activPAL Accelerometer Research Articles

ASSOCIATIONS OF PAIN INTENSITY WITH SEDENTARY BEHAVIOR AND PHYSICAL ACTIVITY IN OLDER ADULTS

Exercise is recommended for several painful, age-associated conditions; however, relationships between pain intensity and objectively measured sedentary behavior and physical activity have not been investigated in older adults. Accordingly, we analyzed cross-sectional data on 936 older adults in the ACT Study who self-reported their pain intensity on a 0-10 rating scale (0=no pain; 1-3=mild pain; and 4-10=moderate/severe pain) and wore an activPAL accelerometer. A total of 181 (19.3%) reported no pain, while 564 (60.3%) and 191 (20.4%) reported mild and moderate/severe pain, respectively. Linear regression models adjusted for age and sex estimated that compared to those with no pain, participants with moderate/severe pain walked significantly fewer steps/day (b-coefficient=-778 [95%CI: -1377, -179]) and had fewer sit-to-stand transitions/day (b-coefficient=-2.9 [95%CI: -5.6, -0.1]). In contrast, there were no significant differences in these outcomes comparing no pain versus mild pain. Future research will examine effects of pain treatments (opioids) and diagnoses on accelerometer-measured outcomes.

Editor’s Choice: Dual-process model of older adults’ sedentary behavior: an ecological momentary assessment study

Objective: A 10-day ecological momentary assessment (EMA) study was conducted to test a dual-process model of older adults’ sedentary behavior.Design: Older adults (n = 104, 60–98 years) answered 6 EMA questionnaires/day to assess conscious processes (i.e. momentary intentions, self-efficacy to limit sedentary behavior over the next two hours) and wore an activPAL accelerometer to measure sedentary behavior. Habit strength for sedentary behavior, a non-conscious process, was self-reported at an introductory session.Main outcome measure: Time spent sitting in the two hours after the EMA prompt.Results: Older adults engaged in less sedentary behavior on occasions when their intentions (b = −1.63, p = 0.02) and self-efficacy (b = −2.01, p = 0.003) to limit sedentary behavior were stronger than one’s average level of intentions or self-efficacy, respectively; however, older adults’ average level of intentions (b = −5.30, p = 0.05) or self-efficacy (b = 2.77, p = 0.27) to limit sedentary behavior were not associated with sedentary behavior. Older adults with stronger sedentary behavior habits engaged in greater sedentary behavior in the two hours following the EMA prompt (b = 2.04, p = 0.006).Conclusion: Sedentary behavior is regulated by conscious and non-conscious processes. Interventions targeting older adults’ sedentary behavior should promote momentary intention formation and self-efficacy beliefs to limit sitting as well as content to disrupt habitual sedentary behavior.

Using Accelerometers to Identify Regular Activity Breaks

Background: Regular activity breaks positively impact markers of cardiometabolic health when performed in a laboratory. However, identifying compliance to a free-living regular activity breaks intervention is challenging, particularly if intensity is prescribed. Methods: This study had two parts. In Part A, 20 participants performed activity breaks similar to those shown to impart health benefits while wearing an ActiGraph and activPAL accelerometer, and a heart rate monitor. In Part B, the threshold found to identify these activities was used to identify the activity breaks performed by 78 sedentary, university employees wearing an ActiGraph accelerometer for seven days. Results: A cut-point of 1,000 vector magnitude counts per minute accurately identified activity breaks performed in the laboratory. Applying this cut-point to data collected in free living, sedentary participants identified, on average, seven activity breaks were being performed during work-hours. Conclusions: Using a cut-point of 1,000 vector magnitude counts per minute will identify activity breaks of a similar intensity to those found to elicit acute cardiometabolic benefit. Sedentary university employees may benefit from interventions to increase the number of activity breaks performed across their entire day.

The Acute Effects of a "Reduced Sitting Preschool Day" on Executive Function and Musculoskeletal Health in Preschoolers: A Randomized Cross-Over Study.

