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Pellerine LP, Miller K, Frayne RJ, O'Brien MW. Characterizing objective and self-report habitual physical activity and sedentary time in outpatients with an acquired brain injury. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:338-343. [PMID: 39309460 PMCID: PMC11411321 DOI: 10.1016/j.smhs.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/15/2023] [Accepted: 02/05/2024] [Indexed: 09/25/2024] Open
Abstract
Outpatients with an acquired brain injury (ABI) experience physical, mental, and social deficits. ABI can be classified into two subgroups based on mechanism of injury: mild traumatic brain injury (mTBI; e.g., concussion) and other ABI (e.g., stroke, brain aneurysm, encephalitis). Our understanding of habitual activity levels within ABI populations is limited because they are often collected using self-report measures. The purpose of this study was to, 1) describe the habitual activity levels of outpatients with ABI using objective and self-report monitoring, and 2) compare the activity levels of outpatients with mTBI vs. other ABI. Sixteen outpatients with other ABI (mean ± standard deviation: [58 ± 13] years, 9 females) and 12 outpatients with mTBI ([48 ± 11] years, 9 females) wore a thigh-worn activPAL 24 h/day (h/day) for 7-days. Outpatients with ABI averaged (6.0 ± 2.3) h/day of upright time, (10.6 ± 2.2) h/day of sedentary time, (5.6 ± 2.7) h/day in prolonged sedentary bouts > 1 h, (5 960 ± 3 037) steps/day, and (11 ± 13) minutes/day (min/day) of moderate-vigorous physical activity (MVPA). There were no differences between activPAL-derived upright, sedentary, prolonged sedentary time, and physical activity between the mTBI and other ABI groups (all, p > 0.31). Outpatients with ABI overestimated their MVPA levels (+138 min/week) and underestimated sedentary time (-4.3 h/day) compared to self-report (all, p < 0.001). Despite self-reporting high activity levels, outpatients with ABI objectively exhibit highly inactive and sedentary lifestyles. The habitual movement behaviours of our sample did not differ by mechanism of injury (i.e., mTBI versus other ABI). Targeting reductions in objectively measured sedentary time are needed to progressively improve the habitual movement behaviours of outpatients with ABI.
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Affiliation(s)
- Liam P. Pellerine
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Katerina Miller
- Acquired Brain Injury NeuroCommons, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Ryan J. Frayne
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Myles W. O'Brien
- School of Physiotherapy (Faculty of Health) & Department of Medicine (Faculty of Medicine), Dalhousie University, Halifax, Nova Scotia, Canada
- Geriatric Medicine Research, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia, Canada
- Centre de Formation Médicale Du Nouveau-Brunswick, New Brunswick & Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Chen LK. Exercise reshapes aging bodies and minds. Arch Gerontol Geriatr 2024; 126:105581. [PMID: 39033054 DOI: 10.1016/j.archger.2024.105581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Affiliation(s)
- Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
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Pîrșcoveanu CI, Hansen EA, Franch J, Madeleine P. Walking against the odds: The intricate connection between spatiotemporal characteristics, kinetic and kinematic variables, cognitive stress, and passive assistive exoskeletons in senior and young adults. Hum Mov Sci 2024; 97:103268. [PMID: 39128412 DOI: 10.1016/j.humov.2024.103268] [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: 01/05/2024] [Revised: 06/19/2024] [Accepted: 08/02/2024] [Indexed: 08/13/2024]
Abstract
In this study, we investigated the combined effects of age, dual-tasking (DT) and a passive hip exoskeleton on gait patterns among senior (SA) and young adults (YA). It was hypothesized that SA will be more affected by DT and that wearing the exoskeleton will improve gait patterns for both groups during DT. Twenty-two SA and twenty-six YA performed a single task (normal walking) and DT walking at their preferred speed with an exoskeleton (EXO), without (noEXO), and a sham version (SHAM) in a randomized and balanced order. Speed, cadence, double support time (DST), step length, hip joint power, range of motion (ROM), and moments (mom), as well as DT performance, were extracted using mocap, force plates (1000 Hz), and a voice recorder. Three-way MANOVA with group × device × condition was conducted (p < .05, inferred significance). Results showed a predominantly significant main effect of group for step length, speed, DST, ROM, and mom (p ≤ .01), main effect of condition for cadence, DST, speed, and mom (p < .01) and a main effect of the device for ROMz and mom (p < .05). Age-related changes were seen by decreased walking speed and step length, independent of DT and use of exoskeleton. Wearing the EXO aided the SA group to maintain similar levels of cadence from single to DT and decreased the hip internal rotation mom by 65%. There was no difference in DT performance between groups. In conclusion, SA showed a decline in gait patterns during DT that was somewhat mitigated by wearing an EXO.
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Affiliation(s)
- Cristina-Ioana Pîrșcoveanu
- Aalborg University, Faculty of Medicine, Department of Health Science and Technology, ExerciseTech, Aalborg, Denmark.
| | - Ernst Albin Hansen
- University College Absalon, Centre for Health and Rehabilitation, Slagelse, Denmark
| | - Jesper Franch
- Aalborg University, Faculty of Medicine, Department of Health Science and Technology, ExerciseTech, Aalborg, Denmark
| | - Pascal Madeleine
- Aalborg University, Faculty of Medicine, Department of Health Science and Technology, ExerciseTech, Aalborg, Denmark
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JOENSUU LAURA, WALLER KATJA, KANKAANPÄÄ ANNA, PALVIAINEN TEEMU, KAPRIO JAAKKO, SILLANPÄÄ ELINA. Genetic Liability to Cardiovascular Disease, Physical Activity, and Mortality: Findings from the Finnish Twin Cohort. Med Sci Sports Exerc 2024; 56:1954-1963. [PMID: 38768019 PMCID: PMC11419275 DOI: 10.1249/mss.0000000000003482] [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: 05/22/2024]
Abstract
PURPOSE We investigated whether longitudinally assessed physical activity (PA) and adherence specifically to World Health Organization PA guidelines mitigate or moderate mortality risk regardless of genetic liability to cardiovascular disease (CVD). We also estimated the causality of the PA-mortality association. METHODS The study used the older Finnish Twin Cohort with 4897 participants aged 33 to 60 yr (54.3% women). Genetic liability to coronary heart disease and systolic and diastolic blood pressure was estimated with polygenic risk scores (PRS) derived from the Pan-UK Biobank ( N ≈ 400,000; >1,000,000 genetic variants). Leisure-time PA was assessed with validated and structured questionnaires three times during 1975 to 1990. The main effects of adherence to PA guidelines and the PRS × PA interactions were evaluated with Cox proportional hazards models against all-cause and CVD mortality. A cotwin control design with 180 monozygotic twin pairs discordant for meeting the guidelines was used for causal inference. RESULTS During the 17.4-yr (mean) follow-up (85,136 person-years), 1195 participants died, with 389 CVD deaths. PRS (per 1 SD increase) were associated with a 17% to 24% higher CVD mortality risk but not with all-cause mortality except for the PRS for diastolic blood pressure. Adherence to PA guidelines did not show significant independent main effects or interactions with all-cause or CVD mortality. Twins whose activity levels adhered to PA guidelines over a 15-yr period did not have statistically significantly reduced mortality risk compared with their less active identical twin sibling. The findings were similar among high, intermediate, and low genetic risk levels for CVD. CONCLUSIONS The genetically informed Finnish Twin Cohort data could not confirm that adherence to PA guidelines either mitigates or moderates genetic CVD risk or causally reduces mortality risk.
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Affiliation(s)
- LAURA JOENSUU
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, FINLAND
| | - KATJA WALLER
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - ANNA KANKAANPÄÄ
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, FINLAND
| | - TEEMU PALVIAINEN
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, FINLAND
| | - JAAKKO KAPRIO
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, FINLAND
| | - ELINA SILLANPÄÄ
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
- Wellbeing Services County of Central Finland, Jyväskylä, FINLAND
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SMALL SCOTTR, CHAN SHING, WALMSLEY ROSEMARY, VON FRITSCH LENNART, ACQUAH AIDAN, MERTES GERT, FEAKINS BENJAMING, CREAGH ANDREW, STRANGE ADAM, MATTHEWS CHARLESE, CLIFTON DAVIDA, PRICE ANDREWJ, KHALID SARA, BENNETT DERRICK, DOHERTY AIDEN. Self-Supervised Machine Learning to Characterize Step Counts from Wrist-Worn Accelerometers in the UK Biobank. Med Sci Sports Exerc 2024; 56:1945-1953. [PMID: 38768076 PMCID: PMC11402590 DOI: 10.1249/mss.0000000000003478] [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] [Indexed: 05/22/2024]
Abstract
PURPOSE Step count is an intuitive measure of physical activity frequently quantified in health-related studies; however, accurate step counting is difficult in the free-living environment, with error routinely above 20% in wrist-worn devices against camera-annotated ground truth. This study aimed to describe the development and validation of step count derived from a wrist-worn accelerometer and assess its association with cardiovascular and all-cause mortality in a large prospective cohort. METHODS We developed and externally validated a self-supervised machine learning step detection model, trained on an open-source and step-annotated free-living dataset. Thirty-nine individuals will free-living ground-truth annotated step counts were used for model development. An open-source dataset with 30 individuals was used for external validation. Epidemiological analysis was performed using 75,263 UK Biobank participants without prevalent cardiovascular disease (CVD) or cancer. Cox regression was used to test the association of daily step count with fatal CVD and all-cause mortality after adjustment for potential confounders. RESULTS The algorithm substantially outperformed reference models (free-living mean absolute percent error of 12.5% vs 65%-231%). Our data indicate an inverse dose-response association, where taking 6430-8277 daily steps was associated with 37% (25%-48%) and 28% (20%-35%) lower risk of fatal CVD and all-cause mortality up to 7 yr later, compared with those taking fewer steps each day. CONCLUSIONS We have developed an open and transparent method that markedly improves the measurement of steps in large-scale wrist-worn accelerometer datasets. The application of this method demonstrated expected associations with CVD and all-cause mortality, indicating excellent face validity. This reinforces public health messaging for increasing physical activity and can help lay the groundwork for the inclusion of target step counts in future public health guidelines.
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Affiliation(s)
- SCOTT R. SMALL
- Nuffield Department of Population Health, University of Oxford, Oxford, UNITED KINGDOM
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UNITED KINGDOM
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UNITED KINGDOM
| | - SHING CHAN
- Nuffield Department of Population Health, University of Oxford, Oxford, UNITED KINGDOM
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UNITED KINGDOM
| | - ROSEMARY WALMSLEY
- Nuffield Department of Population Health, University of Oxford, Oxford, UNITED KINGDOM
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UNITED KINGDOM
| | - LENNART VON FRITSCH
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UNITED KINGDOM
| | - AIDAN ACQUAH
- Nuffield Department of Population Health, University of Oxford, Oxford, UNITED KINGDOM
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UNITED KINGDOM
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UNITED KINGDOM
| | - GERT MERTES
- Nuffield Department of Population Health, University of Oxford, Oxford, UNITED KINGDOM
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UNITED KINGDOM
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UNITED KINGDOM
| | - BENJAMIN G. FEAKINS
- Nuffield Department of Population Health, University of Oxford, Oxford, UNITED KINGDOM
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UNITED KINGDOM
| | - ANDREW CREAGH
- Nuffield Department of Population Health, University of Oxford, Oxford, UNITED KINGDOM
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UNITED KINGDOM
| | | | - CHARLES E. MATTHEWS
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - DAVID A. CLIFTON
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UNITED KINGDOM
| | - ANDREW J. PRICE
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UNITED KINGDOM
| | - SARA KHALID
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UNITED KINGDOM
| | - DERRICK BENNETT
- Nuffield Department of Population Health, University of Oxford, Oxford, UNITED KINGDOM
| | - AIDEN DOHERTY
- Nuffield Department of Population Health, University of Oxford, Oxford, UNITED KINGDOM
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UNITED KINGDOM
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Niu J, Li Y, Zhou Q, Liu X, Yu P, Gao F, Gao X, Wang Q. The association between physical activity and delayed neurocognitive recovery in elderly patients: a mediation analysis of pro-inflammatory cytokines. Aging Clin Exp Res 2024; 36:192. [PMID: 39259352 PMCID: PMC11390811 DOI: 10.1007/s40520-024-02846-z] [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: 06/01/2024] [Accepted: 09/03/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Delayed neurocognitive recovery (dNCR) can result in unfavorable outcomes in elderly surgical patients. Physical activity (PA) has been shown to improve cognitive function, potentially by reducing systemic inflammatory responses. However, there is a lack of supportive data indicating whether PA has a protective effect against dNCR. AIMS To examine the correlation between dNCR and PA, and to further analyze if pro-inflammatory cytokines mediate this relationship. METHODS This study is a prospective nested case-control investigation of elderly patients who had knee replacement surgery. dNCR was defined as a decline in cognitive function compared with baseline by using a battery of neuropsychological tests. PA was assessed with the Physical Activity Scale for the Elderly (PASE). Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentrations of IL-6, IL-1β, and TNF-α. Multivariable logistic regression analysis was conducted to assess the association between PA and dNCR. Mediation analysis was employed to evaluate whether pro-inflammatory cytokines mediate the relationship between them. RESULTS A cohort of 152 patients was included, resulting in an incidence rate of dNCR of 23.68%. PA was associated with dNCR after full adjustment [OR = 0.199, (95% CI, 0.061; 0.649), P = 0.007]. Mediation analysis showed that the IL-6 mediated the statistical association between PA and dNCR, with mediation proportions (%) of 77.68 (postoperative concentration of IL-6) or 27.58 (the absolute change in IL-6 before and after surgery). CONCLUSIONS PA serves as a protective factor against dNCR, possibly through the reduction of pro-inflammatory cytokine concentrations. THE CHINESE CLINICAL TRAIL REGISTRY: : www.http://chictr.org.cn , Registration No. ChiCTR2300070834, Registration date: April 24, 2023.
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Affiliation(s)
- Junfang Niu
- Department of Anesthesiology, Hebei Medical University Third Hospital, Shijiazhuang, China
| | - Yanan Li
- Department of Anesthesiology, Hebei Medical University Third Hospital, Shijiazhuang, China
| | - Qi Zhou
- Department of Anesthesiology, Hebei Medical University Third Hospital, Shijiazhuang, China
| | - Xiang Liu
- Department of Anesthesiology, Hebei Medical University Third Hospital, Shijiazhuang, China
| | - Peixia Yu
- Department of Anesthesiology, Hebei Medical University Third Hospital, Shijiazhuang, China
| | - Fang Gao
- Department of Anesthesiology, Hebei Medical University Third Hospital, Shijiazhuang, China
| | - Xia Gao
- Department of Epidemiology and Statistics & Hebei Province Key Laboratory of Environment and Human Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Qiujun Wang
- Department of Anesthesiology, Hebei Medical University Third Hospital, Shijiazhuang, China.
