Physical Activity and Sedentary Behavior Assessment: A Laboratory-Based Evaluation of Agreement between Commonly Used ActiGraph and Omron Accelerometers

Validation of the LPA-SQUASH in post-liver-transplant patients

AIM

This study aimed to validate the revised Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) to measure sedentary activity in post-liver-transplant patients. The proposed scale could be useful for transplantation nurses to assess and modify sedentary lifestyles and increase physical activity.

METHODS

The SQUASH was modified to include items on sitting time and light-intensity physical activity (LPA-SQUASH). A pilot study was conducted with 20 liver transplant patients, and an expert panel validated the scale contents. Then, post-liver-transplant outpatients at a Japanese university hospital participated in the main study (September-October 2020), in which questionnaires were mailed twice to assess test-retest reliability, and accelerometers used to establish criterion validity. Intra-class correlation coefficients (ICC) were calculated for test-retest reliability. Spearman correlations and Bland-Altman plots were used to assess validity and measurement error.

RESULTS

In total, 173 participants returned the questionnaires, and 106 and 71 completed the reliability and validation studies, respectively. The range of LPA-SQUASH correlation coefficients for test-retest was .49-.58. ICCs ranged from .72 to .80 for items other than leisure. Accelerometer data and the LPA-SQUASH total physical activity amount and light-intensity physical activity correlated moderately.

CONCLUSION

We modified the SQUASH, which was developed to measure physical activity in healthy adults, to assess light-intensity physical activity in post-liver-transplant patients. The LPA-SQUASH showed acceptable validity and reliability. The questionnaire may be used by transplantation nurses to examine light-intensity physical activity content/duration, deliver patient education considering patients' sedentary lifestyle, and facilitate goal setting for physical activity interventions to prevent metabolic syndrome.

Joint Association between Sedentary Time and Moderate-to-Vigorous Physical Activity with Obesity Risk in Adults from Latin America

Recent studies have shown various relationships between physical activity and the incidence of obesity, but this study critically explored the association of sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) with obesity risk in adults from eight Latin American countries. ST and MVPA were assessed with accelerometers and stratified into 16 joint categories. Multivariate logistic regression models were used. The obesity risk indicators evaluated were body mass index (BMI), waist circumference (WC), and neck circumference (NC). Quartile 4 of ST and ≥300 min/week of MVPA was associated with lower odds of BMI compared to quartile 1 of ST and ≥300 min/week of MVPA. Quartile 1 of ST and 150-299 min/week of MVPA, quartile 1 of ST and 76-149 min/week MVPA, quartile 3 of ST and 76-149 min/week MVPA, and quartiles 1, 2, and 3 of ST with 0-74 min/week MVPA were associated with higher odds of high WC compared to quartile 1 of ST and ≥300 min/week of MVPA. Quartile 3 of ST and 150-299 min/week of MVPA, quartiles 1 and 3 of ST and 76-149 min/week of MVPA, and quartile 1 of ST and 0-74 min/week MVPA were associated with higher NC compared to quartile 1 of ST and ≥300 min/week of MVPA. This study suggests that achieving the MVPA recommendations will likely protect against obesity, regardless of ST.

The association of subjective vision with objectively measured intensity-specific physical activity and bout-specific sedentary behavior among community-dwelling older adults in Japan

PURPOSE

Visual impairment is a possible cause of physical frailty. Reduced physical activity (PA) may be involved in the pathway from visual impairment to physical frailty, although the association between vision and objectively measured PA among older adults remains unclear. This study examined the sex-specific association of subjective vision with intensity-specific PA and bout-specific sedentary behavior (SB) among community-dwelling, older Japanese adults.

STUDY DESIGN

Cross-sectional study METHODS: This study used data from the Neuron to Environmental Impact across Generations study analyzing older adults (527 participants, aged 65-84 years) living in rural areas of Niigata Prefecture, Japan. Subjective vision was assessed by use of a questionnaire. Intensity-specific PA (light-intensity PA and moderate-to-vigorous PA [MVPA]), bout-specific SB, and daily step count were objectively evaluated by use of an accelerometer. The association of subjective vison with PA and SB, stratified by sex, was analyzed by means of general regression analyses, with adjustment for covariates.

