Validity of accelerometry for the assessment of moderate intensity physical activity in the field

Reliability and validity of time-use surveys in assessing 24-hour movement behaviors in adults

Background

Time-use surveys are considered a valid alternative for assessing physical activity (PA) and sedentary behavior (SB). The International Classification of Activities for Time-Use Statistics (ICATUS) has been widely adopted, as a standardized framework for categorizing time-use data. A classification system has been developed to classify ICATUS-based activities into sleep, SB, light PA (LPA), and moderate-to-vigorous PA (MVPA). This study aimed to evaluate the reliability and validity of ICATUS-based time-use classifications.

Methods

Participants aged 18-59 years were recruited from five organizations located in the Bangkok metropolitian area (n = 220). The study was conducted from September to October 2022. Participants wore an accelerometer for ten consecutive days and completed two-day time-use diaries. The intraclass correlation coefficient (ICC) was calculated to assess test-retest reliability between the first and second entries of time-use surveys, as well as for accelerometer data. Validity was assessed by comparing the two time-use surveys with corresponding accelerometer data using Spearman correlations.

Results

Test-retest reliability showed strong absolute agreement in the average time-use estimates for sleep and SB, with ICCs of 0.80 and 0.83, respectively. Moderate agreement was observed for LPA (ICC = 0.71) and MVPA (ICC = 0.51). Moderate validity correlations were found for SB, while LPA showed weak correlations, and MVPA results were inconsistent.

Conclusion

ICATUS-based time-use data demonstrated strong reliability and moderate validity for SB, and moderate reliability and low validity for PA in working adults. The classification system appears to be a verified tool, supporting its applicability of time-use data, particularly in developing countries.

C.E.R.E.B.R.O.: A home-based physical activity study for older Latino adults

Background

The growing Latino population is 1.5 times more likely to develop Alzheimer's Disease (AD) and Related Dementias (ADRD) than non-Latino Whites. Interventions that can reduce the risk of ADRD are needed. Older Latinos face many barriers to the incorporation of physical activity (PA) into their daily lives given a lack social support, caregiving responsibilities, and lacking resources to maintain PA. Walking and dancing are the two most frequently reported forms of PA among older Latinos, and indoor PA programs conducted in a community location or at home can overcome barriers to participation.

Methods

C.E.R.E.B.R.O. (Cognitive Enhancement and Risk-reduction through Exercise for Brain-Related Outcomes; meaning "brain" in English) is testing two remote intervention programs, the BAILAMOS™ dance program and ¡En Forma y Fuerte! (Fit & Strong!), a PA/behavior change program. Participants are randomly assigned to either study condition. The BAILAMOS™ dance program is a 6-month long dance program, in which participants learn different Latin dances including Merengue, Cha Cha Cha, Bachata, Salsa, Cumbia, and Kizomba. Trained CEREBRO staff also lead monthly discussions. Persons randomized to the 3-month long ¡En Forma y Fuerte! program participate in flexibility and aerobic exercise, strength training, and health education. All classes are held live via Zoom. Trained study staff assist participants with technology-related issues. Data are collected through remote testing at baseline, 12 weeks, and 24 weeks after the start of the interventions. Outcomes include PA, cognition, quality of life, social connectedness, and cost-effectiveness.

Conclusion

CEREBRO has the potential to provide evidence regarding the advantages of providing remote intervention programs to reduce PA barriers in the older Latino community.

Exploring the link between sleep patterns and early cardiovascular disease markers in young adults with chronic anxiety

Chronic anxiety is commonly associated with poor sleep patterns, which may contribute to an increased risk of cardiovascular disease (CVD) through mechanisms like oxidative stress, vascular dysfunction, and poor blood pressure control. As sleep disturbances, particularly poor sleep quality and/or regularity, have been independently linked to CVD development, this study explored whether sleep quality/regularity in young adults with chronic anxiety is associated with early indicators of CVD risk, specifically oxidative stress, vascular function, and blood pressure control. Twenty-eight young (24 ± 4 yr) participants with a prior clinical diagnosis of generalized anxiety disorder (GAD) or elevated GAD symptoms (GAD-7 > 10) had their sleep quality [total sleep time (TST) and sleep efficiency (SE)] and regularity [via TST/SE standard deviations (SD)] assessed for seven consecutive days. Various precursors to CVD development such as oxidative stress, brachial artery function, microvascular function, and blood pressure control [exercise pressor responses and cardiovagal baroreflex sensitivity (cBRS)] were also evaluated. Pearson's correlations were used to determine potential relationships between sleep quality/regularity and CVD precursors. Both sleep irregularity variables [SE-SD (r = 0.61; P < 0.01) and TST-SD (r = 0.39; P = 0.04)], but neither of the sleep quality variables, were positively correlated with oxidative stress. TST-SD alone was significantly associated with lower brachial artery function (r = -0.44; P = 0.02) and cBRS (r = 0.43; P = 0.02), with TST-SD median splits further highlighting these differences. The study found that irregular TST in individuals with chronic anxiety was significantly associated with higher oxidative stress, lower brachial artery function, and blunted blood pressure control (lower cBRS), key precursors of CVD.NEW & NOTEWORTHY This study examined the relationship between sleep irregularity and early cardiovascular disease (CVD) precursors in young adults with chronic anxiety. Key findings revealed that irregular total sleep time, rather than overall sleep quality, was significantly associated with greater oxidative stress, lower brachial artery function, and diminished blood pressure control. These results suggest that sleep irregularity in individuals with chronic anxiety may play a critical role in the development of CVD in this population.

A Review of the Monitoring Techniques Used to Detect Oestrus in Sows

The agricultural industries have embraced the use of technologies as they improve efficiency and food security. The pork industry is no exception to this, as monitoring techniques and artificial intelligence allow for unprecedented capacity to track the physiological and behavioural condition of individual animals. This article reviews a range of those technologies in reference to the detection of oestrus in sows, a time when the ability to precisely ascertain physiological and behavioural changes associated with fluctuating hormone levels can have an immense impact on the economic profitability of the farm. The strengths and weaknesses of each technique from a practical application perspective are discussed, followed by considerations for further research and refinement.

The German version of the Pregnancy Physical Activity Questionnaire: a translation, cross-cultural adaptation, reliability and validity assessment

BACKGROUND

Validated and internationally standardised measurement instruments are a prerequisite for ensuring that physical activity during pregnancy is comparable and for deriving physical activity recommendations. In Germany, there has been no adapted version of the internationally used Pregnancy Physical Activity Questionnaire (PPAQ) until now. This study's aim centred around translating the original English version into German (PPAQ-G) and determining its reliability as well as validity in a German population.

METHODS

The PPAQ was translated into German using the forward-backwards technique. Its reliability and validity were tested. Thirty-four correctly completed questionnaires were analysed. The test-retest reliability was presented using the intraclass correlation coefficient (ICC) and Spearman correlation coefficient. Validity was tested by using accelerometer (n = 23) and determined by Spearman correlation coefficient.

RESULTS

In the transcultural adjustment, two questions were amended to describe intensity more precisely, and two other questions were adapted to reflect the units of measurement used in Germany. The ICC indicated a reliability of r = 0.79 for total activity (without sitting), and the intensity subcategories ranged from r = 0.70 (moderate-intensity activities) to r = 0.90 (sitting). Although, validity assessment showed no significant correlation for sedentary, moderate or vigorous intensity, there were significant correlations for total activity (light and above; r = 0.49; p < 0.05) and for light activity (r = 0.65; p < 0.01).

CONCLUSIONS

The PPAQ-G showed good reliability for use on pregnant German women and a moderately accurate measurement of physical activity. It can be used nationally for epidemiological studies, and it also enables international comparisons of physical activity during pregnancy.

TRIAL REGISTRATION

DRKS00023426; Registration date 20 May 2021.

Differences among physical activity actigraphy algorithms in three chronic illness populations

OBJECTIVES

In three chronic illness populations and in a combined sample, we assessed differences in two algorithms to determine wear time (WT%) and four algorithms to determine: Kilocalories, light physical activity (PA), moderate-to-vigorous PA (MVPA), and metabolic equivalents (METs).

METHODS

Data were collected from 29 people living with HIV (PLHIV), 27 participants recovering from a cardiac event, and 15 participants with hypertension (HTN). Participants wore the ActiGraphTM wGT3X-BT for > 3 days on their hip. Analysis of variance (ANOVA) was used to assess differences among the algorithms.

RESULTS

No differences were found between the two algorithms to assess WT% or among the four algorithms to assess kilocalories in each of the chronic illness populations or in the combined sample. Significant differences were found among the four algorithms for light PA (p < .001) and METs (p < .001) in each chronic illness population and in the combined sample. MVPA was significantly different among the four algorithms in the PLHIV (p = .007) and in the combined sample (p < .001), but not in the cardiac (p = .064) or HTN samples (p = .200).

DISCUSSION

Our findings indicate that the choice of algorithm does make a difference in PA determination. Differences in algorithms should be considered when comparing PA across different chronic illness populations.

Feasibility and preliminary efficacy of a novel web-based physical activity intervention in adults with overweight/obesity: A pilot randomized controlled trial

BACKGROUND

Only 14% of adults with obesity attain federal guidelines for physical activity (PA), but few interventions address obesity-specific barriers to PA. We designed the web-based Physical Activity for The Heart (PATH) intervention to address this gap.

