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Lönn A, Ekblom Ö, Kallings LV, Börjesson M, Ekström M. Decrease in accelerometer assessed physical activity during the first-year post-myocardial infarction: a prospective cohort study. SCAND CARDIOVASC J 2024; 58:2397442. [PMID: 39193855 DOI: 10.1080/14017431.2024.2397442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/18/2024] [Accepted: 07/29/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVES To elucidate physical activity in the first year after myocardial infarction (MI), and to explore differences in various subgroups, delineated by age, participation in exercise-based cardiac rehabilitation (exCR), or restrictions due to the covid-19 pandemic. Secondly, to explore associations between changes in physical activity variables with blood pressure and lipid levels. METHODS A longitudinal study in 2017-2023. Physical activity variables were assessed via accelerometers at two- and twelve months post-MI. The intensity was divided into, sedentary, light, moderate, and vigorous-intensity physical activity, according to established cut-offs. Blood pressure and lipids were measured by standardized procedures at the same time points. RESULTS There were 178 patients included at baseline, 81% male, mean age of 64 (9 SD) years. Patients spent 72% of their time sedentary, followed by light (19%), moderate (8%), and vigorous physical activity (1%). Patients included during covid-19 restrictions and younger patients had a higher level of moderate-intensity physical activity compared to patients included during non-pandemic restrictions and older patients. At 12-month follow-up, patients overall increased time (1%) in sedentary behavior (p = 0.03) and decreased time (0.6%) in moderate-intensity physical activity (p = 0.04), regardless of participation in exCR or age. There was a positive association between the change in mean physical activity intensity and HDL-cholesterol (p = 0.047). CONCLUSIONS Participants had a low fraction of time in moderate-to-vigorous-intensity physical activity two months post-MI, which deteriorated during the first year. This emphasizes the need for improved implementation of evidence-based interventions to support and motivate patients to perform regular physical activity.
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Affiliation(s)
- Amanda Lönn
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Women´s Health and Allied Health Professionals Theme Medical Unit Occupational therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Örjan Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Solna, Sweden
| | - Lena Viktoria Kallings
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Unit of Family Medicine, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mats Börjesson
- Center for lifestyle intervention, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of MGAÖ, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mattias Ekström
- Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm, Sweden
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Phillips SM, Starikovsky J, Solk P, Desai R, Reading JM, Hasanaj K, Wang SD, Cullather E, Lee J, Song J, Spring B, Gradishar W. Feasibility and preliminary effects of the Fit2ThriveMB pilot physical activity promotion intervention on physical activity and patient reported outcomes in individuals with metastatic breast cancer. Breast Cancer Res Treat 2024; 208:391-403. [PMID: 39014267 DOI: 10.1007/s10549-024-07432-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE Physical activity research among patients with metastatic breast cancer (MBC) is limited. This study examined the feasibility and potential benefits of Fit2ThriveMB, a tailored mHealth intervention. METHODS Insufficiently active individuals with MBC (n = 49) were randomized 1:1 to Fit2ThriveMB (Fit2ThriveMB app, Fitbit, and weekly coaching calls) or Healthy Lifestyle attention control (Cancer.Net app and weekly calls) for 12 weeks. Fit2ThriveMB aimed to increase daily steps via an algorithm tailored to daily symptom rating and step goal attainment. The primary outcome was feasibility defined as ≥ 80% completion rate. Secondary feasibility metrics included meeting daily step goal and wearing the Fitbit ≥ 70% of study days, fidelity, adherence to intervention features and safety. Secondary outcomes included physical activity, sedentary time, patient reported outcomes (PROs), health-related quality of life (QOL) and social cognitive theory constructs. A subsample (n = 25) completed functional performance tests via video conferencing. RESULTS The completion rate was 98% (n = 1 died). No related adverse events were reported. Fit2ThriveMB participants (n = 24) wore the Fitbit 92.7%, met their step goal 53.1%, set a step goal 84.6% and used the app 94.1% of 84 study days. Intent-to-treat analyses indicated trends toward improvements in activity, QOL, and some PROs, social cognitive theory constructs, and functional performance tests favoring the Fit2ThriveMB group. Significant effects favoring Fit2ThriveMB were observed for self-efficacy and goal-setting. However, some PROs and functional performance improvements favored the control group (p-values > 0.05). CONCLUSIONS Fit2ThriveMB is feasible and safe for patients with MBC and warrants further evaluation in randomized controlled trials with larger sample sizes. Registration Clinicaltrials.gov NCT04129346, https://clinicaltrials.gov/ct2/show/NCT04129346.
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Affiliation(s)
- Siobhan M Phillips
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA.
| | - Julia Starikovsky
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Payton Solk
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Ria Desai
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Jean M Reading
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Kristina Hasanaj
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Shirlene D Wang
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Erin Cullather
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Jungwha Lee
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Jing Song
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - William Gradishar
- Department of Medicine, Hematology and Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Pesonen E, Farrahi V, Brakenridge CJ, Ollila MM, Morin-Papunen LC, Nurkkala M, Jämsä T, Korpelainen R, Moran LJ, Piltonen TT, Niemelä M. 24-hour movement behaviours and cardiometabolic markers in women with polycystic ovary syndrome (PCOS): a compositional data analysis. Hum Reprod 2024:deae232. [PMID: 39366675 DOI: 10.1093/humrep/deae232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 09/02/2024] [Indexed: 10/06/2024] Open
Abstract
STUDY QUESTION Are 24-h movement composition and time reallocations between the movement behaviours (moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behaviour (SB), and sleep) differentially associated with cardiometabolic markers in women with polycystic ovary syndrome (PCOS) relative to women without PCOS? SUMMARY ANSWER There was no difference in 24-h movement composition between the groups, although among women without PCOS, reducing SB time while increasing either MVPA or LPA time was associated with beneficial differences in cardiometabolic markers, whereas in women with PCOS beneficial differences were observed only when SB time was replaced with MVPA. WHAT IS KNOWN ALREADY Women with PCOS display lower levels of physical activity, higher sedentary time, and less total sleep than women without the syndrome. Exercise interventions among women with PCOS have shown improvements in body composition and insulin sensitivity, while the findings regarding blood pressure, insulin resistance, and lipid profiles are contradictory. STUDY DESIGN, SIZE, DURATION This study was part of a prospective, general population-based Northern Finland Birth Cohort 1966 (NFBC1966) (n = 5889 women). At the 31-year and 46-year follow-up, data collection was performed through postal and clinical examinations, including fasting blood samples and anthropometric measurements. Accelerometer data collection of 14 days (n = 2602 women) and a 2-h oral glucose tolerance test (n = 2780 women) were performed at the 46-year follow-up. Participants were identified as women with or without PCOS at age 31 (n = 1883), and the final study population included those who provided valid accelerometer data at age 46 (n = 857). PARTICIPANTS/MATERIALS, SETTING, METHODS Women with PCOS (n = 192) were identified based on the 2023 International Evidence-based Guideline, while those who exhibited no PCOS features were considered women without PCOS (controls; n = 665). Accelerometer-measured MVPA, LPA, and SB were combined with self-reported sleep to obtain 24-h compositions. Multivariable regression analysis based on compositional data analysis and isotemporal reallocations were performed to investigate the associations between 24-h movement composition and cardiometabolic markers. Isotemporal reallocations were expressed as differences (%Δ) from the sample's mean. MAIN RESULTS AND THE ROLE OF CHANCE There was no difference in overall 24-h movement composition between women with PCOS and controls in midlife. The 24-h movement composition was associated with waist circumference, triglycerides, fasting serum insulin, and Homeostatic Model Assessment-insulin resistance (HOMA-IR) in both controls and women with PCOS. Reallocating 15 min from SB to MVPA was associated with favourable differences in cardiometabolic markers in both controls (%Δ range from -1.7 to -4.9) and women with PCOS (%Δ range from -1.9 to -8.6). Reallocating 15 min from SB to LPA was also associated with favourable differences in cardiometabolic markers among controls (%Δ range from -0.5 to -1.6) but not among women with PCOS. LIMITATIONS, REASONS FOR CAUTION The substitution technique used in this study is theoretical, which can be considered as a limitation. Other limitations of this study are the use of self-reported sleeping time and the difference in the group sample sizes. WIDER IMPLICATIONS OF THE FINDINGS These findings suggest that women with PCOS should be targeted with interventions involving physical activity of at least moderate intensity to improve their cardiometabolic health and underline the importance of developing tailored activity guidelines for women with PCOS. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Jenny and Antti Wihuri Foundation, Sigrid Juselius Foundation, Novo Nordisk (NNF21OC0070372), Research Council of Finland (315921/2018, 321763/2019, 6GESS 336449), Ministry of Education and Culture of Finland (OKM/54/626/2019, OKM/85/626/2019, OKM/1096/626/2020, OKM/20/626/2022, OKM/76/626/2022, and OKM/68/626/2023), and Roche Diagnostics International Ltd. L.J.M. is supported by a Veski Fellowship. M.Nu. has received funding from Fibrobesity-project, a strategic profiling project at the University of Oulu, which is supported by Research Council of Finland (Profi6 336449). NFBC1966 follow-ups received financial support from University of Oulu (Grant no. 65354, 24000692), Oulu University Hospital (Grant no. 2/97, 8/97, 24301140), Ministry of Health and Social Affairs (Grant no. 23/251/97, 160/97, 190/97), National Institute for Health and Welfare, Helsinki (Grant no. 54121), Regional Institute of Occupational Health, Oulu, Finland (Grant no. 50621, 54231), and ERDF European Regional Development Fund (Grant no. 539/2010 A31592). T.T.P. declares consulting fees from Gedeon Richter, Organon, Astellas, Roche; speaker's fees from Gedeon Richter, Exeltis, Roche, Stragen, Merck, Organon; and travel support from Gedeon Richter. The remaining authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- E Pesonen
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - V Farrahi
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
| | - C J Brakenridge
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
| | - M M Ollila
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - L C Morin-Papunen
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - M Nurkkala
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - T Jämsä
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - R Korpelainen
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - L J Moran
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC, Australia
| | - T T Piltonen
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - M Niemelä
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Centre for Wireless Communications, University of Oulu, Oulu, Finland
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Atoui S, Bernard P, Carli F, Liberman AS. Association Between Physical Activity, Sedentary Behaviors, and Sleep-Related Outcomes Among Cancer Survivors: a Cross-Sectional Study. Int J Behav Med 2024; 31:741-752. [PMID: 37656309 DOI: 10.1007/s12529-023-10216-8] [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] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Limited research has examined the association between moderate to vigorous physical activity (MVPA), sedentary behavior (SB), and sleep-related outcomes in cancer survivors. Therefore, this study aimed to examine these associations using a nationally representative sample of US adults. METHODS Data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. A total of 3229 adults with cancer histories were included. Physical activity was measured through accelerometry, and questions on daily activities, sedentary time, and sleep were collected during the household interview. Weighted multivariable analyses were conducted after accounting for the complex sampling design of the NHANES dataset. RESULTS After adjustments, physical activity and SB outcomes were associated with several self-reported sleep-related parameters. Increases in minutes of self-reported MVPA and SB were associated with a decreased likelihood of reporting ≥ 8 h of sleep (OR = 0.92, 95% CI = 0.86, 0.99 and OR = 0.88, 95% CI = 0.82, 0.95). Converse associations were found between device-measured MVPA and SB with the likelihood of reporting often/always feeling overly sleepy during the day (OR = 0.86, 95% CI = 0.75 and OR = 1.13, 95% CI = 1.05, respectively). However, an increased likelihood of waking up too early in the morning (OR = 1.22, 95% CI = 1.04) was observed with increases in minutes of device-measured MVPA. CONCLUSIONS A sensible strategy to decrease the frequency of sedentary breaks and increase minutes of physical activity throughout the day may reduce sleep complaints reported in cancer survivors.
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Affiliation(s)
- Sarah Atoui
- Division of Experimental Surgery, Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, Room L10.106, Montreal, QC, H3G 1A4, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, 141, Avenue du Président Kennedy, Montreal, QC, H2X 1Y4, Canada
- Research Centre, University Institute of Mental Health in Montreal, Montreal, QC, Canada
| | - Francesco Carli
- Department of Anesthesia, McGill University Health Centre, 1650 Cedar Ave, Room E10.160, Montreal, QC, H3G 1A4, Canada
| | - A Sender Liberman
- Division of Experimental Surgery, Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, Room L10.106, Montreal, QC, H3G 1A4, Canada.
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Vazquez JE, Sotres-Alvarez D, Carlson JA, Gallo LC, Talavera GA, Castañeda SF, Evenson KR. Concurrent validity of the Global Physical Activity Questionnaire to accelerometry in Hispanic/Latino adults: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Sci Med Sport 2024; 27:708-715. [PMID: 39003169 DOI: 10.1016/j.jsams.2024.06.005] [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: 01/17/2024] [Revised: 05/30/2024] [Accepted: 06/17/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVES The validity of the Global Physical Activity Questionnaire has not been thoroughly evaluated among Hispanics/Latinos. In this cross-sectional study, we assessed the concurrent validity and correlates of discordance of the Global Physical Activity Questionnaire by comparing it to accelerometry in estimating sedentary behavior, moderate-to-vigorous physical activity, and meeting United States physical activity guidelines by sociodemographic, behavioral, and health characteristics. DESIGN The Hispanic Community Health Study/Study of Latinos is a 4-site cohort study of United States adults aged 18-74 years enrolled from 2008 to 2011. METHODS Participants (n = 11,873) completed the Global Physical Activity Questionnaire and wore an accelerometer for 1 week. Lin's concordance and Pearson correlations assessed concurrent validity between self-reported and accelerometry-assessed measures of sedentary behavior and moderate-to-vigorous physical activity. Kappa coefficients assessed agreement of meeting physical activity guidelines. Linear and logistic regression models identified correlates of discordance. RESULTS The overall Lin's concordance and Pearson correlations between the Global Physical Activity Questionnaire and accelerometry estimates were 0.10 (95 % confidence interval 0.09, 0.12) and 0.24 (0.21, 0.27) for sedentary behavior, and 0.04 (0.03, 0.05) and 0.18 (0.15, 0.22) for moderate-to-vigorous physical activity, respectively. Agreement was poor for meeting the physical activity guideline classifications (Kappa coefficients: 0.12 to 0.26). Over a 16-hour day, sedentary behavior was under-reported by 3.8 h and moderate-to-vigorous physical activity was over-reported by 1.9 h. CONCLUSIONS The concurrent validity of the Global Physical Activity Questionnaire in measuring moderate-to-vigorous physical activity and sedentary behavior when compared to accelerometry was poor among Hispanic/Latino adults.
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Affiliation(s)
- Jesus E Vazquez
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, United States.
