Physical activity decreases in patients on the liver transplant waiting list and influences postoperative outcome-a prospective cohort study

Background

Physical deconditioning affects patients suffering from end-stage liver disease (ESLD). Liver transplantation (LT) is the only curative option for ESLD. Growing evidence suggests that pre-habilitation is beneficial in reducing post-surgical morbidity and mortality. We investigated physical activity (PA) in patients awaiting LT in a country with long waiting times.

Methods

Prospective, single center, longitudinal study in Bern, Switzerland between June 2019 and February 2020 (halted due to SARS-CoV-2 pandemic), with follow-up data up to six months post-transplant. Patients were instructed to use a wrist tracker (FitBit) to monitor PA, which was assessed using mixed-effects generalized linear models. The study was approved by the local ethics committee (BASEC ID 2019-00606).

Results

Thirty-five patients were included [71% male, median 59 years, body mass index (BMI) 28 kg/m2, lab Model End-Stage Liver Disease (MELD) 11], 17 (49%) pre-frail and 5 (14%) frail according to the Liver Frailty Index (LFI). Twenty-eight patients underwent transplantation with 0 ninety-day mortality and 15 (53.6%) composite adverse clinical outcome. Median daily steps were 4,661 [interquartile range (IQR), 1,685-8,609] and weekly moderate PA (MPA) was 41 min (IQR, 0-127 min). Longitudinal analysis showed that female patients and patients on nutritional support had an increase in MPA between weeks 20 and 40. A significant decrease was seen in MPA after week 40, whilst no significant association was seen with age, Child-Pugh Score, LFI or quality of life at time of inclusion. MPA was significantly associated with the occurrence of the composite clinical endpoint after week 30 of waiting time (odds ratio 0.882, P=0.026). World Health Organization (WHO)-recommended MPA was significantly associated with less adverse composite clinical outcomes (P<0.001).

Conclusions

In patients listed for LT, MPA decreased over time, showing a significant association with adverse outcome, specifically after week 30 on the waiting list. Our data support the implementation of routine pre-habilitation in patients awaiting LT.

A focus group study among insufficiently physically active African American adults regarding technology-delivered team-based gamification for physical activity promotion

Background

Gamification represents a promising approach for facilitating positive social interactions among groups of individuals and is increasingly being leveraged in physical activity (PA) interventions to promote enhanced intervention engagement and PA outcomes. Although African American (AA) adults experience disparities associated with health conditions that can be ameliorated with increased PA, little is known about how best to culturally target PA gamification strategies for this population. The purpose of this study was to gather perspectives from AA adults residing in the Southeast United States and subsequently identify themes to help inform the cultural adaptation of an existing electronic and mobile health (e/mHealth) gamification- and theory-based PA intervention for teams of insufficiently active AA adults.

Methods

An AA moderator facilitated six online focus groups among AA adults (n=42; 93% female; 45.09±9.77 years; 34.40±57.38 minutes/week of reported moderate-intensity equivalent PA), using a semi-structured focus group guide. Drawing from a content analysis approach, transcripts were coded and salient themes were identified.

Results

The focus groups revealed the following seven themes: (I) motivation (team-based gamification motivating); (II) accountability (team-based gamification promotes accountability); (III) competition (competitive elements attractive); (IV) weekly challenges (prefer to choose weekly PA challenges); (V) leaderboard feedback (preference for viewing steps and active minutes via a leaderboard); (VI) cultural relevancy (prefer elements reflective of their race and culture that promote team unity); (VII) teammate characteristics (mixed preferences regarding ideal sociodemographic characteristics and starting PA level of teammates).

Conclusions

Integrating team-based gamification in an e/mHealth-based PA intervention may be acceptable among AA adults. The identification of specific design preferences and perceptions of the value of the social environment points to the need to consider surface-level and deep structure cultural targeting when developing and further exploring best practices regarding gamified PA interventions for insufficiently active AAs.

Time to embed physical activity within usual care in cancer services: A qualitative study of cancer healthcare professionals' views at a single centre in England

PURPOSE

An increasing number of people affected by cancer (PABC) are living longer lives as treatment continues to advance. There is growing evidence for physical activity (PA) supporting health in this population before, during and after cancer treatment, but PA advice is not part of usual care. This study investigates views of frontline oncology healthcare professionals (HCPs) in one NHS teaching hospital in England to understand the role of PA advice across cancer services.

