Community Health Activities Model Program Research Articles

Associations between perceptions of relationship quality and markers of inflammation and insulin resistance among couples coping with cancer.

Couples' health and health behaviors are intertwined, where the health of one partner can influence the health of the other but the biologic underpinnings are not known. We examined the associations between relational health and markers of inflammation and insulin resistance in couples coping with breast or prostate cancer. Participants (90 cancer survivor-spouse dyads) completed self-report measures of relational health including Dyadic Adjustment Scale-7 (relationship quality), Dyadic Coping Inventory (communication), and shared physical activity, as well as Community Health Activities Model Program for Seniors (individual physical activity). Inflammation (C-reactive protein (CRP)) and homeostasis model assessment of insulin resistance (HOMA-IR) were measured in serum samples. Structural equation modeling including demographic and clinical covariate controls was used to estimate separate actor and partner effects of relationship quality, communication, and physical activity on CRP and HOMA-IR. Participants were aged 63.1 ± 10.4years with an average relationship duration of 30.0 ± 1.1years. Higher survivor perceived relationship quality was associated with lower spouse CRP (b = - 0.07; 95%CI: - 0.13, - 0.01), whereas higher spouse perceived relationship quality was associated with lower survivor HOMA-IR (b = - 0.07; 95%CI: - 0.13, - 0.03). There were no other significant actor or partner effects observed. Among cancer survivor-spouse dyads, how one member of the couple perceives the quality of the relationship impacts disease biomarkers in the other, providing preliminary evidence for biological linkage between relational health and chronic disease risk. Relationship quality may positively influence biomarkers of inflammation and insulin resistance in couples coping with breast and prostate cancer. Dyadic approaches to optimize survivorship health may be warranted. ClinicalTrials.gov NCT03630354, 08/14/2018; Open Science Framework ( https://bit.ly/3S4rUtJ ).

Reliability and Validity of Light-Intensity Physical Activity Scales in Adults: A Systematic Review

ABSTRACT This study aimed to review the validity and/or reliability of light-intensity physical activity (LPA) questionnaires and identify the most suitable questionnaires for measurement of LPA in adults. Following the PRISMA-P 2020 guidelines, we searched MEDLINE, PsycINFO, CINAHL, Scopus, Embase, and MedNar. Only studies that targeted adults ≥18 years old and used LPA measured by accelerometer and/or heart rate monitor as an objective criterion were included. The search resulted in 2748 article hits, from which we extracted 16 studies with 14 questionnaires. The 7-Day Sedentary and LPA Log and LPA Questionnaire were specifically designed for LPA measurement, and the Community Health Activities Model Program for Seniors physical activity self-report questionnaire scale has been revised for LPA measurement. These questionnaires had comparatively high reliability and validity in this review. Most studies contained methodological limitations such as test-retest period. In the future, more accurate reliability/validity studies should be conducted for each questionnaire.

Pragmatic Evaluation of Older Adults' Physical Activity in Scale-Up Studies: Is the Single-Item Measure a Reasonable Option?

Convergent validity and responsiveness to change of the single-item physical activity measure were assessed in adults aged 60 years and older, at baseline (n = 205) and 6 months (n = 177) of a health promotion program, Choose to Move. Spearman correlations were used to examine associations between physical activity as measured by the single-item measure and the Community Health Activities Model Program for Seniors (CHAMPS) questionnaire at baseline and for 6-month change in all participants and for sex and age (60-74 years, and ≥75 years) subgroups. Effect size assessed responsiveness to change in physical activity for both tools. Baseline physical activity by the single-item measure correlated moderately with physical activity by the CHAMPS questionnaire in all participants and subgroups. Correlations were weaker for change in physical activity. Effect size for physical activity change was larger for the single-item measure than for the CHAMPS questionnaire. The single-item measure is a valid, pragmatic tool for use in intervention and scale-up studies with older adults.