To examine the acute effects of a reduced sitting day on executive function (EF) and musculoskeletal health in preschoolers. A sample of 29 children (54% boys; 4-5y) participated in a randomized cross-over trial. Each child completed 2 protocols, which simulate a day at childcare in random order for 2.5 hours; a typical preschool day (50% sitting) and a reduced preschool day (25% sitting) where most sitting activities were replaced with standing activities. Sitting, standing, and stepping time were objectively assessed using an activPAL accelerometer. EF was evaluated using tablet-based EF assessments (inhibition, working memory, and task shifting). Musculoskeletal health was assessed using a handheld dynamometer and goniometer. Compared with the typical preschool day, the reduced sitting day showed no significant differences for EF scores. Effect sizes for inhibition (d = 0.04), working memory (d = 0.02), and shifting (d = 0.11) were all small. For musculoskeletal health, no significant differences were reported after the reduced preschool day. The effect sizes for the hip extension force, hamstring flexibility, gastrocnemius length, and balancing on 1 leg were all small (d = 0.21, d = 0.25, d = 0.28, and d = 0.28). This study suggests that reducing sitting time is unlikely to result in acute changes in EF and musculoskeletal health among preschoolers.

Feasibility, acceptability and efficacy of a text message-enhanced clinical exercise rehabilitation intervention for increasing \u2018whole-of-day\u2019 activity in people living with and beyond cancer

BackgroundExercise interventions are typically delivered to people with cancer and survivors via supervised clinical rehabilitation. However, motivating and maintaining activity changes outside of the clinic setting remains challenging. This study investigated the feasibility, acceptability and efficacy of an individually-tailored, text message-enhanced intervention that focused on increasing whole-of-day activity both during and beyond a 4-week, supervised clinical exercise rehabilitation program for people with cancer and survivors.MethodsParticipants (n = 36; mean ± SD age 64.8 ± 9.6 years; 44.1 ± 30.8 months since treatment) were randomized 1:1 to receive the text message-enhanced clinical exercise rehabilitation program, or the standard clinical exercise rehabilitation program alone. Activity was assessed at baseline, 4-weeks (end of the standard program) and 12-weeks (end of enhanced program) using both device (activPAL accelerometer; sitting, standing, light-stepping, moderate-stepping) and self-report [Multimedia Activity Recall for Children and Adults (MARCA); sedentary, light, moderate-to-vigorous physical activity (MVPA)] methods. The MARCA also assessed time use domains to provide context to activity changes. Changes and intervention effects were evaluated using linear mixed models, adjusting for baseline values and potential confounders.ResultsThe study had high retention (86%) and participants reported high levels of satisfaction [4.3/5 (±0.8)] with the intervention. Over the first 4 weeks, MARCA-assessed MVPA increased [+ 53.2 (95%CI: 2.9, 103.5) min/d] between groups, favoring the text message-enhanced program, but there were no significant intervention effects on sedentary behavior. By 12 weeks, relative to the standard group, participants in the text message-enhanced group sat less [activPAL overall sitting: − 48.2 (− 89.9, − 5.6) min/16 h awake; MARCA: -80.1 (− 156.5, − 3.8) min/d] and were participating in more physical activity [activPAL light stepping: + 7.0 (0.4, 13.6: min/16 h awake; MARCA MVPA: + 67.3 (24.0, 110.6) min/d]. The time-use domains of Quiet Time [− 63.3 (− 110.5, − 16.0) min/d] and Screen Time [− 62.0 (− 109.7, − 14.2) min/d] differed significantly between groups.ConclusionsResults demonstrate feasibility, acceptability and efficacy of a novel, text message-enhanced clinical exercise rehabilitation program to support changes in whole-of-day activity, including both physical activity and sedentary behavior. Changes were largely seen at 12-week follow-up, indicating potential for the intervention to result in continued improvement and maintenance of behavior change following a supervised exercise intervention.Trial registrationThis trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000641493; date registered 17/5/16).

