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Evans JT, Stanesby O, Blizzard L, Greaves S, Timperio A, Jose K, Sharman MJ, Palmer AJ, Cleland VJ. Is public transport a promising strategy for increasing physical activity? Evidence from a study of objectively measured public transport use and physical activity. Int J Behav Nutr Phys Act 2024; 21:91. [PMID: 39160546 PMCID: PMC11331653 DOI: 10.1186/s12966-024-01633-3] [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: 03/25/2024] [Accepted: 07/23/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Greater public transport use has been linked to higher physical activity levels. However, neither the amount of physical activity associated with each daily public transport trip performed, nor the potential total physical activity gain associated with an increase in trips/day, has been determined. Using objective measures, we aimed to quantify the association between public transport use, physical activity and sedentary time. METHODS A longitudinal study of Australian adults living in Hobart, Tasmania, who were infrequent bus users (≥ 18 years; used bus ≤ 2 times/week). The number of bus trips performed each day was determined from objective smartcard data provided by the public transportation (bus) provider across a 36-week study timeframe. Accelerometer measured steps/day (primary outcome), moderate-to-vigorous physical activity (min/day), and sedentary time (min/day) were assessed across four separate one-week periods. RESULTS Among 73 participants across 1483 day-level observations, on days that public transport was used, participants achieved significantly more steps (β = 2147.48; 95%CI = 1465.94, 2829.03), moderate to vigorous physical activity (β = 22.79; 95% CI = 14.33, 31.26), and sedentary time (β = 37.00; 95% CI = 19.80, 54.21) compared to days where no public transport trips were made. The largest increase in steps per day associated with a one-trip increase was observed when the number of trips performed each day increased from zero to one (β = 1761.63; 95%CI = 821.38, 2701.87). The increase in the number of steps per day was smaller and non-significant when the number of trips performed increased from one to two (β = 596.93; 95%CI=-585.16, 1779.01), and two to three or more (β = 632.39; 95%CI=-1331.45, 2596.24) trips per day. Significant increases in sedentary time were observed when the number of trips performed increased from zero to one (β = 39.38; 95%CI = 14.38, 64.39) and one to two (β = 48.76; 95%CI = 25.39, 72.12); but not when bus trips increased from two to three or more (β=-27.81; 95%CI=-76.00, 20.37). CONCLUSIONS Greater public transport use was associated with higher physical activity and sedentary behaviour. Bus use may yield cumulative increases in steps that amount to 15-30% of the daily recommended physical activity target. A policy and public health focus on intersectoral action to promote public transport may yield meaningful increases in physical activity and subsequent health benefits.
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Affiliation(s)
- Jack T Evans
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
| | - Oliver Stanesby
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
| | - Stephen Greaves
- Institute of Transport and Logistics Studies, University of Sydney, Sydney, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Kim Jose
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
| | - Melanie J Sharman
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
| | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
| | - Verity J Cleland
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia.
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
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Estrada-Saldaña E, Marques A, Silva DR, Farías-Valenzuela C, Ferrero-Hernández P, Guzman-Habinger J, Rezende LFM, Ferrari G. Combined association of physical activity and sitting time with cardiometabolic risk factors in Chilean adults. Sci Rep 2023; 13:9236. [PMID: 37286727 DOI: 10.1038/s41598-023-36422-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 06/03/2023] [Indexed: 06/09/2023] Open
Abstract
In this study we examined the combined association of physical activity and sitting time with cardiometabolic risk factors in adults in Chile. This is a cross-sectional study based on 3201 adults aged from 18 to 98 years from the Chilean National Health Survey (2016-2017) who responded to the GPAQ questionnaire. Participants were considered inactive if spent < 600 METs-min/wk-1 in physical activity. High sitting time was defined as ≥ 8 h/day. We classified participants into the following 4 groups: active and low sitting time; active and high sitting time; inactive and low sitting time; inactive and high sitting time. The cardiometabolic risk factors considered were metabolic syndrome, body mass index, waist circumference, total cholesterol, and triglycerides. Multivariable logistic regression models were performed. Overall, 16.1% were classified as inactive and high sitting time. Compared to active participants with low sitting time, both inactive participants with low (OR: 1.51; 95% CI 1.10, 1.92) and high sitting time (1.66; 1.10, 2.22) had higher body mass index. Similar results were found for high waist circumference: inactive participants with low (1.57; 1.14, 2.00) and high sitting time (1.84; 1.25, 2.43). We found no combined association of physical activity and sitting time with metabolic syndrome, total cholesterol, and triglycerides. These findings may be useful to inform programs focused on obesity prevention in Chile.
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Affiliation(s)
- Esteban Estrada-Saldaña
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | - Danilo R Silva
- Department of Physical Education, Federal University of Sergipe, Sao Cristovao, Brazil
- Department of Sports and Computer Science, Universidad Pablo de Olavide (UPO), 41013, Seville, Spain
| | - Claudio Farías-Valenzuela
- Facultad de Ciencias Para el Cuidado de la Salud, Universidad San Sebastián, Lota 2465, Providencia 7510157, Santiago, Chile
| | - Paloma Ferrero-Hernández
- Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, 8900000, Santiago, Chile
| | - Juan Guzman-Habinger
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, 8580745, Santiago, Chile
| | - Leandro F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile.
