Average Metabolic Equivalents Research Articles

The Relationship Between Metabolic Syndrome with Physical Activity and Eating Habits: The Result of the Tabari Cohort Study

Background: Metabolic syndrome (MetS) is a group of metabolic issues that increase the risk of type 2 diabetes and heart disease. Objectives: To reduce deaths from type 2 diabetes and heart disease, this study was conducted to determine the relationship between metabolic syndrome, physical activity, and eating habits in participants of the Tabari cohort study. Methods: In this descriptive cross-sectional study, data from the Tabari cohort in an urban and mountain area in Sari, Mazandaran, was utilized from June 2015 to November 2017. Background information of participants was documented, and their eating habits were assessed using a food habit questionnaire. Additionally, the physical activity levels of the participants were recorded. All individuals were assessed for metabolic syndrome according to the third Adult Treatment Panel (ATP III) guidelines. The gathered data was then inputted into SPSS V.23 software for analysis. Qualitative variables, such as demographic and epidemiological data, were compared between the two groups using the chi-square test, while quantitative variables were compared using an independent t-test. Results: A total of 10,255 adults between the ages of 35 and 70 participated in this study, and after applying entry and exit criteria, 9,976 people, including 4,083 with metabolic syndrome and 5,893 healthy individuals, were included in the final analysis. There was no significant difference in the average Body Mass Index (BMI) between individuals with metabolic syndrome (30.6 ± 4.5 kg/m²) and healthy individuals (26.8 ± 4.4 kg/m²). However, individuals with metabolic syndrome exhibited significantly higher values for height, weight, waist circumference, abdominal circumference, and wrist circumference compared to the control group (P = 0.001). The average Metabolic Equivalent of Task (MET) for the entire population was 43.03 ± 9.27, with a median of 40.68 (range: Twenty-four-one hundred three) hours/day. A greater percentage of individuals with metabolic syndrome (57.0%) and healthy individuals (45.2%) had MET values below the average (P = 0.001). Regarding energy intake, individuals with metabolic syndrome consumed an average of 2189.74 ± 721.90 calories, while healthy individuals consumed 2354.92 ± 4.04 calories, showing a significant difference (P = 0.006). Moreover, healthy individuals demonstrated significantly higher consumption of added salt in food, fried foods, fried potatoes, fried onions, fried vegetables, and various types of cooking oils compared to those with metabolic syndrome (P = 0.001). Conclusions: Based on the results of the Tabari cohort study, the prevalence of metabolic syndrome in Mazandaran was 41.10%, highlighting the need for prevention and screening programs. In this study, individuals with metabolic syndrome consumed fewer fried foods, trans fats, and daily calories compared to the healthy group. Considering that this study is cross-sectional and utilized data from the Tabari cohort, it is assumed that the difference is due to dietary compliance and lifestyle changes in patients with metabolic syndrome. It is recommended that prospective studies be designed to evaluate the causes of differences in metabolic syndrome components between the two groups.

Physical therapist burden delivering gait training for a patient with lateropulsion after stroke during inpatient rehabilitation: a single-case design