Cross-cultural modifications and measurement properties of the CHAMPS questionnaire among Chinese older adults

Background/objectiveThe Community Health Activities Model Program for Seniors questionnaires (CHAMPS-Q) is one of the most extensively used instruments in assessing physical activity among older adults. However, no study had translated the CHAMPS-Q into Chinese, and no evaluations were made on the psychometric properties of the CHAMPS-Q among the Chinese population. Considering cultural differences in perceptions of language, cultural context and living habits, this study was of necessary to 1) translate and cross-culturally adapt the original CHAMPS-Q, and 2) examine the test-retest reliability and construct/predictive validity of the Chinese version of the CHAMPS-Q. MethodsThe English CHAMPS-Q was first translated into Chinese, synthesized, back-translated, and revised by an expert committee according to the pre-test results. The Chinese CHAMPS-Q was then assessed in a cross-sectional study consisting of 101 apparently healthy older adults. Test-retest reliability test was conducted with 7 days apart. The construct validity of the Chinese CHAMPS-Q was tested against accelerometer data, and the predictive validity was assessed against physical fitness as measured by the Senior Fitness Test. ResultsThe Chinese CHAMPS-Q has moderate to excellent test-retest reliability (ICC = 0.72-.96, p < .05). Energy expenditure and duration in PA significantly correlated with all accelerometry outcomes (ρ = 0.22-.31, p < .05). All the outcomes from the CHAMPS-Q showed significant correlations with upper body muscle strength (ρ = 0.22-.34, p < .05). ConclusionThe Chinese CHAMPS-Q has excellent test-retest reliability and acceptable construct and predictive validity in assessing the physical activity of Chinese older adults.

Feasibility of low-cost accelerometers in measuring functional recovery after major oncologic surgery.

Low-cost consumer-based activity monitors (CAMs), such as the Fitbit, are popular for fitness and wellness tracking. Functional status is an excellent predictor of postoperative outcomes, yet objective measurements are resource-intensive. The aim of this study is to demonstrate the feasibility of using activity monitors during the perioperative period in patients undergoing major oncologic surgery. An institution review board proved that a prospective study was conducted. CAMs were worn throughout the perioperative period and accelerometer data were collected. Baseline and 21-days follow-up functional measures included short physical performance battery, Community Health Activities Model Program questionnaire, mobility assessment tool-short form, and 400 m walk. A total of 19 of 22 (86%) patients who wore a CAM during the perioperative period had analyzable data. Compliance with wearing the device varied significantly: 100% preadmission, 19% in-hospital, and 82% postdischarge. Median daily steps decreased from preadmission to postdischarge (77% median reduction). Established resource-intensive measures of functional status did not perform well as measures of decreased functional status and activity when comparing baseline to 21-day postdischarge assessments. Activity monitors are a feasible, low-cost measure of perioperative activity for patients undergoing major surgery, and may be useful in identifying patients vulnerable to postsurgical complications.

High-Intensity Functional Training Shows Promise for Improving Physical Functioning and Activity in Community-Dwelling Older Adults: A Pilot Study.

Healthy aging allows older adults to remain active in their communities; however, sedentary behaviors can lead to physical deconditioning and decreased physical function. Structured exercise programs are recommended to facilitate activity engagement and prevent muscle atrophy due to aging to facilitate older adults' abilities to complete activities of daily living. In particular, high-intensity functional training (HIFT) is a multicomponent group exercise program that has previously been shown to increase physical function for middle-age cancer survivors. This study examined the preliminary feasibility and effectiveness of HIFT for improving physical function and participation in physical activity for community-dwelling older adults. The 8-week pilot study included two 60-minute HIFT sessions per week. Participants (n = 8) were 75% female with a mean age of 71 (6) years. Study initiation, adherence, and acceptability were assessed to determine feasibility. Effectiveness was assessed via 5 physical function measures conducted during sessions 1 and 16 and included the Timed Up and Go, lift and carry test, chair stand test, a repeated stair climb test, and the 6-minute walk test. Participants also self-reported confidence and difficulty for activities of daily living via the Outpatient Physical Therapy Improvement in Movement Assessment Log and physical activity participation via the Community Health Activities Model Program for Seniors questionnaire. The study recruitment rate was 88.9% and 87.5% of participants adhered. Intervention acceptability was promising, as 4 participants reported liking multiple aspects of the intervention (eg, coaching/supervision and similar age peers). Intervention effectiveness was promising with significant improvement in 1 of 5 physical function measures, although clinical effects were most likely trivial. Participants reported increased participation in both leisure and structured physical activities. HIFT appeared feasible and showed promise for counteracting the loss of physical function and sedentary behaviors associated with aging. Results should be confirmed in a longer, fully powered study.