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FARRAHI VAHID, ROSTAMI MEHRDAD, DUMUID DOT, CHASTIN SEBASTIENFM, NIEMELÄ MAISA, KORPELAINEN RAIJA, JÄMSÄ TIMO, OUSSALAH MOURAD. Joint Profiles of Sedentary Time and Physical Activity in Adults and Their Associations with Cardiometabolic Health. Med Sci Sports Exerc 2022; 54:2118-2128. [PMID: 35881930 PMCID: PMC9671590 DOI: 10.1249/mss.0000000000003008] [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] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to identify and characterize joint profiles of sedentary time and physical activity among adults and to investigate how these profiles are associated with markers of cardiometabolic health. METHODS The participants included 3702 of the Northern Finland Birth Cohort 1966 at age 46 yr, who wore a hip-worn accelerometer during waking hours and provided seven consecutive days of valid data. Sedentary time, light-intensity physical activity, and moderate- to vigorous-intensity physical activity on each valid day were obtained, and a data-driven clustering approach ("KmL3D") was used to characterize distinct joint profiles of sedentary time and physical activity intensities. Participants self-reported their sleep duration and performed a submaximal step test with continuous heart rate measurement to estimate their cardiorespiratory fitness (peak heart rate). Linear regression was used to determine the association between joint profiles of sedentary time and physical activities with cardiometabolic health markers, including adiposity markers and blood lipid, glucose, and insulin levels. RESULTS Four distinct groups were identified: "active couch potatoes" ( n = 1173), "sedentary light movers" ( n = 1199), "sedentary exercisers" ( n = 694), and "movers" ( n = 636). Although sufficiently active, active couch potatoes had the highest daily sedentary time (>10 h) and lowest light-intensity physical activity. Compared with active couch potatoes, sedentary light movers, sedentary exercisers, and movers spent less time in sedentary by performing more physical activity at light-intensity upward and had favorable differences in their cardiometabolic health markers after accounting for potential confounders (1.1%-25.0% lower values depending on the health marker and profile). CONCLUSIONS After accounting for sleep duration and cardiorespiratory fitness, waking activity profiles characterized by performing more physical activity at light-intensity upward, resulting in less time spent in sedentary, were associated with better cardiometabolic health.
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Affiliation(s)
- VAHID FARRAHI
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FINLAND
- Centre of Machine Vision and Signal Analysis, Faculty of Information Technology, University of Oulu, Oulu, FINLAND
| | - MEHRDAD ROSTAMI
- Centre of Machine Vision and Signal Analysis, Faculty of Information Technology, University of Oulu, Oulu, FINLAND
| | - DOT DUMUID
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, AUSTRALIA
| | - SEBASTIEN F. M. CHASTIN
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UNITED KINGDOM
- Department of Movement and Sports Science, Ghent University, Ghent, BELGIUM
| | - MAISA NIEMELÄ
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FINLAND
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, FINLAND
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., FINLAND
| | - RAIJA KORPELAINEN
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, FINLAND
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., FINLAND
- Center for Life Course Health Research, University of Oulu, Oulu, FINLAND
| | - TIMO JÄMSÄ
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FINLAND
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, FINLAND
| | - MOURAD OUSSALAH
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FINLAND
- Centre of Machine Vision and Signal Analysis, Faculty of Information Technology, University of Oulu, Oulu, FINLAND
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van der Laag PJ, Wondergem R, Pisters MF. Movement behavior patterns composition remains stable, but individuals change their movement behavior pattern over time in people with a first-ever stroke. Eur Rev Aging Phys Act 2022; 19:11. [PMID: 35459097 PMCID: PMC9026674 DOI: 10.1186/s11556-022-00290-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/10/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Movement behaviors (i.e., physical activity levels, sedentary behavior) in people with stroke are not self-contained but cluster in patterns. Recent research identified three commonly distinct movement behavior patterns in people with stroke. However, it remains unknown if movement behavior patterns remain stable and if individuals change in movement behavior pattern over time. OBJECTIVES 1) To investigate the stability of the composition of movement behavior patterns over time, and 2) determine if individuals change their movement behavior resulting in allocation to another movement behavior pattern within the first two years after discharge to home in people with a first-ever stroke. METHODS Accelerometer data of 200 people with stroke of the RISE-cohort study were analyzed. Ten movement behavior variables were compressed using Principal Componence Analysis and K-means clustering was used to identify movement behavior patterns at three weeks, six months, one year, and two years after home discharge. The stability of the components within movement behavior patterns was investigated. Frequencies of individuals' movement behavior pattern and changes in movement behavior pattern allocation were objectified. RESULTS The composition of the movement behavior patterns at discharge did not change over time. At baseline, there were 22% sedentary exercisers (active/sedentary), 45% sedentary movers (inactive/sedentary) and 33% sedentary prolongers (inactive/highly sedentary). Thirty-five percent of the stroke survivors allocated to another movement behavior pattern within the first two years, of whom 63% deteriorated to a movement behavior pattern with higher health risks. After two years there were, 19% sedentary exercisers, 42% sedentary movers, and 39% sedentary prolongers. CONCLUSIONS The composition of movement behavior patterns remains stable over time. However, individuals change their movement behavior. Significantly more people allocated to a movement behavior pattern with higher health risks. The increase of people allocated to sedentary movers and sedentary prolongers is of great concern. It underlines the importance of improving or maintaining healthy movement behavior to prevent future health risks after stroke.
