Interrelations between factors related to physical activity in inactive adults with knee pain

To describe leisure participation in adolescents with congenital heart defects (CHD) and identify factors associated with intensity of participation. Eighty adolescents with CHD were recruited (39 males, 41 females; mean age [SD] 15y 8mo [1y 8mo] range 11y 5mo-19y 11mo) of whom 78 completed the Children's Assessment of Participation and Enjoyment (CAPE) outcome measure of leisure participation. The measure has five subscales: recreational, active-physical, social, skill-based, and self-improvement. Associations between the CAPE and age, sex, and development were examined. Motor ability (Movement Assessment Battery for Children, Second Edition), cognition (Leiter International Performance Scale-Revised), behavior (Strengths and Difficulties Questionnaire), and motivation (Dimensions of Mastery Questionnaire) were assessed. Participants exhibited impaired motor (43.5%), behavioral (23.7%), and cognitive (29.9%) development. The most intense participation was in social (mean [SD] 3.3 [0.99]) and recreational (2.9 [0.80]) activity types on the CAPE. Male sex (p<0.05) and younger age were associated with greater physical activity (<15y: 1.87; ≥15y: 1.31, p<0.05). Greater engagement in social activities was related to better cognition (r=0.28, p<0.05), higher motor function (r=0.30-0.36, p<0.01), and fewer behavioral difficulties (r=-0.32 to -0.47, p<0.01). Cognitive ability (r=0.27, p<0.05), dexterity and aiming/catching (r=0.27-0.33, p<0.05), and behavior problems (r=0.38-0.49, p=0.001) were correlated with physical activity participation. Persistence in tasks, an aspect of motivation, correlated with physical (r=0.45, p<0.001) and social activity involvement (r=0.28, p<0.05). Ongoing developmental impairments in adolescents with CHD are associated with decreased active-physical and social engagement, putting them at risk of poor physical and mental health. Health promotion strategies should be considered. Adolescents with congenital heart defects (CHD) have limited engagement in active-physical leisure activities. Cognitive, motor, and behavioral impairments are associated with decreased participation in leisure in children with CHD. Female sex and older age are associated with less engagement in leisure. Mastery motivation correlates with participation, suggesting an avenue for intervention.

Regular physical activity (PA) plays an important role in improving and maintaining one's health, especially as one ages. Although many older Americans are aware of the benefits of regular PA, the majority do not participate in regular PA that meets recommended guidelines. The purpose of this study was to gain insight into the motivators, barriers, and beliefs regarding PA of independent-living older adults with easy access to fitness facilities. In this qualitative design, focus group interviews were used to explore the individual perceptions of physically active and inactive older adults regarding PA and exercise. Thirty-one older adults, over age 60 participated in focus group discussions regarding PA beliefs and behaviors. Groups were homogenous based on current PA behaviors. Demographic information was collected. Discussions were audiotaped and transcribed verbatim and deidentified. Two researchers independently coded for emergent themes. Interrater reliability was established (κ = 0.89). Peer review was used to further ensure trustworthiness and credibility. No significant differences were noted in age, body mass index, or educational levels between the physically active and inactive groups. Differences in perceptions were noted between the groups regarding the construct of PA, barriers to participation in regular PA, and the components of an ideal PA program. Physically inactive persons had much lower fitness expectations of a physically active older adult, more perceived barriers to regular PA, and required individual tailoring of a PA program if they were going to participate. In addition, inactive persons were intimidated by the fitness facilities and concerned about slowing others down in a group exercise setting. Both groups shared similar motivators to participate in PA, such as maintaining health and socialization; however, inactive persons also described PA as needing to be purposeful and fun. Physically inactive persons perceived themselves to be physically active, as their perception of PA was grounded in a social context. Although both groups shared some barriers to regular PA participation, physically active individuals developed strategies to overcome them. Issues relating to self-efficacy and stages of change need to be explored to address the individual perceptions and needs of inactive older adults if initiation or long-term adherence to a PA program is to be achieved.