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, United States
| | - Jordan A Carlson
- Center for Children's Health Lifestyles & Nutrition, Children's Mercy Kansas City, United States
| | - Linda C Gallo
- Department of Pediatrics, Children's Mercy Kansas City and University of Missouri Kansas City, United States
| | | | | | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, United States
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Adeyinka BO, Gatti AA, Chopp-Hurley JN. Investigating the relationship between physical activity and self-reported outcomes in adults with rotator cuff related shoulder pain. Physiother Theory Pract 2024; 40:2256-2264. [PMID: 37642369 DOI: 10.1080/09593985.2023.2250438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Rotator cuff related shoulder pain is common among older adults. While exercise is often recommended for this condition, the relationship between physical activity levels and self-reported outcomes is unclear. This study investigated whether self-reported outcomes (pain, function, depressive symptoms, self-efficacy, general mental and physical health) relate to physical activity, and whether those who participated in shoulder-specific exercise had better self-reported outcomes than those who performed whole-body exercise. METHODS Forty-six participants with rotator cuff related shoulder pain participated from which 35 had complete datasets. Questionnaires were used to assess physical activity, pain, physical function, general health, and self-efficacy. Physical activity levels were also measured using an accelerometer. RESULTS Neither pain nor other self-reported outcomes were related to subjective or objective physical activity levels. Participants that completed shoulder-specific exercise had significantly higher exercise self-efficacy than those who completed nonspecific exercise (P = .01; d = 0.91). CONCLUSION A significant relationship between pain or self-reported outcomes and physical activity was not identified. Those who self-reported regularly exercising their injured shoulder had higher exercise self-efficacy than those who did not. These findings have clinical implications, suggesting that strategies to boost exercise self-efficacy may be important for older adults with rotator cuff related shoulder pain.
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Affiliation(s)
- Baithat O Adeyinka
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Anthony A Gatti
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
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Pomiersky R, Matting L, Haigis D, Eschweiler GW, Frahsa A, Niess A, Thiel A, Sudeck G. Physical Activity, Sedentary Behavior, and Their Predictors Among Nursing Home Residents-Cross-Sectional Results of the BaSAlt Study. J Aging Phys Act 2024; 32:588-597. [PMID: 38589013 DOI: 10.1123/japa.2023-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 12/04/2023] [Accepted: 02/23/2024] [Indexed: 04/10/2024]
Abstract
Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (β = -0.27, p = .008), body mass index (β = -0.29, p = .002), Barthel Index (β = 0.24, p = .040), and hand grip strength (β = 0.30, p = .048). SB was significantly predicted by body mass index (β = 0.27, p = .008) and Barthel Index (β = -0.30, p = .012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB.
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Affiliation(s)
- Rebekka Pomiersky
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Leon Matting
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Daniel Haigis
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Gerhard W Eschweiler
- Center for Geriatric Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Andreas Niess
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Gordon Sudeck
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
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8
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Kim S, Mangum LC, Glaviano NR. Influence of unilateral versus bilateral patellofemoral pain on physical activity, pain self-efficacy, and disability. Musculoskelet Sci Pract 2024; 73:103167. [PMID: 39178490 DOI: 10.1016/j.msksp.2024.103167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 08/10/2024] [Accepted: 08/19/2024] [Indexed: 08/25/2024]
Abstract
BACKGROUND Patellofemoral pain (PFP) affects physical and psychosocial health; however, it is unclear if unilateral and bilateral PFP induce similar levels of impairments. OBJECTIVES We aimed to compare physical activity (PA), pain self-efficacy, and disability between individuals with unilateral and bilateral PFP, and to compare these groups against pain-free controls. DESIGN Cross-sectional case-control. METHOD Sixty-two individuals with PFP (25 unilateral and 37 bilateral) and 20 pain-free controls completed the PA assessment using an accelerometer by daily steps, light PA, and moderate-to-vigorous PA (MVPA). We also calculated variability in each PA variable. Pain self-efficacy and disability were measured using the Pain Self-Efficacy Questionnaire and Anterior Knee Pain Scale, respectively. RESULTS Individuals with bilateral PFP took fewer daily steps compared to pain-free controls (9568.1 ± 3827.0 vs. 12,285.8 ± 2821.2 steps/day; P = 0.018, Cohen d = 0.79), whereas individuals with unilateral PFP did not (11,099.2 ± 3547.1 steps/day; P = 0.503, Cohen d = 0.37). Individuals with bilateral PFP showed greater variability in MVPA compared to individuals with unilateral PFP (42.9 ± 23.1 vs. 29.0 ± 15.9; P = 0.011, Cohen d = 0.91) and pain-free controls (42.9 ± 23.1 vs. 17.6 ± 6.1; P < 0.001, Cohen d = 1.21). Individuals with unilateral and bilateral PFP similarly exhibited less time spent in MVPA, greater variability in daily steps, lower pain self-efficacy, and greater disability compared to pain-free controls (P < 0.001, Cohen d = 1.14-3.89). CONCLUSIONS Versus pain-free controls, individuals with bilateral PFP displayed greater variability in MVPA than individuals with unilateral PFP. However, it is important to note that unilateral PFP influenced time spent in MVPA, variability in daily steps, pain self-efficacy, and disability at similar levels to bilateral PFP.
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Affiliation(s)
- Sungwan Kim
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States; Institute for Sports Medicine, University of Connecticut, Storrs, CT, United States.
| | - L Colby Mangum
- School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, FL, United States; Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Neal R Glaviano
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States; Institute for Sports Medicine, University of Connecticut, Storrs, CT, United States
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Nagai K, Matsuzawa R, Sasai H, Tamaki K, Kusunoki H, Wada Y, Tsuji S, Hashimoto K, Mori T, Shinmura K. Developing a brief older adults' physical activity questionnaire. Geriatr Gerontol Int 2024. [PMID: 39348881 DOI: 10.1111/ggi.14986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 09/02/2024] [Accepted: 09/13/2024] [Indexed: 10/02/2024]
Abstract
AIM This study aimed to develop and evaluate the Brief Older Adults' Physical Activity Questionnaire (BOPAQ), which was designed to quickly assess moderate-to-vigorous physical activity (MVPA) in community-dwelling older adults. METHODS We used a cross-sectional study design involving 165 older participants. The BOPAQ calculated weekly MVPA duration based on two questions regarding the number of days per week engaged in MVPA and the daily duration of activity. Validity was assessed by correlating the MVPA durations derived from the BOPAQ with those obtained from the ActiGraph and International Physical Activity Questionnaire short form. Reliability was evaluated using the intraclass correlation coefficient, and measurement errors were analyzed using Bland-Altman plots. RESULTS The BOPAQ reasonably correlated with accelerometer-based MVPA (rho = 0.297) and showed good test-retest reliability (intraclass correlation coefficient of 0.78, 95% CI 0.64-0.87). In contrast, the correlation between the International Physical Activity Questionnaire short form and accelerometer-based MVPA was poor (rho = 0.139). The cut-off value for the BOPAQ was set to identify participants engaging in <150 min of objectively measured physical activity per week, corresponding to the 150-min threshold. However, the area under the curve in the receiver operating characteristic analyses was not significantly high (0.601, 95% CI 0.514-0.688). The Bland-Altman plots showed an underestimation bias of 51.72 min/week (95% CI 1.61-101.84) and showed heteroscedasticity. CONCLUSION Despite some measurement errors, the BOPAQ is an available tool for assessing MVPA in community-dwelling older adults. Geriatr Gerontol Int 2024; ••: ••-••.
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Affiliation(s)
- Koutatsu Nagai
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan
| | - Ryota Matsuzawa
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kayoko Tamaki
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Hiroshi Kusunoki
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Department of Internal Medicine, Osaka Dental University, Hirakata, Japan
| | - Yosuke Wada
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Roppou Clinic, Toyooka, Japan
| | - Shotaro Tsuji
- Department of Orthopedic Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Kana Hashimoto
- School of Pharmacy, Hyogo Medical University, Kobe, Japan
| | - Takara Mori
- Amagasaki Medical COOP Honden Clinic, Amagasaki, Japan
| | - Ken Shinmura
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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Sepúlveda AR, Rojo M, Lacruz T, Solano S, Graell M, Veiga ÓL. Testing a Family System-based Intervention (ENTREN-F Programme) for a paediatric obesity sample by a Randomized Controlled Trial. Appetite 2024:107696. [PMID: 39353503 DOI: 10.1016/j.appet.2024.107696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 08/06/2024] [Accepted: 09/27/2024] [Indexed: 10/04/2024]
Abstract
This study evaluated the effectiveness of 'ENTREN-F' -a multi-component, family system-based intervention- for managing paediatric obesity at National Health Primary Care. A 3-arm, parallel-design, single-blinded randomized controlled trial (RCT), 165 families were randomized: Arm 1) ENTREN-F(n = 62) is a 12-week cognitive-behavioural intervention (CBT) family system-based programme, addressing lifestyle changes, children's emotional and social development and the family system, Arm 2) 'ENTREN' (n = 52) is a CBT family-based programme for children and parents, not addressing the family system, and Arm 3) Control group (CG) (n = 51) covers individual behavioural monitoring. All children were clinical interviewed to assess a diagnosis. Their effectiveness was assessed against six-month changes in children's body mass index (BMI) z-score, children's psychological well-being, levels of expressed maternal emotion, depression symptoms, parental feeding practices, levels of physical activity and sedentary lifestyles. The maintenance of the changes was evaluated for two years. High-attendance rates for ENTREN-F (72.6% vs. 66% vs. 33%, respectively) indicated its greater acceptance. After programme completion, the BMI z-score reduced by 0.5 points in almost 50% ENTREN-F (n = 22/45), 21.9% ENTREN (n = 7/32) and 11.8% (n = 2/17) CG participants. There were no significant differences between the three trial arms for anthropometric, psychological, or family-related measures. At the two-year follow-up, both ENTREN-F and ENTREN showed similar long-term effectiveness without between-group differences, and weight trajectories were favourable. ENTREN-F appears effective for childhood obesity management; however, the COVID-19 pandemic limited the sample size. Also, the tendency towards multiple differences in child and family outcomes could not be statistically shown. It also provides further evidence of the role of psychological and family-related factors that may underlie the origin and maintenance of weight gain.
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Affiliation(s)
- Ana Rosa Sepúlveda
- Department of Biological and Health Psychology. Faculty of Psychology. Autonomous University of Madrid, Campus of Cantoblanco. 28049. Spain.
| | - Marta Rojo
- Faculty of Psychology. Autonomous University of Madrid, Campus of Cantoblanco. 28049. Spain.
| | - Tatiana Lacruz
- Faculty of Psychology. Autonomous University of Madrid, Campus of Cantoblanco. 28049. Spain
| | - Santos Solano
- Faculty of Psychology. Autonomous University of Madrid, Campus of Cantoblanco. 28049. Spain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Clinical Psychology, Niño Jesús Child Hospital. Faculty of Medicine. Autonomous University of Madrid. CIBERSAM Member, Madrid, Spain.
| | - Óscar L Veiga
- Department of Physical Education, Sport & Human Motricity. Autonomous University of Madrid, Campus of Cantoblanco. 28049. Spain.
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11
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Nilsson J, Jiang Y, Johannesson M, Moberg M, Wang R, Fabre S, Lövdén M, Ekblom Ö, Ekblom M. Plasma markers of neurodegeneration, latent cognitive abilities and physical activity in healthy aging. Sci Rep 2024; 14:21702. [PMID: 39289522 PMCID: PMC11408627 DOI: 10.1038/s41598-024-72806-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Accepted: 09/10/2024] [Indexed: 09/19/2024] Open
Abstract
Blood-based biomarkers of neurodegeneration demonstrate great promise for the diagnosis and prognosis of Alzheimer's disease. Ultra-sensitive plasma assays now allow for quantification of the lower concentrations in cognitively unimpaired older adults, making it possible to investigate whether these markers can provide insight also into the early neurodegenerative processes that affect cognitive function and whether the markers are influenced by modifiable risk factors. Adopting an exploratory approach in 93 healthy older adults (65-75 years), we used structural equation modelling to investigate cross-sectional associations between multiple latent cognitive abilities (working memory, episodic memory, spatial and verbal reasoning) and plasma amyloid beta (Aβ42/Aβ40 ratio), phosphorylated-tau 181 (ptau-181), glial fibrillary acidic protein (GFAP), and neurofilament light (NfL), as well as the influence of device-measured habitual physical activity on these associations. The results showed that NfL was negatively associated with working memory, and that NfL interacted with moderate-to-vigorous physical activity in its association with episodic memory. The study has thereby demonstrated the potential of neurodegenerative plasma markers for improving understanding of normative cognitive aging and encourages future research to test the hypothesis that high levels of NfL, indicative of white matter pathology, limit the beneficial effect of physical activity on episodic memory in healthy aging.
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Affiliation(s)
- Jonna Nilsson
- Swedish School of Sport and Health Sciences, Stockholm, Sweden.
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
| | - Yiwen Jiang
- Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | | | - Marcus Moberg
- Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Rui Wang
- Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | | | - Martin Lövdén
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Örjan Ekblom
- Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Maria Ekblom
- Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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12
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Kunin-Batson AS, Crain AL, Sherwood NE, Kelly AS, Kharbanda EO, Gunnar MR, Haapala J, Seburg EM, French SA. Do Children's Health Behaviors Buffer the Impact of Cumulative Environmental Stress on Emerging Cardiometabolic Risk? J Am Heart Assoc 2024; 13:e032492. [PMID: 39248253 DOI: 10.1161/jaha.123.032492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 07/23/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Previous studies have found that exposure to childhood environmental stress is associated with cardiometabolic risk. However, it is not known whether individual health behaviors disrupt this relationship. This study prospectively evaluated the relationship between cumulative environmental stress in a low-income sample and cardiometabolic risk in middle childhood and examined whether child health behaviors attenuated this relationship. METHODS AND RESULTS In a cohort of children (n=338; 57% Hispanic children; 25% Black children), environmental stressors (family and neighborhood factors representing disadvantage/deprivation) and child health behaviors (accelerometry measured physical activity; parent-reported screen time and diet recalls) were measured over 5 time points beginning when children were aged 2 to 4 years and ending when they were aged 7 to 11 years. Children's cardiometabolic risk factors (body mass index, blood pressure, triglyceride/high-density lipoprotein ratio, glucose, hemoglobin A1c, C-reactive protein) were measured at 7 to 11 years. Emerging cardiometabolic risk was defined as having ≥1 elevations that exceeded clinical thresholds. In adjusted path analyses, greater cumulative environmental stress was associated with higher likelihood of emerging cardiometabolic risk in middle childhood (P<0.001). Higher levels of moderate to vigorous physical activity and fewer sedentary minutes attenuated the positive relationship between stress and cardiometabolic risk (P<0.05). Children with >2 hours of average daily screen time had a higher likelihood of elevated cardiometabolic risk (P<0.01), but screen time did not moderate the stress-cardiometabolic risk relationship. Dietary intake was not related to cardiometabolic risk. CONCLUSIONS Interventions that promote moderate to vigorous physical activity and limit sedentary behavior may have particular importance for the cardiometabolic health of children exposed to high levels of cumulative environmental stress.