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Affiliation(s)
- Patricia J van der Laag
- Physical Therapy Sciences, Program in Clinical Health Sciences, Utrecht University, Utrecht, the Netherlands. .,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands. .,Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center, Utrecht, the Netherlands.
| | - Roderick Wondergem
- Physical Therapy Sciences, Program in Clinical Health Sciences, Utrecht University, Utrecht, the Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center, Utrecht, the Netherlands.,Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands
| | - Martijn F Pisters
- Physical Therapy Sciences, Program in Clinical Health Sciences, Utrecht University, Utrecht, the Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center, Utrecht, the Netherlands.,Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands
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5
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Sit Less and Move More-A Multicomponent Intervention With and Without Height-Adjustable Workstations in Contact Center Call Agents: A Pilot Randomized Controlled Trial. J Occup Environ Med 2021; 63:44-56. [PMID: 33122540 DOI: 10.1097/jom.0000000000002066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To pilot a multicomponent intervention to sit less and move more, with (SLAMM+) and without (SLAMM) height-adjustable workstations, in contact center call agents. METHODS Agents were individually randomized to SLAMM or SLAMM+ in this 10-month, parallel, open-label, pilot trial. Mixed-methods assessed response, recruitment, retention, attrition and completion rates, adverse effects, trial feasibility and acceptability, preliminary effectiveness on worktime sitting, and described secondary outcomes. RESULTS The participant recruitment rate, and randomization, data collection, and interventions were mostly acceptable. Refinements to organization recruitment were identified. High staff turnover negatively impacted retention and completion rates. The multicomponent intervention with height-adjustable workstations has potential to reduce sitting time at work. CONCLUSIONS The demonstrated findings will help prepare for a future randomized controlled trial designed to assess the effect of the interventions.
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The Influence of Sitting, Standing, and Stepping Bouts on Cardiometabolic Health Markers in Older Adults. J Aging Phys Act 2021; 30:114-122. [PMID: 33992024 DOI: 10.1123/japa.2020-0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/24/2021] [Accepted: 03/03/2021] [Indexed: 11/18/2022]
Abstract
Aside from total time spent in physical activity behaviors, how time is accumulated is important for health. This study examined associations between sitting, standing, and stepping bouts, with cardiometabolic health markers in older adults. Participants from the Mitchelstown Cohort Rescreen Study (N = 221) provided cross-sectional data on activity behaviors (assessed via an activPAL3 Micro) and cardiometabolic health. Bouts of ≥10-, ≥30-, and ≥60-min sitting, standing, and stepping were calculated. Linear regression models were fitted to examine the associations between bouts and cardiometabolic health markers. Sitting (≥10, ≥30, and ≥60 min) and standing (≥10 and ≥30 min) bouts were detrimentally associated with body composition measures, lipid markers, and fasting glucose. The effect for time spent in ≥60-min sitting and ≥30-min standing bouts was larger than shorter bouts. Fragmenting sitting with bouts of stepping may be targeted to benefit cardiometabolic health. Further insights for the role of standing need to be elicited.
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7
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Länsitie M, Niemelä M, Kangas M, Venojärvi M, Härkönen P, Keinänen‐Kiukaanniemi S, Korpelainen R. Physical activity profiles and glucose metabolism — A population‐based cross‐sectional study in older adults. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Miia Länsitie
- Department of Sports and Exercise Medicine Oulu Deaconess Institute Foundation sr. Oulu Finland
- Center for Life Course Health Research University of Oulu Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
| | - Maisa Niemelä
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
- Research Unit of Medical Imaging Physics and Technology University of Oulu Oulu Finland
| | - Maarit Kangas
- Department of Sports and Exercise Medicine Oulu Deaconess Institute Foundation sr. Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
- Research Unit of Medical Imaging Physics and Technology University of Oulu Oulu Finland
| | - Mika Venojärvi
- Institute of Biomedicine, Sports and Exercise Medicine University of Eastern Finland Kuopio Finland
| | - Pirjo Härkönen
- Center for Life Course Health Research University of Oulu Oulu Finland
| | - Sirkka Keinänen‐Kiukaanniemi
- Center for Life Course Health Research University of Oulu Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
- Healthcare and Social Services of Selänne Pyhäjärvi Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine Oulu Deaconess Institute Foundation sr. Oulu Finland
- Center for Life Course Health Research University of Oulu Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
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Pope ZC, Gabriel KP, Whitaker KM, Chen LY, Schreiner PJ, Jacobs DR, Sternfeld B, Carr JJ, Lloyd-Jones DM, Pereira MA. Association between Objective Activity Intensity and Heart Rate Variability: Cardiovascular Disease Risk Factor Mediation (CARDIA). Med Sci Sports Exerc 2020; 52:1314-1321. [PMID: 32427750 DOI: 10.1249/mss.0000000000002259] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE We evaluated the associations between accelerometer-estimated physical activity (PA) intensity and heart rate variability (HRV) and examined mediation of these associations by glycemic control indices and other cardiovascular disease risk factors. METHODS Data were from 1668 participants (X[Combining Overline]age = 45.9 ± 3.5 yr, 58.0% female, 39.9% black) who participated in year 20 (2005-2006) of the Coronary Artery Risk Development in Young Adults Fitness Study. The ActiGraph 7164 estimated participants' mean minutes per day of vigorous-intensity PA (VPA), moderate-intensity PA (MPA), and light-intensity PA (LPA) over 7 d. Three sequential 10-s 12-lead ECG strips were used to derive standard deviation of all normal RR intervals (SDNN) and root mean square of all successive RR intervals (rMSSD) HRV. Mediators representing glycemic control indices included fasting glucose, fasting insulin, and 2-h oral glucose tolerance, with other mediators being traditional cardiovascular disease risk factors. Multiple linear regression assessed independent associations of PA intensity with HRV per 1-SD. Mediation analyses computed the proportion of the PA-HRV association attributable to physiological mediators. RESULTS Participants averaged 2.7 ± 6.2 min·d, 33.0 ± 22.0 min·d, and 360.2 ± 83.8 min·d of VPA, MPA, and LPA, respectively, with mean values for SDNN (32.6 ± 22.4 ms) and rMSSD (34.0 ± 24.8 ms) similar. After adjustment for demographic and lifestyle behaviors, VPA was associated with both HRV metrics (SDNN: std beta = 0.06 [0.03, 0.10]; rMSSD: std beta = 0.08 [0.05, 0.12]) and LPA with rMSSD only (std beta = 0.05 [0.01, 0.08]). Fasting insulin and glucose mediated 11.6% to 20.7% of the association of VPA and LPA with HRV, with triglycerides also potentially mediating these associations (range, 9.6%-13.4%). CONCLUSIONS Accelerometer-estimated VPA was associated with higher (i.e., improved) HRV. Light-intensity PA also demonstrated a positive association. Mediation analyses suggested these associations may be most attributable to glucose-insulin dynamics.