Background/Aims Gait training for patients with lateropulsion after stroke improves outcomes (eg reduced lateropulsion and improved function) but can be burdensome on the physical therapist. This study describes the physical therapist burden and performance of a patient with moderate lateropulsion during three gait training approaches during inpatient rehabilitation. Methods A physical therapist delivered gait training (one session each of overground robotic exoskeleton, overground supported walking, and body weight-supported treadmill training) for a patient with lateropulsion (scoring 8 out of 17 on the Burke Lateropulsion Scale). Outcomes were physiological burden (heart rate, metabolic equivalents, respiratory exchange ratio and energy expenditure), which were measured via a wearable metabolic system and perceptual burden (National Aeronautics and Space Administration Task Load Index) on the physical therapist. Patient performance (step count, time walking, time spent upright and time in moderate-to-vigorous intensity) was recorded. Results During overground robotic exoskeleton gait training, the physical therapist's physiological metrics included an average heart rate of 116 beats per minute (minimum–maximum: 98–127, time in moderate-to-vigorous intensity was 0%), average metabolic equivalents of 3.2 (minimum–maximum: 1.7–4.3), a respiratory exchange ratio of 0.79 (minimum–maximum: 0.70–0.93), an energy expenditure of 228 kcal/hour and a perceptual burden of 33.3. The patient walked 228 steps, spent 15.4 minutes upright, 8.7 minutes walking and achieved 0% in moderate-to-vigorous intensity. During overground supported walking, the physical therapist's metrics included an average heart rate of 145 beats per minute (minimum–maximum: 113–164, time in moderate-to-vigorous intensity was 87%), average metabolic equivalents of 4.7 (minimum–maximum: 2.7–6.0), a respiratory exchange ratio of 0.96 (minimum–maximum: 0.81–1.16), an energy expenditure of 343 kcal/hour and a perceptual burden of 60.8. The patient walked 588 steps, spent 19.6 minutes upright, 10.5 minutes walking and achieved 38% in moderate-to-vigorous intensity. During body weight-supported treadmill training, the physical therapist's metrics included an average heart rate of 112 beats per minute (minimum–maximum: 69–137, time in moderate-to-vigorous intensity was 34%), average metabolic equivalents of 3.9 (minimum–maximum: 3.2–4.4), a respiratory exchange ratio of 0.89 (minimum–maximum: 0.82–0.95), an energy expenditure of 281 kcal/hour and a perceptual burden of 32.5. The patient walked 682 steps, spent 16.0 minutes upright, 10.0 minutes walking and achieved 0% in moderate-to-vigorous intensity. Conclusions As concordance between physical therapist burden and patient gait performance was low in this study, future efforts to identify gait training approaches that minimise therapist burden while maximising outcomes for the patient with lateropulsion are necessary for the health of both. Implications for practice Physical therapists may consider advanced technology use such as overground robotic exoskeletons to reduce the burden during the provision of gait training for patients with lateropulsion. Gait training performance of patients with lateropulsion may vary across different gait training approaches with low correspondence to therapist burden.

The influence of accelerometer epoch length on physical activity output in adolescent athletes.

Epoch in accelerometer measurements is an important option that affects the results of physical activity (PA) analysis. Many studies have been conducted to investigate the effect of epoch on PA output in adolescents, but few have been performed on highly active youth athletes. We aimed to examine the differences in energy expenditure and time spent in different activity intensities by applying various epoch lengths in adolescent athletes. The participants of this study comprised 31 male athletes aged 12 to 13 in basketball, soccer, and taekwondo teams. Athletes wore a tri-axial accelerometer attached to the right hip for 6 to 7 consecutive days, including sleeping time. Subsequently, the recorded data from the accelerometer were downloaded using the ActiLife software and analyzed by varying the epoch to 1, 10, 30, and 60 sec. Daily average metabolic equivalents (METs) increased as the epoch increased (F=2.918, P=0.037), showing a significant difference between 1 and 60-sec epochs. As epoch length increased, sedentary (0-1.5 METs) (F=94.001, P=0.000) and high intensity (6 METs and higher) activity time (F=3.536, P=0.017) decreased, while low (1.5-3 METs) (F=173.949, P= 0.000), moderate (3-6 METs) (F=70.792, P=0.000), and moderate-to-vigorous activity (3 METs and higher intensity) (F=34.683, P=0.000) times increased. Comparing PA among adolescent athletes by varying epoch settings of accelerometers revealed differences in PA levels and time spent in different activity intensities. Future studies should consider the characteristic changes in the PA outputs according to the epoch length in very active adolescent athletes.

Lifetime occupational and recreational physical activity and risk of lymphoma subtypes. Results from the European Epilymph case-control study

Physical activity is known to convey protection against several cancers. However, results on the risk of lymphoma overall and its subtypes have been inconsistent. The aim of this study was to investigate occupational and recreational physical activity in relation to risk of lymphoma subtypes adjusting for established occupational risk factors. We applied standardized tools to assess energy expenditure at work and in recreational physical activities to the questionnaire information on lifetime work and exercise history in 1117 lymphoma cases, including Hodgkin lymphoma, and B-cell (including chronic lymphocytic leukemia, and multiple myeloma) and T-cell non-Hodgkin’s lymphoma (NHL) subtypes, and 1207 controls who took part in the multicentre European EpiLymph case-control study. We calculated the risk of lymphoma (all subtypes), B-cell NHL and its most represented subtypes, and Hodgkin’s lymphoma (all subtypes) associated with weekly average Metabolic Equivalent of Task (MET-hours/week) and cumulative MET-hours of lifetime recreational, occupational, and total physical activity, with unconditional logistic regression and polytomous regression analysis adjusting by age, centre, sex, education, body mass index, history of farm work and solvent use. We observed an inverse association of occupational, and total physical activity with risk of lymphoma (all subtypes), and B-cell non-Hodgkin’s lymphoma among women, and an upward trend in risk of Hodgkin’s lymphoma with recreational and total physical activity among men, for which we cannot exclude chance or bias. Our results suggest no effect of overall physical activity on risk of lymphoma and its subtypes.

