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Zhu L, Wang Y, Li J, Zhou H, Li N, Wang Y. Depressive symptoms and all-cause mortality among middle-aged and older people in China and associations with chronic diseases. Front Public Health 2024; 12:1381273. [PMID: 38841667 PMCID: PMC11151855 DOI: 10.3389/fpubh.2024.1381273] [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: 02/03/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction It remains unclear whether depressive symptoms are associated with increased all-cause mortality and to what extent depressive symptoms are associated with chronic disease and all-cause mortality. The study aims to explore the relationship between depressive symptoms and all-cause mortality, and how depressive symptoms may, in turn, affect all-cause mortality among Chinese middle-aged and older people through chronic diseases. Methods Data were collected from the China Health and Retirement Longitudinal Study (CHARLS). This cohort study involved 13,855 individuals from Wave 1 (2011) to Wave 6 (2020) of the CHARLS, which is a nationally representative survey that collects information from Chinese residents ages 45 and older to explore intrinsic mechanisms between depressive symptoms and all-cause mortality. The Center for Epidemiological Studies Depression Scale (CES-D-10) was validated through the CHARLS. Covariates included socioeconomic variables, living habits, and self-reported history of chronic diseases. Kaplan-Meier curves depicted mortality rates by depressive symptom levels, with Cox proportional hazards regression models estimating the hazard ratios (HRs) of all-cause mortality. Results Out of the total 13,855 participants included, the median (Q1, Q3) age was 58.00 (51.00, 63.00) years. Adjusted for all covariates, middle-aged and older adults with depressive symptoms had a higher all-cause mortality rate (HR = 1.20 [95% CI, 1.09-1.33]). An increased rate was observed for 55-64 years old (HR = 1.23 [95% CI, 1.03-1.47]) and more than 65 years old (HR = 1.32 [95% CI, 1.18-1.49]), agricultural Hukou (HR = 1.44, [95% CI, 1.30-1.59]), and nonagricultural workload (HR = 1.81 [95% CI, 1.61-2.03]). Depressive symptoms increased the risks of all-cause mortality among patients with hypertension (HR = 1.19 [95% CI, 1.00-1.40]), diabetes (HR = 1.41[95% CI, 1.02-1.95]), and arthritis (HR = 1.29 [95% CI, 1.09-1.51]). Conclusion Depressive symptoms raise all-cause mortality risk, particularly in those aged 55 and above, rural household registration (agricultural Hukou), nonagricultural workers, and middle-aged and older people with hypertension, diabetes, and arthritis. Our findings through the longitudinal data collected in this study offer valuable insights for interventions targeting depression, such as early detection, integrated chronic disease care management, and healthy lifestyles; and community support for depressive symptoms may help to reduce mortality in middle-aged and older people.
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Affiliation(s)
- Lan Zhu
- School of Education and Psychology, Key Research Institute of Humanities and Social Sciences of State Ethnic Affairs Commission, and Research Centre of Sichuan Minzu Education Development, Southwest Minzu University, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yixi Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Huan Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ningxiu Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
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Amatori S, Gobbi E, Sisti D, Pivato G, Giombini G, Rombaldoni R, Calcagnini G, Rocchi MBL, Perroni F. Physical activity, musculoskeletal disorders, burnout, and work engagement: a cross-sectional study on Italian white-collar employees. Front Public Health 2024; 12:1375817. [PMID: 38746006 PMCID: PMC11091297 DOI: 10.3389/fpubh.2024.1375817] [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: 01/24/2024] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction Both mental and physical health of office workers had a positive relationship with their work engagement, with the latter relationship being driven by the association of a healthy diet and physical activity (PA). This observational study aimed to investigate the associations between PA levels, musculoskeletal disorders (MSDs), burnout, and work engagement, in a sample of white-collar employees. Methods A total of 615 workers (age 42.2 ± 9.5 years) successfully completed an online questionnaire comprising work-related information and standardized questionnaires on PA, MSDs, burnout and work engagement. Results 36.9% of the participants did not meet the PA guidelines, 19.0% adhered to them, and 44.1% exceeded them. A significant portion of participants reported suffering from MSDs, primarily neck/shoulder and/or low back/hip pain. Those exceeding PA guidelines had fewer MSDs compared to non-compliant participants and exhibited better mental health and work engagement. Compliance with PA guidelines was associated with a 38% reduced risk of emotional exhaustion, with an even greater reduction of 47% among those surpassing the guidelines. Discussion PA could exert a positive effect on physical and mental health of employees, but only if performed above a certain amount. The study supports the need to identify workplaces as suitable for health-focused interventions and lifestyle changes.
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Affiliation(s)
- Stefano Amatori
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Erica Gobbi
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Davide Sisti
- Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino Carlo Bo, Urbino, Italy
| | - Giorgia Pivato
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Germana Giombini
- Department of Economics, Social Science, and Politics, University of Urbino Carlo Bo, Urbino, Italy
| | - Rosalba Rombaldoni
- Department of Economics, Social Science, and Politics, University of Urbino Carlo Bo, Urbino, Italy
| | - Giorgio Calcagnini
- Department of Economics, Social Science, and Politics, University of Urbino Carlo Bo, Urbino, Italy
| | - Marco B. L. Rocchi
- Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino Carlo Bo, Urbino, Italy
| | - Fabrizio Perroni
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
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Cristi-Montero C, Martínez-Flores R, Espinoza-Puelles JP, Favero-Ramirez L, Zurita-Corvalan N, Cañete IC, Leppe J, Ferrari G, Sadarangani KP, Cancino-López J, Hernandez-Jaña S, Farias TY, Lemes VB, Rodríguez-Rodríguez F, Brand C. Study protocol and rationale of "the UP project": evaluating the effectiveness of active breaks on health indicators in desk-based workers. Front Public Health 2024; 12:1363015. [PMID: 38566792 PMCID: PMC10985339 DOI: 10.3389/fpubh.2024.1363015] [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: 12/29/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Background Excessive sedentary time has been negatively associated with several health outcomes, and physical activity alone does not seem to fully counteract these consequences. This panorama emphasizes the essential of sedentary time interruption programs. "The Up Project" seeks to assess the effectiveness of two interventions, one incorporating active breaks led by a professional and the other utilizing a computer application (self-led), of both equivalent duration and intensity. These interventions will be compared with a control group to evaluate their impact on physical activity levels, sedentary time, stress perception, occupational pain, and cardiometabolic risk factors among office workers. Methods This quasi-experimental study includes 60 desk-based workers from universities and educational institutes in Valparaiso, Chile, assigned to three groups: (a) booster breaks led by professionals, (b) computer prompts that are unled, and (c) a control group. The intervention protocol for both experimental groups will last 12 weeks (only weekdays). The following measurements will be performed at baseline and post-intervention: cardiometabolic risk based on body composition (fat mass, fat-free mass, and bone mass evaluated by DXA), waist circumference, blood pressure, resting heart rate, and handgrip strength. Physical activity and sedentary time will be self-reported and device-based assessed using accelerometry. Questionnaires will be used to determine the perception of stress and occupational pain. Discussion Governments worldwide are addressing health issues associated with sedentary behavior, particularly concerning individuals highly exposed to it, such as desk-based workers. Despite implementing certain strategies, there remains a noticeable gap in comprehensive research comparing diverse protocols. For instance, studies that contrast the outcomes of interventions led by professionals with those prompted by computers are scarce. This ongoing project is expected to contribute to evidence-based interventions targeting reduced perceived stress levels and enhancing desk-based employees' mental and physical well-being. The implications of these findings could have the capacity to lay the groundwork for future public health initiatives and government-funded programs.
