Bouts Of Moderate-vigorous Physical Activity Research Articles

Physical Activity, Inactivity and Sleep in Individuals with Hypertrophic Cardiomyopathy.

Physical activity presents an important cornerstone in the management and care of individuals with hypertrophic cardiomyopathy (HCM). Twenty-one individuals with HCM (age: 52±15 years old, body mass index (BMI): 30±7 kg/m2) completed 7-day monitoring using wrist-worn triaxial accelerometers (GENEActiv, ActivInsights Ltd, UK) and were compared to age and sex-matched healthy controls (age: 51±14 years old, BMI: 25±4 kg/m2). For individuals with HCM, clinical parameters (left atrial diameter and volume, peak oxygen consumption, NTproBNP and Minnesota Living with Heart Failure (MLHF)) were correlated with accelerometry. After adjusting for BMI, individuals with HCM spent less time in moderate-vigorous physical activity (MVPA) (86 (55-138) vs. 140 (121-149) minutes/day, p<0.05) compared to healthy controls. Individuals with HCM engaged in fewer MVPA-5 min (6 (2-15) vs. 27 (23-37) minutes/day, p<0.01) and MVPA-10 min bouts (9 (0-19) vs. 35 (17-54) minutes/day, p<0.01) versus healthy controls. For HCM only, peak oxygen consumption was correlated with MVPA (r=0.60, p<0.01) and MVPA-5 min bouts (r=0.47, p<0.05). MLHF score was correlated with sleep duration (r=0.45, p<0.05). Individuals with HCM should be encouraged to engage in moderate-intensity physical activity bouts and reduce prolonged periods of inactivity in order to potentially improve exercise tolerance and reduce disease burden.

221Association of physical activity bout length and changing intensity with mortality in UK Biobank

Abstract Background Spending more time active (and less time sedentary) is associated with many health benefits but it is unclear whether these associations differ depending on whether time spent sedentary or in moderate-vigorous physical activity (MVPA) is accumulated in long or short bouts. We used a novel analytical approach to examine whether length of sedentary and MVPA bouts associates with all-cause mortality. Methods We used data on 79,507 participants from UK Biobank. We derived the total time participants spent in activity categories (sleep, sedentary, light activity and MVPA) and in sedentary and MVPA bouts of short (1-15 minutes), medium (16-40 minutes) and long (41+ minutes) duration, on average per day. We used Cox proportion hazards regression to estimate the association of spending 10 minutes more average daily time in one activity or bout length category, coupled with spending 10 minutes less time in another, with all-cause mortality. Results Those spending more time in MVPA had lower mortality risk, irrespective of whether this replaced time spent sleeping, sedentary or in light activity. We found little evidence to suggest that mortality risk differed depending on the length of sedentary or MVPA bouts. Conclusions We uniquely show that higher total MVPA improves health irrespective of whether it is obtained from several short bouts or fewer longer bouts, supporting recent policy changes in some countries. Key messages Our results suggest that time spent in MVPA associates with lower mortality risk irrespective of whether it is obtained from several short bouts or fewer longer bouts.

Adherence to physical activity and cardiovascular recommendations during the 2years after stroke rehabilitation discharge.

Objective measurement is essential to represent habitual physical activity. To date only one study has objectively measured physical activity for>12months after stroke. This study aimed to measure physical activity, cardiovascular risk factors, mobility, mood, fatigue and cognition during the 2years after rehabilitation discharge and to investigate whether stroke survivors meet physical activity and cardiovascular risk recommendations. This was a longitudinal observational study. Survivors of a first-ever stroke admitted to a large metropolitan rehabilitation hospital were recruited. Outcomes were measured at rehabilitation discharge and 6, 12 and 24months later. Outcomes were physical activity measured by the SenseWear Armband (e.g., moderate-vigorous physical activity, steps/day) and cardiovascular risk factors (e.g., blood pressure, fasting lipid profile and plasma glucose, waist circumference, body mass index), mobility, mood, fatigue and cognition. Changes over time were evaluated with random-effects regression modelling. Participants (n=79, 33% female) had mean (SD) age of 65 (14) years and median gait speed 1.2m/s (interquartile range: 0.8-1.4) at baseline. We found no change in physical activity levels over time. Step count and time spent in bouts of moderate-vigorous physical activity remained low. Many participants achieved the recommended 30min of daily moderate-vigorous physical activity at baseline, but this was decreased at 2years (72% [57/79] versus 65% [37/57]). Adherence to cardiovascular recommendations decreased over time, notably for body mass index, plasma glucose and triglyceride levels. Waist circumference and body mass index increased at each time point relative to baseline (by a mean of 3.2cm and 1.2kg.m2, respectively, at 2years, P<0.01). This is the largest longitudinal study of objectively measured physical activity after stroke. Adherence to cardiovascular risk recommendations decreased over time post-stroke, and physical activity levels remained low. Stroke survivors may benefit from annual multidisciplinary reviews to identify increasing risk and initiate appropriate interventions.

