24-hour Activity Research Articles

Assessing the impact of 24-hour activity behaviors on cardiorespiratory fitness in the older adult: a component analysis approach

BackgroundCardiorespiratory fitness (CRF) serves as a critical measure of the cardiovascular system’s efficiency in delivering oxygenated blood to tissues and organs. Understanding the relationship between various activity behaviors and CRF is essential for devising effective health interventions for the older adult population.ObjectiveThis study aimed to investigate the association between 24-h activity behaviors and CRF in older adult individuals, utilizing compositional data analysis.MethodsWe utilized baseline data from the “Fifth National Physical Fitness Monitoring Cohort Study in Tianjin, China,” which included 540 older adult participants. Physical activity and sedentary behavior were objectively measured using a three-dimensional accelerometer, and CRF was assessed via a gas metabolism analyzer. Compositional data analysis was employed to examine the relationships between 24-h activity behaviors—specifically, moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB), and sleep (SLP)—and CRF.ResultsThe analysis demonstrated that MVPA was significantly positively associated with CRF (βMVPA = 5.36, p < 0.01), whereas SB was significantly negatively associated (βSB = −3.97, p < 0.01). No significant associations were observed for LPA and SLP with CRF. The isochronous substitution model revealed that reallocating 15 min of MVPA to SB, LPA, or SLP significantly decreased CRF by 0.31, 0.27, and 0.23 mL/kg/min, respectively. Conversely, substituting 15 min of SB, LPA, or SLP with MVPA resulted in increases in CRF by 0.29, 0.22, and 0.17 mL/kg/min, respectively. Additionally, replacing SB with LPA or SLP led to improvements in CRF, though these changes were not significant, underscoring the potential benefits of reducing sedentary time and enhancing physical activity levels.ConclusionThese findings underscore the critical role of increasing MVPA and reducing SB in improving CRF among the older adult. This study provides a robust scientific foundation for health promotion and intervention strategies targeting older adults. Comprehensive modifications to daily activity patterns are imperative for optimizing cardiovascular health in this population.

Relationship between physical activity and neighborhood environment in preschool children during COVID-19.—A cross-sectional study using 24-hour activity records-

Maintaining physical activity and the development of physical and cognitive functions are essential especially in vulnerable populations such as children. Considering the substantial impact of the COVID-19 epidemic on preschool children and the lack of research focusing on this age group, this study examined the duration of physical activity among preschool-aged children on weekend days and its relationship with the environment. This study was conducted between October and November 2021, with the cooperation of 357 parents of preschoolers attending kindergartens, nurseries, and childcare centers. Physical activity was assessed using a 24h physical activity record. A questionnaire was used to collect basic data on the neighborhood environment. Stepwise multiple regression analysis was used to analyze the relationship between the five physical activity measures (sedentary time, screen time, indoor playing time, outdoor playing time, and going out time) and the questionnaire data. Our findings revealed a relationship between physical activity and the neighborhood environment; however, the R2 values were low. Despite low prediction accuracy, the results of this study were similar to those of previous studies, indicating a positive correlation of physical activity with the absence of undulating roads, a crime-free environment, and safety around the home. Overall, these findings emphasize the need for providing children with opportunities for outdoor physical activity and play in the context of the COVID-19 recovery phase for adherence to the relevant guidelines.

Considering the 24-Hour Activity Cycle in Older Adults.

Older adults are often advised to engage in more moderate-to-vigorous physical activity (MVPA). Although MVPA offers significant health benefits, focusing solely on MVPA may be difficult for many in this population due to their typically higher levels of sedentary behavior (SB). Increasing light-intensity physical activity (LIPA) can offer similar health benefits and be a more achievable starting point for inactive older adults. The 24-hour activity cycle provides a conceptual model that can assist healthcare providers in promoting physical activity. This model emphasizes the interaction between four key behaviors (i.e., sleep, sedentary behavior, LIPA, and MVPA) and presents a holistic approach to optimizing the balance of these activity behaviors. This article outlines strategies to help older adults increase their physical activity and reduce sedentary time within the 24-hour activity cycle, promoting sustainable, long-term behavior change in this population.

Prevalence of physiological and perceptual markers of low energy availability in male academy football players: a study protocol for a cross-sectional study

Low energy availability (LEA) is a core feature of the female athlete triad and relative energy deficiency in sport (REDs). LEA underpins multiple adverse health and performance outcomes in various...