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Affiliation(s)
- Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Ricardo Martínez-Flores
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | | | - Laura Favero-Ramirez
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Natalia Zurita-Corvalan
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Ignacio Castillo Cañete
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Jaime Leppe
- School of Physical Therapy Faculty of Medicine, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia, Santiago, Chile
| | - Kabir P. Sadarangani
- Universidad Autónoma de Chile, Santiago, Chile
- Escuela de Kinesiología, Facultad de Salud Y Odontología, Universidad Diego Portales, Santiago, Chile
| | - Jorge Cancino-López
- Laboratorio de Fisiología del Ejercicio y Metabolismo, Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae. Santiago, Santiago, Chile
| | - Sam Hernandez-Jaña
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | | | - Vanilson Batista Lemes
- Universidade Federal do Rio Grande do Sul, Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil
| | | | - Caroline Brand
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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Larisch LM, Blom V, Hagströmer M, Ekblom M, Ekblom Ö, Nilsson J, Kallings LV. Improving movement behavior in office workers: effects of two multi-level cluster-RCT interventions on mental health. BMC Public Health 2024; 24:127. [PMID: 38195449 PMCID: PMC10985866 DOI: 10.1186/s12889-024-17647-2] [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: 08/22/2023] [Accepted: 01/02/2024] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND We have previously reported on the design and efficacy of two cluster-randomized multi-level workplace interventions, attempting to decrease sedentary behavior (SED) or increase moderate to vigorous physical activity (MVPA) among office workers to improve mental health outcomes. The aim of this study was to investigate intervention effects on mental health outcomes, i.e., mental wellbeing, depression or anxiety symptoms, and stress immediately after the 6-month intervention period. METHODS Teams of 263 office workers were cluster-randomized to one of two interventions or a waitlist control group. The PA intervention (iPA) focused on increasing MVPA and the SED intervention (iSED) on reducing SED. Both multi-level interventions targeted individual office workers and their social, physical, and organizational work environment, incorporating counseling based on cognitive behavioral therapy and motivational interviewing. Mental health outcomes were assessed using validated questionnaires before and immediately after the intervention. Intervention effects were analyzed using linear mixed effects models. RESULTS Participants were mostly female and highly educated, with a mean age of 42 years and had favorable levels of mental health at baseline. Mental wellbeing improved for the iSED group (β = 8, 95% CI 1 to 15, p = 0.030) but not for the iPA group (β = 6, 95% CI -1 to 12, p = 0.072) compared to the control group. No effects were found for depression or anxiety symptoms or stress. CONCLUSIONS The multi-level interventions improved mental wellbeing among this population of office workers, reaching statistical significance in the iSED group. The size of the effect can be regarded meaningful, considering favorable mental health and high PA level at baseline. Thus, workplace interventions that provide support on multiple levels appear to have potential for improving mental wellbeing, but not reducing ill-health variables, among healthy office workers. More research is needed to understand the mechanisms through which such improvements can be achieved and to identify the most effective intervention components. TRIAL REGISTRATION ISRCTN92968402 (27 February 2018).
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Affiliation(s)
- Lisa-Marie Larisch
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Victoria Blom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - 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
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
| | - Maria Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Örjan Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Jonna Nilsson
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Lena V Kallings
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Division of Family Medicine and Preventive Medicine, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Gisour BB, Ghayour Najafabadi M, Zandi HG, Shaw I. Using teleconsultation for health aspects of computer-based workers in the new normal situation (post COVID-19) of the world. Work 2024; 77:1071-1074. [PMID: 38217560 DOI: 10.3233/wor-230033] [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: 01/15/2024] Open
Abstract
BACKGROUND The use of teleconsultation platforms enabling health professionals to provide advice especially in the new normal post COVID-19 situation has increased in both developing and developed countries. This teleconsultation has also expanded beyond that of post COVID-19 application to other purposes such as in the treatment of musculoskeletal pain. OBJECTIVE The purpose of this commentary is to focus on presenting a feasible guide related to physical as well as psychological aspects in relation to computer based workers that could be taught to the computer-based workers using teleconsultation platforms. METHODS A multi-criteria search was performed among available guidelines and approaches related to the physical and psychological aspects used for computer-based workers. RESULTS A continuation of musculoskeletal pain creates a feedforward loop of pain and distress. Several conventional methods exist to manage musculoskeletal pain, however, the new normal situation following COVID-19 has rendered many of these moot, especially in computer based workers and with the increased reliance on teleconsultation platforms. CONCLUSIONS During the COVID-19 pandemic, individuals were required to stay home due to varying levels of lockdown protocols and provide their usual services using online platforms both increasing sedentary behaviour in computer based workers and limiting the tools available to health professionals. Following in what is now the worldwide new normal post COVID-19 situation, individuals have adapted and accepted that they receive much of their necessary health advice using teleconsultation platforms as well.
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Affiliation(s)
- Bita Bagheri Gisour
- Department of Sport Psychology, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | | | - Hassan Gharayagh Zandi
- Department of Sport Psychology, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Ina Shaw
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
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Larisch LM, Kallings LV, Thedin Jakobsson B, Blom V. "It depends on the boss" - a qualitative study of multi-level interventions aiming at office workers' movement behaviour and mental health. Int J Qual Stud Health Well-being 2023; 18:2258564. [PMID: 37731364 PMCID: PMC10515662 DOI: 10.1080/17482631.2023.2258564] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/09/2023] [Indexed: 09/22/2023] Open
Abstract
PURPOSE This embedded qualitative study explored the acceptability, feasibility, and fidelity of two multi-level RCT interventions among office workers, aiming at improving movement behaviour to enhance mental health and cognition. The interventions addressed the organizational, environmental, and individual level. METHODS Semi-structured interviews and focus group discussions were conducted with 38 stakeholders after completion of the interventions. Data were analysed using reflexive thematic analysis. RESULTS The interventions were well appreciated, and office workers attributed improvements in movement behaviour and wellbeing to the interventions. Especially the cognitive behavioural therapy (CBT) based counselling and free gym access were appreciated, feasible and delivered as planned. Participants described existing workplace norms as barriers to more activity, particularly for reducing sitting. Support from managers and team support were considered crucial components. However, delivering these components was difficult. CONCLUSIONS The findings support the design of the multi-level interventions for changing movement behaviour. Results highlight the potential of CBT for this target group and the importance of manager and team support. Desired effects of similar multi-level interventions, including CBT, might be achieved in future studies that carefully address the issues with feasibility and acceptability and the resulting low fidelity of some intervention components that were identified in this study.