Post-Meal Walking Improves Postprandial Glycaemia in Women with Gestational Diabetes Mellitus

PURPOSE: To investigate the effects of post-meal walking (PMW) on glycaemic control in women with Gestational Diabetes Mellitus (GDM). METHODS: Eighty women with physician-diagnosed GDM will be randomised to i) Control standard-care alone (CON), or ii) PMW in addition to standard-care, from weeks 28 to 36 of gestation. Participants in the PMW group were advised to perform 10 min of PMW after main meals, whilst the CON group were advised to perform 30 min of daily physical activity. Blood glucose was assessed using continuous Glucose Monitoring (iPro CGM) and physical activity, sedentary time and adherence was assessed using ActivPal accelerometers for 7-days at weeks 28 and 35 of gestation. Fasting glucose was measured from capillary glucometer measures each morning. RESULTS: Preliminary data from nine women with GDM are presented (PMW n=5 and CON n=4). Postprandial, fasting glucose and physical activity did not differ between the CON and PMW groups during the first 7-day monitoring period. Compared to baseline, the PMW improved the 3-h average glucose after breakfast (-0.35 mmol.L-1, p = 0.03) and lunch (-0.34 mmol.L-1, p = 0.01), enough to remain in target ranges for blood glucose (5.0 - 7.4 mmol.L-1). No difference was seen after dinner in the PMW group (-0.11 mmol.L-1, p = 0.22), due to reduced adherence (40%) to PMW after dinner. CONCLUSIONS: Preliminary data supports the notion that PMW can improve blood glucose levels after breakfast and lunch in women with GDM when adhered to, however the impact of dinner requires further research. PMW may be an effective adjunct to standard-care for the management of GDM in pregnancy.

Week and Weekend Day Cadence Patterns Long-Term Post-Bariatric Surgery.

Objectively describe the walking cadence of individuals' long-term post-bariatric surgery. Fifty-eight participants, 51.2 ± 8.9years old, with a BMI of 34.6 ± 10.1kg/m2, 10.0 ± 3.1years post-surgery wore an activPAL accelerometer for 7 consecutive days. Data was analyzed using participants' current BMI, dichotomized by obesity status, < or ≥ 30kg/m2. On average, participants walked 5124 ± 2549 steps/day on weekdays and 6097 ± 2786 steps/day on weekend days (p= .003). Participants spent the majority (75%) of their daily steps at a slow-walking average cadence (non-obese: week = 65.3 ± 5.0 steps/min and weekend = 63.8 ± 6.7 steps/min; obese: week = 67.8 ± 8.2 steps/min and weekend = 63.3 ± 6.9 steps/min), with no difference between groups for week or weekend days (p= .153 and .774). The cadence of participants with obesity was significantly lower on weekends compared to weekdays for walking events > 30s (p= .002) and > 60s (p= .008) in duration. Weekday cadence of participants without obesity was similar to weekend day cadence across all walking event durations. The majority of walking events occurred below 30s in duration for all participants. Long-term post-bariatric surgery, movement occurs in short duration bouts at a slow-walking cadence for the majority of movement. Individuals without obesity had similar movement patterns from week to weekend days while participants with obesity significantly lowered their cadence on weekend days.

