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Meredith SJ, Shepherd AI, Saynor ZL, Scott A, Gorczynski P, Perissiou M, Horne M, McNarry MA, Mackintosh KA, Witcher CSG. Device-based 24-hour movement behaviours in adult phase III cardiac rehabilitation service-users during the COVID-19 pandemic: a mixed-methods prospective observational study. Disabil Rehabil 2024:1-12. [PMID: 39257350 DOI: 10.1080/09638288.2024.2397086] [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: 06/30/2023] [Revised: 08/21/2024] [Accepted: 08/22/2024] [Indexed: 09/12/2024]
Abstract
PURPOSE To examine changes in device-based 24-hour movement behaviours (MB), and facilitators and barriers to physical activity (PA) and exercise, during remotely-delivered cardiac rehabilitation (RDCR). MATERIALS AND METHODS This prospective observational study used wrist-worn GENEActiv accelerometers to assess MB of 10 service-users (63 ± 10 years) at the start, middle, and end of three-months of RDCR. Barriers and facilitators to PA and exercise were explored through self-report diaries and analysed using content analysis. RESULTS At start, service-users were sedentary for 12.6 ± 0.7 h · day-1 and accumulated most PA at a light-intensity (133.52 ± 28.57 min · day-1) - neither changed significantly during RDCR. Sleep efficiency significantly reduced from start (88.80 ± 4.2%) to the end (86.1 ± 4.76%) of CR, with values meeting health-based recommendations (≥85%). Barriers to RDCR exercise included exertional discomfort and cardiac symptoms, and reduced confidence when exercising alone. Setting meaningful PA goals, self-monitoring health targets, and having social support, facilitated PA and exercise during RDCR. CONCLUSIONS Our RDCR programme failed to elicit significant changes in MB or sleep. To increase the likelihood of successful RDCR, it is important to promote a variety of exercise and PA options, target sedentary time, and apply theory to RDCR design, delivery, and support strategies.
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Affiliation(s)
- S J Meredith
- Academic Geriatric Medicine and National Institute of Health Research Collaboration for Leadership in Health Research and Care Wessex, University of Southampton, Southampton, UK
| | - A I Shepherd
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Z L Saynor
- School of Health Sciences, University of Southampton, Southampton, UK
| | - A Scott
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - P Gorczynski
- School of Human Sciences, University of Greenwich, London, UK
| | - M Perissiou
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - M Horne
- School of Healthcare, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - M A McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Department of Sport and Exercise Sciences, Swansea University, Swansea, UK
| | - K A Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Department of Sport and Exercise Sciences, Swansea University, Swansea, UK
| | - C S G Witcher
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
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Hendrickx W, Wondergem R, Veenhof C, English C, Visser-Meily JMA, Pisters MF. Improving Movement Behavior in People after Stroke with the RISE Intervention: A Randomized Multiple Baseline Study. J Clin Med 2024; 13:4341. [PMID: 39124608 PMCID: PMC11313465 DOI: 10.3390/jcm13154341] [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: 07/02/2024] [Revised: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Objective: High amounts of sedentary behavior increase the risk of cardiovascular disease. This study aimed to determine the preliminary effectiveness and feasibility of the RISE intervention to support community-dwelling people with stroke, who are highly sedentary, to reduce and interrupt sedentary time. Additionally, the added value of including participatory support was determined. Methods: A randomized, multiple-baseline study was conducted including 14 participants. All received the RISE intervention, a 15-week blended behavioral intervention in which a primary care physiotherapist provided personalized coaching in the home setting by using behavior-change techniques and the RISE eCoaching system, including an activity monitor and app to provide real time feedback. Half of the participants (randomly allocated) received participatory support from someone from their social network (e.g., partner or close friend) who joined them in the intervention. Preliminary effectiveness was determined with significant changes in total sedentary time and fragmentation (interruption) of sedentary time using a randomization test. Feasibility was assessed by adherence with the intervention protocol, safety, and satisfaction with the intervention. Results: Participants significantly reduced total sedentary time (p = 0.01) by 1.3 h on average and increased their fragmentation (p < 0.01). Subgroup analyses showed significant improvements in both outcomes only in the group with participatory support. Thirteen (92.9%) participants completed the intervention, no related adverse events occurred, and the reported participant satisfaction was sufficient. Conclusions: The RISE intervention appears promising to support people with stroke who are highly sedentary to reduce and interrupt their sedentary time. Participatory support appears to contribute to greater results. Trial registration: ISRCTN international trial registry, 10694741.