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Affiliation(s)
- Lisa-Marie Larisch
- The Swedish School of Sport and Health Sciences, Department of Physical Activity and Health, Stockholm, Sweden
| | - Lena V. Kallings
- The Swedish School of Sport and Health Sciences, Department of Physical Activity and Health, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden
| | - Britta Thedin Jakobsson
- The Swedish School of Sport and Health Sciences, Department of Physical Activity and Health, Stockholm, Sweden
- The Swedish School of Sport and Health Sciences, Department of Movement, Culture and Society, Stockholm, Sweden
| | - Victoria Blom
- The Swedish School of Sport and Health Sciences, Department of Physical Activity and Health, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Division of Insurance Medicine, Stockholm, Sweden
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Strobl H, Herrmann-Johns A, Loss J, Hable R, Tittlbach S. A Person-Centered Perspective on Physical Activity-Related Barriers Perceived by Male Fluctuators 50 Plus: A Cross-Sectional Study. Am J Mens Health 2023; 17:15579883231193915. [PMID: 37688411 PMCID: PMC10493066 DOI: 10.1177/15579883231193915] [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: 04/09/2023] [Revised: 07/02/2023] [Accepted: 07/06/2023] [Indexed: 09/10/2023] Open
Abstract
Men aged 50 or older (50 plus) represent a hard-to-reach target group for health-enhancing physical activity (PA) interventions. However, a considerable percentage of men 50 plus do not entirely fail to achieve the PA milestones set by the World Health Organization (WHO) guidelines. They show fluctuating PA behavior, influenced by various barriers hindering or preventing regular PA participation. As "one-size-fits-all" behavioral change interventions are only partially effective in specific subgroups, it is essential to tailor PA promotion measures to the particular needs of male fluctuators 50 plus. The standardized questionnaire included validated instruments measuring participants' current stage of behavioral change, their perceived barriers to PA, questions on selected psychosocial correlates of PA, and sociodemographic variables. Out of 1,013 participants, 133 men (13.1%) classified themselves as fluctuators. Using a person-centered approach, we formed groups with similar intra-individual relevant barrier profiles using hierarchical cluster analysis (Ward method) followed by k-means clustering. We identified four clusters. Cluster 1 (n = 31) involves men predominantly perceiving physical constraints. Cluster 2 (n = 33) represents men lacking self-motivation and struggling with their weaker selves. Men in Cluster 3 (n = 51) primarily indicate professional and private obligations that prevent them from being physically active. Finally, men in Cluster 4 (n = 18) miss appropriate sports courses that meet their individual needs. Our findings support identifying individually tailored strategies designed to promote regular PA in male fluctuators 50 plus. Further research is required to determine the effectiveness of this approach in improving adherence to PA guidelines and corresponding health-enhancing effects for men 50 plus.
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Affiliation(s)
- Helmut Strobl
- Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | | | | | - Robert Hable
- Deggendorf Institute of Technology, Deggendorf, Germany
| | - Susanne Tittlbach
- Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
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Cuesta-Vargas AI, Biró A, Escriche-Escuder A, Trinidad-Fernández M, García-Conejo C, Roldán Jiménez CR, Tang W, Salvatore A, Nikolova B, Muro-Culebras A, Martín-Martín J, González-Sánchez M, Ruiz-Muñoz M, Mayoral F. Effectiveness of a gamified digital intervention based on lifestyle modification (iGAME) in secondary prevention: a protocol for a randomised controlled trial. BMJ Open 2023; 13:e066669. [PMID: 37316318 DOI: 10.1136/bmjopen-2022-066669] [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] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Combating physical inactivity and reducing sitting time are one of the principal challenges proposed by public health systems. Gamification has been seen as an innovative, functional and motivating strategy to encourage patients to increase their physical activity (PA) and reduce sedentary lifestyles through behaviour change techniques (BCT). However, the effectiveness of these interventions is not usually studied before their use. The main objective of this study will be to analyse the effectiveness of a gamified mobile application (iGAME) developed in the context of promoting PA and reducing sitting time with the BCT approach, as an intervention of secondary prevention in sedentary patients. METHODS AND ANALYSIS A randomised clinical trial will be conducted among sedentary patients with one of these conditions: non-specific low back pain, cancer survivors and mild depression. The experimental group will receive a 12-week intervention based on a gamified mobile health application using BCT to promote PA and reduce sedentarism. Participants in the control group will be educated about the benefits of PA. The International Physical Activity Questionnaire will be considered the primary outcome. International Sedentary Assessment Tool, EuroQoL-5D, MEDRISK Instruments and consumption of Health System resources will be evaluated as secondary outcomes. Specific questionnaires will be administered depending on the clinical population. Outcomes will be assessed at baseline, at 6 weeks, at the end of the intervention (12 weeks), at 26 weeks and at 52 weeks. ETHICS AND DISSEMINATION The study has been approved by the Portal de Ética de la Investigación Biomédica de Andalucía Ethics Committee (RCT-iGAME 24092020). All participants will be informed about the purpose and content of the study and written informed consent will be completed. The results of this study will be published in a peer-reviewed journal and disseminated electronically and in print. TRIAL REGISTRATION NUMBER NCT04019119.
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Affiliation(s)
- Antonio I Cuesta-Vargas
- Departamento de Fisioterapia, Universidad de Malaga, Andalucia Tech, Malaga, España
- Instituto de Investigacion Biomédica de Málaga (IBIMA), Malaga, España
| | - Attila Biró
- Departamento de Fisioterapia, Universidad de Malaga, Andalucia Tech, Malaga, España
- Instituto de Investigacion Biomédica de Málaga (IBIMA), Malaga, España
- ITware, Budapest, Hungary
- Department of Electrical Engineering and Information Technology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
| | - Adrian Escriche-Escuder
- Departamento de Fisioterapia, Universidad de Malaga, Andalucia Tech, Malaga, España
- Instituto de Investigacion Biomédica de Málaga (IBIMA), Malaga, España
| | - Manuel Trinidad-Fernández
- Departamento de Fisioterapia, Universidad de Malaga, Andalucia Tech, Malaga, España
- Instituto de Investigacion Biomédica de Málaga (IBIMA), Malaga, España
| | - Celia García-Conejo
- Departamento de Fisioterapia, Universidad de Malaga, Andalucia Tech, Malaga, España
- Instituto de Investigacion Biomédica de Málaga (IBIMA), Malaga, España
| | - Cristina Roldán Roldán Jiménez
- Departamento de Fisioterapia, Universidad de Malaga, Andalucia Tech, Malaga, España
- Instituto de Investigacion Biomédica de Málaga (IBIMA), Malaga, España
| | - Wen Tang
- Bournemouth University, Poole, UK
| | | | | | - Antonio Muro-Culebras
- Departamento de Fisioterapia, Universidad de Malaga, Andalucia Tech, Malaga, España
- Instituto de Investigacion Biomédica de Málaga (IBIMA), Malaga, España
| | - Jaime Martín-Martín
- Instituto de Investigacion Biomédica de Málaga (IBIMA), Malaga, España
- Departamento de Medicina Legal, Universidad de Malaga, Málaga, España
| | | | - María Ruiz-Muñoz
- Departamento de Enfermeria, Universidad de Malaga, Malaga, España
| | - Fermin Mayoral
- Instituto de Investigacion Biomédica de Málaga (IBIMA), Malaga, España
- Salud Mental, Hospital Regional Universitario de Malaga, Malaga, Spain
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Levine JA. The Fidget Factor and the obesity paradox. How small movements have big impact. Front Sports Act Living 2023; 5:1122938. [PMID: 37077429 PMCID: PMC10106700 DOI: 10.3389/fspor.2023.1122938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/24/2023] [Indexed: 04/05/2023] Open
Abstract
The hypothesis is that the Fidget Factor is the innate neurological pulse that propels humans and other species to move to support their health. Fidgets, previously thought to be spontaneous, are neurologically regulated and highly ordered (non-random). Modern societies being chair-based overwhelm Fidget Factor pulses and consequently inflict chair-based living for transportation, labor, and leisure. Despite impulses firing through the nervous system, people sit because environmental design overwhelms the biology. Urbanization and chair-based societies were designed after the industrial revolution to promote productivity; however, the consequence has been opposite. Crushing the natural urge to move—the Fidget Factor—is a public health calamity. Excess sitting is associated with a myriad of detrimental health consequences and impairs productivity. Fidgeting may reduce all-cause mortality associated with excessive sitting. The Fidget Factor offers hope; data demonstrate that workplaces and schools can be designed to promote activity and free people's Fidget Factors. Evidence shows that people are happier, healthier, wealthier, and more successful if their Fidget Factors are freed.
