Changes In Physical Activity Levels Research Articles

Usefulness of measuring temporal changes in physical activity levels using an accelerometer for prediction and early detection of postoperative complications after hepatectomy.

This research aimed to determine whether patterns of temporal changes in activity levels can indicate postoperative complications following hepatectomy. Between December 2016 and December 2019, 147 patients wore an accelerometer to measure their physical activity levels after hepatectomy until postoperative day 7. Patterns of changes in activity levels were categorized as follows: upward slope type (n=88), wherein activity levels gradually increased; bell curve type (n=13), wherein activity levels initially increased but subsequently decreased; and flat type (n=46), wherein there was no apparent increase in activity levels. Patient characteristics and postoperative complications were compared for each group. Postoperative complications occurred in 4.5% of patients in the upward slope group, in 76.9% in the bell curve group, and in 65.2% in the flat group (p<0.001). Surgical site infections (SSI), refractory pleural effusion, and ascites were more common in the bell curve group, while pneumonia was only observed in the flat group. SSI, pleural effusion, and ascites should be considered when previously increasing activity levels decline during the postoperative period. In addition, there is a high risk of SSI and pneumonia when activity levels do not increase at all after surgery.

CHANGES IN PHYSICAL ACTIVITY LEVELS IN PATIENTS WITH ACUTE CORONARY SYNDROME BETWEEN THE FIRST AND THIRD DECADES OF THE 21st CENTURY.

Sedentary lifestyle and obesity increase the risk of coronary disease (CAD). The aims of this prospective study were to estimate the trends in physical activity (PA) level, accuracy of the Baecke's/LRC-PA questionnaires, and trends in obesity parameters (body mass index-BMI/waist-to-hip ratio-WHR) in patients with acute coronary syndrome (ACS) in the last two decades. We grouped 209 patients with ACS (UAP-unstable angina, STEMI-ST-elevation myocardial infarction, NSTEMI-non STEMI) by year of admission (Group 2002-05/Group 2017) and compared them by the levels of PA (Baecke's/LRC-PA questionnaires) and obesity parameters (BMI, WHR). Group 2017 had higher WHR (1.02 vs. 0.97) and leisure PA index (LI) (3.00 vs. 2.50), as well as less high and very low activity patients (P<0.05). Patients with UAP/STEMI had higher WHR in 2017 (1.02 vs. 0.96, 1.02 vs. 0.99, respectively) (P<0.05) and had lower LI in 2002-05 (2.50 vs. 3.25, 2.75 vs. 3.50, respectively) (P<0.05). In conclusion, leisure PA and WHR was increased in the study period both in patients with ACS and in the general population. We emphasize the usage of more precise methods for evaluation of PA and obesity (Baecke's/Four-point LRC-PA questionnaires, WHR), and that only increased PA with dietary changes leads to reduction of central obesity and risk of ACS.

Prescribing Smartphone Apps for Physical Activity Promotion in Primary Care: Modeling Study of Health Gain and Cost Savings.

BackgroundInadequate physical activity is a substantial cause of health loss worldwide, and this loss is attributable to diseases such as coronary heart disease, diabetes, stroke, and certain forms of cancer.ObjectiveThis study aims to assess the potential impact of the prescription of smartphone apps in primary care settings on physical activity levels, health gains (in quality-adjusted life years [QALYs]), and health system costs in New Zealand (NZ).MethodsA proportional multistate lifetable model was used to estimate the change in physical activity levels and predict the resultant health gains in QALYs and health system costs over the remaining life span of the NZ population alive in 2011 at a 3% discount rate.ResultsThe modeled intervention resulted in an estimated 430 QALYs gained (95% uncertainty interval 320-550), with net cost savings of 2011 NZ $2.2 million (2011 US $1.5 million) over the remaining life span of the 2011 NZ population. On a per capita basis, QALY gains were generally larger in women than in men and larger in Māori than in non-Māori. The health impact and cost-effectiveness of the intervention were highly sensitive to assumptions on intervention uptake and decay. For example, the scenario analysis with the largest benefits, which assumed a 5-year maintenance of additional physical activity levels, delivered 1750 QALYs and 2011 NZ $22.5 million (2011 US $15.1 million) in cost savings.ConclusionsThe prescription of smartphone apps for promoting physical activity in primary care settings is likely to generate modest health gains and cost savings at the population level in this high-income country. Such gains may increase with ongoing improvements in app design and increased health worker promotion of the apps to patients.