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Cuthbertson CC, Evenson KR, Wen F, Moore CC, Howard AG, Di C, Parada H, Matthews CE, Manson JE, Buring J, Shiroma EJ, LaCroix AZ, Lee IM. Associations of steps per day and step intensity with the risk of cancer: Findings from the Women's Health Accelerometry Collaboration cohort. Prev Med 2024; 186:108070. [PMID: 39029743 PMCID: PMC11338699 DOI: 10.1016/j.ypmed.2024.108070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 07/14/2024] [Accepted: 07/15/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE Accumulating more steps/day is associated with a lower risk of cancer mortality and composite cancer outcomes. However, less is known about the relationship of steps/day with the risk of multiple site-specific cancers. METHODS This study included >22,000 women from the Women's Health Accelerometry Collaboration Cohort (2011-2022), comprised of women from the Women's Health Study and Women's Health Initiative Objective Physical Activity and Cardiovascular Health Study. Steps/day and step intensity were collected with accelerometry. Incident cancer cases and deaths were adjudicated. Stratified Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the associations of steps/day and step intensity with incident breast, colon, endometrial, lung, and ovarian cancers, a composite of 13 physical activity-related cancers, total invasive cancer, and fatal cancer. RESULTS On average, women were 73.4 years old, accumulated 4993 steps/day, and had 7.9 years of follow-up. There were small nonsignificant inverse associations with the risks of colon cancer (HR = 0.94, 95% CI: 0.83, 1.05), endometrial cancer (HR = 0.91, 95% CI: 0.82, 1.01), and fatal cancer (HR = 0.95 95% CI: 0.90, 1.00) per 1000 steps/day. More minutes at ≥40 steps/min and a faster peak 10- and 30-min step cadence were associated with a lower risk of endometrial cancer, but findings were attenuated after adjustment for body mass index and steps/day. CONCLUSIONS Among women 62-97 years, there were small nonsignificant inverse associations of colon, endometrial, and fatal cancer with more steps/day. Epidemiologic studies with longer follow-up and updated assessments are needed to further explore these associations.
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Affiliation(s)
- Carmen C Cuthbertson
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, United States of America.
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Fang Wen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Christopher C Moore
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Annie G Howard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Chongzhi Di
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States of America
| | - Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD, United States of America
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Julie Buring
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Eric J Shiroma
- Division of Cardiovascular Sciences, National Heart Lung Blood Institute, Bethesda, MD, United States of America
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States of America
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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Dohrn IM, Tarp J, Steene-Johannessen J, Vasankari T, Hagströmer M. Device-measured physical activity and sedentary time in the Nordic countries: A scoping review of population-based studies. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:650-660. [PMID: 38580050 PMCID: PMC11282347 DOI: 10.1016/j.jshs.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/26/2024] [Accepted: 03/11/2024] [Indexed: 04/07/2024]
Abstract
PURPOSE The purpose of this scoping review was to summarize and describe the methodology and results from population-based studies of physical activity and sedentary time measured with devices in the Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) and published in 2000 or later. METHODS A systematic search was carried out in PubMed and Web of Science in June 2023 using predefined search terms. RESULTS Fourteen unique research projects or surveillance studies were identified. Additionally, 2 surveillance studies published by national agencies were included, resulting in a total of 16 studies for inclusion. National surveillance systems exist in Finland and Norway, with regular survey waves in school-aged children/adolescents and adults. In Denmark, recent nationally representative data have been collected in school children only. So far, Sweden has no regular national surveillance system using device-based data collection. No studies were found from Iceland. The first study was conducted in 2001 and the most recent in 2022, with most data collected from 2016 to date. Five studies included children/adolescents 6-18 years, no study included preschoolers. In total 11 studies included adults, of which 8 also covered older adults. No study focused specifically on older adults. The analytical sample size ranged from 205 to 27,890. Detailed methodology is presented, such as information on sampling strategy, device type and placement, wear protocols, and physical activity classification schemes. Levels of physical activity and sedentary time in children/adolescents, adults, and older adults across the Nordic countries are presented. CONCLUSION A growing implementation of device-based population surveillance of physical activity and sedentary behavior in the Nordic countries has been identified. The variety of devices, placement, and data procedures both within and between the Nordic countries highlights the challenges when it comes to comparing study outcomes as well as the need for more standardized data collection.
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Affiliation(s)
- Ing-Mari Dohrn
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden
| | - Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sports Sciences, 0806 Oslo, Norway
| | | | - Tommi Vasankari
- UKK Institute for Health Promotion Research, 33500 Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden; Academic Primary Health Care Centre, Region Stockholm, 133 65 Stockholm, Sweden.
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Nemoto Y, Brown WJ, Ding D, Nguyen B, Mielke GI. Trajectories of Physical Activity and Chronic Conditions Among Mid-Aged Women. Am J Prev Med 2024; 67:389-396. [PMID: 38796029 DOI: 10.1016/j.amepre.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION Women's physical activity levels vary throughout adulthood. However, the associations between trajectories of physical activity and health outcomes have been little studied. The aim of this study was to examine the associations of physical activity trajectories with incident diabetes, hypertension, obesity, depression, and physical disability in mid-aged women. METHODS Data were from the 1946-51 cohort of the Australian Longitudinal Study on Women's Health (n=11,611). Mailed surveys at 3-year intervals from 1998 (age 47-52) to 2019 (age 68-73) were used to collect data on physical activity and each outcome. The analyses were conducted in 2023/24. Physical activity trajectories from age 47-61 (2-4 time-points) were identified using group-based trajectory modeling. Cox regression models with time-varying covariates were used to examine the associations of physical activity trajectories with adverse health outcomes onset from ages 56-73 (2-5 time-points). RESULTS Trajectories of physical activity were labeled as Low (59.7% of participants), Declining (5.9%), Increasing (26.3%), and High (8.1%). The median of 9-year overall physical activity (MET.minutes/week) was 450 in the Low, 1324 in the Declining, 1399 in the Increasing, and 2323 in the High group. Compared with the Low group, the risks of diabetes, obesity and physical disability were lower in the Increasing and High groups, and the risk of depression was lower in the High group. Conversely, the risk of obesity was higher in the Declining group. CONCLUSIONS Targeting mid-aged women with declining physical activity for prevention programs could enhance health in later life.
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Affiliation(s)
- Yuta Nemoto
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia; Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan; School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan.
| | - Wendy J Brown
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Binh Nguyen
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Gregore Iven Mielke
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Chaturvedi A, Prabhakaran D. Transforming Cardiovascular Care With Digital Health: The Past, Progress, and Promise. JACC. ADVANCES 2024; 3:101183. [PMID: 39220713 PMCID: PMC11364112 DOI: 10.1016/j.jacadv.2024.101183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Affiliation(s)
- Abhishek Chaturvedi
- Section of Interventional Cardiology, Georgetown University MedStar Washington Hospital Center, Washington District of Columbia, USA
- Center for Chronic Disease Control, New Delhi, India
| | - Dorairaj Prabhakaran
- Center for Chronic Disease Control, New Delhi, India
- Public Health Foundation of India, Gurugram, India
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11
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Rubin DS, Conroy DE, Danilovich MK. Association of Daily Physical Activity With Motivation in Prefrail and Frail Older Adults Living in Retirement Communities. J Aging Phys Act 2024:1-8. [PMID: 39209280 DOI: 10.1123/japa.2023-0174] [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: 05/15/2023] [Revised: 06/06/2024] [Accepted: 06/14/2024] [Indexed: 09/04/2024]
Abstract
Older adults living in retirement communities are an understudied population, and the association between their motivation and daily physical activity is unknown. We recruited participants (n = 173) living in a retirement community who completed the Behavioral Regulation in Exercise Questionnaire-2 and wore an activPAL accelerometer to evaluate this relationship. Participants had a median age of 81 years and demonstrated low levels of daily activity with an average step count of 3,637 (±1,965) steps per day and 52 (±25) min of daily stepping time. External motivation was negatively associated with the square root of daily step count (β = -4.57; p < .001) and square root of daily stepping time (β = -0.49; p < .001). Older adults living in retirement communities demonstrated low levels of daily activity, with a negative association between external motivation and daily activity. Strategies are needed to make an active lifestyle supportive and enticing for older adults in these communities.
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Affiliation(s)
- Daniel S Rubin
- Department of Anesthesia and Critical Care, The University of Chicago, Chicago, IL, USA
| | - David E Conroy
- Department of Kinesiology, Penn State College of Health and Human Development, Hershey, PA, USA
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12
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Delorme M, Bonnevie T. [Get up, stand up! What sit-to-stand tests tell us about respiratory failure]. Rev Mal Respir 2024:S0761-8425(24)00229-8. [PMID: 39209564 DOI: 10.1016/j.rmr.2024.06.003] [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: 03/11/2024] [Accepted: 03/27/2024] [Indexed: 09/04/2024]
Abstract
Diseases associated with chronic respiratory failure have a negative impact on quality of life and life expectancy, notably through a reduction in patients' functional capacity. Assessing balance, coordination, muscular strength and endurance, as well as exercise tolerance, is therefore an important component of the evaluation of individuals with chronic respiratory failure. This evaluation can be made easier by using simple tools such as sit-to-stand tests. This review presents the main sit-to-stand tests that have been described and that can be used in everyday practice. The aim is to provide information to the clinician on the contribution of each test, and to identify the extent to which and the purpose for which these tests can be incorporated into a routine pulmonology and/or respiratory rehabilitation evaluation. Because of their inherently functional nature, these tests could help to identify the indications and/or the effects of respiratory rehabilitation.
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Affiliation(s)
- M Delorme
- Centre de recherche cardio-thoracique de Bordeaux, université de Bordeaux, Bordeaux, France; Inserm, U1045, Pessac, France.
| | - T Bonnevie
- Association ADIR (Aide à domicile des patients insuffisants respiratoires), 18, rue Marie-Curie, 76000 Rouen, France; GRHVN UR 3830, université de Rouen Normandie, Normandie université, 76000 Rouen, France
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13
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Wei Y, Chen Z, Sun N, Tang Z, Guo H, Zeng C. Autologous osteoperiosteal transplantation for cystic osteochondral lesions of the talus: Bone reconstruction is essential. Chin J Traumatol 2024:S1008-1275(24)00110-X. [PMID: 39242245 DOI: 10.1016/j.cjtee.2024.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 05/29/2024] [Accepted: 07/03/2024] [Indexed: 09/09/2024] Open
Abstract
PURPOSE Autologous osteoperiosteal transplantation (AOPT) is one of the most feasible and effective techniques for cystic osteochondral lesions of the talus (OLT). However, few reports have been reported about the process of graft-host bone healing and bone articular surface reconstruction, which help us to further understand the actual situation of bone healing and modify surgical methods. METHODS We retrospectively evaluated 33 osteochondral lesions in 30 patients undertaking AOPT for OLT with subchondral cysts from December 2016 to October 2021. According to CT observation, we used 4 variables to describe the bony articular repair, including the integration of the articular surface, the height of the bone filling, the status of bone union, and the appearance of bone resorption or cystic change. We also analyzed the demographic data and clinical function. Descriptive statistics were used for demographic and clinical variables. Normally distributed data were presented as mean ± SD, and non-normally distributed data were presented as median (Q1, Q3). Associations between these variables and the primary clinical outcomes were examined using t-test or one-way ANOVA test for continuous variables. RESULTS The patients' mean age was (41.7 ± 14.0) years old and the mean follow-up time was (29.6 ± 17.8) months. The chondral lesion size was (14.3 ± 4.1) mm. The cyst depth was (10.9 ± 3.7) mm. Significant improvements were observed in functional outcomes (according to the numeric rating scale for pain when walking and the American orthopedic foot and ankle society score) between the preoperative and latest follow-up evaluations, from 4.2 ± 2.1 to 2.2 ± 2.0 (p < 0.001), and from 66.8 ± 12.9 to 83.2 ± 10.4, respectively (p < 0.001). The overall satisfaction reached 8.3 of 10 points. All patients returned to sports and their median daily steps reached 8000 steps with 27 (81.8%) patients walking over 6000 steps daily. According to CT observation, "discontinuous bony articular surface and gap > 1 mm" was found in 27 grafts (81.8%), and "below the level of the adjacent articular surface, ≤ 1 mm" in a third of the grafts. Abnormal height of bone filling affected numeric rating scale score (p = 0.049) and American Orthopedic Foot and Ankle Society score (p = 0.027). Of note, bone resorption or cystic changes appeared in up to 13 autografts (39.4%). CONCLUSIONS AOPT is an effective and acceptable technique for cystic OLT. Bone reconstruction is essential for large cystic OLT. How to get better bony articular reconstruction and avoid cyst recurrence should still be paid more attention.
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Affiliation(s)
- Yuxuan Wei
- Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Zhuhong Chen
- Department of Orthopaedic Surgery, Central People's Hospital of Zhanjiang, Zhanjiang, 524045, Guangdong Province, China
| | - Nian Sun
- Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Zhu Tang
- Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China
| | - Hao Guo
- Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.
| | - Canjun Zeng
- Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China.
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Zaccardi F, Rowlands AV, Dempsey PC, Razieh C, Henson J, Goldney J, Maylor BD, Bhattacharjee A, Chudasama Y, Edwardson C, Laukkanen JA, Ekelund U, Davies MJ, Khunti K, Yates T. Interplay between physical activity volume and intensity with modeled life expectancy in women and men: A prospective cohort analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2024:100970. [PMID: 39181446 DOI: 10.1016/j.jshs.2024.100970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 04/29/2024] [Accepted: 06/07/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND There is a lack of research examining the interplay between objectively measured physical activity volume and intensity with life expectancy. METHODS Individuals from UK Biobank with wrist-worn accelerometer data were included. The average acceleration and intensity gradient were extracted to describe the physical activity volume and intensity profile. Mortality data were obtained from national registries. Adjusted life expectancies were estimated using parametric flexible survival models. RESULTS 40,953 (57.1%) women (median age = 61.9 years) and 30,820 (42.9%) men (63.1 years) were included. Over a median follow-up of 6.9 years, there were 1719 (2.4%) deaths (733 in women; 986 in men). At 60 years, life expectancy was progressively longer for higher physical activity volume and intensity profiles, reaching 95.6 years in women and 94.5 years in men at the 90th centile for both volume and intensity, corresponding to 3.4 (95% confidence interval (95%CI): 2.4-4.4) additional years in women and 4.6 (95%CI: 3.6-5.6) additional years in men compared to those at the 10th centiles. An additional 10-min or 30-min daily brisk walk was associated with 0.9 (95%CI: 0.5-1.3) and 1.4 (95%CI: 0.9-1.9) years longer life expectancy, respectively, in inactive women; and 1.4 (95%CI: 1.0-1.8) and 2.5 (95%CI: 1.9-3.1) years in inactive men. CONCLUSION Higher physical activity volumes were associated with longer life expectancy, with a higher physical activity intensity profile further adding to a longer life. Adding as little as a 10-min brisk walk to daily activity patterns may result in a meaningful benefit to life expectancy.