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Affiliation(s)
- Alicia S Kunin-Batson
- Department of Pediatrics and Center for Pediatric Obesity Medicine University of Minnesota Medical School Minneapolis MN
| | | | - Nancy E Sherwood
- Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN
| | - Aaron S Kelly
- Department of Pediatrics and Center for Pediatric Obesity Medicine University of Minnesota Medical School Minneapolis MN
| | | | - Megan R Gunnar
- Institute for Child Development, University of Minnesota Minneapolis MN
| | | | | | - Simone A French
- Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN
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13
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Yan H, Gonzalo-Encabo P, Wilson RL, Christopher CN, Cannon JD, Kang DW, Gardiner J, Perez M, Norris MK, Gundersen D, Hayman LL, Freedman RA, Rebbeck TR, Shi L, Dieli-Conwright CM. Testing home-based exercise strategies in underserved minority cancer patients undergoing chemotherapy (THRIVE) trial: a study protocol. Front Oncol 2024; 14:1427046. [PMID: 39351353 PMCID: PMC11439870 DOI: 10.3389/fonc.2024.1427046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 08/23/2024] [Indexed: 10/04/2024] Open
Abstract
Background Higher rates of physical inactivity and comorbid conditions are reported in Hispanic/Latinx and Black cancer patients receiving chemotherapy compared to their White counterparts. Despite the beneficial effect of exercise training for cancer patients, rates of participation in exercise oncology clinical trials are low among disadvantaged and racial and ethnic minority groups. Here, we will examine the effect of an exercise intervention using a novel, accessible, and cost-effective home-based exercise approach among Hispanic/Latinx and Black cancer patients receiving chemotherapy on exercise participation and cardiovascular disease risk. Methods The THRIVE trial is an 8-month prospective, three-arm study of 45 patients who are randomized in a 1:1:1 fashion to a supervised exercise intervention (SUP), unsupervised exercise (UNSUP), or an attention control (AC) group. Eligible patients include those with breast, colorectal, or prostate cancer, who are sedentary, overweight or obese, self-identify as Hispanic/Latinx or Black, and plan to receive chemotherapy. Patients randomized to the SUP group participate in a home-based 16-week periodized aerobic and resistance exercise program performed three days per week, supervised through video conference technology. Patients randomized to the UNSUP group participate in an unsupervised 16-week, telehealth-based, periodized aerobic and resistance exercise program performed three days per week using the same exercise prescription parameters as the SUP group. Patients randomized to the AC group receive a 16-week home-based stretching program. The primary outcome is changes in minutes of physical activity assessed by 7-day accelerometry at post-intervention. Secondary outcomes include cardiovascular risk factors, patient-reported outcomes, and physical function. Outcome measures are tested at baseline, post-intervention at month 4, and after a non-intervention follow-up period at month 8. Discussion The THRIVE trial is the first study to employ a novel and potentially achievable exercise intervention for a minority population receiving chemotherapy. In addition, this study utilizes an intervention approach to investigate the biological and behavioral mechanisms underlying exercise participation in these cancer patients. Results will guide and inform large randomized controlled trials to test the effect of home-based exercise on treatment outcomes and comorbid disease risk in minority patients with cancer undergoing chemotherapy. Clinical trial registration https://classic.clinicaltrials.gov/ct2/show/NCT05327452, identifier (NCT#05327452).
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Affiliation(s)
- Huimin Yan
- Department of Exercise and Health Sciences, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Paola Gonzalo-Encabo
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Educación Física y Deportiva, Madrid, Spain
| | - Rebekah L Wilson
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Cami N Christopher
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - James D Cannon
- Department of Exercise and Health Sciences, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - John Gardiner
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Michelle Perez
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Mary K Norris
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Daniel Gundersen
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Laura L Hayman
- Department of Nursing, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Rachel A Freedman
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Timothy R Rebbeck
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Ling Shi
- Department of Nursing, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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14
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Davidson JM, Callaghan JP. A week-long field study of seated pelvis and lumbar spine kinematics during office work. APPLIED ERGONOMICS 2024; 122:104374. [PMID: 39255720 DOI: 10.1016/j.apergo.2024.104374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 08/28/2024] [Accepted: 08/30/2024] [Indexed: 09/12/2024]
Abstract
The study objective was to quantify "natural" seated pelvis and lumbar spine kinematics over multiple days of work at individuals' workstations. Twenty participants completed five days of their usual office work while seated time was characterized from a thigh-worn activity monitor. Seated pelvic tilt and lumbar spine flexion-extension were measured from tri-axial accelerometers. Seated time accounted for approximately 90% of participants' workdays. Sitting was characterized by posterior pelvic tilt and lumbar flexion (43-79% of maximum flexion) with an average of 9 shifts and 13 fidgets every 15 min. No significant differences emerged by sex or between days indicating that a single representative day can capture baseline sitting responses in the field. Average field kinematics tended to agree with the laboratory-collected kinematics, but postural variability was larger in the field. These kinematic values could be useful for designing interventions aimed at reducing spine flexion and increasing spine movement in occupational sitting.
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Affiliation(s)
- Jessa M Davidson
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Jack P Callaghan
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
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15
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Kekäläinen T, Luchetti M, Terracciano A, Gamaldo AA, Sliwinski MJ, Sutin AR. Momentary Associations Between Physical Activity, Affect, and Purpose in Life. Ann Behav Med 2024:kaae051. [PMID: 39231442 DOI: 10.1093/abm/kaae051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Physical activity is associated with both the hedonic (e.g., affect) and eudaimonic (e.g., purpose in life) aspects of well-being. While there is evidence linking momentary physical activity and affect in daily life, the examination of momentary purpose remains largely unexplored. PURPOSE This study investigates the bidirectional associations between physical activity, positive and negative affect, and momentary purpose using Ecological Momentary Assessment (EMA) and accelerometer data. METHODS Middle-aged participants (40-70 years old, n = 291) wore accelerometers and completed three daily EMA surveys on momentary experiences for 8 consecutive days. Physical activity (active time and counts) from 20- to 60-min periods before and after EMA surveys were used in the analyses. Multilevel models were adjusted for temporal and contextual factors, age, sex, education, work status, and race/ethnicity. RESULTS When participants were more physically active than usual, they reported feeling more purpose-driven and positive affect. Similarly, when participants reported feeling more purpose-driven or experiencing positive affect, they engaged in more physical activity in the subsequent time period. These associations were similar for physical activity from 20- to 60-min periods before and after the EMA survey. Physical activity and negative affect were not related in either direction. CONCLUSIONS In middle-aged adults' daily lives, physical activity has bidirectional relations with purpose and positive affect. This study highlights the dynamic associations between physical activity and the positive aspects of both hedonic and eudaimonic well-being. Future interventions or public health programs should integrate physical activity and mental well-being to maximize mutual benefits.
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Affiliation(s)
- Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
| | | | - Martin J Sliwinski
- Human Development and Family Studies, The Pennsylvania State University, PA, USA
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
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16
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Wang J, Yao J, He Y. A comparison of the physical activity levels of 3-to-6-year-old children with autism spectrum disorder and children with typical development. Front Psychol 2024; 15:1432389. [PMID: 39295756 PMCID: PMC11408300 DOI: 10.3389/fpsyg.2024.1432389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 08/14/2024] [Indexed: 09/21/2024] Open
Abstract
Background Physical activity during early development is closely related to health. Differences in physical activity between young children with autism spectrum disorder and those with typical development are unclear. The purpose of this study was to compare the physical activity levels in children with autism spectrum disorder and typically developing children from the same area, including their sedentary physical activity, light physical activity, moderate-to-vigorous physical activity, and number of days in which the moderate-to-vigorous physical activity guideline recommendation of 60 min per day was met. Methods A total of 77 participants aged 3-6 years were included: 41 children with autism spectrum disorder (mean age = 61.41 ± 10.69 months) and 36 children with typical development (mean age = 60.36 ± 10.16 months). The physical activity of the children was measured using an ActiGraph GT3x accelerometer. Results There were no significant differences in daily sedentary physical activity (439.70 ± 54.98 vs. 450.42 ± 53.67) or moderate-to-vigorous physical activity (46.62 ± 18.93 vs. 47.47 ± 18.26) between the two groups. The average daily moderate-to-vigorous physical activity of the two groups did not reach 60 min, and they had similar proportions of participants who reached 60 min a given number of times (24.4% vs. 25%). Daily light physical activity was significantly higher in the autism spectrum disorder group (263.96 ± 43.17 vs. 242.32 ± 37.91, p < 0.05). The moderate-to-vigorous physical activity of both groups was similar and lower than the recommended minimum physical activity. Conclusion Targeted interventions should be considered in early intervention programs for children with autism spectrum disorder to increase their moderate-to-vigorous physical activity.
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Affiliation(s)
- Jing Wang
- School of Education and Psychology, Tianjin University of Sport, Tianjin, China
- Key Laboratory of Competitive Sport Psychological and Psychological Regulation, Tianjin University of Sport, Tianjin, China
| | - Jiaxin Yao
- School of Education and Psychology, Tianjin University of Sport, Tianjin, China
- Key Laboratory of Competitive Sport Psychological and Psychological Regulation, Tianjin University of Sport, Tianjin, China
| | - Yingli He
- Tianjin Rehabilitation Service Guidance Center for the Disabled, Tianjin, China
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17
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Rosa-Souza FJ, Freire YA, Galliano LM, Dalton-Alves F, de Lima Pinto JCB, Godtsfriedt CES, Delevatti RS, Gerage AM, Rech CR, Ritti-Dias RM, Costa EC. Association of physical symptoms with accelerometer-measured movement behaviors and functional capacity in individuals with Long COVID. Sci Rep 2024; 14:20652. [PMID: 39232125 PMCID: PMC11374976 DOI: 10.1038/s41598-024-71589-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 08/29/2024] [Indexed: 09/06/2024] Open
Abstract
Long COVID has been linked to a decline in physical activity and functional capacity. However, it remains unclear which physical symptoms are associated with specific aspects of movement behaviors and functional capacity. We aimed to investigate the associations of fatigue, dyspnea, post-exertional malaise, myalgia, and the co-occurrence of symptoms with movement behaviors and functional capacity in individuals with Long COVID. A cross-sectional multicenter study was conducted. Questionnaires were used to assess fatigue, dyspnea, post-exertional malaise, and myalgia. Accelerometry was employed to assess sedentary time, steps per day, light physical activity, and moderate-to-vigorous physical activity. The six-minute walk test, 30-s chair stand test, and timed up and go were used to assess functional capacity. One hundred and two community-dwelling individuals who had been living with Long COVID for 15 ± 10 months participated in the study. Fatigue, post-exertional malaise, and the co-occurrence of physical symptoms showed a negative association with step count, while post-exertional malaise was also negatively associated with moderate-to-vigorous physical activity. Dyspnea showed a negative association with the functional score, including all tests. Our findings suggest that fatigue, post-exertional malaise, and the co-occurrence of physical symptoms are negatively associated with physical activity, while dyspnea is negatively associated with functional capacity in individuals with Long COVID.
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Affiliation(s)
- Francisco José Rosa-Souza
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Yuri Alberto Freire
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Leony Morgana Galliano
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Francisco Dalton-Alves
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | | | - Rodrigo Sudatti Delevatti
- Graduate Program in Physical Education, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Aline Mendes Gerage
- Graduate Program in Physical Education, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Cassiano Ricardo Rech
- Graduate Program in Physical Education, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | | | - Eduardo Caldas Costa
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
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18
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Wiranto Y, Siengsukon C, Mazzotti DR, Burns JM, Watts A. Sex differences in the role of sleep on cognition in older adults. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae066. [PMID: 39372545 PMCID: PMC11450268 DOI: 10.1093/sleepadvances/zpae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 08/21/2024] [Indexed: 10/08/2024]
Abstract
Study Objectives The study aimed to investigate sex differences in the relationship between sleep quality (self-report and objective) and cognitive function across three domains (executive function, verbal memory, and attention) in older adults. Methods We analyzed cross-sectional data from 207 participants with normal cognition (NC) or mild cognitive impairment (89 males and 118 females) aged over 60 years. The relationship between sleep quality and cognitive performance was estimated using generalized additive models. Objective sleep was measured with the GT9X Link ActiGraph, and self-reported sleep was measured with the Pittsburgh Sleep Quality Index. Results We found that females exhibited lower executive function with increased objective total sleep time, with a steeper decline in performance after 400 minutes (p = .015). Additionally, longer objective sleep correlated with lower verbal memory linearly (p = .046). In males, a positive linear relationship emerged between objective sleep efficiency and executive function (p = .036). Self-reported sleep was not associated with cognitive performance in females and males with NC. However, in males with cognitive impairment, there was a nonlinear positive relationship between self-reported sleep and executive function (p < .001). Conclusions Our findings suggest that the association between sleep parameters on cognition varies between older males and females, with executive function being most strongly associated with objective sleep for both sexes top of form. Interventions targeting sleep quality to mitigate cognitive decline in older adults may need to be tailored according to sex, with distinct approaches for males and females.
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Affiliation(s)
- Yumiko Wiranto
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Catherine Siengsukon
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Diego R Mazzotti
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jeffrey M Burns
- Alzheimer’s Disease Research Center, University of Kansas, Fairway, KS, USA
| | - Amber Watts
- Department of Psychology, University of Kansas, Lawrence, KS, USA
- Alzheimer’s Disease Research Center, University of Kansas, Fairway, KS, USA
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Cuthbertson CC, Evenson KR, Wen F, Moore CC, Howard AG, Di C, Parada H, Matthews CE, Manson JE, Buring J, Shiroma EJ, LaCroix AZ, Lee IM. Associations of steps per day and step intensity with the risk of cancer: Findings from the Women's Health Accelerometry Collaboration cohort. Prev Med 2024; 186:108070. [PMID: 39029743 PMCID: PMC11338699 DOI: 10.1016/j.ypmed.2024.108070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 07/14/2024] [Accepted: 07/15/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE Accumulating more steps/day is associated with a lower risk of cancer mortality and composite cancer outcomes. However, less is known about the relationship of steps/day with the risk of multiple site-specific cancers. METHODS This study included >22,000 women from the Women's Health Accelerometry Collaboration Cohort (2011-2022), comprised of women from the Women's Health Study and Women's Health Initiative Objective Physical Activity and Cardiovascular Health Study. Steps/day and step intensity were collected with accelerometry. Incident cancer cases and deaths were adjudicated. Stratified Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the associations of steps/day and step intensity with incident breast, colon, endometrial, lung, and ovarian cancers, a composite of 13 physical activity-related cancers, total invasive cancer, and fatal cancer. RESULTS On average, women were 73.4 years old, accumulated 4993 steps/day, and had 7.9 years of follow-up. There were small nonsignificant inverse associations with the risks of colon cancer (HR = 0.94, 95% CI: 0.83, 1.05), endometrial cancer (HR = 0.91, 95% CI: 0.82, 1.01), and fatal cancer (HR = 0.95 95% CI: 0.90, 1.00) per 1000 steps/day. More minutes at ≥40 steps/min and a faster peak 10- and 30-min step cadence were associated with a lower risk of endometrial cancer, but findings were attenuated after adjustment for body mass index and steps/day. CONCLUSIONS Among women 62-97 years, there were small nonsignificant inverse associations of colon, endometrial, and fatal cancer with more steps/day. Epidemiologic studies with longer follow-up and updated assessments are needed to further explore these associations.