Change in Physical Activity and Function in Patients with Baseline Advanced Nondialysis CKD.

Although progressive decline in physical activity and function are common in individuals with worsening CKD, little is known about the effect of dialysis initiation on physical activity. We assessed for any association of progression to dialysis in people with advanced CKD with temporal rates of change in physical activity and function. Canadian Frailty Observation and Interventions Trial (CanFIT) participants with an eGFR of <30 ml/min per 1.73 m2 were included. Outcomes included change in physical activity level, measured using the Physical Activity Scale for the Elderly, and physical function, measured using the chair stand, 4-m gait speed, and grip strength tests. Generalized linear regression models were conducted to determine whether dialysis initiation was associated with greater decline in physical activity or function. Of 386 individuals, 162 progressed to dialysis. Both assessments were completed by 98% of individuals for the Physical Activity Scale for the Elderly, 86% for the chair stand test, 84% for the gait speed test, and 91% for the grip strength test. Median (interquartile range) interassessment follow-up was 427 (357-578) days for the "stable advanced CKD" group and 606 (428-1000) days for the "progressed to dialysis" group. Self-reported physical activity and gait speed significantly declined in both groups. Mean (SD) chair stand time increased from 20.8 (17.1) to 24.0 (21.0) seconds among patients with stable advanced CKD, and from 18.5 (15.4) to 27.4 (22.2) seconds among those who progressed to dialysis (adjusted difference in change, 5.2 seconds; 95% confidence interval, 0.8 to 9.7 seconds; P=0.02). Patients with advanced CKD experience progressive declines in physical activity and function. Transition to dialysis is associated with accelerated decline in physical function, as measured by the chair stand test. This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2021_12_01_CJN07050521.mp3.

Changes in Physical Activity Among University Students in Indonesia from Before to During the COVID-19 Pandemic: A Retrospective Cohort Study

University life is an important phase for forming healthy physical activity habits among university students. However, little is known about the change in physical activity level during the COVID-19 pandemic among university students in Indonesia, which has a low stringency index. A retrospective cohort study was conducted among students of Universitas Gadjah Mada (n=153) from October to November 2020, where there were asked to recall their physical activity level and type of physical activity engaged in at four points of time: before the pandemic, early pandemic, Ramadan period, and relaxation period. Then, we conducted three-way mixed analyses of variance followed by Bonferroni’s post hoc comparisons tests to compare the mean difference of total moderate-vigorous physical activity with a subject over time and between subgroups in a similar time. Containment measures during the pandemic resulted in a 69.4-minute drop (95% confidence interval: 40.1 to 98.7 minutes, p&lt;.001) of total moderate-vigorous physical activity. While the relaxation of containment measures could restore non-health natural science students’ physical activity to the pre-pandemic amount, it did not influence health science students’ physical activity. Our findings provide evidence that pandemic situations in a low stringency index country also affected physical activity behavior among university students. More efforts are needed to increase university students’ physical activity during the COVID-19 pandemic, particularly among health science students.

Predicting Injury Risk Over Changes in Physical Activity in Children Using the Acute:Chronic Workload Ratio.