PURPOSE

Test the feasibility and preliminary efficacy of PATH for promoting PA and reducing cardiovascular disease (CVD) risk in adults with overweight/obesity.

METHODS

In a 12-week pilot RCT, participants were randomized to PATH (n = 41) or wait-list control (n = 41) groups. Treatment group received access to PATH and met twice/month with a remote coach. The control group received a self-help PA guide and newsletters on general health. Moderate-to-vigorous PA (MVPA) was assessed via Actigraph-GT3X, steps via Fitbit Charge 2™, weight via smart scale, blood pressure (BP) via Omron BP device, and lipids/HbAIC via dry blood spot. Linear mixed modeling examined between- and within-group differences in PA and CVD risk.

RESULTS

The sample (N = 82) was on average 55.9 ± 8.2 years old; mean BMI 35.5 ± 6.2 kg/m2; 57.3% white and 80.5% female. Recruitment lasted 6-months, and 12-week retention was 96.3%. Treatment group accessed PATH ≥twice/week (92.1%), spent ≥10 min/visit (89.5%) and thought the site was culturally appropriate (79%). At 12 wks, the PATH group had greater mean changes in weekly MVPA (+58.9 vs. +0.9 min, p = .024) and daily steps (+1246.4 vs. -64.2 steps, p = .002) compared to the control group. Also, the PATH group improved in weight, BMI, body fat, waist circumference, and BP (p < .05).

CONCLUSION

The PATH intervention is feasible/acceptable and demonstrated preliminary efficacy for promoting PA among adults with overweight/obesity.

The dilemma of physical activity questionnaires: Fitter people are less prone to over reporting

Physical activity questionnaires (PAQs) are a popular method of monitoring physical activity, although their validity is usually low. Descriptions of physical activity levels in questionnaires usually rely on physical responses to physical activity. Therefore, we hypothesised that the validity of PAQs would be higher in the more physically fit group of participants. To test this, we conducted a validation study with 179 adults whom we divided into three fitness groups based on their cardiovascular fitness and age. Participants were measured for one week using the UKK RM42 accelerometer and self-reported their physical activity using IPAQ-SF, GPAQ, and EHIS-PAQ. We analysed the differences between fitness groups in terms of validity for each PAQ using ANOVA. We also performed an equivalence testing to compare the data obtained with the PAQs and the accelerometers. The results showed a significant trend toward higher validity for moderate to vigorous physical activity from the low to high fitness group as assessed by GPAQ and IPAQ-SF (low, intermediate and high fitness group: 0.06-0.21; 0.26-0.29; 0.40, respectively). The equivalence testing showed that all fitness groups overestimated their physical activity and underestimated their sedentary behaviour, with the high fitness group overestimating their physical activity the least. However, EHIS-PAQ was found to agree best with accelerometer data in assessing moderate to vigorous physical activity, regardless of fitness group, and had a validity greater than 0.4 for all fitness groups. In conclusion, we confirmed that when using PAQs describing physical responses to physical activity, participants' fitness should be considered in the interpretation, especially when comparing results internationally.

Validation of the 24-hour perceived exertion recall survey (PERS) in women in rural Tigray, Ethiopia

Background

Physical activity affects nutritional status and health. Currently, there are few validated survey tools for estimating physical activity in rural areas of low-income countries, including Ethiopia, which limits the ability of researchers to assess how physical activity affects nutritional status.

Objectives

This study used accelerometry to validate 2 in-person questionnaires, the global physical activity questionnaire (GPAQ) and the 24-h perceived exertion recall survey (PERS).

Methods

This study recruited 180 women aged between 18 and 45 y living in rural Tigray, Ethiopia. Participants had previously participated in an impact evaluation of a public work safety net. They wore an accelerometer for 8 d and responded to perceived exertion questionnaires twice. Data were collected on 89 women during the short rainy period and 91 women during the main rainy season. A survey method was considered valid if the proportion of time spent in moderate or vigorous physical activity (MVPA) levels had a Pearson's correlation coefficient of >0.40 to the proportion of time spent in MVPA recorded by accelerometry.

Results

The GPAQ had high reliability, but the overall validity was poorer than accelerometry. The proportion of time spent in MVPA according to the accelerometer was associated with discordance between GPAQ and accelerometry. MVPA levels, as measured by the 24-h PERS, had a fair agreement with accelerometry. The agreement increased to moderate/acceptable when adjusted for season and BMI.

Conclusions

The 24-h PERS is a valid tool for estimating the physical activity of women living in rural highland Ethiopia. It can be used in future research to understand the physical activity demands of living in rural highland Ethiopia, enabling more targeted programs to address undernutrition.

Accelerometer-Based Physical Activity Assessment During Intermittent Conditions: Effect of Epoch Length on Energy Expenditure Estimate

Purpose: This study analyzed the effect of epoch length on energy expenditure (EE) estimates and on the moderate-to-vigorous physical activity (MVPA) measure obtained from EE estimates during accelerometer-based assessment. Methods: Ten active students exercised on a treadmill for four 5-min bouts, using two effort intensities (running and walking) and two physical activity (PA) patterns (continuous or intermittent) wearing an accelerometer. The criterion measure of EE was achieved using indirect calorimetry. Data obtained from the accelerometer were reintegrated into 1-sec, 10-sec, 30-sec and 60-sec epochs. Results: During the running intermittent condition, EE and MVPA estimates from the accelerometer were no different from the criterion measure with 30- and 60-sec epoch lengths but they were different with shorter epoch lengths. During the walking intermittent condition, no difference was observed between EE estimates and the criterion measure, regardless of the epoch length. During the running continuous condition, EE estimated from the accelerometer was significantly lower than the EE obtained with the criterion measure, regardless of the epoch length. During the walking continuous condition, no difference was observed. Conclusion: During the intermittent running condition, longer epoch lengths gave the best EE and MVPA estimates. This conclusion is contrary to the current general view that shorter epochs are the most accurate for PA assessment. However, PA estimates are closer to an external load estimates whereas EE estimates are closer to the internal load estimate. Depending on the objective of their study, researchers should be aware of these findings.

Nine-axis inertial measurement unit output discriminates activities of varying intensity in the dog

OBJECTIVE

To explore relationships between 9-axis inertial measurement unit (IMU) output and activities of varying intensity in dogs of various sizes.

ANIMALS

20 healthy, agility course-trained dogs of various ages and sizes.

PROCEDURES

Height, weight, body condition score, age, length from IMU to the ischium, and height of IMU to the floor were recorded. Dogs performed a series of activities (rest, walk, trot, and agility course) while wearing the IMU device. IMU and video output were reviewed by independent investigators. Correlations and multiple regression models were used to explore relationships between independent variables and IMU output.

RESULTS

Calibration demonstrated excellent correlation and concordance between IMUs (intraclass correlation > 0.9) and that the IMUs reliably measured a known acceleration (gravity at rest). Resultant vector magnitude {sqrt[(x^2) + (y^2) + (z^2)]} normalized to body size was calculated from the data. IMU output clearly discriminates between activities of varying intensity in the dog.

CLINICAL RELEVANCE

The inability to accurately measure chronic pain is a barrier to the development of new, or critical evaluation of, therapeutics. Activity monitors (AM) may be the ideal diagnostic target since they are small and provide objective data that can be collected while the pet remains in its natural environment. These results demonstrate the concurrent and predictive validity of the IMU tested. Our long-range goal is to validate an open-source algorithm for the IMU so activity in a pet's natural environment can be used as an outcome measure in future studies.

A Multi-Label Based Physical Activity Recognition via Cascade Classifier

Physical activity recognition is a field that infers human activities used in machine learning techniques through wearable devices and embedded inertial sensors of smartphones. It has gained much research significance and promising prospects in the fields of medical rehabilitation and fitness management. Generally, datasets with different wearable sensors and activity labels are used to train machine learning models, and most research has achieved satisfactory performance for these datasets. However, most of the methods are incapable of recognizing the complex physical activity of free living. To address the issue, we propose a cascade classifier structure for sensor-based physical activity recognition from a multi-dimensional perspective, with two types of labels that work together to represent an exact type of activity. This approach employed the cascade classifier structure based on a multi-label system (Cascade Classifier on Multi-label, CCM). The labels reflecting the activity intensity would be classified first. Then, the data flow is divided into the corresponding activity type classifier according to the output of the pre-layer prediction. The dataset of 110 participants has been collected for the experiment on PA recognition. Compared with the typical machine learning algorithms of Random Forest (RF), Sequential Minimal Optimization (SMO) and K Nearest Neighbors (KNN), the proposed method greatly improves the overall recognition accuracy of ten physical activities. The results show that the RF-CCM classifier has achieved 93.94% higher accuracy than the 87.93% obtained from the non-CCM system, which could obtain better generalization performance. The comparison results reveal that the novel CCM system proposed is more effective and stable in physical activity recognition than the conventional classification methods.