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Molecular mechanisms of exercise contributing to tissue regeneration. Signal Transduct Target Ther 2022; 7:383. [PMID: 36446784 PMCID: PMC9709153 DOI: 10.1038/s41392-022-01233-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/03/2022] [Accepted: 10/17/2022] [Indexed: 12/03/2022] Open
Abstract
Physical activity has been known as an essential element to promote human health for centuries. Thus, exercise intervention is encouraged to battle against sedentary lifestyle. Recent rapid advances in molecular biotechnology have demonstrated that both endurance and resistance exercise training, two traditional types of exercise, trigger a series of physiological responses, unraveling the mechanisms of exercise regulating on the human body. Therefore, exercise has been expected as a candidate approach of alleviating a wide range of diseases, such as metabolic diseases, neurodegenerative disorders, tumors, and cardiovascular diseases. In particular, the capacity of exercise to promote tissue regeneration has attracted the attention of many researchers in recent decades. Since most adult human organs have a weak regenerative capacity, it is currently a key challenge in regenerative medicine to improve the efficiency of tissue regeneration. As research progresses, exercise-induced tissue regeneration seems to provide a novel approach for fighting against injury or senescence, establishing strong theoretical basis for more and more "exercise mimetics." These drugs are acting as the pharmaceutical alternatives of those individuals who cannot experience the benefits of exercise. Here, we comprehensively provide a description of the benefits of exercise on tissue regeneration in diverse organs, mainly focusing on musculoskeletal system, cardiovascular system, and nervous system. We also discuss the underlying molecular mechanisms associated with the regenerative effects of exercise and emerging therapeutic exercise mimetics for regeneration, as well as the associated opportunities and challenges. We aim to describe an integrated perspective on the current advances of distinct physiological mechanisms associated with exercise-induced tissue regeneration on various organs and facilitate the development of drugs that mimics the benefits of exercise.
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Evaluation of an Online Course Promoting Health and Wellbeing for University Students and Employees. Eur J Investig Health Psychol Educ 2022; 12:1369-1390. [PMID: 36135234 PMCID: PMC9497908 DOI: 10.3390/ejihpe12090096] [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: 07/28/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
Published studies dealing with health promotion activities, such as the improvement of physical activity and healthy eating, for workers and students prove the effectiveness of these preventive interventions. The consequent benefits include better prevention of cardiovascular risk and an improvement in quality of life. Considering this, an intervention aimed at promoting healthy eating and non-sedentary lifestyles has been implemented within an Italian university: the aim of the present research is to evaluate its effectiveness. The intervention consisted of a targeted asynchronous e-learning two-hour course on healthy eating and non-sedentary lifestyles. The attendants were 2004 university students and employees. We conducted two surveys before and after the training intervention, and, through the responses obtained, we evaluated the effectiveness of the intervention. We applied different statistical methods, including unpaired t-tests and nonparametric tests, principal components and cluster analysis. Our results indicate that the post-training knowledge has been significantly improved, compared to that pre-training (7.3 vs. 8.7, p < 0.001). Moreover, the whole sample showed an improved awareness of the importance of healthy behaviors, and perception of the University as an institution promoting a healthy lifestyle. Through the principal components analysis, we identified a unidimensional latent factor named “health and behaviors”. The cluster analysis highlighted that the sub-group reporting the lowest scores at the survey before the training was the one with the highest improvement after the intervention. To the best of our knowledge, this is the first Italian study testing, before and after a health promotion intervention, the knowledge and the attitudes and behaviors towards healthy lifestyles of a group of students and workers. Moreover, we also evaluated the pre- and post-intervention perceived health status, as well as the level of engagement of the attendants, with respect to their colleagues and management in an educational institution promoting wellbeing. The conclusions of our study support the need for further adoption of health promotion training interventions, similar to the one we performed, in order to improve healthy eating and non-sedentary behaviors among workers and students.
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12
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Bojsen-Møller E, Wang R, Nilsson J, Heiland EG, Boraxbekk CJ, Kallings LV, Ekblom M. The effect of two multi-component behavior change interventions on cognitive functions. BMC Public Health 2022; 22:1082. [PMID: 35641971 PMCID: PMC9158235 DOI: 10.1186/s12889-022-13490-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/18/2022] [Indexed: 11/21/2022] Open
Abstract
Background We previously reported the effects of two cluster-randomized 6-month multi-component workplace interventions, targeting reducing sedentary behavior or increasing physical activity among office workers, on movement behaviors and cardiorespiratory fitness. The primary aim of this study was to investigate the effects of these interventions on cognitive functions compared to a wait-list control group. The secondary aims were to examine if changes in cognition were related to change in cardiorespiratory fitness or movement behaviors and if age, sex, or cardiorespiratory fitness moderated these associations. Methods Both interventions encompassed multi-components acting on the individual, environmental, and organizational levels and aimed to change physical activity patterns to improve mental health and cognitive function. Out of 263 included participants, 139 (mean age 43 years, 76% females) completed a neuropsychological test battery and wore accelerometers at baseline and 6-month follow-up. The intervention effect (aim 1) on cognitive composite scores (i.e., Executive Functions, Episodic Memory, Processing Speed, and Global Cognition) was investigated. Additionally, associations between changes in movement behaviors and cardiorespiratory fitness, and changes in cognition were examined (aim 2). Moreover, age, sex, and cardiorespiratory fitness level were investigated as possible moderators of change associations (aim 3). Results Overall, cognitive performance improved from baseline to follow-up, but the change did not differ between the intervention groups and the control group. Changes in cardiorespiratory fitness or any movement behavior category did not predict changes in cognitive functions. The association between changes in time in bed and changes in both Executive Function and Global Cognition were moderated by age, such that a more positive relation was seen with increasing age. A less positive association was seen between changes in sedentary behavior and Processing Speed for men vs. women, whereas higher cardiorespiratory fitness was related to a more positive association between changes in moderate-intensity physical activity and Global Cognition. Conclusion The lack of an intervention effect on cognitive functions was expected since the intervention did not change movement behavior or fitness. Age, sex, and cardiorespiratory fitness level might moderate the relationships between movement behaviors and cognitive functions changes. Trial registration ISRCTN92968402. Registered 09/04/2018.
