Changes In Physical Activity Levels Research Articles

A BIOPSYCHOSOCIAL APPROACH TOWARD PREDICTING PHYSICAL ACTIVITY AMONG OLDER ADULTS WITH KNEE OSTEOARTHRITIS

Abstract Regular physical activity (PA) is imperative for preventing disability among older adults with knee osteoarthritis (KOA). However, PA is a complex behavior that relies on determinants from biological, psychological and social factors. Identifying determinants that predict PA would be informative for providing support for patients with KOA who are physically inactive. This study aimed to employ a biopsychosocial (BPS) approach to identify the strongest PA determinants among older adults with KOA. Methods: Adults (age 65+) diagnosed with KOA (n=1,343) from the Osteoarthritis Initiative dataset were included to test the BPS model. Putative BPS determinants from baseline were identified by testing if they correlated with two-year follow-up change scores of accelerometry PA data. Each model factor was tested using ordinary least-squared regressions, and significant determinants were then used for the biopsychosocial model test, which employed hierarchical multiple regression. Results: Bivariate correlations revealed 21 variables representing biological (n=13), psychological (n=4), and social (n=4) variables that correlated with change in levels of PA. Four significant variables were identified in separate regression models. Testing these predictors using hierarchical regression revealed the strongest determinant to be the 400-meter walk (β =-.26, p<.001), followed by age (β=-.23, p<.001), general health (β=-.15, p<.001), and BMI (β=-.21, p<.001). Conclusion: The BPS model test revealed 50% of determinants to be mutable (fitness and BMI), and the remaining to be non/less mutable. The 400-meter walk test was the strongest indicator of future PA, suggesting that individuals with KOA who score low on this test could benefit from supported PA programs.

ASSOCIATIONS BETWEEN COGNITIVE CHANGE AND OBJECTIVE CHANGE IN PHYSICAL ACTIVITY AMONG OLDER ADULTS: THE LIFE STUDY

Abstract Objective To investigate the associations between domain-specific cognitive change and objectively measured change in physical activity in a sample of community-dwelling older adults. We hypothesized that domain-specific changes in cognition are associated with longitudinal changes in physical activity levels. Methods We used data from 955 participants from The LIFE Study, a multi-center randomized clinical trial. Longitudinal relationships between cognitive domains (i.e., memory, attention, processing speed, executive function) and accelerometer-measured change in daily minutes of physical activity were examined using multivariable linear regression. Cognitive tests included Modified Mini-Mental State Examination (3MSE), Hopkins Verbal Learning Test (HVLT), Digital Symbol Substitution Test (DSST), Task Switching Test, Eriksen Flanker Test and N-Back Test. Physical activity was measured longitudinally using an accelerometer and was categorized to total, light, and moderate to vigorous according to standardized activity count cut points. Results Our results showed an association between cognitive change in the processing speed domain and change in minutes of total (β = 0.47; 95% CI: 0.04, 0.89; p = 0.034) and light (β = 0.42; 95%CI: 0.03, 0.80; p= 0.033) physical activity. Relationships between all other cognitive assessments and physical activity categories were not statistically significant. Conclusions This study demonstrates an association between a decline in processing speed and a decline in the duration of total and light daily physical activity in older adults with low to moderate physical function.

Responsiveness of Patient-Reported and Device-Based Physical Activity Measures: Secondary Analysis of Four Randomized Trials.