MATERIALS AND METHODS

This was a qualitative study interviewing HCPs and using thematic analysis.

RESULTS

Four main themes were identified: 1. Awareness of the roles of PA in cancer; 2. Patient-specific factors in rehabilitation; 3. Cancer-specific factors in rehabilitation; 4. Barriers and opportunities to integrating PA within usual care. HCPs' awareness of the role of PA in cancer rehabilitation was low overall and PA was found not to be embedded within rehabilitation. Contrastingly, there was awareness of PA's potential to impact disease and treatment-related outcomes positively. Ideas for PA integration included training for staff and giving PA advice within consultations.

CONCLUSIONS

Low awareness of benefits of PA-based rehabilitation and lack of integration in usual care contrasted with HCPs' interest in this area's potential. Training HCPs to begin the conversation with patients affected by cancer in teachable moments may increase patient access.Implications for rehabilitationIntegrating physical activity education and training for trainees and existing healthcare professionals workforce would help embed physical activity into routine clinical practice.Brief advice intervention training during every consultation, such as providing relevant individualised information and signposting, can be impactful.Physical activity within a broader cancer rehabilitation programme should be integrated as standard for every cancer patient.Individualised plans may include prehabilitation, restorative rehabilitation and palliative rehabilitation.Patient preferences and the patient experience should continue to shape service design.There is a need to ensure physical activity advice is consistent throughout healthcare settings and not fragmented between primary, secondary and tertiary care.

Can Exercise Enhance the Efficacy of Checkpoint Inhibition by Modulating Anti-Tumor Immunity?

Immune checkpoint inhibition (ICI) has revolutionized cancer therapy. However, response to ICI is often limited to selected subsets of patients or not durable. Tumors that are non-responsive to checkpoint inhibition are characterized by low anti-tumoral immune cell infiltration and a highly immunosuppressive tumor microenvironment. Exercise is known to promote immune cell circulation and improve immunosurveillance. Results of recent studies indicate that physical activity can induce mobilization and redistribution of immune cells towards the tumor microenvironment (TME) and therefore enhance anti-tumor immunity. This suggests a favorable impact of exercise on the efficacy of ICI. Our review delivers insight into possible molecular mechanisms of the crosstalk between muscle, tumor, and immune cells. It summarizes current data on exercise-induced effects on anti-tumor immunity and ICI in mice and men. We consider preclinical and clinical study design challenges and discuss the role of cancer type, exercise frequency, intensity, time, and type (FITT) and immune sensitivity as critical factors for exercise-induced impact on cancer immunosurveillance.

UAE Women's Knowledge and Attitudes towards Physical Activity during Pregnancy

The benefits of being physically active during pregnancy are widely acknowledged. It is important for the prevention of chronic diseases and the promotion of good health for mothers and children. However, physical activity by women in the UAE is notoriously low and reduced further during pregnancy. The same can be said regarding research about the knowledge and understanding of the benefits and risks associated with exercise as a predictor of behavior. We aimed to assess knowledge and attitudes towards physical activity during pregnancy amongst Emirati women. A cross-sectional digital survey was designed to assess knowledge and attitudes and distributed to women, aged 18-40 years, using non-randomized, purposeful snowball sampling. A total of 1538 women were recruited. Most participants were aged 20-29 years (53.5%), were Emiratis (88.9%), and had no history of chronic disease (68.6%). The participants self-reported very low levels of PA (75.5%) and had a below-average level of knowledge overall (40.6 ± 20). Younger ages (p < 0.001), lower educational levels (p = 0.004), being employed (p = 0.014), and having a history of chronic disease (p = 0.016) were significantly associated with lower mean knowledge scores, while being married (p = 0.003) was significantly associated with higher scores. The participants also exhibited a positive attitude towards physical activity during pregnancy by selecting answers that they supported it. To encourage physical activity, women living in the UAE could benefit from clear advice about safe physical activity during pregnancy.