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Affiliation(s)
- Emil Bojsen-Møller
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden.
| | - Rui Wang
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jonna Nilsson
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Emerald G Heiland
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden.,Department of Surgical Sciences, Medical Epidemiology, University of Uppsala, Uppsala, Sweden
| | - Carl-Johan Boraxbekk
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.,Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden.,Institute of Sports Medicine Copenhagen (ISMC) and Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.,Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lena V Kallings
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Maria Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden.,Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Invernizzi PL, Signorini G, Scurati R, Michielon G, Benedini S, Bosio A, Staiano W. The UP150: A Multifactorial Environmental Intervention to Promote Employee Physical and Mental Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031175. [PMID: 35162197 PMCID: PMC8834533 DOI: 10.3390/ijerph19031175] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 02/01/2023]
Abstract
Physical activity (PA) is a major health factor and studies suggest workplaces could promote PA by modifying office design, motivational strategies and technology. The present study aims to evaluate the efficiency of UP150, a multifactorial workplace intervention for the improvement and maintenance of the level of physical fitness (PF) and wellbeing. Forty-five employees were randomly divided into the experimental (EG) and control (CG) groups. The PF was assessed pre-post intervention using the cubo fitness test (CFT), the amount of PA was evaluated using the IPAQ questionnaire and accelerometers while the workload was assessed using the NASA-TLX questionnaire and psycho-physical health by using the SF-12 questionnaire. The EG worked in UP150 offices while the CG worked in their usual offices for 8 weeks. The EG and CG came back 4 weeks after the intervention for CFT retention. The EG improved CFT motor efficiency and the amount of moderate PA, while it reduced mental load. The EG retained reached motor efficiency levels 4 weeks after the intervention. No differences were found in IPAQ. The UP150 demonstrated to be a proactive environment and to be efficient in the promotion of PA, improving PF and mental health while decreasing mental load.
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Affiliation(s)
- Pietro Luigi Invernizzi
- Department of Biomedical Sciences for Health, University of Milan, 20129 Milan, Italy; (P.L.I.); (G.S.); (R.S.); (G.M.); (S.B.)
| | - Gabriele Signorini
- Department of Biomedical Sciences for Health, University of Milan, 20129 Milan, Italy; (P.L.I.); (G.S.); (R.S.); (G.M.); (S.B.)
| | - Raffaele Scurati
- Department of Biomedical Sciences for Health, University of Milan, 20129 Milan, Italy; (P.L.I.); (G.S.); (R.S.); (G.M.); (S.B.)
| | - Giovanni Michielon
- Department of Biomedical Sciences for Health, University of Milan, 20129 Milan, Italy; (P.L.I.); (G.S.); (R.S.); (G.M.); (S.B.)
| | - Stefano Benedini
- Department of Biomedical Sciences for Health, University of Milan, 20129 Milan, Italy; (P.L.I.); (G.S.); (R.S.); (G.M.); (S.B.)
- Polispecialistic Clinique San Carlo Srl., 20037 Paderno Dugnano, Italy
| | - Andrea Bosio
- Human Performance Laboratory, Mapei Sport Research Centre, 21057 Olgiate Olona, Italy;
| | - Walter Staiano
- Department of Physical Education and Sport, University of Valencia, 46010 Valencia, Spain
- Correspondence:
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Pal Chowdhury J, Haldar C. Stress associated ovarian dysfunctions in a seasonal breeder Funambulus pennanti: Role of glucocorticoids and possible amelioration by melatonin. Gen Comp Endocrinol 2022; 316:113962. [PMID: 34890689 DOI: 10.1016/j.ygcen.2021.113962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 01/11/2023]
Abstract
Studies have shown that stress caused by lack of physical activity disrupts the normal pattern of glucocorticoid secretion which adversely affects the reproductive axis. We studied the effect of chronic movement restriction on ovarian responses in the Indian Palm Squirrel Funambulus pennanti, a highly active diurnal rodent. Physical restraint of squirrels induced stress that led to a significant increase in plasma cortisol, corticosterone and decreased 17β-estradiol level leading to follicular atresia. Ovarian Reactive Oxygen Species (ROS) content, lipid peroxidation (LPO), activities of superoxide dismutase (SOD) and catalase (CAT) enzymes increased in restrained squirrels. Elevated ROS increased the oxidative load that led to ovarian cell death as evidenced by increased Bax and decreased Bcl2 expression causing further decline in Aromatase and ERα proteins. To elaborate the mechanism(s) involved in stress induced glucocorticoid mediated oxidative damages to the ovary we extended our study by exposing ovaries in vitro to the synthetic glucocorticoid dexamethasone (200 μM). We observed that glucocorticoid receptor (GR) expression was significantly increased in dexamethasone treated ovaries in vitro with a decrease in expression of Nrf2 and HO-1 proteins. Melatonin supplementation (10 nM) along with dexamethasone significantly decreased ovarian ROS production, lipid peroxidation and increased antioxidant enzyme activities by improving the expression of Nrf2 and HO-1, reinstating the cellular redox homeostasis. Therefore, it can be suggested that physical restraint induced glucocorticoid and its receptor activation interfered with the ovarian antioxidant defense mechanism. Melatonin via its receptor MT1 significantly alleviated ovarian damages acting as a cytoprotective agent.
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Affiliation(s)
- Jayita Pal Chowdhury
- Pineal Research Lab, Department of Zoology, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Chandana Haldar
- Pineal Research Lab, Department of Zoology, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India.