This study aimed to compare the responsiveness of patient-reported and device-based instruments within four physical activity trials. This was a secondary analysis of four randomized trials that used both a patient-reported outcome measure (the Incidental and Planned Exercise Questionnaire (IPEQ)) and a device-based instrument (ActiGraph or ActivPAL) to measure physical activity. The four trials included were (i) Activity and MObility UsiNg Technology (AMOUNT), digitally enabled exercises in those undertaking aged care and neurological rehabilitation; (ii) Balance Exercise Strength Training at Home, home-based balance and strength exercises in community-dwelling people 65 yr or older; (iii) Coaching for Healthy Ageing (CHAnGE), physical activity coaching and fall prevention intervention in community-dwelling people 60 yr or older; and (iv) Fitbit trial, fall prevention and physical activity promotion with health coaching and activity monitor in community-dwelling people 60 yr or older. We estimated treatment effects for all variables within each physical activity instrument using regression analyses and expressed results as effect sizes (ES). Overall, device-based instruments were more responsive among healthy older adults (ES range, 0.01 to 0.32), whereas the IPEQ was more responsive among adults requiring rehabilitation (ES range, -0.06 to 0.35). Both the IPEQ and device-based instruments were more responsive in trials that promoted walking via coaching participants to increase their daily steps (AMOUNT (ES range, -0.06 to 0.35), CHAnGE (ES range, -0.24 to 0.22), and Fitbit trial (ES range, -0.23 to 0.32)). Individual variables within the IPEQ and device-based instruments varied in their responsiveness (ES range, -0.13 to 0.20). Both the IPEQ and device-based instruments are able to detect small changes in physical activity levels. However, responsiveness varies across different interventions and populations. Our findings provide guidance for researchers and clinicians in selecting an appropriate instrument to measure changes in physical activity.

Importance of training volume through the use of step trackers apps promoted from the subject of physical education to change body composition, physical fitness and physical activity in adolescents and the influence of gender✰,✰✰

The aim of the present study was to determine the changes in physical activity level (PA), kinanthropometric and derived variables, and physical fitness in adolescents, as a result of an out-of-school intervention with mobile step tracker apps promoted from the field of physical education, according to the volume of training completed and gender. A randomized controlled trial was carried out with 400 adolescents (210 males and 190 females) aged 12 to 16 years old (mean age: 13.96 ± 1.21 years-old). Adolescents were divided into experimental group (EG) (n = 240) and control group (CG) (n = 160). Two measurements were carried out, separated by a 10-week intervention, and PA, kinanthropometric variables and physical condition were measured. During the intervention, EG must use Strava (n = 74); Pokémon Go (n = 59); Pacer (n = 60); and MapMyWalk (n = 47) a minimum of 3 times per week, covering an incremental distance from 7,000 steps per day (week 1) to 12,500 steps per day (week 10). After that, EG were divided in quartile according to the volume of training completed. The results obtained showed a significant increase between pre-and post in PA (p = 0.009–0.044) and curl-up (p < 0.001–0.040) in EG regardless the quartile of compliance, and a reduction in fat variables (p < 0.001) and an increase in CMJ in 75–100 % compliance group (p = 0.005). The introduction of the covariate gender did not introduce changes in the intra-group evolution. On inter-group differences, differences were only found for the post-test values between 0–25 % Vs 25–50 % and between 50–75 % Vs 75–100 % with the group that completed a longer distance being the one that showed the lowest values in the post-test in both cases. When including the covariate gender, no significant differences were found for either the pre-test or the post-test on either variable. To conclude, a higher training volume with mobile apps seems to be relevant in the increase PA and strength and decrease of fat mass. The gender factor is not influential in the intra-group changes, but it is influential in the inter-group differences.

94 Physical Activity, Emotional Functioning, and Cognitive Concerns During the COVID-19 Pandemic Among Older Adults in the US