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Affiliation(s)
- Francesco Zaccardi
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - Paddy C Dempsey
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Cameron Razieh
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Joe Henson
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - Jonathan Goldney
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Benjamin D Maylor
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Atanu Bhattacharjee
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Yogini Chudasama
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Charlotte Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - Jari A Laukkanen
- Department of Medicine, Central Finland Health Care Hospital District, 40620 Jyväskylä, Finland; Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, 70210 Kuopio, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210 Kuopio, Finland
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, 0863 Oslo, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, 0473 Oslo, Norway
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Applied Research Collaborations East Midlands, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK.
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Liu L, Wang H, Xing Y, Zhang Z, Zhang Q, Dong M, Ma Z, Cai L, Wang X, Tang Y. Dose-response relationship between computerized cognitive training and cognitive improvement. NPJ Digit Med 2024; 7:214. [PMID: 39147783 PMCID: PMC11327304 DOI: 10.1038/s41746-024-01210-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 08/01/2024] [Indexed: 08/17/2024] Open
Abstract
Although computerized cognitive training (CCT) is an effective digital intervention for cognitive impairment, its dose-response relationship is understudied. This retrospective cohort study explores the association between training dose and cognitive improvement to find the optimal CCT dose. From 2017 to 2022, 8,709 participants with subjective cognitive decline, mild cognitive impairment, and mild dementia were analyzed. CCT exposure varied in daily dose and frequency, with cognitive improvement measured weekly using Cognitive Index. A mixed-effects model revealed significant Cognitive Index increases across most dose groups before reaching the optimal dose. For participants under 60 years, the optimal dose was 25 to <30 min per day for 6 days a week. For those 60 years or older, it was 50 to <55 min per day for 6 days a week. These findings highlight a dose-dependent effect in CCT, suggesting age-specific optimal dosing for cognitive improvement.
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Affiliation(s)
- Liyang Liu
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
- Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Haibo Wang
- Clinical Research Institute, Institute of Advanced Clinical Medicine, Peking University, 100191, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, 38 Xueyuan St, Haidian district, 100191, Beijing, China
| | - Yi Xing
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
- Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Ziheng Zhang
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Qingge Zhang
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Ming Dong
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Zhujiang Ma
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Longjun Cai
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Xiaoyi Wang
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Yi Tang
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China.
- Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China.
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Mazéas A, Forestier C, Harel G, Duclos M, Chalabaev A. The Impact of a Gamified Intervention on Daily Steps in Real-Life Conditions: Retrospective Analysis of 4800 Individuals. J Med Internet Res 2024; 26:e47116. [PMID: 39133533 PMCID: PMC11347891 DOI: 10.2196/47116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 03/10/2024] [Accepted: 05/01/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Digital interventions integrating gamification features hold promise to promote daily steps. However, results regarding the effectiveness of this type of intervention are heterogeneous and not yet confirmed in real-life contexts. OBJECTIVE This study aims to examine the effectiveness of a gamified intervention and its potential moderators in a large sample using real-world data. Specifically, we tested (1) whether a gamified intervention enhanced daily steps during the intervention and follow-up periods compared to baseline, (2) whether this enhancement was higher in participants in the intervention than in nonparticipants, and (3) what participant characteristics or intervention parameters moderated the effect of the program. METHODS Data from 4819 individuals who registered for a mobile health Kiplin program between 2019 and 2022 were retrospectively analyzed. In this intervention, participants could take part in one or several games in which their daily step count was tracked, allowing individuals to play with their overall activity. Nonparticipants were people who registered for the program but did not take part in the intervention and were considered as a control group. Daily step counts were measured via accelerometers embedded in either commercial wearables or smartphones of the participants. Exposure to the intervention, the intervention content, and participants' characteristics were included in multilevel models to test the study objectives. RESULTS Participants in the intervention group demonstrated a significantly greater increase in mean daily steps from baseline than nonparticipants (P<.001). However, intervention effectiveness depended on participants' initial physical activity. The daily steps of participants with <7500 baseline daily steps significantly improved from baseline both during the Kiplin intervention (+3291 daily steps) and the follow-up period (+945 daily steps), whereas participants with a higher baseline had no improvement or significant decreases in daily steps after the intervention. Age (P<.001) and exposure (P<.001) positively moderated the intervention effect. CONCLUSIONS In real-world settings and among a large sample, the Kiplin intervention was significantly effective in increasing the daily steps of participants from baseline during intervention and follow-up periods compared to nonparticipants. Interestingly, responses to the intervention differed based on participants' initial steps, with the existence of a plateau effect. Drawing on the insights of self-determination theory, we can assume that the effect of gamification could depend of the initial motivation and activity of participants.
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Affiliation(s)
- Alexandre Mazéas
- Laboratoire Sport et Environnement Social (SENS), Université Grenoble Alpes, Grenoble, France
- National Research Institute for Agriculture, Food and Environment (INRAE), Clermont-Ferrand, France
- Kiplin, Nantes, France
| | - Cyril Forestier
- Laboratoire Motricité, Interactions, Performance (MIP - UR4334), Nantes Université, Nantes, France
| | | | - Martine Duclos
- National Research Institute for Agriculture, Food and Environment (INRAE), Clermont-Ferrand, France
- Department of Sport Medicine and Functional Exploration, University Hospital Clermont-Ferrand, Hospital G. Montpied, Clermont-Ferrand, France
| | - Aïna Chalabaev
- Laboratoire Sport et Environnement Social (SENS), Université Grenoble Alpes, Grenoble, France
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17
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Babcock MC, Robinson AT. Not like us: Exploring the cardiovascular consequences of ultramarathons. Exp Physiol 2024; 109:1249-1250. [PMID: 38877872 PMCID: PMC11291857 DOI: 10.1113/ep092003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 08/02/2024]
Affiliation(s)
- Matthew C. Babcock
- Division of Geriatric Medicine, School of MedicineUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Austin T. Robinson
- Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
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18
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Roseen EJ, McNaughton DT, Harrison S, Downie AS, Øverås CK, Nim CG, Jenkins HJ, Young JJ, Hartvigsen J, Stone KL, Ensrud KE, Lee S, Cawthon PM, Fink HA. Association of back pain with all-cause and cause-specific mortality among older men: a cohort study. PAIN MEDICINE (MALDEN, MASS.) 2024; 25:505-513. [PMID: 38741219 PMCID: PMC11292054 DOI: 10.1093/pm/pnae040] [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: 01/31/2024] [Revised: 03/27/2024] [Accepted: 04/18/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE We evaluated whether more severe back pain phenotypes-persistent, frequent, or disabling back pain-are associated with higher mortality rate among older men. METHODS In this secondary analysis of a prospective cohort, the Osteoporotic Fractures in Men (MrOS) study, we evaluated mortality rates by back pain phenotype among 5215 older community-dwelling men (mean age, 73 years, SD = 5.6) from 6 sites in the United States. The primary back pain measure used baseline and Year 5 back pain questionnaire data to characterize participants as having no back pain, nonpersistent back pain, infrequent persistent back pain, or frequent persistent back pain. Secondary measures of back pain from the Year 5 questionnaire included disabling back pain phenotypes. The main outcomes measured were all-cause and cause-specific death. RESULTS After the Year 5 exam, during up to 18 years of follow-up (mean follow-up = 10.3 years), there were 3513 deaths (1218 cardiovascular, 764 cancer, 1531 other). A higher proportion of men with frequent persistent back pain versus no back pain died (78% versus 69%; sociodemographic-adjusted HR = 1.27, 95% CI = 1.11-1.45). No association was evident after further adjustment for health-related factors, such as self-reported general health and comorbid chronic health conditions (fully adjusted HR = 1.00; 95% CI = 0.86-1.15). Results were similar for cardiovascular deaths and other deaths, but we observed no association of back pain with cancer deaths. Secondary back pain measures, including back-related disability, were associated with increased mortality risk that remained statistically significant in fully adjusted models. CONCLUSION Although frequent persistent back pain was not independently associated with risk of death in older men, additional secondary disabling back pain phenotypes were independently associated with increased mortality rate. Future investigations should evaluate whether improvements in disabling back pain affect general health and well-being or risk of death.
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Affiliation(s)
- Eric J Roseen
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedision School of Medicine and Boston Medical Center, Boston, MA 02131, United States
- Department of Physical Medicine & Rehabilitation and Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA 02130, United States
| | - David T McNaughton
- School of Psychological Sciences, Macquarie University, Sydney, 2109, Australia
| | - Stephanie Harrison
- Research Institute, California Pacific Medical Center, San Francisco, CA 94107, United States
| | - Aron S Downie
- Department of Chiropractic, Macquarie University, Sydney, 2109, Australia
| | - Cecilie K Øverås
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, 7034, Norway
| | - Casper G Nim
- Spine Centre of Southern Denmark, University Hospital of Southern Denmark, Middelfart, 5000, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, 5000, Denmark
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, 5000, Denmark
| | - Hazel J Jenkins
- Department of Chiropractic, Macquarie University, Sydney, 2109, Australia
| | - James J Young
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, 5000, Denmark
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, M5T 0S8, Canada
| | - Jan Hartvigsen
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, M5T 0S8, Canada
- The Chiropractic Knowledge Hub, University of Southern Denmark, Odense, 5000, Denmark
| | - Katie L Stone
- Research Institute, California Pacific Medical Center, San Francisco, CA 94107, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94158, United States
| | - Kristine E Ensrud
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55415, United States
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN 55417, United States
| | - Soomi Lee
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, United States
| | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, CA 94107, United States
| | - Howard A Fink
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55415, United States
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN 55417, United States
- Geriatric Research Education and Clinical Center, Veterans Affairs Health Care System, Minneapolis, MN 55417, United States
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Rodríguez-Gutiérrez E, Torres-Costoso A, Del Pozo Cruz B, de Arenas-Arroyo SN, Pascual-Morena C, Bizzozero-Peroni B, Martínez-Vizcaíno V. Daily steps and all-cause mortality: An umbrella review and meta-analysis. Prev Med 2024; 185:108047. [PMID: 38901742 DOI: 10.1016/j.ypmed.2024.108047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/03/2024] [Accepted: 06/16/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE This study aimed to describe the variability in estimates of the association of daily steps and all-cause mortality in systematic reviews with meta-analyses, to identify the factors potentially responsible for it, and to provide an updated estimate. METHODS Five databases were systematically searched up to May 2024 to identify systematic reviews with meta-analyses and prospective cohort studies. A qualitative synthesis of previous reviews and an updated meta-analysis of cohort studies were performed. Pooled hazard ratios (HRs) with their 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS Eleven systematic reviews with meta-analyses and 14 cohort studies were included, revealing considerable variability in result presentation. Our updated meta-analysis showed a nonlinear association, indicating a lower risk of all-cause mortality with increased daily steps, with a protective threshold at 3143 steps/day, and a pooled HR of 0.91 (95% CI: 0.87, 0.95) per 1000 steps/day increment. Physical activity categories consistently indicated progressively reduced mortality risk, with the highly active category (>12,500 steps/day) exhibiting the lowest risk (0.35 (95% CI: 0.29, 0.42)). CONCLUSION Systematic reviews and meta-analyses showed considerable variability in effect estimates due to different methods of quantifying exposure. Despite it, our study underscores the importance of increased daily steps in reducing all-cause mortality, with a minimum protective dose of 3000 steps/day, although the optimal dose differed according to age and sex. It is recommended that future studies categorise daily steps by physical activity category, perform dose-response analyses, and use increments of 1000 steps/day.
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Affiliation(s)
- Eva Rodríguez-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
| | - Ana Torres-Costoso
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, 45071 Toledo, Spain.
| | - Borja Del Pozo Cruz
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz, Spain; Faculty of Education, University of Cádiz, Cádiz, Spain; Faculty of Sports Sciencies, Universidad Europea de Madrid, Madrid, Spain; Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Sergio Núñez de Arenas-Arroyo
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
| | - Carlos Pascual-Morena
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha - Campus Albacete, Albacete, Spain
| | - Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Instituto Superior de Educación Física, Universidad de la República, 40000 Rivera, Uruguay
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 3460000 Talca, Chile
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Latrille C, Hayot M, Bosselut G, Bughin F, Boiché J. Determinants of physical activity in newly diagnosed obstructive sleep apnea patients: testing the health action process approach. J Behav Med 2024; 47:609-621. [PMID: 38413452 DOI: 10.1007/s10865-024-00474-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024]
Abstract
This study aims to identify the determinants associated with physical activity (PA) behavior in newly diagnosed obstructive sleep apnea (OSA) patients by applying the Health Action Process Approach (HAPA) with a longitudinal design. Anthropometric and clinical (OSA severity, subjective somnolence, use of continuous positive airway pressure (CPAP)) variables, the determinants of physical activity specified in the HAPA (motivational self-efficacy, outcome expectancies, risk perception, intention, maintenance self-efficacy, action planning, coping planning, social support), as well as physical activity behavior were assessed using a longitudinal (T1 and T2) design in a sample of 57 OSA patients in routine care. Applying regression analyses, regarding the motivation phase, the amount of explained variance in intention was 77% and 39% of the variance in physical activity. In the motivational phase, motivational self-efficacy, risk perception and outcome expectancies were associated with intention. In the volitional phase, physical activity at T1 and social support (family) were related with physical activity at T2. In conclusion, the assumptions of HAPA were partially found in the context of newly diagnosed OSA patients. This study provided additional evidence regarding the role of motivational self-efficacy, outcome expectancies and risk perception during motivational phase, and highlighted the important role of social support from the family in the PA in this population.
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Affiliation(s)
- Christophe Latrille
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 avenue du Pic Saint-Loup, 34090, Montpellier, France.