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15
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Wang R, Blom V, Nooijen CFJ, Kallings LV, Ekblom Ö, Ekblom MM. The Role of Executive Function in the Effectiveness of Multi-Component Interventions Targeting Physical Activity Behavior in Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:266. [PMID: 35010526 PMCID: PMC8751160 DOI: 10.3390/ijerph19010266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/07/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
A knowledge gap remains in understanding how to improve the intervention effectiveness in office workers targeting physically active (PA) behavior. We aim to identify the modifying effect of executive function (EF) on the intervention effectiveness targeting PA-behaviors, and to verify whether the observed effect varies by Job Demand Control (JDC) categories. This workplace-based intervention study included 245 participants who were randomized into a control group and two intervention arms-promoting physical activity (iPA) group or reducing sedentary behavior (iSED) group. The interventions were conducted through counselling-based cognitive behavioral therapy and team activities over 6 months. PA-behaviors were measured by an accelerometer. EF was assessed by the Trail Making Test-B, Stroop, and n-back test. The JDC categories were measured by the demand control questionnaire. Higher EF level at baseline was significantly associated with the intervention effect on increased sleep time (β-coefficient: 3.33, p = 0.003) and decreased sedentary time (-2.76, p = 0.049) in the iSED-group. Participants with active jobs (high job demands, high control) presented significantly increased light-intensity PA in the iSED-group in comparison to the control group. Among participants with a high level of EF and active jobs, relative to the control group, the iPA-group showed a substantial increase in light-intensity PA (1.58, p = 0.036) and the iSED-group showed a tendency of reducing sedentary behavior (-5.35, p = 0.054). The findings suggest that office workers with a high EF and active jobs may benefit most from an intervention study targeting PA-behaviors.
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Affiliation(s)
- Rui Wang
- Department of Physical Activity and Health, the Swedish School of Sport and Health Sciences, GIH, 11433 Stockholm, Sweden; (V.B.); (C.F.J.N.); (L.V.K.); (Ö.E.); (M.M.E.)
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska University Hospital at Huddinge, 14157 Huddinge, Sweden
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
| | - Victoria Blom
- Department of Physical Activity and Health, the Swedish School of Sport and Health Sciences, GIH, 11433 Stockholm, Sweden; (V.B.); (C.F.J.N.); (L.V.K.); (Ö.E.); (M.M.E.)
- Department of Psychology, Stockholm University, 10691 Stockholm, Sweden
| | - Carla F. J. Nooijen
- Department of Physical Activity and Health, the Swedish School of Sport and Health Sciences, GIH, 11433 Stockholm, Sweden; (V.B.); (C.F.J.N.); (L.V.K.); (Ö.E.); (M.M.E.)
| | - Lena V. Kallings
- Department of Physical Activity and Health, the Swedish School of Sport and Health Sciences, GIH, 11433 Stockholm, Sweden; (V.B.); (C.F.J.N.); (L.V.K.); (Ö.E.); (M.M.E.)
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, 75236 Uppsala, Sweden
| | - Örjan Ekblom
- Department of Physical Activity and Health, the Swedish School of Sport and Health Sciences, GIH, 11433 Stockholm, Sweden; (V.B.); (C.F.J.N.); (L.V.K.); (Ö.E.); (M.M.E.)
| | - Maria M. Ekblom
- Department of Physical Activity and Health, the Swedish School of Sport and Health Sciences, GIH, 11433 Stockholm, Sweden; (V.B.); (C.F.J.N.); (L.V.K.); (Ö.E.); (M.M.E.)
- The Department of Neuroscience, Karolinska Institutet, 17176 Stockholm, Sweden
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16
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Blom V, Drake E, Kallings LV, Ekblom MM, Nooijen CFJ. The effects on self-efficacy, motivation and perceived barriers of an intervention targeting physical activity and sedentary behaviours in office workers: a cluster randomized control trial. BMC Public Health 2021; 21:1048. [PMID: 34078342 PMCID: PMC8173750 DOI: 10.1186/s12889-021-11083-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/11/2021] [Indexed: 11/27/2022] Open
Abstract
Background The importance of physical activity on health is clear, but changing behaviour is difficult. Successful interventions aiming to improve physical activity and reduce sedentary behaviour is therefore of importance. The aim of this study was to evaluate effects on motivation, self-efficacy and barriers to change behaviour from two different behavioural intervention focusing either on reducing sedentary behaviour or on increasing physical activity as compared to a waiting list control group. Methods The study was designed as a cluster randomized control trial (RCT) within two private companies. Self-efficacy, motivation and perceived barriers were together with demographic variables assessed before and after a 6-month intervention. Participant cluster teams were randomly allocated to either the physical activity intervention (iPA), the sedentary behaviour intervention (iSED), or control group. The intervention was multi componential and included motivational counselling based on Cognitive behaviour therapy and Motivational interviewing, group activities and management involvement. Group differences were determined using Bayesian multilevel modelling (parameter estimate; credible interval (CI)), analysing complete cases and those who adhered to the protocol by adhering to at least 3 out of 5 intervention sessions. Results After the intervention, the complete cases analysis showed that the iPA group had significantly higher autonomous motivation (0.33, CI: 0.05–0.61) and controlled motivation (0.27, CI: 0.04–0.51) for physical activity compared with the control group. The iSED group scored less autonomous and controlled motivation compared to the iPA group (0.38, CI: − 0.69- -0.087 respectively − 0.32, CI: − 0.57-0.07) but no significant differences compared with the control group. Among individuals that adhered to the protocol, the results showed higher scores on Exercise (3.03, CI: 0.28–6.02) and Sedentary self-efficacy (3.59, CI: 0.35–7.15) for individuals in the iPA group and on Sedentary self-efficacy (4.77, CI: 0.59–9.44) for the iSED group compared to the control group. Conclusion These findings indicate that the interventions were successful in increasing self-efficacy in each intervention group and autonomous motivation for exercise in the iPA group, in particular when actively participating in the motivational counselling sessions.
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Affiliation(s)
- Victoria Blom
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden. .,Division of Insurance medicine, Department of Clinical Neuroscience, Karolinska institutet, Stockholm, Sweden. .,Department of Psychology, Stockholm university, Stockholm, Sweden.
| | - Emma Drake
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Lena V Kallings
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Maria M Ekblom
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
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Kuster RP, Grooten WJA, Blom V, Baumgartner D, Hagströmer M, Ekblom Ö. How Accurate and Precise Can We Measure the Posture and the Energy Expenditure Component of Sedentary Behaviour with One Sensor? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115782. [PMID: 34072243 PMCID: PMC8198866 DOI: 10.3390/ijerph18115782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022]
Abstract
Sedentary behaviour is an emergent public health topic, but there is still no method to simultaneously measure both components of sedentary behaviour-posture and energy expenditure-with one sensor. This study investigated the accuracy and precision of measuring sedentary time when combining the proprietary processing of a posture sensor (activPAL) with a new energy expenditure algorithm and the proprietary processing of a movement sensor (ActiGraph) with a published posture algorithm. One hundred office workers wore both sensors for an average of 7 days. The activPAL algorithm development used 38 and the subsequent independent method comparison 62 participants. The single sensor sedentary estimates were compared with Bland-Atman statistics to the Posture and Physical Activity Index, a combined measurement with both sensors. All single-sensor methods overestimated sedentary time. However, adding the algorithms reduced the overestimation from 129 to 21 (activPAL) and from 84 to 7 min a day (ActiGraph), with far narrower 95% limits of agreements. Thus, combining the proprietary data with the algorithms is an easy way to increase the accuracy and precision of the single sensor sedentary estimates and leads to sedentary estimates that are more precise at the individual level than those of the proprietary processing are at the group level.
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Affiliation(s)
- Roman P. Kuster
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Stockholm, Sweden; (W.J.A.G.); (M.H.)