Objective:Physical inactivity is associated with a greater risk of frailty, neuropsychiatric symptoms, worse quality of life, and increased risk for Alzheimer’s disease. Little is known about how physical activity engagement of older adults during the COVID-19 pandemic relates to subjective cognitive concerns and management of emotional distress. This study aimed to examine whether there were changes in physical activity during the pandemic in older adults at baseline and 3 months compared to before the pandemic and whether these changes varied based on age, sex, income level, and employment status. Further, we examined whether individuals who reported engaging in less physical activity experienced greater subjective cognitive difficulties and symptoms of depression and anxiety than those who maintained or increased their physical activity levels.Participants and Methods:301 participants (73% non-Hispanic whites) completed an online survey in either English or Spanish between May and October 2020 and 3 months later. The Everyday Cognition Scale was used to measure subjective cognitive decline, the CES-D-R-10 scale to measure depressive symptoms, and the GAD-7 scale to measure anxiety symptoms. Changes in physical activity were measured with the question “Since the coronavirus disease pandemic began, what has changed for you or your family in regard to physical activity or exercise levels?” with options “less physical activity,” “increase in physical activity,” or “same activity level.” Income was self-reported as high, middle, or low. Analyses of chi-squared tests were used to examine differences in physical activity maintenance by age, income level, sex, and employment status.Results:Most individuals (60%) reported having decreased their physical activity levels during the pandemic, at baseline and 3-month followup. There were differences in physical activity levels based on income and age: participants with a high income reported engaging in more physical activity than those with low income (X^2=4.78, p =.029). At the 3-month follow-up, middle-income participants reported being less active than the high-income earners (X^2=8.92, p=.003), and younger participants (55-65 years, approximately) reported being less active than older participants (X^2=5.28, p =.022). Those who reported an increase in their physical activity levels had fewer cognitive concerns compared to those who were less active at baseline, but this difference was not seen in the 3-month follow-up. Participants of all ages who reported having maintained or increased their physical activity levels had fewer depressive symptoms than those who were less active (p &lt; 0.0001). Those who reported maintaining their physical activity levels exhibited fewer anxiety symptoms than those who were less active (p &lt; 0.01).Conclusions:Older adults reported changes in physical activity levels during the pandemic and some of these changes varied by sociodemographic factors. Further, maintaining physical activity levels was associated with lower symptoms of depression, anxiety, and cognitive concerns. Encouraging individuals and providing resources for increasing physical activity may be an effective way to mitigate some of the pandemic’s adverse effects on psychological wellbeing and may potentially help reduce the risk for cognitive decline. Alternately, it is possible that improving emotional distress could lead to an increase in physical activity levels and cognitive health.

Changes in Physical Activity Level and Energy Intake of Japanese Sprint and Endurance Athletes by Training Segmentation Period: A Longitudinal Study

Changes in Physical Activity Level and Energy Intake of Japanese Sprint and Endurance Athletes by Training Segmentation Period: A Longitudinal Study

Which behaviour change techniques are associated with interventions that increase physical activity in pre-school children? A systematic review

BackgroundInsufficient physical activity (PA) is a significant risk factor that contributes to several health problems and there is a need to improve our understanding of how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between behaviour change techniques (BCTs) and interventions that increased PA among pre-school children aged < 6 years old.MethodsSystematic searches of six databases were undertaken from inception to July 2022, updated in December 2022, to locate studies that evaluated interventions and reported a positive change in PA levels in children aged < 6 years old.ResultsA total of 5,304 studies were screened, and 28 studies involving 10,605 subjects aged 2.5 to 5.9 years met the eligibility criteria. Each eligible study (n = 28) was independently appraised by two researchers using the Cochrane risk of bias tool. The BCT Taxonomy v1 and the Template for Intervention Description and Replication (TIDieR) guided the extraction and analysis of data, and this process led to the identification of 27 BCTs.ConclusionsPotentially promising BCTs for increasing PA among young children included ‘shaping knowledge,’ ‘antecedents,’ ‘goals and planning,’ and ‘comparison of behaviour.’ Future PA interventions that target young children should consider integrating these promising BCTs into their programmes. However, such consideration needs to be tempered by the fact that most of the reviewed studies were deemed to have a high or unclear risk of bias and/or were limited with respect to the populations that they targeted. Further research using rigorous methodologies is required to establish a higher standard that addresses the needs of young children who are expected to have insufficient levels of physical activity.

Changes in Physical Activity and Incidence of Nonfatal Cardiovascular Events in 47 153 Survivors of Myocardial Infarction.