Limited research exists on the relationship between changes in physical activity levels and injury in children. In this study, we investigated the prognostic relationship between changes in activity, measured by the acute:chronic workload ratio (ACWR), and injury in children. We used data from the Childhood Health, Activity, and Motor Performance School Study Denmark (2008-2014), a prospective cohort study of 1,660 children aged 6-17 years. We modeled the relationship between the uncoupled 5-week ACWR and injury, defined as patient-reported musculoskeletal pain, using generalized additive mixed models. These methods accounted for repeated measures, and they improved model fit and precision compared with previous studies that used logistic models. The prognostic model predicted an injury risk of approximately 3% between decreases in activity level of up to 60% and increases of up to 30%. Predicted risk was lower when activity decreased by more than 60% (minimum of 0.5% with no recreational activity). Predicted risk was higher when activity increased by more than 30% (4.5% with a 3-fold increase in activity). Girls were at significantly higher risk of injury than boys. We observed similar patterns but lower absolute risks when we restricted the outcome to clinician-diagnosed injury. Predicted increases in injury risk with increasing activity were much lower than those of previous studies carried out in adults.

Changes in physical activity levels and mental health during COVID-19: Prospective findings among adult twin pairs.

BackgroundPhysical distancing and other COVID-19 pandemic mitigation strategies have negatively impacted physical activity (PA) levels and mental health in cross-sectional studies. The purpose of this study was to investigate associations between changes in PA and mental health outcomes during the COVID-19 pandemic, following implementation of mitigation strategies, in a sample of adult twins.MethodsThis was a prospective study of 3,057 adult twins from the Washington State Twin Registry. Study participants completed online surveys in 2020, at baseline (March 26 –April 5), and three follow-up waves (W1: April 20 –May 3; W2: Jul 16 –Aug 2; W3: Sept 16 –Oct 1). Physical activity was operationalized as self-reported moderate-to-vigorous PA (MVPA) and neighborhood walking (minutes/week), and mental health outcomes, operationalized as self-reported anxiety and perceived stress were assessed in the three waves of follow-up. Latent growth curve models (LGCMs) were used to assess changes in PA and mental health outcomes over time. Parallel LGCMs were used to estimate the cross-sectional, parallel, and prospective associations between PA and mental health over time. All models took into within-pair correlations and adjusted for age, sex, and race.ResultsIndividuals’ amount of MVPA and walking decreased over time, whereas levels of anxiety remained stable, and stress increased slightly. Cross-sectional associations observed between both PA predictors and mental health outcomes were weak. After taking into account cross-sectional associations between PA and mental health outcomes, changes in PA over time were not associated with changes in mental health outcomes over time.ConclusionsOver a time period aligned with COVID-19 mitigation strategies and social restrictions, changes in physical activity was not associated with changes in anxiety or stress levels in the current sample. Nonetheless, the average decline in PA over time is worrisome. Public health resources should continue to promote PA as a means to improve physical health during the pandemic.

Changes in physical activity levels and relationship to balance performance, gait speed, and self-rated health in older Swedish women: a longitudinal study.

Background and aimPhysical activity levels in older people often decrease and may mean impaired physical functioning leading to an increased fall risk. The aim of this study was to investigate self-reported change in physical activity dose and deterioration in balance performance, gait speed, and self-rated health (SRH) in older women between two time points in a follow-up study.MethodsA cohort of community-living women, aged 69–79 years (n = 351) were evaluated by questionnaire and clinical tests on balance, gait speed, and SRH at baseline. One hundred and eighty-six women were followed-up by these tests 8.5 years after inclusion. The non-parametric Wilcoxon signed-rank test and Mann–Whitney U test were used for the analysis.ResultsThe greatest changes were seen in one-leg standing time (OLST) with eyes closed (− 60%) and eyes open (− 42%). The population was divided into high exercise (HE, n = 49) and low exercise (LE, n = 51) groups. At baseline the HE group had an OLST of 19 s with eyes open and 3 s with eyes closed. In the LE group, these values were 7.3 s and 2 s. At follow-up, differences between HE and LE concerning tandem walk forwards (steps) (HE = 8.5; LE = 2.5) and backwards (HE = 11; LE = 3.5) emerged. The HE group estimated SRH (VAS-scale) 30 mm higher at baseline and 17 mm higher at follow-up than the LE group.ConclusionGreater physical activity seems to be an important predictor for maintaining physical function and SRH in older women.