Comparison of the Portuguese Version of the Pregnancy Physical Activity Questionnaire (PPAQ) with Accelerometry for Classifying Physical Activity among Pregnant Women with Obesity

In recent years, the number of pregnant women with obesity has increased exponentially; thus, it is important to evaluate and characterize the physical activity levels of this specific group. The aim of this study is to evaluate the reliability and validity of the Portuguese version of the Physical Activity and Pregnancy Questionnaire and Pregnancy Questionnaire in pregnant women with obesity and to classify physical activity using the Physical Activity and Pregnancy Questionnaire and accelerometry. An analytical observational study was carried out between May and August of 2019 at the University Hospital Center of São João, with a sample of 31 pregnant women with obesity (30.9 ± 4.6 years 36.5 ± 4.6 kg/m2 of BMI and 21.5 ± 9 gestational weeks). The physical activity of participants was evaluated using an accelerometer and Physical Activity and Pregnancy Questionnaire at two time points (the first visit at the moment of consultation and the second seven days after, with accelerometer retest), the interclass correlation coefficient was used to test reliability between the Physical Activity and Pregnancy Questionnaire filled out at visit1 and the Physical Activity and Pregnancy Questionnaire filled out at visit2, and Pearson's correlation was used to determine validity between the Physical Activity and Pregnancy Questionnaire and accelerometry. The interclass correlation coefficient values for total activity were 0.95, 0.97 for moderate and 0.58 for vigorous intensities. It ranged from 0.74 for sports/exercise to 0.96 for domestic activities. The Pearson's correlations showed that the Physical Activity and Pregnancy Questionnaire is moderately valid for moderate intensity (r = 0.435). A total of 67.7% of the pregnant women complied with international physical activity recommendations.

High daily energy expenditure of Tuvan nomadic pastoralists living in an extreme cold environment

Research investigating thermoregulatory energy costs in free-living humans is limited. We determined the total energy expenditure (TEE) of Tuvan pastoralists living in an extreme cold environment and explored the contribution of physical activity and cold-induced thermogenesis. Twelve semi-nomadic pastoralists (47 ± 8 years, 64 ± 8 kg) living under traditional circumstances, in Tuva, south-central Siberia, Russia, were observed during two consecutive 6-day periods in winter. TEE was measured via the doubly labelled water technique. Skin and ambient temperatures, and physical activity were continuously monitored. The outdoor temperature during the observation period was - 27.4 ± 5.4 °C. During the daytime, the participants were exposed to ambient temperatures below 0 °C for 297 ± 131 min/day. The Tuvan pastoralists were more physically active compared to western populations (609 ± 90 min/day of light, moderate, and vigorous physical activity). In addition, TEE was 13.49 ± 1.33 MJ/day (3224 ± 318 kcal/day), which was significantly larger by 17% and 31% than predicted by body mass, and fat-free mass, respectively. Our research suggests the daily cold exposure combined with high levels of physical activity contributed to the elevated TEE. Future research should reconsider the assumption that energy costs due to thermoregulation are negligible in free-living humans.

Criterion validity of ActiGraph monitoring devices for step counting and distance measurement in adults and older adults: a systematic review

BACKGROUND

Wearable activity monitors such as ActiGraph monitoring devices are widely used, especially in research settings. Various research studies have assessed the criterion validity of ActiGraph devices for step counting and distance estimation in adults and older adults. Although several studies have used the ActiGraph devices as a reference system for activity monitoring, there is no summarized evidence of the psychometric properties. The main objective of this systematic review was to summarize evidence related to the criterion validity of ActiGraph monitoring devices for step counting and distance estimation in adults and/or older adults.

METHODS

Literature searches were conducted in six databases (Medline (OVID), Embase, IEEExplore, CINAHL, Engineering Village and Web of Science). Two reviewers independently conducted selection, a quality analysis of articles (using COSMIN and MacDermid's grids) and data extraction.

RESULTS

This review included 21 studies involving 637 participants (age 30.3 ± 7.5 years (for adults) and 82.7 ± 3.3 years (for older adults)). Five ActiGraph devices (7164, GT1M, wGTX +, GT3X +/wGT3X + and wGT3X - BT) were used to collect data at the hip, wrist and ankle to assess various walking and running speeds (ranging from 0.2 m/s to 4.44 m/s) over durations of 2 min to 3 days (13 h 30 mins per day) for step counting and distance estimation. The ActiGraph GT3X +/wGT3X + and wGT3X - BT had better criterion validity than the ActiGraph 7164, wGTX + and GT1M according to walking and running speeds for step counting. Validity of ActiGraph wGT3X + was good for distance estimation.

CONCLUSION

The ActiGraph wGT3X - BT and GT3X +/wGT3X + have good criterion validity for step counting, under certain conditions related to walking speeds, positioning and data processing.

Reliability of the accelerometer to control the effects of physical activity in older adults

Background

Reliable physical activity measurements in community-dwelling older adults are important to determine effects of targeted health promotion interventions. Many exercise interventions aim to improve time spent sedentary (SED), in light-intensity-physical-activity (LPA) and moderate-to-vigorous-intensity-physical-activity (MVPA), since these parameters have independently proposed associations with health and longevity. However, many previous studies rely on self-reports which have lower validity compared to accelerometer measured physical activity patterns. In addition, separating intervention-effects from reactivity measurements requires sufficient test-retest reliability for accelerometer assessments, which is lacking in older adults.

Objectives

The study objective was to investigate the reliability of sensor-based PA-patterns in community-dwelling older adults. Furthermore, to investigate change over time of physical activity patterns and examine any compensatory-effect from the eight-week supervised exercise-intervention.

Methods

An exercise-group (n = 78, age-range:65-91yrs) performed two 1h-exercise sessions/week during eight-weeks. PA-pattern was assessed (using hip-worn accelerometers), twice before and once during the last-week of the intervention. A control-group (n = 43, age-range:65-88yrs) performed one pre-test and the end-test with no exercise-intervention. A dependent-t-test, mean-difference (95%-CI), limits-of-agreement and intraclass-correlation-coefficient-ICC were used between the two pre-tests. Repeated-measures-ANOVA were used to analyze any intervention-effects.

Results

The exercise-groups´ two pre-tests showed generally no systematic change in any PA- or SED-parameter (ICC ranged 0.75–0.90). Compared to the control group, the exercise intervention significantly (time x group-interaction, p<0.05) increased total-PA-cpm (exercise-group/control-group +17%/+7%) and MVPA-min/week (+41/-2min) and decreased %-of-wear-time for SED-total (-4.7%/-2.7%) and SED-bouts (-5.7%/-1.8%), and SED-bouts min/d (-46/-16min). At baseline level, no significant differences were found between the two groups for any parameter.

Conclusions

The current study presents a good test-retest-reliability of sensor-based-one-week-assessed-PA-pattern in older-adults. Participating in an 8-week supervised exercise intervention improved some physical activity and sedentary parameters compared to the control group. No compensatory-effect was noted in the intervention-group i.e., no decrease in any PA-parameter or increase in SED at End-test (in %-of-wear-time, min/day or total-PA).

Changes in physical activity across a 6-month weight loss intervention in adolescents with intellectual and developmental disabilities

BACKGROUND

Adolescents and young adults with intellectual and developmental disabilities (IDD) have high rates of obesity and low levels of physical activity. This analysis examined changes in light, moderate-to-vigorous physical activity (MVPA) and sedentary time, and the association between changes in MVPA and weight loss in adolescents and young adults with IDD and overweight and obesity participating in a 6-month multi-component weight loss intervention.

METHODS

Adolescents and young adults with IDD and overweight or obesity (body mass index ≥ 85 percentile, n = 110, age ~16 years, 52.7% female) and a parent were randomised to one of three intervention groups: face-to-face delivery/conventional reduced energy diet (n = 36), remote delivery (RD)/conventional reduced energy diet (n = 39), or RD/reduced energy enhanced stop light diet (eSLD) (n = 35.) Participants were asked to engage in 60 min/day of MVPA on 5 or more days/wk. Participants and a parent attended twice monthly education/behavioural counselling sessions with a health educator to assist participants in complying with dietary and MVPA recommendations. Education/counselling in the RD arms was delivered remotely using video conferencing, and self-monitoring of MVPA and daily steps was completed using a wireless activity tracker. Education/counselling in the face-to-face arm was delivered during home-visits and self-monitoring of MVPA and daily steps was completed by self-report using paper tracking forms designed for individuals with IDD. MVPA, light activity, and sedentary time were assessed over 7 days at baseline and 6 months using a portable accelerometer (ActiGraph wGT3x-BT).

RESULTS

Mixed modelling analysis completed using participants with valid accelerometer data (i.e. ≥4-10 h days) at baseline (n = 68) and 6 months (n = 30) revealed no significant changes in light, moderate- MVPA, or sedentary time across the 6-month intervention (all P > 0.05). Participants obtained 15.2 ± 21.5 min/day of MVPA at baseline and 19.7 ± 19.7 min/day at 6 months (P = 0.119). Mixed modelling indicated no significant effects of group (P = 0.79), time (P = 0.10), or group-by-time interaction (P = 0.21) on changes in MVPA from baseline to 6 months. Correlational analysis conducted on participants with valid accelerometer data at both baseline and 6 months (n = 24) revealed no significant associations between baseline sedentary time (r = 0.10, P = 0.40) and baseline MVPA (r = -0.22, P = 0.30) and change in MVPA across the 6-month intervention. Additionally, attendance at education/counselling sessions (r = 0.26, P = 0.22) and frequency of self-monitoring of MVPA were not significantly associated with change in MVPA from baseline to 6 months (r = 0.26, P = 0.44). Baseline MVPA (r = 0.02, P = 0.92) and change in MVPA from baseline to 6 months (r = 0.13, P = 0.30) were not associated with changes in body weight across the 6-month intervention.