Health-Related Quality of Life and Adherence to Physical Activity and Screen Time Recommendations in Schoolchildren: Longitudinal Cohort Ciao Corona

Objectives: We investigated changes in adherence to physical activity (PA) and screen time (ST) recommendations of children and adolescents throughout the pandemic, and their association with health-related quality of life (HRQOL). Methods: 1,769 primary (PS, grades 1-6) and secondary (SS, 7-9) school children from Ciao Corona, a school-based cohort study in Zurich, Switzerland, with five questionnaires 2020-2022. HRQOL was assessed using the KINDL questionnaire. PA (≥60 min/day moderate-to-vigorous PA) and ST (≤2 h/day ST) recommendations followed WHO guidelines. Results: Adherence to PA recommendations dropped in 2020 (83%-59% PS, 77%-52% SS), but returned to pre-pandemic levels by 2022 (79%, 66%). Fewer children met ST recommendations in 2020 (74% PS, 29% SS) and 2021 (82%, 37%) than pre-pandemic (95%, 68%). HRQOL decreased 3 points between 2020 and 2022, and was 9.7 points higher (95% CI 3.0-16.3) in March 2021 in children who met both versus no recommendations. Conclusion: Adherence to WHO guidelines on PA and ST during the pandemic had a consistent association with HRQOL despite longitudinal changes in behavior.

Relationships between the Physical Activity Intensity and the Medical Expenditure of Middle-Aged and Elderly People: Parsing from the CHARLS Database

There are many studies on the impact of physical activity on health but few studies on the relationship between physical activity and medical expenditure among the elderly. Based on the China Health and Retirement Longitudinal Survey (CHARLS) database and selected 4456 valid samples, this paper used a two-part model to analyze the effects of high, moderate, and low physical activity intensity on medical expenditure. It is found that the intensity of physical activity was negatively correlated with medical expenditure, and the medical expenditure of the high physical activity intensity group was significantly lower than that of the low physical activity intensity group. For example, compared to people with no physical activity, the total medical expenditure decreased by 22.4%, 40.4%, and 62.5% per week in those with low, moderate, and high physical activity intensity. Thus, the government should provide more places for the elderly to exercise, planning special exercise areas for the elderly in community playgrounds, such as a dancing square, which will also help the elderly to increase their amount of exercise per week and develop a daily exercise habit.

Social Return on Investment of Social Prescribing via a Diabetes Technician for Preventing Type 2 Diabetes Progression

In Wales, the prevalence of Type 2 Diabetes Mellitus (T2DM) has increased from 7.3% in 2016 to 8% in 2020, creating a major concern for the National Health Service (NHS). Social prescribing (SP) has been found to decrease T2DM prevalence and improve wellbeing. The MY LIFE programme, a scheme evaluated between June 2021 and February 2022 in the Conwy West Primary Care Cluster, aimed to prevent T2DM by referring prediabetic patients with a BMI of ≥30 to a diabetes technician (DT), who then signposted patients to community-based SP programmes, such as the National Exercise Referral Scheme (NERS), KindEating, and Slimming World. Although some patients engaged with SP, others chose to connect only with the DT. A Social Return on Investment (SROI) analysis was conducted to evaluate those patients who engaged with the DT plus SP, and those who connected solely with the DT. Relevant participant outcomes included 'mental wellbeing' and 'good overall health', which were measured at baseline (n = 54) and at the eight-week follow-up (n = 24). The estimated social value for every GBP 1 invested for participants who engaged with the 'DT only' ranged from GBP 4.67 to 4.70. The social value for participants who engaged with the 'DT plus SP programme' ranged from GBP 4.23 to 5.07. The results indicated that most of the social value generated was associated with connecting with the DT.

Associations of physical activity with cognitive function and daily physical function among Chinese individuals with heart disease: A cross-sectional study

Background

To investigate the associations between different dimensions of physical activity (PA), cognitive function, and daily physical function in Chinese individuals with heart disease.

Materials and methods

This study included 2,792 individuals from the China Health and Retirement Longitudinal Study conducted in 2015. Physical activity (PA) was divided into vigorous PA (VPA), moderate PA (MPA), and light PA (LPA). Linear and logistic regression models were established to assess the associations among the indicators.

