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Kolovelonis A, Syrmpas I, Marcuzzi A, Khudair M, Ng K, Tempest GD, Peric R, Bartoš F, Maier M, Brandes M, Carlin A, Ciaccioni S, Cortis C, Corvino C, Di Credico A, Drid P, Gallè F, Izzicupo P, Jahre H, Kongsvold A, Kouidi E, Mork PJ, Palumbo F, Rumbold PLS, Sandu P, Stavnsbo M, Vilela S, Woods C, Wunsch K, Capranica L, MacDonncha C, Ling FCM. DE-PASS best evidence statement (BESt): determinants of adolescents' device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis. BMC Public Health 2024; 24:1706. [PMID: 38926707 PMCID: PMC11202347 DOI: 10.1186/s12889-024-19136-y] [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: 10/25/2023] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents' device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings. METHODS A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents' device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID CRD42021282874. RESULTS Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual-psychological, four individual-behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found. CONCLUSIONS Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents' device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents' PA/SB, including policy and environmental variables.
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Affiliation(s)
- Athanasios Kolovelonis
- Department of Physical Education and Sport Science, University of Thessaly, 42 100 Karies, Trikala, Greece.
| | - Ioannis Syrmpas
- Department of Physical Education and Sport Science, University of Thessaly, 42 100 Karies, Trikala, Greece
| | - Anna Marcuzzi
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Mohammed Khudair
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
| | - Kwok Ng
- Faculty of Education, University of Turku, Turku, Finland
- Department of Physical Education and Sport Sciences, Physical Activity for Health Centre, University of Limerick, Limerick, Ireland
- Institute of Innovation and Sports Science, Lithuanian Sports University, Kaunas, Lithuania
| | - Gavin Daniel Tempest
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
| | - Ratko Peric
- Exercise Physiology Laboratory, OrthoSport Banja Luka, Banja Luka, Bosnia-Herzegovina
| | - František Bartoš
- Department of Psychological Methods, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Mirko Brandes
- Department of Prevention and Evaluation, Leibniz, Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Angela Carlin
- Centre for Exercise Medicine, Physical Activity and Health, Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK
| | - Simone Ciaccioni
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Chiara Corvino
- Faculty of Economics, Department of Psychology, Universita Cattolica del Sacro Cuore, Milan, Italy
| | - Andrea Di Credico
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Francesca Gallè
- Department of Medical, Movement and Wellbeing Sciences, University of Naples "Parthenope", Naples, Italy
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Henriette Jahre
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Atle Kongsvold
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Evangelia Kouidi
- Laboratory of Sports Medicne, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Federico Palumbo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | | | - Petru Sandu
- Health Promotion and Evaluation, National Institute of Public Health in Romania, Bucharest, Romania
| | - Mette Stavnsbo
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Sofia Vilela
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - Catherine Woods
- Physical Activity for Health Cluster, Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Laura Capranica
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Ciaran MacDonncha
- Physical Activity for Health Cluster, Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Fiona Chun Man Ling
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
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Braem CIR, Yavuz US, Hermens HJ, Veltink PH. Missing Data Statistics Provide Causal Insights into Data Loss in Diabetes Health Monitoring by Wearable Sensors. SENSORS (BASEL, SWITZERLAND) 2024; 24:1526. [PMID: 38475061 DOI: 10.3390/s24051526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/14/2024] [Accepted: 02/25/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Data loss in wearable sensors is an inevitable problem that leads to misrepresentation during diabetes health monitoring. We systematically investigated missing wearable sensors data to get causal insight into the mechanisms leading to missing data. METHODS Two-week-long data from a continuous glucose monitor and a Fitbit activity tracker recording heart rate (HR) and step count in free-living patients with type 2 diabetes mellitus were used. The gap size distribution was fitted with a Planck distribution to test for missing not at random (MNAR) and a difference between distributions was tested with a Chi-squared test. Significant missing data dispersion over time was tested with the Kruskal-Wallis test and Dunn post hoc analysis. RESULTS Data from 77 subjects resulted in 73 cleaned glucose, 70 HR and 68 step count recordings. The glucose gap sizes followed a Planck distribution. HR and step count gap frequency differed significantly (p < 0.001), and the missing data were therefore MNAR. In glucose, more missing data were found in the night (23:00-01:00), and in step count, more at measurement days 6 and 7 (p < 0.001). In both cases, missing data were caused by insufficient frequency of data synchronization. CONCLUSIONS Our novel approach of investigating missing data statistics revealed the mechanisms for missing data in Fitbit and CGM data.