Sex differences in barriers and facilitators related to physical activity in adults with knee pain

The role of physical activity in diabetes is critical, influencing this disease's development, man-agement, and overall outcomes. In China, 22.3% of adults do not meet the minimum level of physical activity recommended by the World Health Organization. Therefore, it is imperative to identify the factors that contributing to lack of physical activity must be identified. To investigate the relationship among delay discounting, delay aversion, glycated hemoglobin (HbA1c), and various levels of physical activity in Chinese adults diagnosed with type 2 diabetes mellitus (T2DM). In 2023, 400 adults with T2DM were recruited from the People's Hospital of Linxia Hui Autonomous Prefecture of Gansu Province. A face-to-face questionnaire was used to gather demographic data and details on physical activity, delay discounting, and delay aversion. In addition, HbA1c levels were measured in all 400 participants. The primary independent variables considered were delay discounting and delay aversion. The outcome variables included HbA1c levels and different intensity levels of physical activity, including walking, moderate physical activity, and vigorous physical activity. Multiple linear regression models were utilized to assess the relationship between delay discounting, delay aversion, and HbA1c levels, along with the intensity of different physical activity measured in met-hours per week. After controlling for the sample characteristics, delay discounting was negatively associated with moderate physical activity (β = -2.386, 95%CI: -4.370 to -0.401). Meanwhile, delay aversion was negatively associated with the level of moderate physical activity (β = -3.527, 95% CI: -5.578 to -1.476) in the multiple linear regression model, with statistically significant differences. Elevated delay discounting and increased delay aversion correlated with reduced levels of moderate physical activity. Result suggests that delay discounting and aversion may influence engagement in moderate physical activity. This study recommends that health administration and government consider delay discounting and delay aversion when formulating behavioral intervention strategies and treatment guidelines involving physical activity for patients with T2DM, which may increase participation in physical activity. This study contributes a novel perspective to the research on physical activity in adults with T2DM by examining the significance of future health considerations and the role of emotional responses to delays.

Walkability is positively associated with physical activity in adults. Walkability is more consistently associated with walking for transportation than recreational walking. The purpose of this study is to examine how the association between walkable neighbourhoods and physical activity varies by age and type of physical activity using a new Canadian walkability database. The 2016 Canadian Active Living Environments (Can-ALE) database was attached to two cross-sectional health surveys: the Canadian Health Measures Survey (CHMS; 2009 to 2015) and the Canadian Community Health Survey (CCHS; 2015 to 2016). Physical activity was measured in the CHMS using the Actical accelerometer (n = 10,987; ages 3 to 79). Unorganized physical activity outside of school among children aged 3 to 11 was reported by parents in the CHMS (n = 4,030), and physical activity data by type (recreational, transportation-based, school-based, and household and occupational) was self-reported by respondents in the CCHS (n = 105,876; ages 12 and older). Walkability was positively associated with accelerometer-measured moderate-to-vigorous physical activity in youth (p < 0.05), younger adults (p < 0.0001) and older adults (p < 0.05), while walkability was negatively associated with light physical activity in youth (ages 12 to 17) and older adults (ages 60 to 79) (p < 0.05). Walkability was positively associated with self-reported transportation-based physical activity in youth (p < 0.001) and adults of all ages (p < 0.0001). Walkability was negatively associated with parent-reported unorganized physical activity of children aged 5 to 11, and children living in the most walkable neighbourhoods accumulated 10 minutes of physical activity less-on average-than those living in the least walkable neighbourhoods. The results of this study are consistent with previous studies indicating that walkability is more strongly associated with physical activity in adults than in children and that walkability is associated with transportation-based physical activity. Walkability is one of many built environment factors that may influence physical activity. More research is needed to identify and understand the built environment factors associated with physical activity in children and with recreational or leisure-time physical activity.