Results

Compared with taking no PA, MPA, and VPA at a frequency of 6-7 d/w had lower risks of impaired daily physical function (OR = 0.47, 95% CI: 0.25, 0.91; OR = 0.57, 95% CI: 0.37, 0.88) and higher cognitive function scores (β = 1.22, 95% CI: 0.42, 2.03; β = 1.08, 95% CI: 0.43, 1.73), while VPA at 3-5 d/w had lower cognitive function scores (β = -1.96, 95% CI: -3.51, -0.40). Light PA (LPA) with a duration of 30-119 min/d had a lower risk of impaired daily physical function (OR = 0.59, 95% CI: 0.36, 0.97). Moderate PA (MPA) and VPA of 30-119 min/d had higher cognitive function scores (β = 1.43, 95% CI: 0.49, 2.37; β = 1.30, 95% CI: -0.56, 2.06). The 1,800-2,999 METs had the lowest risks of impaired daily physical function and the highest cognitive function scores (OR = 0.18, 95% CI: 0.04, 0.75; β = 2.94, 95% CI: 1.67, 4.21).

Conclusion

Moderate PA (MPA) and LPA with a frequency of 6-7 d/w and a duration of 30-119 min/d, and PA in 1,800-2,999 MET min/week were most closely related to better cognitive and daily physical function, while VPA (3-5 d/w; ≥300 min/w) may be related to low cognition, but high-quality research is necessary to prove causality.

Trial registration

IRB00001052-11015.

Recreational physical activity before and during pregnancy and placental DNA methylation-an epigenome-wide association study

BACKGROUND

Physical activity (PA) prior to and during pregnancy may have intergenerational effects on offspring health through placental epigenetic modifications. We are unaware of epidemiologic studies on longitudinal PA and placental DNA methylation.

OBJECTIVES

We evaluated the association between PA before and during pregnancy and placental DNA methylation.

METHODS

Placental tissues were obtained at delivery and methylation was measured using HumanMethylation450 Beadchips for participants in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singletons among 298 participants. Using the Pregnancy Physical Activity Questionnaire, women recalled periconception PA (past 12 mo) at 8-13 wk of gestation and PA since last visit at 4 follow-up visits at 16-22, 24-29, 30-33, and 34-37 wk. We conducted linear regression for associations of PA at each visit with methylation controlling for false discovery rate (FDR). Top 100 CpGs were queried for enrichment of functional pathways using Ingenuity Pathway Analysis.

RESULTS

Periconception PA was significantly associated with 1 CpG site. PA since last visit for visits 1-4 was associated with 2, 2, 8, and 0 CpGs (log fold changes ranging from -0.0319 to 0.0080, after controlling for FDR). The largest change in methylation occurred at a site in TIMP2 , which is known to encode a protein critical for vasodilation, placentation, and uterine expansion during pregnancy (log fold change: -0.05; 95% CI: -0.06, -0.03 per metabolic equivalent of task-h/wk at 30-33 wk). Most significantly enriched pathways include cardiac hypertrophy signaling, B-cell receptor signaling, and netrin signaling. Significant CpGs and enriched pathways varied by visit.

CONCLUSIONS

Recreational PA in the year prior and during pregnancy was associated with placental DNA methylation. The associated CpG sites varied based on timing of PA. If replicated, the findings may inform the mechanisms underlying the impacts of PA on placenta health. This study was registered at clinicaltrials.gov as NCT00912132.

Women's Lives Matter-The Critical Need for Women to Prioritize Optimal Physical Activity to Reduce COVID-19 Illness Risk and Severity

Physical activity (PA) is beneficial for the health and wellness of individuals and societies. During an infectious disease pandemic, such as the one caused by COVID-19, social distancing, quarantines, and lockdowns are used to reduce community spread of the disease. Unfortunately, such nonpharmacological interventions or physical risk mitigation measures also make it challenging to engage in PA. Reduced PA could then trigger physiological changes that affect both mental and physical health. In this regard, women are more likely to experience physical and psychological distress. PA is a safe and effective nonpharmacological modality that can help prevent and manage several mental and physical health problems when performed correctly. PA might even confer benefits that are directly related to decreasing COVID-19 morbidity and mortality in women. In this review, we summarize why optimal PA must be a priority for women during the COVID-19 pandemic. We then discuss chronic COVID-19 illness and its impact on women, which further underscores the need for worldwide preventive health strategies that include PA. Finally, we discuss the importance of vaccination against COVID-19 for women, as part of prioritizing preventive healthcare and an active lifestyle.