Engagement in Physical Activity Improves after Participation in Pasos Para Prevenir Cancer-An Obesity-Related Cancer Prevention Program in El Paso, Texas.

Background: This present study experimentally evaluated the Pasos Para Prevenir Cancer (PPPC) program to determine whether participation was associated with improved physical activity engagement. Evidence suggests that obesity prevention programs improve physical activity (PA) engagement and lead to healthier weights, which substantially impacts cancer and cardiometabolic disease risk. There is a shortage of knowledge on the effectiveness of programs tailored to populations along the U.S.–Mexico border. Methods: We collected demographic, nutrition, and physical activity data at baseline, 6 months, and 12 months using the Research Electronic Data Capture (REDCap) for 209 participants. We analyzed the average metabolic equivalents (METS) per week for all physical activity levels and types and the achievement of the recommended METS per week to determine the demographic characteristics most associated with a change between baseline, 6 months, and 12 months. Results: Light activity was the most common activity at all three points, and it slightly increased at 6 months in work settings. Subjects conducted moderate physical activity primarily at home and work, and moderate physical activity increased more compared to vigorous physical activity. Conclusions: Intervention tailoring might improve PA engagement in Mexican Americans residing on the U.S.–Mexico border; however, larger studies that are more diverse are required.

Respiratory muscle strength, exercise capacity and physical activity in patients with primary ciliary dyskinesia: A cross-sectional study

Background and objectivesThe pathophysiological mechanisms of primary ciliary dyskinesia (PCD) may affect many functions, including respiratory, physical, and health status. This study aimed to compare respiratory muscle strength, inspiratory muscle endurance, muscle strength, exercise capacity, physical activity levels, and quality of life in PCD patients and controls. MethodsTwenty-seven patients and 28 controls were included. Respiratory muscle strength (maximal inspiratory (MIP) and maximal expiratory (MEP) pressures), inspiratory muscle endurance (incremental threshold loading test), muscle strength (quadriceps femoris, shoulder abductor, elbow flexor, handgrip), exercise capacity (6-min walk test (6MWT)), physical activity and quality of life (QOL-PCD) were evaluated. ResultsMIP, inspiratory muscle endurance, quadriceps femoris, and handgrip muscle strength, 6MWT distance, total energy expenditure; childrens' (6–12 years) and their parents' physical function, upper, lower respiratory, and hearing symptoms and treatment burden QOL-PCD subscales scores were significantly lower in patients compared with controls (p < 0.05). The 66.7% of patients did not meet the optimal number of steps. MEP, shoulder abductor, and elbow flexor muscle strength, active energy expenditure, physical activity duration, average metabolic equivalents, number of steps, lying time, and sleep duration; childrens' and their parents' other subscales and adolescents’ all QOL-PCD subscales scores were similar between groups (p > 0.05). ConclusionInspiratory muscle strength and endurance, lower extremity and total muscle strength, exercise capacity, total energy expenditure, and childrens’ quality of life are impaired compared to healthy controls. Decreased physical activity level is prevalent in these patients. Effects of pulmonary rehabilitation on these impaired outcomes for PCD patients should be investigated. Trial registrationClinicaltrials.gov: NCT03370029; December 12, 2017.

Comparison of modifiable risk factors for dementia among rural and urban elderly adults: Data from two cohorts in India