Academically Oriented Activity Breaks for First-Grade Chilean Students: Development and Pilot Testing Effectiveness.

We developed and pilot tested the effectiveness of a physically active academic program, Active Breaks (AB), whose objective is to increase school time moderate/vigorous physical activity (MVPA) among first graders, through daily 15-minute bouts of MVPA, at the beginning of the first lesson. Initially, 240 cards including one game each were developed and tested in first-grade students from 16 schools in Santiago. Trained observers and school teachers assessed the time, ease, and feasibility of implementation for each card. Barriers and facilitators to implementation were obtained from semistructured interviews to 14 teachers (out of 16). In eight schools (n = 556 students), we compared school time MVPA (with accelerometers) at baseline and follow-up, using test of proportions. One-hundred and twenty cards (games) complied with all aspects. AB were implemented 50% of the time with a duration of 14 minutes (SD = 5). More than 90% of the time, teachers felt competent to conduct AB, and children understood the instructions and enjoyed the activity. The main facilitators included teachers liking physical activity and considering it important, support of principal and school staff, and conducting AB inside the classroom. Barriers included teacher's workload and having to conduct AB during the first lesson. During the 4-month period of implementation, MVPA increased by 1.5 and 1.2 percentage points in boys and girls, respectively. The set of 120 cards is easy and feasible to implement. Moreover, preliminary results suggest they could be effective in increasing MVPA during school time, although studies with longer follow-ups are needed to assess the validity of these findings.

Association of sedentary time and physical activity levels with immunometabolic markers in early pregnancy: The GESTAFIT project.

To analyze the association of sedentary time and physical activity (PA) intensity levels with immunometabolic markers during early pregnancy; and to examine if meeting the PA recommendations is associated with the immunometabolic profile of pregnant women. Fifty Caucasian pregnant women (age: 32.8±4.7years old, body mass index: 24.2±4.1kg/m2 , gestational age: 17±1.5weeks) participated in this cross-sectional study (from September 2015 through May 2016). Sedentary time and PA intensity levels were objectively measured with triaxial accelerometer (seven consecutive valid days). Fasting serum glucose, total cholesterol, phospholipids, and triglycerides were assessed with standard methods. Serum pro-inflammatory and anti-inflammatory cytokines (fractalkine, interleukin-1β, interleukin-6, interleukin-8, interleukin-10, interferon-γ, and tumor necrosis factor-α) were measured using Luminex xMAP technology. Sedentary time and PA were not correlated with any glycemic or lipid marker (P>.05). After adjusting for the potential confounders, vigorous PA showed a positive non-significant association with interleukin-6 (P=.06), and bouts of moderate-vigorous PA was inversely associated with interleukin-1β and interferon-γ (P=.02 and P=.04, respectively). Meeting the PA guidelines was inversely associated with interleukin-1β and positively associated with interleukin-8 (P=.01 and P=.04, respectively). These associations disappeared after controlling for multiplicity. Increasing the time spent in moderate-vigorous PA, or meeting the PA recommendations, is associated with the cytokine profile of women without metabolic disruptions in early pregnancy. However, sedentary time and PA do not seem to be associated with glucose or lipid levels. These results should be interpreted cautiously in view of the discrepancies after adjusting for multiple comparisons. Future studies in this novel field of research are warranted before reaching any conclusion.

A comparison of physical activity from Actigraph GT3X+ accelerometers worn on the dominant and non‐dominant wrist