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Affiliation(s)
- Carmen C Cuthbertson
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, United States of America.
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Fang Wen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Christopher C Moore
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Annie G Howard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Chongzhi Di
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States of America
| | - Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD, United States of America
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Julie Buring
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Eric J Shiroma
- Division of Cardiovascular Sciences, National Heart Lung Blood Institute, Bethesda, MD, United States of America
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States of America
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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20
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Tandon PS, Gabert T, Kuhn M, Tran N, Ola C, Sullivan E, Zhou C, Stein M, Mendoza JA, Sasser T, Gonzalez E. Modernizing behavioral parent training program for ADHD with mHealth strategies, telehealth groups, and health behavior curriculum: a randomized pilot trial. J Pediatr Psychol 2024; 49:664-675. [PMID: 39279226 DOI: 10.1093/jpepsy/jsae073] [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: 02/01/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 09/18/2024] Open
Abstract
OBJECTIVE Parent behavior management training (BMT) is an evidence-based yet underutilized tool to treat children with ADHD and address related health disparities. This pilot study investigated the acceptability and feasibility of a novel, health behavior-, and technology-adapted BMT (LEAP) vs. standard BMT. METHODS The weekly 9-session LEAP telemedicine group program is based on a standard BMT curriculum enhanced with strategies for supporting optimal child sleep, problematic media use (PMU), and physical activity, including wrist-worn activity trackers. Children ages 6-10 years with ADHD and their caregivers were randomized to LEAP or standard BMT. Acceptability and feasibility were tracked. Caregivers completed standardized measures, and children wore hip-worn accelerometers for 1 week at baseline, postintervention (10 weeks), and follow-up (20 weeks). RESULTS 84 parent/child dyads were randomized to LEAP or standard BMT, with high and comparable acceptability and feasibility. Both treatment groups demonstrated decreased ADHD symptoms and improved executive functions postintervention (p < .0001), maintained at follow-up. Average accelerometer-measured MVPA decreased and sleep duration remained unchanged, while PMU and bedtime resistance improved for both groups. CONCLUSIONS LEAP is highly feasible and acceptable, and yielded similar initial clinical and health behavior improvements to standard BMT. Innovative and targeted supports are needed to promote healthy behaviors in children with ADHD.
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Affiliation(s)
- Pooja S Tandon
- Child Health, Behavior, Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Tess Gabert
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Providence, RI, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Michelle Kuhn
- Child Health, Behavior, Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Nguyen Tran
- Child Health, Behavior, Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Cindy Ola
- Child Health, Behavior, Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Erin Sullivan
- Child Health, Behavior, Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Chuan Zhou
- Child Health, Behavior, Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Mark Stein
- Child Health, Behavior, Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Jason A Mendoza
- Child Health, Behavior, Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Tyler Sasser
- Child Health, Behavior, Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Erin Gonzalez
- Child Health, Behavior, Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
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Coyle-Asbil HJ, Breau B, Ma DWL, Haines J, Buchholz AC, Vallis LA. Compliance with the 24-hour movement behavior guidelines and the impact of sleep methods among toddler, preschool, and school-aged children enrolled in the Guelph Family Health Study. J Sci Med Sport 2024; 27:631-639. [PMID: 38937183 DOI: 10.1016/j.jsams.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/30/2024] [Accepted: 05/27/2024] [Indexed: 06/29/2024]
Abstract
Canadian movement guidelines focused on physical activity (PA), sleep, and screen time support childhood development and reduce the risk of chronic disease. Accelerometers are often used to capture these behaviors; however, they are limited in their ability to record daytime sleep due to potential misclassification. OBJECTIVES The objectives of this study were to 1) determine the prevalence of children enrolled in the Guelph Family Health Study who met the guidelines and to 2) compare the impact of different sleep measurement methods. DESIGN/METHODS Toddlers (1.5-<3 years; n = 128; valid data for all movement behaviors, n = 70), preschoolers (3-<5 years; n = 143; valid data for all movement behaviors, n = 104), and school-aged (5-<6 years; n = 49; valid data for all movement behaviors, n = 31) children were included. Screen time and sleep habits were obtained through parental report and published normative data. PA and sleep were recorded using accelerometers (wGT3X-BT ActiGraph; right hip). RESULTS It was found that 66 % of toddler, 44 % of preschool, and 63 % of school-aged children met the screen time guidelines. Further, 63 % of toddler, 98 % of preschooler, and 80 % of school-aged children met PA guidelines. Sleep guideline compliance ranged from 3 % to 83 % in toddler, 27 % to 92 % in preschooler, and 32 % to 90 % in school-aged children. These proportions were found to be significantly different (Cochran's Q and McNemar's tests). CONCLUSIONS Nearly all children met PA guidelines. In contrast, less than half to two-thirds met screen time guidelines. Compliance with sleep guidelines varied substantially with measurement method, highlighting the need for standardization.
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Affiliation(s)
- Hannah J Coyle-Asbil
- Department of Human Health and Nutritional Sciences, University of Guelph, Canada
| | - Becky Breau
- Department of Human Health and Nutritional Sciences, University of Guelph, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Canada
| | - Andrea C Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Canada
| | - Lori Ann Vallis
- Department of Human Health and Nutritional Sciences, University of Guelph, Canada.
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Lai TF, Chang CC, Hsueh MC, Koohsari MJ, Shibata A, Liao Y, Oka K. Association of 24-Hour movement behavior and cognitive function in older Taiwanese adults. Geriatr Nurs 2024; 59:60-66. [PMID: 38986430 DOI: 10.1016/j.gerinurse.2024.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/31/2024] [Accepted: 06/21/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVES This study investigates how 24-hour movement behaviors (physical activity, sedentary time, sleep) relate to cognitive performance in older adults. METHODS 213 adults (aged 65+) wore accelerometers to track activity. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Isotemporal substitution analysis examined how replacing one behavior with another affected cognition. RESULTS Increased light physical activity was linked to better cognitive function, whereas longer sleep had a negative impact. Replacing 30 min of sedentary behavior or sleep with light physical activity improved orientation, attention, language, and short-term memory. Substituting moderate-to-vigorous physical activity did not have the same cognitive benefit. CONCLUSION Encouraging older adults to replace sedentary time or excess sleep with light physical activity could support cognitive health and potentially help prevent dementia. These findings have implications for public health strategies promoting cognitive well-being in aging populations.
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Affiliation(s)
- Ting-Fu Lai
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan
| | - Chih-Ching Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Mohammad Javad Koohsari
- School of Advanced Science and Technology, Japan Advanced Institute of Science and Technology, Nomi, Japan; Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan; School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yung Liao
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan; Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan.
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
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23
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Minakata Y, Sasaki S, Murakami Y, Kawabe K, Ono H. Processing of Sedentary Time and Its Reference Equation in Patients with COPD. Int J Chron Obstruct Pulmon Dis 2024; 19:1931-1942. [PMID: 39219565 PMCID: PMC11365531 DOI: 10.2147/copd.s474273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
Purpose Sedentary time (ST) is associated with mortality independent of moderate-to-vigorous physical activity in patients with COPD. The proper processing methods for the measurement data and factors related to ST are still unknown. We investigated several conditions for determining the proper processing of ST accelerometric data and created a reference equation for ST using ST-related factors. Patients and Methods In Study 1, we evaluated the minimum required number of days to obtain repeatability at different measurement times and assessed the effects of rainy days or weekend days on ST in patients with COPD. In Study 2, we detected the ST-related factors among 28 parameters and created a reference equation for ST using the detected factors. Results In Study 1, 38 patients with stable COPD were analyzed. The minimum number of days required for repeatability was 3 for 8-h wearing and 2 for 10-h wearing. The ST was significantly prolonged on rainy days, but not on weekends. In Study 2, 216 patients with stable COPD were analyzed. BMI, FEV1%pred, 6MWD, and mMRC were detected as ST-related factors, and a reference equation could be created using these four factors. The equation was validated for patients whose ST was ≥ 6 h. Conclusion By using properly processed measurement data of ST, we created a reference equation for assessing ST that is expected to be useful for providing individual guidance on the shortening of ST to patients with COPD.
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Affiliation(s)
- Yoshiaki Minakata
- Department of Respiratory Medicine, NHO Wakayama Hospital, Hidaka-gun, Wakayama, Japan
| | - Seigo Sasaki
- Department of Respiratory Medicine, NHO Wakayama Hospital, Hidaka-gun, Wakayama, Japan
| | - Yusuke Murakami
- Department of Respiratory Medicine, NHO Wakayama Hospital, Hidaka-gun, Wakayama, Japan
| | - Kazumi Kawabe
- Department of Respiratory Medicine, NHO Wakayama Hospital, Hidaka-gun, Wakayama, Japan
| | - Hideya Ono
- Department of Respiratory Medicine, NHO Wakayama Hospital, Hidaka-gun, Wakayama, Japan
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Hedberg-Graff J, Bezuidenhout L, Krumlinde-Sundholm L, Hallgren J, Moulaee Conradsson D, Hagströmer M. Association between upper limb clinical tests and accelerometry metrics for arm use in daily life in children with unilateral cerebral palsy. Disabil Rehabil 2024:1-7. [PMID: 39192545 DOI: 10.1080/09638288.2024.2393801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024]
Abstract
PURPOSE To evaluate the association between upper-limb (UL) clinical tests and UL accelerometry-derived metrics in children with unilateral Cerebral Palsy (CP). METHODS In this cross-sectional study, twenty children with unilateral CP and Manual Ability Classification System level I-III were included. Outcomes of the Assisting Hand Assessment, Box and Block-Test and accelerometry metrics were collected in the clinical setting and in daily life. UL asymmetry index (i.e., the ratio between the well-functioning UL and the affected UL use) was evaluated in different physical activity levels and relative use of UL was evaluated during daily living. Spearman's correlation was used to determine the association between UL clinical tests and accelerometry metrics in a clinical setting and in daily life. RESULTS The strongest negative association was between the Assisting Hand Assessment units and accelerometry metrics during the sedentary time in daily life (rs = -0.64). The asymmetries between ULs were highest during the child's sedentary time (asymmetry index: 45.15) compared to when the child was in light (asymmetry index: 23.97) or higher intensity physical activity (asymmetry index: 13.39). The children used both ULs simultaneously for 44% of the time during daily life. CONCLUSION Accelerometry metrics may provide additional objective information to clinical tests by quantifying the amount of UL movements and the amount of asymmetry between the upper limbs in daily life.
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Affiliation(s)
- Jenny Hedberg-Graff
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - Lucian Bezuidenhout
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa
| | | | - Jenny Hallgren
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - David Moulaee Conradsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Occupational Therapy & Physiotherapy, Theme Women's Health and Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Avcademic Primary Health Care Centre, Stockholm, Sweden
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Evans JT, Stanesby O, Blizzard L, Greaves S, Timperio A, Jose K, Sharman MJ, Palmer AJ, Cleland VJ. Is public transport a promising strategy for increasing physical activity? Evidence from a study of objectively measured public transport use and physical activity. Int J Behav Nutr Phys Act 2024; 21:91. [PMID: 39160546 PMCID: PMC11331653 DOI: 10.1186/s12966-024-01633-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/23/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Greater public transport use has been linked to higher physical activity levels. However, neither the amount of physical activity associated with each daily public transport trip performed, nor the potential total physical activity gain associated with an increase in trips/day, has been determined. Using objective measures, we aimed to quantify the association between public transport use, physical activity and sedentary time. METHODS A longitudinal study of Australian adults living in Hobart, Tasmania, who were infrequent bus users (≥ 18 years; used bus ≤ 2 times/week). The number of bus trips performed each day was determined from objective smartcard data provided by the public transportation (bus) provider across a 36-week study timeframe. Accelerometer measured steps/day (primary outcome), moderate-to-vigorous physical activity (min/day), and sedentary time (min/day) were assessed across four separate one-week periods. RESULTS Among 73 participants across 1483 day-level observations, on days that public transport was used, participants achieved significantly more steps (β = 2147.48; 95%CI = 1465.94, 2829.03), moderate to vigorous physical activity (β = 22.79; 95% CI = 14.33, 31.26), and sedentary time (β = 37.00; 95% CI = 19.80, 54.21) compared to days where no public transport trips were made. The largest increase in steps per day associated with a one-trip increase was observed when the number of trips performed each day increased from zero to one (β = 1761.63; 95%CI = 821.38, 2701.87). The increase in the number of steps per day was smaller and non-significant when the number of trips performed increased from one to two (β = 596.93; 95%CI=-585.16, 1779.01), and two to three or more (β = 632.39; 95%CI=-1331.45, 2596.24) trips per day. Significant increases in sedentary time were observed when the number of trips performed increased from zero to one (β = 39.38; 95%CI = 14.38, 64.39) and one to two (β = 48.76; 95%CI = 25.39, 72.12); but not when bus trips increased from two to three or more (β=-27.81; 95%CI=-76.00, 20.37). CONCLUSIONS Greater public transport use was associated with higher physical activity and sedentary behaviour. Bus use may yield cumulative increases in steps that amount to 15-30% of the daily recommended physical activity target. A policy and public health focus on intersectoral action to promote public transport may yield meaningful increases in physical activity and subsequent health benefits.
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Affiliation(s)
- Jack T Evans
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
| | - Oliver Stanesby
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
| | - Stephen Greaves
- Institute of Transport and Logistics Studies, University of Sydney, Sydney, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Kim Jose
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
| | - Melanie J Sharman
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
| | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia
| | - Verity J Cleland
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, 7000, Australia.
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
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Hoydick JF, Johnson ME, Cook HA, Alfikri ZF, Jakicic JM, Piva SR, Chambers AJ, Bell KM. Algorithm Validation for Quantifying ActiGraph™ Physical Activity Metrics in Individuals with Chronic Low Back Pain and Healthy Controls. SENSORS (BASEL, SWITZERLAND) 2024; 24:5323. [PMID: 39205017 PMCID: PMC11360344 DOI: 10.3390/s24165323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 08/05/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
Assessing physical activity is important in the treatment of chronic conditions, including chronic low back pain (cLBP). ActiGraph™, a widely used physical activity monitor, collects raw acceleration data, and processes these data through proprietary algorithms to produce physical activity measures. The purpose of this study was to replicate ActiGraph™ algorithms in MATLAB and test the validity of this method with both healthy controls and participants with cLBP. MATLAB code was developed to replicate ActiGraph™'s activity counts and step counts algorithms, to sum the activity counts into counts per minute (CPM), and categorize each minute into activity intensity cut points. A free-living validation was performed where 24 individuals, 12 cLBP and 12 healthy, wore an ActiGraph™ GT9X on their non-dominant hip for up to seven days. The raw acceleration data were processed in both ActiLife™ (v6), ActiGraph™'s data analysis software platform, and through MATLAB (2022a). Percent errors between methods for all 24 participants, as well as separated by cLBP and healthy, were all less than 2%. ActiGraph™ algorithms were replicated and validated for both populations, based on minimal error differences between ActiLife™ and MATLAB, allowing researchers to analyze data from any accelerometer in a manner comparable to ActiLife™.