CONCLUSION

We observed a non-significant increase in MVPA (30%), which was not associated with the magnitude of weight loss in a sample of adolescents and young adults with IDD who participated in a 6-month multi-component weight loss intervention. Additional strategies to increase MVPA in adolescents and young adults with IDD participating in weight loss interventions need to be developed and evaluated.

Sensor technology in eating disorders research: A systematic review

OBJECTIVE

Sensor technologies offer exciting potential to objectively measure psychopathological correlates of eating pathology and eating disorder (ED) research utilizing sensors has rapidly proliferated in the past several years. The aims of the present review are: (1) characterize the types of sensors that have been utilized in ED research, (2) identify the psychopathological factors relevant to EDs that have been assessed using sensors, (3) describe the data supporting the validity and reliability of these sensors, (4) discuss limitations associated with these sensors, and (5) identify gaps that persist within the ED literature with regard to use of sensor technologies.

METHOD

A systematic search was conducted of PubMed, PsycINFO, Web of Science, ProQuest, and "gray" literature sources. Eligible publications were empirical studies that utilized sensors to measure at least one psychological variable among clinical ED populations.

RESULTS

Sensors have been utilized with ED samples to measure eating behaviors, physical activity, sleep, autonomic nervous system activity, eyeblink startle response, visual attention, and visual-haptic object integration. The reliability and validity of these sensors varies widely and there are a number of significant gaps that remain in the literature with regard to the types of sensors utilized, context in which sensors have been used, and populations studied.

DISCUSSION

The existing literature utilizing sensors within ED research largely support the feasibility and acceptability of these tools. Sensors should continue to be utilized within the field, with a specific focus on examining the reliability and validity of these tools within ED samples and increasing the diversity of samples studied.

PUBLIC SIGNIFICANCE STATEMENT

Sensor technologies, such as those included in modern smartwatches, offer new opportunities to measure factors that may maintain or contribute to symptoms of eating disorders. This article describes the types of sensors that have been used in eating disorders research, challenges that may arise in using these sensors, and discusses new applications of these sensors that may be pursued in future research.

BAILA: A Randomized Controlled Trial of Latin Dancing to Increase Physical Activity in Spanish-Speaking Older Latinos

BACKGROUND

Latinos are the fastest growing minority group of the older adult population. Although physical activity (PA) has documented health benefits, older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance, popular among Latinos, holds promise as a culturally relevant form of PA.

PURPOSE

To describe self-reported and device-assessed changes in PA as a result of a randomized controlled trial of BAILAMOS, a 4-month Latin dance program with a 4-month maintenance program, versus a health education control group.

METHODS

Adults, aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels at baseline, and risk for disability were randomized to the dance program (n = 167) or health education condition (n = 166). Data were analyzed using multilevel modeling with full information maximum likelihood.

RESULTS

A series of multilevel models revealed significant time × group interaction effects for moderate-to-vigorous physical activity (MVPA), dance PA, leisure PA, and total PA. Exploring the interaction revealed the dance group to significantly increase their MVPA, dance PA, leisure PA, and total PA at months 4 and 8. Household PA and activity counts from accelerometry data did not demonstrate significant interaction effects.

CONCLUSIONS

The study supports organized Latin dance programs to be efficacious in promoting self-reported PA among older Latinos. Efforts are needed to make dancing programs available and accessible, and to find ways for older Latinos to add more PA to their daily lives.

CLINICAL TRIAL INFORMATION

NCT01988233.

The Cut-Off Value for Classifying Active Italian Children Using the Corresponding National Version of the Physical Activity Questionnaire

The present study aimed to determine a cut-off value following the filling in of a questionnaire (PAQ-C-It) to identify active Italian children. One-hundred-twenty-nine primary school children (5 Piedmont schools; 47.3% female; mean age = 10 ± 1 years) wore an accelerometer (Actigraph wGT3X-BT) to objectively quantify individual moderate-to-vigorous physical activity during one week. Afterwards, the PAQ-C-It was filled in by participants. A ROC curve procedure was applied to obtain an active/non-active cut-off point. Spearman’s correlation coefficient was also applied to establish the relationship between the two parameters. According to the ROC analysis, the PAQ-C-It cut-off point value is identifiable at >2.75 to indicate active children (area under the curve = 0.62; standard error = 0.05; p = 0.025; coefficient intervals = 0.518−0.716; sensitivity = 0.592, specificity = 0.382), determining that 65 participants (55%) were non-active (mean PAQ-C-It value = 2.3 ± 0.4; active mean PAQ-C-It value = 3.3 ± 0.4). Spearman’s correlation coefficient results were significant but with a small effect size (rho = 0.214; p = 0.008). In conclusion, the present results suggest that the PAQ-C-It can be cautiously used as tool to practically classify active Italian children because of a non-solid relationship between respective accelerometer data and MVPA daily data.

Energy Requirements and Nutritional Strategies for Male Soccer Players: A Review and Suggestions for Practice

Soccer is a high intensity intermittent sport, featuring critical events completed at high/maximal intensity which is superimposed onto an aerobic base of lower intensity activities and rest. Due to these varying energic demands and the duration of competition the need for optimal nutritional strategies to offset and delay fatigue are paramount. Over the last 50 years, several investigations have been reported on aspects of soccer be they nutrition-focused or those concerning the demands of the sport. Emanating from these scientific papers, observations have been made on the likely factors which result in the fatigue during match-play. Factors such as muscle glycogen depletion and hypoglycaemia are discussed. Studies on the energy demands of soccer have employed a variety of methodologies which are briefly reviewed and vary between the use of heart rate telemetry to the use of global positioning systems (GPS). Moving on from observations of the energy demands of the sport leads to the major focus of this review which highlights key nutritional strategies to support the preparation and recovery of male soccer players to enhance performance, or at least to enable players to perform adequately. This review examines relevant methodologies in assessing training and competitive energy costs as well as the concomitant energy intakes demanded for successful performance outcomes. In order to bring an applied aspect to the overall findings from areas discussed, some practical ideas of feeding strategies are presented.

Do Fitter Children Better Assess Their Physical Activity with Questionnaire Than Less Fit Children?

Most physical activity (PA) questionnaires assess moderate to vigorous PA (MVPA) describing the physical exertion of individuals that might be influenced by their physical fitness. Therefore, the aim of this study was to determine whether fitter children could better assess their PA with the questionnaire than less fit children. The cross-sectional validation study was conducted with 108 children (60 girls) aged 11 to 14 years, who were divided into three fitness groups based on the results of the 600 m running test. To answer the research question, the agreement between their assessment of PA using the SHAPES questionnaire and the UKK RM42 accelerometer data was analysed. One quarter of the participants achieved at least 60 min of MVPA each day, measured by accelerometer. The average MVPA obtained was 97.8 ± 35.6 min per day, with the high fitness group having a significantly higher value compared with the other groups. Moderate to high validity coefficients were found in the high fitness group (Spearman’s ρ range 0.34–0.70). In contrast, the lower fitness groups had poor to moderate validity for all variables (Spearman’s ρ range 0.03–0.42). These results suggest that the fittest children self-assess their PA with the questionnaire better than less fit children, which may advance new directions for the development and evaluation of PA questionnaires and their usability.

Reliability and Validity of Slovenian Versions of IPAQ-SF, GPAQ, and EHIS-PAQ for Assessing Physical Activity and Sedentarism of Adults

Health policies rely on physical activity (PA) and sedentary behavior data collected through PA questionnaires (PAQs). Validity of international PAQs varies among countries. Therefore, it is important to know the validity of the national versions of the PAQs to properly evaluate the results. We conducted a validation study of the Slovenian versions of the International PAQ Short Form (IPAQ-SF), the Global PAQ (GPAQ), and the PAQ used in the European Health Interview Survey (EHIS-PAQ) on 306 healthy adults. The most valid and reliable constructs in all tested were sedentary behavior and vigorous PA (VPA), however the criterion validity of these constructs was low (Spearman's ρ 0.38-0.45 for sedentary behavior and 0.34-0.42 for VPA). Moderate to vigorous PA (MVPA) had low validity (0.26-0.29) despite being used as a standard measure of PA behavior. Participants over-reported MVPA for 17 to 156 min and underreported the sedentary behavior for more than two hours. The test-retest study found high reliability for sedentary behavior (0.69-0.81) and low to moderate reliability for PA behavior (0.42-0.76). The Slovenian versions of the observed PAQs are a useful tool for national PA surveillance, but for qualitative assessment of individual health-related PA behavior they should be combined with accelerometer-based devices.

The effects of supervision on three different exercises modalities (supervised vs. home vs. supervised+home) in older adults: Randomized controlled trial protocol

BACKGROUND

Multicomponent physical exercise programs are a viable strategy for treating physical decline resulting from the aging process in older populations and can be applied in supervised and home-based modalities. However, the magnitude of the intervention effects in terms of physical function development may vary according to the modalities application due to different supervision degrees.