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Affiliation(s)
- Zachary C Pope
- Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN
| | | | - Kara M Whitaker
- Department of Health and Human Physiology and Department of Epidemiology, University of Iowa, Iowa City, IA
| | - Lin Y Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN
| | | | - J Jeffrey Carr
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN
| | | | - Mark A Pereira
- Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN
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Arigo D, Mogle JA, Brown MM, Roberts SR, Pasko K, Butryn ML, Downs DS. Differences between accelerometer cut point methods among midlife women with cardiovascular risk markers. Menopause 2020; 27:559-567. [PMID: 32049926 PMCID: PMC7903971 DOI: 10.1097/gme.0000000000001498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Midlife women experience elevated risk for cardiovascular disease and often receive advice to increase physical activity to mitigate this risk. Use of accelerometers to measure ambulatory physical activity requires selection of appropriate thresholds for estimating moderate-to-vigorous physical activity (MVPA), and choice of cut points may lead to meaningfully different conclusions about midlife women's physical activity (PA) engagement. This is particularly important given the recent elimination of 10-minute bout requirements for MVPA. This two-phase study examined differences between four cut point methods among midlife women with cardiovascular disease (CVD) risk. We used findings from Study 1 (exploratory) to generate hypotheses for Study 2 (confirmatory). METHODS Across studies, participants (N = 65) were midlife women with an additional CVD risk factor (eg, hypertension). Participants wore waistband accelerometers for seven days. Daily totals were calculated for minutes in light and MVPA using four common quantification methods (Freedson, Matthews, Swartz, and Troiano). RESULTS Multilevel models showed meaningful differences between methods (P < 0.0001). For total (non-bouted) minutes of MVPA, Freedson and Troiano methods showed that participants barely met MVPA recommendations (30 min per day), whereas Matthews and Swartz methods showed that participants greatly exceeded this goal. As differences between methods were smaller using MVPA bouts of 10 minutes or more (though remained significant), the observed variation was due in part to small bursts of MVPA dispersed throughout the day. CONCLUSIONS Findings demonstrate the need for careful consideration of PA quantification among midlife women with CVD risk, and for further investigation to determine the most appropriate quantification method. : Video Summary:http://links.lww.com/MENO/A545.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, NJ
| | | | - Megan M. Brown
- Department of Psychology, Rowan University, Glassboro, NJ
| | | | - Kristen Pasko
- Department of Psychology, Rowan University, Glassboro, NJ
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Direito A, Tooley M, Hinbarji M, Albatal R, Jiang Y, Whittaker R, Maddison R. Tailored Daily Activity: An Adaptive Physical Activity Smartphone Intervention. Telemed J E Health 2020; 26:426-437. [DOI: 10.1089/tmj.2019.0034] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Artur Direito
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mark Tooley
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Moohamad Hinbarji
- The Insight Centre for Data Analytics, Dublin City University, Dublin, Ireland
| | - Rami Albatal
- The Insight Centre for Data Analytics, Dublin City University, Dublin, Ireland
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Ralph Maddison
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
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11
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Martins J, Marques A, Teixeira PJ, Mota J, Lopes C, Nicola PJ. Socio-demographic factors associated with physical activity and sitting time patterns in adults: An analysis based on the Portuguese Food, Nutrition and Physical Activity Survey. Eur J Sport Sci 2020; 21:250-260. [PMID: 32105186 DOI: 10.1080/17461391.2020.1736643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
ABSTRACTPhysical activity (PA) and sedentary behaviours (SB) influence health. Since most people engage in different combinations of both behaviours every day, understanding the socio-demographic characteristics of adults with distinct PA and sitting time (ST) patterns is important to contribute to evidence-based planning of public health strategies. Data from a national survey on diet and activity behaviours (IAN-AF, 2015/16) including 1724 adults (50.5% women, 18-64 years) from a representative sample of Portuguese adults was used in this study. Participants were interviewed face-to-face, and the International Physical Activity Questionnaire (IPAQ) was used. Logistic regression examined the associations between socio-demographic factors each of the four-low/high PA-ST groups. PA low/high categories were defined as in IPAQ, while ST low/high categories were defined according to ST tertiles (≤180 min/day, ≥360 min/day). A 'higher risk' behaviour pattern (low PA/high ST) was present in 37.3% of the adults and was likely associated with a middle household income, and with having 12 or more years of education. The 'lower risk' (high PA/low ST) represented 26.6% of the sample and was likely associated with middle-aged adults and with having a lower educational level. Being male, young and highly educated was related to being physically active and spending large amounts of time in ST. Besides adding to the body of mixed evidence on this theme, the identification of the socio-demographic factors associated with each PA/ST pattern will permit national public health authorities to define policies and tailored actions to promote PA and reduce ST.