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Affiliation(s)
- Jordan F. Hoydick
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.F.A.); (A.J.C.)
| | - Marit E. Johnson
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Harold A. Cook
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.F.A.); (A.J.C.)
| | - Zakiy F. Alfikri
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.F.A.); (A.J.C.)
| | - John M. Jakicic
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Sara R. Piva
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA 15213, USA;
| | - April J. Chambers
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.F.A.); (A.J.C.)
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Kevin M. Bell
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.F.A.); (A.J.C.)
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Domingues WJR, Germano-Soares AH, Cucato GG, de Souza LC, Brandão EKSDS, Souza ELDCD, da Silva E Silva TR, Arêas GPT, Costa C, Campelo PRDS, Dos Santos NJN, Silva GOD, Simões CF. Physical activity levels in patients with chronic venous insufficiency. Phlebology 2024:2683555241273153. [PMID: 39126137 DOI: 10.1177/02683555241273153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
BACKGROUND Increasing the levels of physical activity (PA) is widely recommended for people with chronic venous insufficiency (CVI). However, studies investigating the patterns of PA and adherence to PA guidelines using objective measures are lacking. OBJECTIVE The primary aim was to examine the patterns of PA and adherence to PA guidelines among patients with CVI. A secondary aim was to identify whether adherence to PA recommendations differed according to patients' sociodemographic and clinical characteristics. METHODS This cross-sectional study included 96 patients with CVI with Clinical-Etiology-Anatomy-Pathology (CEAP) C3 to C6 (69.1% women 59 ± 11 years; 51.5% C5-C6 on CEAP classification). Objective time spent in PA was measured by a triaxial accelerometer. To examine adherence to PA guidelines, patients were grouped as meeting (or) the recommendations if they had at least 150 min/week of moderate to vigorous PA. Sociodemographic and clinic characteristics were obtained by self-report. Binary logistic regression was employed to examine whether sociodemographic and clinical characteristics were associated with adherence to PA guidelines. T-tests were employed to compare PA levels at different intensities according to patients' age. RESULTS Patients spent an average of 311.4 ± 91.5 min/week, 42.1 ± 28.0 min/week, and 19.8 ± 17.8 min/week in low-light PA, high-light PA, and moderate-to-vigorous PA, respectively. The proportion of patients meeting PA recommendations was 36.2%, and older patients had lower odds (OR = 0.94; 95%CI: 0.89 to 0.99). Additional analysis reinforced that by showing lower time in high-light PA (51.2 ± 30.0 min/day vs. 31.9 ± 21.8 min/day; p = .001) and moderate-to-vigorous PA (24.3 ± 15.8 min/day vs. 14.8 ± 18.8 min/day; p = .012) among older patients than their peers younger. CONCLUSION Our findings showed that 36,2% of CVI patients met PA recommendations, with lower odds found among older patients. Public health interventions to enhance PA engagement among CVI patients should prioritize those who are older.
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Affiliation(s)
| | | | - Gabriel Grizzo Cucato
- Department of Sport Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, UK
| | - Lenon Corrêa de Souza
- Graduation Program in Human Movement Sciences, Universidade Federal do Amazonas, Manaus, Brazil
| | | | | | | | | | - Cleinaldo Costa
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
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Kemani MK, Hanafi R, Brisby H, Lotzke H, Lundberg M. Long-Term Follow-Up of a Person-Centered Prehabilitation Program Based on Cognitive-Behavioral Physical Therapy for Patients Scheduled for Lumbar Fusion. Phys Ther 2024; 104:pzae069. [PMID: 38753831 DOI: 10.1093/ptj/pzae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 01/09/2024] [Accepted: 04/09/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Long-term follow-ups of prehabilitation programs for lumbar spine surgery are lacking, and more comprehensive evaluations are needed. In the current study, we evaluated the long-term effects of a prehabilitation program compared with conventional care in relation to lumbar fusion surgery in patients with degenerative disc disease. METHODS Patients (n = 118) receiving lumbar fusion surgery were included in a multicenter randomized controlled trial, involving 1 university hospital and 2 spine clinics. The intervention was a person-centered prehabilitation program based on cognitive-behavioral physical therapy that targeted psychological presurgical risk factors, physical activity, and overall health. The control group received conventional preoperative care. Patient-reported outcome measures (PROMs) included assessments at 8 time-points: low back disability (primary outcome), back pain intensity, leg pain intensity, pain catastrophizing, fear of movement, anxiety and depressive mood, health-related quality of life, and patient-specific functioning. Physical activity and physical capacity were assessed at 5 time points. Linear mixed models were used to analyze the effects of the intervention. RESULTS There were no significant differences between groups at the 12- and 24-month follow-ups for any outcome, except for the One Leg Stand test 1 year following surgery, in favor of the control group. There were significant improvements for both groups, from baseline to the 12- and 24-month follow-ups for all physical capacity test and patient-reported outcome measures, except for leg pain and self-efficacy for exercise. CONCLUSION No long-term effects were found for the prehabilitation program compared to conventional care. Physical activity did not improve over time, despite significantly improved self-reported functioning and physical capacity measurements. IMPACT These findings have implications for the current understanding of the long-term effects of prehabilitation and suggest that future research should focus on programs promoting physical activity both before and after lumbar spine surgery to decrease the risk of long-term adverse health outcomes.
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Affiliation(s)
- Mike K Kemani
- Back in Motion Research Group, Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Health Professionals, Theme Women's Health and Allied Health Professionals, Karolinska University Hospital, Solna, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Rikard Hanafi
- Back in Motion Research Group, Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
- Department of Health Professionals, Theme Women's Health and Allied Health Professionals, Karolinska University Hospital, Solna, Sweden
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Helena Brisby
- Department of Orthopaedics, Institute of the Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanna Lotzke
- Back in Motion Research Group, Department of Rehabilitation, Ängelholm Hospital, Ängelholm, Sweden
| | - Mari Lundberg
- Back in Motion Research Group, Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, Gothenburg, Sweden
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Sima C, Taani MH, Apchemengich I, Andargeery SY. Associations Between Components of Self-Management Theory and Falls Among Older Adults. J Gerontol Nurs 2024; 50:19-28. [PMID: 39088049 DOI: 10.3928/00989134-20240703-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
PURPOSE To examine the relationship of key individual and family self-management theory (IFSMT) components, including self-management process variables on proximal (self-management behaviors) and distal (falls) outcomes in older adults. METHOD A secondary data analysis was conducted using data of 99 older adults living in continuing care retirement communities in the U.S. Midwest. Descriptive statistics, multiple regression, and logistic regression were performed to analyze the data. RESULTS The multiple regression model demonstrated a positive association between self-efficacy for physical activity and steps per day. The logistic regression model showed that high expectations regarding aging are associated with reduced likelihood of meeting daily protein intake. CONCLUSION Key components of the IFSMT, such as self-efficacy, steps per day, and expectations regarding aging, are important when designing self-management interventions to prevent falls. [Journal of Gerontological Nursing, 50(8), 19-28.].
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Haussmann A, Ungar N, Tsiouris A, Schmidt LI, Müller J, von Hardenberg J, Wiskemann J, Steindorf K, Sieverding M. Determinants of physical activity during cancer treatment: a longitudinal exploration of psycho-cognitive variables and physician counseling. J Behav Med 2024; 47:566-580. [PMID: 38017252 PMCID: PMC11291613 DOI: 10.1007/s10865-023-00458-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/23/2023] [Indexed: 11/30/2023]
Abstract
Individuals with cancer are recommended to engage in regular physical activity (PA) even during cancer therapy. The aim of this study was to explore how patient-reported physician PA counseling influences their PA intention and behavior in addition to psycho-cognitive determinants derived from the theory of planned behavior (TPB). A longitudinal study during cancer treatment was conducted among N = 115 patients with breast, prostate, or colorectal cancer (Mage = 58.0, SD = 11.5; 55.7% female). The median time since diagnosis was 2 months, and 19.1% were diagnosed with metastases. Participants provided information on PA counseling by their physicians and on psycho-cognitive variables of the TPB at three measurement points. Additionally, they wore accelerometers for seven days at baseline and three months later. Nearly half of participants (48%) reported basic PA counseling and 30% reported in-depth PA counseling. Patients in poorer health and with lower education reported significantly less in-depth counseling. In addition to patient self-efficacy in performing PA, only in-depth physician PA counseling, but not basic physician counseling, predicted intention for PA four weeks later. Patients' PA three months after baseline was predicted by patients' PA at baseline and their intention for PA. Overall, the PA level at baseline was identified as the most important predictor of PA three months later. Nevertheless, physicians seem to have the ability to increase their cancer patients' intention for PA by in-depth counseling.
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Affiliation(s)
- Alexander Haussmann
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
| | - Nadine Ungar
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117, Heidelberg, Germany
- Faculty of Healthcare and Nursing, Catholic University of Applied Sciences Mainz, Saarstraße 3, 55122, Mainz, Germany
| | - Angeliki Tsiouris
- Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany
| | - Laura I Schmidt
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117, Heidelberg, Germany
| | - Jana Müller
- Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Jost von Hardenberg
- Department of Urology and Urological Surgery, Medical Faculty Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Joachim Wiskemann
- Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Monika Sieverding
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117, Heidelberg, Germany
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Haigis D, Wagner S, Pomiersky R, Matting L, Hahn LS, Eschweiler GW, Thiel A, Frahsa A, Sudeck G, Nieß AM. [Sarcopenia, physical activity and sedentary behavior among nursing home residents in Germany]. Z Gerontol Geriatr 2024; 57:395-401. [PMID: 38276995 PMCID: PMC11315749 DOI: 10.1007/s00391-023-02275-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Residents in nursing homes show a high prevalence of the musculoskeletal syndrome sarcopenia and tend not to achieve current physical activity recommendations. OBJECTIVE The aim of this study is to identify differences in physical activity and sedentary behavior of sarcopenic residents compared with nonsarcopenic and presarcopenic residents. METHODS Sarcopenia assessment was performed among 63 nursing home residents in Baden-Wuerttemberg (D) using the European Working Group on Sarcopenia in Older People 2 specifications. Structured activity sessions (per week), accelerometer-based physical activity (steps/day), and sedentary behavior (percentual/day) were examined. The group comparisons were determined with Kruskal-Wallis tests and Dunn-Bonferroni post hoc tests. RESULTS Significant differences were found for number of steps (p = 0.005) and percentual sedentary behavior (p = 0.019). Moreover, steps per day presented significant results in group comparison for no sarcopenia (2824.4 [423-14275]) with probable sarcopenia (1703.9 [118-5663]) and confirmed/severe sarcopenia (1571.2 [240-2392]) (both p = 0.022; |r| = 0.34). Sedentary behavior demonstrated significant differences in groups with no sarcopenia (87.9% [69.1-94.3]) and with probable sarcopenia (91.7% [80.4-9835]) (p = 0.018; |r| = 0.35). CONCLUSION Nonsarcopenic residents demonstrated a higher number of steps and lower sedentary behavior compared with presarcopenic and sarcopenic residents. Increasing steps, reducing sedentary behavior and promoting activities of daily living can contribute to the prevention and treatment of sarcopenia in the nursing home setting.
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Affiliation(s)
- Daniel Haigis
- Abteilung Sportmedizin, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland.
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland.
| | - Silas Wagner
- Abteilung Sportmedizin, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Rebekka Pomiersky
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Leon Matting
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Lea-Sofie Hahn
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Gerhard W Eschweiler
- Geriatrisches Zentrum, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland
| | - Ansgar Thiel
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Annika Frahsa
- Institut für Sozial- und Präventivmedizin, Universität Bern, 3012, Bern, Schweiz
| | - Gorden Sudeck
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Andreas M Nieß
- Abteilung Sportmedizin, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
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Quiles NN, Uher D, Balachandran A, Ortiz A, Garber C. Criterion Validity and Reliability of 2 Brief Physical Activity Questionnaires in Ethnically Diverse Adults. J Phys Act Health 2024; 21:787-793. [PMID: 38849119 DOI: 10.1123/jpah.2023-0697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 03/23/2024] [Accepted: 04/03/2024] [Indexed: 06/09/2024]
Abstract
PURPOSE The study compares moderate- to vigorous-intensity physical activity (MVPA) as evaluated by the Exercise Vital Signs (EVS) and Physical Activity Vital Signs (PAVS) questionnaires to accelerometry, and evaluates the reliability of the questionnaires in ethnically diverse adults. METHODS Ninety-nine participants (mean age 38.1 y; 49.5% women; Hispanics 43.8%; European American 18.8%; African American 14.6%) were included in the analyses. Participants wore an accelerometer at the hip for at least 7 days and completed the EVS and PAVS questionnaires at the beginning (T1) and at the end (T2) of the 7 days. Associations between the questionnaires and accelerometry were examined using Spearman rho. The reliability of the questionnaires was evaluated using intraclass correlation coefficient. Sensitivity and specificity were also calculated. RESULTS Weak positive correlations were observed between the accelerometer MVPA and the EVS MVPA at T2 (ρ = .263, P = .013), and the PAVS MVPA at T2 (ρ = .327, P = .003). The sensitivity of the EVS and PAVS was 73.2% and 82.6%, respectively. The specificity for each questionnaire was 35.3%. The reliability for the EVS questionnaire (intraclass correlation coefficient = .855; 95% CI, .791-.901; P < .001) was good, while the reliability of the PAVS questionnaire (intraclass correlation coefficient = .652; 95% CI, .511-.758; P < .001) was moderate. CONCLUSION Caution should be used when utilizing the EVS and PAVS questionnaires in ethnically diverse adults.