Background The majority of patients survive the acute phase of myocardial infarction (MI) but have an increased risk of recurrent cardiovascular disease (CVD) events. To be regularly physically active or change activity level is associated with a lower risk of all-cause mortality. The objective was to explore to what extent physical activity (PA) levels or change in PA levels during the first year post-MI was associated with any recurrent nonfatal CVD events and specific CVD events (eg, MI, ischemic stroke, and vascular dementia). Methods and Results This cohort study among MI survivors was based on Swedish national registries between 2005 and 2020. PA levels were self-rated at 2 and 12 months post-MI, and patients were classified into remaining physically inactive, increasing, decreasing, or remaining active. A total of 6534 nonfatal CVD events occurred during 6 years of follow-up among the 47 153 included patients. In fully adjusted analyses, the risk of any nonfatal CVD event was lower (P<0.05) among patients remaining active (37%), increasing (22%), or decreasing (18%) PA level compared with remaining inactive. Compared with remaining inactive, the risk of recurring MI and stroke was lower (P>0.05) among remaining active (41% versus 52%, respectively), increasing (20% versus 35%, respectively), or decreasing PA level (24% versus 34%, respectively). For vascular dementia, patients remaining physically active had an 80% lower risk compared with remaining inactive (P<0.05). Conclusions Remaining physically active or change in PA levels during the first year post-MI was associated with a lower risk of recurrent nonfatal CVD events. This emphasizes the importance of supporting patients to continue to be or become physically active.

A natural experiment to determine if FitEx works: Impact of a statewide walking program.

The National Cooperative Extension System offers walking programs, but impacts are underreported. One program offered in two state systems is FitEx, an 8-week, group-based behavior change intervention. The purpose of this work was to evaluate FitEx through the RE-AIM (reach, effect, adoption, implementation, maintenance) Framework, with a primary focus on reach and effectiveness (individual-level dimensions). Through a pragmatic, natural experiment, the impact of FitEx was assessed from 2015 to 2020. Reach was operationalized as the number and characteristics of eligible community members who participated. Effectiveness was operationalized as changes in physical activity levels. From 2015 to 2020, there were 1995 FitEx participants (274 ± 233 participants per year) who were 45.22 ± 14.13 years of age, predominantly female (83%) and White (78%). At the start of the program, 33% met physical activity guidelines and during the program 58% met guidelines (X2(1, 1648) = 1.6; P < .0). The reach and effectiveness of FitEx are comparable to-and in some cases, greater than-similar community-based walking programs. FitEx consistently reached middle-aged insufficiently active adults. Future work is needed to reach a more diverse population, establish objectively measured impacts, and establish a process to scale FitEx across the nation.

S12-1 School-based interventions to promote physical activity amongst children and adolescents

Abstract Background Regular physical activity (PA) is associated with many benefits for physiological and mental wellbeing in children and adolescents. Despite this, many children and adolescents are failing to meet current PA guidelines. Given the age-related declines in PA as children move into adolescence, and then adulthood, the development of interventions to promote PA in this population is important. Schools have been identified as a key setting for the promotion of health-related behaviours, and young people spend a significant proportion of their waking day within the school setting. Aim This symposium will engage researchers, practitioners, health care professionals and policy makers to discuss novel school-based interventions. The objectives of this symposium are to: (1) Disseminate the findings of school-based interventions across a number of countries (France, Ireland, United Kingdom, Spain); (2) Highlight cross-cultural challenges in the development and evaluation of school-based interventions, and (3) Outline how co-design and Patient and Public Involvement (PPI) have been utilised in the development of school-based interventions. Symposia presentations 1. The effectiveness of a peer-led school-based walking intervention on adolescent girls’ physical activity: the Walking In ScHools (WISH) study. This presentation will highlight findings from the first fully powered trial to investigate the effectiveness of a peer-led brisk walking intervention in adolescent girls, including primary and secondary outcome data, and process evaluation measures. 2. School-based physical activity promotion in a cross-cultural context: interventions from France and Spain. This presentation will highlight key learnings on how best to connect cross-cultural educational contexts for the promotion of physical activity and discuss the development of a cross-cultural intervention guide. 3. Co-production of the Move Well, Feel Good movement behaviours intervention. This presentation will describe the feasibility evaluation of the Move Well, Feel Good intervention. The Move Well, Feel Good intervention was developed using a co-design approach, and aims to enhance children’s mental health through motor competence and psychosocial development. 4. Physical activity trends among Second-level Active School Flag programme 2019-2021. This presentation will evaluate the impact of the Active School Flag programme and outline changes in physical activity levels over a three-year period.