Using an activity tracker to increase motivation for physical activity in patients with type 2 diabetes in primary care: a randomized pilot trial

BACKGROUND

Adopting healthy lifestyle habits reduces the risk of type 2 diabetes (T2D) and its complications. The use of an activity tracker to monitor physical activity (PA) could favor behavior changes in patients with chronic diseases such as diabetes. The aims of this study were: (I) to evaluate the impact of an activity tracker on PA and cardiometabolic risk variables in patients with T2D; (II) to assess the feasibility of its implantation in a primary care setting.

METHODS

This 3-month study was a pilot randomized controlled trial of 30 patients with T2D followed at a university-affiliated Family Medicine Group. Patients were randomly assigned to either: (I) control group, including a PA promotion intervention supported by a kinesiologist or (II) intervention group, including a PA promotion intervention supported by a kinesiologist with the addition of an activity tracker (Fitbit). Cardiometabolic risk variables, PA and motivation were assessed at baseline and after three months. Satisfaction and acceptability of wearing the activity tracker were measured in the intervention group.

RESULTS

PA assessed by questionnaires increased in both groups, change being greater in the intervention group (P<0.05). Autonomous motivation in both groups was higher than controlled motivation (P<0.001). Eighty-six percent of the participants in the intervention group were satisfied with their activity tracker use and the compliance remained high. High-density lipoprotein cholesterol increased in the intervention group and decreased in the control group (P=0.014). Resting systolic and diastolic blood pressure decreased over time in both groups (P<0.05) whereas glycated hemoglobin tended to decrease in both groups (P=0.080). Significant correlations were observed between average steps per day and changes in waist circumference (pre: -0.721, P=0.044; post: -0.736, P=0.038), body mass index (pre: -0.764, P=0.010; post: -0.771, P=0.009) and fat percentage (pre: -0.654, P=0.040; post: -0.686, P=0.028) in the intervention group.

CONCLUSIONS

Our pilot study shows that the use of an activity tracker improves cardiometabolic risk variables in patients with T2D and could potentially be a motivation tool to increase PA in primary care setting.

Moderate-to-vigorous physical activity and processing speed: predicting adaptive change in ADHD levels and related impairments in preschoolers

BACKGROUND

Preschool ADHD symptoms have predictive utility for later presence of ADHD diagnoses (Harvey, Youngwirth, Thakar, & Errazuriz, 2009, Journal of Consulting and Clinical Psychology, 77, 349; Lahey et al., 2004, American Journal of Psychiatry, 161(11), 2014), yet some level of inattention, hyperactivity, and impulsivity are present even in typically developing preschoolers. Physical activity (PA) is known to have a broad spectrum of positive effects on the brain in school-age typically developing children (Centers for Disease Control and Prevention, 2010, The association between school based physical activity, including physical education, and academic performance. Atlanta, GA: U.S. Department of Health and Human Services), including functions impaired by ADHD (Halperin, Berwid, & O'Neill, 2014, Child and Adolescent Psychiatric Clinics of North America, 23, 899), yet links between PA and ADHD levels and impairments have rarely been studied in either typically developing or at-risk preschool children. Importantly, impaired processing speed (PS), though not a symptom of ADHD, is a robust neuropsychological correlate (Willcutt & Bidwell, 2011, Treating attention deficit hyperactivity disorder: Assessment and intervention in developmental context. Kingston, NJ: Civic Research Institute) that may indicate additional risk for ADHD. Hence, we examined whether baseline PS moderates the association between preschoolers' PA, specifically moderate-to-vigorous PA (MVPA), and changes in ADHD levels and related behaviors.

METHOD

Eighty-five preschoolers (49.4% female; M_age  = 4.14, SD_age  = .64) were drawn from a larger study of the effects of the Kiddie Children and Teachers (CATs) on the Move PA program on school readiness. The sample was largely Head Start eligible (68.2%) and ethnically diverse. Hierarchical regressions were utilized to examine links between MVPA, averaged over a school year, and changes in inattention (IA), hyperactivity/impulsivity (HI), oppositional behaviors, moodiness, and peer functioning, and whether these associations varied based on baseline PS.

RESULTS

Results indicated that for IA, HI, and peer functioning, higher amounts of MVPA were associated with greater adaptive change for those with lower (but not higher) levels of PS.