Physical activity patterns of patients immediately after lumbar surgery

Purpose: To describe the physical activity patterns of patients in the first week after lumbar surgery, and to investigate factors that potentially limit walking time early after surgery. Materials and methods: Adults undergoing lumbar decompression, discectomy and/or fusion surgery (N = 216, mean age 62 years, SD 13.9) were invited to participate. Walking time and step count were recorded for the first seven post-operative days, using an ActivPAL accelerometer. Participants recorded daily pain scores, supervision requirements while walking, and any complications that prevented walking. Results: On the first post-operative day, participants spent an average of 17 min (SD 20) walking, by Day 6, participants spent an average of 53 min (SD 38) walking. Participants who reported minor post-operative complications had a significantly lower step count than those without complications (p < 0.01). A lower step count was associated with a longer time to achieve independent mobility (r= −0.60, 95% CI −0.68 to −0.50), and a longer hospital admission (r= −0.70, 95% CI −0.76 to −0.63). Conclusions: This study found that patients walk for less than an hour a day over the week after lumbar surgery. Further research is required to investigate whether intervention designed to increase walking time improves post-operative activity and longer-term patient outcome. IMPLICATIONS FOR REHABILITATION While resuming walking after lumbar surgery is a common focus of early rehabilitation, little is known about how much walking patients do, or how walking impacts recovery. The findings from this study describe activity patterns early after lumbar surgery, which may be used to inform patients about normal post-operative recovery. A lower post-operative step count was associated with several patient factors, including a fusion procedure and more severe post-operative pain, which may be used to guide peri-operative care and rehabilitation protocols.

Associations of sedentary time and self-reported television time during pregnancy with incident gestational diabetes and plasma glucose levels in women at risk of gestational diabetes in the UK

BackgroundSedentary time is associated with increased risk of type 2 diabetes, but the association between objectively measured sedentary time and incident gestational diabetes mellitus (GDM) has not been tested. The purpose of this paper is to test associations between objectively measured sedentary time and self-reported television time during pregnancy with incident GDM and plasma glucose levels among women at high risk for GDM.MethodsAt 20 weeks’ gestation, pregnant women (n = 188) in the North East of England with a risk factor for GDM wore an activPAL accelerometer and reported their usual television time. Participants underwent a standard oral glucose tolerance test at 24–28 weeks’ gestation. Regression analyses were used to test for associations of total and prolonged sedentary time, breaks in sedentary time, and television time with GDM and fasting and 2-h glucose levels. Interaction terms were applied to examine whether the association between each indicator of sedentary time and glucose levels differed by GDM status.ResultsTotal sedentary time (hours/day) was not associated with incident GDM (OR 1.00 (95%CI 1.00, 1.01)). The association between total sedentary time and glucose levels depended on GDM status: sedentary time was associated with fasting (β = 0.16 (95%CI 0.01, 0.31)) and 2-h (β = 0.15 (95%CI 0.01, 0.30)) glucose levels for those without GDM, while breaks in sedentary time were associated with lower fasting (β = − 0.55 (95%CI – 0.92, − 0.17)) and 2-h (β = − 0.40 (95%CI - 0.77, − 0.03)) glucose levels for those with GDM. Prolonged sedentary time was associated with higher fasting glucose levels regardless of GDM status (β 0.15 (0.01, 0.30)). Television time was associated with development of GDM (OR 3.03 (95%CI 1.21, 7.96)) but not with plasma glucose levels.ConclusionsThis is the first study to test associations between posture-based measures of sedentary time during pregnancy and GDM and glucose levels. The findings presented here suggest the possible importance of minimizing or breaking up sedentary time for the management of glucose levels during pregnancy, at least among women at high risk of GDM. Further research is needed to understand the different roles of total sedentary time and television time in the development of GDM.

Maintenance of physical activity and sedentary behavior change, and physical activity and sedentary behavior change after an abridged intervention: Secondary outcomes from the ACTIVATE Trial