The purpose of this study was to evaluate the agreement between several activity measures using raw acceleration data from accelerometers worn concurrently on the dominant and non-dominant wrist. Fifty-five adults (31·9±9·7years, 26 males) wore two ActiGraph GT3X+ monitors continuously for 1day, one on their non-dominant wrist and the other on their dominant wrist. Paired t-tests were undertaken with sequential Holm-Bonferroni corrections to compare wear time, moderate-vigorous physical activity (MVPA), time spent in 10-min bouts of MVPA (MVPA10min ) and the average magnitude of dynamic wrist acceleration (ENMO). Level of agreement between outcome variables from the wrists was examined using intraclass correlation coefficients (ICC, single measures, absolute agreement) with 95% confidence intervals and limits of agreement (LoA). Time spent across acceleration levels in 40mg resolution were also examined. There were no significant differences between the non-dominant and dominant wrist for ENMO, wear time, MVPA or MVPA10min . Agreement between wrists was strong for most outcomes (ICC ≥0·92) including wear time, ENMO, MVPA, MVPA10min and the distribution of time across acceleration levels. Agreement was strong in the low acceleration bands (ICC=0·970 and 0·922) with a mean bias of 3·08min (LoA -55·18 to 61·34) and -5·43 (LoA -43·47 to 32·62). In summary, ENMO, MVPA, MVPA10min , wear time and the distribution of time across acceleration levels compared well at the group level. The LOA from the two lowest acceleration levels suggest further work over a longer monitoring period is needed to determine whether outputs from each wrist are comparable.

The impact of sedentary and physical activity behaviour on frailty in middle-aged and older adults.

Physical activity and sedentary behaviours are associated with frailty. However, it is unknown if different accumulation patterns of these behaviours are linked with frailty. Four studies were conducted: the first 3 determined if bouts of moderate-vigorous physical activity (MVPA) and patterns of sedentary behaviours were associated with frailty (study 1), and if sex (study 2) and cardiovascular disease (CVD) status (study 3) affected these associations. Study 4 systematically reviewed the evidence to determine if preoperative physical activity and sedentary behaviours were linked to postcardiac surgical outcomes. Studies 1-3 used accelerometer data from the 2003-2004/2005-2006 National Health and Nutrition Examination Survey. Bouted (≥10 min) and sporadic (<10 min) durations of MVPA were analyzed based on meeting a proportion of the physical activity guidelines of 150 min/week. Prolonged sedentary behaviours were measured in bouts lasting ≥30 min. Breaks from sedentary behaviour were any ≥1 min interruption in sedentary time. Average intensity and duration during breaks were analyzed. Frailty was measured with a 46-item frailty index (FI). Study 4 included investigations that linked preoperative physical activity behaviours to postoperative health outcomes. The first 3 studies revealed that sporadic and bouted MVPA were associated with a lower FI. Meeting 1%-49% of the physical activity guidelines had a protective association with frailty. Prolonged sedentary bouts had a more detrimental association with frailty in females than males. Bouted MVPA was associated with a lower FI in CVD participants but not in those without CVD. Average break intensity was associated with a lower FI across studies. Average break duration was associated with frailty in males and in those with CVD. Study 4 included 11 articles, which reported inconsistent findings in relation to self-reported physical activity behaviour and postoperative outcomes in cardiac surgery patients. No studies analyzed sedentary behaviour or frailty. Data from this thesis suggest that bouts of MVPA and patterns of sedentary behaviours are associated with frailty, and support the need to limit extended periods of sedentary time and promote a physically active lifestyle. Studies are needed to determine if preoperative physical activity and sedentary behaviours are associated with postcardiac surgical frailty.

Validity and Reliability of the Exercise Vital Signs Questionnaire in a Diverse Urban Population

The Exercise Vital Signs (EVS) is a new brief (<30 seconds) physical activity (PA) questionnaire used by the Exercise is Medicine initiative within the American College of Sports Medicine. While the criterion validity of the EVS has been evaluated in a select number of ethnic groups, research on the validity and reliability of the EVS questionnaire in a diverse, urban sample is lacking. PURPOSE: To determine the validity and reliability of the EVS in a diverse, urban sample. METHODS: An ethnically-diverse sample (White 33%, Latino 31%, Asian 21%, Black 15%) of N=39 participants [age 31(10.4)] were asked to wear an accelerometer at the hip for 9 days and to complete the EVS at the beginning (T1) and end (T2) of the wear period. The criterion validity of the EVS-estimated minutes of weekly moderate-vigorous PA (MVPA) was determined against accelerometer-derived estimates of the total time spent in ≥10min bouts of MVPA using Spearman’s correlations. EVS responses were used to predict subjects who were confirmed to meet current PA guidelines of ≥150 MVPA min/week via accelerometry using logistic regression. The EVS receiver operating characteristic area under the curve (AUC), sensitivity, and specificity were calculated. The concurrent validity of the EVS MVPA estimates was tested against accelerometer- derived steps/day using Spearman’s correlations. The intraclass correlation coefficient (ICC) was calculated between the EVS responses at T1 and T2 in order to evaluate questionnaire test-retest reliability. RESULTS: Reliability for the EVS questionnaire was strong (ICC= .98). There was a moderate correlation (rho= .58 at T2, p= <.01) between the EVS-estimated PA minutes/ week and the accelerometer-derived MVPA minutes/week. There was also a moderate correlation (rho= .43 at T2, p= .006) between EVS-determined PA minutes/week and the accelerometer-derived steps/day. The T2 EVS specificity and sensitivity were 56% and 78%, respectively, and the AUC was 0.74. CONCLUSIONS: In a diverse, urban sample, the EVS questionnaire has acceptable validity and high test-retest reliability. The EVS may be a useful tool for identifying ethnically-diverse individuals not meeting current PA guidelines. Further research in larger ethnically-diverse samples is needed.