OBJECTIVE

This study aims to compare the effects of supervision in a multicomponent exercise program in different application modalities (supervised vs. home vs. supervised+home) in neuromuscular adaptations, muscle strength, gait, physical function, and quality of life, analyzing the differences between intensity, volume, and density of home and supervised sessions in community older adults.

METHODS

This protocol is a randomized controlled clinical trial with a sample of 66 older adults divided into three groups: supervised exercise (SUP = 22), home-based exercise (HB = 22), and supervised plus home-based exercise (SUP+HB = 22). The multicomponent exercise program will last 12 weeks, three times per week, for 60 min per session and include warm-up, balance, muscle-strengthening, gait, and flexibility exercises. The study's primary outcomes will be neuromuscular function, composed of the assessment of muscle isokinetic strength, muscle architecture, and neuromuscular electrical activation. The secondary outcome will be physical function, usual and maximum gait speed with and without dual-task, and quality of life. All outcomes will be assessed at baseline and post-intervention (week 12).

CONCLUSION

This study will be the first clinical trial to examine the effects of different supervision levels on home-based exercises compared to supervised protocols. The results of this study will be essentials for planning coherent and viable home-based programs for older adults.

TRIAL REGISTRATION

Brazilian Registry of Clinical Trials. Number RBR- 7MZ2KR. https://apps.who.int/trialsearch/Trial2.aspx?TrialID=RBR-7mz2kr.

Using Kinect body joint detection system to predict energy expenditures during physical activities

The purpose of this study was to explore the potential of Kinect body joint detection to facilitate the calculation of energy expenditure during exergame exercises. Two Kinect-based biomechanical models - mechanical energy (KineticE) and work (WorkE) were employed to estimate the energy expenditure during four Wii™ exergame session. Consequently, two stepwise regression models were developed from nineteen participants' data and then validated by five holdout participants. The data collected using an accelerometer (r = 0.835, p < 0.001) had the highest correlation as compared to that of the WorkE (r = 0.805, p < 0.001) and KineticE (r = 0.466, p < 0.001) correlations with the reference indirect calorimetry using Quark activity energy expenditure (QuarkAEE). The regression results show that KineticE and the weight of the participant were significant factors for mechanical energy prediction (AEEKinetic). However, according to the work prediction equation (AEEWork), only WorkE was significant. The new energy prediction models showed significant agreement with the standard QuarkAEE (AEEKinect, r = 0.641, p = 0.02; AEEWork, r = 0.793, p < 0.001), and they were comparable to accelerometer predictions (r = 0.682, p = 0.001). The findings indicate that Kinect can be a potentially viable alternative to measure energy expenditures. The models can be applied with higher accuracy, especially when the activity demands high body movements.

Personalised Accelerometer Cut-point Prediction for Older Adults' Movement Behaviours using a Machine Learning approach

BACKGROUND AND OBJECTIVES

Body-worn accelerometers are the most popular method for objectively assessing physical activity in older adults. Many studies have developed generic accelerometer cut-points for defining activity intensity in metabolic equivalents for older adults. However, methodological diversity in current studies has led to a great deal of variation in the resulting cut-points, even when using data from the same accelerometer. In addition, the generic cut-point approach assumes that 'one size fits all' which is rarely the case in real life. This study proposes a machine learning method for personalising activity intensity cut-points for older adults.

METHODS

Firstly, raw accelerometry data was collected from 33 older adults who performed set activities whilst wearing two accelerometer devices: GENEActive (wrist worn) and ActiGraph (hip worn). ROC analysis was applied to generate personalised cut-point for each data sample based on a device. Four cut-points have been considered: Sensitivity optimised Sedentary Behaviour; Specificity optimised Moderate to Vigorous Physical Activity; Youden optimised Sedentary Behaviour; and Youden optimised Moderate to Vigorous Physical Activity. Then, an additive regression algorithm trained on biodata features, that concern the individual characteristics of participants, was used to predict the cut-points. As the model output is a numeric cut-point value (and not discrete), evaluation was based on two error metrics, Mean Absolute Error and Root Mean Square Error. Standard Error of estimation was also calculated to measure the accuracy of prediction (goodness of fit) and this was used for performance comparison between our approach and the state-of-the-art. Hold-out and 10-Fold cross validation methods were used for performance validation and comparison.

RESULTS

The results show that our personalised approach performed consistently better than the state-of-the-art with 10-Fold cross validation on all four cut-points considered for both devices. For the ActiGraph device, the Standard Error of estimation from our approach was lower by 0.33 (Youden optimised Sedentary Behaviour), 9.50 (Sensitivity optimised Sedentary Behaviour), 0.64 (Youden optimised Moderate to Vigorous Physical Activity) and 22.11 (Specificity optimised Moderate to Vigorous Physical Activity). Likewise, the Standard Error of estimation from our approach was lower for the GENEActiv device by 2.29 (Youden optimised Sedentary Behaviour), 41.65 (Sensitivity optimised Sedentary Behaviour), 4.31 (Youden optimised Moderate to Vigorous Physical Activity) and 347.15 (Specificity optimised Moderate to Vigorous Physical Activity).

CONCLUSIONS

personalised cut-point can be predicted without prior knowledge of accelerometry data. The results are very promising especially when we consider that our method predicts cut-points without prior knowledge of accelerometry data, unlike the state-of-the-art. More data is required to expand the scope of the experiments presented in this paper.

Estimating Total Energy Expenditure for Fire-Fighters during Large Scale Disaster Response Training Using a Tri-Axial Accelerometer

The present study was conducted to estimate total energy expenditure (TEE) of fire-fighters using tri axial-accelerometers in conjunction with an activity log survey on a large number of subjects undergoing training mimicking a large-scale disaster. Subjects were 240 fire-fighters participating in a two-day fire-fighting training dedicated to large-scale natural disasters. Data was analyzed by job type of activity group and the job rank, and by comparing the average. The average TEE of the total survey training period is about 3619 (±499) kcal, which is the same value of expenditure for professional athletes during the soccer game season. From the activity group, the rescue and other teams consumed significantly more energy than the fire and Emergency Medical Team (EMS) teams. From the job rank, Fire Captain (conducting position) consumed significantly lower energy than the Fire Lieutenant and Fire Sergeant. Furthermore, it was found that a middle position rank consumed the most energy. This research supports a need to reconsider the current rescue food (and protocols) to supplement the energy expenditure of fire-fighters. In addition, since there was a significant difference between the job type and the job rank, it is necessary to examine the energy amount and shape suitable for each.

Sensing leg movement enhances wearable monitoring of energy expenditure

Physical inactivity is the fourth leading cause of global mortality. Health organizations have requested a tool to objectively measure physical activity. Respirometry and doubly labeled water accurately estimate energy expenditure, but are infeasible for everyday use. Smartwatches are portable, but have significant errors. Existing wearable methods poorly estimate time-varying activity, which comprises 40% of daily steps. Here, we present a Wearable System that estimates metabolic energy expenditure in real-time during common steady-state and time-varying activities with substantially lower error than state-of-the-art methods. We perform experiments to select sensors, collect training data, and validate the Wearable System with new subjects and new conditions for walking, running, stair climbing, and biking. The Wearable System uses inertial measurement units worn on the shank and thigh as they distinguish lower-limb activity better than wrist or trunk kinematics and converge more quickly than physiological signals. When evaluated with a diverse group of new subjects, the Wearable System has a cumulative error of 13% across common activities, significantly less than 42% for a smartwatch and 44% for an activity-specific smartwatch. This approach enables accurate physical activity monitoring which could enable new energy balance systems for weight management or large-scale activity monitoring.

Are all MVPA minutes equal? Associations between MVPA characteristics, independent of duration, and childhood adiposity

BACKGROUND

The inverse relationship between moderate-to-vigorous physical activity (MVPA) duration and childhood adiposity is well established. Less is known about how characteristics of MVPA accumulation may be associated with adiposity, independent of MVPA duration. This study aimed to investigate how the MVPA characteristics of children, other than duration (bout length, time of day, day-to-day consistency, intensity), were associated with adiposity.

METHODS

Cross-sectional study of the Australian arm of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) (participants: n = 424, age range 9-11, 44% male). Adiposity was determined by percent body fat via bioelectrical impedance. MVPA duration and characteristics (bout length, time of day, consistency, intensity) were derived from 7-day, 24-h accelerometry. Generalised estimating equations were used to examine the individual and multivariate associations between MVPA characteristics and adiposity.

RESULTS

Univariate analyses showed that higher MVPA duration (β range = - 0.26,-0.15), longer bouts of MVPA (β range = 0.15,0.22) and higher MVPA intensity (β range = - 0.20,-0.13) were all inversely associated with adiposity (all p < 0.05). When models were adjusted for MVPA duration, only MVPA intensity (β range = - 0.16,-0.04) showed consistent significant associations with adiposity.

CONCLUSIONS

Characteristics of MVPA other than duration and intensity appear to be unrelated to adiposity.