This brief report examines the maintenance of moderate to vigorous physical activity (MVPA) and sedentary behavior changes approximately 12weeks after the delivery of the ACTIVATE Trial primary intervention (use of the Garmin Vivofit 2 activity tracker coupled with a behavioral feedback and goal-setting session and 5 telephone-delivered health coaching sessions). We also examine the efficacy of an abridged intervention (use of the Garmin Vivofit 2 only) in the waitlist control group. A pre-post design was employed to examine the secondary aims of the ACTIVATE Trial (n=80; mean age=62years). MVPA and sedentary behavior were measured using Actigraph and activPAL accelerometers after delivery of the primary intervention (T2), and again 12weeks later (T3). Linear mixed models with random effects were used to examine within-group changes in MVPA and sitting time variables. After the 12-week follow-up period, women in the primary intervention group had maintained their higher levels of MVPA (change from T2 to T3=14min/wk; 95% CI=-18 to 46; P=.37). However, their sitting time increased slightly, by 7min/d (95% CI=-20 to 34; P=.58), but it did not return to its preintervention level. After receiving the Garmin Vivofit 2, the waitlist control group increased their MVPA by 33min/wk (95% CI=3-64; P=.03) and reduced their sitting time by 38min/d (95% CI=-69 to -7; P=.02) over the same 12-week period. The secondary outcomes from the ACTIVATE Trial suggest that wearable technology may generate sustainable changes in MVPA and sitting time. Wearable technology alone may be sufficient to change behavior, at least in the short term.

A randomized controlled trial of a wearable technology-based intervention for increasing moderate to vigorous physical activity and reducing sedentary behavior in breast cancer survivors: The ACTIVATE Trial.

The benefits of an active lifestyle after a breast cancer diagnosis are well recognized, but the majority of survivors are insufficiently active. The ACTIVATE Trial examined the efficacy of an intervention (use of the Garmin Vivofit 2 activity monitor coupled with a behavioral feedback and goal-setting session and 5 telephone-delivered health coaching sessions) to increase moderate to vigorous physical activity (MVPA) and reduce sedentary behavior in breast cancer survivors. This randomized controlled trial recruited 83 inactive, postmenopausal women diagnosed with stage I-III breast cancer who had completed primary treatment. Participants were randomly assigned to the intervention group or to the control group, and the intervention was delivered over a 12-week period. MVPA and sedentary behavior were measured with Actigraph and activPAL accelerometers at baseline (T1) and at the end of the intervention (T2). Retention in the trial was high, with 80 (96%) of participants completing T2 data collection. At T2, there was a significant between-group difference in MVPA (69min/wk; 95% CI=22-116) favoring the intervention group. The trial resulted in a statistically significant decrease in both total sitting time and prolonged bouts (≥20min) of sitting, with between-group reductions of 37min/d (95% CI=-72 to -2) and 42min/d (95% CI=-83 to -2), respectively, favoring the intervention group. Results from the ACTIVATE Trial suggest that the use of wearable technology presents an inexpensive and scalable opportunity to facilitate more active lifestyles for cancer survivors. Whether or not such wearable technology-based interventions can create sustainable behavioral change should be the subject of future research.

Within-day time-varying associations between motivation and movement-related behaviors in older adults

ObjectivesEmerging evidence suggests both motivation and movement-related behaviors vary within and across days. Yet common data analytic approaches assume static or consistent relationships between motivation and behavior across time. Just as motivation and behavior change across time, so too might associations between motivation and behavior. This study will apply time-varying effect modeling to Ecological Momentary Assessment (EMA) data to examine time of day differences in how motivational constructs predict older adults’ subsequent movement-related behavior over the next 2 h. DesignOlder adults (n = 104) completed a 10-day EMA protocol. MethodParticipants answered up to 6 EMA prompts/day to assess momentary intentions and self-efficacy to stand or move as well as intentions and self-efficacy to limit sedentary time over the next 2 h. Participants wore an activPAL accelerometer continuously to measure time spent being upright (i.e., standing or moving) and time spent sitting. ResultsOn weekdays, intentions and self-efficacy were generally predictive of subsequent behavior in the expected direction over the majority of the day whereas these constructs predicted subsequent behavior in the expected directions over a smaller range of times on weekend days. ConclusionsThis study adds to emerging evidence that associations between motivational constructs and subsequent behavior change over the course of the day, but these time-varying associations may be different depending on the day of week. This work has implications for intervention design and the timing of intervention content delivery in approaches like just-in-time adaptive interventions.