Accumulating physical activity in at least 10-minute bouts predicts better lung function after 3-years in adults with cystic fibrosis.

Achieving physical activity guidelines by undertaking multiple bouts of moderate-vigorous physical activity ≥10 min duration, but not shorter periods of activity, was independently associated with less decline in FEV1 over 3 years among adults with CF http://ow.ly/yk6930ivCV8

The association between bouts of moderate to vigorous physical activity and patterns of sedentary behavior with frailty

ObjectivesTo determine if bouts of moderate-vigorous physical activity (MVPA) and patterns of sedentary behavior are associated with frailty. MethodAccelerometry from community-dwelling adults ≥50 years old (n = 2317) enrolled in the 2003–04 and 2005–06 National Health and Nutrition Examination Survey were used. Bouted (≥10 min) and sporadic (<10 min) durations of MVPA were analyzed based on meeting 0%, 1–49%, 50–99%, and ≥100% of physical activity guidelines (150 min/week of MVPA). Prolonged sedentary behavior were bouts lasting ≥30 min. Breaks from sedentary behavior were defined as any ≥1 min interruption in sedentary behavior. Average intensity (counts/min) and duration (minutes) during breaks were also analyzed. Frailty was measured with a 46-item frailty index. ResultsMultivariable linear regression models adjusting for age, sex, education, ethnicity, income, marital status, smoking, alcohol consumption, body mass index, total sedentary time and accelerometer wear time indicated that meeting any percentage of the activity guidelines with bouted and sporadic MVPA was associated with reduced frailty. This relationship peaked at meeting 50–99% of guidelines and was associated with a 1.5 and 2.0 point reduction in the frailty index for bouted and sporadic MVPA, respectively. Two additional prolonged sedentary behavior bouts/day were associated with an additional frailty index deficit while every additional 100 cpm in average break intensity and every 2 min in average break duration were associated with one less deficit. Total sedentary breaks were not associated with frailty. ConclusionThese population-level data give justification for determining if interventions which target short bouts of MVPA and interrupting prolonged, uninterrupted time spent in sedentary behaviors can treat or prevent frailty worsening.

Associations between quality of life and duration and frequency of physical activity and sedentary behaviour: Baseline findings from the WALK 2.0 randomised controlled trial.

While physical and mental health benefits of regular physical activity are well known, increasing evidence suggests that limiting sedentary behaviour is also important for health. Evidence shows associations of physical activity and sedentary behaviour with health-related quality of life (HRQoL), however, these findings are based predominantly on duration measures of physical activity and sedentary behaviour (e.g., minutes/week), with less attention on frequency measures (e.g., number of bouts). We examined the association of HRQoL with physical activity and sedentary behaviour, using both continuous duration (average daily minutes) and frequency (average daily bouts≥10 min) measures. Baseline data from the WALK 2.0 trial were analysed. WALK 2.0 is a randomised controlled trial investigating the effects of Web 2.0 applications on engagement, retention, and subsequent physical activity change. Daily physical activity and sedentary behaviour (duration = average minutes, frequency = average number of bouts ≥10 minutes) were measured (ActiGraph GT3X) across one week, and HRQoL was assessed with the ‘general health’ subscale of the RAND 36-Item Health Survey. Structural equation modelling was used to evaluate associations. Participants (N = 504) were 50.8±13.1 (mean±SD) years old with a BMI of 29.3±6.0. The 465 participants with valid accelerometer data engaged in an average of 24.0±18.3 minutes and 0.64±0.74 bouts of moderate-vigorous physical activity per day, 535.2±83.8 minutes and 17.0±3.4 bouts of sedentary behaviour per day, and reported moderate-high general HRQoL (64.5±20.0). After adjusting for covariates, the duration measures of physical activity (path correlation = 0.294, p<0.05) and sedentary behaviour were related to general HRQoL (path coefficient = -0.217, p<0.05). The frequency measure of physical activity was also significant (path coefficient = -0.226, p<0.05) but the frequency of sedentary behaviour was not significantly associated with general HRQoL. Higher duration levels of physical activity in fewer bouts, and lower duration of sedentary behaviour are associated with better general HRQoL. Further prospective studies are required to investigate these associations in different population groups over time.