- PhyMedExp, CNRS, CHRU, INSERM, University of Montpellier, Montpellier, France.
| | - Maurice Hayot
- PhyMedExp, CNRS, CHRU, INSERM, University of Montpellier, Montpellier, France
| | - Grégoire Bosselut
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 avenue du Pic Saint-Loup, 34090, Montpellier, France
| | - François Bughin
- PhyMedExp, CNRS, CHRU, INSERM, University of Montpellier, Montpellier, France
| | - Julie Boiché
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 avenue du Pic Saint-Loup, 34090, Montpellier, France
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21
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Tarp J, Dalene KE, Fagerland MW, Steene-Johannesen J, Hansen BH, Anderssen SA, Hagströmer M, Dohrn IM, Dempsey PC, Wijndaele K, Brage S, Nordström A, Nordström P, Diaz KM, Howard VJ, Hooker SP, Morseth B, Hopstock LA, Sagelv EH, Yates T, Edwardson CL, Lee IM, Ekelund U. Physical Activity Volume, Intensity, and Mortality: Harmonized Meta-Analysis of Prospective Cohort Studies. Am J Prev Med 2024:S0749-3797(24)00262-9. [PMID: 39089430 DOI: 10.1016/j.amepre.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION It is unclear whether moderate-to-vigorous physical activity (MVPA) is associated with a lower mortality risk, over and above its contribution to total physical activity volume. METHODS 46,682 adults (mean age: 64 years) were included in a meta-analysis of nine prospective cohort studies. Each cohort generated tertiles of accelerometry-measured physical activity volume and volume-adjusted MVPA. Hazard ratios (HR, with 95% confidence intervals) for mortality were estimated separately and in joint models combining volume and MVPA. Data was collected between 2001 and 2019 and analyzed in 2023. RESULTS During a mean follow-up of 9 years, 4,666 deaths were recorded. Higher physical activity volume, and a greater contribution from volume-adjusted MVPA, were each associated with lower mortality hazard in multivariable-adjusted models. Compared to the least active tertile, higher physical activity volume was associated with a lower mortality (HRs: 0.62; 0.58, 0.67 and 0.50; 0.42, 0.60 for ascending tertiles). Similarly, a greater contribution from MVPA was associated with a lower mortality (HRs: 0.94; 0.85, 1.04 and 0.88; 0.79, 0.98). In joint analysis, a lower mortality from higher volume-adjusted MVPA was only observed for the middle tertile of physical activity volume. CONCLUSIONS The total volume of physical activity was associated with a lower risk of mortality to a greater extent than the contribution of MVPA to physical activity volume. Integrating any intensity of physical activity into daily life may lower mortality risk in middle-aged and older adults, with a small added benefit if the same amount of activity is performed with a higher intensity.
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Affiliation(s)
- Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.
| | - Knut E Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Morten W Fagerland
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | | | - Bjørge H Hansen
- Department of Sports Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Sigmund A Anderssen
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
| | - Ing-Mari Dohrn
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia; MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Katrien Wijndaele
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Søren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Anna Nordström
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Medical Sciences, Rehabilitation Medicine, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Peter Nordström
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
| | - Keith M Diaz
- Department of Medicine, Columbia University Medical Center, New York, New York
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, California
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Edvard H Sagelv
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Thomas Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Charlotte L Edwardson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - I-Min Lee
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
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22
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Spartano NL, Zhang Y, Liu C, Chernofsky A, Lin H, Trinquart L, Borrelli B, Pathiravasan CH, Kheterpal V, Nowak C, Vasan RS, Benjamin EJ, McManus DD, Murabito JM. Agreement Between Apple Watch and Actical Step Counts in a Community Setting: Cross-Sectional Investigation From the Framingham Heart Study. JMIR BIOMEDICAL ENGINEERING 2024; 9:e54631. [PMID: 39047284 PMCID: PMC11306942 DOI: 10.2196/54631] [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: 11/16/2023] [Revised: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Step counting is comparable among many research-grade and consumer-grade accelerometers in laboratory settings. OBJECTIVE The purpose of this study was to compare the agreement between Actical and Apple Watch step-counting in a community setting. METHODS Among Third Generation Framingham Heart Study participants (N=3486), we examined the agreement of step-counting between those who wore a consumer-grade accelerometer (Apple Watch Series 0) and a research-grade accelerometer (Actical) on the same days. Secondarily, we examined the agreement during each hour when both devices were worn to account for differences in wear time between devices. RESULTS We studied 523 participants (n=3223 person-days, mean age 51.7, SD 8.9 years; women: n=298, 57.0%). Between devices, we observed modest correlation (intraclass correlation [ICC] 0.56, 95% CI 0.54-0.59), poor continuous agreement (29.7%, n=957 of days having steps counts with ≤15% difference), a mean difference of 499 steps per day higher count by Actical, and wide limits of agreement, roughly ±9000 steps per day. However, devices showed stronger agreement in identifying who meets various steps per day thresholds (eg, at 8000 steps per day, kappa coefficient=0.49), for which devices were concordant for 74.8% (n=391) of participants. In secondary analyses, in the hours during which both devices were worn (n=456 participants, n=18,760 person-hours), the correlation was much stronger (ICC 0.86, 95% CI 0.85-0.86), but continuous agreement remained poor (27.3%, n=5115 of hours having step counts with ≤15% difference) between devices and was slightly worse for those with mobility limitations or obesity. CONCLUSIONS Our investigation suggests poor overall agreement between steps counted by the Actical device and those counted by the Apple Watch device, with stronger agreement in discriminating who meets certain step thresholds. The impact of these challenges may be minimized if accelerometers are used by individuals to determine whether they are meeting physical activity guidelines or tracking step counts. It is also possible that some of the limitations of these older accelerometers may be improved in newer devices.
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Affiliation(s)
- Nicole L Spartano
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
| | - Yuankai Zhang
- Boston University School of Public Health, Boston, MA, United States
| | - Chunyu Liu
- Boston University School of Public Health, Boston, MA, United States
| | - Ariel Chernofsky
- Boston University School of Public Health, Boston, MA, United States
| | - Honghuang Lin
- University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Ludovic Trinquart
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, United States
- Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, United States
| | - Belinda Borrelli
- Boston University Henry M. Goldman School of Dental Medicine, Center for Behavioral Science Research, Boston, MA, United States
| | | | | | | | - Ramachandran S Vasan
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
- University of Texas School of Public Health and University of Texas Health Sciences Center, San Antonio, TX, United States
| | - Emelia J Benjamin
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of Cardiology, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - David D McManus
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Joanne M Murabito
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, United States
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23
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Xu Z, Zheng X, Ding H, Zhang D, Cheung PMH, Yang Z, Tam KW, Zhou W, Chan DCC, Wang W, Wong SYS. The Effect of Walking on Depressive and Anxiety Symptoms: Systematic Review and Meta-Analysis. JMIR Public Health Surveill 2024; 10:e48355. [PMID: 39045858 PMCID: PMC11287235 DOI: 10.2196/48355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 07/25/2024] Open
Abstract
Background Previous literature lacks summative information on the mental health benefits achieved from different forms of walking. Objective The aim of this study was to assess the effectiveness of different forms of walking in reducing symptoms of depression and anxiety. Methods This was a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effects of walking on depressive and anxiety symptoms. MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Allied and Complementary Medicine Database (AMED), CINAHL, and Web of Science were searched on April 5, 2022. Two authors independently screened the studies and extracted the data. Random-effects meta-analysis was used to synthesize the data. Results were summarized as standardized mean differences (SMDs) with 95% CIs in forest plots. The risk of bias was assessed by using the Cochrane Risk of Bias tool. Results This review included 75 RCTs with 8636 participants; 68 studies reported depressive symptoms, 39 reported anxiety symptoms, and 32 reported both as the outcomes. One study reported the results for adolescents and was not included in the meta-analysis. The pooled results for adults indicated that walking could significantly reduce depressive symptoms (RCTs: n=44; SMD -0.591, 95% CI -0.778 to -0.403; I2=84.8%; τ2=0.3008; P<.001) and anxiety symptoms (RCTs: n=26; SMD -0.446, 95% CI -0.628 to -0.265; I2=81.1%; τ2=0.1530; P<.001) when compared with the inactive controls. Walking could significantly reduce depressive or anxiety symptoms in most subgroups, including different walking frequency, duration, location (indoor or outdoor), and format (group or individual) subgroups (all P values were <.05). Adult participants who were depressed (RCTs: n=5; SMD -1.863, 95% CI -2.764 to -0.962; I2=86.4%; τ2=0.8929) and those who were not depressed (RCTs: n=39; SMD -0.442, 95% CI -0.604 to -0.280; I2=77.5%; τ2=0.1742) could benefit from walking effects on their depressive symptoms, and participants who were depressed could benefit more (P=.002). In addition, there was no significant difference between walking and active controls in reducing depressive symptoms (RCTs: n=17; SMD -0.126, 95% CI -0.343 to 0.092; I2=58%; τ2=0.1058; P=.26) and anxiety symptoms (14 RCTs, SMD -0.053, 95% CI -0.311 to 0.206, I2=67.7%, τ2=0.1421; P=.69). Conclusions Various forms of walking can be effective in reducing symptoms of depression and anxiety, and the effects of walking are comparable to active controls. Walking can be adopted as an evidence-based intervention for reducing depression and anxiety. More evidence on the effect of low-intensity walking is needed in the future.
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Affiliation(s)
- Zijun Xu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Xiaoxiang Zheng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Hanyue Ding
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Dexing Zhang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Peter Man-Hin Cheung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Zuyao Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - King Wa Tam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Weiju Zhou
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Dicken Cheong-Chun Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Wenyue Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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24
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Kistner TM, Tavormina A, Lieberman DE. Myokine secretion during moderate-intensity physical activity: Dose-response of interleukin 6 to walking duration. Am J Hum Biol 2024:e24131. [PMID: 39030918 DOI: 10.1002/ajhb.24131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/23/2024] [Accepted: 06/27/2024] [Indexed: 07/22/2024] Open
Abstract
During vigorous physical activity, contracting muscles secrete a variety of immunomodulatory and metabolic factors called myokines that perform a variety of functions. Foremost among these is interleukin 6 (IL-6), which increases fatty acid mobilization and stimulates anti-inflammatory cytokine release. Despite being well characterized in vigorous exercise contexts, whether IL-6 is secreted during moderate-intensity activities such as walking is unclear. This is especially pertinent as regular walking is one of the oldest and most common forms of physical activity and comes with a variety of health benefits, which may be coordinated in part by IL-6 signaling. To test the hypothesis that IL-6 release occurs during evolutionarily normal physical activity contexts like long distance walking, we performed a dose-response experiment to test the effect of walking duration on IL-6 secretion. Thirteen participants completed four moderate-intensity walking trials (55% HRmax) of varying durations (30 min, 1 h, 2 h, and 3 h) in a randomized order with intervening washout periods of at least 1 week. Using a linear mixed effects model, we found that IL-6 levels modestly increased during only the 2 h and 3 h walking trials. These results suggest that small frequent increases in IL-6 signaling may be an important mechanism underlying the health benefits of regular walking. Furthermore, this finding raises the possibility that IL-6 secretion is an adaptation to fuel physical activity, especially during periods of negative energy balance.
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Affiliation(s)
- Timothy M Kistner
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Anna Tavormina
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Daniel E Lieberman
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
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25
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Yin H, Omar Dev RD, Soh KG, Li F, Lian M. Assessment and development of physical education teachers' physical literacy: A systematic review. PLoS One 2024; 19:e0307505. [PMID: 39024325 PMCID: PMC11257255 DOI: 10.1371/journal.pone.0307505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 07/06/2024] [Indexed: 07/20/2024] Open
Abstract
In recent years, physical literacy (PL) has gained a great deal of attention in global academia. Children's physical activity (PA) participation is severely underrepresented today, and students' participation in PA and PL level development is strongly dependent on the PL levels of PE teachers. This study aims to offer information for PE teachers to improve their PL levels and for the future development of tools to assess the PL of PE teachers through a systematic review of studies assessing PL of PE teachers. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to conduct a comprehensive and systematic search in six databases-Web of Science, Scopus, ScienceDirect, PubMed, ProQuest; and SportDiscus, and a total of 671 papers were retrieved, but after removing duplicates, article identification, and screening only eight papers met the inclusion criteria. This study's results indicate a paucity of research related to PL among PE teachers, focusing on children, students, older adults, and children with disabilities. PE teachers performed poorly in the physical competence domain and better in the cognitive and affective domains, with a moderate level of overall PL. Only one instrument is currently available to assess PE teachers' (perceived) PL, and other studies have used instrument components. Therefore, it was concluded that the current PE teachers' PL level is not high. Also, because the concept of PL among PE teachers has not been standardized, no tool has been developed to evaluate the PL of PE teachers comprehensively and systematically. The CPD (continuing professional development) is considered an effective means of enhancing PL among PE teachers, and research should prioritize the development of CPD programs and tools that are specifically tailored to assess PL among PE teachers in the future.
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Affiliation(s)
- Hang Yin
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Roxana Dev Omar Dev
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Fangyi Li
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Menglong Lian
- Zhengzhou Vocational College of Automobile Engineering, Zhengzhou, Henan Province, China
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26
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Hamaya R, Shiroma EJ, Moore CC, Buring JE, Evenson KR, Lee IM. Time- vs Step-Based Physical Activity Metrics for Health. JAMA Intern Med 2024; 184:718-725. [PMID: 38767892 PMCID: PMC11106710 DOI: 10.1001/jamainternmed.2024.0892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/08/2024] [Indexed: 05/22/2024]
Abstract
Importance Current US physical activity (PA) guidelines prescribe moderate to vigorous PA (MVPA) time of at least 150 minutes per week for health. An analogous step-based recommendation has not been issued due to insufficient evidence. Objective To examine the associations of MVPA time and step counts with all-cause mortality and cardiovascular disease (CVD). Design, Setting, and Participants This cohort study analyzed data from an ongoing follow-up study of surviving participants of the Women's Health Study, a randomized clinical trial conducted from 1992 to 2004 in the US to evaluate use of low-dose aspirin and vitamin E for preventing cancer and CVD. Participants were 62 years or older who were free from CVD and cancer, completed annual questionnaires, and agreed to measure their PA with an accelerometer as part of a 2011-2015 ancillary study. Participants were followed up through December 31, 2022. Exposures Time spent in MVPA and step counts, measured with an accelerometer for 7 consecutive days. Main Outcomes and Measures The associations of MVPA time and step counts with all-cause mortality and CVD (composite of myocardial infarction, stroke, and CVD mortality) adjusted for confounders. Cox proportional hazards regression models, restricted mean survival time differences, and area under the receiver operating characteristic curve (AUC) were used to evaluate the associations. Results A total of 14 399 women (mean [SD] age, 71.8 [5.6] years) were included. The median (IQR) MVPA time and step counts were 62 (20-149) minutes per week and 5183 (3691-7001) steps per day, respectively. During a median (IQR) follow-up of 9.0 (8.0-9.9) years, the hazard ratios (HR) per SD for all-cause mortality were 0.82 (95% CI, 0.75-0.90) for MVPA time and 0.74 (95% CI, 0.69-0.80) for step counts. Greater MVPA time and step counts (top 3 quartiles vs bottom quartile) were associated with a longer period free from death: 2.22 (95% CI, 1.58-2.85) months and 2.36 (95% CI, 1.73-2.99) months at 9 years follow-up, respectively. The AUCs for all-cause mortality from MVPA time and step counts were similar: 0.55 (95% CI, 0.52-0.57) for both metrics. Similar associations of these 2 metrics with CVD were observed. Conclusion and Relevance Results of this study suggest that among females 62 years or older, MVPA time and step counts were qualitatively similar in their associations with all-cause mortality and CVD. Step count-based goals should be considered for future guidelines along with time-based goals, allowing for the accommodation of personal preferences.