RESULTS

The data of 512 participants (men: 46.9%; with poor subjective vision: 22.9%) were analyzed. Poor subjective vision was significantly associated with log MVPA (partial regression coefficient = -0.261, P = .013) and log steps (partial regression coefficient = -0.164; P = .021) among women, whereas a tendency of an association was observed with prolonged SB time among men (partial regression coefficient: 39.1; P = .073).

CONCLUSION

Older Japanese women with poor subjective vision performed less MVPA and had fewer step counts than those of participants with good subjective vision, and men with poor subjective vision had longer prolonged SB, which may all accelerate the process to physical frailty.

Physical activity and daily steps cut offs points for overweight/obesity prevention among eight Latin American countries

This study aims to establish cut-off points for the number of minutes of physical activity intensity and the number of daily steps that identify overweight/obesity in adolescents, adults, and older adults. This study examined data from 2737 participants. Physical activity intensity and the number of daily steps were assessed using GT3X+ ActiGraph model accelerometers. Body mass index, waist-to-height ratio, and waist-to-hip ratio were used as indicators of overweight/obesity. The cut-off points for moderate-to-vigorous physical activity for the prevention of overweight/obesity according to body mass index in women ranged from 15.1 to 30.2 min/day; in men, the values were from 15.4 to 33.8 min/day. The lowest cut-off point for daily steps was established in the adolescent group for women and men (7304 and 5162). The highest value in women was 11,412 (51-65 years) and 13,234 in men (18-30 years). Results from measurements different from BMI, show average cut-off points for moderate-to-vigorous physical activity and daily steps of 29.1/8348 and 43.5/10,456 according to waist-to-height ratio; and results of 29.3/11,900 and 44.3/11,056 according to the waist-to-hip ratio; in women and men respectively. A more specific recommendation of physical activity and daily steps adjusted by sex and age range is suggested to prevent overweight/obesity.

Meeting 24-h movement guidelines and markers of adiposity in adults from eight Latin America countries: the ELANS study

This study aimed to compare compliance with 24-h movement guidelines across countries and examine the associations with markers of adiposity in adults from eight Latin American countries. The sample consisted of 2338 adults aged 18-65 years. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) data were objectively measured using accelerometers. Sleep duration was self-reported using a daily log. Body mass index and waist circumference were assessed as markers of adiposity. Meeting the 24-h movement guidelines was defined as ≥ 150 min/week of MVPA; ≤ 8 h/day of SB; and between 7 and 9 h/day of sleep. The number of guidelines being met was 0.90 (95% CI 0.86, 0.93) with higher value in men than women. We found differences between countries. Meeting two and three movement guidelines was associated with overweight/obesity (OR: 0.75, 95% CI 0.58, 0.97 and OR: 0.69, 95% CI 0.51, 0.85, respectively) and high waist circumference (OR: 0.74, 95% CI 0.56, 0.97 and OR: 0.77, 95% CI 0.62, 0.96). Meeting MVPA and SB recommendations were related to reduced adiposity markers but only in men. Future research is needed to gain insights into the directionality of the associations between 24-h movement guidelines compliance and markers of adiposity but also the mechanisms underlying explaining differences between men and women.

Perceived Urban Environment Attributes and Device-Measured Physical Activity in Latin America: An 8-Nation Study

INTRODUCTION

Attributes of the neighborhood-built environment are associated with self-reported physical activity, but only a few studies have concentrated on device-measured physical activity in Latin America. This study examines the associations of perceived neighborhood-built environment attributes, device-measured sedentary time, and light-intensity and moderate-to-vigorous physical activity in adults from 8 Latin American countries.

METHODS

Data from Estudio Latinoamericano de Nutrición y Salud adult study, an observational multicountry study (N=2,478), were analyzed in 2020. Data were collected between 2014 and 2015. Perceived neighborhood-built environment attributes were measured using the Neighbourhood Environment Walkability Survey. Sedentary time, light-intensity physical activity, and moderate-to-vigorous physical activity data were collected using accelerometers.

RESULTS

No associations between perceived neighborhood-built environment attributes and sedentary time were found. Positive perceptions of walking/cycling facilities (β=6.50, 95% CI=2.12, 10.39) were associated with more light-intensity physical activity. Perceptions of better aesthetics (Argentina) and better walking/cycling facilities (Brazil and Ecuador) were positively associated with light-intensity physical activity. Land use mix-diversity (β=0.14, 95% CI=0.03, 0.25), walking/cycling facilities (β=0.16, 95% CI=0.05, 0.27), aesthetics (β=0.16, 95% CI=0.02, 0.30), and safety from traffic (β=0.18, 95% CI=0.05, 0.24) were positively associated with moderate-to-vigorous physical activity. Land use mix-diversity, street connectivity, and safety from traffic were positively associated with moderate-to-vigorous physical activity in Venezuela.

