to surgery and (3) used and reported objective measures of PA in the study. DATA EXTRACTION AND SYNTHESIS Participant characteristics, intervention details, PA measurement, and clinical and health-related outcomes were extracted. Risk of bias was assessed following the revised Cochrane risk of bias tool. Meta-analysis was not possible due to heterogeneity, therefore narrative synthesis was used. RESULTS 6533 unique articles were identified in the search; 21 articles (based on 15 trials) were included in the review. There was little evidence to suggest that prehabilitation is associated with increases in objectively measured PA, but this may be due to insufficient statistical power as most (n=8) trials included in the review were small feasibility/pilot studies. Where studies tested associations between objectively measured PA during the intervention period and health-related outcomes, significant beneficial associations were reported. Limitations in the evidence base precluded any assessment via meta-regression of the association between objectively measured PA and clinical or health-related outcomes. CONCLUSIONS Additional large-scale studies are needed, with clear and consistent reporting of objective measures including accelerometry variables and outcome variables, to improve our understanding of the impact of changes in PA prior to surgery on surgical and health-related outcomes. PROSPERO REGISTRATION NUMBER CRD42019151475.
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Affiliation(s)
| | - Enoch Akowuah
- Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK
| | - Rebecca H Maier
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Helen C Hancock
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
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17
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Liu F, Wanigatunga AA, Schrack JA. Assessment of Physical Activity in Adults using Wrist Accelerometers. Epidemiol Rev 2021; 43:65-93. [PMID: 34215874 DOI: 10.1093/epirev/mxab004] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 11/12/2022] Open
Abstract
The health benefits of physical activity have been widely recognized, yet traditional measures of physical activity including questionnaires and category-based assessments of volume and intensity provide only broad estimates of daily activities. Accelerometers have advanced epidemiologic research on physical activity by providing objective and continuous measurement of physical activity in free-living conditions. Wrist-worn accelerometers have become especially popular due to low participant burden. However, the validity and reliability of wrist-worn devices for adults have yet to be summarized. Moreover, accelerometer data provide rich information on how physical activity is accumulated throughout the day, but only a small portion of these rich data have been utilized by researchers. Lastly, new methodological developments that aim to overcome some of the limitations of accelerometers are emerging. The purpose of this review is to provide an overview of accelerometry research, with a special focus on wrist-worn accelerometers. We describe briefly how accelerometers work, summarize the validity and reliability of wrist-worn accelerometers, discuss the benefits of accelerometers including measuring light-intensity physical activity, and discuss pattern metrics of daily physical activity recently introduced in the literature. A summary of large-scale cohort studies and randomized trials that implemented wrist-worn accelerometry is provided. We conclude the review by discussing new developments and future directions of research using accelerometers, with a focus on wrist-worn accelerometers.
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Affiliation(s)
- Fangyu Liu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, United States
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18
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Criterion validity of the ActiGraph and activPAL in classifying posture and motion in office-based workers: A cross-sectional laboratory study. PLoS One 2021; 16:e0252659. [PMID: 34077463 PMCID: PMC8171934 DOI: 10.1371/journal.pone.0252659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/19/2021] [Indexed: 11/30/2022] Open
Abstract
Background The ActiGraph and activPAL monitors are the most frequently used thigh-worn devices to measure motion and posture, but the criterion validity to measure sitting, standing and postural transfer in the office setting is not known. Research question: To examine the criterion validity of the ActiGraph and activPAL activity monitors in repeatedly measuring a variety of different postures and motion in the office setting. Methods Twenty office workers from the University of Zurich wore an ActiGraph and activPAL during two identical laboratory experiments lasting approximately 60 minutes each, within a maximum of 7 days. The experimental setting consisted of a standard computer office workstation with an electrically powered height-adjustable desk, a swivel chair without arm rests, a standard chair, a footrest, and a bookcase. The protocol consisted of 24 pre-defined tasks mimicking sitting, standing, stepping, and postural transitions around the workplace. All tasks were supervised and observed by the same experimenter. Results In repeated measurements (40 individual experiments), the percentages of correctly classified tasks for the ActiGraph and activPAL were, respectively, 100% vs. 85% for sitting, 87% vs. 100% for standing, and 100% vs. 73% for postural transitions. Both monitors correctly identified all stepping tasks. The activPAL misclassified sitting with legs outstretched, and sitting with both feet placed beneath the chair, as standing ~25–70% and 45% of the time, respectively. The ActiGraph misclassified standing with the right foot on a footrest as sitting in 65% of events. Conclusions The ActiGraph appears to be slightly more sensitive than the activPAL with respect to the measurement of sitting and postural transitions of short duration, whereas the activPAL seems to be slightly more accurate in capturing standing postures. This knowledge will help guide researchers to choose the best suitable monitor for their research setting.
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Guirado T, Metz L, Pereira B, Bergouignan A, Thivel D, Duclos M. Effects of cycling workstation to get tertiary employee moving on their overall health: study protocol for a REMOVE trial. Trials 2021; 22:359. [PMID: 34022938 PMCID: PMC8140559 DOI: 10.1186/s13063-021-05317-2] [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: 08/11/2020] [Accepted: 05/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sedentary behaviour (SB) and low levels of physical activity (PA) are predictors of morbidity and mortality. Tertiary employees spend a considerable amount of their daily time seated and new efficient strategies to both reduce sedentary time and increase physical activity are needed. In that context, the REMOVE study aims at evaluating the health effects of a 24-week cycling desk intervention among office workers. METHODS A prospective, open-label, multicentre, two-arm parallel, randomized controlled trial (RCT) will be conducted in office-sitting desk workers. Office workers (N = 80) who have 0.8 full time equivalent hours (FTE) and 75% of this time in a sitting position will be recruited from tertiary worksites in Clermont-Ferrand, France. Subjects will be randomly assigned to one of the two following interventions: (i) PPM6: performance of two 30 min of cycling desk (using portable pedal exercise machine-PPM) per working day for 6 months or (ii) CTL_PPM3: 3 months with no intervention (control) followed by 3 months during which workers will be asked to complete two 30 min of PPM per working day. At baseline (T0), at 3 months (T1) and at 6 months (T2) after the start of the interventions, primary outcomes; 7-day PA and SB (3D-accelerometers), secondary outcomes; body composition (bioelectrical impedance), physical fitness (aerobic fitness, upper and lower limb strength), metabolic outcomes (fasting blood samples), self-perceived stress, anxiety, quality of life at work and job strain (questionnaires), tertiary outcomes; resting metabolic rate and cycling energy expenditure (indirect calorimetry) and eating behaviours (questionnaires) will be measured. An ergonomic approach based on observations and individual interviews will be used to identify parameters that could determine adherence. DISCUSSION The REMOVE study will be the first RCT to assess the effects of cycling workstations on objectively measured PA and SB during working and non-working hours and on key physiological and psychological health outcomes. This study will provide important information regarding the implementation of such cycling workstations in office workers and on the associated potential health benefits. TRIAL REGISTRATION ClinicalTrials.gov NCT04153214 . Registered on November 2019, version 1.