Physical activity change after a promotora-led intervention in low-income Mexican American women residing in South Texas

BackgroundThe purpose of this study was to determine physical activity (PA) preferences associated with increases in moderate-to-vigorous physical activity (MVPA) and decrease in sedentary time in Mexican American (MA) women participating in a Promotora (community health worker)-led intervention on the U.S.-Mexico border.MethodsEnlace (‘to link’ in Spanish) was a randomized clinical trial to increase PA in low-income, MA women living in South Texas on the U.S.-Mexico border. A total of 620 participants were recruited into the study. The primary outcome was increase in moderate to vigorous physical activity (MVPA) using the Actigraph GT3X 16 Mb accelerometer. A modified version of the Community Health Activities Model Program for Seniors Physical Activity (CHAMPS) instrument was used to predict MVPA. Adjusted and unadjusted logistic regression models predicted change in MVPA by change in CHAMPS activities. ANOVA analysis determined the variance explained in change in MVPA by change in time engaged in activity. Individual effect sizes were then calculated for significant activity type change on MVPA increase.ResultsThere were significant increases in all CHAMPS activities except aerobic machines and errand walking. An increase in leisure walking (O.R. = 2.76, p = .046), errand (O.R. = 3.53, p = .051), and brisk walking (O.R. = 4.74, p = .011), dance (O.R. = 8.22, p = .003), aerobics class (O.R. = 32.7, p = .001), and light housework (O.R. = 6.75, p = .000), were associated with a decrease in sedentary time. Significant effect sizes for MVPA were observed for jogging (1.2, p = .050), general exercise (1.6, p = .024), and other exercise not specified (2.6, p = .003). Significant effect sizes for sedentary time were detected for leisure time (.031, p = .036), errands (.017, p = .022), brisk walking (.022, p = .003), dance (.042, p = .005), and aerobics class (.013, p = .009).DiscussionParticipants who engaged in walking and aerobic activities through this intervention significantly increased their engagement in MVPA and decreased their sedentary time. These findings are novel, since preferences have not been examined in relation to MVPA or sedentary time in MA women.ConclusionPA preferences need to be considered when aiming to promote activities that reduce sedentary time and increase PA participation among marginalized groups, such as MA women.Trial registrationNCT02046343.

Validity and Reliability of the Polish Adaptation of the CHAMPS Physical Activity Questionnaire.

The aim of the study was to investigate the reliability and construct validity of the Polish adaptation of the Community Health Activities Model Program for Seniors (CHAMPS) physical activity questionnaire among the elderly. The sample included 104 volunteers, 75 women (age = 71.0 ± 5.0 years) and 29 men (age = 75.1 ± 6.6 years). To assess the reliability of the Polish version of the CHAMPS physical activity questionnaire, measurements were conducted by one-week test-retest. The construct validity of the CHAMPS physical activity questionnaire was evaluated using accelerometers. Criterion validation was verified by self-reported measurements (health self-assessment, life satisfaction, and wellbeing) and body composition analysis. Intraclass correlation coefficients of the one-week test-retest ranged from 0.79 to 0.85. Significant Pearson's correlations were found between caloric expenditure measured by accelerometer and CHAMPS caloric expenditure in all listed physical activities (r = 0.33) and caloric expenditure in at least moderate intensity physical activities (r = 0.37) of the CHAMPS physical activity questionnaire. Moderate and greater intensity physical activities of CHAMPS measure were significantly related to total bone mass, health self-assessment, life satisfaction as a whole, and personal wellbeing (r ranged from 0.26 to 0.34). The findings of the study allow us to conclude that the Polish version of the CHAMPS physical activity questionnaire has acceptable reliability and validity to assess physical activity of older adults.