Testing a tailored weight management program for veterans with PTSD: The MOVE! + UP randomized controlled trial

Post-traumatic stress disorder (PTSD), prevalent among Veterans, increases risk for having a high Body Mass Index. Although the Veterans Health Administration (VHA) offers an evidence-based behavioral weight management program called MOVE!, participants with PTSD lose less weight than those without mental health conditions, despite comparable participation. PTSD symptoms can interfere with one's ability to be physically active and maintain a healthy diet, the key targets in weight management programs. We developed and piloted a behavioral weight management program called MOVE! + UP that targets PTSD-related weight loss barriers. MOVE! + UP includes 16 group sessions with training in evidence-based weight management strategies, coupled with Cognitive Behavior Therapy (CBT) skills to address PTSD-specific barriers. The 16 sessions also include 30-min community walks to address PTSD-related barriers that may impede exercise. Two individual dietician sessions are provided. This hybrid type 1 randomized controlled trial (RCT) will compare MOVE! + UP to standard care-MOVE!-among 164 Veterans with BMI ≥ 25 who are receiving care for PTSD. We will randomize participants to MOVE! + UP or standard care and will compare absolute post-baseline change in weight at 6 (primary outcome) and 12 (secondary outcome) months, and PTSD symptom severity at 6 and 12 months (secondary outcome). Exploratory analyses will compare the treatment conditions on treatment targets measured at 6 months (e.g., physical activity, eating behavior, social support). Finally, we will estimate intervention costs, and identify MOVE! + UP implementation barriers and facilitators. If effective, MOVE! + UP could be an efficient way to simultaneously address physical and mental health for Veterans with PTSD.

Physical Activity during Weekdays and Weekends in Persons with Multiple Sclerosis

The assessment of the functional performance status of persons with multiple sclerosis (PwMS) is a useful tool to optimize healthcare. This concept does not seem to be extensively explored in this population. This study aimed to determine the level of activity of PwMS during weekdays and weekends, and to establish associations between clinical parameters. Forty-one PwMS and 16 healthy persons participated in this study. Their physical activity in real-life conditions was assessed with an accelerometer. For the clinical evaluations, the quality of life, fatigue, gait, and balance were assessed. The level of activity between PwMS for weekdays, weekends, Saturdays, and Sundays was significantly reduced compared with the reference group (p = 0.001-0.00001, d = 0.95-1.76). PwMS had a constant level of activity throughout the week, whereas the reference group increased its level of activity on Saturdays (p = 0.04, d = 0.69). The level of activity was correlated in descending order with multiple sclerosis disability, body mass index, gait velocity, six-minute walk test, and timed up and go test. This study showed that PwMS had a stable level of activity throughout the week, contrary to healthy persons. It could be necessary to develop programs to facilitate physical activity and participation during the weekdays, but especially during weekends.

Moderate-to-vigorous intensity physical activity trajectories during adolescence and young adulthood predict adiposity in young adulthood: The Iowa Bone Development Study

This study examined the associations of moderate-to-vigorous intensity physical activity (MVPA) trajectories in adolescence through young adulthood with adiposity in young adults. Participants from The Iowa Bone Development Study cohort were longitudinally assessed (N = 297; 57% female). Accelerometry-measured MVPA (min/day) at ages 15 through 23 years, and fat mass and visceral adipose tissue mass indices (kg/m2, g/m2) derived from dual-energy X-ray absorptiometry scans at age 23 years were analyzed. Latent trajectory analyses classified MVPA into two patterns. Multivariable linear regression analyses showed that being in the high MVPA trajectory group was associated with lower fat mass index z-scores. Individuals who were consistently active with high MVPA (vs. moderately active with decreasing MVPA) during adolescence up until early young adulthood had less accumulation of total body adiposity in young adulthood. This study suggests that adopting a consistently active lifestyle throughout adolescence can result in healthier body composition in young adulthood.

Reliability, Validity and Responsiveness of Physical Activity Monitors in Patients with Inflammatory Myopathy

OBJECTIVE

Idiopathic inflammatory myopathies (IIM) cause proximal muscle weakness, which affect activities of daily living. Wearable physical activity monitors (PAMs) objectively assess continuous activity with potential clinical usefulness in IIM assessment. We examined the psychometric characteristics for PAM outcomes in IIM.

METHODS

Adult IIM patients were prospectively evaluated (baseline, 3 and 6-months) in an observational study. A waist-worn PAM (ActiGraph GT3X-BT) assessed average step counts/min, peak 1-min cadence, and vector magnitude/min. Validated myositis core set measures (CSM) including manual muscle testing (MMT), physician global disease activity (MD global), patient global disease activity (Pt global), extra-muscular disease activity (Ex-muscular global), HAQ-DI, muscle enzymes, and patient-reported physical function were evaluated. Test-retest reliability, construct validity, and responsiveness were determined for PAM measures and CSM using Pearson correlations and other appropriate analyses.

RESULTS

50 adult IIM patients enrolled [mean (SD) age, 53.6 (±14.6); 60% female, 94% Caucasian]. PAM measures showed strong test-retest reliability, moderate-to-strong correlations at baseline with MD global (r=-0.37- -0.48), Pt-global (r=-0.43- -0.61), HAQ-DI (r=-0.47- -0.59) and MMT (r = 0.37-0.52), and strong discriminant validity for categorical MMT and HAQ-DI. Longitudinal association with MD global (r=-0.38- -0.44), MMT (r = 0.50-0.57), HAQ-DI (r=-0.45- -0.55), and functional tests (r = 0.30-0.65) were moderate-to-strong. PAM measures were responsive to MMT improvement (≥10%) and moderate-to-major improvement on ACR/EULAR myositis response criteria. Peak 1-min cadence had the largest effect size and Standardized Response Means (SRMs).

CONCLUSION

PAM measures showed promising construct validity, reliability, and longitudinal responsiveness; especially peak 1-min cadence. PAMs provide valid outcome measures for future use in IIM clinical trials.

Human walking in the real world: Interactions between terrain type, gait parameters, and energy expenditure

Humans often traverse real-world environments with a variety of surface irregularities and inconsistencies, which can disrupt steady gait and require additional effort. Such effects have, however, scarcely been demonstrated quantitatively, because few laboratory biomechanical measures apply outdoors. Walking can nevertheless be quantified by other means. In particular, the foot's trajectory in space can be reconstructed from foot-mounted inertial measurement units (IMUs), to yield measures of stride and associated variabilities. But it remains unknown whether such measures are related to metabolic energy expenditure. We therefore quantified the effect of five different outdoor terrains on foot motion (from IMUs) and net metabolic rate (from oxygen consumption) in healthy adults (N = 10; walking at 1.25 m/s). Energy expenditure increased significantly (P < 0.05) in the order Sidewalk, Dirt, Gravel, Grass, and Woodchips, with Woodchips about 27% costlier than Sidewalk. Terrain type also affected measures, particularly stride variability and virtual foot clearance (swing foot's lowest height above consecutive footfalls). In combination, such measures can also roughly predict metabolic cost (adjusted R2 = 0.52, partial least squares regression), and even discriminate between terrain types (10% reclassification error). Body-worn sensors can characterize how uneven terrain affects gait, gait variability, and metabolic cost in the real world.

Reliability and Convergent Validity of Self-Reported Physical Activity Questionnaires for People With Mental Disorders: A Systematic Review and Meta-Analysis

PURPOSE

To examine the reliability and convergent validity of self-reported questionnaires (SRQs) to measure physical activity (PA).

METHODS

Systematic review with meta-analysis. The validity and reliability of SRQs to assess PA in people with mental disorders (January 20, 2020). Random-effects meta-analyses were performed pooling (1) test-retest correlations or (2) the convergent validity between the SRQs and objective measures (eg, accelerometry). Associations were provided in r values with the 95% confidence interval. Methodological quality was assessed.

RESULTS

A total of 9 unique studies (N = 1344; 40.5% females) were included. The authors found a moderate correlation test-retest reliability for PA SRQs in the assessment of vigorous PA (r = .69 [.38 to .85]; P = .001), moderate to vigorous PA (r = .63 [.25 to .84]; P = .003), moderate PA (r = .63 [.39 to .79]; P = .001), and good correlation total PA (r = .75 [.37 to .92]; P = .001). The SRQs have moderate correlations with objective measures for moderate to vigorous PA (r = .25 [.18 to .32]; P = .0001) and total PA (r = .47 [.28 to .62]; P = .005), a poor correlation for moderate PA (r = .18 [.03 to .36]; P = .047), and no correlation with vigorous PA (r = .06 [-.10 to .22]; P = .440).

CONCLUSION

Current evidence indicates that SRQs are reliable over time to assess moderate, vigorous, and total PA levels and valid when assessing moderate PA.

Improving Energy Expenditure Estimation through Activity Classification and Walking Speed Estimation Using a Smartwatch

Energy expenditure (EE) estimation is an important factor in tracking personal activity and preventing chronic diseases, such as obesity and diabetes. The challenge is to provide accurate EE estimations in free-living environment through portable and unobtrusive devices. In this paper, we present an experimental study to estimate energy expenditure during sitting, standing and treadmill walking using a smartwatch. We introduce a novel methodology, which aims to improve the EE estimation by first separating sedentary (sitting and standing) and non-sedentary (walking) activities, followed by estimating the walking speeds and then calculating the energy expenditure using advanced machine learning based regression models. Ten young adults participated in the experimental trials. Our results showed that combining activity type and walking speed information with the acceleration counts substantially improved the accuracy of regression models for estimating EE. On average, the activity-based models provided 7% better EE estimation than the traditional acceleration-based models.