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Affiliation(s)
- Rikuta Hamaya
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eric J. Shiroma
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Christopher C. Moore
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - Julie E. Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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27
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Linhares M, Oliveira GTA, Cabral DAR, Rêgo MLM, Araújo ADO, Silva RDM, Silva LRFD, Lima MNMD, Neto LDO, Cureau FV, Elsangedy HM. Sit less and move more! A cross-sectional study of the associations between physical activity and sedentary behaviors with inhibitory control in Brazilian adults. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 73:102643. [PMID: 38593966 DOI: 10.1016/j.psychsport.2024.102643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/04/2024] [Accepted: 04/05/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE To investigate the independent and joint associations between sedentary behaviors (SB) and physical activity (PA) with inhibitory control (IC) in adults. METHODS A total of 111 participants (median age = 30 years; 60% women), completed the Stroop Color-Words test to assess IC. They also wore accelerometers for seven days to measure SB, light PA, moderate-to-vigorous PA (MVPA), and daily steps. We previously set cutoff points for SB and PA measurements and tested them to determine their association with IC. All analyses were adjusted for potential confounding factors including age, gender, post-secondary education, income, body mass index, and accelerometer wear time. RESULTS Low SB, high MVPA, and high daily steps were independently associated with a better IC compared to their respective counterparts. Adults with low levels of SB and light PA demonstrated better IC performance (β = -227.67, 95%CI = -434.14 to -21.20) compared to those with high SB and low light PA. Conversely, individuals with high SB and high light PA exhibited worse performance (β = 126.80, 95%CI = 2.11 to 251.50) than those in the high SB and low light PA group. Furthermore, the joint association of low SB with high MVPA (β = -491.12, 95%CI = -689.23 to -293.01) or low SB with high daily steps (β = -254.29, 95%CI = -416.41 to -92.16) demonstrated better IC performance compared to those with high SB and low MVPA or low daily steps. CONCLUSION Our findings highlight independent and joint associations between low SB, high MVPA, and high daily steps with enhanced IC in adults.
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Affiliation(s)
- Maristela Linhares
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | | | | | | | - Raíssa de Melo Silva
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | | | - Leônidas de Oliveira Neto
- Department of Arts, Postgraduate Program in Rehabilitation Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Felipe Vogt Cureau
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Hassan Mohamed Elsangedy
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
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Saoudi I, Maltagliati S, Chalabaev A, Sarrazin P, Cheval B. Sociodemographic precursors of explicit and implicit attitudes towards physical activity. Psychol Health 2024:1-23. [PMID: 38946132 DOI: 10.1080/08870446.2024.2371964] [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: 07/31/2023] [Accepted: 06/19/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE In high-income countries, people with low socio-economic status (SES) engage in less leisure-time physical activity (PA) than those with higher SES. Beyond a materialistic account of this difference, the role of motivational precursors-among which attitudes are emblematic-remains poorly understood, particularly when it comes to dissociating the automatic vs. deliberative components of attitudes. This pre-registered study aimed to examine the associations between SES (i.e. income and educational attainment) and motivational precursors of PA (i.e. explicit and implicit attitudes), and whether gender and age may moderate these relationships. METHOD We used data from 970 adults (64% of women; mean age = 33 ± 12 years) from the Attitudes, Identities, and Individual Differences (AIID) study. RESULTS Results of multiple linear regression analyses showed that participants with the highest level of income (>150,000$ per year) reported more positive explicit and implicit attitudes towards PA than those with lower income. Exploratory analysis further showed that women reported weaker explicit attitudes towards PA, while both explicit and implicit attitudes towards PA became weaker at age increases. In contrast, educational attainment was not significantly associated with those attitudes, and there was only mixed evidence for a moderating role of participants' gender on the pattern of associations. CONCLUSION Our findings suggest that both the explicit and implicit attitudes towards PA may be socially patterned. Future intervention studies should examine whether these attitudinal differences could be reduced, and whether such a reduction could help buffer the unequal participation in PA behaviors across social groups.
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Affiliation(s)
| | | | | | | | - Boris Cheval
- Department of Sport Sciences and Physical Education, Ecole Normale Supérieure Rennes, Bruz, France
- Laboratory VIPS, University of Rennes, Rennes, France
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Lyu H, Sugita N, Komatsu S, Wakasugi M, Yokoseki A, Yoshihara A, Kobayashi T, Sato K, Kawashima H, Onodera O, Narita I, Tabeta K. UCP2 polymorphisms, daily step count, and number of teeth associated with all-cause mortality risk in Sado City: A hospital-based cohort study. Heliyon 2024; 10:e32512. [PMID: 38952382 PMCID: PMC11215260 DOI: 10.1016/j.heliyon.2024.e32512] [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: 12/08/2023] [Revised: 05/13/2024] [Accepted: 06/05/2024] [Indexed: 07/03/2024] Open
Abstract
Objective Uncoupling protein 2 (UCP2) is an ion/anion transporter in the mitochondrial inner membrane that plays a crucial role in immune response, regulation of oxidative stress, and cellular metabolism. UCP2 polymorphisms are linked to chronic inflammation, obesity, diabetes, heart disease, exercise efficiency, and longevity. Daily step count and number of teeth are modifiable factors that reduce mortality risk, although the role of UCP2 in this mechanism is unknown. This study aimed to assess the possible effects of UCP2 polymorphisms on the association between daily step count and number of teeth with all-cause mortality. Methods This study was conducted as a cohort project involving adult Japanese outpatients at Sado General Hospital (PROST). The final number of participants was 875 (mean age: 69 y). All-cause mortality during thirteen years (from June 2008 to August 2021) was recorded. The functional UCP2 genotypes rs659366 and rs660339 were identified using the Japonica Array®. Survival analyses were performed using multivariate Cox proportional hazard models. Results There were 161 deaths (mean observation period: 113 months). Age, sex, daily step count, and the number of teeth were significantly associated with mortality. In females, UCP2 polymorphisms were associated with mortality independent of other factors (rs659366 GA compared to GG + AA; HR = 2.033, p = 0.019, rs660339 C T compared to CC + TT; HR = 1.911, p = 0.029). Multivariate models, with and without UCP2 genotypes, yielded similar results. The interaction terms between UCP2 genotype and daily step count or number of teeth were not significantly associated with mortality. Conclusion The effects of UCP2 polymorphisms on the association between daily step count or the number of teeth and all-cause mortality were not statistically significant. In females, UCP2 polymorphisms were significantly associated with all-cause mortality. Our findings confirmed the importance of physical activity and oral health and suggested a role of UCP2 in mortality risk independently with those factors.
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Affiliation(s)
- Han Lyu
- Division of Periodontology, Department of Oral Biological Science, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Noriko Sugita
- Division of Periodontology, Department of Oral Biological Science, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | | | - Minako Wakasugi
- Department of Inter-Organ Communication Research, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akio Yokoseki
- Department of Inter-Organ Communication Research, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akihiro Yoshihara
- Division of Oral Science and Health Promotion, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tetsuo Kobayashi
- Division of Periodontology, Department of Oral Biological Science, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- General Dentistry and Clinical Education Unit, Faculty of Dentistry & Medical and Dental Hospital, Niigata University, Niigata, Japan
| | | | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan
| | - Osamu Onodera
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koichi Tabeta
- Division of Periodontology, Department of Oral Biological Science, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Garstang KR, Jackman PC, Healy LC, Cooper SB, Magistro D. What Effect Do Goal Setting Interventions Have on Physical Activity and Psychological Outcomes in Insufficiently Active Adults? A Systematic Review and Meta-Analysis. J Phys Act Health 2024; 21:541-553. [PMID: 38560998 DOI: 10.1123/jpah.2023-0340] [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: 07/06/2023] [Revised: 12/17/2023] [Accepted: 02/20/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Goal setting is commonly used for promoting physical activity (PA) among insufficiently active individuals. Previous reviews have analyzed the effects of goal setting on PA, but the purpose of this systematic review was to examine the concurrent effects of goal setting on PA and psychological outcomes in insufficiently active individuals to support interventions aiming to produce sustained PA behavior change. METHODS In this review (PROSPERO: CRD42021243970), we identified 13 studies with 1208 insufficiently active adults that reported the effects of goal-setting interventions (range 3-24 wk) on both PA and psychological outcomes (eg, self-efficacy, motivation, and affect). We used meta-analysis and narrative synthesis to analyze these effects. RESULTS All goals used in the included studies were specific goals. Setting specific goals had a large, positive effect on PA (g [standard mean difference] = 1.11 [P < .001]; 95% confidence interval, 0.74-1.47), but only a small, positive effect on the combined psychological outcomes (g [standard mean difference] = 0.25 [P < .001]; 95% CI, 0.10-0.40). Moderator analyses revealed that interventions that did not reward participants had a significantly greater effect on PA than interventions that did provide rewards (g = 1.30 vs 0.60, respectively, P ≤ .003). No other significant moderators were found. CONCLUSION Our review offers initial insight into the long-term effects of specific goals on PA and psychological outcomes in insufficiently active adults. Further research that examines the PA and psychological effects of goal-setting interventions and investigates a wider range of goal types could develop a stronger evidence base to inform intervention for insufficiently active individuals.
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Affiliation(s)
- Katie R Garstang
- Sport, Health and Performance Enhancement (SHAPE) Research Group,Department of Sport Science,School of Science & Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Patricia C Jackman
- School of Sport and Exercise Science, University of Lincoln, Lincoln, United Kingdom
| | - Laura C Healy
- Sport, Health and Performance Enhancement (SHAPE) Research Group,Department of Sport Science,School of Science & Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Simon B Cooper
- Sport, Health and Performance Enhancement (SHAPE) Research Group,Department of Sport Science,School of Science & Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Daniele Magistro
- Sport, Health and Performance Enhancement (SHAPE) Research Group,Department of Sport Science,School of Science & Technology, Nottingham Trent University, Nottingham, United Kingdom
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Ao Z, He H, Shi H, Liu H. Step count and multiple health outcomes: An umbrella review. J Evid Based Med 2024; 17:278-295. [PMID: 38566344 DOI: 10.1111/jebm.12596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This study aimed to quantify the association between step count and multiple health outcomes in a healthy population. METHODS PubMed, Embase, Web of Science, and The Cochrane Library were systematically searched for systematic reviews and meta-analyses from inception to April 1, 2022. Literature screening, data extraction, and data analysis were performed in this umbrella review. The intervention factor was daily step counts measured based on devices. Multiple health outcomes included metabolic diseases, cardiovascular diseases, all-cause mortality, and other outcomes in the healthy population. RESULTS Twenty studies with 94 outcomes were identified in this umbrella review. The increase in daily step count contributed to a range of human health outcomes. Furthermore, the special population, different age groups, countries, and cohorts should be carefully considered. Negative correlation between step counts and the following outcomes: metabolic outcomes, cardiovascular diseases, all-cause mortality, postural balance, cognitive function, and mental health. However, there was no association between participation in the outdoor walking group and the improvement of systolic blood pressure and diastolic blood pressure. Analysis of the dose-response association between increasing daily step count and the risk of cardiovascular disease events and all-cause mortality showed a substantially linear relationship. CONCLUSION A wide range of health outcomes can benefit from the right number of steps.
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Affiliation(s)
- Zhimin Ao
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hongbo He
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hongxia Shi
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Liu
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
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Brellenthin AG, Lee DC, Lefferts EC, Lefferts WK, Dougherty RJ, Kim Y. Physical Activity Intensity and Risk of Dementia. Am J Prev Med 2024; 66:948-956. [PMID: 38307157 DOI: 10.1016/j.amepre.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Abstract
INTRODUCTION Regular participation in aerobic physical activity is associated with a reduced risk of dementia. It is currently unclear whether this association is due to the total volume or intensity of physical activity. METHODS This prospective cohort study analyzed 386,486 adults from the UK Biobank who were free of dementia and self-reported >0 minutes of moderate-to-vigorous intensity physical activity (MVPA) at baseline (2007-2010). Participants were categorized as performing 0%, >0%-30%, or >30% of their total MVPA in vigorous activity (VPA). Cox proportional hazards regression models were used to examine the associations between categories of VPA and incident dementia while adjusting for sociodemographic and lifestyle factors including total MVPA. Analyses were performed in 2022. RESULTS Over an average follow-up of 12.0 (1.7) years, there were 5,177 (1.3%) cases of dementia. Compared to the group reporting 0% VPA, the hazard ratios (95% confidence intervals) of dementia for the groups reporting >0%-30% and >30% VPA were 0.73 (0.68-0.78) and 0.81 (0.75-0.87), respectively, in the fully adjusted model. In a joint analysis, reporting some VPA was associated with a reduced risk of dementia regardless of meeting the aerobic physical activity guidelines (HR=0.78 [0.72-0.85]) or not (HR=0.76 [0.60-0.98]), while meeting the aerobic physical activity guidelines alone without VPA was not associated with incident dementia (HR=0.98 [0.90-1.07]), compared to the group that did not meet the guidelines and reported no VPA. CONCLUSIONS These results suggest that engaging in VPA as part of MVPA is associated with a lower risk of dementia.
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Affiliation(s)
| | - Duck-Chul Lee
- Department of Kinesiology, Iowa State University, Ames, Iowa
| | | | | | - Ryan J Dougherty
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Youngwon Kim
- University of Hong Kong, Li Ka Shing Faculty of Medicine, School of Public Health, Pokfulam, Hong Kong; University of Cambridge, MRC Epidemiology Unit, Cambridge, United Kingdom.
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Dederichs R, Voß J, Falz R. [eHealth applications for promotion of physical activity after visceral surgery : A systematic review]. CHIRURGIE (HEIDELBERG, GERMANY) 2024; 95:443-450. [PMID: 38459189 DOI: 10.1007/s00104-024-02060-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/09/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND eHealth applications can support early mobilization and physical activity (PA) after surgery. This systematic review provides an overview of eHealth services to enhance or record PA after visceral surgery interventions. METHODS Two electronic databases (MEDLINE PubMed and Web of Science) were systematically searched (November 2023). Articles were considered eligible if they were controlled trials and described digital devices used to promote PA after visceral surgery. The Cochrane risk of bias (RoB-2) tool was used to determine the methodological quality of studies. RESULTS A total of nine randomized controlled studies (RCT) were included in this systematic review. The studies differed with respect to the interventions, surgical indications and evaluation variables. The risk of bias of the individual studies was moderate. The six studies using activity trackers (AT) predominantly showed insignificant improvements in the postoperative step count. The more complex fitness applications could partially reveal significant advantages compared to the control groups and the home-based online training also showed a significant increase in functional capacity. CONCLUSION Activity tracking alone has so far failed to show clinically relevant effects. In contrast, the more complex eHealth applications revealed advantages compared to usual postoperative care. More high-quality studies are needed for evidence-based recommendations for eHealth services in conjunction with visceral surgery.