CONCLUSIONS

These findings have implications for policy recommendations, which can guide policies to promote physical activity in the region. Land use mix-diversity, walking/cycling facilities, aesthetics, and safety from traffic can maintain or increase the levels of light-intensity and moderate-to-vigorous physical activity among Latin American adults.

The Validity of the Energy Expenditure Criteria Based on Open Source Code through two Inertial Sensors

Through this study, we developed and validated a system for energy expenditure calculation, which only requires low-cost inertial sensors and open source R software. Five healthy subjects ran at ten different speeds while their kinematic variables were recorded on the thigh and wrist. Two ActiGraph wireless inertial sensors and a low-cost Bluetooth-based inertial sensor (Lis2DH12), assembled by SensorID, were used. Ten energy expenditure equations were automatically calculated in a developed open source R software (our own creation). A correlation analysis was used to compare the results of the energy expenditure equations. A high interclass correlation coefficient of estimated energy expenditure on the thigh and wrist was observed with an Actigraph and Sensor ID accelerometer; the corrected Freedson equation showed the highest values, and the Santos-Lozano vector magnitude equation and Sasaki equation demonstrated the lowest one. Energy expenditure was compared between the wrist and thigh and showed low correlation values. Despite the positive results obtained, it was necessary to design specific equations for the estimation of energy expenditure measured with inertial sensors on the thigh. The use of the same formula equation in two different placements did not report a positive interclass correlation coefficient.

Prevalence and sociodemographic correlates of meeting the Canadian 24-hour movement guidelines among latin american adults: a multi-national cross-sectional study

BACKGROUND

24-hour movement behaviors, including moderate-to-vigorous physical activity (MVPA), sedentary time (ST), and sleep duration, have important implications for health across the lifespan. However, no studies exist that have examined the integration of these 24-hour movement behaviors in Latin America. The purpose of this study was to examine the prevalence of meeting the Canadian 24-Hour Movement Guideline recommendations and sociodemographic correlates of meeting the guidelines in adults from eight Latin American countries.

METHODS

This was a multi-national cross-sectional study of 2338 adults aged 18 to 64 years from the Latin American Study of Nutrition and Health. MVPA and ST data were collected using accelerometers. Sleep duration was self-reported using a daily log. Socio-demographic correlates included sex, age, education level, and marital status. Meeting the 24-hour movement guidelines was defined as: ≥150 min/week of MVPA; ≤8 h/day of ST; and between 7 and 9 h/day of sleep. Logistic regression models were estimated on pooled data.

RESULTS

The prevalence of adults who met the MVPA, ST, sleep duration, and integrated recommendations was 48.3, 22.0, 19.4, and 1.6%, respectively. Overall, being a woman (OR: 0.72; 95%CI: 0.55,0.93) and having a middle (0.63; 0.47,0.85) or high education level (0.31; 0.17,0.56) was associated with lower odds of meeting all three of the 24-hour movement guideline recommendations. Being married (1.70; 1.25,2.29) was associated with greater odds of meeting all three recommendations. Being a woman (0.46; 0.39,0.55), aged 50-64 years (0.77; 0.60,0.97), and married (0.79; 0.65,0.96) were associated with lower odds of meeting the MVPA recommendation. Having a middle (0.64; 0.50,0.80) or high (0.36; 0.23,0.55) education level was associated with lower odds and being married (1.86; 1.46,2.36) was associated with greater odds of meeting the ST recommendation. Being a woman (0.63; 0.51,0.78) was associated with lower odds; whereas being aged 50-64 years (1.40; 1.04,1.88) and having a middle education level (1.37; 1.09,1.73) were associated with greater odds of meeting the sleep duration recommendation.

CONCLUSIONS

Overall, the proportion of Latin American adults achieving healthy levels of 24-hour movement behaviors was low. Further efforts are needed to promote more MVPA, less ST, and sufficient sleep in Latin American adults.