S12-5 Physical activity trends among second-level Active School Flag programme 2019-2021

Abstract Purpose Schools in the second level Active School Flag (ASF) programme are required to carry out a whole school survey to capture the student voice within the programme. Data from these surveys can be used to measure changes in physical activity behaviours at the school level. This presentation outlines the changes in physical activity levels over a three-year period from students in ASF schools. Methods From five schools involved in the ASF programme from 2019 to 2021, students reported frequencies of 60 minutes of aerobic physical activity, muscle strengthening, and active transport. Students were grouped into inactive (0-2 days), somewhat active (3-4 days), active (5-6 days) and daily active (7 days), as well as meeting muscle strengthening guidelines (3+ days/week) and not meeting (0 – 2 days). Furthermore, only students who lived within 5km of their school were included in the active transport analyses, where active transport was a combination of walking and cycling. Contingency tables were produced, and logistic regressions were used to analyse changes between 2019 (reference), 2020 (COVID-19 lockdown), and 2021, with age as confounders and stratified by gender. Results There was an 80% response rate across the five schools. Of the 7646 students (male 33%, female 65%, other 2%), minimal changes in ‘daily active’ students were observed from 2019 (12%), 2020 (13%), to 2021 (12%), whereas ‘inactive’ students decreased from 25% in 2019 to 23% in both 2020 and 2021. Rates of meeting muscle-strengthening guidelines remained steady over the years for both males and females. Active transport increased from 55% in 2019 to 66% in 2021 for males and 50% in 2019, 63% in 2020, to 65% in 2021 for females. In addition to these overall trends, idiosyncratic analyses of the schools revealed different trends from being in the ASF programme. Conclusions There were high level of responses from the whole school survey. The ASF intervention contains adaptable components due to the complex adaptive sub-systems and may shed light on the differences in physical activity over time. Furthermore, COVID-19 restrictions may have affected the program-related results.

Mediating Effects of the COVID-19 Pandemic on the Associations between Physical Activity and Physical Fitness; Cross-Sectional Study among High School Adolescents.

The COVID-19 pandemic and the imposed social distancing measures caused negative changes in physical activity levels (PALs) and physical fitness (PF) among adolescents, but the potential mediating effect of the pandemic on the association between PAL and PF is unknown. This study aimed to evaluate gender-specific associations between objectively measured PAL and indices of PF among high school adolescents during the period of the COVID-19 pandemic. The participants were 150 adolescents (101 females) aged 14-18 years; their anthropometrics were evaluated, and they were tested on PF (cardiorespiratory fitness (CRF; beep test), power (broad jump), flexibility (sit-and-reach test), and abdominal strength (sit-ups)) and PAL (using a pedometer for 7 days) during the pandemic period. A T-test was calculated to determine differences between genders. Associations between variables were evaluated using Pearson correlations. Additionally, multivariate taxonomic classification was used to sort participants into homogenous groups (clusters) according to their PF, and then analysis of variance (ANOVA) was performed to differentiate them according to PAL. For the total sample, PAL was correlated with CRF only (R = 0.25, p < 0.05), while gender-stratified correlations showed that PAL was significantly associated with CRF among girls only (R = 0.29, p < 0.05), which was additionally confirmed with multivariate cluster analysis and subsequent ANOVA. No association between PAL and PF was found for boys. The relatively low association between PAL and PF is most likely related to the mediating effect of the change in life circumstances during the COVID-19 pandemic, and limited applicability of pedometers in evaluating high-intensity PAL. Further studies in other age groups and environments are warranted.

Effect of Pre-Hospitalization Fall History on Physical Activity and Sedentary Behavior After the Implementation of a Behavioral Change Approach in Patients with Minor Ischemic Stroke: A Secondary Analysis of a Randomized Controlled Trial.