Mindsets predict physical activity and management strategies in individuals with knee osteoarthritis

BackgroundChildren with cerebral palsy (CP) are less physically active and more sedentary than other children which implies risk factors for their physical and mental health. Physical activity on prescription (PAP) is an effective intervention to promote a lifestyle change towards increased physical activity in adults in general. Knowledge is lacking about the use of PAP in children with CP. Therefore, the aim of this study was to evaluate the feasibility of PAP for children with CP and its effectiveness on participation in physical activity and sedentary behaviour.MethodsEleven children with CP, aged 7-11 years, participated in PAP, consisting of a written agreement between each child, their parents and the physiotherapist and based on Motivational Interviewing (MI), Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS). Individual goals, gross motor function and physical activity were assessed at baseline, at 8 and/or 11 months using COPM, GAS, logbooks, Gross Motor Function Measure (GMFM-66), physical activity questionnaires, physical activity and heart rate monitors and time-use diaries. At 8 and 11 months the feasibility of the intervention and costs and time spent for the families and the physiotherapist were evaluated by questionnaires.ResultsThe intervention was feasible according to the feasibility questionnaire. Each child participated in 1-3 self-selected physical activities during 3-6 months with support from the physiotherapist, and clinically meaningful increases from baseline of COPM and GAS scores were recorded. Being physically active at moderate-vigorous levels varied between less than 30 and more than 240 minutes/day, and the median for the whole group was 84 minutes/day at baseline and 106 minutes/day at 8 months.ConclusionsThe intervention PAP seems to be feasible and effective for children with CP, involving both every day and organised physical activities to promote an active lifestyle through increased participation, motivation, and engagement in physical activities. Further research of PAP is needed, preferably in a long term randomised controlled trial and including health economic analysis to show costs and benefits.Trial RegistrationISRCTN76366356, retrospectively registered.

Physical literacy has been shown to relate to children’s engagement in physical activity. However, it is unclear whether this relationship extends to adults. A two-phase cross-sectional study was conducted to examine whether physical literacy relates to physical activity in adults. In phase one, 225 participants reported their perceived levels of physical literacy using the Physical Literacy in Adults Scale (PLAS) and their physical activity behaviours using the International Physical Activity Questionnaire. In phase two, 59 participants wore an accelerometer to provide a device-based assessment of physical activity before completing the PLAS. A series of bivariate regressions were conducted to assess the relationship between physical literacy and physical activity. Physical literacy was a significant predictor of self-reported moderate to vigorous physical activity (MVPA) and total physical activity. However, scores on the PLAS did not predict light intensity self-reported physical activity. For device-based assessment of physical activity, physical literacy was a significant predictor of MVPA, but did not predict light or total physical activity. These findings indicate that physical literacy relates to physical activity, particularly MVPA. Differences in findings between self-report and device-based assessment warrant further consideration. Future research should continue to assess the role of physical literacy across physical activity types (e.g. leisure time, work related) and intensities.

Background The physical and mental health benefits of physical activity (PA) in older adults have been well-documented. However, a large proportion of older adults worldwide fail to meet the internationally recommended guidelines of 150 minutes of moderate intensity PA per week. Factors associated with engagement in PA among older adults are complex, interacting and wide-reaching, involving individual, social, physical and environmental factors. Thus, to develop preventive lifestyle interventions it is necessary to carefully explore these factors. Methods This qualitative study (as part of a larger funded study to develop a PA-intervention) sought to identify and explore facilitators and barriers to PA in community dwelling older adults (≥65). Focus groups were conducted in Ireland (one) and France (two) and findings were analysed using thematic analysis. Results The main facilitators that emerged from focus group participants (n=33) were: availability of resources; tailored classes facilitated by staff knowledgeable of older adults’ needs; activities that facilitated social support and connectedness; perceived physical and psychological health benefits. Similar factors also influence continued participation in PA, as well as feelings of wellbeing and enjoyment, family support and motivation, although it was noted that it did sometimes require considerable effort. Barriers to engagement in PA included: lack of social support and resources; environmental factors, whether built, social, location or weather-related. Barriers of a more personal nature also emerged and included fear, loss of confidence due to functional changes, and lack of opportunity. Conclusion PA guidelines are but the first step. There is a need to develop implementation strategies at all levels: personal; interpersonal; organisational; community; and public policy, specifically for older adults, that will incorporate the above facilitators and address the above barriers to optimize engagement and maintenance in PA among older adults.