TRIAL REGISTRATION

Clinical Trials NCT02226627 . Retrospectively registered on August 27, 2014.

Association of sarcopenia and physical activity with functional outcome in older Asian patients hospitalized for rehabilitation

BACKGROUND

Previous studies reported that sarcopenia and physical inactivity affected clinical outcome in older adults; however, the association with functional outcome has not been studied in a rehabilitation setting.

AIM

This study aimed to assess the association of sarcopenia and physical activity with the functional outcome in older hospitalized rehabilitation patients.

METHODS

A cross-sectional study was performed in older patients consecutively admitted to convalescent rehabilitation wards. Sarcopenia was diagnosed based on the Asia Working Group for Sarcopenia 2019 criteria, and physical activity time (light-intensity physical activity, LIPA; moderate-to-vigorous physical activity, MVPA) was measured using an activity monitor with a triaxial accelerometer. The association of sarcopenia and physical activity with functional outcome, measured by the Functional Independence Measure (FIM) motor function, was determined using multiple regression analysis adjusted for age, sex, primary disease diagnosis, length of acute hospital stay, Charlson comorbidity index, body mass index, and mini-nutritional assessment-short form score.

RESULTS

Out of 211 rehabilitation older inpatients [median (interquartile range) age 78 (11) years, 150 women (71%)], 104 patients (49%) were diagnosed with sarcopenia. Patients with sarcopenia had significantly lower LIPA (p < 0.001) and MVPA (p = 0.002) than those without sarcopenia. In multiple regression analysis, LIPA (β = 0.39, p < 0.001) and MVPA (β = 0.12, p = 0.02) were associated with FIM-motor function even after they were adjusted for confounding factors, including sarcopenia.

CONCLUSIONS

In rehabilitation older inpatients, sarcopenia and physical activity were independently associated with functional outcome, and physical activity was lower in sarcopenia patients than in those without sarcopenia.

Validity of Domain-Specific Sedentary Time Using Accelerometer and Questionnaire with activPAL Criterion

Accelerometers based on the cut-point method are generally the most used in sedentary time (ST) research. However, mixed cut-points are an issue, so an accelerometer based on metabolic equivalents (METs) could be used as an alternative. This study aimed to validate a METs-based accelerometer (HJA-750C, OMRON) and a questionnaire that estimates domain-specific sedentary time measures using activPAL as a criterion value. We also examined whether measurement validity differed according to gender and occupation. We used data from 242 workers in the validation study. Participants wore activPAL on the thigh and OMRON on the waist for seven consecutive days with daily recording logs. The Workers Living Activity-time Questionnaire (WLAQ) was administered once. The domain-specific ST assessed quantities of ST during commuting, working time, non-working time on a workday, and non-workday. Intraclass correlation coefficients (ICC) and Spearman's rho coefficients were then used to conduct analyses. The OMRON accelerometer showed acceptable values (r = 0.67-0.86 and ICC of 0.63-0.87) in the overall domain-specific ST. Additionally, each measurement result suggested that working time is the most accurate domain to measure ST (ICC of 0.87 for OMRON and 0.68 for WLAQ). Moreover, there were no differences in the overall validity of the results according to gender and occupation. The METs-based accelerometer has acceptable validity for ST measurements to be used among workers. Additionally, working time may be the preferred domain for the accurate assessment of ST in both objective and subjective measurements. These results can advance the quality of the sedentary research field.

Methodological design for the assessment of physical activity and sedentary time in eight Latin American countries - The ELANS study

Worldwide studies of physical activity and sedentary time have historically under-represented low- and middle-income countries due to the lack of surveillance data. The purpose of this paper is to describe the methods and procedures used for the assessment of physical activity and sedentary time in the Latin American Study of Nutrition and Health (Estudio Latinoamericano de Nutrición y Salud; ELANS). ELANS is a multicentre, cross-sectional and surveillance study of a nationally representative sample from eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Two instruments were used to evaluate different domains and intensities of physical activity and sedentary time: self-reported data and a triaxial accelerometer (model GT3X+). ELANS will generate important self-reported and objective information for the Latin American populations, namely:•evidence on the distribution of physical activity and sedentary time across population subgroups (e.g. sex, age, socioeconomic- and educational level). These sets of information will increase the evidence base and can help to inform future intervention strategies in Latin America;•self-reported and objective information on physical activity and sedentary time.