Associations between rest–activity/light-exposure rhythm characteristics and depression in United States adults: A population-based study

This cross-sectional study investigated the association between 24-hour rest-activity rhythm (RAR), light exposure rhythm (LER), and depression symptoms in American adults, using data from the National Health and Nutrition Examination Survey (2011–2014, N = 6852). RAR and LER characteristics were derived from a 24-hour activity recorder and analyzed using the extended cosine model, focusing on intradaily variability (IV), interdaily stability (IS), and relative amplitude (RA). Depression was assessed via the Patient Health Questionnaire-9 (PHQ-9).Multiple logistic and linear regression models showed that higher IV in RAR and LER were associated with increased depression risk (RAR-IV OR = 1.92 [95 % CI: 0.89–4.13]; LER-IV OR = 2.5 [1.45–4.30]), while higher IS and RA in both rhythms were linked to lower depression risk (RAR-IS OR = 0.22 [0.10–0.48], RAR-RA OR = 0.20 [0.11–0.37], LER-IS OR = 0.22 [0.10–0.49], LER-RA OR = 0.29 [0.15–0.56]). Participants in the highest tertile for IS and RA had a significantly lower depression risk compared to the lowest tertile. Subgroup analyses indicated interactions between age and RAR-IV, gender and LER-IV, and BMI and LER-RA (p-interaction < 0.05). Disruptions in RAR and LER are positively associated with depression, emphasizing the need for rhythm regulation interventions considering age, gender, and BMI factors.

Associations between 24-hour activity behaviours and emotional and behavioural problems of left-behind children: a component analysis of data from a cross-sectional study

ObjectivesThis study employed compositional data analysis to examine the association between 24-hour activity behaviours and emotional and behavioural problems among left-behind children (LBC).DesignCross-sectional analysis.SettingThe research used a cross-sectional approach to...

Impact of Physical Activity in Patients With Atrial Fibrillation Undergoing Catheter Ablation: The Multicenter Randomized BE-ACTION Trial.

Arrhythmia recurrence after pulmonary vein isolation (PVI) is common. We conducted a multicenter, randomized trial to determine the impact of increased physical activity on atrial fibrillation recurrence after PVI. From 2018 to 2020, we randomly assigned 200 patients with atrial fibrillation to the ACTION or NO-ACTION group in 4 different centers in the local country of Brandenburg, Germany. Patients were eligible if they were scheduled to undergo PVI, aged ≥50 to ≤77 years, body mass index ≥23 to ≤35 kg/m2, and accepted wearing an activity tracker allowing 24-hour activity monitoring via mobile app. Patients in the ACTION group were actively remote-controlled via transmitted activity data by a physiotherapist, and individual motivational interviewing call sessions were scheduled with each ACTION patient every 2 weeks. The primary end point was the composite of recurrence of any atrial arrhythmia >30 seconds, additional ablation procedure, cardioversion, and new onset of antiarrhythmic drugs earliest after 90 days after index PVI over 12 months. Overall, the median age of patients was 66 (interquartile range, 61-71) years, 33.5% were women, and 52% had persistent atrial fibrillation. The number of steps per day increased in both groups of patients from baseline to 12 months (P<0.001). The absolute increase in steps per day did not differ between patients in the ACTION group with +3205 steps (597-4944) compared with those in the NO-ACTION group +2423 steps (17-4284), P=0.325. Unadjusted intention-to-treat analysis showed no difference in the primary composite end point in the ACTION group (27.3%) versus the NO-ACTION group (32.7%), P=0.405. Physical activity improved in patients after PVI. The present randomized controlled trial shows that activity tracker and motivational calls to increase physical activity versus activity tracker alone did not reduce the occurrence of the primary composite end point of atrial fibrillation recurrence or the absolute increase in steps per day. URL: https://www.cochranelibrary.com; Unique identifier: DRKS00012914.

Five-year changes in 24-hour sleep-wake activity and dementia risk in oldest old women.