Factors Associated with Reduction in Physical Activity during the COVID-19 Pandemic in São Paulo, Brazil: An Internet-Based Survey Conducted in June 2020.

Background: The COVID-19 pandemic negatively affected physical activity levels. This study investigated the factors associated with the change in physical activity level in Brazilians residing in the city of São Paulo. Methods: A self-administered questionnaire, addressing personal data, restriction level, education level, family income, daily working hours, and physical activity level, was answered by 2140 volunteers, of which 1179 were excluded because the answers were either incomplete or the respondents were not from São Paulo. The total number of participants selected was 961 (581 female and 380 male). Results: The physical activity level adopted prior to the pandemic period (p < 0.001) and family income (p = 0.001) correlated significantly with physical activity level reduction during the pandemic. The proportion of people who reduced their physical activity was greater among those who were very active than those who were active (adjusted prevalence ratio [aPR]: 0.65 [confidence interval (CI): 0.52–0.80]) or insufficiently active [aPR: 0.39 (0.18–0.82)]. The proportion of people who reduced their physical activity was greater among those who received a salary less than minimum wage (MW) than those who received a salary between three to six times minimum wage [(aPR: 0.50 (CI 0.35–0.70)] or more than 6 MW [(aPR: 0.56 (CI 0.40–0.79)]. Conclusions: A higher prevalence of Brazilians residing in the city of São Paulo reduced their physical activity who had a vigorous level of physical activity prior to the pandemic and who received less than a MW.

Relationship between Physical Activity and Physical and Mental Health Status in Pregnant Women: A Prospective Cohort Study of the Japan Environment and Children's Study.

To discuss appropriate physical activity (PA) levels during pregnancy, this prospective cohort study examined the relationships between PA levels before and during pregnancy and physical and mental health status. Fixed data for 104,102 pregnant women were used from the Japan Environment and Children’s Study, of which data for 82,919 women were analyzed after excluding women with multiple birth and pregnancy complications. PA levels were measured using the International Physical Activity Questionnaire-Short Form. The 8-Item Short Form Health Survey was used to measure outcomes. Logistic regression with multiple imputations showed that moderate PA for over 720 min/wk and vigorous PA before pregnancy were associated with poorer mental health in the first trimester (adjusted odds ratio (AOR): 1.087–1.376. Walking in the second and third trimesters was associated with better physical and mental health (AOR: 0.855–0.932). Moderate PA over 1080 min/wk and vigorous PA in the second and third trimesters were associated with poorer mental health (AOR: 1.223–1.873). Increases over 4135.4 MET–min/wk and decreases in PA levels were associated with poorer mental and physical health (AOR: 1.070–1.333). Namely, pregnant women receiving health benefits prefer continuous walking in addition to avoiding vigorous PA and excessive changes in PA levels during pregnancy.