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Affiliation(s)
- Wendy Hendrickx
- Research Group Empowering Healthy Behavior, Department of Health Innovations and Technology, Fontys University of Applied Sciences, 5600 AH Eindhoven, The Netherlands;
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht University, 3584 CX Utrecht, The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, 3454 PV De Meern, The Netherlands
| | - Roderick Wondergem
- School of Sport Studies, Fontys University of Applied Sciences, 5644 HZ Eindhoven, The Netherlands
| | - Cindy Veenhof
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht University, 3584 CX Utrecht, The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, 3454 PV De Meern, The Netherlands
- Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, 3584 CS Utrecht, The Netherlands
| | - Coralie English
- School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
- Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
- Centre of Research Excellence to Accelerate Stroke Trial Innovation and Translation, University of Sydney, Sydney, NSW 2010, Australia
| | - Johanna M. A. Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center and De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands
| | - Martijn F. Pisters
- Research Group Empowering Healthy Behavior, Department of Health Innovations and Technology, Fontys University of Applied Sciences, 5600 AH Eindhoven, The Netherlands;
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht University, 3584 CX Utrecht, The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, 3454 PV De Meern, The Netherlands
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Bamrotia J, Joshi AN, Paralikar S, Kathrotia R, Patel VK, Rajendran R. Effects of Different Types of Physical Activity on Respiratory Health Parameters in Elderly Males: A Cross-Sectional Study. Cureus 2024; 16:e59759. [PMID: 38846224 PMCID: PMC11152964 DOI: 10.7759/cureus.59759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 06/09/2024] Open
Abstract
Background Population aging is a global phenomenon associated with declines in muscle mass, physical activity levels, and respiratory health among elderly individuals. Despite evidence suggesting the benefits of physical activity on respiratory function, there is limited research examining its effects on lung function in the Indian elderly population. Materials and methods This cross-sectional study aimed to investigate the impact of different intensities of physical activity on respiratory health parameters among apparently healthy elderly males aged 60-80 years. Participants were categorized into walking, swimming, and sedentary groups based on their level of physical activity. Anthropometric measurements, cardiovascular parameters, respiratory endurance tests, and spirometry were conducted to assess lung function. Statistical analysis included nonparametric tests to compare the groups. Results Age, height, weight, BMI, waist circumference, and hip circumference were similar across groups, but the waist-to-hip ratio was higher in the sedentary group. Systolic and diastolic blood pressure did not differ significantly, while the pulse rate was lower in the swimming group. The sedentary group exhibited lower respiratory endurance, with a significantly reduced 40 mmHg endurance test and maximum expiratory pressure compared to the walking and swimming groups. Spirometry results showed significant improvements in various parameters, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow rate (PEFR), forced expiratory flow 25% (FEF-25), and maximum voluntary ventilation (MVV) in the walking and swimming groups compared to the sedentary group. Conclusion Regular physical activity, particularly walking and swimming, appears to positively influence respiratory health parameters among elderly males. Engaging in these activities may enhance respiratory muscle strength and lung function, potentially mitigating age-related declines in pulmonary function and promoting overall well-being.