SAT-096 Later Timing of Energy Intake Associates with Higher Fat Mass in Adults with Overweight and Obesity

Background Emerging literature suggests that later timing of energy intake and sleep are related to obesity (1-3). However, few studies have assessed both meal and sleep timing in adults with obesity, and it is not clear whether eating later in the day is associated with shorter sleep duration or higher adiposity. Understanding whether temporal feeding and sleep patterns are associated with body composition will help in the design of novel weight loss and maintenance interventions aimed at altering the timing of lifestyle behaviors. Methods Thirty-two overweight and obese adults (90% female sex, age 36.4±6.4 years, and BMI=33.4±5.5 kg/m2) were recruited to participate in an ongoing weight loss trial comparing daily caloric restriction to time-restricted feeding. Participants simultaneously wore an activPAL accelerometer on the thigh and an Actiwatch on the non-dominant wrist for 7 days in a free-living environment to assess waking sedentary behavior and nighttime sleep, respectively. A cell phone application (MealLogger) was used to photograph and timestamp all caloric events during the 7-day period to determine daily feeding duration, which was verified using a continuous glucose monitor. Assessments were performed at baseline and will be repeated at 12 weeks following completion of the weight loss intervention. Correlation analyses were performed on baseline data to determine associations among the duration and timing of daily energy intake and sleep. Results are reported as mean±SD. Results On average, participants consumed energy over 11.0±1.9 hours during the day and slept for 7.2±0.7 hours at night. The clock time of the last caloric event averaged 7:54pm ± 93 min. Later meal timing (midpoint of the feeding window) was positively correlated with later sleep timing (midpoint of the sleep window, r = 0.67, P = <0.0001) but did not impact sleep duration. A later feeding midpoint correlated with higher BMI (r = 0.49, P = 0.005) and fat mass (r = 0.55, P = 0.001). Conclusions We used a novel set of methods to show that individuals with overweight and obesity may be eating later into the day. In addition, later meal timing was associated with higher BMI and fat mass. Future studies are needed to compare the timing of energy intake and sleep in normal weight versus obese individuals. These findings support ongoing studies by our group investigating whether restricting energy intake to the early part of the day lowers obesity risk. References (1) McHill et al., Am J Clin Nutr. 2017 Nov;106(5):1213-1219. (2) Baron et al., Obesity (Silver Spring). 2011 Jul;19(7):1374-81. (3) Garaulet, Gomez-Abellan, Physiol Behav. 2014 Jul;134:44-50. Sources of Research Support: This research has received funding from the NIH

Flexible learning spaces reduce sedentary time in adolescents

ObjectivesMany schools internationally are replacing traditional classrooms (TC) with innovative flexible learning spaces (FLS) to improve academic outcomes. Via a stealth approach, there may be additional unintended health benefits if students reduce their total and prolonged sitting. The aim of this study was to compare student sitting patterns between TC and FLS. DesignSchool-based cross-over trial. MethodsStudents at nine secondary schools (n=191, M age=13.2±1.0years) wore activPAL accelerometers in both a traditionally furnished and arranged classroom (TC), and a FLS containing a variety of furniture and layout options, utilizing student-centered pedagogies, for the duration of one double classroom lesson (M=76min). The lesson content and teacher were consistent across both conditions. Data were analyzed using multilevel mixed-effects linear regression. ResultsIn FLS, students spent less class time sitting (mean=18%; 95% CI: −20.8, −15.0), and accumulated more breaks in sitting (2.1; 95% CI: 0.8, 3.5 per 60min), more bouts of intermittent (≤9min) sitting (2.2; 95% CI: 0.8, 3.6 per 60min), and fewer bouts of prolonged (≤30min) sitting (−0.2; 95% CI: −0.3, −0.1 per 60min), than in TC. Students also spent more class time standing (15%; 95% CI: 12.7, 18.0) and stepping (3%; 95% CI: 2.0, 3.1) in FLS than TC. ConclusionThe results suggest that, by stealth, elements of FLS including a variety of furniture and resources, and greater use of student-centered pedagogies, facilitate improvements in adolescents’ sedentary profiles during class time. This may translate into beneficial health impacts over a longer period given the health benefits of reducing total and breaking up prolonged sitting.