Anxiety and depression levels in Malta: A year into Covid-19 pandemic

BackgroundCovid-19 pandemic resulted in a number of lifestyle changes and restrictive measures. The aim was to assess for the impact of Covid-19 on anxiety- depression levels and associated behavioural attitudes among the adult population of Malta.MethodsAn anonymous survey using Google Forms was disseminated on social media (1st to 26th of February), targeting the adult residents of Malta. The survey's questions assessed for socio-demographic characteristics, changes in physical activity levels, and body weight. The Generalised Anxiety Disorder assessment tool was used to evaluate the level of anxiety and the Patient Health Questionnaire-9 assessment tool was used to evaluate the level of depression among the participants during the pandemic. Quantitative and qualitative analyses were performed.ResultsA total of 1,034 participants responded. Mild anxiety levels (41.20% CI95%:38.24 - 44.23) and minimal depression levels (54.23% CI95%:51.17-57.25) were generally reported. On stratification by employment status, students reported severe anxiety levels (p = <0.01). Indeed, a participant reported, “COVID-19 made me very anxious…not knowing if I will be finishing my degree”. Covid-19 also impacted on behavioural attitudes, “I am eating more, I put on weight…resulting in feeling a bit depressed and have nothing to look forward to”. Indeed, a proportional increase in body weight was reported among those with mild to severe anxiety levels (p = <0.01). An inverse trend with an increase in anxiety and depression scores and decrease physical activity levels was observed (p = <0.01 respectively).ConclusionsThe population's mental health has been impacted differently, with some societal groups more susceptible than others. An increase in body weight and a decrease in physical activity appears to be linked with both anxiety and depression levels.Key messages Increase in mental health burden and obesity prevalence is anticipated as a resultant effect of Covid-19.Enhanced psychological support and prevention strategies targeting mental health and obesity are recommended.

Longitudinal Effects of Physical Activity Change on Hippocampal Volumes over up to 12Years in Middle and Older Age Community-Dwelling Individuals.

The objectives of this study were to investigate the long-term associations between changes in physical activity levels and hippocampal volumes over time, while considering the influence of age, sex, and APOE-ε4 genotype. We investigated the effects of change in physical activity on hippocampal volumes in 411 middle age (mean age = 47.2years) and 375 older age (mean age = 63.1years) adults followed up to 12years. An annual volume decrease was observed in the left (middle age: 0.46%; older age: 0.51%) but not in the right hippocampus. Each additional 10 metabolic equivalents (METs, ~2h of moderate exercise) increase in weekly physical activity was associated with 0.33% larger hippocampal volume in middle age (equivalent to ~1year of typical aging). In older age, each additional MET was associated with 0.05% larger hippocampal volume; however, the effects declined with time by 0.005% per year. For older age APOE-ε4 carriers, each additional MET was associated with a 0.10% increase in hippocampal volume. No sex effects of physical activity change were found. Increasing physical activity has long-term positive effects on hippocampal volumes and appears especially beneficial for older APOE-ε4 carriers. To optimize healthy brain aging, physical activity programs should focus on creating long-term exercise habits.

Effect of Lockdown on Diabetes Care During the COVID-19 Pandemic: Result of a Telephone-Based Survey Among Patients Attending a Diabetic Clinic in Northern India.

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has aggravated the demand for diabetes care due to restrictive measures like the lockdown affecting access to healthcare services. The current study was conducted to assess the changes in medication compliance, dietary pattern, and glucose monitoring during the lockdown period as compared to the pre-lockdown period among patients living with type 2 diabetes mellitus (T2DM) attending a diabetes clinic in northern India.MethodsThis cross-sectional study was conducted between May and July 2020. Information regarding the sociodemographic and clinical profiles of the patients like age, sex, income, qualification, family history of diabetes, history of smoking and alcohol, type of treatment, co-morbidities, drug adherence for T2DM, changes in the pattern of diet, physical activity, blood glucose monitoring, and drug usage during and before the lockdown was collected through telephonic interviews using a structured tool. Descriptive analysis was performed, and the chi-square and Wilcoxon sign ranks tests were used to see the association between variables.ResultsA total of 260 patients were enrolled in the study. A higher proportion of males reported a decrease in the consumption of cereals (13.9%), eggs (56.5%), and meat and fish (92.7%) and an increase in water intake (25.8%) while a higher proportion of females reported no change in physical activity levels (77.2%) during the lockdown against pre-COVID times. There was a significant improvement in medication adherence and glycemic control during the lockdown period as compared to the pre-lockdown times.ConclusionMore time for self-care, adequate counseling about glycemic goals, and knowledge of self-monitoring of blood glucose levels helped the majority of patients in adopting a healthy lifestyle and achieve better glycemic control during the COVID-19 lockdown.