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Affiliation(s)
| | | | | | - Rajesh Kathrotia
- Physiology, All India Institute of Medical Sciences, Rajkot, IND
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Dey KC, Zakrzewski-Fruer JK, Smith LR, Jones RL, Bailey DP. Interrupting sitting acutely attenuates cardiometabolic risk markers in South Asian adults living with overweight and obesity. Eur J Appl Physiol 2024; 124:1163-1174. [PMID: 37950762 PMCID: PMC10954978 DOI: 10.1007/s00421-023-05345-7] [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: 07/19/2023] [Accepted: 10/16/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE This study examined the acute effects of interrupting sitting with light-intensity walking on postprandial cardiometabolic risk markers in South Asian adults. METHODS South Asians with overweight/obesity (n = 19; body mass index [BMI] > 23 kg·m-2) and normal-weight (n = 8; BMI 18.0-22.9 kg·m-2) aged 48.8 ± 5.6 years completed two, 5-h conditions: (1) prolonged sitting (SIT), and (2) interrupted sitting with 5-min bouts of light-intensity walking every 30-min (INT-SIT). Blood samples and resting expired air samples were collected throughout each condition. Statistical analyses were completed using linear mixed models. RESULTS In participants with overweight/obesity, postprandial glucose, triglycerides (TAG) and metabolic load index (MLI) over time were lower, whereas resting substrate utilisation and resting energy expenditure (REE) were higher, in INT-SIT than SIT (all p ≤ 0.05). Compared with SIT (0.18 [95% CI 0.13, 0.22] kcal.min-1), INT-SIT (0.23 [95% CI 0.18, 0.27] kcal.min-1) increased postprandial REE iAUC in participants with overweight/obesity (p = 0.04, d = 0.51). Postprandial TAG concentrations over time were lower in INT-SIT versus SIT (p = 0.01, d = 30) in normal-weight participants, with no differences in any other outcomes for this sample group. CONCLUSION These findings suggest that interrupting sitting with 5-min bouts of light walking every 30-min acutely attenuates cardiometabolic risk markers among South Asians living with overweight/obesity, whereas limited effects may be seen in individuals with normal-weight.
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Affiliation(s)
- Kamalesh Chandra Dey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford, UK
- Preventive Neurology Unit, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Julia K Zakrzewski-Fruer
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford, UK.
| | - Lindsey R Smith
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford, UK
| | - Rebecca L Jones
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford, UK
- Health Advancement Research Team (HART), School of Sport and Exercise Science, University of Lincoln, Lincoln, UK
| | - Daniel P Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford, UK.
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UK.
- Centre for Physical Activity in Health and Disease, Brunel University London, Uxbridge, UK.
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Cristi-Montero C, Martínez-Flores R, Espinoza-Puelles JP, Favero-Ramirez L, Zurita-Corvalan N, Cañete IC, Leppe J, Ferrari G, Sadarangani KP, Cancino-López J, Hernandez-Jaña S, Farias TY, Lemes VB, Rodríguez-Rodríguez F, Brand C. Study protocol and rationale of "the UP project": evaluating the effectiveness of active breaks on health indicators in desk-based workers. Front Public Health 2024; 12:1363015. [PMID: 38566792 PMCID: PMC10985339 DOI: 10.3389/fpubh.2024.1363015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Background Excessive sedentary time has been negatively associated with several health outcomes, and physical activity alone does not seem to fully counteract these consequences. This panorama emphasizes the essential of sedentary time interruption programs. "The Up Project" seeks to assess the effectiveness of two interventions, one incorporating active breaks led by a professional and the other utilizing a computer application (self-led), of both equivalent duration and intensity. These interventions will be compared with a control group to evaluate their impact on physical activity levels, sedentary time, stress perception, occupational pain, and cardiometabolic risk factors among office workers. Methods This quasi-experimental study includes 60 desk-based workers from universities and educational institutes in Valparaiso, Chile, assigned to three groups: (a) booster breaks led by professionals, (b) computer prompts that are unled, and (c) a control group. The intervention protocol for both experimental groups will last 12 weeks (only weekdays). The following measurements will be performed at baseline and post-intervention: cardiometabolic risk based on body composition (fat mass, fat-free mass, and bone mass evaluated by DXA), waist circumference, blood pressure, resting heart rate, and handgrip strength. Physical activity and sedentary time will be self-reported and device-based assessed using accelerometry. Questionnaires will be used to determine the perception of stress and occupational pain. Discussion Governments worldwide are addressing health issues associated with sedentary behavior, particularly concerning individuals highly exposed to it, such as desk-based workers. Despite implementing certain strategies, there remains a noticeable gap in comprehensive research comparing diverse protocols. For instance, studies that contrast the outcomes of interventions led by professionals with those prompted by computers are scarce. This ongoing project is expected to contribute to evidence-based interventions targeting reduced perceived stress levels and enhancing desk-based employees' mental and physical well-being. The implications of these findings could have the capacity to lay the groundwork for future public health initiatives and government-funded programs.