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Affiliation(s)
- Terry Guirado
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UE3533, Clermont Auvergne University, F-63171 63170 Aubiere CEDEX, 80026, Clermont-Ferrand, BP, France.,Auvergne Research Center for Human Nutrition (CRNH), 63000, Clermont-Ferrand, France.,Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France.,INRA, UMR 1019, Clermont-Ferrand, France
| | - Lore Metz
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UE3533, Clermont Auvergne University, F-63171 63170 Aubiere CEDEX, 80026, Clermont-Ferrand, BP, France. .,Auvergne Research Center for Human Nutrition (CRNH), 63000, Clermont-Ferrand, France.
| | - Bruno Pereira
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - Audrey Bergouignan
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000, Strasbourg, France.,Division of Endocrinology, Metabolism and Diabetes, Anschutz Health & Wellness Center, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - David Thivel
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UE3533, Clermont Auvergne University, F-63171 63170 Aubiere CEDEX, 80026, Clermont-Ferrand, BP, France.,Auvergne Research Center for Human Nutrition (CRNH), 63000, Clermont-Ferrand, France
| | - Martine Duclos
- Auvergne Research Center for Human Nutrition (CRNH), 63000, Clermont-Ferrand, France.,Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France.,INRA, UMR 1019, Clermont-Ferrand, France
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20
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Kracht CL, Beyl RA, Maher JP, Katzmarzyk PT, Staiano AE. Adolescents' sedentary time, affect, and contextual factors: An ecological momentary assessment study. Int J Behav Nutr Phys Act 2021; 18:53. [PMID: 33858416 PMCID: PMC8047569 DOI: 10.1186/s12966-021-01121-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 04/08/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Few adolescents achieve sufficient levels of physical activity, and many are spending most of their time in sedentary behavior. Affective response following sedentary time may influence motivation to remain sedentary. Ecological Momentary Assessment (EMA) is a real-time data capture methodology that can be used to identify factors influencing sedentary time, such as the context of the home setting, and resulting affective state within a free-living setting. The purpose of this study was to evaluate the relationship between context at home and adolescent sedentary time, and the relationship of sedentary time and subsequent affect. METHODS Adolescents (n = 284; 10-16 y) participated in an EMA study that used random, interval-based sampling methods. Adolescents each received 22 unannounced surveys over 7-days through a smartphone application. One survey was randomly sent within each 2-h time-period. These time-periods occurred between 4:00 pm-8:00 pm on weekdays and 8:00 am-8:00 pm on the weekend. This 15-question survey included a series of questions on context (indoors/outdoors, alone/not alone) and positive affect. Adolescents concurrently wore an accelerometer at the hip, and the 30-min bout of accelerometry data prior to each survey was used in analyses. Mixed-effect location scale models were used to examine the association between context at home and sedentary time (stage 1) and the adjusted sedentary time and positive affect (stage 2), with each model adjusted for covariates. RESULTS Adolescents were 12.6 ± 1.9 y of age on average, about half were White (58%), and engaged in high levels of sedentary behavior during the 30 min prior to the survey (21.4 ± 6.8 min). Most surveys occurred when adolescents were with others (59%) and indoors (88%). In Stage 1, both being alone and being indoors at home were positively associated with sedentary time (p < 0.001 for both). In Stage 2, adjusted sedentary time was not related to positive affect. Age was negatively related to positive affect (p < 0.001). CONCLUSIONS Both contextual factors, being alone and indoors at home, were related to additional time spent sedentary compared to being with someone or outdoors. After adjustment, sedentary time was not related to subsequent positive affect, indicating other factors may be related to adolescent's positive affect in home settings.
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Affiliation(s)
- Chelsea L Kracht
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Robbie A Beyl
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Jaclyn P Maher
- University of North Carolina Greensboro, 1408 Walker Ave., Greensboro, NC, 27412, USA
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Amanda E Staiano
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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21
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Bort-Roig J, Chirveches-Pérez E, Giné-Garriga M, Navarro-Blasco L, Bausà-Peris R, Iturrioz-Rosell P, González-Suárez AM, Martínez-Lemos I, Puigoriol-Juvanteny E, Dowd K, Puig-Ribera A. An mHealth Workplace-Based "Sit Less, Move More" Program: Impact on Employees' Sedentary and Physical Activity Patterns at Work and Away from Work. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8844. [PMID: 33260697 PMCID: PMC7730175 DOI: 10.3390/ijerph17238844] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Most workplace interventions that aim to reduce sedentary behaviour have 38 focused on employees' sedentary patterns at-work but less have focused on understanding the 39 impact beyond working time. The aim of this study was to evaluate the impact of a 13-week m-40 health workplace-based 'sit less, move more' intervention (Walk@WorkApp; W@W-App) on 41 physical activity (PA) and sitting in desk-based employees at-work and away from work. METHODS Participants (n = 141) were assigned by hospital to an intervention group (IG; used the W@W-App; n = 90) or an active comparison group (A-CG; monitored occupational activity; n = 51). The W@W-App, installed on the participants´ own smartphones, provided real-time feedback for occupational sitting, standing, and stepping, and gave access to automated strategies to sit less and move more at work. Changes between groups were assessed for total sitting time, sedentary bouts and breaks, and light and moderate-to-vigorous PA (activPAL3TM; min/day) between the baseline and after program completion. RESULTS Compared to the A-CG, employees that used the W@W-App program increased their number of daily breaks and the time spent on short sedentary bouts (<20 min, p = 0.047) during weekends. Changes in shortest sedentary bouts (5-10 min) during weekends were also statistically significant (p < 0.05). No changes in workday PA or sitting were observed. CONCLUSION Desk-based employees seemed to transfer the W@W-App program knowledge outside of work. Evaluating the impact of workplace (mHealth-based or not) interventions at work but also away from work would provide a better understating of the impact of such interventions.