CHILDREN WITH CONGENITAL HEART DISEASE EXHIBIT LOWER PHYSICAL ACTIVITY LEVELS AND LOSS OF SEASONAL PATTERNS DURING THE COVID-19 PANDEMIC

<h3>BACKGROUND</h3> Congenital heart disease (CHD) occurs in about 1% of live births. Most patients with CHD now survive to adulthood, but they are at increased risk of secondary cardiovascular outcomes. This increased risk can be mitigated through modifiable behaviours, including physical activity. Public health measures in effect from March 2020 onward to reduce the spread of COVID-19 had widespread impacts on daily behaviours. In this study, we aimed to prospectively quantify changes in physical activity levels among children with CHD during the COVID-19 pandemic in 2020. <h3>METHODS AND RESULTS</h3> We measured physical activity continuously using step-counts from Fitbit trackers in a sample of children with CHD (9-16 years old at enrolment; diagnosed with coarctation of the aorta, tetralogy of Fallot, transposition of the great arteries, or Fontan circulation) participating in an ongoing prospective cohort study. In 2019 and 2020 respectively, 114 (54 % male, 12.7±2.5 years) and 93 (48% male, 13.1±2.5 years) participants had valid data. Mean daily step-counts were lower in 2020 than in 2019 (8,581±5,598 vs. 9,859±5,420, respectively, p < 0.001). The mean daily step-count was below 12,000 (an estimated equivalent of 60 minutes of moderate-to-vigorous physical activity per day) throughout 2019 and 2020. Step-count peaks (late spring and fall) and troughs (winter and summer holidays) observed in 2019 were absent in 2020. During the initial phase of the COVID-19 pandemic (spring 2020) there was a downward trend and trough in step-counts. Weekly comparison of mean daily step-counts between 2019 and 2020 demonstrated a significant decrease in 18/52 weeks (35% of the year, p < 0.05). These significant reductions corresponded to lost seasonality: all occurred in the spring (April-June) and fall (September-November), in place of anticipated peaks. In spring 2020, 68% of participants attended school virtually, while in the fall that had decreased to 9%. <h3>CONCLUSION</h3> There was a significant decrease in overall physical activity in children with CHD during 2020. This decrease was temporally linked to COVID-19 related public health measures. We found a loss of seasonal physical activity variations in 2020, even when the majority of participants had returned to in-person schooling. This year-long reduced physical activity is of significant concern for children with CHD. Physical activity reduces cardiovascular risk, has broad health impacts, and behavioural patterns that track into adulthood. Therefore as COVID-19 related measures continue, it is crucial to support and promote physical activity in this vulnerable population to mitigate long-term health impacts.

How much does the Level of Physical Activity Change in Patients with Physical Disabilities Hospitalized for Rehabilitation?

Objective: This study aimed to examine the short term effect of inpatient rehabilitation program on self –reported physical activity in participants with physical disabilities.&#x0D; Material and Methods: The patients were divided into groups as group 1: individuals with physical disability due to musculoskeletal diseases, and group 2: individuals with physical disability due to neurological diseases. The results of Physical Activity Scales for Individuals with Physical Disabilities (PASIPD) at one month after discharge (PA2) compared with the results of PASIPD at hospitalization (PA1). The first assessment was done face-to face, but the assessment after discharge were made using phone. &#x0D; Results: There was a significant difference between PA2 and PA1 in group 1, group 2, and among all participants (p=0.001). The change in physical activity level from hospitalization to one month after discharge was similar in the two groups (p=0.564).&#x0D; Conclusion: While people learn to live with a disability, quickly integrating physical activity with rehabilitation program into their new daily routine can be seen as a good strategy.