AbstractBackgroundModifiable risk factors for dementia such as, diabetes, hypertension, dyslipidemia, hyperhomocysteinemia and lack of physical exercise contribute significantly to the etiology of dementia. SANSCOG and TLSA are prospective, community‐based cohort studies of aging population to identify risk and protective factors for cognitive decline and Alzheimer’s disease among individuals more than 45 years of age from rural Srinivaspura and urban Bengaluru respectively, in the state of Karnataka, India.MethodWe have recruited 1860 and 464 participants in SANSCOG (rural cohort) and TLSA (urban cohort) respectively. We calculated prevalence of modifiable risk factors and chi square test was used to determine group difference between both cohorts.ResultThe mean age and year of education in SANSCOG was 58.2years and 4.34years respectively, while in TLSA it was 66.6years and 16.3years.There was a statistically significant (p&lt;0.001) difference in prevalence of chronic medical conditions between the groups with SANSCOG having low prevalence in hypertension, diabetes mellitus and hyperhomocysteinemia when compared to TLSA. However SANSCOG had high prevalence of dyslipidemia. The average metabolic equivalents (MET) as calculated from GPAQ for SANSCOG cohort was 5200, while it was 2500 for TLSA cohort.ConclusionThe rural cohort (SANSCOG) has less prevalence of hypertension, diabetes mellitus, and hyperhomocysteinemia, more physically active and higher prevalence of dyslipidemia when compared to urban cohort (TLSA).

Levels of Physical Activity Among Older Adults in the European Union.

The study aimed to ascertain the levels of older European people's physical activity according to sociodemographic variables. The sample size was 7,893 citizens aged 65 and over from the European Union. The participants were classified as physically inactive, adequately active, or highly active, according to the World Health Organization. The total metabolic equivalents of task minutes per week were also calculated. In the results, 55.5% of older people were adequately active, and 43.8% were highly active, especially in the North and West. The average metabolic equivalents of task minutes per week was 1,313 metabolic equivalents of task minutes, with walking as the main activity, followed by moderate physical activity and vigorous activity. Male older people of a lower age from the North and West, with a higher level of education and less difficulty in paying bills, were more likely to be physically active. As a conclusion, only slightly more than half the population were adequately active. These sociodemographic inequalities show the necessity of implementing specific measures.

Perilaku Aktivitas Fisik dan Determinannya pada Mahasiswa Fakultas Ilmu - Ilmu Kesehatan Universitas Muhammadiyah Prof. Dr. Hamka

ABSTRACT&#x0D; Based on data from the 2013 Basic Health Research (Riskesdas) groups of adolescents to young adults (15-24) have sedentary lifestyles (sedentary / lack of physical activity) of 52%. Lack of physical activity can lead to health risks especially the complications of non-communicable diseases such as obesity, diabetes, hypertension and heart problems. This study aims to determine the relationship of physical activity and its determinants. This study uses a quantitative method with a cross-sectional study design. A total of 846 FIKES UHAMKA students participated in this study. Data collected by filling out the questionnaire by students. Data analysis used the chi square test to determine the relationship between physical activity and its determinants and logistic regression to determine the predictors of physical activity. This study provides results that the average Metabolic Equivalent (MET) score is 1420.33 ± 2384.297. Respondents who have low physical activity by 47.8%, moderate physical activity by 39.6% and high physical activity by only 12.6% of respondents. There is a significant relationship between gender, work status, availability of sports facilities, lecturer support, and perception of sports on physical activity. Active physical activity is more common in male sex respondents, students who are already working, the availability of sports facilities at home or the surrounding environment, the invitation of lecturers to exercise and a good perception of sports. The results also showed that respondents who did not work, did not have sports facilities at home, and had a poor perception of sports were predictors of having passive / mild physical activity.&#x0D; Keywords : Perception, Attitude, Environment, Sports Facilities, Physical Activity of Students

Children’s metabolic expenditure during object projection skill performance: New insight for activity intensity relativity

ABSTRACTObjective: To examine children’s energy expenditure (EE) during object projection skill performance at three intensity intervals. Methods: Children’s (42, Mage = 8.1) average metabolic equivalents of task (METs) were calculated using a COSMED K4b2 while they repeatedly performed blocks of kicking, throwing (overhand), and striking (two-handed) during 6, 12, and 30-s interval conditions. A repeated-measures analysis of covariance examined differences in METs while controlling for skill level. Results: Data indicated a main effect for interval condition (df = 2, 123, F = 94.36, p <.001, η2 = .605). Post hoc t-tests demonstrated decreasing performance interval times yielded progressively higher METs (p <.001) across the three conditions (30s = 4.5±0.8 METs, 12s = 6.3±1.3, 6s = 8.3±1.6). There also was a main effect for sex (df = 1,120, F = 52.28, p <.001 η2 = .305). Boys demonstrated higher METs at each performance interval (p <.001). Conclusion: Skill practice with a maximum of one trial every 30s resulted in the equivalent of at least moderate physical activity (>4.0 METs) and intervals of 6s demonstrated vigorous physical activity (>7.0 METs). Practicing/performing object projection skills, even at intervals that allow for adequate instruction and feedback (i.e., 1 trial/30s), promotes MVPA in children.