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Affiliation(s)
- Judit Bort-Roig
- Sport and Physical Activity Research Group, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, 08500 Barcelona, Spain;
| | - Emilia Chirveches-Pérez
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, 08500 Barcelona, Spain;
| | - Maria Giné-Garriga
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, 08022 Barcelona, Spain;
- Department of Physiotherapy, Faculty of Health Sciences Blanquerna, Ramon Llull University, 08025 Barcelona, Spain
| | - Lydia Navarro-Blasco
- Occupational Health Service, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (L.N.-B.); (R.B.-P.)
| | - Roser Bausà-Peris
- Occupational Health Service, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (L.N.-B.); (R.B.-P.)
| | - Pedro Iturrioz-Rosell
- Unidad Docente Pluridisciplinar de Atención Familiar y Comunitaria, Hospital Universitario de Donostia, 20014 Donostia-San Sebastián, Spain;
| | - Angel M. González-Suárez
- Department of Physical Education and Sport, University of the Basque Country, 01007 Vitoria-Gasteiz, Spain;
| | - Iván Martínez-Lemos
- Well-Move Research Group (HI-23), Faculty of Educational Sciences and Sports, University of Vigo, 36005 Pontevedra, Spain;
| | - Emma Puigoriol-Juvanteny
- Tissue Repair and Regeneration Laboratory (TR2Lab), Faculty of Sciences and Technology, University of Vic-Central University of Catalonia, 08500 Vic, Barcelona, Spain;
- Epidemiology Unit, University Hospital of Vic-Vic Hospital Consortium (HUV-CHV), 08500 Barcelona, Spain
| | - Kieran Dowd
- Department of Sport and Health Sciences, Athlone Institute of Technology, N37 HD68 Athlone, Co. Westmeath, Ireland;
| | - Anna Puig-Ribera
- Sport and Physical Activity Research Group, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, 08500 Barcelona, Spain;
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22
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Vincent GE, Gupta CC, Sprajcer M, Vandelanotte C, Duncan MJ, Tucker P, Lastella M, Tuckwell GA, Ferguson SA. Are prolonged sitting and sleep restriction a dual curse for the modern workforce? a randomised controlled trial protocol. BMJ Open 2020; 10:e040613. [PMID: 32718927 PMCID: PMC7389768 DOI: 10.1136/bmjopen-2020-040613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Prolonged sitting and inadequate sleep are a growing concern in society and are associated with impairments to cardiometabolic health and cognitive performance. However, the combined effect of prolonged sitting and inadequate sleep on measures of health and cognitive performance are unknown. In addition, the circadian disruption caused by shiftwork may further impact workers' cardiometabolic health and cognitive performance. This protocol paper outlines the methodology for exploring the impact of simultaneous exposure to prolonged sitting, sleep restriction and circadian disruption on cardiometabolic and cognitive performance outcomes. METHODS AND ANALYSIS This between-subjects study will recruit 208 males and females to complete a 7-day in-laboratory experimental protocol (1 Adaptation Day, 5 Experimental Days and 1 Recovery Day). Participants will be allocated to one of eight conditions that include all possible combinations of the following: dayshift or nightshift, sitting or breaking up sitting and 5 hour or 9 hour sleep opportunity. On arrival to the laboratory, participants will be provided with a 9 hour baseline sleep opportunity (22:00 to 07:00) and complete five simulated work shifts (09:00 to 17:30 in the dayshift condition and 22:00 to 06:30 in the nightshift condition) followed by a 9 hour recovery sleep opportunity (22:00 to 07:00). During the work shifts participants in the sitting condition will remain seated, while participants in the breaking up sitting condition will complete 3-min bouts of light-intensity walking every 30 mins on a motorised treadmill. Sleep opportunities will be 9 hour or 5 hour. Primary outcome measures include continuously measured interstitial blood glucose, heart rate and blood pressure, and a cognitive performance and self-perceived capacity testing battery completed five times per shift. Analyses will be conducted using linear mixed models. ETHICS AND DISSEMINATION The CQUniversity Human Ethics Committee has approved this study (0000021914). All participants who have already completed the protocol have provided informed consent. Study findings will be disseminated via scientific publications and conference presentations. TRIAL REGISTRATION DETAILS This study has been registered on Australian New Zealand Clinical Trials Registry (12619001516178) and is currently in the pre-results stage.
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Affiliation(s)
- Grace E Vincent
- Appleton Institute, Central Queensland University - Adelaide Campus, Wayville, South Australia, Australia
| | - Charlotte C Gupta
- Appleton Institute, Central Queensland University - Adelaide Campus, Wayville, South Australia, Australia
| | - Madeline Sprajcer
- Appleton Institute, Central Queensland University - Adelaide Campus, Wayville, South Australia, Australia
| | - Corneel Vandelanotte
- School of Health Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Mitch J Duncan
- School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
| | - Phil Tucker
- Psychology Department, Swansea University, Swansea, United Kingdom
- Stress Research Institute, Department of Psychology, Stocklholm University, Stockholm, Sweden
| | - Michele Lastella
- Appleton Institute, Central Queensland University - Adelaide Campus, Wayville, South Australia, Australia
| | - Georgia A Tuckwell
- Appleton Institute, Central Queensland University - Adelaide Campus, Wayville, South Australia, Australia
| | - Sally A Ferguson
- Appleton Institute, Central Queensland University - Adelaide Campus, Wayville, South Australia, Australia
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23
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Fanning J, Rejeski WJ, Chen SH, Nicklas BJ, Walkup MP, Axtell RS, Fielding RA, Glynn NW, King AC, Manini TM, McDermott MM, Newman AB, Pahor M, Tudor-Locke C, Miller ME. A Case for Promoting Movement Medicine: Preventing Disability in the LIFE Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci 2020; 74:1821-1827. [PMID: 30778518 DOI: 10.1093/gerona/glz050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The movement profile of older adults with compromised function is unknown, as is the relationship between these profiles and the development of major mobility disability (MMD)-a critical clinical outcome. We first describe the dimensions of movement in older adults with compromised function and then examine whether these dimensions predict the onset of MMD. METHODS Older adults at risk for MMD (N = 1,022, mean age = 78.7 years) were randomized to receive a structured physical activity intervention or health education control. We assessed MMD in 6-month intervals (average follow-up of 2.2 years until incident MMD), with activity assessed at baseline, 6-, 12- and 24-month follow-up via accelerometry. RESULTS A principal components analysis of 11 accelerometer-derived metrics yielded three components representing lifestyle movement (LM), extended bouts of moderate-to-vigorous physical activity (MVPA), and stationary body posture. LM accounted for the greatest proportion of variance in movement (53%). Within health education, both baseline LM (HR = 0.74; 95% CI 0.62 to 0.88) and moderate-to-vigorous physical activity (HR = 0.69; 95% CI 0.54 to 0.87) were associated with MMD, whereas only LM was associated with MMD within physical activity (HR = 0.74; 95% CI 0.61 to 0.89). There were similar nonlinear relationships present for LM in both physical activity and health education (p < .04), whereby risk for MMD was lower among individuals with higher levels of LM. CONCLUSIONS Both LM and moderate-to-vigorous physical activity should be central in treatment regimens for older adults at risk for MMD. TRIAL REGISTRATION clinicaltrials.gov Identifier NCT01072500.