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Affiliation(s)
- Norberto N Quiles
- Department of Family, Nutrition and Exercise Sciences, Queens College of the City University of New York (NY), Queens, NY, USA
| | - David Uher
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Anoop Balachandran
- Department of Family, Nutrition and Exercise Sciences, Queens College of the City University of New York (NY), Queens, NY, USA
| | - Alexis Ortiz
- Physical Therapy Program, Allen College, Waterloo, IA, USA
- Population Health Sciences, UT Health San Antonio, San Antonio, TX, USA
| | - Carol Garber
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
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Schumacher BT, LaMonte MJ, Di C, Parada H, Hooker SP, Bellettiere J, Simonsick EM, Liles S, LaCroix AZ. Associations of Relative Intensity of Physical Activity With Incident Cardiovascular Events and All-Cause Mortality. J Gerontol A Biol Sci Med Sci 2024; 79:glae113. [PMID: 38699999 PMCID: PMC11212487 DOI: 10.1093/gerona/glae113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The relative intensity of physical activity (PA) can be estimated as the percent of one's maximal effort required. METHODS We compared associations of relative and absolute intensity PA with incident major cardiovascular disease (CVD) and all-cause mortality in 5 633 women from the Objective Physical Activity and Cardiovascular Health Study (mean age 78.5 ± 6.7). Absolute intensity was measured by accelerometry. Relative intensity was estimated by dividing accelerometer-estimated metabolic equivalents (METs) by maximal MET capacity. Both were aggregated into mean daily hours of light intensity PA (LPA) and moderate-to-vigorous PA (MVPA). Cox proportional hazard models estimated hazard ratios (HRs) for 1-hour higher amounts of PA on outcomes. RESULTS During follow-up (median = 7.4 years), there were 748 incident CVD events and 1 312 deaths. Greater LPA and MVPA, on either scale, were associated with reduced risk of both outcomes. HRs for a 1-hour increment of absolute LPA were 0.88 (95% CI: 0.83-0.93) and 0.88 (95% CI: 0.84-0.92) for incident CVD and mortality, respectively. HRs for a 1-hour increment of absolute MPVA were 0.73 (95% CI: 0.61-0.87) and 0.55 (95% CI: 0.48-0.64) for the same outcomes. HRs for a 1-hour increment of relative LPA were 0.70 (95% CI: 0.59-0.84) and 0.78 (95% CI: 0.68-0.89) for incident CVD and mortality, respectively. HRs for a 1-hour increment of relative MPVA were 0.89 (95% CI: 0.83-0.96) and 0.82 (95% CI: 0.77-0.87) for the same outcomes. On the relative scale, LPA was more strongly, and inversely associated with both outcomes than relative MVPA. Absolute MVPA was more strongly inversely associated with the outcomes than relative MVPA. CONCLUSIONS Findings support the continued shift in the PA intensity paradigm toward recommendation of more movement, regardless of intensity. Relative LPA--a modifiable, more easily achieved behavioral target, particularly among ambulatory older adults--was associated with reduced risk of incident major CVD and death.
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Affiliation(s)
- Benjamin T Schumacher
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo–SUNY, Buffalo, New York, USA
| | - Chongzhi Di
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA
- UCSD Moores Cancer Center, La Jolla, California, USA
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, California, USA
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Eleanor M Simonsick
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Sandy Liles
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
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Izquierdo-Gomez R, Shields N. Organised and non-organised activities contribute to overall physical activity levels in adolescents and young adults with Down syndrome: a cross-sectional study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:997-1006. [PMID: 38890147 DOI: 10.1111/jir.13164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 04/15/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Participation in organised and non-organised physical activities among adolescents and young adults with Down syndrome is underexplored. This study aimed to examine differences between organised and non-organised physical activities among adolescents and young adults with Down syndrome. METHODS Forty participants with Down syndrome (27 woman; mean age 21.4 ± 4.9 years) were recruited. Data on physical activity participation were collected by self- or proxy-reported questionnaires about attendance, involvement and type of physical activity. RESULTS Adolescents and young adults with Down syndrome participated in more organised than non-organised activities (P < 0.05), more often (P < 0.05), but there was no difference in the total time spent participating in these activities overall. Participants spent more time in vigorous physical activity during organised activities (P < 0.05) and spent more time in light physical activity during non-organised physical activities (P < 0.05). Dancing (organised activity) and walking (non-organised activity) were the most reported activities. CONCLUSIONS Participation in both organised and non-organised physical activities is important to increase overall physical activity levels of adolescents and young adults with Down syndrome. Future research exploring physical activity preferences may help guide the planning and adaption of community programmes for this group.
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Affiliation(s)
- R Izquierdo-Gomez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
- Research Unit, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - N Shields
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
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Tarp J, Dalene KE, Fagerland MW, Steene-Johannesen J, Hansen BH, Anderssen SA, Hagströmer M, Dohrn IM, Dempsey PC, Wijndaele K, Brage S, Nordström A, Nordström P, Diaz KM, Howard VJ, Hooker SP, Morseth B, Hopstock LA, Sagelv EH, Yates T, Edwardson CL, Lee IM, Ekelund U. Physical Activity Volume, Intensity, and Mortality: Harmonized Meta-Analysis of Prospective Cohort Studies. Am J Prev Med 2024:S0749-3797(24)00262-9. [PMID: 39089430 DOI: 10.1016/j.amepre.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION It is unclear whether moderate-to-vigorous physical activity (MVPA) is associated with a lower mortality risk, over and above its contribution to total physical activity volume. METHODS 46,682 adults (mean age: 64 years) were included in a meta-analysis of nine prospective cohort studies. Each cohort generated tertiles of accelerometry-measured physical activity volume and volume-adjusted MVPA. Hazard ratios (HR, with 95% confidence intervals) for mortality were estimated separately and in joint models combining volume and MVPA. Data was collected between 2001 and 2019 and analyzed in 2023. RESULTS During a mean follow-up of 9 years, 4,666 deaths were recorded. Higher physical activity volume, and a greater contribution from volume-adjusted MVPA, were each associated with lower mortality hazard in multivariable-adjusted models. Compared to the least active tertile, higher physical activity volume was associated with a lower mortality (HRs: 0.62; 0.58, 0.67 and 0.50; 0.42, 0.60 for ascending tertiles). Similarly, a greater contribution from MVPA was associated with a lower mortality (HRs: 0.94; 0.85, 1.04 and 0.88; 0.79, 0.98). In joint analysis, a lower mortality from higher volume-adjusted MVPA was only observed for the middle tertile of physical activity volume. CONCLUSIONS The total volume of physical activity was associated with a lower risk of mortality to a greater extent than the contribution of MVPA to physical activity volume. Integrating any intensity of physical activity into daily life may lower mortality risk in middle-aged and older adults, with a small added benefit if the same amount of activity is performed with a higher intensity.
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Affiliation(s)
- Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.
| | - Knut E Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Morten W Fagerland
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | | | - Bjørge H Hansen
- Department of Sports Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Sigmund A Anderssen
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
| | - Ing-Mari Dohrn
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia; MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Katrien Wijndaele
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Søren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Anna Nordström
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Medical Sciences, Rehabilitation Medicine, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Peter Nordström
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
| | - Keith M Diaz
- Department of Medicine, Columbia University Medical Center, New York, New York
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, California
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Edvard H Sagelv
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Thomas Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Charlotte L Edwardson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - I-Min Lee
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
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Macaluso R, Giffhorn M, Prokup S, Cleland B, Lee J, Lim B, Lee M, Lee HJ, Madhavan S, Jayaraman A. Safety & efficacy of a robotic hip exoskeleton on outpatient stroke rehabilitation. J Neuroeng Rehabil 2024; 21:127. [PMID: 39080666 PMCID: PMC11287981 DOI: 10.1186/s12984-024-01421-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 07/15/2024] [Indexed: 08/03/2024] Open
Abstract
OBJECTIVE The objective of this study was to analyze the safety and efficacy of using a robotic hip exoskeleton designed by Samsung Electronics Co., Ltd., Korea, called the Gait Enhancing and Motivating System-Hip (GEMS-H), in assistance mode only with the poststroke population in an outpatient-rehabilitation setting. METHODS Forty-one participants with an average age of 60 and average stroke latency of 6.5 years completed this prospective, single arm, interventional, longitudinal study during the COVID-19 pandemic. Significant modifications to the traditional outpatient clinical environment were made to adhere to organizational physical distancing policies as well as guidelines from the Centers for Disease Control. All participants received gait training with the GEMS-H in assistance mode for 18 training sessions over the course of 6-8 weeks. Performance-based and self-reported clinical outcomes were assessed at four time points: baseline, midpoint (after 9 training sessions), post (after 18 training sessions), and 1-month follow up. Daily step count was also collected throughout the duration of the study using an ankle-worn actigraphy device. Additionally, corticomotor excitability was measured at baseline and post for 4 bilateral lower limb muscles using transcranial magnetic stimulation. RESULTS By the end of the training program, the primary outcome, walking speed, improved by 0.13 m/s (p < 0.001). Secondary outcomes of walking endurance, balance, and functional gait also improved as measured by the 6-Minute Walk Test (47 m, p < 0.001), Berg Balance Scale (2.93 points, p < 0.001), and Functional Gait Assessment (1.80 points, p < 0.001). Daily step count significantly improved with and average increase of 1,750 steps per day (p < 0.001). There was a 35% increase in detectable lower limb motor evoked potentials and a significant decrease in the active motor threshold in the medial gastrocnemius (-5.7, p < 0.05) after training with the device. CONCLUSIONS Gait training with the GEMS-H exoskeleton showed significant improvements in walking speed, walking endurance, and balance in persons with chronic stroke. Day-to-day activity also improved as evidenced by increased daily step count. Additionally, corticomotor excitability changes suggest that training with this device may help correct interhemispheric imbalance typically seen after stroke. TRIAL REGISTRATION This study is registered with ClinicalTrials.gov (NCT04285060).
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Affiliation(s)
- Rebecca Macaluso
- Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Matt Giffhorn
- Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Sara Prokup
- Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Brice Cleland
- College of Applied Health Sciences, University of Illinois, Chicago, USA
| | - Jusuk Lee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Bokman Lim
- Robot R&D Team, WIRobotics Inc, Yongin, Republic of Korea
| | - Minhyung Lee
- Robot System Team, Samsung Research, Samsung Electronics, Suwon, Republic of Korea
| | - Hwang-Jae Lee
- Robot Business Team, Samsung Electronics, Suwon, Republic of Korea
| | - Sangeetha Madhavan
- College of Applied Health Sciences, University of Illinois, Chicago, USA
| | - Arun Jayaraman
- Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA.
- Department of Physical Medicine and Rehabilitation, Northwestern University, 710 N Lake Shore Dr, Chicago, IL, 60611, USA.
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Spartano NL, Zhang Y, Liu C, Chernofsky A, Lin H, Trinquart L, Borrelli B, Pathiravasan CH, Kheterpal V, Nowak C, Vasan RS, Benjamin EJ, McManus DD, Murabito JM. Agreement Between Apple Watch and Actical Step Counts in a Community Setting: Cross-Sectional Investigation From the Framingham Heart Study. JMIR BIOMEDICAL ENGINEERING 2024; 9:e54631. [PMID: 39047284 PMCID: PMC11306942 DOI: 10.2196/54631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Step counting is comparable among many research-grade and consumer-grade accelerometers in laboratory settings. OBJECTIVE The purpose of this study was to compare the agreement between Actical and Apple Watch step-counting in a community setting. METHODS Among Third Generation Framingham Heart Study participants (N=3486), we examined the agreement of step-counting between those who wore a consumer-grade accelerometer (Apple Watch Series 0) and a research-grade accelerometer (Actical) on the same days. Secondarily, we examined the agreement during each hour when both devices were worn to account for differences in wear time between devices. RESULTS We studied 523 participants (n=3223 person-days, mean age 51.7, SD 8.9 years; women: n=298, 57.0%). Between devices, we observed modest correlation (intraclass correlation [ICC] 0.56, 95% CI 0.54-0.59), poor continuous agreement (29.7%, n=957 of days having steps counts with ≤15% difference), a mean difference of 499 steps per day higher count by Actical, and wide limits of agreement, roughly ±9000 steps per day. However, devices showed stronger agreement in identifying who meets various steps per day thresholds (eg, at 8000 steps per day, kappa coefficient=0.49), for which devices were concordant for 74.8% (n=391) of participants. In secondary analyses, in the hours during which both devices were worn (n=456 participants, n=18,760 person-hours), the correlation was much stronger (ICC 0.86, 95% CI 0.85-0.86), but continuous agreement remained poor (27.3%, n=5115 of hours having step counts with ≤15% difference) between devices and was slightly worse for those with mobility limitations or obesity. CONCLUSIONS Our investigation suggests poor overall agreement between steps counted by the Actical device and those counted by the Apple Watch device, with stronger agreement in discriminating who meets certain step thresholds. The impact of these challenges may be minimized if accelerometers are used by individuals to determine whether they are meeting physical activity guidelines or tracking step counts. It is also possible that some of the limitations of these older accelerometers may be improved in newer devices.
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Affiliation(s)
- Nicole L Spartano
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
| | - Yuankai Zhang
- Boston University School of Public Health, Boston, MA, United States
| | - Chunyu Liu
- Boston University School of Public Health, Boston, MA, United States
| | - Ariel Chernofsky
- Boston University School of Public Health, Boston, MA, United States
| | - Honghuang Lin
- University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Ludovic Trinquart
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, United States
- Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, United States
| | - Belinda Borrelli
- Boston University Henry M. Goldman School of Dental Medicine, Center for Behavioral Science Research, Boston, MA, United States
| | | | | | | | - Ramachandran S Vasan
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
- University of Texas School of Public Health and University of Texas Health Sciences Center, San Antonio, TX, United States
| | - Emelia J Benjamin
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of Cardiology, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - David D McManus
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Joanne M Murabito
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, United States
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Rekant J, Ortmeyer H, Giffuni J, Friedman B, Addison O. Physical Functioning, Physical Activity, and Variability in Gait Performance during the Six-Minute Walk Test. SENSORS (BASEL, SWITZERLAND) 2024; 24:4656. [PMID: 39066052 PMCID: PMC11280787 DOI: 10.3390/s24144656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/09/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024]
Abstract
Instrumenting the six-minute walk test (6MWT) adds information about gait quality and insight into fall risk. Being physically active and preserving multi-directional stepping abilities are also important for fall risk reduction. This analysis investigated the relationship of gait quality during the 6MWT with physical functioning and physical activity. Twenty-one veterans (62.2 ± 6.4 years) completed the four square step test (FSST) multi-directional stepping assessment, a gait speed assessment, health questionnaires, and the accelerometer-instrumented 6MWT. An activity monitor worn at home captured free-living physical activity. Gait measures were not significantly different between minutes of the 6MWT. However, participants with greater increases in stride time (ρ = -0.594, p < 0.01) and stance time (ρ = -0.679, p < 0.01) during the 6MWT reported lower physical functioning. Neither physical activity nor sedentary time were related to 6MWT gait quality. Participants exploring a larger range in stride time variability (ρ = 0.614, p < 0.01) and stance time variability (ρ = 0.498, p < 0.05) during the 6MWT required more time to complete the FSST. Participants needing at least 15 s to complete the FSST meaningfully differed from those completing the FSST more quickly on all gait measures studied. Instrumenting the 6MWT helps detect ranges of gait performance and provides insight into functional limitations missed with uninstrumented administration. Established FSST cut points identify aging adults with poorer gait quality.