Physical Activity Intensity and Cardiovascular Disease Prevention—From the Seguimiento Universidad de Navarra Study

The association between the intensity of physical activity and the incidence of cardiovascular diseases (CVD), irrespective of energy expenditure (EE), requires further study. Our objective is to examine this relationship using data from a large Spanish cohort. The Seguimiento Universidad de Navarra cohort is formed of university graduates recruited from March 1999 to October 2015. We included 18,737 adults free of CVD (mean age 38 years, 61% women), with a median follow-up of 10.3 years. We estimated the average intensity of leisure time physical activity (LTPA) using a validated questionnaire. We classified respondents into 3 groups: Inactive, <6 average metabolic equivalents (METs) and ≥6 average METs. We used Cox proportional hazards models adjusted by the EE in LTPA (MET-h/week) and other confounding factors, to examine this association. During 1,72,299 person-years of follow-up, we registered 127 cases of CVD (myocardial infarction, stroke, and death due to cardiovascular causes). The adjusted hazard ratio for CVD was 0.76 (95% CI 0.48 to 1.21) in the lower intensity group, and 0.31 (95% CI 0.12 to 0.79) in the higher intensity group, compared with the inactive, with a linear trend (p = 0.03). In conclusion, given the same level of EE, those respondents engaged in higher intensity LTPA, had a lower risk of CVD.

Exercise behaviors by ethnic group among patients with polycystic ovary syndrome

To characterize exercise behavior of patients with polycystic ovary syndrome (PCOS) by ethnicity. This was a cross-sectional assessment of women who attended a multidisciplinary PCOS clinic. Participants were recruited consecutively from 2006-2018 from a PCOS specialty clinic at a tertiary academic institution and systematically evaluated for demographic and anthropometric data. Exercise data were ascertained by the validated International Physical Activity Questionnaire, from which we calculated metabolic equivalents (METs) as the unit of energy expenditure. Threshold for adequate physical activity was defined by the guidelines published by the US Department of Health and Human Services (DHHS), either as 150 minutes a week of moderate-intensity, or 75 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Patients were divided into three groups based on their self-reported ethnicity (White, Hispanic, or East/Southeast Asian). Statistical analysis was performed with SAS 9.4, 32-bit edition. All testing was performed at the 0.05 level of significance. Of the 375 women evaluated, 71.7% (n = 269) were White, 17.6% (n = 66) were Hispanic, and 10.7% (n = 40) were East/Southeast (SE) Asian. The study population was notable for Hispanic patients having higher BMI (p < 0.01) and waist circumference (p < 0.01). Analysis of exercise data revealed differences in mean METs from vigorous activity (METvig) as well as mean total METs (moderate plus vigorous activity (METtotal)) between the 3 groups. These differences approach, but do not reach, statistical significance when controlled for age (p = 0.08 for METvig and p = 0.12 for METtotal). This trend is mainly attributed to differences in METvig and METtotal between East/SE Asian and White patients (paired p-values of 0.16 and 0.15, respectively), where East/SE Asian patients have less METvig and METtotal. The three ethnic groups also differ significantly in frequency of meeting threshold for adequate physical activity (p = 0.03). Hispanic patients were observed to be more likely to have inadequate physical activity compared to White patients (paired odds ratio of 1.58; 95% CI [1.04, 2.41], p = 0.03). We observed a trend for East/Southeast Asian patients to achieve the least amount of average metabolic equivalents from both vigorous activity and overall physical activity. Additionally, Hispanic patients were noted to be less likely to have adequate physical activity using a threshold approach. These observations could guide providers in delivering targeted counseling and encouragement when caring for PCOS patients from different backgrounds.

Physical activity and the risk of colorectal cancer in Lynch syndrome.