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Affiliation(s)
- Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Ricardo Martínez-Flores
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | | | - Laura Favero-Ramirez
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Natalia Zurita-Corvalan
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Ignacio Castillo Cañete
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Jaime Leppe
- School of Physical Therapy Faculty of Medicine, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia, Santiago, Chile
| | - Kabir P. Sadarangani
- Universidad Autónoma de Chile, Santiago, Chile
- Escuela de Kinesiología, Facultad de Salud Y Odontología, Universidad Diego Portales, Santiago, Chile
| | - Jorge Cancino-López
- Laboratorio de Fisiología del Ejercicio y Metabolismo, Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae. Santiago, Santiago, Chile
| | - Sam Hernandez-Jaña
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | | | - Vanilson Batista Lemes
- Universidade Federal do Rio Grande do Sul, Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil
| | | | - Caroline Brand
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 182] [Impact Index Per Article: 182.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Kongsvold A, Flaaten M, Logacjov A, Skarpsno ES, Bach K, Nilsen TIL, Mork PJ. Can the bias of self-reported sitting time be corrected? A statistical model validation study based on data from 23 993 adults in the Norwegian HUNT study. Int J Behav Nutr Phys Act 2023; 20:139. [PMID: 38012746 PMCID: PMC10680356 DOI: 10.1186/s12966-023-01541-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/18/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Despite apparent shortcomings such as measurement error and low precision, self-reported sedentary time is still widely used in surveillance and research. The aim of this study was threefold; (i) to examine the agreement between self-reported and device-measured sitting time in a general adult population; (ii), to examine to what extent demographics, lifestyle factors, long-term health conditions, physical work demands, and educational level is associated with measurement bias; and (iii), to explore whether correcting for factors associated with bias improves the prediction of device-measured sitting time based on self-reported sitting time. METHODS A statistical validation model study based on data from 23 993 adults in the Trøndelag Health Study (HUNT4), Norway. Participants reported usual sitting time on weekdays using a single-item questionnaire and wore two AX3 tri-axial accelerometers on the thigh and low back for an average of 3.8 (standard deviation [SD] 0.7, range 1-5) weekdays to determine their sitting time. Statistical validation was performed by iteratively adding all possible combinations of factors associated with bias between self-reported and device-measured sitting time in a multivariate linear regression. We randomly selected 2/3 of the data (n = 15 995) for model development and used the remaining 1/3 (n = 7 998) to evaluate the model. RESULTS Mean (SD) self-reported and device-measured sitting time were 6.8 (2.9) h/day and 8.6 (2.2) h/day, respectively, corresponding to a mean difference of 1.8 (3.1) h/day. Limits of agreement ranged from - 8.0 h/day to 4.4 h/day. The discrepancy between the measurements was characterized by a proportional bias with participants device-measured to sit less overestimating their sitting time and participants device-measured to sit more underestimating their sitting time. The crude explained variance of device-measured sitting time based on self-reported sitting time was 10%. This improved to 24% when adding age, body mass index and physical work demands to the model. Adding sex, lifestyle factors, educational level, and long-term health conditions to the model did not improve the explained variance. CONCLUSIONS Self-reported sitting time had low validity and including a range of factors associated with bias in self-reported sitting time only marginally improved the prediction of device-measured sitting time.