The Role of Social Support and the Neighborhood Environment on Physical Activity in Low-income, Mexican-American Women in South Texas.

ObjectivesTo determine the relationships between physical activity (PA), the neighborhood environment support for PA, and social support for PA among Mexican-American women living in South Texas. The Enlace study was a randomized controlled trial that tested the effectiveness of a promotora-led PA intervention among low-income Mexican origin women (n=614) living in colonias.MethodsThe dependent measures included accelerometer-measured average moderate to vigorous physical activity (MVPA) and sedentary breaks and the Community Health Activities Model Program for Seniors PA 41-item questionnaire. The independent measures included the Physical Activity and Neighborhood Environment Scale (PANES) and the 13-item Physical Activity Social Support (PASS) scale.ResultsEnlace participants were on average 40.4 (standard deviation, 10.3) years old, born in Mexico (86.1%), and uninsured (83.1%). Adjusted linear regression results indicated that each 1-point increment in the PANES overall score was associated with 0.050 (p<0.001) unit increase in sedentary break and a −0.043 (p=0.001) unit decrease in sedentary break duration. Both PANES (β=0.296; p=0.002) and PASS scores (β=0.076; p<0.001) were associated with weekly average self-reported MVPA. Interaction effects were observed between PASS scores and accelerometer-measured frequency of sedentary breaks and sedentary time duration.ConclusionsThe findings of this study indicate that the relationships between PA and built environment and social support are measure-dependent and suggest that reducing sedentary time in this population may require a closer assessment of social support for PA.

Reliability and validity of the Brief Pain Inventory in individuals with chronic obstructive pulmonary disease.

Pain is prevalent in chronic obstructive pulmonary disease (COPD) and the Brief Pain Inventory (BPI) appears to be a feasible questionnaire to assess this symptom. However, the reliability and validity of the BPI have not been determined in individuals with COPD. This study aimed to determine the internal consistency, test-retest reliability and validity (construct, convergent, divergent and discriminant) of the BPI in individuals with COPD. In order to examine the test-retest reliability, individuals with COPD were recruited from pulmonary rehabilitation programmes to complete the BPI twice 1week apart. In order to investigate validity, de-identified data was retrieved from two previous studies, including forced expiratory volume in 1-s, age, sex and data from four questionnaires: the BPI, short-form McGill Pain Questionnaire (SF-MPQ), 36-Item Short Form Survey (SF-36) and Community Health Activities Model Program for Seniors (CHAMPS) questionnaire. In total, 123 participants were included in the analyses (eligible data were retrieved from 86 participants and additional 37 participants were recruited). The BPI demonstrated excellent internal consistency and test-retest reliability. It also showed convergent validity with the SF-MPQ and divergent validity with the SF-36. The factor analysis yielded two factors of the BPI, which demonstrated that the two domains of the BPI measure the intended constructs. The BPI can also discriminate pain levels among COPD patients with varied levels of quality of life (SF-36) and physical activity (CHAMPS). The BPI is a reliable and valid pain questionnaire that can be used to evaluate pain in COPD. This study formally established the reliability and validity of the BPI in individuals with COPD, which have not been determined in this patient group. The results of this study provide strong evidence that assessment results from this pain questionnaire are reliable and valid.

Obesity Moderates the Effects of Motivational Interviewing Treatment Outcomes in Fibromyalgia.