The promotion of physical activity for the prevention of Alzheimer's disease in adults with Down Syndrome: Rationale and design for a 12 Month randomized trial

Nearly all individuals with Down Syndrome (DS) display pathology associated with Alzheimer's disease (AD) beginning as early as age 30. Previous research in typically developed adults suggests that increased moderate-to-vigorous physical activity (MVPA) may improve cognitive function and protect against age-related structural and functional changes in the brain; however, the potential impact of increased MVPA on the development of AD in adults with DS has not been evaluated. Despite the potential positive impact of MVPA on cognition and AD risk, participation in MVPA among young adults with DS is low. The limited research evaluating strategies for increasing MVPA in adults with DS has been unsuccessful in increasing MVPA. Results from our preliminary investigation where we remotely delivered real-time MVPA, led by a trained health educator, to groups of adults with DS in their homes via video conferencing on a tablet computer demonstrated high attendance, increased MVPA during group sessions, and improvements in cognitive function. However, the sustainability, impact on total daily MVPA, optimal session frequency, and potential impacts on cognitive function and brain health of remotely delivered group MVPA sessions in adults with DS are unknown. Therefore, we will conduct a trial in 80 non-demented adults with DS to determine the feasibility and potential efficacy of remotely delivered group MVPA sessions to increase daily MVPA, relative to a usual care control. Secondarily we will assess the impact of MVPA on cardiovascular fitness, quality of life, cognitive function and brain parameters related to AD.

NCT REGISTRATION

NCT04048759.

Patterns of leisure time and household physical activity and the risk of mortality among middle-aged Korean adults

Background

Although many studies have focused on leisure time physical activity (LTPA), household physical activity (HPA) can contribute to health benefits. This study aimed to compare LTPA and HPA patterns and to examine the association of these types of activities with the risk of mortality in Korea.

Methods

A total of 125,299 participants 40 to 69 years old and enrolled in the Health Examinees (HEXA) study from 2004 to 2012 were included in this study. The sex-specific LTPA and HPA categories were defined based on a questionnaire. A multinomial logistic regression was used to examine the LTPA and HPA correlates. Hazard ratios (HR) with 95% confidence intervals (95% CIs) of all-cause mortality were estimated using the Cox proportional hazard model.

Results

Overall, the LTPA and HPA patterns differed by age, income, and history of chronic diseases. LTPA reduced the risk of death, and lower risks were observed in more time spent engaged in or a vigorous LTPA intensity. The subjects who participated only in HPA and were not involved in LTPA also had lower risks of mortality (HR = 0.72, 95% CIs: 0.60–0.85 for men, and HR = 0.84, 95% CIs: 0.69–1.02 for women) than those who did not participate in both LTPA and HPA.

Conclusions

HPA reduced the risks of mortality in middle-aged Korean adults and could even decrease the risk of death in those who did not participate in LTPA.

Low sleep efficiency does not impact upper or lower limb vascular function in young adults

NEW FINDINGS

What is the central question of this study? We sought to investigate whether young adults reporting low sleep quality possessed lower vascular function and altered autonomic nervous system modulation when compared with young adults reporting high sleep quality. What is the main finding and its importance? The study revealed that in young adults reporting low sleep quality, neither vascular nor autonomic function was significantly different when compared with young adults reporting high sleep quality. These findings suggest that young adults are either not substantially impacted by or can adequately adapt to the negative consequences commonly associated with poor sleep.

ABSTRACT

The aim of the study was to investigate whether young adults reporting low sleep quality also possessed lower vascular function, potentially stemming from altered autonomic nervous system modulation, when compared with young adults reporting high sleep quality. Thirty-one healthy young adults (age 24 ± 4 years) underwent a 7 night sleep assessment (Actigraph GT3X accelerometer). After the sleep assessment, subjects meeting specific criteria were separated into high (HSE; ≥85%; n = 11; eight men and three women) and low (LSE; <80%; n = 11; nine men and two women) sleep efficiency groups. Peripheral vascular function was assessed in the upper and lower limb, using the flow-mediated dilatation technique in the arm (brachial artery) and leg (superficial femoral artery). Heart rate variability was evaluated during 5 min of rest and used frequency parameters reflective of parasympathetic and/or sympathetic nervous system modulation (high- and low-frequency parameters). By experimental design, significant differences in sleep quality between groups were reported, with the LSE group exhibiting a longer time awake after sleep onset, higher number of awakenings and longer average time per awakening when compared with the HSE group. Despite these differences in sleep quality, no significant differences in upper and lower limb vascular function and heart rate variability measures were revealed when comparing the LSE and HSE groups. Additionally, in all subjects (n = 31), no correlations between sleep efficiency and vascular function/autonomic modulation were revealed. This study revealed that low sleep quality does not impact upper or lower limb vascular function or autonomic nervous system modulation in young adults.

Proportion and associated factors of meeting the 2018 Physical Activity Guidelines for Americans in adults with or at risk for knee osteoarthritis

OBJECTIVES

Evaluate the prevalence of meeting the updated 2018 Physical Activity Guidelines for Americans (150 unbouted minutes in moderate-to-vigorous intensity physical activity [MVPA]) and determine cross-sectional factors associated with Guideline attainment in a community-based cohort of adults with or at elevated risk for knee osteoarthritis (OA).

METHODS

Physical activity was monitored for 1 week in a subset of Osteoarthritis Initiative (OAI) participants with or at increased risk for knee OA. Accelerometer-measured weekly MVPA minutes were calculated; sociodemographic (age, sex, race, education, and working status) and health-related (body mass index [BMI], comorbidity, depressive symptoms, radiographic knee OA, and frequent knee symptoms) factors were assessed. We evaluated the prevalence of meeting 2018 Guidelines and used multivariate partial proportional odds model to identify factors associated with Guideline attainment, controlling for other factors in the model.

RESULTS

Among 1922 participants (age 65.1 [standard deviation 9.1] years, BMI 28.4 [4.8] kg/m2, 55.2% women), 44.1% men and 22.2% women met the 2018 PA Guidelines. Adjusted cross-sectional factors associated with not-meeting 2018 Guidelines were: women, older age, higher BMI, non-Whites, depressive symptoms, not working, and frequent knee symptoms.

CONCLUSION

In community-recruited adults with or at high risk for knee OA, more than 50% of men and nearly 80% of women failed to achieve the 2018 recommended level of at least 150 weekly unbouted minutes of MVPA. Study findings support gender and racial disparity in Guideline attainment and suggest addressing potentially modifiable factors (e.g., BMI, depressive symptoms, and frequent knee symptoms) to optimize benefits in PA-promoting interventions.

Daily physical activity and alcohol use among young adults

Evidence suggests that physical activity and alcohol use are positively related among young adults. Two studies have examined daily relations, and results have shown conflicting findings. We examined relations between physical activity and alcohol use at both within- and between-individual levels and investigated moderators of the relation at both levels. 269 college students wore accelerometers to collect physical activity data over a 2-week period. At the end of each day, they indicated whether or not they drank alcohol. Multilevel logistic regression indicated neither within- nor between-subject relations were statistically significant. Positive affect, negative affect, and drinking motives moderated these relations at the between-subject level. Contrary to previous research, we did not observe a relation between physical activity and alcohol use at the daily level. Unique features of the current study suggest next steps for future research examining the perplexing PA-alcohol relation in this population.

Physical activity across the curriculum (PAAC3): Testing the application of technology delivered classroom physical activity breaks

Only 43% of children in the U.S., ages 6-11 yrs., meet current physical activity (PA) guidelines. To satisfy the MVPA requirement, schools have begun incorporating MVPA in the form of activity breaks or MVPA academic lessons. We completed two, 3 academic-yr. cluster randomized trials (DK61489, DK85317) called "Physical Activity Across the Curriculum" (PAAC) which involved increasing MVPA in the classroom. Across 3-yrs. teachers in PAAC schools delivered ~60 min/wk. (12 min/day) of MVPA. Although short of our MVPA goal (20 min/d), the PAAC approach substantially increased in-school MVPA. Teacher reluctance to devote additional time to develop and integrate PA lessons into their curriculum was the overwhelming barrier to meeting the MVPA goal. Therefore, to reduce barriers to delivery of classroom PA we developed a 3-academic yr. cluster randomized trial (2 yrs. active intervention, 1 yr. follow-up) to compare the effectiveness and sustainability of technology delivered (PAAC-R) and classroom teacher delivered (PAAC-T) activity breaks for increasing classroom MVPA in elementary school students in grades 2 and 3 at baseline who will progress to grades 4-5. NCT registration: NCT03493139.

Effect of epoch length on intensity classification and on accuracy of measurement under controlled conditions on treadmill: Towards a better understanding of accelerometer measurement

Purpose

The aim of this study was to analyze the effect of epoch length on intensity classification during continuous and intermittent activities.

Methods

Ten active students exercised under controlled conditions on a treadmill for four 5-min bouts by combining two effort intensities (running and walking) and two physical activity (PA) patterns (continuous or intermittent). The testing session was designed to generate a known level of moderate to vigorous PA (MVPA) for each condition. These PA levels were used as criterion measures to compare with the accelerometer measures. Data obtained from the accelerometer were reintegrated into 1-sec, 10-sec, 30-sec and 60-sec epochs. Equivalence testing was used to examine measurement agreements between MVPA values obtained with the different epochs and the reference values. Mean absolute percent errors (MAPE) were also calculated to provide an indicator of overall measurement error.