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Affiliation(s)
- Atle Kongsvold
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Mats Flaaten
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Aleksej Logacjov
- Department of Computer Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Eivind Schjelderup Skarpsno
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Kerstin Bach
- Department of Computer Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinic of Anesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Nazaret A, Sapiro G. A large-scale observational study of the causal effects of a behavioral health nudge. SCIENCE ADVANCES 2023; 9:eadi1752. [PMID: 37738345 PMCID: PMC10516489 DOI: 10.1126/sciadv.adi1752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/18/2023] [Indexed: 09/24/2023]
Abstract
Nudges are interventions promoting healthy behavior without forbidding options or substantial incentives; the Apple Watch, for example, encourages users to stand by delivering a notification if they have been sitting for the first 50 minutes of an hour. On the basis of 76 billion minutes of observational standing data from 160,000 subjects in the public Apple Heart and Movement Study, we estimate the causal effect of this notification using a regression discontinuity design for time series data with time-varying treatment. We show that the nudge increases the probability of standing by up to 43.9% and remains effective with time. The nudge's effectiveness increases with age and is independent of gender. Closing Apple Watch Activity Rings, a visualization of participants' daily progress in Move, Exercise, and Stand, further increases the nudge's impact. This work demonstrates the effectiveness of behavioral health interventions and introduces tools for investigating their causal effect from large-scale observations.
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Affiliation(s)
- Achille Nazaret
- Department of Computer Science, Columbia University, New York, NY, USA
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Kochman M, Brzuszek M, Jabłoński M. Changes in Metabolic Health and Sedentary Behavior in Obese Children and Adolescents. J Clin Med 2023; 12:5456. [PMID: 37685523 PMCID: PMC10487512 DOI: 10.3390/jcm12175456] [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: 07/17/2023] [Revised: 08/08/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Obesity is becoming more common among children and adolescents. As in adults, obesity in the pediatric population is associated with an increased risk of metabolic disorders and diseases. In the related literature, little attention has been devoted to evaluating how metabolic health and sedentary behavior change in the obese pediatric population. Therefore, this study aimed to assess changes in metabolic health and sedentary behavior in obese children aged 7-12 and adolescents aged 13-17. For this single-center hospital-based prospective observational study, we included 202 Polish children and adolescents aged 7-17 years. We performed blood pressure measurements and collected blood samples to assess metabolic health markers. Based on the performed measurements, we also calculated additional indexes and ratios: BMI, WHtR, ABSI, VAI, and HOMA-IR. The analysis of the results showed clear and significant differences between the study groups. The older boys and girls were identified with higher values of anthropometric ratios, blood pressure, time spent sitting, and lower HDL cholesterol values (p < 0.05). The analysis also revealed a strong-to-moderate correlation between age and anthropometric ratios, blood pressure, HDL cholesterol, and sitting time (p < 0.05). Obese children and adolescents included in this study represent poor metabolic health and are at great risk of developing other metabolic diseases such as type 2 diabetes, hypertension, or metabolic syndrome. This risk increases with age; therefore, a number of preventive and therapeutic actions should be taken in overweight and obese children and adolescents to avoid further metabolic complications.
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Affiliation(s)
- Maciej Kochman
- Physiotherapy Department, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Marszałkowska 24, 35-215 Rzeszów, Poland
| | - Marta Brzuszek
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Kopisto 2a, 35-959 Rzeszów, Poland
| | - Mirosław Jabłoński
- Chair of Rehabilitation and Physiotherapy, Faculty of Health Sciences, Medical University of Lublin, Jaczewskiego 8 Street, 20-090 Lublin, Poland
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