Assessing the Intensity of Dog Walking and Impact on Overall Physical Activity: A Pilot Study Using Accelerometry

Introduction: Despite a growing body of research indicating that dog walking contributes to meeting physical activity (PA) guidelines, this literature is limited by the use of self-report measures of dog walking and overall PA. The objectives of this pilot study were to objectively assess dog walking with accelerometry, characterize the frequency, duration, and intensity of dog walking, and determine the contribution of dog walking to overall moderate-vigorous physical activity (MVPA). Methods: Sixty-five dog owners wore an Actigraph GT3X accelerometer for up to 7 consecutive days and recorded start/end times for dog walks with daily log sheets. Each minute with an activity count ≥ 760 was classified as MVPA. Descriptive statistics were used to summarize all variables. Logistic regression was used to examine associations between dog walking MVPA bouts and meeting PA guidelines, controlling for age, education, income, and gender. Results: Participants walked their dog an average of 1.2 ± 1.1 times/day, averaged 28.0 ± 15.6 minutes/walk, and accumulated 22.9 ± 17.5 minutes of MVPA/day during dog walks, of which 21.7 ± 17.9 minutes were accumulated in bouts ≥10 minutes. Seventy-eight percent of dog walking was classified as moderate-intensity and 3.5% was vigorous. Dog walking MVPA had a statistically significant positive association with meeting PA guidelines (OR = 2.32; 95% CI = 1.06, 5.08). Conclusions: The majority of dog walking minutes were moderate-intensity and most minutes of MVPA during dog walking occurred in bouts. These findings suggest that dog walking is consistent with current PA guidelines for adults and should receive more consideration as a PA promotion strategy.

Relationship of pase to moderate/vigorous physical activity measured by accelerometry in the osteoarthritis initiative

Purpose: Physical activity conveys health benefits for people with osteoarthritis (OA). Epidemiological studies often use self-reported instruments to explore this relationship, but these measures do not effectively capture actual time spent in physical activity in varying intensities. Public health physical activity guidelines are tied to time spent in physical activity of moderate/vigorous intensity. This study utilizes accelerometers to objectively assess time spent in moderate/vigorous physical activity (MVPA) in adults with knee OA.We investigated the correlation of objectivemeasures with less burdensome subjective measures from Physical Activity Scale in the Elderly (PASE) scores. We also evaluated the association of subjective and objective measures to physical function. Methods: Cross-sectional accelerometer data from 969 adults aged 55 and above with radiographic knee OA (Kellgren-Lawrence 2 in one or both knees) participating in the Osteoarthritis Initiative accelerometer monitoring ancillary study was assessed for physical activity and function. Participants’ response to the PASE questionnaire was followed by 7 days of accelerometer monitoring. Accelerometer measures included average daily minutes in MVPA and average daily minutes in MVPA sessions of 10 minutes or more (MVPA bouts). Other subjective measures including WOMAC (Western OntarioMacMaster) function, SF12 (12-Item Short Form Health Survey) physical function, objective measure gait speed averaged from two 20 meter walks, and covariables including demographics (age, gender), and heath factors (BMI and waist circumference) were assessed. Results: Mean PASE score was 149.80 (SD1⁄478.4) and mean accelerometer MVPA was 15.55 minutes/day (SD1⁄417.18). PASE scores were modestly correlated with average daily minutes in MVPA (r1⁄40.31) and MVPA bouts (r1⁄40.21). PASE scores correlated better with accelerometer measures of MVPA and MVPA bouts in participants who were particularly inactive (characterized by older age, higher BMI, and greater waist circumference). There were no significant gender effects. Accelerometer measures of MVPA and MVPA bouts compared to PASE scores had stronger correlation in WOMAC function (r:-0.14, -0.12 versus -0.02), SF12 physical function (r: 0.22, 0.19, versus 0.07), and gait speed (r: 0.35, 0.29, versus 0.16). Conclusions: In this population with radiographic knee OA, modest correlations of PASE with accelerometer MVPA assessments limit the ability to use this self-reported instrument to explore relationships of activity intensity and OA. Accelerometry data are complementary and help to better characterize the effects of physical activity on health outcomes. Accelerometer MVPA and MVPA bouts were more strongly associated with physical function than PASE, although that correlation was modest at best. The choice of PASE versus objectivemeasurement for future epidemiologic studies must take into account the purpose for which physical activity is being measured.