PHYSICAL ACTIVITY BEFORE AND DURING COVID-19 PANDEMIC; ANALYSIS OF CHANGES AND CORRELATES IN CROATIAN ADOLESCENTS

The COVID-19 pandemic affected the changes in physical activity levels (PAL). The purpose of this study was to determine the correlates of PAL during the COVID-19 pandemic among adolescents. This research included 209 adolescents aged 15-17 years from Croatia (89 boys, 120 girls). They were tested on anthropometrics, and fitness status (predictors). The fitness status was assessed before lockdown and included test of running 6 minutes (F6), jump rope, and sprint 100 meters. The PAL (assessed by the Physical Activity Questionnaire for Adolescents) was evidenced before- and during-lockdown and was observed as criteria. Changes in PAL between baseline and follow-up were evidenced by t-test for dependent samples. Associations between the fitness and anthropometric variables and PAL were evidenced by univariate and multivariate analyses. The PAL decreased significantly as a result of lockdown (t-test =3.46, p&lt;0.001). In the total sample, significant correlations were found between aerobic endurance and sprinting, and baseline PAL (r=0.37; r=-0.32, respectively), aerobic endurance and follow-up PAL (r=0.34), sprint 100m and baseline to follow-up difference in PAL (r=-0.23). When gender stratified, correlations were significant only for boys. Better aerobic endurance determined baseline PAL, better sprint determined greater PAL decline as a result of lockdown. Results evidenced specific correlates of PAL before and during pandemic. Future studies investigating other correlates of PAL are warranted, to create interventions for maintaining adequate PAL during COVID-19 and similar crises.

Momentary affective response to bouts of moderate-to-vigorous physical activity predicts changes in physical activity and sedentary behavior during behavioral weight loss

BackgroundAffective responses are posited to be key predictors of the uptake and maintenance of health behaviors. However, few studies have examined how individuals’ affective response to physical activity, as well as the degree to which their affect response changes, may predict changes in physical activity and sedentary time during behavioral weight loss treatment. PurposeThe current study examined how baseline momentary affective response (i.e., stress and anxiety) to moderate-to-vigorous physical activity (MVPA) and the degree of pre--post intervention change in this response predicted change in daily sedentary, light, and MVPA time during a three-month internet-based weight loss program. MethodsWomen with overweight/obesity (final N = 37) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after the intervention. ResultsWomen who had more reinforcing responses to MVPA (i.e., greater reductions in anxiety and stress response following MVPA bouts) at baseline had greater increases in overall MVPA at the end of the intervention. Those who had greater anxiety reductions after MVPA bouts at baseline also evidenced less sedentary time at the end of the intervention. Changes in affective responses across the intervention were not related to changes in physical activity levels. ConclusionsFindings suggest initial levels of affective reinforcement from MVPA bouts predict future change in MVPA and sedentary time during behavioral weight loss. Future work is needed to examine the utility of more precisely targeting affective responses to physical activity to optimize intervention approaches.

The effects of COVID‐19 on self‐management behaviours and service experiences in type 2 diabetes mellitus

This study explored the impact of COVID‐19 on adults with type 2 diabetes mellitus (T2DM) self‐management behaviours and service experiences within an ethnically diverse UK sample.A cross‐sectional survey design was employed. An 18‐item survey was administered to suitable patients attending the Lambeth Diabetes Intermediate Care Team (South East London, UK) via text message (n=993) or post (n=62).A total of 150 participants completed the survey, which revealed that 30% had changed their diabetes medication taking behaviour since the start of the COVID‐19 pandemic for a number of reasons. Negative changes in physical activity levels and dietary behaviours were also reported. Of those who received a telephone consultation, high satisfaction levels were reported but a clear preference for face‐to‐face consultations was still present.Our findings suggest that the COVID‐19 pandemic is having a negative impact on individuals with T2DM physical activity levels and dietary behaviours. Additionally, the findings indicate that although telephone consultations were highly accepted, many would prefer to receive a face‐to‐face consultation in future. Copyright © 2021 John Wiley & Sons.