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Affiliation(s)
- João Martins
- Laboratório de Pedagogia, Faculdade de Motricidade Humana e UIDEF, Instituto de Educação, Universidade de Lisboa, Lisboa, Portugal.,Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Adilson Marques
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Centro Interdisciplinar do Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Pedro J Teixeira
- Centro Interdisciplinar do Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Jorge Mota
- Centro de Investigação em Actividade Física Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Carla Lopes
- Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Paulo J Nicola
- Environmental Health Institute, Lisbon Medical School, University of Lisbon, Lisboa, Portugal.,Epidemiology Unit, Institute of Preventive Medicine and Public Health, Lisbon Medical School, University of Lisbon, Lisboa, Portugal
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12
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Hammam N, Ezeugwu VE, Rumsey DG, Manns PJ, Pritchard-Wiart L. Physical activity, sedentary behavior, and long-term cardiovascular risk in individuals with rheumatoid arthritis. PHYSICIAN SPORTSMED 2019; 47:463-470. [PMID: 31122104 DOI: 10.1080/00913847.2019.1623995] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Individuals with rheumatoid arthritis (RA) have increased risk of cardiovascular disease (CVD). Lifestyle factors such as prolonged sedentary behavior (SB) and reduced physical activity (PA) may heighten the risk of CVD. The objective of the study was to investigate the role of SB and PA as predictors for long-term CVD risk in RA patients.Methods: A subsample of 273 people diagnosed with RA was extracted from the 2003-2006 National Health and Nutrition Examination Survey and included in this cross-sectional study. Valid accelerometry data were categorized into sedentary behavior, very light, light, and moderate-to-vigorous physical activity. Functional limitations were assessed using a physical function questionnaire. The Framingham risk score (FRS) was used to calculate 10-year CVD risk. Regression models were used to examine the relationships between SB, PA, and 10-year CVD risk while controlling for potential confounders.Results: Participants spent an average of 9 h/day sedentary, 4 h in very light PA, 1 h in light PA, and 0.4 h in moderate-to-vigorous PA. Greater sedentary time was associated with higher 10-year CVD risk (p= 0.019). Increased daily PA, at all intensities, was inversely associated with 10-year CVD risk (p< 0.01). In the fully adjusted regression model, associations between 10-year CVD risk and SB (β = 0.31, R2 = 0.27, p< 0.01), very light PA (β = -0.19, R2 = 0.26, p< 0.01), light PA (β = -0.16, R2 = 0.25, p< 0.01), and moderate-to-vigorous PA (β = -0.15, R2 = 0.25, p< 0.01) remained significant.Conclusions: Strategies for decreasing SB and increasing PA should be explored with individuals with RA in order to decrease long-term CVD risk.
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Affiliation(s)
- Nevin Hammam
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Rheumatology and Rehabilitation, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Victor E Ezeugwu
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Dax G Rumsey
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
| | - Patricia J Manns
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Lesley Pritchard-Wiart
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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13
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DePaul VG, Bosch J, Oczkowski WJ, Wishart L, O'Donnell M, Hart RG. Promoting Independent Mobility-related Physical ACTivity (IMPACT) in an inpatient stroke rehabilitation unit: a proof-of-concept evaluation of self-management intervention. Disabil Rehabil 2019; 42:3172-3181. [PMID: 30924713 DOI: 10.1080/09638288.2019.1587012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To establish proof-of-concept of a novel rehabilitation self-management program that aims to optimize walking recovery after stroke through engaging patients in independent walking-related practice outside of supervised physiotherapy sessions.Materials and Methods: The Independent Mobility-related Physical ACTivity (IMPACT) Program is a coach-supported intervention that uses self-management strategies to empower patients to engage in additional autonomous walking-related activities after stroke during and after inpatient rehabilitation. The aim of this study was to assess whether implementation of this intervention would be associated with targeted patient behaviors; goal setting, negotiation and completion of a walking-related practice plan outside of formal therapy sessions. Using a pre-intervention/post-intervention design, the Independent Mobility-related Physical Activity program was implemented with a convenience sample of 10 adults (mean age 62.3; SD 11.7 years) within an inpatient stroke rehabilitation unit (mean stroke onset 25.3 [SD 10.5] days).Results: All participants were able to set a personal goal, negotiate an autonomous walking-related activity practice plan, and partially or completely adhere to that plan. Patients completed an average of 36 min/day of practice outside of supervised physiotherapy, practicing on weekdays and weekend days. All patients indicated that the Independent Mobility-related Physical Activity program helped them increase their activity, and indicated they would continue to practice walking-related activities beyond the coaching period.Implications for rehabilitationThe IMPACT program is a feasible self-management strategy to facilitate walking-related practice outside of supervised therapy time during inpatient stroke rehabilitation.Patients were able to engage in goal-setting and practice plan development with support of a therapist-coach.Patients who are able to stand and walk with minimal assist were able to practice walking-related activities outside of formal therapy sessions.Therapists may benefit from specific training and support to adopt self-management strategies into practice.