Sleep disruptions are associated with cognitive aging in older adults. However, it is unclear whether longitudinal changes in 24-hour multidimensional sleep-wake activity are linked to cognitive impairment in the oldest old. We studied 733 cognitively unimpaired women (mean age=82.5±2.9 years) who completed two actigraphy assessments over five years. We performed hierarchical clustering on principal components in nine sleep, napping, and circadian rest-activity rhythm parameters to identify multidimensional sleep-wake change profiles and multinomial logistic regression to evaluate the associations between sleep-wake changes and risk of cognitive impairment at follow-up. We identified three sleep-wake change profiles: Stable Sleep (43.8%), Declining Nighttime Sleep (34.9%), and Increasing Sleepiness (21.3%). After adjustment for demographics and comorbidities, women with Increasing Sleepiness had approximately doubled (odds ratio=2.21, p=0.018) risk of dementia compared to those with Stable Sleep. Increasing sleepiness may be an independent marker or risk factor for dementia in oldest old women.

Reallocating just 10 min to moderate-to-vigorous physical activity from other components of 24-hour movement behaviors improves cardiovascular health in adults

BackgroundAs components of a 24-hour day, sedentary behavior (SB), physical activity (PA), and sleep are all independently linked to cardiovascular health (CVH). However, insufficient understanding of components’ mutual exclusion limits the exploration of the associations between all movement behaviors and health outcomes. The aim of this study was to employ compositional data analysis (CoDA) approach to investigate the associations between 24-hour movement behaviors and overall CVH.MethodsData from 581 participants, including 230 women, were collected from the 2005–2006 wave of the US National Health and Nutrition Examination Survey (NHANES). This dataset included information on the duration of SB and PA, derived from ActiGraph accelerometers, as well as self-reported sleep duration. The assessment of CVH was conducted in accordance with the criteria outlined in Life’s Simple 7, encompassing the evaluation of both health behaviors and health factors. Compositional linear regression was utilized to examine the cross-sectional associations of 24-hour movement behaviors and each component with CVH score. Furthermore, the study predicted the potential differences in CVH score that would occur by reallocating 10 to 60 min among different movement behaviors.ResultsA significant association was observed between 24-hour movement behaviors and overall CVH (p < 0.001) after adjusting for potential confounders. Substituting moderate-to-vigorous physical activity (MVPA) for other components was strongly associated with favorable differences in CVH score (p < 0.05), whether in one-for-one reallocations or one-for-remaining reallocations. Allocating time away from MVPA consistently resulted in larger negative differences in CVH score (p < 0.05). For instance, replacing 10 min of light physical activity (LPA) with MVPA was related to an increase of 0.21 in CVH score (95% confidence interval (95% CI) 0.11 to 0.31). Conversely, when the same duration of MVPA was replaced with LPA, CVH score decreased by 0.67 (95% CI -0.99 to -0.35). No such significance was discovered for all duration reallocations involving only LPA, SB, and sleep (p > 0.05).ConclusionsMVPA seems to be as a pivotal determinant for enhancing CVH among general adult population, relative to other movement behaviors. Consequently, optimization of MVPA duration is an essential element in promoting overall health and well-being.

Sleep, 24-Hour Activity Rhythms, and Subsequent Amyloid-β Pathology

Sleep disturbances are common among older adults and have been associated with the development of Alzheimer disease (AD), such as amyloid-β (Aβ) pathology. For effective AD prevention, it is essential to pinpoint the specific disturbances in sleep and the underlying 24-hour activity rhythms that confer the highest risk of Aβ deposition. To determine the associations of 24-hour activity rhythms and sleep with Aβ deposition in adults without dementia, to evaluate whether disrupted 24-hour activity and sleep may precede Aβ deposition, and to assess the role of the apolipoprotein E ε4 (APOE4) genotype. This was an observational cohort study using data from the Rotterdam Study. Of 639 participants without dementia who underwent Aβ positron emission tomography (PET) from September 2018 to November 2021, 319 were included in the current study. Exclusion criteria were no APOE genotyping and no valid actigraphy data at the baseline visits from 2004 to 2006 or from 2012 to 2014. The mean (SD) follow-up was 7.8 (2.4) years. Data were analyzed from March 2023 to April 2024. Actigraphy (7 days and nights, objective sleep, and 24-hour activity rhythms), sleep diaries (self-reported sleep), Aβ42/40, phosphorylated tau (p-tau)181 and p-tau217 plasma assays, 18F-florbetaben PET (mean standard uptake value ratio [SUVR] in a large cortical region of interest), and APOE4 genotype. Association of objective and self-reported sleep and 24-hour activity rhythms at baseline with brain Aβ PET burden at follow-up. The mean (range) age in the study population was 61.5 (48-80) years at baseline and 69.2 (60-88) years at follow-up; 150 (47%) were women. Higher intradaily variability at baseline, an indicator of fragmented 24-hour activity rhythms, was associated with higher Aβ PET burden at follow-up (β, 0.15; bootstrapped 95% CI, 0.04 to 0.26; bootstrapped P = .02, false discovery rate [FDR] P = .048). APOE genotype modified this association, which was stronger in APOE4 carriers (β, 0.38; bootstrapped 95% CI, 0.05 to 0.64; bootstrapped P = .03) compared to noncarriers (β, 0.07; bootstrapped 95% CI, -0.04 to 0.18; bootstrapped P = .19). The findings remained largely similar after excluding participants with AD pathology at baseline, suggesting that a fragmented 24-hour activity rhythm may have preceded Aβ deposition. No other objective or self-reported measure of sleep was associated with Aβ. Among community-dwelling adults included in this study, higher fragmentation of the 24-hour activity rhythms was associated with greater subsequent Aβ burden, especially in APOE4 carriers. These results suggest that rest-activity fragmentation could represent a modifiable risk factor for AD.