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Affiliation(s)
- Carlijn I R Braem
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands
| | - Utku S Yavuz
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands
| | - Hermie J Hermens
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands
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Lamunion SR, Brychta RJ, Saint-Maurice PF, Matthews CE, Chen KY. Does Wrist-Worn Accelerometer Wear Compliance Wane over a Free-Living Assessment Period? An NHANES Analysis. Med Sci Sports Exerc 2024; 56:209-220. [PMID: 37703285 PMCID: PMC10872893 DOI: 10.1249/mss.0000000000003301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
PURPOSE Accelerometers are used to objectively measure physical behaviors in free-living environments, typically for seven consecutive days or more. We examined whether participants experience "wear fatigue," a decline in wear time day over day, during typical assessment period acquired in a nationally representative sample of 6- to 80-yr-olds in the United States. METHODS Participants were instructed to wear an ActiGraph GT3X+ on their nondominant wrist continuously for seven consecutive days. Participants with seven complete days of recorded data, regardless of wear status, were included in the analyses ( N = 13,649). Wear was scored with the sleep, wake, and nonwear algorithm. RESULTS Participants averaged 1248 ± 3.6 min·d -1 (mean ± SE) of wear over the assessment, but wear time linearly decreased from day 1 (1295 ± 3.2 min) to day 7 (1170 ± 5.3 min), resulting in a wear fatigue of -18.1 ± 0.7 min·d -1 ( β ± SE). Wear fatigue did not differ by sex but varied by age-group-highest in adolescents (-26.8 ± 2.4 min·d -1 ) and lowest in older adults (-9.3 ± 0.9 min·d -1 ). Wear was lower in evening (1800-2359 h) and early morning (0000-0559 h) compared with the middle of the day and on weekend days compared with weekdays. We verified similar wear fatigue (-23.5 ± 0.7 min·d -1 ) in a separate sample ( N = 14,631) with hip-worn devices and different wear scoring. Applying minimum wear criteria of ≥10 h·d -1 for ≥4 d reduced wear fatigue to -5.3 and -18.7 min·d -1 for the wrist and hip, respectively. CONCLUSIONS Patterns of wear suggest noncompliance may disproportionately affect estimates of sleep and sedentary behavior, particularly for adolescents. Further study is needed to determine the effect of wear fatigue on longer assessments.
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Affiliation(s)
- Samuel R Lamunion
- Energy Metabolism Section, National Institute of Diabetes, Digestive and Kidney Diseases, Diabetes, Endocrinology, and Obesity Branch, National Institutes of Health (NIH), Bethesda, MD
| | - Robert J Brychta
- Energy Metabolism Section, National Institute of Diabetes, Digestive and Kidney Diseases, Diabetes, Endocrinology, and Obesity Branch, National Institutes of Health (NIH), Bethesda, MD
| | - Pedro F Saint-Maurice
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Charles E Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Kong Y Chen
- Energy Metabolism Section, National Institute of Diabetes, Digestive and Kidney Diseases, Diabetes, Endocrinology, and Obesity Branch, National Institutes of Health (NIH), Bethesda, MD
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Zhang T, Meng DT, Lyu DY, Fang BY. The Efficacy of Wearable Cueing Devices on Gait and Motor Function in Parkinson Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2024; 105:369-380. [PMID: 37532166 DOI: 10.1016/j.apmr.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVE To summarize the efficacy of wearable cueing devices for improving gait and motor function of patients with Parkinson disease (PWP). DATA SOURCES PubMed, Embase, and Cochrane CENTRAL databases were searched for papers published in English, from inception to October 23, 2022. STUDY SELECTION Randomized controlled trials focusing on the effects of wearable cueing devices on gait and motor function in PWP were included. DATA EXTRACTION Two reviewers independently selected articles and extracted the data. The Cochrane Bias Risk Assessment Tool was used to assess risk of bias and the Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of evidence. DATA SYNTHESIS Seven randomized controlled trials with 167 PWP were included in the meta-analysis. Significant effect of wearable cueing devices on walking speed (mean difference [MD]=0.07 m/s, 95% confidence interval [CI]: [0.05, 0.09], P<.00001) was detected; however, after sensitivity analysis, no significant overall effect on walking speed was noted (MD=0.04 m/s, 95% CI: [-0.03, 0.12], P=.25). No significant improvements were found in stride length (MD=0.06 m, 95% CI: [0.00, 0.13], P=.05), the Unified Parkinson's Disease Rating Scale-III score (MD=-0.61, 95% CI: [-4.10, 2.88], P=.73), Freezing of Gait Questionnaire score (MD=-0.83, 95% CI: [-2.98, 1.33], P=.45), or double support time (MD=-0.91, 95% CI: [-3.09, 1.26], P=.41). Evidence was evaluated as low quality. CONCLUSIONS Wearable cueing devices may result in an immediate improvement on walking speed; however, there is no evidence that their use results in a significant improvement in other gait or motor functions.
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Affiliation(s)
- Tian Zhang
- Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - De-Tao Meng
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Di-Yang Lyu
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Bo-Yan Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.