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Affiliation(s)
- Vincent G DePaul
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada.,Population Health Research Institute, Hamilton, Canada
| | - Jackie Bosch
- Population Health Research Institute, Hamilton, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Wieslaw J Oczkowski
- Population Health Research Institute, Hamilton, Canada.,Department of Medicine, McMaster University, Hamilton, Canada
| | - Laurie Wishart
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Martin O'Donnell
- Population Health Research Institute, Hamilton, Canada.,Translational Medicine, National University of Ireland, Galway, Ireland
| | - Robert G Hart
- Population Health Research Institute, Hamilton, Canada.,Department of Medicine, McMaster University, Hamilton, Canada
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14
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Butler KM, Ramos JS, Buchanan CA, Dalleck LC. Can reducing sitting time in the university setting improve the cardiometabolic health of college students? Diabetes Metab Syndr Obes 2018; 11:603-610. [PMID: 30323641 PMCID: PMC6181072 DOI: 10.2147/dmso.s179590] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE The high prevalence of metabolic syndrome (MetS), prediabetes, and increased risk of cardiovascular diseases linked with prolonged sitting has created a need to identify options to limit sedentary behaviors. A potentially simple approach to achieve this goal in the university setting is to provide students the option to stand during courses rather than sit. The purpose of the present study was to examine the effects of standing in the college classroom setting on cardiometabolic risk factors in a cohort of college students. PATIENTS AND METHODS Healthy college students (n=21) who attended at least two courses per week (a minimum of 5 hours) in a specified university building with standing desks participated in a 7-week intervention that was divided into three phases: 3 weeks of standing, 1 week of washout (sitting), and 3 weeks of sitting. The participants (mean ± SD: age, height, weight, body mass index, and waist-to-hip ratio were 22.7±6.4 years, 174.3±10.0 cm, 70.6±14.3 kg, 23.0±3.0 kg/m2, and 0.76±0.05, respectively) were randomly assigned to the phase of intervention of which they should start (sitting or standing), and all participants engaged in sitting during the washout phase. Cardiometabolic risk factors and metabolic equivalents (METs) were measured at baseline and weekly throughout the intervention. RESULTS Paired t-tests revealed significant differences (P<0.05) in all cardiometabolic risk factors between the 3 weeks of sitting and 3 weeks of standing time blocks. Moreover, MetS z-score was significantly improved (P<0.05) during the 3 weeks of standing (-5.91±2.70) vs 3 weeks of sitting (-5.25±2.69). The METs were significantly higher (P<0.05) during standing (1.47±0.09) than during sitting (1.02±0.07). Although there was considerable interindividual variability in the ∆ MetS z-score response, there was a 100% (21/21) incidence of a favorable change (ie, responders) in MetS z-score response. CONCLUSION A standing desk in the classroom paradigm was found to significantly improve cardiometabolic health throughout a short 3 weeks time span. Increasing standing time in the classroom, and therefore lessening weekly sedentary behavior, could be a potential wide-scale, effective strategy for primordial prevention of cardiometabolic diseases.
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Affiliation(s)
- Karrie M Butler
- Department of Recreation, Exercise, and Sport Science, Western State Colorado University, Gunnison, CO, USA,
| | - Joyce S Ramos
- SHAPE Research Centre, Exercise Science and Clinical Exercise Physiology, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia,
| | - Christina A Buchanan
- Department of Recreation, Exercise, and Sport Science, Western State Colorado University, Gunnison, CO, USA,
| | - Lance C Dalleck
- Department of Recreation, Exercise, and Sport Science, Western State Colorado University, Gunnison, CO, USA,
- SHAPE Research Centre, Exercise Science and Clinical Exercise Physiology, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia,
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15
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Changes in Objectively Measured Activity Behavior Among Women Undergoing Breast Cancer Treatment: Longitudinal Cohort Study. REHABILITATION ONCOLOGY 2018. [DOI: 10.1097/01.reo.0000000000000137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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16
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Guell C, Panter J, Griffin S, Ogilvie D. Towards co-designing active ageing strategies: A qualitative study to develop a meaningful physical activity typology for later life. Health Expect 2018; 21:919-926. [PMID: 29624803 PMCID: PMC6186535 DOI: 10.1111/hex.12686] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Physical activity levels decline in later life despite the known benefits for physical, cognitive and mental health. Older people find it difficult to meet activity targets; therefore, more realistic and meaningful strategies are needed. We aimed to develop a typology of older people's motivations and lifelong habits of being active as a starting point to co-designing active ageing strategies in a workshop. METHODS We conducted semi-structured interviews with 27 participants aged 65-80 in Norfolk, UK, and participant observation with 17 of them. At a workshop with 13 study participants and 6 government and civil society representatives, we invited reflections on preliminary findings. RESULTS Three types were developed. "Exercisers" had engaged in sport and exercise throughout their life but experienced physical ill health and limitations as barriers. "Out-and-about-ers" pursued social engagement and a variety of interests but experienced biographical disruption through retirement and loss of companions that limited social activities in later life. A final type characterized people who preferred "sedentary/solitary" activities. A workshop elicited suggestions for new strategies relating to these types that addressed people's specific motivations. An example was to combine social engagement and physical activity in "dog-parent"-walking schemes to link people through shared responsibility for a dog. CONCLUSIONS We suggest that these potential strategies map more closely onto the everyday life-worlds in which public health might seek to intervene than common physical activity interventions. Most notably, this means a more differentiated understanding of barriers, and acknowledging that intellectual, social or solitary pursuits can include incidental physical activity.
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Affiliation(s)
- Cornelia Guell
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR)University of CambridgeCambridgeUK
- European Centre for Environment and Human HealthUniversity of ExeterTruroUK
| | - Jenna Panter
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR)University of CambridgeCambridgeUK
| | - Simon Griffin
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR)University of CambridgeCambridgeUK
- The Primary Care UnitInstitute of Public HealthUniversity of CambridgeCambridgeUK
| | - David Ogilvie
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR)University of CambridgeCambridgeUK
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17
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Vasankari V, Husu P, Vähä-Ypyä H, Suni JH, Tokola K, Borodulin K, Wennman H, Halonen J, Hartikainen J, Sievänen H, Vasankari T. Subjects with cardiovascular disease or high disease risk are more sedentary and less active than their healthy peers. BMJ Open Sport Exerc Med 2018; 4:e000363. [PMID: 29765701 PMCID: PMC5950643 DOI: 10.1136/bmjsem-2018-000363] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2018] [Indexed: 01/10/2023] Open
Abstract
Objectives We investigated differences in objectively measured sedentary behaviour (SB) and physical activity (PA) levels in subjects with cardiovascular disease (CVD) diagnosis or high CVD risk compared with healthy controls. Methods The present study includes a subsample (n=1398, Health 2011 Study) of participants, who attended health examinations and wore a triaxial accelerometer (≥4 days). Patients with CVD were identified and CVD risk was calculated for others using Framingham Risk Score (FRS). Participants were categorised into groups: FRS<10%; FRS=10%–30%; FRS>30%/CVD. Raw acceleration data were analysed with mean amplitude deviation (MAD) and angle for posture estimation (APE). MAD corresponding to intensity of PA was converted to metabolic equivalents (MET) and categorised to light (1.5–2.9 METs) and moderate to vigorous PA (MVPA≥3.0 METs). APE recognises SB and standing. Results Daily accumulated time of >30 s MVPA bouts was higher in FRS<10% group (46 min) than in FRS>30%/CVD group (29 min) (p<0.001). FRS>30%/CVD group were more sedentary, their mean daily number of >10 min SB bouts (13.2) was higher than in FRS <10% group (11.5) (p=0.002). Conclusion Number and accumulated times of SB and PA bouts differed between the CVD risk groups. Causative research is required to assess the importance of SB and PA in prevention and rehabilitation of CVDs.