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Affiliation(s)
- Julie Rekant
- Baltimore VA Medical Center, Baltimore Department of Physical Therapy and Rehabilitation Sciences, University of Maryland, Baltimore, MD 21201, USA; (H.O.); (J.G.); (B.F.); (O.A.)
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Tanabe H, Akai M, Hayashi K, Yonemoto K. Relationship between quantitative physical activity and deterioration of locomotive function: a cross-sectional study using baseline data from a cohort. BMC Geriatr 2024; 24:601. [PMID: 38997632 PMCID: PMC11245818 DOI: 10.1186/s12877-024-04995-2] [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: 11/29/2023] [Accepted: 04/18/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND In aged society, health policies aimed at extending healthy life expectancy are critical. Maintaining physical activity is essential to prevent the deterioration of body functions. Therefore, it is important to understand the physical activity levels of the target age group and to know the content and intensity of the required physical activity quantitatively. Especially we focused the role of non-exercise activity thermogenesis and sedentary time, which are emphasized more than the introduction of exercise in cases of obesity or diabetes. METHODS A total of 193 patients from 25 institutions were included. Participants underwent a locomotive syndrome risk test (stand-up test, 2-step test, and Geriatric Locomotive Function Scale-25 questionnaire) and were classified into three stages. Physical activity was quantitatively monitored for one week with 3-axial accelerometer. Physical activity was classified into three categories; (1) Sedentary behavior (0 ∼ ≤ 1.5 metabolic equivalents (METs)), (2) Light physical activity (LPA:1.6 ∼ 2.9 METs), and (3) Moderate to vigorous physical activity (MVPA: ≥3 METs). We investigated the relationship between physical activity, including the number of steps, and the stages after gender- and age- adjustment. We also investigated the relationship between social isolation using Lubben's Social Network Scale (LSNS), as social isolation would lead to fewer opportunities to go out and less outdoor walking. RESULTS Comparison among the three stages showed significant difference for age (p = 0.007) and Body Mass Index (p < 0.001). After gender-and age-adjustment, there was a significant relation with a decrease in the number of steps (p = 0.002) and with MVPA. However, no relation was observed in sedentary time and LPA. LSNS did not show any statistically significant difference. Moderate to high-intensity physical activity and the number of steps is required for musculoskeletal disorders. The walking, not sedentary time, was associated to the locomotive stages, and this finding indicated the importance of lower extremity exercise. CONCLUSIONS Adjusting for age and gender, the number of steps and moderate to vigorous activity levels were necessary to prevent worsening, and there was no effect of sedentary behavior. Merely reducing sedentary time may be inadequate for locomotive disorders. It is necessary to engage in work or exercise that moves lower extremities more actively.
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Affiliation(s)
- Hideki Tanabe
- Tanabe Orthopedic Clinic, 3-3-11 Narimasu, Itabashi-ku, Tokyo, 175-0094, Japan
| | - Masami Akai
- Graduate School, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo, 107-8402, Japan.
| | - Kunihiko Hayashi
- School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi-shi, Gunma, 371-8514, Japan
| | - Koji Yonemoto
- Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0125, Japan
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Stalling I, Gruber M, Bammann K. Sex differences in physical functioning among older adults: cross-sectional results from the OUTDOOR ACTIVE study. BMC Public Health 2024; 24:1766. [PMID: 38956507 PMCID: PMC11221023 DOI: 10.1186/s12889-024-19218-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Maintaining good functional ability is a key component of healthy ageing and a basic requirement for carrying out activities of daily living, staying independent, and delaying admission to a nursing home. Even though women have a higher life expectancy and slower age-related muscle mass loss than men, they often show a higher prevalence of limitations in physical functioning. However, the reasons behind these sex differences are still unclear. Therefore, the aims of this study were to investigate sex differences among older adults regarding physical functioning and to study which factors are explaining these sex differences. METHODS Cross-sectional data from participants of the OUTDOOR ACTIVE study residing in Bremen, Germany, aged 65 to 75 years, were included in the analyses. Physical functioning was assessed via a self-administered questionnaire using the SF-36 10-item Physical Functioning Scale. Social, lifestyle, and health-related factors were also assessed using the questionnaire. Physical activity was measured objectively using wrist-worn accelerometers over seven consecutive days. Descriptive analyses with absolute and relative frequencies, means and standard deviations, as well as T-tests and chi-square tests were carried out. To test for associations between sex, physical functioning, and several individual factors, linear regressions were performed. RESULTS Data of 2 141 participants (52.1% female) were included in the study. Women and men showed statistically significant differences in physical functioning, with men perceiving fewer limitations than women. On average, women had a physical functioning score of 81.4 ± 19.3 and men 86.7 ± 17.0. Linear regression showed a statistically significant negative association between physical functioning score and sex (β: -0.15, 95% CL: -0.19, -0.10). The association remained statistically significant when adding individual factors to the model. All factors together were only able to explain 51% of the physical functioning-sex association with health indicators and the presence of chronic diseases being the most influential factors. CONCLUSIONS We found sex differences in physical functioning, with older women having more limitations than older men. The results showed that health-related factors and chronic diseases played the biggest roles in the different physical functioning scores of women and men. These findings contribute to future longitudinal, more in-depth research. TRIAL REGISTRATION German Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018).
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Affiliation(s)
- Imke Stalling
- Institute of Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2a, 28359, Bremen, Germany.
| | - Martin Gruber
- Institute of Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2a, 28359, Bremen, Germany
| | - Karin Bammann
- Institute of Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2a, 28359, Bremen, Germany
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Lu Y, Li Q, Wang W, Du L, He Q, Chen S, Zhang X, Pan Y. Associations between accelerometer-measured physical activity and sedentary behaviour with physical function among older women: a cross-sectional study. BMC Public Health 2024; 24:1754. [PMID: 38956531 PMCID: PMC11218370 DOI: 10.1186/s12889-024-19270-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 06/25/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND This study aimed to investigate the relationships between accelerometer-measured physical activity (PA) and sedentary behaviour (SB) with physical function (PF) among older Chinese women in the community. METHODS The present study comprised 1,113 community-dwelling older females, with an average age of 65 ± 2 years. We employed a linear regression analysis to investigate the relationship between patterns of PA and SB with PF. PA variables consisted of total PA time, bouted PA time (a continuous PA that lasts equal to or more than 10 min), and sporadic PA time (a continuous PA that lasts less than 10 min). SB variables included total SB time, 30-min bout of SB (a continuous SB that lasts equal to or more than 30 min), and 60-min bout of SB (a continuous SB that lasts equal to or more than 60 min). PF variables comprised handgrip strength (HGS), one-legged stance test with eyes closed (OLSTEC), usual walking speed (UWS), maximum walking speed (MWS) and chair-stand time (CT). To explore the joint effects of moderate-to-vigorous-intensity PA (MVPA) and SB on PF, we divided the duration of SB and MVPA participation in older women into different combinations: low MVPA & high SB, low MVPA & low SB, high MVPA & high SB, high MVPA & low SB. RESULTS The study revealed a significant association between 30-min bout of SB and CT, which remained after adjusting for total MVPA time (P = 0.021). Both total MVPA and bouted MVPA were found to be positively associated with better UWS, MWS, CT, and PF Z-score. When the combination of low MVPA & high SB was used as a reference, the regression coefficients for PF ascended by 1.32 (P < 0.001) in the high MVPA & high SB group and by 1.13 (P < 0.001) in the high MVPA & low SB group. CONCLUSIONS A significant association was observed between poorer lower limb function and prolonged, uninterrupted SB in older women, rather than with the total SB time. Concurrently, the insufficient engagement in MVPA may also be a crucial factor contributing to poorer PF in older women. Engaging in longer durations and higher intensity of PA, such as bouts of MVPA lasting a minimum of 10 min or longer, may contribute to better PF.
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Affiliation(s)
- Yanyu Lu
- School of Physical Education, Shandong University, Jinan, China
| | | | - Wenbo Wang
- Zaozhuang Vocational College of Science and Technology, Zaozhuang, China
| | - Litao Du
- School of Physical Education, Shandong University, Jinan, China
| | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, Jinan, China
| | - Yang Pan
- School of Physical Education, Shandong University, Jinan, China.
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Germano-Soares AH, Farah BQ, Da Silva JF, Barros MVG, Tassitano RM. Clustering of 24H movement behaviors associated with clinic blood pressure in older adults: a cross-sectional study. J Hum Hypertens 2024; 38:575-579. [PMID: 38890411 DOI: 10.1038/s41371-024-00925-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
Physical activity (PA), sedentary behavior (SB), and sleep duration are known to have an individual effect on clinic blood pressure (BP) of older adults. However, whether different patterns of these so-called movement behaviors over the 24h-cycle on BP remains poorly investigated. The study aimed to identify movement behavior patterns associated with clinic BP among older adults with chronic diseases. Cross-sectional study with 238 older adults (80.3% female; mean age 68.8 ± 6.6) with at least one chronic disease. PA, SB, and sleep duration were measured by a triaxial accelerometer. Clinic systolic BP (SBP) and diastolic BP (DBP) were obtained through an automated method following standard procedures. Non-hierarchical K-means cluster and linear regression modeling were employed to identify the clusters of movement behaviors and to examine the associations. Two clusters were identified [active and non-sedentary, n = 103 (i.e., sufficient sleep duration, higher LPA and MVPA, and lower SB) and sedentary and inactive, n = 135 (i.e., sufficient sleep duration, lower LPA and MVPA, and higher SB). Active and non-sedentary older adults presented lower systolic BP compared to sedentary and inactive ones, even after adjustments for sociodemographic and clinical characteristics (β = 6.356; CI 95% from 0.932 to 11.779; P = 0.022). No associations were found for diastolic BP. In conclusion, higher PA and lower SB were associated with lower systolic BP in older adults with chronic diseases. However, sleep duration did not modify this association. Therefore, interventions focusing on concomitantly increasing PA levels and reducing SB should be the priority for controlling blood pressure.
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Affiliation(s)
- Antonio H Germano-Soares
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
- Department of Physical Education Faculdade Pernambucana de Saúde, Recife, Pernambuco, Brazil
| | - Breno Q Farah
- Department of Physical Education Federal Rural University of Pernambuco, Recife, Brazil
| | - José F Da Silva
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
| | - Mauro V G Barros
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
| | - Rafael M Tassitano
- Department of Health and Kinesiology University of Illinois at Urbana-Champaign, Champaign, IL, USA.
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Marino FR, Deal JA, Dougherty RJ, Bilgel M, Tian Q, An Y, Simonsick EM, Resnick SM, Ferrucci L, Spira AP, Wanigatunga AA, Schrack JA. Differences in Daily Physical Activity by Alzheimer's Risk Markers Among Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glae119. [PMID: 38742659 PMCID: PMC11157965 DOI: 10.1093/gerona/glae119] [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: 01/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Daily physical activity patterns differ by Alzheimer's disease (AD) status and might signal cognitive risk. It is critical to understand whether patterns are disrupted early in the AD pathological process. Yet, whether established AD risk markers (β-amyloid [Aβ] or apolipoprotein E-ε4 [APOE-ε4]) are associated with differences in objectively measured activity patterns among cognitively unimpaired older adults is unclear. METHODS Wrist accelerometry, brain Aβ (+/-), and APOE-ε4 genotype were collected in 106 (Aβ) and 472 (APOE-ε4) participants (mean age 76 [standard deviation{SD}: 8.5) or 75 [SD: 9.2] years, 60% or 58% women) in the Baltimore Longitudinal Study of Aging. Adjusted linear and function-on-scalar regression models examined whether Aβ or APOE-ε4 status was cross-sectionally associated with activity patterns (amount, variability, or fragmentation) overall and by time of day, respectively. Differences in activity patterns by combinations of Aβ and APOE-ε4 status were descriptively examined (n = 105). RESULTS There were no differences in any activity pattern by Aβ or APOE-ε4 status overall. Aβ+ was associated with lower total amount and lower within-day variability of physical activity overnight and early evening, and APOE-ε4 carriers had higher total amount of activity in the evening and lower within-day variability of activity in the morning. Diurnal curves of activity were blunted among those with Aβ+ regardless of APOE-ε4 status, but only when including older adults with mild cognitive impairment/dementia. CONCLUSIONS Aβ+ in cognitively unimpaired older adults might manifest as lower amount and variability of daily physical activity, particularly during overnight/evening hours. Future research is needed to examine changes in activity patterns in larger samples and by other AD biomarkers.
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Affiliation(s)
- Francesca R Marino
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ryan J Dougherty
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Murat Bilgel
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Qu Tian
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Yang An
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Susan M Resnick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Adam P Spira
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Rosenberg DE, Wu Y, Idu A, Greenwood-Hickman MA, McCurry SM, LaCroix AZ, Shaw PA. Historic Cognitive Function Trajectories as Predictors of Sedentary Behavior and Physical Activity in Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glae125. [PMID: 38747395 PMCID: PMC11176976 DOI: 10.1093/gerona/glae125] [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: 01/17/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND We examined whether trajectories of cognitive function over 10 years predict later-life physical activity (PA), sedentary time (ST), and sleep. METHODS Participants were from the Adult Changes in Thought (ACT) cohort study. We included 611 ACT participants who wore accelerometers and had 3+ measures of cognition in the 10 years prior to accelerometer wear. The Cognitive Assessment Screening Instrument (CASI) measured cognition and was scored using item-response theory (IRT). activPAL and ActiGraph accelerometers worn over 7 days measured ST and PA outcomes. Self-reported time in bed and sleep quality measured sleep outcomes. Analyses used growth mixture modeling to classify CASI-IRT scores into latent groups and examine associations with PA, ST, and sleep including demographic and health covariates. RESULTS Participants (Mean age = 80.3 (6.5) years, 90.3% White, 57.1% female, 29.3% had less than 16 years of education) fell into 3 latent trajectory groups: average stable CASI (56.1%), high stable CASI (34.0%), and declining CASI (9.8%). The declining group had 16 minutes less stepping time (95% confidence interval [95% CI]: 0.6, 31.4), 1 517 fewer steps per day (95% CI: 138, 2 896), and 16.3 minutes per day less moderate-to-vigorous PA (95% CI: 1.3, 31.3) compared to the average stable group. There were no associations between CASI trajectory and sedentary or sleep outcomes. CONCLUSIONS Declining cognition predicted lower PA providing some evidence of a reverse relationship between PA and cognition in older adults. However, this conclusion is limited by having outcomes at only one time point, a nonrepresentative sample, self-reported sleep outcomes, and using a global cognition measure.