Effects of orthodontic aligners on 24-hour masseter muscle activity: a multiple-day electromyographic study

ABSTRACT Objective This study aimed to assess the effects of aligners on masseter muscle activity by using an electromyographic device in the home environment. Methods The study was performed on healthy patients who required orthodontic treatment. Three different 24 h-EMG recording sessions were performed in different conditions: without aligners, with passive aligners, and with active aligners. The non-functional MMA work index (nfMMA-WI) and the non-functional MMA time index (nfMMA-TI) for both awake and sleep hours were assessed. ANOVA test was used to compare the average activity during the three recording conditions. Results On average, a total recording time of 204.7 ± 7.9 hours were provided for each patient. For most patients, ANOVA test showed an absence of significant differences between the recording sessions. Conclusions The impact of our results is not negligible: clinicians can find remarkable support to the hypothesis that the use of aligners affects the MMA only in a minority of subjects.

Evening regular activity breaks extend subsequent free-living sleep time in healthy adults: a randomised crossover trial

ObjectiveTo determine if performing regular 3-min bouts of resistance exercise spread over 4 hours in an evening will impact subsequent sleep quantity and quality, sedentary time and physical activity compared...

The Association of the 24-Hour Activity Cycle Profiles With Cognition in Older Adults With Mild Cognitive Impairment: A Cross-Sectional Study.

The relationship of cognition and the 24-h activity cycle (24-HAC), encompassing physical activity, sedentary behavior, and sleep, in older adults with mild cognitive impairment (MCI) remains uncertain. Distinct combinations of 24-HAC behaviors can characterize unique activity profiles and influence cognition. We aimed to characterize 24-HAC activity profiles in older adults with MCI and assess whether differences in cognition exist across profiles. We conducted a cross-sectional analysis utilizing baseline data from 3 randomized controlled trials involving 253 community-dwelling older adults (55 + years) with MCI (no functional impairment, dementia diagnosis, and Montreal Cognitive Assessment score <26/30). Using MotionWatch8© wrist-worn actigraphy (+5 days), we captured the 24-HAC. Cognition was indexed by the Alzheimer's Disease Assessment Scale Cognitive Plus (ADAS-Cog-Plus). Compositional data and latent profile analyses identified distinct 24-HAC activity profiles. Analysis of covariance examined whether 24-HAC activity profiles differed in cognition. Four distinct activity profiles were identified. Profile 1 ("Average 24-HAC," n = 103) engaged in all 24-HAC behaviors around the sample average. Profile 2 ("Active Chillers," n = 70) depicted lower-than-average engagement in physical activity and higher-than-average sedentary behavior. Profile 3 ("Physical Activity Masters," n = 54) were the most active and the least sedentary. Profile 4 ("Sedentary Savants," n = 26) were the least active and the most sedentary. Sleep was similar across profiles. There were no significant differences in ADAS-Cog-Plus scores between 24-HAC activity profiles (p > .05). Older adults with MCI exhibited four 24-HAC activity profiles conforming to recommended physical activity and sleep guidelines. Nonetheless, cognition was similar across these profiles.