We aimed to determine whether a history of falls before admission affected physical activity levels and sedentary behavior negatively after implementing a behavior modification approach in patients with minor ischemic stroke. This study constituted a secondary analysis of an intervention trial. In the intervention study, patients with minor ischemic stroke were randomly assigned to two groups: intervention and control groups. The intervention group was encouraged to reduce sedentary behavior during hospitalization and after discharge, while the control group was encouraged to increase physical activity levels solely during hospitalization. The study included 52 patients who completed the intervention trial. The exposure factor examined was a history of falls. Upon admission, patients were queried about any falls experienced in the year preceding admission and subsequently classified into fall and non-fall groups based on their responses. The primary outcome of interest focused on changes in physical activity levels (step count, light-intensity physical activity, and moderate-to-vigorous-intensity physical activity) and sedentary behavior. Measurements were obtained at two time points: before the intervention, during hospitalization (baseline), and 3months after discharge (post-intervention). Only a significantly lower change in the number of steps taken in the fall group than in the non-fall group was found. Those with a history of falls showed a lesser change in the number of steps taken before and after implementing a behavior change approach compared with those without a history of falls. Those with a history of falls may have engaged in activities other than walking.

Changes in physical activity level of adolescents and its relationship with mental health during regular COVID-19 prevention and control.

This study aimed to analyze the impact of regular prevention and control of COVID-19 on the physical activity level (PAL) of adolescents and the relationship between PAL and mental health. Using the convenience sampling method, two stages of the on-site cross-sectional investigation were conducted in 11 middle schools in Guiyang City in China. There were 1132 participants who completed the Physical Activity Questionnaire for old children (PAQ-C) in October 2020, and 1503 participants who completed the PAQ-C and Mental Health Inventory of Middle-school students (MMHI-60) in October 2021. All participants reported their demographic data. Descriptive, quantitative statistics were used for data analysis. One-way ANOVA was used to explore associations between PAL and mental health. The results of statistical analysis showed a gradual yearly increase in the PAL of teenagers, and the PAL of male junior middle school students has a significant increase (p<.05); while that of adolescents in Grade 10 significantly decreased (p<.001). There is a statistically significant correlation between adolescents' mental health (except for anxiety) and PAL (p<.05). The overall abnormal rate of mental health was 27.9%; The PAL and the total mean score of mental health had a negative correlation (p<.001). There was a significant difference between mental health scores and corresponding PAL (p<.001). Furthermore, there are statistically significant differences in scores of mental health factors corresponding to varying PAL among junior high school students and male students (p<.05). The regular epidemic prevention and control measures had significant adverse effects on the PAL of girls and high school adolescents, especially Grade 10 adolescents. Improving adolescents' PAL can promote their mental health. Interventions based on PAL slightly lower than the level recommended in the physical activity guidelines can bring significant mental health effects.

Impact of the COVID-19 Lockdown on Physical Activity Levels and Health Parameters in Young Adults with Cancer.

The lockdown of the COVID-19 pandemic impacted physical activity (PA) levels around the world, affecting health parameters in young adults with cancer (YAC). To our knowledge, there is no evidence of the impact of the lockdown on the Spanish YAC. To analyse the changes in PA levels before, during, and after the lockdown of the YAC and its impact on health metrics in Spain, in this study, we utilized a self-reported web survey. PA levels decreased during the lockdown, and a significant increase in PA was observed after the lockdown. Moderate PA had the largest reduction (49%). Significant increases in moderate PA were noted after the lockdown (85.2%). Participants self-reported more than 9 h of sitting per day. HQoL and fatigue levels were significantly worse during the lockdown. The impact of the COVID-19 pandemic in this cohort of Spanish YAC showed a decrease in PA levels during the lockdown, affecting sedentarism, fatigue and HQoL. After lockdown, PA levels partially recovered, while HQoL and fatigue levels remained altered. This may have long-term physical effects such as cardiovascular comorbidities associated with sedentarism and psychosocial effects. It is necessary to implement strategies such as cardio-oncology rehabilitation (CORE), an intervention that can be delivered online, potentially improving participants' health behaviours and outcomes.