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Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina.,Department of internal medicine, section on gerontology and geriatric medicine, Winston-Salem, North Carolina
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
| | - Shyh-Huei Chen
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Barbara J Nicklas
- Department of internal medicine, section on gerontology and geriatric medicine, Winston-Salem, North Carolina
| | - Michael P Walkup
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Robert S Axtell
- Department of Exercise Science, Southern Connecticut State University, New Haven
| | - Roger A Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging, Nutrition, Exercise Physiology and Sarcopenia Laboratory, Tufts University, Boston, Massachusetts
| | - Nancy W Glynn
- Department of epidemiology, University of Pittsburgh, Pennsylvania
| | - Abby C King
- Department of Health Research and Policy and Stanford Prevention Research Center, Palo Alto, California
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville
| | - Mary M McDermott
- Devision of General Internal medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anne B Newman
- Department Epidemiology and Medicine, University of Pittsburgh, Pennsylvania
| | - Marco Pahor
- Department of Aging and Geriatric Research, University of Florida, Gainesville
| | - Catrine Tudor-Locke
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Michael E Miller
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
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24
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Felez-Nobrega M, Bort-Roig J, Briones L, Sanchez-Niubo A, Koyanagi A, Puigoriol E, Puig-Ribera A. Self-reported and activPAL TM-monitored physical activity and sedentary behaviour in college students: Not all sitting behaviours are linked to perceived stress and anxiety. J Sports Sci 2020; 38:1566-1574. [PMID: 32279592 DOI: 10.1080/02640414.2020.1748359] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study examined relationships between physical activity (PA) and sedentary behaviour (SB) with state-trait anxiety and stress. State-Trait anxiety (State-Trait Anxiety Inventory), psychological stress (Perceived Stress Scale), SB across domains during weekdays and weekends (Last 7-day Sedentary Behaviour Questionnaire) and PA intensities (International Physical Activity Questionnaire) were assessed by self-report in 360 undergraduates (44% females, mean age 20.9 ± 2.93 years). A subsample (n = 121; 53.7% females; mean age 20.8 ± 2.6 years) wore an activPALTM to determine total SB, light, and moderate-to-vigorous intensity PA (MVPA). Self-reported MVPA was significantly associated with lower trait anxiety and perceived stress, whereas light PA was only associated with lower perceived stress. Weekend total self-reported SB was related to higher trait anxiety and perceived stress levels, while total SB during the week was not. Of all SB domains, only leisure SB (screen and non-screen based) was associated with higher trait anxiety and perceived stress. PA attenuated the negative relationships between excessive sitting time and trait anxiety but not perceived stress. No associations were found for monitor-based measures of PA and SB. No associations were found between PA or SB variables with state anxiety. Further research is needed to assess causal and reciprocal relationships between PA, SB and mental health in college students.
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Affiliation(s)
- Mireia Felez-Nobrega
- Research and Development Unit, Parc Sanitari Sant Joan de Déu , Barcelona, Spain.,Sport and Physical Activity Research Group and Centre for Health and Social Care Research, Department of Physical Activity and Sports Sciences, University of Vic - Central University of Catalonia , Vic, Barcelona, Spain
| | - Judit Bort-Roig
- Sport and Physical Activity Research Group and Centre for Health and Social Care Research, Department of Physical Activity and Sports Sciences, University of Vic - Central University of Catalonia , Vic, Barcelona, Spain
| | - Laia Briones
- Mental Health and Social Innovation Research Group and Centre for Health and Social Care Research, Department of Health Sciences, University of Vic - Central University of Catalonia , Vic, Barcelona, Spain
| | - Albert Sanchez-Niubo
- Research and Development Unit, Parc Sanitari Sant Joan de Déu , Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM) , Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu , Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM) , Spain.,ICREA, Pg ., Barcelona, Spain
| | - Emma Puigoriol
- Epidemiology Department, Hospital Universitari de Vic , Barcelona, Spain
| | - Anna Puig-Ribera
- Sport and Physical Activity Research Group and Centre for Health and Social Care Research, Department of Physical Activity and Sports Sciences, University of Vic - Central University of Catalonia , Vic, Barcelona, Spain
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25
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Beale C, Rauff EL, O’Brien WJ, Shultz SP, Fink PW, Kruger R. Are all Sedentary Behaviors Equal? An Examination of Sedentary Behavior and Associations with Indicators of Disease Risk Factors in Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082643. [PMID: 32290586 PMCID: PMC7216008 DOI: 10.3390/ijerph17082643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 02/06/2023]
Abstract
Sedentary behavior increases risk for non-communicable diseases; associations may differ within different contexts (e.g., leisure time, occupational). This study examined associations between different types of sedentary behavior and disease risk factors in women, using objectively measured accelerometer-derived sedentary data. A validation study (n = 20 women) classified sedentary behavior into four categories: lying down; sitting (non-active); sitting (active); standing. A cross-sectional study (n = 348 women) examined associations between these classifications and disease risk factors (body composition, metabolic, inflammatory, blood lipid variables). Participants spent an average of 7 h 42 min per day in sedentary behavior; 58% of that time was classified as non-active sitting and 26% as active sitting. Non-active sitting showed significant (p ≤ 0.001) positive correlations with BMI (r = 0.244), body fat percent (r = 0.216), body mass (r = 0.236), fat mass (r = 0.241), leptin (r = 0.237), and negative correlations with HDL-cholesterol (r = −0.117, p = 0.031). Conversely, active sitting was significantly (p ≤ 0.001) negatively correlated with BMI (r = −0.300), body fat percent (r = −0.249), body mass (r = −0.305), fat mass (r = −0.320), leptin (r = −0.259), and positively correlated with HDL-cholesterol (r = 0.115, p = 0.035). In summary, sedentary behavior can be stratified using objectively measured accelerometer-derived activity data. Subsequently, different types of sedentary behaviors may differentially influence disease risk factors. Public health initiatives should account for sedentary classifications when developing sedentary behavior recommendations.