Exploring an objective measure of overactivity in children with rare genetic syndromes

BackgroundOveractivity is prevalent in several rare genetic neurodevelopmental syndromes, including Smith-Magenis syndrome, Angelman syndrome, and tuberous sclerosis complex, although has been predominantly assessed using questionnaire techniques. Threats to the precision and validity of questionnaire data may undermine existing insights into this behaviour. Previous research indicates objective measures, namely actigraphy, can effectively differentiate non-overactive children from those with attention-deficit hyperactivity disorder. This study is the first to examine the sensitivity of actigraphy to overactivity across rare genetic syndromes associated with intellectual disability, through comparisons with typically-developing peers and questionnaire overactivity estimates.MethodsA secondary analysis of actigraphy data and overactivity estimates from The Activity Questionnaire (TAQ) was conducted for children aged 4-15 years with Smith-Magenis syndrome (N=20), Angelman syndrome (N=26), tuberous sclerosis complex (N=16), and typically-developing children (N=61). Actigraphy data were summarized using the M10 non-parametric circadian rhythm variable, and 24-hour activity profiles were modelled via functional linear modelling. Associations between actigraphy data and TAQ overactivity estimates were explored. Differences in actigraphy-defined activity were also examined between syndrome and typically-developing groups, and between children with high and low TAQ overactivity scores within syndromes.ResultsM10 and TAQ overactivity scores were strongly positively correlated for children with Angelman syndrome and Smith-Magenis syndrome. M10 did not substantially differ between the syndrome and typically-developing groups. Higher early morning activity and lower evening activity was observed across all syndrome groups relative to typically-developing peers. High and low TAQ group comparisons revealed syndrome-specific profiles of overactivity, persisting throughout the day in Angelman syndrome, occurring during the early morning and early afternoon in Smith-Magenis syndrome, and manifesting briefly in the evening in tuberous sclerosis complex.DiscussionThese findings provide some support for the sensitivity of actigraphy to overactivity in children with rare genetic syndromes, and offer syndrome-specific temporal descriptions of overactivity. The findings advance existing descriptions of overactivity, provided by questionnaire techniques, in children with rare genetic syndromes and have implications for the measurement of overactivity. Future studies should examine the impact of syndrome-related characteristics on actigraphy-defined activity and overactivity estimates from actigraphy and questionnaire techniques.

480 Effect of Chronic DBS on Ventral Capsule Ventral Striatum-Specific Circadian Rhythm in Refractory Obsessive-Compulsive Disorder

INTRODUCTION: Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) improves symptoms in ∼66% of patients with treatment-resistant obsessive-compulsive disorder (OCD). However, a common adverse effect of VC/VS DBS is hypomania, marked by decreased need for sleep and increased risk-taking behaviors. Modern DBS devices have enabled 24-hour collection of neural data, allowing for tracking of circadian rhythms reflected by VC/VS local field potentials (LFPs). METHODS: We implanted six patients with treatment-resistant OCD with a DBS device configured for constant VC/VS stimulation and recording. Spectral power in the 9 ± 2.5 Hz band was estimated onboard the device every 10 minutes for a median of 249 days (range 77-608). We assessed the rhythmicity of power in this spectral band by fitting 7-day retrospective rolling windows of per-day normalized LFP power to cosine functions using least-squared regression. Output metrics included acrophase (time of peak activity), amplitude, and fit significance. We quantified trends in acrophase over time using Pearson correlation. RESULTS: All six patients demonstrated consistent 24-hour cyclic LFP activity bilaterally. Two of the six had diurnal peaks which shifted significantly earlier across the study period. The remaining four patients had nocturnal peaks, all shifting significantly later over time. Notably, a patient in the latter group experienced three days of hypomania after DBS initiation associated with circadian disruptions even after clinical symptom resolution. Only after clinical DBS adjustment 2 weeks later did circadian rhythm rapidly return to pre-hypomanic levels. CONCLUSIONS: Study patients demonstrated evolving circadian VC/VS LFP activity across the course of DBS therapy, usually independent of cyclic whole-brain activity (i.e. sleep). Conversely, disruptions to these circadian patterns, as observed here during hypomania, may serve as biomarkers of region-specific stimulation side effects.

Ultradian Rest-activity Rhythms Induced by Quinpirole in Mice Using Wavelet Analysis.