Measuring Physical Activity in Younger and Older Adults with Sickle Cell Disease Using Accelerometers

Theory-based approaches imply that values may be a construct that influences motivation and adherence to health behavior change. PURPOSE: This study examined the associations between individual values and change in physical activity in adults enrolled in a 6-month behavioral weight loss intervention. METHODS: Baseline data for 67 participants (age = 44.2±9.0 years; body mass index = 32.6±3.9 kg/m2) and 58 participants at 6 months (age = 43.9±9.2 years; body mass index = 32.6±4.0 kg/m2) were analyzed. The 6-month behavioral weight loss intervention included prescribed moderate-to-vigorous physical activity of 150 to 250min/wk. Only participants prescribed physical activity within the intervention were included in the statistical analysis. Assessments at baseline and 6 months included: 1) self-reported leisure-time physical activity, 2) personal values, 3) perception of engaging in physical activity would have on their values. RESULTS: At both baseline and 6 months, the three most frequently identified values were marriage/couples/intimate relationships (75.9%), family (60.3%), and parenting (56.9%). Spearman correlation coefficients were not statistically significant between change in leisure-time physical activity and perception of the impact engaging in a physical activity will have on their values at baseline (range of r’s: -0.029 to 0.154, p’s range: 0.364 to 0.927) and 6 months (range of r’s: -0.018 to 0.098, p’s range: 0.564 to 0.916). DISCUSSION: Self-reported values did not change following participation in a behavioral weight loss intervention. Perceptions of how engagement in physical activity would alter values were also not associated with change in leisure-time physical activity. These results suggest that linking physical activity to values would not impact the magnitude of improvement in leisure-time physical activity within the context of a comprehensive behavioral weight loss intervention. However, this warrants additional investigation to determine if interventions specifically linking values to physical activity would elicit similar effects.

The Fitbit tracker is a wearable technology designed to motivate individuals to become physically active by increasing awareness of physical activity (PA) levels. The Fitbit tracks activity, sleep, nutrition, uploads wirelessly, and is tiny and discreet. Published data is limited concerning the effectiveness of Fitbit technology on increasing PA levels in inactive adult populations. PURPOSE: To study changes in PA as a result of wearing the Fitbit for 8 weeks in individuals 50+ years of age. METHODS: Sixty university employees were stratified into two groups, intervention (n=29) and comparison (n=31), based on meeting PA recommendations of 150 minutes per week. Of these employees, 18 were ages 50 and over (7 intervention; 11 comparison). Intervention group participants (not meeting ACSM PA recommendations) were given a Fitbit to wear for 8 weeks, while comparison group participants were not and were encouraged to maintain their current PA habits. Demographic, anthropometric, and biometric data, body composition, flexibility, muscular strength/endurance, and cardiorespiratory fitness were assessed prior to and following the intervention. Self-reported PA was assessed via online survey. Independent sample T-tests were used to analyze differences between intervention and control groups. Paired sample T-tests were used to analyze differences pre- and post-Fitbit intervention. RESULTS: Mean age, weight, and BMI for the adult (50+) cohort of the sample was 58±5 years, 172±27 pounds, and 28.8±3.8 kg/m2, respectively. There were no significant differences between intervention and control groups at pre-test despite a large difference in self-reported PA (intervention: 70 minutes, comparison: 399 minutes). There was a positive change in self-reported PA in the intervention group from pre- to post-intervention that trended towards significance (p=0.08). Six out of seven of the intervention group participants were meeting PA recommendations post-intervention. CONCLUSIONS: Based on these results, wearing the Fitbit for 8 weeks increased PA in inactive adults (50+) to the point of meeting/exceeding PA recommendations. Further research is needed to determine the levels of improvement for this older adult population using this technology.