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Affiliation(s)
- Ville Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland.,Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland.,The University of Eastern Finland (UEF), Kuopio, Finland
| | - Pauliina Husu
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | | | - Kari Tokola
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Katja Borodulin
- The National Institute of Health and Welfare (THL), Helsinki, Finland
| | - Heini Wennman
- The National Institute of Health and Welfare (THL), Helsinki, Finland
| | - Jari Halonen
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland.,The University of Eastern Finland (UEF), Kuopio, Finland
| | - Juha Hartikainen
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland.,The University of Eastern Finland (UEF), Kuopio, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland
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18
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Direito A, Walsh D, Hinbarji M, Albatal R, Tooley M, Whittaker R, Maddison R. Using the Intervention Mapping and Behavioral Intervention Technology Frameworks: Development of an mHealth Intervention for Physical Activity and Sedentary Behavior Change. HEALTH EDUCATION & BEHAVIOR 2017; 45:331-348. [PMID: 29216765 DOI: 10.1177/1090198117742438] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Few interventions to promote physical activity (PA) adapt dynamically to changes in individuals' behavior. Interventions targeting determinants of behavior are linked with increased effectiveness and should reflect changes in behavior over time. This article describes the application of two frameworks to assist the development of an adaptive evidence-based smartphone-delivered intervention aimed at influencing PA and sedentary behaviors (SB). Intervention mapping was used to identify the determinants influencing uptake of PA and optimal behavior change techniques (BCTs). Behavioral intervention technology was used to translate and operationalize the BCTs and its modes of delivery. The intervention was based on the integrated behavior change model, focused on nine determinants, consisted of 33 BCTs, and included three main components: (1) automated capture of daily PA and SB via an existing smartphone application, (2) classification of the individual into an activity profile according to their PA and SB, and (3) behavior change content delivery in a dynamic fashion via a proof-of-concept application. This article illustrates how two complementary frameworks can be used to guide the development of a mobile health behavior change program. This approach can guide the development of future mHealth programs.
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Affiliation(s)
| | | | | | | | - Mark Tooley
- 1 University of Auckland, Auckland, New Zealand
| | | | - Ralph Maddison
- 1 University of Auckland, Auckland, New Zealand.,3 Deakin University, Melbourne, Victoria, Australia
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19
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Fenton SAM, Veldhuijzen van Zanten JJCS, Kitas GD, Duda JL, Rouse PC, Yu CA, Metsios GS. Sedentary behaviour is associated with increased long-term cardiovascular risk in patients with rheumatoid arthritis independently of moderate-to-vigorous physical activity. BMC Musculoskelet Disord 2017; 18:131. [PMID: 28356089 PMCID: PMC5404687 DOI: 10.1186/s12891-017-1473-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 03/06/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Rheumatoid Arthritis (RA) is associated with an increased risk of cardiovascular disease (CVD). The physical dysfunction symptomatic of RA means people living with this disease spend large periods of the day sedentary, which may further elevate their risk of CVD. The primary aim of this study was to investigate relationships between objectively assessed sedentary behaviour patterns and light physical activity (LPA) with 10-year risk of CVD. Secondary aims were to explore the role of sedentary behaviour patterns and LPA for individual CVD risk factors and functional disability in RA. The extent to which associations were independent of moderate-to-vigorous physical activity (MVPA) engagement was also examined. METHODS Baseline data from a subsample of participants recruited to the Physical Activity in Rheumatoid Arthritis (PARA) study were used to answer current research questions. Sixty-one patients with RA (mean age (± SD) = 54.92 ± 12.39 years) provided a fasted blood sample and underwent physical assessments to evaluate factors associated with their cardiovascular health. Sedentary behaviour patterns (sedentary time, sedentary bouts, sedentary breaks), LPA and MVPA were measured via 7-days of accelerometry. Ten-year CVD risk was computed (Q-risk-score2), and functional disability determined via questionnaire. RESULTS Regressions revealed significant positive associations between sedentary time and the number of sedentary bouts per day ≥20 min with 10-year CVD risk, with the reverse true for LPA participation. Associations were independent of MVPA engagement. CONCLUSIONS Promoting LPA participation and restricting sedentary bouts to <20 min may attenuate long-term CVD risk in RA, independent of MVPA engagement. TRIAL REGISTRATION ISRCTN04121489 (retrospectively registered 19/10/2012).