Ultradian rhythms are biological rhythms with periods of a few seconds to a few hours. Along with circadian rhythms, ultradian rhythms influence human physiology. However, such rhythms have not been studied as intensively as circadian rhythms. This study aimed to identify ultradian rest-activity rhythms induced by the dopamine D2/D3 agonist quinpirole in mice. We used 10 mice from the Institute of Cancer Research. Quinpirole was administered at a dose of 0.5 mg/kg. We assessed free rest-activity using infrared detectors and conducted wavelet analysis to measure the period and its variation. We also used the paired t test to compare ultradian rhythm patterns. Quinpirole did not significantly change total 24-hour locomotor activity (p = 0.065). However, it significantly increased locomotor activity during the dark phase (p = 0.001) and decreased it during the light phase (p = 0.016). In the continuous wavelet transform analysis, the mean period was 5.618 hours before quinpirole injection and 4.523 hours after injection. The period showed a significant decrease (p = 0.040), while the variation remained relatively consistent before and after quinpirole injection. This study demonstrated ultradian rest-activity rhythms induced by quinpirole using wavelet analysis. Quinpirole-induced ultradian rhythms exhibited rapid oscillations with shortened periods and increased activity during the dark phase. To better understand these changes in ultradian rhythms caused by quinpirole, it is essential to compare them with the effects of other psychopharmacological agents. Furthermore, investigating the pharmacological impact on ultradian rest-activity rhythms may have valuable applications in clinical studies.

Adherence to 24-hour integrated activity guidelines among infants, toddlers and preschool children in Singapore.

This study examined children's adherence to the Singapore Integrated 24-Hour Activity Guidelines for Early Childhood in infants, toddlers and preschoolers aged 0-6 years. A total of 901 caregivers, comprising 219 infants, 379 toddlers, and 303 preschoolers, provided information regarding their children's physical activity (PA), screen viewing time (SVT), and sleep durations on both weekdays and weekends. Meeting the 24-hour integrated activity guidelines was defined as follows: for infants ≥ 30 minutes per day of tummy time or floor-based play; zero SVT; total sleep of 14-17 hours per day for ages 0-3 months, 12-16 hours per day for ages 4-11 months; for toddlers ≥ 180 minutes of total PA per day; zero SVT under 2 years; <1 hour for ages 2 to less than 3 years; and a total sleep of 11-14 hours per day; for preschoolers ≥ 180 minutes of total PA per day; SVT <1 hour per day; total sleep of 10-13 hours per day for those aged 3-5 years, and 10-11 hours per day for 6-year-olds. Chi-squared tests were used to examine the differences in guideline adherence between weekdays and weekends. Compared to weekdays, during weekends there was a higher proportion of toddlers and preschoolers adhering to the PA guidelines (68.9% vs 50.1%; 78.9% vs 55.4%, respectively, p<0.05), and a lower proportion of toddlers adhering to SVT (38.8% vs 21.8%; p = 0.001). There was a declining adherence to all three activity guidelines as age groups progressed from infants (44.7%) to toddlers (15.8%) and then to preschoolers (9.4%). Concurrently, there was a decrease in adherence to SVT recommendations across the age groups, with adherence rates being highest among infants (83.1%), followed by toddlers (15.8%), and preschoolers (9.4%). Decreasing compliance with all three guidelines, coupled with a corresponding decline in adherence to SVT guidelines as children transition from toddlerhood to preschool age, is a cause for concern. This underscores the need for proactive efforts to educate caregivers about reducing or eliminating SVT among infants and young children.

Adherence to the Singapore Integrated 24-Hour Activity Guidelines by Infants and Toddlers and Its Association With Well-Being.

This study estimated the prevalence of Singapore infants and toddlers who met the new Singapore Integrated 24-Hour Activity Guidelines for Early Childhood and examined its association with well-being. A total of 267 parents of children aged between 0 and 2years completed an online questionnaire that consists of the Singaporean Children Lifestyle Questionnaire and either the Pediatric Quality of Life (PedsQL) Inventory Infant Scale or the Strength and Difficulties Questionnaire. Well-being of infants was measured through parent responses to PedsQL and that of toddlers was measured through Strength and Difficulties Questionnaire. Data were benchmarked against age-specific guidelines for physical activity, screen time, and sleep in the Singapore Integrated 24-Hour Activity Guidelines for Early Childhood. A higher percentage of infants (37.3%) than toddlers (20.6%) had met 3 guidelines. In contrast, a lower percentage of infants than toddlers met at least one or did not meet any guidelines (3.8% and 0% for infants vs 22.4% and 1.8% for toddlers, respectively). Infants who met more guidelines had significantly higher parent-reported PedsQL total scale score than infants who met fewer guidelines (P < .05). However, the present study found that the number of guidelines met was not associated to infants' PedsQL scale score and toddlers' total difficulty score (P > .05). Adherence to this set of local guidelines should be widely publicized, so parents will have greater awareness and knowledge on cultivating good physical activity, screen time, and sleep habits for their child from a young age.