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Affiliation(s)
- Rebecca Dederichs
- Institut für Sportmedizin und Prävention, Universität Leipzig, Rosa-Luxemburg-Str. 20-30, 04103, Leipzig, Deutschland
| | - Johannes Voß
- Institut für Sportmedizin und Prävention, Universität Leipzig, Rosa-Luxemburg-Str. 20-30, 04103, Leipzig, Deutschland
| | - Roberto Falz
- Institut für Sportmedizin und Prävention, Universität Leipzig, Rosa-Luxemburg-Str. 20-30, 04103, Leipzig, Deutschland.
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Zhou M, Gebreslassie M, Ponce de Leon A, Tynelius P, Ahlqvist VH, Dahlen M, Berglind D, Lager A, Brynedal B. The influence of the COVID-19 pandemic on physical activity in Stockholm County - Evidence from time series models of smartphone measured daily steps data spanning over 3 years. Prev Med 2024; 183:107969. [PMID: 38653392 DOI: 10.1016/j.ypmed.2024.107969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/18/2024] [Accepted: 04/20/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND It has been reported that physical activity levels decreased during the COVID-19 pandemic. Previous studies often relied on self-reported physical activity, which has low accuracy. Studies based on objectively measured physical activity have had short data collection periods, thereby not allowing the consideration of pre-pandemic levels of physical activity or the influence over the different waves of the pandemic. METHODS In this study, we utilize smartphone-measured step data from a nonprobability sample in Stockholm County, Sweden, where measures to limit the spread of COVID-19 differed from those in many other countries. The results are based on 522 individuals and 532,739 person-days with step data spanning from 2019 to 2021. Generalized additive models were fitted for each individual, and meta-regression was used to combine the results from individual models. RESULTS Daily steps decreased during the first wave but increased during the third wave compared to individual pre-pandemic levels. The decrease in daily steps occurred primarily in young individuals and those with occupations allowing remote work. Individuals of retirement age on the contrary increased their daily steps during the same period. CONCLUSIONS This study reveal that the influence of the COVID-19 pandemic was temporary and that younger age and the possibility of working from home were associated with a decreasing trend in physical activity.
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Affiliation(s)
- Minhao Zhou
- Center for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden
| | - Mihretab Gebreslassie
- Center for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden
| | - Antonio Ponce de Leon
- Center for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden; Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Per Tynelius
- Center for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Viktor H Ahlqvist
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Micael Dahlen
- Center for Wellbeing, Welfare and Happiness, Stockholm School of Economics, Stockholm, Sweden
| | - Daniel Berglind
- Center for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Center for Wellbeing, Welfare and Happiness, Stockholm School of Economics, Stockholm, Sweden
| | - Anton Lager
- Center for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Boel Brynedal
- Center for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
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Fanaroff AC, Patel MS, Chokshi N, Coratti S, Farraday D, Norton L, Rareshide C, Zhu J, Klaiman T, Szymczak JE, Russell LB, Small DS, Volpp KGM. Effect of Gamification, Financial Incentives, or Both to Increase Physical Activity Among Patients at High Risk of Cardiovascular Events: The BE ACTIVE Randomized Controlled Trial. Circulation 2024; 149:1639-1649. [PMID: 38583084 DOI: 10.1161/circulationaha.124.069531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Physical activity is associated with a lower risk of major adverse cardiovascular events, but few individuals achieve guideline-recommended levels of physical activity. Strategies informed by behavioral economics increase physical activity, but their longer-term effectiveness is uncertain. We sought to determine the effect of behaviorally designed gamification, loss-framed financial incentives, or their combination on physical activity compared with attention control over 12-month intervention and 6-month postintervention follow-up periods. METHODS Between May 2019 and January 2024, participants with clinical atherosclerotic cardiovascular disease or a 10-year risk of myocardial infarction, stroke, or cardiovascular death of ≥7.5% by the Pooled Cohort equation were enrolled in a pragmatic randomized clinical trial. Participants received a wearable device to track daily steps, established a baseline, selected a step goal increase, and were randomly assigned to control (n=151), behaviorally designed gamification (n=304), loss-framed financial incentives (n=302), or gamification+financial incentives (n=305). The primary outcome of the trial was the change in mean daily steps from baseline through the 12-month intervention period. RESULTS A total of 1062 patients (mean±SD age, 67±8; 61% female; 31% non-White) were enrolled. Compared with control subjects, participants had significantly greater increases in mean daily steps from baseline during the 12-month intervention in the gamification arm (adjusted difference, 538.0 [95% CI, 186.2-889.9]; P=0.0027), financial incentives arm (adjusted difference, 491.8 [95% CI, 139.6-844.1]; P=0.0062), and gamification+financial incentives arm (adjusted difference, 868.0 [95% CI, 516.3-1219.7]; P<0.0001). During the 6-month follow-up, physical activity remained significantly greater in the gamification+financial incentives arm than in the control arm (adjusted difference, 576.2 [95% CI, 198.5-954]; P=0.0028), but it was not significantly greater in the gamification (adjusted difference, 459.8 [95% CI, 82.0-837.6]; P=0.0171) or financial incentives (adjusted difference, 327.9 [95% CI, -50.2 to 706]; P=0.09) arms after adjustment for multiple comparisons. CONCLUSIONS Behaviorally designed gamification, loss-framed financial incentives, and the combination of both increased physical activity compared with control over a 12-month intervention period, with the largest effect in gamification+financial incentives. These interventions could be a useful component of strategies to reduce cardiovascular risk in high-risk patients. REGISTRATION URL: https://clinicaltrials.gov; Unique Identifier: NCT03911141.
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Affiliation(s)
- Alexander C Fanaroff
- Department of Medicine, Perelman School of Medicine, (A.C.F., N.C., J.Z., T.K., K.G.M.V.), University of Pennsylvania, Philadelphia
- Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center (A.C.F.), University of Pennsylvania, Philadelphia
- Penn Center for Health Incentives and Behavioral Economics (AC.F., S.C., D.F., L.N., C.R., J.Z., T.K., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics (A.C.F., N.C., L.B.R., D.S.S., K.G.M.V.), University of Pennsylvania, Philadelphia
- Penn Center for Digital Cardiology (A.C.F., N.C.), University of Pennsylvania, Philadelphia
| | | | - Neel Chokshi
- Department of Medicine, Perelman School of Medicine, (A.C.F., N.C., J.Z., T.K., K.G.M.V.), University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics (A.C.F., N.C., L.B.R., D.S.S., K.G.M.V.), University of Pennsylvania, Philadelphia
- Penn Center for Digital Cardiology (A.C.F., N.C.), University of Pennsylvania, Philadelphia
| | - Samantha Coratti
- Penn Center for Health Incentives and Behavioral Economics (AC.F., S.C., D.F., L.N., C.R., J.Z., T.K., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
| | - David Farraday
- Penn Center for Health Incentives and Behavioral Economics (AC.F., S.C., D.F., L.N., C.R., J.Z., T.K., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
| | - Laurie Norton
- Penn Center for Health Incentives and Behavioral Economics (AC.F., S.C., D.F., L.N., C.R., J.Z., T.K., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
- Department of Medical Ethics and Health Policy (L.N., J.Z., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
| | - Charles Rareshide
- Penn Center for Health Incentives and Behavioral Economics (AC.F., S.C., D.F., L.N., C.R., J.Z., T.K., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
| | - Jingsan Zhu
- Department of Medicine, Perelman School of Medicine, (A.C.F., N.C., J.Z., T.K., K.G.M.V.), University of Pennsylvania, Philadelphia
- Penn Center for Health Incentives and Behavioral Economics (AC.F., S.C., D.F., L.N., C.R., J.Z., T.K., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
- Department of Medical Ethics and Health Policy (L.N., J.Z., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
| | - Tamar Klaiman
- Department of Medicine, Perelman School of Medicine, (A.C.F., N.C., J.Z., T.K., K.G.M.V.), University of Pennsylvania, Philadelphia
- Penn Center for Health Incentives and Behavioral Economics (AC.F., S.C., D.F., L.N., C.R., J.Z., T.K., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
| | - Julia E Szymczak
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City (J.E.S.)
| | - Louise B Russell
- Penn Center for Health Incentives and Behavioral Economics (AC.F., S.C., D.F., L.N., C.R., J.Z., T.K., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics (A.C.F., N.C., L.B.R., D.S.S., K.G.M.V.), University of Pennsylvania, Philadelphia
- Department of Medical Ethics and Health Policy (L.N., J.Z., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
| | - Dylan S Small
- Leonard Davis Institute of Health Economics (A.C.F., N.C., L.B.R., D.S.S., K.G.M.V.), University of Pennsylvania, Philadelphia
- The Wharton School (D.S.S., K.G.M.V.), University of Pennsylvania, Philadelphia
| | - Kevin G M Volpp
- Department of Medicine, Perelman School of Medicine, (A.C.F., N.C., J.Z., T.K., K.G.M.V.), University of Pennsylvania, Philadelphia
- Penn Center for Health Incentives and Behavioral Economics (AC.F., S.C., D.F., L.N., C.R., J.Z., T.K., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics (A.C.F., N.C., L.B.R., D.S.S., K.G.M.V.), University of Pennsylvania, Philadelphia
- Department of Medical Ethics and Health Policy (L.N., J.Z., L.B.R., K.G.M.V.), University of Pennsylvania, Philadelphia
- The Wharton School (D.S.S., K.G.M.V.), University of Pennsylvania, Philadelphia
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Meguro T, Takayama F, Hammarlund H, Honjo M. Effects of a mobile health intervention on health-related outcomes in Japanese office workers: a pilot study. Int J Occup Med Environ Health 2024; 37:153-164. [PMID: 38375630 PMCID: PMC11142403 DOI: 10.13075/ijomeh.1896.02317] [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: 09/22/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES The purpose of the current study was to explore the effects of a mobile health (mHealth) intervention based on the Persuasive System Design (PSD) model on health-related outcomes among office workers. MATERIAL AND METHODS The authors conducted a trial that consisted of a 4-week baseline and an 8-week intervention period by reference to 23 office workers in a private research company. The mHealth application was developed to improve these workers' daily step count, decrease their sedentary time, and increase their sleep duration in accordance with the PSD model. The app features included at least 1 principal factor from each of the 4 main categories of the PSD model (primary task support, dialogue support, system credibility support, and social support). The objective health-related variables were measured using a smartwatch (Fitbit Luxe) that was synchronized with the application using the Fitbit Web Application Programming Interface. Subjects used the app, which included self-monitoring, personalized messages, education, and a competition system for users, during the intervention period. RESULTS Sedentary time exhibited a significant decrease (a median reduction of 14 min/day, p < 0.05) during the intervention period. No significant differences in daily step count and sleep duration were observed between the baseline and intervention periods. CONCLUSIONS This study suggests that the mHealth intervention based on the PSD model was useful for reducing sedentary time among office workers. Given that many previous studies on this topic have not been based on any theories, future studies should investigate the impact of structured selection behavior change theories on health-related outcomes among office workers. Int J Occup Med Environ Health. 2024;37(2):153-64.
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Affiliation(s)
- Takumi Meguro
- KDDI Research, Inc., Life Science Laboratories, Saitama, Japan
| | | | | | - Masaru Honjo
- KDDI Research, Inc., Life Science Laboratories, Saitama, Japan
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Batalik L, Chamradova K, Winnige P, Dosbaba F, Batalikova K, Vlazna D, Janikova A, Pepera G, Abu-Odah H, Su JJ. Effect of exercise-based cancer rehabilitation via telehealth: a systematic review and meta-analysis. BMC Cancer 2024; 24:600. [PMID: 38760805 PMCID: PMC11100177 DOI: 10.1186/s12885-024-12348-w] [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: 02/21/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
PURPOSE Exercise-based cancer rehabilitation via digital technologies can provide a promising alternative to centre-based exercise training, but data for cancer patients and survivors are limited. We conducted a meta-analysis examining the effect of telehealth exercise-based cancer rehabilitation in cancer survivors on cardiorespiratory fitness, physical activity, muscle strength, health-related quality of life, and self-reported symptoms. METHODS PubMed, Web of Science, and reference lists of articles related to the aim were searched up to March 2023. Randomized controlled clinical trials were included comparing the effect of telehealth exercise-based cancer rehabilitation with guideline-based usual care in adult cancer survivors. The primary result was cardiorespiratory fitness expressed by peak oxygen consumption. RESULTS A total of 1510 participants were identified, and ten randomized controlled trials (n = 855) were included in the meta-analysis. The study sample was 85% female, and the mean age was 52.7 years. Meta-analysis indicated that telehealth exercise-based cancer rehabilitation significantly improved cardiorespiratory fitness (SMD = 0.34, 95% CI 0.20, 0.49, I2 = 42%, p < 0.001) and physical activity (SMD = 0.34, 95% CI, 0.17, 0.51, I2 = 71%, p < 0.001). It was uncertain whether telehealth exercise-based cancer rehabilitation, compared with guideline-based usual care, improved the quality of life (SMD = 0.23, 95%CI, -0.07, 0.52, I2 = 67%, p = 0.14) body mass index (MD = 0.46, 95% CI, -1.19, 2.12, I2 = 60%, p = 0.58) and muscle strength (SMD = 0.07, 95% CI, -0.14, 0.28, I2 = 37%, p = 0.51). CONCLUSION This meta-analysis showed that telehealth exercise cancer rehabilitation could significantly increase cardiorespiratory fitness and physical activity levels and decrease fatigue. It is uncertain whether these interventions improve quality of life and muscle strength. High-quality and robust studies are needed to investigate specific home-based exercise regimens in different cancer subgroups to increase the certainty of the evidence.
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Affiliation(s)
- Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic.
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Katerina Chamradova
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Motol University Hospital, Charles University, Prague, Czech Republic
| | - Petr Winnige
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Katerina Batalikova
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
| | - Daniela Vlazna
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czech Republic
| | - Andrea Janikova
- Department of Internal Medicine-Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - Garyfallia Pepera
- Clinical Exercise Physiology and Rehabilitation Research Laboratory Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, Lamia, Greece
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
- School of Nursing, Tung Wah College, Hong Kong, China.