CONCLUSIONS

Preschool MVPA may be a viable method of reducing ADHD levels and impairments for those with lower PS.

Associations between Intensity, Frequency, Duration, and Volume of Physical Activity and the Risk of Stroke in Middle- and Older-Aged Chinese People: A Cross-Sectional Study

Context: Persuasive evidence has shown the inverse associations between physical activity (PA) and the risk of stroke. However, few studies have investigated the associations between different dimensions (intensity, frequency, duration, volume) of PA and the risk of stroke. Objective: To investigate the associations between different dimensions of PA and the risk of stroke in total participants and subgroups. Method: This study included 6250 individuals aged 45 years old and above from the China Health and Retirement Longitudinal Study (CHARLS). PA was divided into vigorous PA (VPA), moderate PA (MPA), and light PA (LPA), and described in different dimensions (intensity, frequency, duration, volume). Stroke was defined on the basis of self-reported diagnosis and related treatments. Binary logistic regression models were established to assess the associations between different dimensions of PA and the risk of stroke in total participants and subgroups stratified by sex. Results: Individuals taking VPA with a frequency of 3–5 d/w, duration of ≥240 min/d, volume of ≥300 min/w had lower risks of strokes in total participants (Odds ratio (OR) = 0.32, 95% confidence interval (CI): 0.13, 0.75; OR = 0.60, 95% CI: 0.38, 0.94; OR = 0.68, 95% CI: 0.46, 0.99, respectively). However, significant associations of VPA with the risk of stroke in men were only observed in the duration of ≥240 min/d and volume of ≥300 min/w (OR = 0.53, 95% CI: 0.30, 0.93; OR = 0.61, 95% CI: 0.38, 0.99, respectively) whereas no significance in women. Compared with individuals taking no MPA, inverse significant associations between the risk of stroke and any level of frequency, duration and volume in MPA were observed in total sample (OR ranging from 0.16–0.40, all p < 0.05), whereas significant associations between the risk of stroke and MPA were found in men except the duration of 10–29 min/d and volume of 150–299 min/w (OR ranging from 0.26–0.35, all p < 0.05), and in women except the frequency of 1–2 d/w and duration of ≥240 min/d (OR ranging from 0.14–0.49, all p < 0.05). No significant associations could be observed in total participants and subgroups between LPA and the risk of stroke. Conclusion: This study revealed some significant associations between different dimensions of PA, especially MPA, and the risk of stroke. Furthermore, the difference of association was observed in the groups with different sex. Further prospective study is needed to determine deeper associations between PA and the risk of stroke.

Does Physical Activity Matter for the Mental Health of University Students during the COVID-19 Pandemic?

Research indicates that university and college students are at higher risk of experiencing mental health problems than other populations. This study aims to examine the relationship between Physical Activity (PA) and the mental health of Ukrainian university students during the Corona Virus Disease 2019 (COVID-19) pandemic lockdown. The conventional sample consisted of 1512 students from 11 Ukrainian universities, with a mean age of 20 years (M = 20.06, SD = 3.05) and 69% of whom were female. The cross-sectional online survey was disseminated through the most popular social media channels in Ukraine (i.e., Facebook, Viber, Telegram) and included the Generalized Anxiety Disorder (GAD-7) scale to measure anxiety and the Patient Health Questionnaire (PHQ-9) to assess depression. Data were collected from 14 May to 4 June 2020 during the COVID-19 pandemic outbreak in Ukraine. Among university students, 43% were engaged in PA ≥ 150 min weekly, 24% met the criteria of GAD, and 32% met the criteria of depression. More students were involved in PA before the COVID-19 outbreak than during the national lockdown. Students with anxiety and depression were almost two times less likely to engage in PA than their counterparts without mental health disorders. The inactive group had higher scores of anxiety and depression than the physically active group. The relationship of PA with anxiety and depression was statistically significant but weak during the COVID-19 pandemic.