The Spinal Cord Injury Program in Exercise (SCIPE) study: study protocol for a randomized controlled trial evaluating teleexercise programs for people with spinal cord injury

BackgroundMany people with spinal cord injury (SCI) have limited access to tailored, readily available exercise resources. As a result, exercise remains an underutilized treatment strategy for improving health and function in people with SCI. The purpose of this study is to test the effectiveness of two remotely delivered exercise programs for people with SCI.MethodsThe Spinal Cord Injury Program in Exercise (SCIPE) study is a three-arm adaptive randomized controlled trial examining two 8-week teleexercise interventions: Movement-to-Music (M2M) and Standard Exercise Training (SET), compared to Attention Control (AC) in 327 adults with SCI. The primary outcome is change in physical activity level at post 8-week intervention. The study contains two interim analyses. The first interim analysis will assess feasibility metrics of the protocol after 36 participants complete the 8-week intervention period. The second interim analysis will examine two effectiveness comparisons: SET vs. AC and M2M vs AC, after 165 participants complete the intervention period. Early termination of the intervention arm(s) will take place when non-significant findings are found in the corresponding intervention(s). Incorporation of such interim analysis enhances trial efficiency by dropping the intervention(s) that deemed ineffective. It provides ethical benefits and allows allocation of additional resources to explore the effective intervention(s).DiscussionDelivery of teleexercise programs may be an effective strategy for addressing transportation barrier to exercise resources and increasing physical activity level and quality of life in people with SCI.Trial registrationClinicalTrials.gov Identifier NCT03925077. Registered trial name: Spinal Cord Injury Program in Exercise (SCIPE). Registered on April 23rd, 2019.

Implementing Exercise in Standard Cancer Care (Bizi Orain Hybrid Exercise Program): Protocol for a Randomized Controlled Trial.

BackgroundDespite the established benefits of regular exercise for patients with cancer to counteract the deleterious effects of the disease itself and treatment-related adverse effects, most of them do not engage in sufficient levels of physical activity and there is a paucity of data on the integration of efficacious exercise programs that are accessible and generalizable to a large proportion of patients with cancer into routine cancer care.ObjectiveWe intend to examine the effects attributable to the implementation of a community-based exercise program on cardiorespiratory functional capacity and quality of life for patients with cancer.MethodsThis will be a hybrid study. In the first experimental phase, patients diagnosed with any type of cancer will be randomized into two parallel groups. One group immediately performs Bizi Orain, a 3-month supervised exercise program (3 times a week), in addition to behavioral counseling in a primary health care setting; the other is a reference group that starts the exercise program 3 months later (delayed treatment). In the second observational phase, the entire cohort of participants will be followed-up for 5 years. Any person diagnosed with cancer in the previous 2 years is eligible for the program. The program evaluation involves the uptake, safety, adherence, and effectiveness assessed after completion of the program and with follow-ups at 3, 6, 12, 24, 36, 48, and 60 months. The primary outcomes of the experimental study, to be compared between groups, are improved physical function and quality of life, whereas overall survival is the main objective of the prospective study. To analyze the association between changes in physical activity levels and overall survival, longitudinal mixed-effects models will be used for repeated follow-up measures.ResultsA total of 265 patients have been enrolled into the study since January 2019, with 42 patients from the hematology service and 223 from the oncology service.ConclusionsBizi Orain is the first population-based exercise program in Spain that will offer more insight into the implementation of feasible, generalizable, and sustainable supportive care services involving structured exercise to extend survival of patients with cancer, improve their physical function and quality of life, and reverse the adverse effects of their disease and related treatments, thereby reducing the clinical burden.Trial RegistrationClinicalTrials.gov NCT03819595; http://clinicaltrials.gov/ct2/show/NCT03819595International Registered Report Identifier (IRRID)DERR1-10.2196/24835