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Affiliation(s)
- Claire Beale
- School of Sport, Exercise, and Nutrition, Massey University, 4442 Palmerston North, New Zealand; (C.B.); (W.J.O.); (P.W.F.); (R.K.)
| | - Erica L. Rauff
- Kinesiology Department, Seattle University, Seattle, WA 98122, USA;
| | - Wendy J. O’Brien
- School of Sport, Exercise, and Nutrition, Massey University, 4442 Palmerston North, New Zealand; (C.B.); (W.J.O.); (P.W.F.); (R.K.)
| | - Sarah P. Shultz
- School of Sport, Exercise, and Nutrition, Massey University, 4442 Palmerston North, New Zealand; (C.B.); (W.J.O.); (P.W.F.); (R.K.)
- Kinesiology Department, Seattle University, Seattle, WA 98122, USA;
- Correspondence:
| | - Philip W. Fink
- School of Sport, Exercise, and Nutrition, Massey University, 4442 Palmerston North, New Zealand; (C.B.); (W.J.O.); (P.W.F.); (R.K.)
| | - Rozanne Kruger
- School of Sport, Exercise, and Nutrition, Massey University, 4442 Palmerston North, New Zealand; (C.B.); (W.J.O.); (P.W.F.); (R.K.)
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26
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Mañas A, Del Pozo-Cruz B, Rodríguez-Gómez I, Losa-Reyna J, Rodríguez-Mañas L, García-García FJ, Ara I. Which one came first: movement behavior or frailty? A cross-lagged panel model in the Toledo Study for Healthy Aging. J Cachexia Sarcopenia Muscle 2020; 11:415-423. [PMID: 31912990 PMCID: PMC7113532 DOI: 10.1002/jcsm.12511] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/05/2019] [Accepted: 09/25/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There has been limited longitudinal assessment of the relationship between moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) with frailty, and no studies have explored the possibility of reverse causality. This study aimed to determine the potential bidirectionality of the relationship between accelerometer-assessed MVPA, SB, and frailty over time in older adults. METHODS Participants were from the Toledo Study for Healthy Aging. We analysed 186 older people aged 67 to 90 (76.7 ± 3.9; 52.7% female participants) over a 4-year period. Time spent in SB and MVPA was assessed by accelerometry. Frailty Trait Scale was used to determine frailty levels. A cross-lagged panel model design was used to test the reciprocal relationships between MVPA/SB and frailty. RESULTS Frailty Trait Scale score changed from 35.4 to 43.8 points between the two times (P < 0.05). We also found a reduction of 7 min/day in the time spent on MVPA (P < 0.05), and participants tended to spend more time on SB (P = 0.076). Our analyses revealed that lower levels of initial MVPA predicted higher levels of later frailty [std. β = -0.126; confidence interval (CI) = -0.231, -0.021; P < 0.05], whereas initial spent time on SB did not predict later frailty (std. β = -0.049; CI = -0.185, 0.087; P = 0.48). Conversely, an initial increased frailty status predicted higher levels of later SB (std. β = 0.167; CI = 0.026, 0.307; P < 0.05) but not those of MVPA (std. β = 0.071; CI = -0.033, 0.175; P = 0.18). CONCLUSIONS Our observations suggest that the relationship between MVPA/SB and frailty is unidirectional: individuals who spent less time on MVPA at baseline are more likely to increase their frailty score, and individuals who are more frail are more likely to spent more time on SB at follow-up. Interventions and policies should aim to increase MVPA levels from earlier stages to promote successful aging.
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Affiliation(s)
- Asier Mañas
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Borja Del Pozo-Cruz
- Motivation and Behaviour Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia
| | - Irene Rodríguez-Gómez
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - José Losa-Reyna
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Leocadio Rodríguez-Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Universitario de Getafe, Getafe, Spain
| | - Francisco J García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
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27
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Malden S, Reilly JJ, Hughes A, Bardid F, Summerbell C, De Craemer M, Cardon G, Androutsos O, Manios Y, Gibson AM. Assessing the acceptability of an adapted preschool obesity prevention programme: ToyBox-Scotland. Child Care Health Dev 2020; 46:213-222. [PMID: 31856335 DOI: 10.1111/cch.12736] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/14/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Childhood obesity is a global public health issue. Interventions to prevent the onset of obesity in the early years are often implemented in preschool settings. The ToyBox intervention was delivered across Europe and targeted energy balance-related behaviours in preschools and children's homes through teacher-led activities and parental education materials and was adapted for use in Scotland. This study assessed the acceptability of the 18-week adapted intervention to both parents and teachers. METHODS Mixed methods were employed to collect both qualitative and quantitative data. Preschool staff and children's parents/caregivers completed post-intervention feedback surveys, from which acceptability scores were calculated and presented as proportions. Focus groups were conducted with preschool staff, whereas parents/caregivers participated in semi-structured interviews. A thematic analysis was applied to qualitative data following the development of a coding framework. Quantitative and qualitative data were analysed using SPSS and NVivo 10, respectively. RESULTS Preschool staff rated the intervention as highly acceptable based on post-intervention feedback surveys (80%; mean score 8.8/11). Lower acceptability scores were observed for parents/caregivers (49%; 3.9/8). Nine preschool practitioners participated in focus groups (n = 3). User-friendliness of the intervention materials, integration of the intervention with the curriculum, and flexibility of the intervention were identified as facilitators to delivery. Barriers to delivery were time, insufficient space, and conflicting policies within preschools with regard to changing classroom layouts. Parental interviews (n = 4) revealed a lack of time to be a major barrier, which prevented parents from participating in home-based activities. Parents perceived the materials to be simple to understand and visually appealing. CONCLUSIONS This study identified a number of barriers and facilitators to the delivery and evaluation of the ToyBox Scotland preschool obesity prevention programme, which should be considered before any further scale-up of the intervention.