Purpose Physical activity and exercise are critical for older adults’ physical and mental health. The purpose of this qualitative study was to richly capture the motivators of and barriers to engaging in physical activity in previously inactive older adults who participated in a three-arm randomized controlled trial (RCT) of eight-week group exercise interventions. Methods We conducted a qualitative content analysis of individual interviews with fifteen participants—five from each study arm: strength training, walking, and inactive control. Participants included nine females and six males ranging from 60 to 86 years of age. Results Key motivators of physical activity included perceived improvements in physical and mental health, positive social influences, observed health deterioration in others, and the desire to spend time with and take care of family members. Barriers to physical activity included existing health conditions, fear of getting hurt, negative social influences, perceived lack of time and motivation, inconvenient times and locations, and monetary cost. Conclusions Our findings add to the body of literature identifying factors that motivate and stand in the way of older adults’ engagement in physical activity. These factors influence older adults’ self-efficacy and should be incorporated into the design of new and existing programs to encourage initiation and maintenance of physical activity.

BackgroundPhysically active lifestyle prevents and contributes to managing non-communicable diseases. Childhood physical activities have shown to associate with physically active lifestyle in adulthood. More research on which childhood physical activity modes associate with physical activity in later life is still needed. Within the present study, we examined how physically active commuting to school in childhood contributed to overall physical activity in adulhood.MethodsThe participants (N = 3596) were from the population-based, longitudinal Cardiovascular Risks in Young Finns Study. Questionnaires were used in assessing subjects' childhood (1980) and adulthood (2001-2018) physical activity. ActiGraph accelerometers were also applied in the adulthood measurements (2018-2020). The results were analyzed using logistic and linear regression models. Participants' age, sex, parents' educational background, parents' income level, childhood living area, participants' educational background, adulthood income level, and adulthood living area were adjusted for in the models.ResultsBased on the preliminary examinations, childhood commuting was not associated with self-reported commuting to work (2001-2018) or accelerometer-measured overall physical activity (2018-2020) in adulthood (p>.05). Active commuting in childhood associated with increased self-reported leisure-time physical activity in the year 2001 (b=.38, p>.001), 2007 (b=.35, p>.001), and 2018 (b=.28, p=.012), but the association between childhood commuting and self-reported physical activity in the years 2001 and 2018 attenuated after adjusting for all covariates (p>.05).ConclusionsPhysically active commuting in childhood (1980) was associated with higher levels of self-reported leisure-time physical activity in adulthood (2001-2018). The associations attenuated after adjusting for covariates excluding the one between active commuting and leisure-time physical activity assessed in 2007. Physically active commuting can be regarded as recommendable with respect to the development of physically active lifestyle, if supportive evidence for the causality between childhood commuting and leisure-time physical activity in adult age can be found. Future research should also focus on assessing whether active commuting in childhood contributes to adulthood activities parallel to active commuting in childhood.

Background and Study Aim. There is no doubt that the Coronavirus disease (COVID-19) pandemic, and its related containment measures such as lockdown and social distancing, is affecting physical activity and sleep quality of the general population worldwide. Algeria, one of the most affected countries in Africa, entered the lockdown on March 9, 2020. Numerous studies have explored the interaction between physical activity and sleep quality showing the effect of physical activity levels on sleep, yet previous researches have not investigated the relationship between physical activity and sleep quality during lockdown. The main purpose of the present study was to investigate the association between physical activity and sleep quality in quarantined individuals. Material and Methods. A national Google online survey was conducted between 16th April and 25th May 2020. 1002 Participants responded to the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the short form of the International Physical Activity Questionnaire (IPAQ). Of the 1002 participants who completed the survey, 358 were students. The final data were collected from the respondents. Results. The COVID-19 home confinement led to a decrease in physical activity levels. However, the majority of the study population had good sleep quality (61.9%), while only (38.1%) had poor sleep quality. In addition, women are less physically active than men (p &lt; 0.01). Moreover, there was a significant difference in sleep quality between sufficient and insufficient physical activity groups (p &lt; 0.05). Conclusions. Our results show that Algerian adults have low levels of physical activity, good sleep quality, and poor sleep quality is associated with insufficient physical activity in adults during lockdown.