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Affiliation(s)
- Dori E Rosenberg
- Investigative Sciences Division, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Yinxiang Wu
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Abisola Idu
- Biostatistics Division, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | | | - Susan M McCurry
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Andrea Z LaCroix
- Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Pamela A Shaw
- Biostatistics Division, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
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Hamaya R, Shiroma EJ, Moore CC, Buring JE, Evenson KR, Lee IM. Time- vs Step-Based Physical Activity Metrics for Health. JAMA Intern Med 2024; 184:718-725. [PMID: 38767892 PMCID: PMC11106710 DOI: 10.1001/jamainternmed.2024.0892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/08/2024] [Indexed: 05/22/2024]
Abstract
Importance Current US physical activity (PA) guidelines prescribe moderate to vigorous PA (MVPA) time of at least 150 minutes per week for health. An analogous step-based recommendation has not been issued due to insufficient evidence. Objective To examine the associations of MVPA time and step counts with all-cause mortality and cardiovascular disease (CVD). Design, Setting, and Participants This cohort study analyzed data from an ongoing follow-up study of surviving participants of the Women's Health Study, a randomized clinical trial conducted from 1992 to 2004 in the US to evaluate use of low-dose aspirin and vitamin E for preventing cancer and CVD. Participants were 62 years or older who were free from CVD and cancer, completed annual questionnaires, and agreed to measure their PA with an accelerometer as part of a 2011-2015 ancillary study. Participants were followed up through December 31, 2022. Exposures Time spent in MVPA and step counts, measured with an accelerometer for 7 consecutive days. Main Outcomes and Measures The associations of MVPA time and step counts with all-cause mortality and CVD (composite of myocardial infarction, stroke, and CVD mortality) adjusted for confounders. Cox proportional hazards regression models, restricted mean survival time differences, and area under the receiver operating characteristic curve (AUC) were used to evaluate the associations. Results A total of 14 399 women (mean [SD] age, 71.8 [5.6] years) were included. The median (IQR) MVPA time and step counts were 62 (20-149) minutes per week and 5183 (3691-7001) steps per day, respectively. During a median (IQR) follow-up of 9.0 (8.0-9.9) years, the hazard ratios (HR) per SD for all-cause mortality were 0.82 (95% CI, 0.75-0.90) for MVPA time and 0.74 (95% CI, 0.69-0.80) for step counts. Greater MVPA time and step counts (top 3 quartiles vs bottom quartile) were associated with a longer period free from death: 2.22 (95% CI, 1.58-2.85) months and 2.36 (95% CI, 1.73-2.99) months at 9 years follow-up, respectively. The AUCs for all-cause mortality from MVPA time and step counts were similar: 0.55 (95% CI, 0.52-0.57) for both metrics. Similar associations of these 2 metrics with CVD were observed. Conclusion and Relevance Results of this study suggest that among females 62 years or older, MVPA time and step counts were qualitatively similar in their associations with all-cause mortality and CVD. Step count-based goals should be considered for future guidelines along with time-based goals, allowing for the accommodation of personal preferences.
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Affiliation(s)
- Rikuta Hamaya
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eric J. Shiroma
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Christopher C. Moore
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - Julie E. Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Hawley NL, Zarei P, Crouter SE, Desai MM, Pomer A, Rivara AC, Naseri T, Reupena MS, Viali S, Duckham RL, McGarvey ST. Accelerometer-Based Estimates of Physical Activity and Sedentary Time Among Samoan Adults. J Phys Act Health 2024; 21:636-644. [PMID: 38621669 DOI: 10.1123/jpah.2023-0590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/15/2024] [Accepted: 02/26/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The prevalence of obesity-related cardiometabolic disease in Samoa is among the highest globally. While physical activity is a modifiable risk factor for obesity-related disease, little is known about physical activity levels among adult Samoans. Using wrist-worn accelerometer-based devices, this study aimed to characterize physical activity among Samoan adults. METHODS Samoan adults (n = 385; 55% female, mean [SD] age 52 [10] y) wore Actigraph GT3X+ devices for 7 to 10 days. General linear models were used to examine mean daily minutes of sedentary time, light physical activity, and moderate to vigorous physical activity by various participant characteristics. RESULTS Time spent in moderate to vigorous physical activity did not differ statistically between men (88 [5] min; 95% confidence interval [CI], 80-97) and women (78 [4] min; 95% CI, 70-86; P = .08). Women, however, spent more time than men in light physical activity: 380 (7) minutes (95% CI, 367-393) versus 344 (7) minutes (95% CI, 329-358; P < .001). While there were no differences in physical activity by census region, education, or occupation among women, men in urban areas spent significantly less time in moderate to vigorous physical activity than those in peri-urban and rural areas (P = .015). Women with class II/III obesity spent more time in sedentary activities than those with healthy weight or overweight/class I obesity (P = .048). CONCLUSIONS This study characterizes physical activity among Samoan adults and highlights variation by sex, urbanicity, and weight status. In providing initial device-measured estimates of physical activity in Samoa, this analysis establishes a baseline from which the success of future attempts to intervene on physical activity may be assessed.
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Affiliation(s)
- Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Parmida Zarei
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Scott E Crouter
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, TN, USA
| | - Mayur M Desai
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Alysa Pomer
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Anna C Rivara
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | | | | | | | - Rachel L Duckham
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, Australia
- Clinical Leadership Effectiveness and Outcomes (CLEO), Digital Health Division, The Northern Hospital, Melbourne, VIC, Australia
| | - Stephen T McGarvey
- Department of Epidemiology and International Health Institute, Brown University School of Public Health, Providence, RI, USA
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Collombon EHGM, Bolman CAW, de Bruijn GJ, Peels DA, Verboon P, Lechner L. The efficacy of online physical activity interventions with added mobile elements within adults aged 50 years and over: Randomized controlled trial. Appl Psychol Health Well Being 2024. [PMID: 38925643 DOI: 10.1111/aphw.12568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024]
Abstract
Electronic health (eHealth) and mobile health (mHealth) could stimulate physical activity (PA) in a time-efficient and cost-effective way. This randomized controlled trial aims to investigate effects on moderate-to-vigorous PA (MVPA) of different combined computer- and mobile-based PA interventions targeted at adults aged 50 years and over. Participants (N = 954) were randomly allocated to a basic existing computer-based intervention (Active Plus [AP] or I Move [IM]) supplemented with one of three mobile elements being (1) activity tracker (AT), (2) ecological momentary intervention (EMI), or (3) chatbot (CB) or a control group (CG). MVPA was assessed via the SQUASH at baseline (T0), 3 months (T1), and 6 months (T2) and via accelerometers at T0 and T2. No intervention effects were found on objective (p = .502) and subjective (p = .368) MVPA for main research groups (AP/IM + AT, AP/IM + EMI, AP/IM + CB). Preliminary MVPA findings for subgroups (AP + AT, AP + EMI, AP + CB, IM + AT, IM + EMI, IM + CB) combined with drop-out data showed potential for the computer-based intervention AP with an integrated AT. Based on these preliminary findings, eHealth developers can be recommended to integrate ATs with existing computer-based PA interventions. However, further research is recommended to confirm the findings as a result of the exploratory nature of the subgroup analyses.
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Affiliation(s)
| | | | - Gert-Jan de Bruijn
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Denise A Peels
- Faculty of Psychology, Open Universiteit, Heerlen, The Netherlands
| | - Peter Verboon
- Faculty of Psychology, Open Universiteit, Heerlen, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology, Open Universiteit, Heerlen, The Netherlands
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Bailly M, Beraud D, Lambert C, Garnier YM, Pereira B, Duclos M, Boirie Y, Isacco L, Thivel D, Verney J. Constitutional thinness might be characterized by physiologically adapted and not impaired muscle function and architecture: new results from the NUTRILEAN study. Eur J Appl Physiol 2024:10.1007/s00421-024-05539-7. [PMID: 38900200 DOI: 10.1007/s00421-024-05539-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE While muscle mass and skeletal muscle fibers phenotype have been shown atypical in constitutional thinness (CT), force production capacities and its architectural determinants have never been explored. The present study compared muscle functionality and architecture between participants with CT and their normal-weight (NW) counterparts. METHODS Anthropometry, body composition (Dual-X-ray Absorptiometry), physical activity/sedentary behavior (ActiGraph wGT3X-BT), ultrasound recording of the Vastus Lateralis (2D-ultrasound system), and functional capacities at maximal isometric and isokinetic voluntary contractions (MVCISO and MVCCON) during knee extension (isokinetic dynamometer chair Biodex) have been measured in 18 women with CT (body mass index < 17.5 kg/m2) and 17 NW women. RESULTS A lower fat-free mass (ES: -1.94, 95%CI: -2.76 to -1.11, p < 0.001), a higher sedentary time, and a trend for a lower time spent at low-intensity physical activity, were observed in CT vs NW participants. While absolute MVCISO, MVCCON, rate of torque development (RTD), and torque work were all markedly lower in CT, these differences disappeared when normalized to body or muscle mass. Muscle thickness and fascicle length were found lower in CT (ES: -1.29, 95%CI: -2.03 to -0.52, p < 0.001; and ES: -0.87, 95%CI: -1.58 to -0.15, p = 0.02, respectively), while pennation angle was found similar. CONCLUSION Despite lower absolute strength capacities observed in CT, present findings support the hypothesis of physiological adaptations to the low body and muscle mass than to some intrinsic contractile impairments. These results call for further studies exploring hypertrophy-targeted strategies in the management of CT.
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Affiliation(s)
- Mélina Bailly
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - Duane Beraud
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - Céline Lambert
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Yoann M Garnier
- Prognostic Factors and Regulatory Factors of Cardiac and Vascular Pathologies, EA3920, Université de Franche-Comté, 25000, Besançon, France
| | - Bruno Pereira
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, CHU Clermont-Ferrand, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Yves Boirie
- Department of Clinical Nutrition, CHU Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Laurie Isacco
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - Julien Verney
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France.
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Lewthwaite H, Gibson PG, Guerrero PDU, Smith A, Clark VL, Vertigan AE, Hiles SA, Bailey B, Yorke J, McDonald VM. Understanding Breathlessness Burden and Psychophysiological Correlates in Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00642-1. [PMID: 38906398 DOI: 10.1016/j.jaip.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/05/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Breathlessness is a disabling symptom, with complexity that is often under-recognized and undertreated in asthma. OBJECTIVE To highlight the burden of breathlessness in people with severe compared with mild-to-moderate asthma and identify psychophysiological correlates of breathlessness. METHODS This was a cross-sectional study of people with mild-to-severe asthma, who attended 2 in-person visits to complete a multidimensional assessment. The proportion of people with mild-to-moderate versus severe asthma who reported physically limiting breathlessness (modified Medical Research Council [mMRC] dyspnea score ≥2) was compared. Psychophysiological factors associated with breathlessness in people with asthma were identified via a directed acyclic graph and explored with multivariate logistic regression to predict breathlessness. RESULTS A total of 144 participants were included, of whom, 74 (51%) had mild-to-moderate asthma and 70 (49%) severe asthma. Participants were predominantly female (n = 103, 72%) with a median (quartile 1, quartile 3) age of 63.4 (50.5, 69.5) years and body mass index (BMI) of 31.3 (26.2, 36.0) kg/m2. The proportion of people reporting mMRC ≥2 was significantly higher in those with severe- (n = 37, 53%) than those with mild-to-moderate (n = 21, 31%) asthma (P = .013). Dyspnoea-12 Total (8.00 [4.75, 17.00] vs 5.00 [2.00, 11.00], P = .037) score was also significantly higher in the severe asthma group. Significant predictors of physically limiting breathlessness were BMI, asthma control, exercise capacity, and hyperventilation symptoms. Airflow limitation and type 2 inflammation were poor breathlessness predictors. CONCLUSIONS Over half of people with severe asthma experience physically limiting breathlessness despite treatment. Targeting psychophysiological factors, or traits, associated with breathlessness may help relieve this distressing symptom, which is of high priority to people with asthma.
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Affiliation(s)
- Hayley Lewthwaite
- Centre for Research Excellence in Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Peter G Gibson
- Centre for Research Excellence in Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Paola D Urroz Guerrero
- Centre for Research Excellence in Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Amber Smith
- Centre for Research Excellence in Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Vanessa L Clark
- Centre for Research Excellence in Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Anne E Vertigan
- Centre for Research Excellence in Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Speech Pathology Department, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Sarah A Hiles
- Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; School of Psychological Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Brooke Bailey
- Centre for Research Excellence in Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Janelle Yorke
- School of Nursing, Faculty of Health Sciences, Polytechnic University, Hong Kong, Hong Kong; School of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, the University of Manchester, Manchester, United Kingdom
| | - Vanessa M McDonald
- Centre for Research Excellence in Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia.
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Pradhan S, Esterov D, Driver S, Whyte J, Bell KR, Barber J, Temkin N, Bombardier CH. Predictors of Physical Activity One Year After Moderate to Severe Traumatic Brain Injury. J Head Trauma Rehabil 2024:00001199-990000000-00165. [PMID: 38916401 DOI: 10.1097/htr.0000000000000966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
OBJECTIVE To identify predictors of moderate to vigorous physical activity (MVPA) at 12-months post-moderate-severe traumatic brain injury (TBI). Setting: Four inpatient rehabilitation centers. PARTICIPANTS Individuals enrolled in the TBI Model Systems with moderate to severe TBI, admitted to inpatient rehabilitation, and able to ambulate without physical assistance from another person. DESIGN Prospective longitudinal cohort study. MVPA was measured by having participants wear an ActiGraph GT3X on their wrist for 7 consecutive days. MAIN ANALYSES We used multivariate regression to predict minutes per week of MVPA at 12 months after TBI. Three classes of predictors were entered hierarchically-demographic and clinical variables (age, sex, body mass index, education, TBI severity, neighborhood walkability score, and self-reported preinjury physical activity [PA] level), baseline TBI-related comorbid conditions (eg, measures of sleep, pain, mood, fatigue, and cognition), and intention to exercise and exercise self-efficacy assessed approximately 1 week after discharge from inpatient rehabilitation. RESULTS 180 participants (ages 17.7-90.3 years) were enrolled, and 102 provided at least 5 days of valid accelerometer data at 12 months. At 12 months, participants recorded an average of 703 (587) minutes per week of MVPA. In univariate and multivariate analyses, age was the only significant predictor of 12-month MVPA (r = -0.52). A sharp decline in MVPA was observed in the tertile of participants who were over the age of 61. CONCLUSIONS Older adults with TBI are at elevated risk of being physically inactive. Assuming PA may enhance health after TBI, older adults are a logical target for prevention or early intervention studies. Studies with longer outcomes are needed to understand the trajectory of PA levels after TBI.
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Affiliation(s)
- Sujata Pradhan
- Author Affiliations: Department of Rehabilitation Medicine (Dr Pradhan and Dr Bombardier), Department of Neurological surgery (Dr Barber and Dr Temkin), University of Washington, Seattle, Washington; Department of Physical Medicine and Rehabilitation (Dr Esterov), Mayo Clinic, Rochester, Minnesota; Department of Physical Medicine and Rehabilitation (Dr Driver), Baylor Scott and White Research Institute, Dallas, Texas; Department of Physical Medicine and Rehabilitation (Dr Whyte), Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania; and Department of Physical Medicine and Rehabilitation (Dr. Bell), University of Texas Southwestern Medical Center, Dallas, Texas
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