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Affiliation(s)
- Stephen Malden
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.,Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, UK
| | - John J Reilly
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Adrienne Hughes
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Farid Bardid
- School of Education, University of Strathclyde, Glasgow, UK.,Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Ann-Marie Gibson
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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28
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Mañas A, del Pozo-Cruz B, Rodríguez-Gómez I, Leal-Martín J, Losa-Reyna J, Rodríguez-Mañas L, García-García FJ, Ara I. Dose-response association between physical activity and sedentary time categories on ageing biomarkers. BMC Geriatr 2019; 19:270. [PMID: 31615446 PMCID: PMC6794876 DOI: 10.1186/s12877-019-1284-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 09/16/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Physical activity and sedentary behaviour have been suggested to independently affect a number of health outcomes. To what extent different combinations of physical activity and sedentary behaviour may influence physical function and frailty outcomes in older adults is unknown. The aim of this study was to examine the combination of mutually exclusive categories of accelerometer-measured physical activity and sedentary time on physical function and frailty in older adults. METHODS 771 older adults (54% women; 76.8 ± 4.9 years) from the Toledo Study for Healthy Aging participated in this cross-sectional study. Physical activity and sedentary time were measured by accelerometry. Physically active was defined as meeting current aerobic guidelines for older adults proposed by the World Health Organization. Low sedentary was defined as residing in the lowest quartile of the light physical activity-to-sedentary time ratio. Participants were then classified into one of four mutually exclusive movement patterns: (1) 'physically active & low sedentary', (2) 'physically active & high sedentary', (3) 'physically inactive & low sedentary', and (4) 'physically inactive & high sedentary'. The Short Physical Performance Battery was used to measure physical function and frailty was assessed using the Frailty Trait Scale. RESULTS 'Physically active & low sedentary' and 'physically active & high sedentary' individuals had significantly higher levels of physical function (β = 1.73 and β = 1.30 respectively; all p < 0.001) and lower frailty (β = - 13.96 and β = - 8.71 respectively; all p < 0.001) compared to 'physically inactive & high sedentary' participants. Likewise, 'physically inactive & low sedentary' group had significantly lower frailty (β = - 2.50; p = 0.05), but significance was not reached for physical function. CONCLUSIONS We found a dose-response association of the different movement patterns analysed in this study with physical function and frailty. Meeting the physical activity guidelines was associated with the most beneficial physical function and frailty profiles in our sample. Among inactive people, more light intensity relative to sedentary time was associated with better frailty status. These results point out to the possibility of stepwise interventions (i.e. targeting less strenuous activities) to promote successful aging, particularly in inactive older adults.
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Affiliation(s)
- Asier Mañas
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Borja del Pozo-Cruz
- Motivation and Behaviour Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - Irene Rodríguez-Gómez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Javier Leal-Martín
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - José Losa-Reyna
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Leocadio Rodríguez-Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- Geriatric Department, Hospital Universitario de Getafe, Getafe, Spain
| | - Francisco J. García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
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O'Brien CM, Duda JL, Kitas GD, Veldhuijzen van Zanten JJCS, Metsios GS, Fenton SAM. Objective measurement of sedentary time and physical activity in people with rheumatoid arthritis: protocol for an accelerometer and activPAL TM validation study. Mediterr J Rheumatol 2019; 30:125-134. [PMID: 32185353 PMCID: PMC7045970 DOI: 10.31138/mjr.30.2.125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/20/2019] [Accepted: 06/22/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The accurate measurement of sedentary time and physical activity in Rheumatoid Arthritis (RA) is critical to identify important health consequences and determinants of these behaviours in this patient group. However, objective methods have not been well-validated for measurement of sedentary time and physical activity in RA. AIMS Specific objectives are to: 1) validate the ActiGraph GT3X+ accelerometer and activPAL3μTM against indirect calorimetry and direct observation respectively, and define RA-specific accelerometer cut-points, for measurement of sedentary time and physical activity in RA; 2) validate the RA-specific sedentary time accelerometer cut-points against the activPAL3μTM; 3) compare sedentary time and physical activity estimates in RA, using RA-specific vs. widely-used non-RA accelerometer cut-points. METHODS Objective 1: People with RA will wear an ActiGraph GT3X+, activPAL3μTM, heart rate monitor and indirect calorimeter, whilst being video-recorded undertaking 11 activities representative of sedentary behaviour, and light and moderate intensity physical activity. Objectives 2 and 3: People with RA will wear an ActiGraph GT3X+ and activPAL3μTM for 7 days to measure free-living sedentary time and physical activity. DISCUSSION This will be the first study to define RA-specific accelerometer cut-points, and represents the first validation of the ActiGraph accelerometer and activPALTM, for measurement of sedentary time and physical activity in RA. Findings will inform future RA studies employing these devices, ensuring more valid assessment of sedentary time and physical activity in this patient group.