- IMES Institute of Mechanical Systems, School of Engineering, ZHAW Zurich University of Applied Sciences, 8401 Winterthur, Switzerland;
- Correspondence: ; Tel.: +46-73-997-53-26
| | - Wilhelmus J. A. Grooten
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Stockholm, Sweden; (W.J.A.G.); (M.H.)
- Women’s Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Victoria Blom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, 114 86 Stockholm, Sweden; (V.B.); (Ö.E.)
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Daniel Baumgartner
- IMES Institute of Mechanical Systems, School of Engineering, ZHAW Zurich University of Applied Sciences, 8401 Winterthur, Switzerland;
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Stockholm, Sweden; (W.J.A.G.); (M.H.)
- Academic Primary Health Care Center, Region Stockholm, 104 31 Stockholm, Sweden
| | - Örjan Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, 114 86 Stockholm, Sweden; (V.B.); (Ö.E.)
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Effects of Two Randomized and Controlled Multi-Component Interventions Focusing On 24-Hour Movement Behavior among Office Workers: A Compositional Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084191. [PMID: 33920971 PMCID: PMC8071247 DOI: 10.3390/ijerph18084191] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 01/03/2023]
Abstract
Intervention studies aiming at changing movement behavior have usually not accounted for the compositional nature of time-use data. Compositional data analysis (CoDA) has been suggested as a useful strategy for analyzing such data. The aim of this study was to examine the effects of two multi-component interventions on 24-h movement behavior (using CoDA) and on cardiorespiratory fitness among office workers; one focusing on reducing sedentariness and the other on increasing physical activity. Office workers (n = 263) were cluster randomized into one of two 6-month intervention groups, or a control group. Time spent in sedentary behavior, light-intensity, moderate and vigorous physical activity, and time in bed were assessed using accelerometers and diaries, both for 24 h in total, and for work and leisure time separately. Cardiorespiratory fitness was estimated using a sub-maximal cycle ergometer test. Intervention effects were analyzed using linear mixed models. No intervention effects were found, either for 24-h behaviors in total, or for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Despite a thorough analysis of 24-h behaviors using CoDA, no intervention effects were found, neither for behaviors in total, nor for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Although the design of the multi-component interventions was based on theoretical frameworks, and included cognitive behavioral therapy counselling, which has been proven effective in other populations, issues related to implementation of and compliance with some intervention components may have led to the observed lack of intervention effect.
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Kuster RP, Grooten WJA, Blom V, Baumgartner D, Hagströmer M, Ekblom Ö. Is Sitting Always Inactive and Standing Always Active? A Simultaneous Free-Living activPal and ActiGraph Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8864. [PMID: 33260568 PMCID: PMC7730923 DOI: 10.3390/ijerph17238864] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 12/13/2022]
Abstract
Sedentary Behavior (SB), defined as sitting with minimal physical activity, is an emergent public health topic. However, the measurement of SB considers either posture (e.g., activPal) or physical activity (e.g., ActiGraph), and thus neglects either active sitting or inactive standing. The aim of this study was to determine the true amount of active sitting and inactive standing in daily life, and to analyze by how much these behaviors falsify the single sensors' sedentary estimates. Sedentary time of 100 office workers estimated with activPal and ActiGraph was therefore compared with Bland-Altman statistics to a combined sensor analysis, the posture and physical activity index (POPAI). POPAI classified each activPal sitting and standing event into inactive or active using the ActiGraph counts. Participants spent 45.0% [32.2%-59.1%] of the waking hours inactive sitting (equal to SB), 13.7% [7.8%-21.6%] active sitting, and 12.0% [5.7%-24.1%] inactive standing (mean [5th-95th percentile]). The activPal overestimated sedentary time by 30.3% [12.3%-48.4%] and the ActiGraph by 22.5% [3.2%-41.8%] (bias [95% limit-of-agreement]). The results showed that sitting is not always inactive, and standing is not always active. Caution should therefore be paid when interpreting the activPal (ignoring active sitting) and ActiGraph (ignoring inactive standing) measured time as SB.
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Affiliation(s)
- Roman P. Kuster
- Institute of Mechanical Systems, School of Engineering, ZHAW Zurich University of Applied Sciences, 8400 Winterthur, Switzerland;
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden; (W.J.A.G.); (M.H.)
| | - Wilhelmus J. A. Grooten
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden; (W.J.A.G.); (M.H.)
- Medical Unit Occupational Therapy and Physiotherapy, Allied Health Professionals, Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Victoria Blom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, 114 86 Stockholm, Sweden; (V.B.); (Ö.E.)
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Daniel Baumgartner
- Institute of Mechanical Systems, School of Engineering, ZHAW Zurich University of Applied Sciences, 8400 Winterthur, Switzerland;
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden; (W.J.A.G.); (M.H.)
- Academic Primary Health Care Center, Region Stockholm, 104 31 Stockholm, Sweden
| | - Örjan Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, 114 86 Stockholm, Sweden; (V.B.); (Ö.E.)
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Nooijen CFJ, Blom V, Ekblom Ö, Heiland EG, Larisch LM, Bojsen-Møller E, Ekblom MM, Kallings LV. The effectiveness of multi-component interventions targeting physical activity or sedentary behaviour amongst office workers: a three-arm cluster randomised controlled trial. BMC Public Health 2020; 20:1329. [PMID: 32873260 PMCID: PMC7466462 DOI: 10.1186/s12889-020-09433-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/24/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Interventions to increase physical activity or reduce sedentary behaviour within the workplace setting have shown mixed effects. This cluster randomised controlled trial assessed whether multi-component interventions, focusing on changes at the individual, environmental, and organisational levels, either increased physical activity or reduced sedentary behaviour, compared to a passive control group. METHODS Teams of office-workers from two companies participated in one of two interventions (iPA: targeting physical activity; or iSED: targeting sedentary behaviour), or wait-list control group (C). Exclusion criterion was very high physical activity level (MVPA ≥30 min/day in ≥10 min bouts every day). Randomisation occurred at the level of workplace cluster, and groups were randomly allocated (1:1) with stratification for company and cluster size. Personnel involved in data collection and processing were blinded to group allocation. Both interventions included five sessions of cognitive behavioural therapy counselling for 6 months. iPA included counselling focused on physical activity, access to a gym, and encouragement to exercise, and go for lunch walks. iSED included counselling on sedentary behaviour and encouragement to reduce sitting and increase engagement in standing- and walking-meetings. At baseline and the 6-month mark accelerometers were worn on the hip and thigh for 7 days. The primary outcomes were group differences in time spent in moderate-to-vigorous intensity physical activity (%MVPA) and in sedentary behaviour (%), analysed using Bayesian multilevel modelling for those with complete data. RESULTS Two-hundred and sixty three office workers (73% women, mean age 42 ± 9 years, education 15 ± 2 years) were randomised into 23 cluster teams (iPA n = 84, 8 clusters; iSED n = 87, 7 clusters; C n = 92, 7 clusters). No significant group differences (posterior mean ratios: 95% credible interval) were found after the intervention for %MVPA or for %Sedentary. %MVPA: iPA vs C (0·04: - 0·80-0·82); iSED vs C (0·47: - 0·41-1·32); iPA vs iSED (0·43: - 0·42-1·27). %Sedentary: iPA vs C (1·16: - 1·66-4·02); iSED vs C (- 0·44: - 3·50-2·64); iPA vs iSED (- 1·60: - 4·72-1·47). CONCLUSIONS The multi-component interventions focusing on either physical activity or sedentary behaviour were unsuccessful at increasing device-measured physical activity or reducing sedentary behaviour compared to a control group. TRIAL REGISTRATION ISRCTN, ISRCTN92968402 . Registered 27/2/2018, recruitment started 15/03/2018.