The Effect of Interrupting Sedentary Behavior on the Cardiometabolic Health of Adults With Sedentary Occupations: A Pilot Study.

The aim of this study was to determine whether mobile phone text messages could modify objectively measured sedentary behavior and cardiometabolic health in office workers. Nine males and 12 females [mean (SD): 27.5 (5.7) years, 23.8 (2.8) kg/m] were assigned to a control (CON) or intervention (PROMPT) group. PROMPT received an activity-promoting text message during office hours. Participants wore an actiGraph and activPAL accelerometer for 7 days during and after the intervention. Blood pressure, lipid, and metabolic profiles were measured before and after the intervention. PROMPT sat less [mean (95% confidence interval, 95% CI): 4.9 (4.4 to 5.4) hours/day] than CON [6.0 (5.5 to 6.4) hours/day; P = 0.04] during the message-receiving period. There was no difference between groups after the intervention and for the other activity variables. There were no changes in cardiometabolic health markers following the intervention. Sitting time was lower during the message-receiving period, but the difference between groups was no longer apparent after the intervention.

Feasibility, acceptability, and potential efficacy of a childcare-based intervention to reduce sitting time among pre-schoolers: A pilot randomised controlled trial

ABSTRACTThe aim of this study was to test the feasibility, acceptability and potential efficacy of a childcare-based intervention to reduce total and prolonged sitting time in pre-schoolers. Four centres and 115 pre-schoolers (44 % boys; 4.1y) participated in a 3-month, 2-arm pilot cluster randomised controlled trial. Feasibility and acceptability were assessed through observations and semi-structured interviews. Sitting time, and breaks and bouts of sitting during childcare were assessed using an activPAL accelerometer over a one-week period at pre- and post-test (12wks). EF (inhibition, working memory and shifting) was assessed using the Early Years Toolbox. Intervention fidelity was high for both intervention centres (77 % vs 70 %) and educators reacted positively to the intervention. Proportion of sitting time per day reduced significantly at post-test in both intervention (−5.3%/day,[2.13, 8.50]) and control centres (−6.45 %,[4.20, 8.71]), resulting in a non- significant between-group difference (p = 0.51[2.4, 4.9]). EF scores did not significantly differ between groups (p > 0.05). Modifications to the childcare environment to reducing sitting, particularly the standing workstations, were feasible and acceptable to educators and children. No differences in sitting time between groups were seen; additional changes and longer-term trials are needed to reduce sitting time in pre-schoolers.

Occupational Physical Activity Habits of UK Office Workers: Cross-Sectional Data from the Active Buildings Study.

Habitual behaviours are learned responses that are triggered automatically by associated environmental cues. The unvarying nature of most workplace settings makes workplace physical activity a prime candidate for a habitual behaviour, yet the role of habit strength in occupational physical activity has not been investigated. Aims of the present study were to: (i) document occupational physical activity habit strength; and (ii) investigate associations between occupational activity habit strength and occupational physical activity levels. A sample of UK office-based workers (n = 116; 53% female, median age 40 years, SD 10.52) was fitted with activPAL accelerometers worn for 24 h on five consecutive days, providing an objective measure of occupational step counts, stepping time, sitting time, standing time and sit-to-stand transitions. A self-report index measured the automaticity of two occupational physical activities (“being active” (e.g., walking to printers and coffee machines) and “stair climbing”). Adjusted linear regression models investigated the association between occupational activity habit strength and objectively-measured occupational step counts, stepping time, sitting time, standing time and sit-to-stand transitions. Eighty-one per cent of the sample reported habits for “being active”, and 62% reported habits for “stair climbing”. In adjusted models, reported habit strength for “being active” were positively associated with average occupational sit-to-stand transitions per hour (B = 0.340, 95% CI: 0.053 to 0.627, p = 0.021). “Stair climbing” habit strength was unexpectedly negatively associated with average hourly stepping time (B = −0.01, 95% CI: −0.01 to −0.00, p = 0.006) and average hourly occupational step count (B = −38.34, 95% CI: −72.81 to −3.88, p = 0.030), which may reflect that people with stronger stair-climbing habits compensate by walking fewer steps overall. Results suggest that stair-climbing and office-based occupational activity can be habitual. Interventions might fruitfully promote habitual workplace activity, although, in light of potential compensation effects, such interventions should perhaps focus on promoting moderate-intensity activity.