Greater physical activity is associated with a decrease in risk of colorectal cancer for the general population; however, little is known about its relationship with colorectal cancer risk in people with Lynch syndrome, carriers of inherited pathogenic mutations in genes affecting DNA mismatch repair (MMR). We studied a cohort of 2,042 MMR gene mutations carriers (n = 807, diagnosed with colorectal cancer), from the Colon Cancer Family Registry. Self-reported physical activity in three age-periods (20-29, 30-49 and ≥50 years) was summarized as average metabolic equivalent of task hours per week (MET-hr/week) during the age-period of cancer diagnosis or censoring (near-term exposure) and across all age-periods preceding cancer diagnosis or censoring (long-term exposure). Weighted Cox regression was used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) for the association between physical activity and colorectal cancer risk. Near-term physical activity was associated with a small reduction in the risk of colorectal cancer (HR ≥35 vs. <3.5 MET-hr/week, 0.71; 95% CI, 0.53-0.96). The strength and direction of associations were similar for long-term physical activity, although the associations were not nominally significant. Our results suggest that physical activity is inversely associated with the risk of colorectal cancer for people with Lynch syndrome; however, further confirmation is warranted. The potential modifying effect of physical activity on colorectal cancer risk in people with Lynch syndrome could be useful for risk prediction and support counseling advice for lifestyle modification to reduce cancer risk.

Validity of a triaxial accelerometer and simplified physical activity record in older adults aged 64-96years: a doubly labeled water study.

The aim was to examine the validity of a triaxial accelerometer (ACCTRI) and a simplified physical activity record (sPAR) in estimating total energy expenditure (TEE) and physical activity level (PAL) in older adults with the doubly labeled water (DLW) method. A total of 44 Japanese elderly individuals (64-96years), of which 28 were community-dwelling healthy adults with or without sporting habits (S or NS group) and 16 were care home residents with frailty (F group), were included in the study. Basal metabolic rate (BMR) was measured by indirect calorimetry, TEE was obtained by the DLW method, and PAL was calculated as TEE/BMR. Daily step count was monitored by a pedometer (Lifecorder). The 24-h average metabolic equivalent was assessed by ACCTRI and sPAR. The TEEDLW in men was 2704 ± 353, 2308 ± 442, and 1795 ± 338kcald-1, and that in women was 2260 ± 208, 1922 ± 285, and 1421 ± 274kcald-1 for the S, NS, and F groups, respectively. ACCTRI and sPAR systematically underestimated actual TEE (- 14.2 ± 11.6 and - 15.3 ± 12.3% for ACCTRI and sPAR, respectively). After diet-induced thermogenesis was taken into account for ACCTRI and sPAR, TEEDLW was significantly correlated with TEEACCTRI (R2 = 0.714) and TEEsPAR (R2 = 0.668). PALDLW was also significantly correlated with PALACCTRI (R2 = 0.438) and PALsPAR (R2 = 0.402). Age, living conditions, frailty, and sporting habits contribute to TEE and PAL in the elderly population. ACCTRI and sPAR underestimated TEE and PAL, and adequate corrections are required. The corrected ACCTRI and sPAR are both useful tools to estimate TEE and PAL.

The First Dedicated Cardiac Rehabilitation Program for Patients With Spontaneous Coronary Artery Dissection: Description and Initial Results

BackgroundSpontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction in women, but the role of rehabilitation after SCAD is unclear. MethodsWe designed a dedicated SCAD cardiac rehabilitation (SCAD-CR) program for our SCAD survivors at Vancouver General Hospital. This program encompasses a multidisciplinary approach including exercise rehabilitation, psychosocial counselling, dietary and cardiovascular disease education, and peer group support. Exercise and educational classes were scheduled weekly with a targeted participation of 6 months. Psychosocial counselling, mindful living sessions, social worker and psychiatry evaluations, and peer-group support were offered. ResultsWe report our first consecutive cohort of 70 SCAD women who joined SCAD-CR from November 2011 to April 2015. The average age was 52.3 ± 8.4 years. Mean participation duration was 12.4 ± 10.5 weeks; 28 completed 6 months, 48 completed ≥ 1 month. At entry, 44 (62.9%) had recurrent chest pains and average metabolic equivalents on exercise treadmill test was 10.1 ± 3.3. At program exit, the proportion with recurrent chest pains was lower (37.1%) and average metabolic equivalents was higher 11.5 ± 3.5 (both P < 0.001). There was a significant improvement in the STOP-D depression questionnaire, with mean scores of 13.0 ± 1.4 before and 8.0 ± 1.7 after the SCAD-CR (P = 0.046). Twenty (28.6%) social worker referrals and 19 (27.1%) psychiatry referrals were made. Mean follow-up was 3.8 ± 2.9 years from the presenting SCAD event, and the major cardiac adverse event rate was 4.3%, lower than our non-SCAD-CR cohort (n = 145; 26.2%; P < 0.001). ConclusionsThis is the first dedicated SCAD-CR program to address the unique exercise and psychosocial needs of SCAD survivors. Our program appears safe and beneficial in improving chest pain, exercise capacity, psychosocial well-being and cardiovascular events.