Results

During the intermittent conditions, only the value obtained with the 1-sec epoch was significantly equivalent to the reference value. With longer epochs the difference increased for both intermittent conditions but in an opposite way: with longer epochs, MVPA decreased during walking but increased during running. Regarding the measurement accuracy, the pattern of variations according to the epoch length selected during the intermittent conditions was identical between walking and running: MAPE increased with the increase in epoch length. MAPE remained low only for the 1-sec epoch (7.6% and 2.7% for walking and running, respectively), increased at 31.3% and 34% for the 10-sec epoch and until near 100% with the 30- and 60-sec epoch lengths.

Conclusion

This study highlighted the misclassification of exercise intensity based on accelerometer measurement and described for the first time the extent and the direction of this misclassification. Moreover, we can confirm that the shorter epochs are more accurate to measure the real exercise intensity during intermittent PA whatever the intensity.

Standardizing Analytic Methods and Reporting in Activity Monitor Validation Studies

INTRODUCTION

A lack of standardization with accelerometry-based monitors has made it hard to advance applications for both research and practice. Resolving these challenges is essential for developing methods for consistent, agnostic reporting of physical activity outcomes from wearable monitors in clinical applications.

METHODS

This article reviewed the literature on the methods used to evaluate the validity of contemporary consumer activity monitors. A rationale for focusing on energy expenditure as a key outcome measure in validation studies was provided followed by a summary of the strengths and limitations of different analytical methods. The primary review included 23 recent validation studies that collectively reported energy expenditure estimates from 58 monitors relative to values from appropriate criterion measures.

RESULTS

The majority of studies reported weak indicators such as correlation coefficients (87%), but only half (52%) reported the recommended summary statistic of mean absolute percent error needed to evaluate actual individual error. Fewer used appropriate tests of agreement such as equivalence testing (22%).

CONCLUSIONS

The use of inappropriate analytic methods and incomplete reporting of outcomes is a major limitation for systematically advancing research with both research grade and consumer-grade activity monitors. Guidelines are provided to standardize analytic methods and reporting in these types of studies to enhance the utility of the devices for clinical mHealth applications.

The Role of Self-Determination in Changing Physical Activity Behavior in People Diagnosed With Bowel Polyps: A Pilot Randomized Controlled Trial

This nonblinded randomized controlled trial investigated the efficacy of a physical activity (PA) intervention underpinned by self-determination theory. Participants (N = 31, mean age 69 years [SD = 4.9]) diagnosed with bowel polyps were randomized to an active lifestyle program (ALP; n = 17) or standard care (n = 14). ALP received supervised exercise and counseling for 6 months. Both groups were followed up at 12 months. Outcomes were change in PA and behavioral regulation. Data were analyzed with intention to treat. At 6 months, differences were observed for behavioral regulation in favor of ALP (p < .05). PA differences were significant for leisure, walking, and vigorous in favor of ALP (p < .05). The self-determination theory can be an effective strategy for promoting PA behavior change in this population, but a larger trial is needed to further explore the utility of the self-determination theory in this context.

Triaxial accelerometer output predicts oxygen uptake in adults with Down syndrome

PURPOSE

This study examined if the relationship between the rate of oxygen uptake (V̇O₂) and output from hip-and wrist-worn accelerometers differs between adults with and without DS, and evaluated the accuracy of accelerometer output in estimating V̇O₂.

MATERIALS AND METHODS

Sixteen adults with DS (10 men) and 19 adults without DS (10 men) performed 12 tasks including physical activities and sedentary behaviors. We measured V̇O₂ with portable spirometry and accelerometer output (vector magnitude [VM]) with hip- and wrist-worn accelerometers. We used multi-level regressions to predict V̇O₂ from VM, group, body mass index (BMI), age, height, weight, and sex. We evaluated prediction accuracy with absolute percent error and Bland-Altman plots.

RESULTS

For both hip- and wrist-accelerometers, VM and group significantly predicted V̇O₂ (p ≤ 0.021). When BMI was added, BMI was a significant predictor but group was not. The final models included VM and BMI (p ≤ 0.001; R² = 0.78 and 0.57, for hip and wrist accelerometer model, respectively). Absolute error was greater for the wrist- than the hip-accelerometer model (wrist: 37.9 ± 38.1%; hip: 22.5 ± 27.4%).

CONCLUSIONS

Adults with DS have different V̇O₂ to VM responses, and this appears due to their higher BMI. Predictability of V̇O₂ from accelerometer output is better for hip- than wrist-worn accelerometers.IMPLICATIONS FOR REHABILITATIONOutput from a triaxial accelerometer has high potential in predicting the energy expenditure and classifying the intensity of physical activity and sedentary behavior in adults with Down syndrome.Accuracy of predicting energy expenditure from accelerometer output is better for hip- than wrist-worn triaxial accelerometers.The development of appropriate rehabilitation interventions that include physical activity for improving health and function in adults with Down syndrome requires accurate assessments of physical activity levels.

Cut points of the Actigraph GT9X for moderate and vigorous intensity physical activity at four different wear locations

Accelerometer cut points are an important consideration for distinguishing the intensity of activity into categories such as moderate and vigorous. It is well-established in the literature that these cut points depend on a variety of factors, including age group, device, and wear location. The Actigraph GT9X is a newer model accelerometer that is used for physical activity research, but existing cut points for this device are limited since it is a newer device. Furthermore, there is not existing data on cut points for the GT9X at the ankle or foot locations, which offers some potential benefit for activities that do not involve arm and/or core motion. A total of N = 44 adults completed a four-stage treadmill protocol while wearing Actigraph GT9X sensors at four different locations: foot, ankle, wrist, and hip. Metabolic Equivalent of Task (MET) levels assessed by indirect calorimetry along with Receiver Operating Characteristic (ROC) curves were used to establish cut points for moderate and vigorous intensity for each wear location of the GT9X. Area under the ROC curves indicated high discrimination accuracy for each case.

Active children are less adipose and insulin resistant in early adolescence; evidence from the Mysore Parthenon Cohort

Background

The aim of this study was to determine whether physical activity volume and intensity in mid-childhood and early adolescence were associated with cardiometabolic risk factors at 13.5 years.

Methods

Participants were recruited from the Mysore Parthenon observational birth cohort. At ages 6–10 and 11–13 years, volume and intensity of physical activity were assessed using AM7164 or GT1M actigraph accelerometers worn for ≥4 days, and expressed as mean counts per day and percentage time spent in light, moderate and vigorous physical activity according to criteria defined by Evenson et al. At 13.5 years, fasting blood samples were collected; lipids, glucose and insulin concentrations were measured and insulin resistance (HOMA) was calculated. Systolic and diastolic blood pressure were measured at the left arm using a Dinamap (Criticon). Anthropometry and bio-impedance analysis were used to assess body size and composition. Metabolic and anthropometric measures were combined to produce a metabolic syndrome risk score.

Results

At 6–10 years, boys and girls respectively spent a median (IQR) of 1.1 (0.5, 2.0) % and 0.8 (0.4, 1.3) % of recorded time vigorously active. At 11–13 years, boys and girls respectively spent a median (IQR) of 0.8 (0.4, 1.7) % and 0.3 (0.1, 0.6) % of time vigorously active. All of the physical activity parameters were positively correlated between the 6–10 year and the 11–13 year measurements indicating that physical activity tracked from childhood to early adolescence. There were no associations between physical activity at 6–10 years and individual 13.5 year risk factors but % time vigorously active was inversely associated with metabolic syndrome score (B = −0.40, 95% CI −0.75, 0.05). Volume of physical activity at 11–13 years was inversely associated with 13.5 year HOMA and fat percentage and vigorous physical activity was associated with HOMA, fat percentage, sum of skinfolds, waist circumference and total: HDL cholesterol ratio. Vigorous physical activity was inversely associated with metabolic syndrome score (B = −0.51, 95% CI −0.94, −0.08).

Conclusions

Volume and intensity of physical activity in early adolescence were negatively associated with metabolic and anthropometric risk factors. Interventions that aim to increase adolescent physical activity, especially vigorous, may prevent cardiometabolic disease in later life.

The validity of two widely used commercial and research-grade activity monitors, during resting, household and activity behaviours

Wearable devices are increasingly prevalent in research environments for the estimation of energy expenditure (EE) and heart rate (HR). The aim of this study was to validate the HR and EE estimates of the Fitbit charge 2 (FC2), and the EE estimates of the Sensewear armband mini (SWA). We recruited 59 healthy adults to participate in walking, running, cycling, sedentary and household tasks. Estimates of HR from the FC2 were compared to a HR chest strap (Polar) and EE to a stationary metabolic cart (Vyntus CPX). The SWA overestimated overall EE by 0.03 kcal/min−1 and was statistically equivalent to the criterion measure, with a mean absolute percentage error (MAPE) of 29%. In contrast, the FC2 was not equivalent overall (MAPE = 44%). In household tasks, MAPE values of 93% and 83% were observed for the FC2 and SWA, respectively. The FC2 HR estimates were equivalent to the criterion measure overall. The SWA is more accurate than the commercial-grade FC2. Neither device is consistently accurate across the range of activities used in this study. The HR data obtained from the FC2 is more accurate than its EE estimates and future research may focus more on this variable.