Physical activity and laryngeal cancer

Although an active lifestyle physical has been convincingly associated with a decreased risk of developing many forms of cancers, including neck and head malignancies, uncertainty surrounds the relationship between physical activity (PA) and laryngeal carcinogenesis. Epidemiologic evidence, garnered from some well-conducted cross-sectional, prospective and retrospective studies, seemingly attests that the impact of PA may be not so straightforward in lowering laryngeal cancer risk as for other malignancies. Reasonable consensus has been reached that moderate-intensity PA may generate the larger potential benefits, whilst the effect of high-intensity PA appears more controversial and even contradictory. This is mainly attributable to the fact that moderate PA may have more favorable effects than high-intensity exercise in decreasing the impact of some risk factors of laryngeal cancer such as metabolic syndrome, cigarette smoking, inflammation, and gastroesophageal reflux disease. Significant biological and psychological benefits from moderate-intensity exercise have also been described in patients surviving from primary laryngeal cancers. This would hence lead us to conclude that promotion of an active lifestyle, characterized by performance of moderate-intensity PA (e.g., between 3 and 6 metabolic equivalents, equaling short distance running), may be beneficial for lowering the risk of developing laryngeal cancer and for improving the quality of life of larynx cancer survivors.

African American women's relationship with their mobile phone, and what they want in a mobile delivered physical activity intervention: guidance for intervention development

BACKGROUND

Mobile phone text messaging is an emerging platform in physical activity (PA) interventions with African American (AA) women. Research on the relationship that AA women have with their mobile phone as well as their views about text messaging as a potentially viable platform to help them acquire and maintain regular PA is central in advancing this field of research. Both self-report measures and qualitative interviews may be helpful in this endeavor.

METHODS

In the current study, a sample of 42 generally physically inactive AA women (mean age =35, SD =10.25) completed the Mobile Phone Affinity Scale (MPAS), which consists of six subscales that represent both positive (Connectedness, Productivity, Empowerment) and negative (Continuous Use, Anxious Attachment, Addiction) cognitions and behaviors that are associated with mobile phone use patterns. A subgroup of twenty participants completed a semi-structured qualitative interview that explored their views of text messaging technology as a potential platform to help become and remain physically active. Quantitative analyses included frequency and analyses of variance (ANOVAs) and assessed mobile phone use patterns and demographic differences based on age, marital status and education on the MPAS. Qualitative content analysis was conducted on participants' verbatim responses.

RESULTS

Results indicated that participants overall endorsed the positive MPAS subscales at a higher frequency compared to the negative subscales. Demographic differences were noted only for age and marital status for some of the MPAS subscales. Younger participants reported higher mean scores for the MPAS subscales Connectedness (P=0.005), Empowerment/Safety (P=0.04), Continuous Use (P=0.04), and Addiction (P=0.004) in comparison to older participants. Significant results for marital status showed single participants were higher on the Connectedness (P=0.02) and Productivity (P=0.01) subscales compared to married participants. Qualitative data showed that 19 of the 20 participants (95%) viewed text messaging as an appealing platform to deliver daily motivational messages to increase PA engagement. Participants stated a text messaging PA intervention would be "convenient" and "motivating". However, most participants suggested that other mobile phone technology applications in addition to text messaging would facilitate self-monitoring PA behaviors (e.g., goal setting, activity tracking) in mobile phone delivered (mHealth) PA interventions targeting AA women.

CONCLUSIONS

The study findings provide guidance in the development of mHealth intervention approaches for PA promotion that are likely to appeal to AA women, increase engagement, and behavior change among this group.

Validity of Research-Grade Actigraphy Unit for Measuring Exercise Intensity

This study was conducted in a free-living setting to investigate the measurement validity of a research-based actigraph for strolling and jogging, and to provide a reference for actual practice and research. Because inadequate physical activity (PA) or sedentary lifestyle has become the fourth leading risk factor for mortality worldwide, many countries have been vigorously promoting the concept of “active living”, and the public has been investing greater effort into intensifying their PA. Although research-grade actigraphs have been widely applied to evaluate PA in routine environments, the measurement results may not accurately reflect the wearers’ PA. Unlike most relevant research, which is conducted in well-controlled laboratory environments, the present study was implemented in the field to examine the sensitivity and convergent validity of the MicroMini Motionlogger^® Actigraph during strolling and jogging. The following results were revealed: (1) Although the exercise movement speed while jogging was significantly faster than that while strolling, the actigraph readings showed no significant difference between strolling and jogging; (2) The actigraph readings were (significantly or nonsignificantly) negatively correlated with metabolic heat and nonsignificantly correlated with movement speeds. Hence, the actigraph validity for measuring PA intensity while strolling and jogging remains debatable.