Monitoring physical activity using wearable technology in people with Achilles tendinopathy undergoing physiotherapy treatment: A feasibility prospective cohort study

ObjectivesPhysical activity modification is an important part of the management of Achilles tendinopathy. However, to our knowledge, there is a lack of evidence on objective physical activity assessment in Achilles tendinopathy. The purpose of this study is to (1) assess feasibility of using an inertial measurement unit (IMU) to monitor physical activity and IMU-derived biomechanical measures over 12-week treatment course by a physiotherapist; (2) conduct a preliminary analysis of changes in physical activity over 12-weeks. DesignA feasibility prospective cohort study SettingA community setting. ParticipantsPeople with Achilles tendinopathy who had recently commenced (≤2 sessions), or were about to commence, treatment with a physiotherapist Main outcome measuresParticipants wore a shank-mounted IMU on the affected side for one week at baseline, 6-, and 12-week follow-ups. The outcomes were pain/symptom severity, IMU-derived physical activity and biomechanical measures (stride rate, peak shank angular velocity, and peak shank acceleration). ResultsThirty participants were recruited. There was a high retention rate (97%), response rate (97%), and IMU wear compliance at each timepoint (>93%). For pain/symptom severity, a significant time effect was observed between baseline and 12-week follow-up. Physical activity and IMU-derived biomechanical measures did not change over 12 weeks. Physical activity decreased at the 6-week follow-up but only returned to the baseline level at 12-week follow-up. ConclusionsA larger-scale cohort study assessing clinical outcomes and physical activity appears feasible. Preliminary data indicate that physical activity may not change significantly over 12-weeks in people undergoing physiotherapy management for Achilles tendinopathy. Contribution of the paper•A larger-scale cohort study assessing physical activity using wearable technology over 12 weeks of treatment by a physiotherapist appears feasible.•Preliminary findings indicate physical activity may not change significantly over 12-weeks of treatment by a physiotherapist for people with Achilles tendinopathy.•Changes in pain and symptom severity after 12 weeks of treatment by a physiotherapist are not correlated with changes in physical activity level.

EVALUATION OF THE PHYSICAL ACTIVITY LEVELS OF COVID-19 PATIENTS IN TURKEY

Purpose: Covid-19 is a viral infection that affects either the respiratory system or the other systems. Studies about the effects of Covid-19 on physical activity are still scarce. This study aims to compare the changes in the physical activity levels of patients before and six months after Covid-19 in Turkey.&#x0D; Methods: One hundred and six participants that have been six months after Covid-19 contraction were included in the study. Along with the Patient Assessment Questionnaire, the International Physical Activity Questionnaire Short Form was used to assess physical activity energy consumption (vigorous-intensity physical activities, moderate-intensity physical activities, walking, and total physical activities).&#x0D; Results: Participants became either less physically active or more sedentary six months after Covid-19 (p=0.019). Vigorous-intensity physical activity levels were significantly decreased (Mean±SD: 341±854 vs. 109±331 Metabolic Equivalent Task minutes/week, p=0.015), and perceived fatigue during exercise was significantly increased between before and six month after infection (Mean±SD: 4.76±2.17 vs 6.17±2.27, p=0.001). Participants who had dyspnea (n=12) during the period of Covid-19, did more moderate-intensity physical activity (p=0.020) and walking (p =0.021) after Covid-19, compared to those who had not.&#x0D; Conclusion: Particularly changes in vigorous-intensity physical activity levels and perceived fatigue during exercise were seen in Covid-19 infected patients. We recommend supporting gradually increased tailor-based exercise programs by health professionals in public health agencies, not only for protecting the individuals from Covid-19 outcomes, but also for returning to their preinfection fitness levels.