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Welsner M, Gruber W, Blosch C, Olivier M, Mellies U, Dillenhoefer S, Brinkmann F, Koerner-Rettberg C, Sutharsan S, Taube C, Stehling F. Impact of habitual physical activity and exercise capacity on quality of life in adolescents and adults with cystic fibrosis. Pediatr Pulmonol 2024. [PMID: 38214406 DOI: 10.1002/ppul.26855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/04/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The influence of habitual physical activity and exercise capacity on health-related quality of life (HRQoL) in people with cystic fibrosis (pwCF) is poorly characterized. This study investigated the influence of habitual physical activity, exercise capacity, lung function, and body mass index (BMI) on HRQoL in adolescent and adult pwCF. METHOD Subjects were fitted with an accelerometer to determine habitual physical activity (steps/day), including time spent at different intensities, for up to 4 weeks. Then bicycle ergometry (maximal exercise capacity; Wpeak), lung function (percent predicted forced expiratory volume in 1 s, ppFEV1 ), BMI, and response to the Cystic Fibrosis Questionnaire-Revised (CFQ-R) were determined. RESULTS Sixty-five pwCF participated in the study. Physically active pwCF had significantly higher ppFEV1 (p < .001) and exercise capacity (p < .001) than inactive pwCF, and had significantly higher scores on the CFQ-R physical (p = .006), emotional (p = .015), role (p = .008), health (p = .006), and weight (p = .004) subscales. On multiple linear regression analysis, ppFEV1 and, to a lesser extent, exercise capacity, were the most important determinants of HRQoL in pwCF. Time spent in moderate-to-vigorous intensity physical activity did not influence any of the CFQ-R subscales, whereas time spent in vigorous-intensity influenced CFQ-R scores for role (p = .007), body (p = .001), health (p = .009), and weight (p = .01). CONCLUSION HRQoL in adolescent and adult pwCF was influenced by several factors. Avoiding sedentary behavior and spending time in vigorous-intensity levels positively influenced HRQoL, whereas the total number of steps per day played only a minor role in determining HRQoL. Both ppFEV1 and exercise capacity markedly influenced HRQoL.
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Affiliation(s)
- Matthias Welsner
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Adult Cystic Fibrosis Center, University of Duisburg-Essen, Essen, Germany
| | - Wolfgang Gruber
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, Essen, Germany
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Christopher Blosch
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, Essen, Germany
- Department of Pediatric Pulmonology, University Children's Hospital, Ruhr University, Bochum, Germany
| | - Margarete Olivier
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, Essen, Germany
| | - Uwe Mellies
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, Essen, Germany
| | - Stefanie Dillenhoefer
- Department of Pediatric Pulmonology, University Children's Hospital, Ruhr University, Bochum, Germany
| | - Folke Brinkmann
- Department of Pediatric Pulmonology, University Children's Hospital, Ruhr University, Bochum, Germany
| | - Cordula Koerner-Rettberg
- Department of Pediatric Pulmonology, University Children's Hospital, Ruhr University, Bochum, Germany
- Children's Hospital, Marienhospital Wesel, Wesel, Germany
| | - Sivagurunathan Sutharsan
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Adult Cystic Fibrosis Center, University of Duisburg-Essen, Essen, Germany
| | - Christian Taube
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Adult Cystic Fibrosis Center, University of Duisburg-Essen, Essen, Germany
| | - Florian Stehling
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, Essen, Germany
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Lev V, Oppezzo MA. Measuring intra-individual physical activity variability using consumer-grade activity devices. Front Digit Health 2023; 5:1239759. [PMID: 37744687 PMCID: PMC10516569 DOI: 10.3389/fdgth.2023.1239759] [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: 06/13/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Many existing sedentary behavior and physical activity studies focus on primary outcomes that assess change by comparing participants' activity from baseline to post-intervention. With the widespread availability of consumer-grade devices that track activity daily, researchers do not need to rely on those endpoint measurements alone. Using activity trackers, researchers can collect remote data about the process of behavior change and future maintenance of the change by measuring participants' intra-individual physical activity variability. Measuring intra-individual physical activity variability can enable researchers to create tailored and dynamic interventions that account for different physical activity behavior change trajectories, and by that, improve participants' program adherence, enhance intervention design and management, and advance interventions measurements' reliability. We propose an application of intra-individual physical activity variability as a measurement and provide three use cases within interventions. Intra-individual physical activity variability can be used: prior to the intervention period, where relationships between participants' intra-individual physical activity variability and individual characteristics can be used to predict adherence and subsequently tailor interventions; during the intervention period, to assess progress and subsequently boost interventions; and after the intervention, to obtain a reliable representation of the change in primary outcome.
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Affiliation(s)
- Vered Lev
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, United States
| | - Marily A. Oppezzo
- Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, CA, United States
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