152 Influencing factors of skeletal muscle weakness in adults with cystic fibrosis

Background Muscle weakness in cystic fibrosis (CF) is reported to be reduced. Influencing factors are still not well defined. Aim This study correlates muscle strength measurements: handgrip force (HGF), quadriceps force (QF) and 6 minute walking distance (6MWD) in adult CF patients with physical activity (PA), pulmonary function and decline, colonization status, and number of hospitalization over the past year. Methods A handheld dynamometer (HHD) was used for HGF, a knee shuttle with HHD for the isometric voluntary QF and a standard 6MWD was performed. Results are expressed as % of normal. PA is measured using Sensewear Pro® armband [Moderate PA (mPA) = 4.8–7.2 metabolic equivalents (MET), vigorous PA (vPA) MET >7.2). Pulmonary function (FVC%, FEV1%) and number of hospitalization were retrieved from the medical file. Results are given as median (interquartile range). Results 31 patients (aged 25 (22–33)years) (12 female(38.7%))(12 chronically colonized(38.7%)) with a FEV1% of 75.4(57–84.7)% participated. Muscle strength was not related to pulmonary function or pulmonary function decline or pseudomonas colonization. 21 patients measured PA. They had an average MET of 1.7 (1.55–2.1), a mPA of 26′/day (19–68.5) and a m-vPA of 40′/day (22–98). The 6MWD was 72.7% (66.9–77.8), the QF% was 46% (40.2–57.4) and the HGF 97.4% (79.8–106.5). Pseudomonas negative patients were more PA (p = 0.034). None of the muscle strength measurements correlated with the PA. The number of hospitalizations correlated with the QF (p = 0.001), the HGF (p = 0.0001) and 6MWD (p = 0.007). Conclusion Muscle weakness in CF was only influenced by the number of hospitalizations over the past year.

Differences Among Exergaming Platforms and Traditional Physical Activity on MET’s and Estimated Energy Expenditure

Unfavorable prevalence of obesity increases the need for effective modes of energy expenditure in adults. Limited research has explored the differences among a variety of active video-gaming platforms and traditional modes of physical activity (PA) on energy expenditure. PURPOSE: The purpose of this study was to examine the differences among three active video-game platforms (PlayStation 3, Xbox 360, Wii Fit) and traditional modes of PA on average metabolic equivalents (METs) and estimated Energy Expenditure (EER) in adults. METHODS: Data were collected on a total of 421 adults recruited from the Mountain West region of the US. Participants engaged in different modes of PA for 30 minutes. Participants engaged in PlayStation 3, Xbox 360, Wii Fit video-gaming activities, or traditional (non-video game) modes of PA. Each participant’s PA data were collected using the Sense Wear armband accelerometer that was worn on the upper left arm. Average MET’s and EER (in kcals/min) were collected during each PA mode. A one-way MANOVA was employed to test the differences among PA modes on the average MET and EER dependent variables. Follow-up ANOVA tests with alpha level correction and discriminant function analysis were performed after the statistically significant multivariate main effect. RESULTS: A significant multivariate main effect was yielded for PA mode (Pillai’s Trace = 0.17, F(6, 834) = 13.14, P < .001). Follow-up ANOVA tests yielded separate significant main effects on METs (F(3, 417) = 25.60, P < .01) and EER (F(3, 417) =25.60, P <.01). Bonferroni post hoc tests revealed that Traditional PA had a 0.60 to 1.50 average greater MET score compared to all other active video-gaming modes (P < .001) and a 1.42 kcal/min to 2.31 kcal/min greater EER compared to the active video-gaming modes. DFA confirmed these results with a function explaining 17.1% of shared variance (χ2 (6) = 78.92, P < .001 RC = 0.41) and Group Centroids of −4.77 for PlayStation3, 0.22 for Xbox 360, −5.40 for the Wii, and 6.70 for Traditional PA. CONCLUSIONS: The results show that Traditional modes of PA had higher average METs and EER after 30 minutes of activity compared to active video gaming in adults and therefore may have greater utility for achieving higher caloric deficits.