Predicting worsening heart failure hospitalizations in patients with implantable cardioverter defibrillators: is it all about alerts? A pooled analysis of nine trials.

To predict worsening heart failure hospitalizations (WHFHs) in patients with implantable defibrillators and remote monitoring, the HeartInsight algorithm (Biotronik, Berlin, Germany) calculates a heart failure (HF) score combining seven physiologic parameters: 24 h heart rate (HR), nocturnal HR, HR variability, atrial tachyarrhythmia, ventricular extrasystoles, patient activity, and thoracic impedance. We compared temporal trends of the HF score and its components 12 weeks before a WHFH with 12-week trends in patients without WHFH, to assess whether trends indicate deteriorating HF regardless of alert status. Data from nine clinical trials were pooled, including 2050 patients with a defibrillator capable of atrial sensing, ejection fraction ≤ 35%, NYHA class II/III, no long-standing atrial fibrillation, and 369 WHFH from 259 patients. The mean HF score was higher in the WHFH group than in the no WHFH group (42.3 ± 26.1 vs. 30.7 ± 20.6, P < 0.001) already at the beginning of 12 weeks. The mean HF score further increased to 51.6 ± 26.8 until WHFH (+22% vs. no WHFH group, P = 0.003). As compared to the no WHFH group, the algorithm components either were already higher 12 weeks before WHFH (24 h HR, HR variability, thoracic impedance) or significantly increased until WHFH (nocturnal HR, atrial tachyarrhythmia, ventricular extrasystoles, patient activity). The HF score was significantly higher at, and further increased during 12 weeks before WHFH, as compared to the no WHFH group, with seven components showing different behaviour and contribution. Temporal trends of HF score may serve as a quantitative estimate of HF condition and evolution prior to WHFH.

Cross-sectional and longitudinal associations between the 24-hour movement behaviours, including muscle and bone strengthening activity, with bone and lean mass from childhood to adolescence

BackgroundThis study aimed to assess whether moderate-to-vigorous physical activity (MVPA), sport and exercise as a proxy measure of muscle and bone strengthening activity, sedentary behaviour, and sleep were associated with total-body-less-head (TBLH) bone mineral content (BMC) and TBLH lean mass cross-sectionally and longitudinally from age 6 to 9 years and age 9 to 11 years to age 15 to 17 years.MethodsWe used longitudinal data from a population sample of Finnish children from the Physical Activity and Nutrition in Children study (age 6 to 9 years: n = 478, 229 females; age 9 to 11 years: n = 384, 197 females; age 15 to 17 years: n = 222, 103 females). Linear regression analysed the cross-sectional and longitudinal associations between accelerometer-assessed MVPA, sedentary time and sleep, and questionnaire-assessed sport and exercise participation and screen time with dual-energy X-ray absorptiometry-assessed TBLH BMC and lean mass.ResultsIn females, MVPA at age 6 to 9 years was positively associated with TBLH BMC at age 15 to 17 years (β = 0.008, p = 0.010). Sport and exercise at age 9 to 11 years was positively associated with TBLH BMC (β = 0.020, p = 0.002) and lean mass (β = 0.343, p = 0.040) at age 15 to 17 years. MVPA at age 9 to 11 years was positively associated with TBLH lean mass (β = 0.272, p = 0.004) at age 15 to 17 years. In males, sleep at age 6 to 9 years was positively associated with TBLH lean mass (β = 0.382, p = 0.003) at age 15 to 17 years. Sport and exercise at age 9 to 11 years was positively associated with TBLH BMC (β = 0.027, p = 0.012) and lean mass (β = 0.721, p < 0.001) at age 15 to 17 years.ConclusionsPromoting engagement in the 24-hour movement behaviours in childhood, particularly sport and exercise to strengthen muscle and bone, is important in supporting bone and lean mass development in adolescence.Trial registrationNCT01803776; first trial registration date: 04/03/2013.