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Affiliation(s)
- Sally A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK. .,Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK.
| | - Jet J C S Veldhuijzen van Zanten
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK
| | - George D Kitas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | | | - Chen-An Yu
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - George S Metsios
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Faculty of Health Education and Wellbeing, University of Wolverhampton, West Midlands, UK.,Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK
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20
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Bakrania K, Edwardson CL, Bodicoat DH, Esliger DW, Gill JMR, Kazi A, Velayudhan L, Sinclair AJ, Sattar N, Biddle SJH, Khunti K, Davies M, Yates T. Associations of mutually exclusive categories of physical activity and sedentary time with markers of cardiometabolic health in English adults: a cross-sectional analysis of the Health Survey for England. BMC Public Health 2016; 16:25. [PMID: 26753523 PMCID: PMC4709945 DOI: 10.1186/s12889-016-2694-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/06/2016] [Indexed: 02/06/2023] Open
Abstract
Background Both physical activity and sedentary behaviour have been individually associated with health, however, the extent to which the combination of these behaviours influence health is less well-known. The aim of this study was to examine the associations of four mutually exclusive categories of objectively measured physical activity and sedentary time on markers of cardiometabolic health in a nationally representative sample of English adults. Methods Using the 2008 Health Survey for England dataset, 2131 participants aged ≥18 years, who provided valid accelerometry data, were included for analysis and grouped into one of four behavioural categories: (1) ‘Busy Bees’: physically active & low sedentary, (2) ‘Sedentary Exercisers’: physically active & high sedentary, (3) ‘Light Movers’: physically inactive & low sedentary, and (4) ‘Couch Potatoes’: physically inactive & high sedentary. ‘Physically active’ was defined as accumulating at least 150 min of moderate-to-vigorous physical activity (MVPA) per week. ‘Low sedentary’ was defined as residing in the lowest quartile of the ratio between the average sedentary time and the average light-intensity physical activity time. Weighted multiple linear regression models, adjusting for measured confounders, investigated the differences in markers of health across the derived behavioural categories. The associations between continuous measures of physical activity and sedentary levels with markers of health were also explored, as well as a number of sensitivity analyses. Results In comparison to ‘Couch Potatoes’, ‘Busy Bees’ [body mass index: −1.67 kg/m2 (p < 0.001); waist circumference: −1.17 cm (p = 0.007); glycated haemoglobin: −0.12 % (p = 0.003); HDL-cholesterol: 0.09 mmol/L (p = 0.001)], ‘Sedentary Exercisers’ [body mass index: −1.64 kg/m2 (p < 0.001); glycated haemoglobin: −0.11 % (p = 0.009); HDL-cholesterol: 0.07 mmol/L (p < 0.001)] and ‘Light Movers’ [HDL-cholesterol: 0.11 mmol/L (p = 0.004)] had more favourable health markers. The continuous analyses showed consistency with the categorical analyses and the sensitivity analyses indicated robustness and stability. Conclusions In this national sample of English adults, being physically active was associated with a better health profile, even in those with concomitant high sedentary time. Low sedentary time independent of physical activity had a positive association with HDL-cholesterol. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2694-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kishan Bakrania
- Department of Health Sciences, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, United Kingdom. .,Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Danielle H Bodicoat
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Dale W Esliger
- National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.
| | - Jason M R Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre (BHF GCRC), Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK.
| | - Aadil Kazi
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Latha Velayudhan
- Psychiatry for the Elderly, Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK.
| | - Alan J Sinclair
- Diabetes Frail Ltd, University of Aston, Birmingham, B4 7ET, UK.
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre (BHF GCRC), Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK.
| | - Stuart J H Biddle
- Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia.
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care - East Midlands (CLAHRC - EM) Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Melanie Davies
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
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21
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Lewis LK, Rowlands AV, Gardiner PA, Standage M, English C, Olds T. Small Steps: Preliminary effectiveness and feasibility of an incremental goal-setting intervention to reduce sitting time in older adults. Maturitas 2016; 85:64-70. [PMID: 26857881 DOI: 10.1016/j.maturitas.2015.12.014] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 12/23/2015] [Accepted: 12/27/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to evaluate the preliminary effectiveness and feasibility of a theory-informed program to reduce sitting time in older adults. DESIGN Pre-experimental (pre-post) study. Thirty non-working adult (≥ 60 years) participants attended a one hour face-to-face intervention session and were guided through: a review of their sitting time; normative feedback on sitting time; and setting goals to reduce total sitting time and bouts of prolonged sitting. Participants chose six goals and integrated one per week incrementally for six weeks. Participants received weekly phone calls. OUTCOME MEASURES Sitting time and bouts of prolonged sitting (≥ 30 min) were measured objectively for seven days (activPAL3c inclinometer) pre- and post-intervention. During these periods, a 24-h time recall instrument was administered by computer-assisted telephone interview. Participants completed a post-intervention project evaluation questionnaire. Paired t tests with sequential Bonferroni corrections and Cohen's d effect sizes were calculated for all outcomes. RESULTS Twenty-seven participants completed the assessments (71.7 ± 6.5 years). Post-intervention, objectively-measured total sitting time was significantly reduced by 51.5 min per day (p=0.006; d=-0.58) and number of bouts of prolonged sitting by 0.8 per day (p=0.002; d=-0.70). Objectively-measured standing increased by 39 min per day (p=0.006; d=0.58). Participants self-reported spending 96 min less per day sitting (p<0.001; d=-0.77) and 32 min less per day watching television (p=0.005; d=-0.59). Participants were highly satisfied with the program. CONCLUSION The 'Small Steps' program is a feasible and promising avenue for behavioral modification to reduce sitting time in older adults.
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Affiliation(s)
- L K Lewis
- School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.
| | - A V Rowlands
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, Australia; Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, Leicestershire LE5 4PW, United Kingdom; National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Leicester, Leicestershire LE5 4PW, United Kingdom.
| | - P A Gardiner
- The University of Queensland, School of Public Health, Brisbane, Australia; Mater Research Institute, The University of Queensland, Brisbane, Australia.
| | - M Standage
- Department for Health, University of Bath, Bath, United Kingdom.
| | - C English
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.
| | - T Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.
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