Validation study of Polar V800 accelerometer

BACKGROUND

The correct quantification of physical activity (PA) and energy expenditure (EE) in daily life is an important target for researchers and professionals. The objective of this paper is to study the validity of the Polar V800 for the quantification of PA and the estimation of EE against the ActiGraph (ActiTrainer) in healthy young adults.

METHODS

Eighteen Caucasian active people (50% women) aged between 19-23 years wore an ActiTrainer on the right hip and a Polar V800 on the preferred wrist during 7 days. Paired samples t-tests were used to analyze differences in outcomes between devices, and Pearson's correlation coefficients to examine the correlation between outcomes. The agreement was studied using the Bland-Altman method. Also, the association between the difference and the magnitude of the measurement (heteroscedasticity) was examined. Sensitivity, specificity and area under the receiver operating characteristic curve (ROC-AUC value) were calculated to evaluate the ability of the devices to accurately define a person who fulfills the recommendation of 10,000 daily steps.

RESULTS

The devices significantly differed from each other on all outcomes (P<0.05), except for Polar V800's alerts vs. ActiTrainer's 1 hour sedentary bouts (P=0.595) and Polar V800's walking time vs. ActiTrainer's lifestyle time (P=0.484). Heteroscedasticity analyses were significant for all outcomes, except for Kcal and sitting time. The ROC-AUC value was fair (0.781±0.048) and the sensitivity and specificity was 98% and 58%, respectively.

CONCLUSIONS

The Polar V800 accelerometer has a comparable validity to the accelerometer in free-living conditions, regarding "1 hour sedentary bouts" and "V800's walking time vs. ActiTrainer's lifestyle time" in young adults.

Correlates of objectively measured physical activity in cardiac patients

Cardiac patients would benefit from increasing their physical activity (PA) levels. Understanding of factors that influence cardiac patients' PA participation would benefit the development of effective interventions. Therefore, the purpose of this study was to determine correlates of objectively-measured PA in cardiac patients. Participants were 65 cardiac patients (74% male, 95% white), age 58.6±10.6 years. The amount of time spent in PA was measured by ActiGraph GT3X accelerometers for 7 days prior to joining cardiac rehabilitation programs (CRP). A total of 25 potential determinants of PA across multiple domains (demographic, clinical, psychosocial, and behavioral) were measured via self-reported questionnaire and clinical examinations. Backward elimination model selection procedures were performed to examine associations of potential determinants with total PA (min/day) and moderate-to-vigorous PA (MVPA) (min/day). Patients spent 153.8±62.8 and 8.4±8.1 min/day in total PA and MVPA, respectively. Across four domains, ten and five potential correlates were found to be significant in univariate analyses for MVPA and total PA, respectively. In the final model, functional capacity, PA readiness, and participation in regular exercise were positively associated with MVPA (R(2) =26.6%). Functional capacity and PA readiness were also positively associated with total PA (R(2) =15.9%). Future initiatives to increase PA levels in cardiac patients could be improved by considering patients' functional capacity, PA readiness, and exercise history in designing interventions.

What are older Latinos told about physical activity and cognition? A content analysis of a top-circulating magazine

OBJECTIVES

Physical activity (PA) may reduce risk of developing Alzheimer's disease (AD). The objectives of this study were to: (a) Compare the content of English and Spanish PA-focused articles in American Association of Retired Persons (AARP) magazines; and (b) Determine whether these articles discuss PA as a potential correlate of AD.

METHOD

AARP (English) and AARP Segunda Juventud (Spanish) magazines were assessed for PA coverage from 2009 to 2010. Articles were analyzed using nonparametric tests.

RESULTS

A total of 63 articles discussed PA (48 English; 15 Spanish). In AARP English, 70.8% of articles discussed formal exercise, while 53.3% of Spanish articles discussed formal exercise. Only three English articles mentioned that PA has the potential to reduce risk of AD. No Spanish articles mentioned this association.

DISCUSSION

Spanish content did not adequately present cognitive health information. Culturally appropriate media coverage is needed to inform diverse populations about cognitive health and risks of AD.