Associations between the Objectively Measured Office Environment and Workplace Step Count and Sitting Time: Cross-Sectional Analyses from the Active Buildings Study.

Office-based workers spend a large proportion of the day sitting and tend to have low overall activity levels. Despite some evidence that features of the external physical environment are associated with physical activity, little is known about the influence of the spatial layout of the internal environment on movement, and the majority of data use self-report. This study investigated associations between objectively-measured sitting time and activity levels and the spatial layout of office floors in a sample of UK office-based workers. Participants wore activPAL accelerometers for at least three consecutive workdays. Primary outcomes were steps and proportion of sitting time per working hour. Primary exposures were office spatial layout, which was objectively-measured by deriving key spatial variables: ‘distance from each workstation to key office destinations’, ‘distance from participant’s workstation to all other workstations’, ‘visibility of co-workers’, and workstation ‘closeness’. 131 participants from 10 organisations were included. Fifty-four per cent were female, 81% were white, and the majority had a managerial or professional role (72%) in their organisation. The average proportion of the working hour spent sitting was 0.7 (SD 0.15); participants took on average 444 (SD 210) steps per working hour. Models adjusted for confounders revealed significant negative associations between step count and distance from each workstation to all other office destinations (e.g., B = −4.66, 95% CI: −8.12, −1.12, p < 0.01) and nearest office destinations (e.g., B = −6.45, 95% CI: −11.88, −0.41, p < 0.05) and visibility of workstations when standing (B = −2.35, 95% CI: −3.53, −1.18, p < 0.001). The magnitude of these associations was small. There were no associations between spatial variables and sitting time per work hour. Contrary to our hypothesis, the further participants were from office destinations the less they walked, suggesting that changing the relative distance between workstations and other destinations on the same floor may not be the most fruitful target for promoting walking and reducing sitting in the workplace. However, reported effect sizes were very small and based on cross-sectional analyses. The approaches developed in this study could be applied to other office buildings to establish whether a specific office typology may yield more promising results.

Change in activity following administration of a lateral wedge insole: analysis from the Inrespond trial

Change in activity following administration of a lateral wedge insole: analysis from the Inrespond trial

Effect of Employment Status on Physical Activity and Sedentary Behavior Long-Term Post-Bariatric Surgery.

Inactivity and weight regain are serious problems post-bariatric surgery. Nearly half of waking time is spent at work, representing an opportunity to accumulate physical activity and help avoid weight regain. The purpose of this study is to evaluate potential differences in physical activity and sedentary time by employment status post-bariatric surgery. A total of 48 adults (employed (n= 19), unemployed (n= 29)) aged 50.7 ± 9.4years, BMI = 34.4 ± 10.1kg/m2, and 10 ± 3years post-surgery participated. ActivPAL accelerometers measured transitions, steps, and sedentary time for 7days. Participants worked on average 8.7 ± 1.8h/day. Twenty-one percent of employed met step/day guidelines on work-days compared to 10% of unemployed. Employed persons transitioned from sitting-to-standing more on work-days (58.6 ± 17.8) than unemployed (45.0 ± 15.4). Employment status did not influence activity or sedentarism on weekend/non-working-days. Employment status may be associated with meaningful improvements in activity post-bariatric surgery.