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Ohkubo H, Fujita K, Ito K, Nakano A, Horiuchi M, Mori Y, Fukumitsu K, Fukuda S, Kanemitsu Y, Uemura T, Tajiri T, Ito Y, Ozawa Y, Murase T, Niimi A. Low Daily Step Count Associated with Small Erector Spinae Muscle Area and Sarcopenia in Idiopathic Pulmonary Fibrosis. Intern Med 2024; 63:1345-1352. [PMID: 37839878 PMCID: PMC11157315 DOI: 10.2169/internalmedicine.2584-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023] Open
Abstract
Objective The daily step count is associated with mortality in idiopathic pulmonary fibrosis (IPF). However, the factors associated with this phenomenon are not yet fully understood. We therefore clarified its association with clinical parameters. Methods Fifty-nine patients with IPF with available data for daily step counts; 6-minute walk distance (6MWD); chest, abdominal, and pelvic computed tomography (CT); pulmonary function; psychological evaluations; and sarcopenia assessments were prospectively enrolled. The daily step count was measured continuously for seven consecutive days. The cross-sectional areas of the erector spinae muscles at the level of the 12th vertebra (ESMCSA) and psoas major muscle volume (PMV) obtained by CT were assessed. Results The average age of the patients was 73.3±8.1 years old, and the percent predicted forced vital capacity was 81.6%±15.8%. The median daily step count was 4,258 (2,155-6,991) steps. The average 6MWD, ESMCSA, and PMV were 413±97 m, 25.5±6.7 cm2, and 270±75.6 cm3, respectively. A linear regression analysis for daily step count showed that the ESMCSA and 6MWD were independent factors for the daily step count, whereas the PMV and skeletal muscle index were not. The daily step count, ESMCSA, and 6MWD were lower in patients with sarcopenia than in those without sarcopenia. Conclusion A lower daily step count was associated with a smaller erector spinae muscle area and sarcopenia in patients with IPF. Further studies are warranted to confirm the importance of physical therapy for muscle strengthening in patients with IPF.
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Affiliation(s)
- Hirotsugu Ohkubo
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Kohei Fujita
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Keima Ito
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Akiko Nakano
- Department of Respiratory Medicine and Allergy, Nagoya City University Midori Municipal Hospital, Japan
| | - Minoru Horiuchi
- Department of Respiratory Medicine and Allergy, Nagoya City University Midori Municipal Hospital, Japan
| | - Yuta Mori
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Kensuke Fukumitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Satoshi Fukuda
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Yoshihiro Kanemitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Takehiro Uemura
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Tomoko Tajiri
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Yutaka Ito
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Yoshiyuki Ozawa
- Department of Radiology, Fujita Health University Okazaki Medical Center of Radiology, Japan
| | - Takayuki Murase
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Japan
| | - Akio Niimi
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
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Culverhouse J, Hillsdon M, Koster A, Bosma H, de Galan BE, Savelberg HHCM, Pulsford R. Cross-sectional associations between patterns and composition of upright and stepping events with physical function: insights from The Maastricht Study. Eur Rev Aging Phys Act 2024; 21:10. [PMID: 38724917 PMCID: PMC11080173 DOI: 10.1186/s11556-024-00343-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/20/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Age-related declines in physical functioning have significant implications for health in later life. Physical activity (PA) volume is associated with physical function, but the importance of the pattern in which PA is accumulated is unclear. This study investigates associations between accelerometer-determined daily PA patterns, including composition and temporal distribution (burstiness) of upright and stepping events, with physical function. METHODS Data was from participants who wore an activPAL3 accelerometer as part of The Maastricht Study. Exposures included a suite of metrics describing the composition and the temporal distribution (burstiness) of upright and sedentary behaviour. Physical function outcomes included the six-minute walk test (6MWT), timed chair-stand test (TCST), grip strength (GS), and SF-36 physical functioning sub-scale (SF-36pf). Multivariable linear regression models were used to assess associations, adjusting for covariates including overall PA volume (daily step count). RESULTS Participants(n = 6085) had 6 or 7 days of valid data. Upright and stepping event metrics were associated with physical function outcomes, even after adjusting PA volume. Higher sedentary burstiness was associated with better function (6MWT, TCST, and SF-36pf), as was duration and step volume of stepping events (6MWT, TCST, GS, and SF-36pf), step-weighted cadence (6MWT, TCST, and SF-36pf). Number of stepping events was associated with poorer function (6MWT, GS, and SF-36pf), as was upright event burstiness (SF-36pf). Associations varied according to sex. CONCLUSION Our study reveals that diverse patterns of physical activity accumulation exhibit distinct associations with various measures of physical function, irrespective of the overall volume. Subsequent investigations should employ longitudinal and experimental studies to examine how changing patterns of physical activity may affect physical function, and other health outcomes.
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Affiliation(s)
- Joshua Culverhouse
- Department of Public Health and Sport Sciences, University of Exeter, Exeter, UK.
| | - Melvyn Hillsdon
- Department of Public Health and Sport Sciences, University of Exeter, Exeter, UK
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Bastiaan E de Galan
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Hans H C M Savelberg
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
- Department of Human Movement Sciences, Maastricht University, Maastricht, the Netherlands
| | - Richard Pulsford
- Department of Public Health and Sport Sciences, University of Exeter, Exeter, UK
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Lewis-de Los Angeles WW. Adverse Childhood Experiences and Accelerometer-Measured Physical Activity and Sleep in Preadolescents. Acad Pediatr 2024; 24:654-661. [PMID: 37748537 DOI: 10.1016/j.acap.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/17/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE To assess the relationship between adverse childhood experiences (ACEs) and objective measures of physical activity and sleep. METHODS Data from the baseline and 2-year follow-up of the Adolescent Brain and Cognitive Development study were analyzed (n = 6227 for physical activity; n = 4151 for sleep). ACEs were assessed by parent report at baseline (mean age 9.9 years) with 3 levels: none, exposure to 1 ACE, and exposure to 2 or more ACEs. Objective measures of physical activity and sleep were assessed with an accelerometer at 2-year follow-up (mean age 11.9 years). Multivariate linear regression analyses were used to examine the relationship between ACEs and physical activity as well as sleep, adjusting for family income and sex. RESULTS Compared to children with no ACEs, children with ACEs had fewer daily steps: 1 ACE (β = -323 (95% CI: -508 to -138), P < .001) and 2 or more ACEs (β = -417 (95% CI: -624 to -209), P < .001). ACEs were also associated with shorter sleep duration (minutes), although only for participants with 2 or more ACEs (1 ACE: β = -2.2 (-5.3 to 0.8), P = .16; 2 or more ACEs: β = -6.2 (95% CI: -9.6 to -2.7), P < .001). Rapid eye movement (REM) sleep specifically was reduced in participants with ACEs (1 ACE (β = -1.4 (-2.7 to -0.01), P = .05) and 2 or more ACEs (β = -2.3 (-3.8 to -0.8), P = .003). CONCLUSIONS There is a dose-response relationship between ACEs and reduced daily steps, total sleep duration, and REM sleep in preadolescents.
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Affiliation(s)
- William W Lewis-de Los Angeles
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, Emma Pendleton Bradley Hospital, Riverside, RI.
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Yamamoto N, Maruyama K, Saito I, Tomooka K, Tanigawa T, Kawamura R, Takata Y, Osawa H. Prospective association of daily ambulatory activity with metabolic syndrome in middle-aged and older Japanese adults: the Toon Health Study. Int J Obes (Lond) 2024; 48:733-740. [PMID: 38307954 DOI: 10.1038/s41366-024-01483-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND This cohort study aimed to examine the relationship between objectively measured daily ambulatory activity (AA) variables and the onset of metabolic syndrome (MetS) in middle-aged and older Japanese individuals. METHODS A total of 1,034 participants (women, 76.8%; mean age, 56.9 years) who were initially free from MetS, underwent objective assessment of daily AA using a uniaxial accelerometer at baseline. The number of steps, time accumulated in light-intensity AA (LIAA), moderate-to-vigorous intensity AA (MVAA), and total AA (LIAA + MVAA) were calculated. The diagnostic criteria outlined by the Japanese standards were employed to define the presence of MetS. To explore the association between AA variables and MetS onset, both multivariate logistic regression and a restricted cubic spline model were used while controlling for variables such as age, sex, education, alcohol habit, smoking habit, energy intake, and the number of MetS components present at baseline. RESULTS Over the course of the 5-year follow-up period, 116 participants (11.2%) developed MetS. In terms of the number of steps, LIAA, and total AA, the third quartile had significantly lower multivariate adjusted odds ratios for MetS onset than the first quartile. The odds ratios (95% confidence intervals) were 0.386 (0.197-0.755), 0.527 (0.285-0.975), and 0.392 (0.206-0.745), respectively. In the spline model, an L-shaped association with MetS was observed for the number of steps (p for nonlinearity = 0.066), LIAA (p for nonlinearity = 0.034), and total AA (p for nonlinearity = 0.040). CONCLUSIONS Among the variables related to AA, the index of daily amount AA, in particular, may be linked to the onset of MetS.
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Affiliation(s)
- Naofumi Yamamoto
- Faculty of Collaborative Regional Innovation, Ehime University, 3 Bunkyo-cho, Matsuyama, Ehime, 790-8577, Japan.
| | - Koutatsu Maruyama
- Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime, 790-8566, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Kiyohide Tomooka
- Department of Public Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ryoichi Kawamura
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Yasunori Takata
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Haruhiko Osawa
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
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Timmins IR, Zaccardi F, Yates T, Dudbridge F. Mendelian randomisation and mediation analysis of self-reported walking pace and coronary artery disease. Sci Rep 2024; 14:9995. [PMID: 38693307 PMCID: PMC11063179 DOI: 10.1038/s41598-024-60398-8] [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: 06/05/2023] [Accepted: 04/23/2024] [Indexed: 05/03/2024] Open
Abstract
The aim of this study was to assess the causal relationship between habitual walking pace and cardiovascular disease risk using a Mendelian randomisation approach. We performed both one- and two-sample Mendelian randomisation analyses in a sample of 340,000 European ancestry participants from UK Biobank, applying a range of sensitivity analyses to assess pleiotropy and reverse causality. We used a latent variable framework throughout to model walking pace as a continuous exposure, despite being measured in discrete categories, which provided more robust and interpretable causal effect estimates. Using one-sample Mendelian randomisation, we estimated that a 1 mph (i.e., 1.6 kph) increase in self-reported habitual walking pace corresponds to a 63% (hazard ratio (HR) = 0.37, 95% confidence interval (CI), 0.25-0.55, P = 2.0 × 10-6) reduction in coronary artery disease risk. Using conditional analyses, we also estimated that the proportion of the total effect on coronary artery disease mediated through BMI was 45% (95% CI 16-70%). We further validated findings from UK Biobank using two-sample Mendelian randomisation with outcome data from the CARDIoGRAMplusC4D consortium. Our findings suggest that interventions that seek to encourage individuals to walk more briskly should lead to protective effects on cardiovascular disease risk.
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Affiliation(s)
- Iain R Timmins
- Department of Population Health Sciences, University of Leicester, Leicester, UK.
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK.
- Statistical Innovation, Oncology R&D, AstraZeneca, Cambridge, UK.
| | | | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Frank Dudbridge
- Department of Population Health Sciences, University of Leicester, Leicester, UK
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Becker MA, Monti DA. Advancing Biopsychosocial Model and Achieving Optimal Health by Incorporating Integrative Medicine into Consultation Liaison Psychiatry Care. J Acad Consult Liaison Psychiatry 2024; 65:219-221. [PMID: 38763466 DOI: 10.1016/j.jaclp.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Affiliation(s)
- Madeleine A Becker
- President, Academy of Consultation-Liaison Psychiatry. Professor, Departments of Integrative Medicine and Nutritional Sciences, Psychiatry and Human Behavior. Sidney Kimmel Medical College. Director, Graduate Medical Education, Associate Director, Integrative Medicine Fellowship Marcus Institute of Integrative Health Thomas Jefferson University 925 Chestnut Street, Suite 120 Philadelphia, PA 19107.
| | - Daniel A Monti
- The Ellen and Ron Caplan Chair, Department of Integrative Medicine & Nutritional Sciences. CEO, Marcus Institute of Integrative Health Thomas Jefferson University 925 Chestnut Street, Suite 120 Philadelphia, PA 19107
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Buendia R, Karpefors M, Folkvaljon F, Hunter R, Sillen H, Luu L, Docherty K, Cowie MR. Wearable Sensors to Monitor Physical Activity in Heart Failure Clinical Trials: State-of-the-Art Review. J Card Fail 2024; 30:703-716. [PMID: 38452999 DOI: 10.1016/j.cardfail.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Estimation of the effects that drugs or other interventions have on patients' symptoms and functions is crucial in heart failure trials. Traditional symptoms and functions clinical outcome assessments have important limitations. Actigraphy may help to overcome these limitations due to its objective nature and the potential for continuous recording of data. However, actigraphy is not currently accepted as clinically relevant by key stakeholders. METHODS AND RESULTS In this state-of-the-art study, the key aspects to consider when implementing actigraphy in heart failure trials are discussed. They include which actigraphy-derived measures should be considered, how to build endpoints using them, how to measure and analyze them, and how to handle the patients' and sites' logistics of integrating devices into trials. A comprehensive recommendation based on the current evidence is provided. CONCLUSION Actigraphy is technically feasible in clinical trials involving heart failure, but successful implementation and use to demonstrate clinically important differences in physical functioning with drug or other interventions require careful consideration of many design choices.
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Affiliation(s)
- Ruben Buendia
- Data Science, Late-Stage Development, Cardiovascular, Renal and Metabolic, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
| | - Martin Karpefors
- Data Science, Late-Stage Development, Cardiovascular, Renal and Metabolic, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Folke Folkvaljon
- Patient Centered Science, BioPharmaceuticals Business, AstraZeneca, Gothenburg, Sweden
| | - Robert Hunter
- Regulatory, Late-Stage Development, Cardiovascular, Renal and Metabolic, BioPharmaceuticals R&D, AstraZeneca, Luton, UK
| | | | - Long Luu
- Digital Health R&D, AstraZeneca, Gaithersburg, MD, US
| | - Kieran Docherty
- British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Martin R Cowie
- Late-Stage Development, Cardiovascular, Renal and Metabolic, BioPharmaceuticals R&D, AstraZeneca, Boston, MA, US
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Freire YA, Rosa-Souza FJ, Cabral LLP, Browne RAV, Farias Júnior JC, Waters DL, Mielke GI, Costa EC. Association of 'Tortoise' and 'Hare' movement behavior patterns with cardiometabolic health, body composition, and functional fitness in older adults. Geriatr Nurs 2024; 57:96-102. [PMID: 38608486 DOI: 10.1016/j.gerinurse.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/12/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
We investigated the association of movement behavior patterns with cardiometabolic health, body composition, and functional fitness in older adults. A total of 242 older adults participated of this cross-sectional study. Sedentary time, light physical activity (LPA) and moderate-vigorous physical activity (MVPA), steps/day, and step cadence were assessed by accelerometry. The movement behavior patterns were derived by principal component analysis. Cardiometabolic health was defined by a metabolic syndrome score (cMetS). Body composition was determined by appendicular lean mass/body mass index (ALM/BMI). Functional fitness was assessed by a composite z-score from the Senior Fitness Test battery. Two patterns were identified: 'Tortoise' (low sedentary time, high LPA and steps/day) and 'Hare' (high MVPA, steps/day, and step cadence). 'Tortoise' and 'Hare' were associated with better cMetS. 'Hare' was positively associated with ALM/BMI and Functional Fitness. While 'Tortoise' and 'Hare' were associated with better cMetS, only 'Hare' was associated with better ALM/BMI and functional fitness.