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Affiliation(s)
- Carla F J Nooijen
- The Swedish School of Sport and Health Sciences (GIH), Box 5626, SE-114 86, Stockholm, Sweden.,The Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Victoria Blom
- The Swedish School of Sport and Health Sciences (GIH), Box 5626, SE-114 86, Stockholm, Sweden.,The Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Örjan Ekblom
- The Swedish School of Sport and Health Sciences (GIH), Box 5626, SE-114 86, Stockholm, Sweden
| | - Emerald G Heiland
- The Swedish School of Sport and Health Sciences (GIH), Box 5626, SE-114 86, Stockholm, Sweden
| | - Lisa-Marie Larisch
- The Swedish School of Sport and Health Sciences (GIH), Box 5626, SE-114 86, Stockholm, Sweden
| | - Emil Bojsen-Møller
- The Swedish School of Sport and Health Sciences (GIH), Box 5626, SE-114 86, Stockholm, Sweden
| | - Maria M Ekblom
- The Swedish School of Sport and Health Sciences (GIH), Box 5626, SE-114 86, Stockholm, Sweden.,The Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lena V Kallings
- The Swedish School of Sport and Health Sciences (GIH), Box 5626, SE-114 86, Stockholm, Sweden. .,Department of Public Health and Caring Sciences, Family Medicine, Uppsala University, Uppsala, Sweden.
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Larisch LM, Kallings LV, Hagströmer M, Desai M, von Rosen P, Blom V. Associations between 24 h Movement Behavior and Mental Health in Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176214. [PMID: 32867159 PMCID: PMC7503924 DOI: 10.3390/ijerph17176214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/27/2020] [Accepted: 08/19/2020] [Indexed: 12/15/2022]
Abstract
The associations between 24 h movement behavior, i.e., the way people distribute their time in different movement-related behaviors, on mental health are not well understood. This study applied a compositional data analysis approach to explore cross-sectional associations between device-measured moderate to vigorous physical activity (MVPA), light intensity physical activity (LIPA), sedentary behavior (SED), self-reported time in bed and mental health outcomes, i.e., depression or anxiety symptoms, burnout, mental wellbeing and stress, in office workers. ActiGraph accelerometers were worn for 24 h for at least 4 days to assess MVPA, LIPA, and SED. Sleep diaries were used in addition to identify time in bed. Analytic sample sizes for the different outcomes ranged from N = 345-370 participants. In this population of office workers with high levels of MVPA, the entire movement behavior composition was not associated to any of the mental health outcomes, but MVPA relative to all other behaviors was positively associated with mental wellbeing. This confirms the importance of MVPA for health relative to other movement-related behaviors.
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Affiliation(s)
- Lisa-Marie Larisch
- Department for Physical Activity and Health, The Swedish School of Sport and Health Sciences, 114 33 Stockholm, Sweden; (L.V.K.); (V.B.)
- Correspondence: ; Tel.: +46-72-247-8050
| | - Lena V. Kallings
- Department for Physical Activity and Health, The Swedish School of Sport and Health Sciences, 114 33 Stockholm, Sweden; (L.V.K.); (V.B.)
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, 752 36 Uppsala, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, 141 83 Stockholm, Sweden; (M.H.); (P.v.R.)
- Academic Primary Health Care Centre, Region Stockholm, 113 65 Stockholm, Sweden
- Department of Health Promoting Science, Sophiahemmet University, 11486 Stockholm, Sweden
| | - Manisha Desai
- Quantitative Science Unit, Stanford University, Palo Alto, CA 94304, USA;
| | - Philip von Rosen
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, 141 83 Stockholm, Sweden; (M.H.); (P.v.R.)
| | - Victoria Blom
- Department for Physical Activity and Health, The Swedish School of Sport and Health Sciences, 114 33 Stockholm, Sweden; (L.V.K.); (V.B.)
- Department of Neuroscience, Karolinska Institutet, 171 65 Stockholm, Sweden
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Chen MF, Ke SR, Liu CL, Wu TC, Yu YM, Chiou AF. Associated factors and impacts of sedentary behaviour in patients with heart failure: A longitudinal study. Eur J Cardiovasc Nurs 2020; 19:609-618. [PMID: 32338530 DOI: 10.1177/1474515120912381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sedentary behaviours may be related to factors such as self-efficacy, mood and social support. However, there is a paucity of longitudinal follow-up studies examining factors related to sedentary behaviour from physical-psychosocial perspectives in patients with heart failure. AIMS The purpose of this study was to explore the multidimensional associated factors and impacts of sedentary behaviour in heart failure patients. METHODS A longitudinal design was used. A convenience sample of 128 heart failure patients recruited from two large medical centres in northern Taiwan was obtained. Patients were interviewed with structured questionnaires to assess physical activity, symptom distress, exercise self-efficacy, anxiety and depression, social support, sleep quality and quality of life before discharge and at 3 and 6 months after discharge. RESULTS Heart failure patients reported low physical activity and tended to be sedentary. Sedentary behaviour was gradually reduced from hospitalization to 6 months after discharge. Sleep quality, quality of life, analgesic use, symptom distress and exercise self-efficacy were significant associated factors that explained 42.1-51% of the variance in sedentary behaviour. Patients with high sedentary behaviour had significantly greater depression and poorer sleep and quality of life than those with low sedentary behaviour at hospitalization and showed a significant improvement in depression at 3 and 6 months after discharge. CONCLUSION Sedentary behaviour is common in heart failure patients and has impacts on depression and quality of life. An appropriate physical activity programme focusing on disease self-management and enhancing self-efficacy is needed for heart failure patients to improve their sedentary behaviour and quality of life.
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Affiliation(s)
- Mei-Fang Chen
- Department of Nursing, Far Eastern Memorial Hospital, Taiwan
| | - Shin-Rong Ke
- Cardiovascular Medicine Department, Far Eastern Memorial Hospital, Taiwan.,General Education Center, Chihlee University of Technology, Taiwan
| | - Chih-Ling Liu
- Department of Nursing, Taipei Veterans General Hospital, Taiwan
| | - Tao-Cheng Wu
- Division of Cardiology, Taipei Veterans General Hospital, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taiwan
| | - Ya-Mei Yu
- Department of Nursing, Far Eastern Memorial Hospital, Taiwan
| | - Ai-Fu Chiou
- School of Nursing, National Yang-Ming University, Taiwan
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