Diabetes prevention through digital therapy for highrisk individuals: Study protocol for the Malaysia Diabetes Prevention Programme (MyDiPP)

Introduction: Intervention approaches that integrate human coaching into technology are considered as a convenient, accessible and scalable method to reach a larger population at risk. The objective of this paper is to present the protocol for a randomised controlled trial that evaluates the efficacy of a lifestyle intervention programme via a mobile phone app (MyDiPP), which aims to prevent diabetes among adults at risk of developing diabetes. Methods: MyDiPP intervention is to be delivered for 12 months with multiple approaches (weight loss, dietary modification, physical activity, and quality of life). Eligible adults aged 18-65 years, overweight/obese (body mass index, BMI ≥ 23kg/m2), and at high risk of type 2 diabetes [American Diabetes Association (ADA) Diabetes Risk Score ≥5, or haemoglobin A1c (HbA1c) of 5.6-6.2%], will be randomly assigned to one of two study groups (intervention or usual care control groups) in a 1:1 ratio using simple randomisation. Results: Changes in weight and HbA1c level (primary outcomes), and changes in physical activity level, dietary intake, and quality of life (secondary outcomes) will be assessed at 6 and 12 months. Conclusion: This study protocol describes the first digital therapy for diabetes prevention in Malaysia, which will determine whether the effect of this intervention is larger than the effect of usual care in reducing body weight and HbA1c level, and improving dietary intake, physical activity, and quality of life of high-risk individuals. Results from this trial may be useful for preventing type 2 diabetes mellitus in Malaysia.

Changes in physical activity during the COVID-19 lockdown based on the sociodemographic profile of 5569 students and academic staff of Austrian universities

ObjectivesThe COVID-19 pandemic and the associated restrictions/lockdowns have influenced the health and lifestyle behaviour of university students and staff, particularly their physical activity (PA) habits. However, the association between the direction of PA changes and sociodemographic characteristics has not been studied. This nationwide study was conducted in Austrian colleges/universities and aimed to identify the magnitude and direction of changes in PA levels during the COVID-19 restrictions and compare participants who had unchanged vs decreased vs increased PA based on sociodemographic characteristics (sex, age, body mass index, study level, living area, nationality and Austrian regions). Study designThis was a cross-sectional study to measure the association between the explanatory variable and outcome measures. MethodsA total number of 4528 students (mean age 24.9 years) and 1041 academic staff (mean age 46.4 years) participated in an online survey and provided self-reported data on sociodemographic characteristics and PA change during the pandemic. ResultsA total of 41.3% of students and 37.5% of academic staff reported a decrease in PA level, whereas PA levels increased in 36.3% and 27.9%, respectively. In students, all sociodemographic variables (including sex, age, body mass index, study level, living area, nationality and Austrian regions) were significantly associated with the direction of PA changes (P < 0.05). Living area and Austrian region were found to be significant indicators of direction of PA changes in academic staff (P < 0.05). ConclusionsThese findings suggest that the inconsistency of previous studies in PA change during the pandemic may at least partly be explained by differences in the sociodemographic characteristics of the participants.

Change in physical activity related to admission for exacerbation in COPD patients

IntroductionThe aim of this study was to determine the impact of hospitalizations on levels of physical activity (PA) and whether other factors were associated with subsequent changes in PA. MethodsProspective observational cohort study with a nested case-control study, with follow-up 60 days from the index hospital admission. Nine hospitals participated in the study. Patients were recruited consecutively. Several variables and questionnaires of the clinical baseline status of the patients were recorded including: the COPD Assessment Test (CAT), the Hospital Anxiety-Depression scale (HADS), comorbidities and the Yale Physical Activity Survey. Patients’ data related to admission and up to two months after discharge were also recorded. Results883 patients were studied: 79.7% male; FEV1 48%; Charlson index 2; 28.7% active smokers. The baseline PA level for the total sample was 23 points. A statistically significant difference in PA was found between patients readmitted up to 2 months after the index admission and those not readmitted (17vs. 27, p < 0.0001). Multivariable linear regression analysis identified the following as predictors of the decrease of PA from baseline (index admission) up to 2 months follow-up: admission for COPD exacerbation in the two months prior to the index admission; readmission up to 2 months after the index admission; baseline HAD depressive symptoms, worse CAT score, and patient-reported “need for help”. ConclusionsIn a cohort of admitted COPD patients, we identified a strong relationship between hospitalization for exacerbation and PA. In addition, some other potentially modifiable factors were found associated with the change in PA level after an admission.