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Affiliation(s)
- Ciara M O'Brien
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - George D Kitas
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
| | - Jet J C S Veldhuijzen van Zanten
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
| | - George S Metsios
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Sally A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
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Júdice PB, Teixeira L, Silva AM, Sardinha LB. Accuracy of Actigraph inclinometer to classify free-living postures and motion in adults with overweight and obesity. J Sports Sci 2019; 37:1708-1716. [PMID: 30843462 DOI: 10.1080/02640414.2019.1586281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Pedro B. Júdice
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Cruz-Quebrada, Portugal
| | - Luís Teixeira
- Scientific Software Platform, Champalimaud Foundation, Lisbon, Portugal
| | - Analiza M. Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Cruz-Quebrada, Portugal
| | - Luís B. Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Cruz-Quebrada, Portugal
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Rodriguez V, Medrano C, Plaza I, Corella C, Abarca A, Julian J. Comparison of Several Algorithms to Estimate Activity Counts with Smartphones as an Indication of Physical Activity Level. Ing Rech Biomed 2019. [DOI: 10.1016/j.irbm.2018.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Measuring Time in the Office Using Bluetooth Sensors: Feasibility and Validity Considerations. ACTA ACUST UNITED AC 2019. [DOI: 10.1123/jmpb.2018-0046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Mañas A, Pozo-Cruz BD, Rodríguez-Gómez I, Losa-Reyna J, Rodríguez-Mañas L, García-García FJ, Ara I. Can Physical Activity Offset the Detrimental Consequences of Sedentary Time on Frailty? A Moderation Analysis in 749 Older Adults Measured With Accelerometers. J Am Med Dir Assoc 2019; 20:634-638.e1. [PMID: 30738823 DOI: 10.1016/j.jamda.2018.12.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/12/2018] [Accepted: 12/16/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To determine whether or not and to what extent the association between sedentary time and frailty was moderated by moderate-to-vigorous physical activity in older adults. DESIGN Cross-sectional. SETTING Community-dwelling individuals. PARTICIPANTS 749 (403 females and 346 males) white older adults. MEASUREMENTS Sedentary time and moderate-to-vigorous physical activity were measured with accelerometers. Frailty was objectively measured using the Frailty Trait Scale. All models were adjusted for age, sex, education, income, marital status, body mass index, moderate-to-vigorous physical activity, and accelerometer wear time. RESULTS The regression model reported a significant effect of sedentary time on frailty (P < .05). Nevertheless, the results indicated that moderate-to-vigorous physical activity moderates the relationship between frailty status and sedentary time. The Johnson-Neyman technique determined that the estimated moderate-to-vigorous physical activity point was 27.25 minutes/d, from which sedentary time has no significant effect on frailty. CONCLUSIONS Moderate-to-vigorous physical activity is a moderator in the relationship between sedentary time and frailty in older adults, offsetting the harmful effects of sedentary behavior with 27 minutes/d of moderate-to-vigorous activity. Engaging in moderate-to-vigorous physical activities should be encouraged. Reducing sedentary behavior may also be beneficial, particularly among inactive older adults.
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Affiliation(s)
- Asier Mañas
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Borja Del Pozo-Cruz
- Motivation and Behaviour Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - Irene Rodríguez-Gómez
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - José Losa-Reyna
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Leocadio Rodríguez-Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Geriatric Department, Hospital Universitario de Getafe, Getafe, Spain
| | - Francisco J García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
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Dixon PM, Saint-Maurice PF, Kim Y, Hibbing P, Bai Y, Welk GJ. A Primer on the Use of Equivalence Testing for Evaluating Measurement Agreement. Med Sci Sports Exerc 2019; 50:837-845. [PMID: 29135817 DOI: 10.1249/mss.0000000000001481] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Statistical equivalence testing is more appropriate than conventional tests of difference to assess the validity of physical activity (PA) measures. This article presents the underlying principles of equivalence testing and gives three examples from PA and fitness assessment research. METHODS The three examples illustrate different uses of equivalence tests. Example 1 uses PA data to evaluate an activity monitor's equivalence to a known criterion. Example 2 illustrates the equivalence of two field-based measures of physical fitness with no known reference method. Example 3 uses regression to evaluate an activity monitor's equivalence across a suite of 23 activities. RESULTS The examples illustrate the appropriate reporting and interpretation of results from equivalence tests. In the first example, the mean criterion measure is significantly within ±15% of the mean PA monitor. The mean difference is 0.18 METs and the 90% confidence interval of -0.15 to 0.52 is inside the equivalence region of -0.65 to 0.65. In the second example, we chose to define equivalence for these two measures as a ratio of mean values between 0.98 and 1.02. The estimated ratio of mean V˙O2 values is 0.99, which is significantly (P = 0.007) inside the equivalence region. In the third example, the PA monitor is not equivalent to the criterion across the suite of activities. The estimated regression intercept and slope are -1.23 and 1.06. Neither confidence interval is within the suggested regression equivalence regions. CONCLUSIONS When the study goal is to show similarity between methods, equivalence testing is more appropriate than traditional statistical tests of differences (e.g., ANOVA and t-tests).
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Affiliation(s)
- Philip M Dixon
- Department of Statistics, Iowa State University, Ames, IA
| | - Pedro F Saint-Maurice
- Department of Statistics, Iowa State University, Ames, IA.,Department of Statistics, Iowa State University, Ames, IA
| | - Youngwon Kim
- Department of Statistics, Iowa State University, Ames, IA
| | - Paul Hibbing
- Department of Statistics, Iowa State University, Ames, IA
| | - Yang Bai
- Department of Statistics, Iowa State University, Ames, IA
| | - Gregory J Welk
- Department of Statistics, Iowa State University, Ames, IA
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Abstract
Purpose: To advance research practices with consumer monitors, standard validation methods are needed. This study provides an example of best practices through systematically evaluating the validity of the Fitbit Charge (FBC) under free-living conditions using a strong reference measure and robust measurement agreement methods. Methods: 94 healthy participants (Mage 41.8 ±9.3 yrs) wore a FBC and two research grade accelerometers (Actigraph GT3X and activPAL) as they went about normal activities for a week. Estimated daily minutes of moderate to vigorous physical activity (MVPA) from the FBC were compared against reference estimates obtained from the Sojourns Including Posture (SIP) methodology, while daily step counts were compared against the activPAL. Results: Correlations with reference indicators were high for average daily MVPA (r = 0.8; p < .0001) and steps (r = 0.76; p < .0001), but the FBC overestimated time spent in MVPA by 56% and steps by 15%. The mean absolute percent errors of MVPA and steps estimated by FBC were 71.5% and 30.0%, respectively. Neither of the MVPA and step estimates from the FBC fell into the ±10% equivalence zone set by the criterion. The Kappa statistics of the classification agreement between the two MVPA assessment methods was 0.32 with a low sensitivity of 30.1% but a high specificity of 96.7%. Conclusion: The FBC overestimated minutes of MVPA and steps when compared to both reference assessments in free-living conditions. Standardized reporting in future studies will facilitate comparisons with other monitors and with future versions of the FBC.