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Affiliation(s)
- Yuri A Freire
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Francisco José Rosa-Souza
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ludmila L P Cabral
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Rodrigo A V Browne
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - José C Farias Júnior
- Department of Physical Education, Federal University of Paraíba, João Pessoa, PB, Brazil
| | - Debra L Waters
- Department of Medicine and School of Physiotherapy, University of Otago, Dunedin, New Zealand; Department of General Internal Medicine/Geriatrics, University of New Mexico, Albuquerque, NM, USA
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Eduardo C Costa
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
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46
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Kubota A, Hamaguchi T. Seasonal changes in daily steps of community-dwelling older individuals with and without lifestyle-related diseases: a retrospective cohort study. J Phys Ther Sci 2024; 36:252-258. [PMID: 38694007 PMCID: PMC11060769 DOI: 10.1589/jpts.36.252] [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: 12/26/2023] [Accepted: 01/29/2024] [Indexed: 05/03/2024] Open
Abstract
[Purpose] Physical activity helps prevent diseases and mitigate their severity in older individuals with lifestyle-related conditions. We investigated whether seasonal factors and existing diseases affect physical activity in this demographic to identify lifestyle guidance indicators for health maintenance. [Participants and Methods] We compared the daily steps of older individuals (age of ≥65 years) by month, sex, and disease status from August to January by using three-way analysis of covariance. We evaluated a total of 115 participants (83 females and 32 males). [Results] Females with diseases had significantly fewer monthly daily steps than females without diseases in November (mean difference=1,138 ± 220) and December (mean difference=1,578 ± 239). Throughout, males with diseases completed significantly fewer monthly daily steps than did males without diseases. Furthermore, monthly daily steps never differed significantly between females with diseases and their male counterparts. [Conclusion] Compared with healthy older individuals, in older persons with diseases, physical activity was lower year-round among males and in November and December among females. Separate daily step count goals may be required for health maintenance in both sexes. It is important to determine the daily steps necessary to prevent various diseases and mitigate their severity while maintaining physical activity among older persons with diseases.
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Affiliation(s)
- Akihito Kubota
- Department of Rehabilitation, Graduate School of Health
Sciences, Saitama Prefectural University: 820 Sannomiya, Koshigaya-city, Saitama 343-8540,
Japan
| | - Toyohiro Hamaguchi
- Department of Rehabilitation, Graduate School of Health
Sciences, Saitama Prefectural University: 820 Sannomiya, Koshigaya-city, Saitama 343-8540,
Japan
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47
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Leung WKC, Cheung J, Wong VCC, Tse KKL, Lee RWY, Lam SC, Suen LKP. Patterns of sedentary behavior among older women with urinary incontinence and urinary symptoms: a scoping review. BMC Public Health 2024; 24:1201. [PMID: 38689284 PMCID: PMC11059602 DOI: 10.1186/s12889-024-18703-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/24/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Independent of physical activity, sedentary behavior has emerged as a significant risk factor for health. Particularly, older adults spent as high as 13 h daily on sedentary activities, which account for 98% of their awake times. Although there is growing evidence revealing the potential association between sedentary behavior and urinary incontinence (UI) across populations of different ages, the relationship between sedentary behavior and urinary symptoms in older women, who are twice as likely to have UI than older men, has not been reviewed. This scoping review aimed to synthesize available evidence of the relationship between sedentary behavior and urinary symptoms in noninstitutionalized older women. METHODS Six electronic databases (PubMed, Web of Science, SPORTDiscus, Ovid Nursing Database, EMBASE, and MEDLINE) were searched from their inception to April 2023. Observational and experimental studies that measured sedentary behavior using objective and/or self-reported methods in older women aged 60 + years having any type of UI, with English full texts available, were included. Relevant data, including sedentary patterns (types, definitions, measurements, and daily patterns) and UI types were tabulated. A narrative synthesis of the findings was also conducted. RESULTS A total of seven studies (n = 1,822) were included for review and reporting. Objective measurement showed that older women with UI were engaged in > 8 h sedentary activities daily (493.3-509.4 min/day), which accounted for 73% of their awake times. The duration of self-reported sedentary behavior was lower than the time measured objectively, and the average weekday sitting time was 300-380 min/day. With or without adjustment for confounding factors (e.g., age and number of vaginal deliveries), the daily proportion of sedentary time and average duration of sedentary bouts were positively associated with the prevalence of urgency UI. Notably, sedentary patients with UI were more likely to have lower urinary tract symptoms, including bothersome incontinence, to use incontinence products, and to have nocturia episodes, than their age-matched counterparts who were less sedentary. CONCLUSION Our findings suggest a potential relationship between sedentary behavior and UI in older women, but the causality of the relationship remains unclear. To further inform the clinical role of sedentary behavior in the context of UI, a greater number of rigorous studies with a prospective study design is urgently needed.
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Affiliation(s)
- Wilson Kin Chung Leung
- School of Nursing, Tung Wah College, 16/F, Ma Kam Chan Memorial Building, 31 Wylie Road, Kowloon, Hong Kong SAR, China.
| | - Jasmine Cheung
- School of Nursing, Tung Wah College, 16/F, Ma Kam Chan Memorial Building, 31 Wylie Road, Kowloon, Hong Kong SAR, China
| | - Vivian Chin Ching Wong
- School of Arts and Humanities, Tung Wah College, 17/F, Cheung Kung Hai Memorial Building, 90A Shantung Street, Kowloon, Hong Kong SAR, China
| | - Kelly Ka Lee Tse
- School of Arts and Humanities, Tung Wah College, 17/F, Cheung Kung Hai Memorial Building, 90A Shantung Street, Kowloon, Hong Kong SAR, China
| | - Ruby Wing Yin Lee
- School of Arts and Humanities, Tung Wah College, 17/F, Cheung Kung Hai Memorial Building, 90A Shantung Street, Kowloon, Hong Kong SAR, China
| | - Simon Ching Lam
- School of Nursing, Tung Wah College, 16/F, Ma Kam Chan Memorial Building, 31 Wylie Road, Kowloon, Hong Kong SAR, China.
| | - Lorna Kwai Ping Suen
- School of Nursing, Tung Wah College, 16/F, Ma Kam Chan Memorial Building, 31 Wylie Road, Kowloon, Hong Kong SAR, China
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Wunsch K, Fiedler J, Hubenschmid S, Reiterer H, Renner B, Woll A. An mHealth Intervention Promoting Physical Activity and Healthy Eating in a Family Setting (SMARTFAMILY): Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e51201. [PMID: 38669071 PMCID: PMC11087865 DOI: 10.2196/51201] [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: 07/24/2023] [Revised: 10/27/2023] [Accepted: 02/27/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Numerous smartphone apps are targeting physical activity (PA) and healthy eating (HE), but empirical evidence on their effectiveness for the initialization and maintenance of behavior change, especially in children and adolescents, is still limited. Social settings influence individual behavior; therefore, core settings such as the family need to be considered when designing mobile health (mHealth) apps. OBJECTIVE The purpose of this study was to evaluate the effectiveness of a theory- and evidence-based mHealth intervention (called SMARTFAMILY [SF]) targeting PA and HE in a collective family-based setting. METHODS A smartphone app based on behavior change theories and techniques was developed, implemented, and evaluated with a cluster randomized controlled trial in a collective family setting. Baseline (t0) and postintervention (t1) measurements included PA (self-reported and accelerometry) and HE measurements (self-reported fruit and vegetable intake) as primary outcomes. Secondary outcomes (self-reported) were intrinsic motivation, behavior-specific self-efficacy, and the family health climate. Between t0 and t1, families of the intervention group (IG) used the SF app individually and collaboratively for 3 consecutive weeks, whereas families in the control group (CG) received no treatment. Four weeks following t1, a follow-up assessment (t2) was completed by participants, consisting of all questionnaire items to assess the stability of the intervention effects. Multilevel analyses were implemented in R (R Foundation for Statistical Computing) to acknowledge the hierarchical structure of persons (level 1) clustered in families (level 2). RESULTS Overall, 48 families (CG: n=22, 46%, with 68 participants and IG: n=26, 54%, with 88 participants) were recruited for the study. Two families (CG: n=1, 2%, with 4 participants and IG: n=1, 2%, with 4 participants) chose to drop out of the study owing to personal reasons before t0. Overall, no evidence for meaningful and statistically significant increases in PA and HE levels of the intervention were observed in our physically active study participants (all P>.30). CONCLUSIONS Despite incorporating behavior change techniques rooted in family life and psychological theories, the SF intervention did not yield significant increases in PA and HE levels among the participants. The results of the study were mainly limited by the physically active participants and the large age range of children and adolescents. Enhancing intervention effectiveness may involve incorporating health literacy, just-in-time adaptive interventions, and more advanced features in future app development. Further research is needed to better understand intervention engagement and tailor mHealth interventions to individuals for enhanced effectiveness in primary prevention efforts. TRIAL REGISTRATION German Clinical Trials Register DRKS00010415; https://drks.de/search/en/trial/DRKS00010415. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/20534.
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Affiliation(s)
- Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Janis Fiedler
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Sebastian Hubenschmid
- Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| | - Harald Reiterer
- Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| | - Britta Renner
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Seino S, Abe T, Nofuji Y, Hata T, Shinkai S, Kitamura A, Fujiwara Y. Dose-response associations between physical activity and sedentary time with functional disability in older adults with or without frailty: a prospective cohort study. Front Public Health 2024; 12:1357618. [PMID: 38721536 PMCID: PMC11076770 DOI: 10.3389/fpubh.2024.1357618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/02/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose Evidence regarding the dose-response curve shapes of physical activity (PA) and sedentary time (ST) in older adults with functional disability (FD) is extremely limited. Moreover, these associations may differ depending on with/without frailty. We examined the dose-response associations between moderate-to-vigorous PA (MVPA) and ST with FD among older adults with/without frailty. Methods We included 7,480 initially nondisabled adults (3,795 men and 3,685 women) aged 65-84 years in Ota City, Tokyo, Japan. MVPA and ST were evaluated using the International Physical Activity Questionnaire-Short Form. FD was prospectively identified using a nationally unified database of the long-term care insurance system. Frailty was determined using Check-List 15, validated against Fried's frailty criteria. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA and ST for FD were calculated, and dose-response curves were examined using restricted cubic splines. Results During 3.6 years of follow-up, 1,001 (13.4%) participants had FD. Among all participants, compared with no MVPA, the HRs for FD reduced linearly up to approximately 2000 metabolic equivalents (METs)■min/week of MVPA, and the lowest HR (HR: 0.61, 95% CI: 0.51-0.74) was reached at around 3,000-4,000 METs■min/week. Although the shape of this association was consistent regardless of with/without frailty, the magnitude of the association tended to be stronger in frail older adults than in non-frail older adults. Compared with those for the median (300 min/day) of ST, the HRs for FD increased linearly as ST reached approximately 600 min/day or more, independent of MVPA, with a maximum HR of 1.31 (95% CI: 1.01-1.71) for 1,080 min/day among all participants. This association was more pronounced among non-frail older adults but not statistically significant among frail older adults. Conclusion Higher MVPA levels consistently reduced the incidence of FD regardless of frailty in a significant inverse nonlinear dose-response manner. A significant positive nonlinear dose-response association between ST and FD risk was identified among non-frail older adults but not among frail older adults. Increasing MVPA and reducing prolonged ST are important for preventing FD among non-frail older adults. However, reducing ST alone may be insufficient; increasing MVPA, even if by only small increments, is highly recommended for frail older adults.
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Affiliation(s)
- Satoshi Seino
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Takumi Abe
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Toshiki Hata
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Department of Nutrition Sciences, Kagawa Nutrition University, Sakado, Saitama, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Health Town Development Science Center, Yao City Public Health Center, Yao City, Osaka, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
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Keadle SK, Eglowski S, Ylarregui K, Strath SJ, Martinez J, Dekhtyar A, Kagan V. Using Computer Vision to Annotate Video-Recoded Direct Observation of Physical Behavior. SENSORS (BASEL, SWITZERLAND) 2024; 24:2359. [PMID: 38610576 PMCID: PMC11014332 DOI: 10.3390/s24072359] [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: 02/14/2024] [Revised: 03/19/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024]
Abstract
Direct observation is a ground-truth measure for physical behavior, but the high cost limits widespread use. The purpose of this study was to develop and test machine learning methods to recognize aspects of physical behavior and location from videos of human movement: Adults (N = 26, aged 18-59 y) were recorded in their natural environment for two, 2- to 3-h sessions. Trained research assistants annotated videos using commercially available software including the following taxonomies: (1) sedentary versus non-sedentary (two classes); (2) activity type (four classes: sedentary, walking, running, and mixed movement); and (3) activity intensity (four classes: sedentary, light, moderate, and vigorous). Four machine learning approaches were trained and evaluated for each taxonomy. Models were trained on 80% of the videos, validated on 10%, and final accuracy is reported on the remaining 10% of the videos not used in training. Overall accuracy was as follows: 87.4% for Taxonomy 1, 63.1% for Taxonomy 2, and 68.6% for Taxonomy 3. This study shows it is possible to use computer vision to annotate aspects of physical behavior, speeding up the time and reducing labor required for direct observation. Future research should test these machine learning models on larger, independent datasets and take advantage of analysis of video fragments, rather than individual still images.
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Affiliation(s)
- Sarah K. Keadle
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
| | | | - Katie Ylarregui
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
| | - Scott J. Strath
- College of Public Health, University of Wisconsin, Milwaukee, WI 53205, USA; (S.J.S.); (J.M.)
| | - Julian Martinez
- College of Public Health, University of Wisconsin, Milwaukee, WI 53205, USA; (S.J.S.); (J.M.)
| | - Alex Dekhtyar
- Department of Computer Science and Software Engineering, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
| | - Vadim Kagan
- Sentimetrix Inc., Bethesda, MD 20814, USA; (S.E.); (V.K.)
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