Exercise during pregnancy and its association with gestational weight gain.

We examined the association between exercise during pregnancy and meeting gestational weight gain recommendations. Data came from the 2009 South Carolina Pregnancy Risk Assessment Monitoring System (n = 856). Women reported their participation in exercise/sports activities before and during pregnancy, including the number of months and types of exercise. We developed an exercise index (EI), the product of the number of months spent in exercise and average metabolic equivalents for specific exercise. The 2009 Institute of Medicine's guideline was used to categorize gestational weight gain into three classes: inadequate, adequate, and excessive. Multinomial logistic regression models were used to adjust for confounders. Over 46 % of women exceeded the recommended weight gain during pregnancy. Nearly one third (31.9 %) of women reported exercising ≥3 times a week at any time during pregnancy. Compared to women who did not report this level of exercise during pregnancy, exercising women were more likely to meet gestational weight gain recommendations (32.7 vs. 18.7 %) and had a lower odds of excessive gestational weight gain [adjusted odds ratio (AOR) 0.43, 95 % confidence interval 0.24-0.78]. Women with an EI above the median value of those women who exercised or women who exercised ≥3 times a week for 6-9 months during pregnancy had lower odds of excessive gestational weight gain (AOR for EI 0.20, 0.08-0.49; AOR for months 0.26, 0.12-0.56, respectively). Our findings support the need to promote or increase exercise during pregnancy to reduce the high proportion of women who are gaining excessive weight.

Investigating the circulatory-respiratory response of elderly people during Tai Chi Yuttari-exercise

The purpose of this study was to examine the circulatory-respiratory dynamics in elderly people during Tai Chi Yuttari-exercise. The subjects were females with an average age of 74 years who had been continuously practicing Tai Chi Yuttari-exercise for at least six months. The heart rate and blood pressure were measured before and after the subjects performed four different versions of Tai Chi Yuttari-exercise. The perceived exertion was evaluated using the Borg scale. The respiratory rate, oxygen uptake and respiratory quotient (RQ) were measured using an expired gas analyzer. The results showed an increase in heart rate during exercise, but confirmed that the rise in HR was below the safety limit. The blood pressure tended to be low post-exercise. Regarding perceived exertion, the maximum heart-lungs Borg scale response was 9 (very light). A slight increase in the respiratory rate was observed while exercising, but no abnormal breathing patterns were observed. The average metabolic equivalents (METs) of the exercise ranged from 1.34 to 1.87, and the average RQ ranged from 0.82 to 0.90. The circulatory-respiratory dynamics observed in this study verified that elderly females with an average age of 70 years could safely perform the Tai Chi Yuttari-exercise. This study helped obtain basic data for expanding the indications for this exercise.

Does Physical Activity During Pregnancy Reduce the Risk of Gestational Diabetes among Previously Inactive Women?

Gestational diabetes affects approximately 7 percent of all pregnancies in the United States; its prevalence may have increased among all ethnic groups since the early 1990 s. Our study examined whether physical activity during pregnancy reduced the risk of gestational diabetes among women who were physically inactive before pregnancy. We used data from the 1988 National Maternal and Infant Health Survey (NMIHS), a nationally representative sample of mothers with live births. The NMIHS obtained mothers' gestational diabetes diagnoses from care providers and mothers reported their physical activity before and during pregnancy, including the number of months with physical activity and types of physical activity. We developed a physical activity index, the product of the number of months with physical activity, and average metabolic equivalents for specific activities. The analysis included 4,813 women who reported being physically inactive before pregnancy, with singleton births and no previous diabetes diagnosis. Gestational diabetes was diagnosed in 3.5 percent of the weighted sample in 1988. About 11.8 percent of these previously inactive women began physical activity during pregnancy. Women who became physically active had 57 percent lower adjusted odds of developing gestational diabetes than those who remained inactive (OR 0.43, 95% CI 0.20-0.93). Women who had done brisk walking during pregnancy had a lower adjusted risk of gestational diabetes (OR 0.44, CI 0.19-1.02) and women with a physical activity index score above the median had 62 percent lower odds of developing gestational diabetes than the inactive women (CI 0.15-0.96). Results suggest that physical activity during pregnancy is associated with lower risk for gestational diabetes among previously inactive women.