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Fanning J, Opina MT, Leng I, Lyles MF, Nicklas BJ, Rejeski WJ. Empowered with Movement to Prevent Obesity & Weight Regain (EMPOWER): Design and methods. Contemp Clin Trials 2018; 72:35-42. [PMID: 30026128 DOI: 10.1016/j.cct.2018.07.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/12/2018] [Accepted: 07/15/2018] [Indexed: 12/20/2022]
Abstract
Promoting lasting weight loss among older adults is an important public health challenge. Participation in physical activity aids in weight loss and is important for the maintenance of physical function and quality of life. However, traditional intensive lifestyle interventions place a focus on discrete bouts of structured activity, leaving much of the remainder of the day for sedentary behavior. Structured exercise and weight loss programs often produce short-term weight loss that is typically followed by weight regain, and older adults are more likely to regain weight as fat mass rather than lean mass. Preliminary evidence suggests a focus on day-long movement intended to minimize time spent sitting produces better short-term weight loss and weight maintenance. Herein we describe the design and methods for a three-arm randomized controlled trial comparing mHealth-supported weight loss (WL) + structured exercise (EX); WL + a novel daily movement intervention (SitLess); and WL + EX + SitLess. Older adults (N = 180) will be randomly assigned to one of the three interventions, each comprised of a 6-month intensive phase; a 3-month transition phase; and a 9-month maintenance phase. The primary aim of the study is to determine whether the addition of SitLess to a traditional intensive lifestyle intervention comprised of dietary weight loss and structured exercise produces a larger 18-month reduction in body weight relative to WL + EX and WL + SitLess.
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Affiliation(s)
- J Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem 27109, NC, USA; Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine, Winston-Salem 27157, NC, USA.
| | - M T Opina
- Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine, Winston-Salem 27157, NC, USA.
| | - I Leng
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem 27157, NC, USA.
| | - M F Lyles
- Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine, Winston-Salem 27157, NC, USA.
| | - B J Nicklas
- Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine, Winston-Salem 27157, NC, USA.
| | - W J Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem 27109, NC, USA.
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Preferred Placement and Usability of a Smart Textile System vs. Inertial Measurement Units for Activity Monitoring. SENSORS 2018; 18:s18082501. [PMID: 30071635 PMCID: PMC6111998 DOI: 10.3390/s18082501] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/22/2018] [Accepted: 07/22/2018] [Indexed: 01/02/2023]
Abstract
Wearable sensors and systems have become increasingly popular in recent years. Two prominent wearable technologies for human activity monitoring are smart textile systems (STSs) and inertial measurement units (IMUs). Despite ongoing advances in both, the usability aspects of these devices require further investigation, especially to facilitate future use. In this study, 18 participants evaluate the preferred placement and usability of two STSs, along with a comparison to a commercial IMU system. These evaluations are completed after participants engaged in a range of activities (e.g., sitting, standing, walking, and running), during which they wear two representatives of smart textile systems: (1) a custom smart undershirt (SUS) and commercial smart socks; and (2) a commercial whole-body IMU system. We first analyze responses regarding the usability of the STS, and subsequently compared these results to those for the IMU system. Participants identify a short-sleeved shirt as their preferred activity monitor. In additional, the SUS in combination with the smart socks is rated superior to the IMU system in several aspects of usability. As reported herein, STSs show promise for future applications in human activity monitoring in terms of usability.
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Felez-Nobrega M, Hillman CH, Dowd KP, Cirera E, Puig-Ribera A. ActivPAL™ determined sedentary behaviour, physical activity and academic achievement in college students. J Sports Sci 2018. [PMID: 29533713 DOI: 10.1080/02640414.2018.1451212] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The aim of this study was to examine relationships between activPAL™-determined sedentary behavior (SB) and physical activity (PA) with academic achievement. A total of 120 undergraduates (N = 57 female; 20.6 ± 2.3 years) participated in the study. Academic achievement was measured as the grade point average obtained from all completed courses. Participants wore on the right tight an activPAL™ for 7 days to determine total sedentary time, total number of sedentary breaks, sedentary bouts, standing time, light and moderate-to-vigorous physical activity (MVPA). Separate multiple linear regression models were performed to examine associations between SB variables and academic achievement. Light PA, MVPA, total sedentary time, total standing time, or total number of sedentary breaks were not related to academic achievement. Independently of PA, the amount of time spent in sedentary bouts of 10-20min during weekdays was positively related to academic achievement. Given that college students spend the majority of their workday in environments that encourage prolonged sitting, these data suggest that interruptions in prolonged periods of sitting time every 10-20min via short breaks may optimize cognitive operations associated with academic performance.
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Affiliation(s)
- Mireia Felez-Nobrega
- a Sport and Physical Activity Research Group, Center for Health and Social Care Research , University of Vic - Central University of Catalonia , Barcelona , Spain
| | - Charles H Hillman
- b Department of Psychology and Department of Health Sciences , Northeastern University , Boston , MA , USA
| | - Kieran P Dowd
- c Department of Sport and Health Sciences , Athlone Institute of Technology , Athlone , Ireland
| | - Eva Cirera
- a Sport and Physical Activity Research Group, Center for Health and Social Care Research , University of Vic - Central University of Catalonia , Barcelona , Spain
| | - Anna Puig-Ribera
- a Sport and Physical Activity Research Group, Center for Health and Social Care Research , University of Vic - Central University of Catalonia , Barcelona , Spain
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Mañas A, del Pozo-Cruz B, García-García FJ, Guadalupe-Grau A, Ara I. Role of objectively measured sedentary behaviour in physical performance, frailty and mortality among older adults: A short systematic review. Eur J Sport Sci 2017; 17:940-953. [DOI: 10.1080/17461391.2017.1327983] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Asier Mañas
- Genud Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBER FES), Madrid, Spain
| | - Borja del Pozo-Cruz
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
| | - Francisco José García-García
- CIBER of Frailty and Healthy Aging (CIBER FES), Madrid, Spain
- Geriatric Department, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Amelia Guadalupe-Grau
- CIBER of Frailty and Healthy Aging (CIBER FES), Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain
| | - Ignacio Ara
- Genud Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBER FES), Madrid, Spain
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40
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Sasai H. Assessing sedentary behavior using wearable devices: An overview and future directions. THE JOURNAL OF PHYSICAL FITNESS AND SPORTS MEDICINE 2017. [DOI: 10.7600/jpfsm.6.135] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Hiroyuki Sasai
- Faculty of Medicine, University of Tsukuba
- Japan Society for the Promotion of Science
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