Obesity is a common comorbid condition among patients with fibromyalgia (FM). Our objective was to assess if obesity moderates the treatment benefits of exercise-based motivational interviewing (MI) for FM. This is a secondary data analysis of a completed clinical trial of 198 FM patients who were randomized to receive either MI or attention control (AC). Using body mass index (BMI) to divide participants into obese (BMI≥30 kg/m) and nonobese (BMI<30 kg m) groups, mixed linear models were used to determine interaction between treatment arms and obesity status with regards to the primary outcome of global FM symptom severity (Fibromyalgia Impact Questionnaire, FIQ). Secondary measures included pain intensity (Brief Pain Inventory), 6-Minute Walk Test, and self-reported physical activity (Community Health Activities Model Program for Seniors). Of the 198 participants, 91 (46%) were nonobese and 107 (54%) were obese. On global FM symptom severity (FIQ), the interaction between treatment arms and obesity status was significant (P=0.02). In the nonobese group, MI was associated with a greater improvement in FIQ than AC. In the obese group, MI participants reported less improvement in FIQ compared with AC. The interaction analysis was also significant for Brief Pain Inventory pain intensity (P=0.01), but not for the walk test and self-reported physical activity. This is the first study to show that obesity negatively affects the treatment efficacy of MI in patients with FM. Our findings suggest that exercise-based MI may be more effective if initiated after weight loss is achieved.

Mentally stimulating activities associate with better cognitive performance in Parkinson disease.

Subjects at risk of dementia benefit from participation in mentally stimulating activities, but no prior studies have investigated similar associations in Parkinson disease (PD). The aim of this study was to investigate the relationship between times spent engaging in mentally stimulating activities and cognitive functions in PD while accounting for the degree of primary neurodegenerations. PD patients (N=41, 33 males; age 68.5±7.2; Hoehn and Yahr stage 2.6±0.6) completed the Community Health Activities Model Program for Seniors questionnaire, mini-mental state examination (MMSE), and [11C]dihydrotetrabenazine dopaminergic and [11C]piperidinyl propionate acetylcholinesterase PET imaging. The subset of mentally stimulating activity items of the Community Health Activities Model Program for Seniors questionnaire was used to develop a rating scale as primary outcome variable in this study. Findings showed that mean rating scale score of time spent in mentally stimulating activities over a 4-week timespan was 20.0±8.3h and mean MMSE score was 28.4±1.9. Regression analysis showed that duration of participation in mentally stimulating activities was a significant predictor of MMSE scores (standardized β=0.39, t=2.8, p=0.009; total model: F (6,34)=3.5, p=0.005) independent from significant effects for cortical cholinergic activity (β=0.35, t=2.4, p=0.024). Caudate nucleus dopaminergic activity, age, education, or duration of disease were not significant regressors. Post hoc analysis did not show significant effects of motor disease severity or level of physical activities. We conclude that engagement in mentally stimulating activities is associated with better cognitive abilities in PD, independent of education, severity of motor disease, nigrostriatal dopaminergic and cortical cholinergic degenerations.

Obesity Moderates the Effects of Motivational Interviewing Treatment Outcomes in Fibromyalgia

PURPOSE: Obesity is a common comorbid condition among patients with fibromyalgia (FM). The purpose of this study was to assess if obesity moderates the treatment benefits of exercise-based motivational interviewing (MI) for FM. METHODS: This is a secondary data analysis of a completed clinical trial of 198 FM patients who were randomized to receive either MI or attention control (AC). Using body mass index (BMI) to divide participants into obese (BMI > 30 kg/m2) and non-obese (BMI < 30 kg m2) groups, mixed linear models were used to determine interaction between treatment arms and obesity status with regards to the primary outcome of global FM symptom severity (Fibromyalgia Impact Questionnaire, FIQ). Secondary measures included pain intensity (Brief Pain Inventory, BPI), 6-minute walk test, and self-reported physical activity (Community Health Activities Model Program for Seniors). RESULTS: Of the 198 participants, 91 (46%) were non-obese and 107 (54%) were obese. On global FM symptom severity (FIQ), the interaction between treatment arms and obesity status was significant (p=0.02). In the non-obese group, MI was associated with a greater improvement in FIQ than AC. In the obese group, MI participants reported less improvement in FIQ compared to AC. The interaction analysis was also significant for BPI pain intensity (p=0.01), but not for the walk test and self-reported physical activity. CONCLUSIONS: This is the first study to show that obesity negatively affects the treatment efficacy of MI in patients with FM. Our findings suggest that exercise-based MI may be more effective if initiated after weight loss is achieved.

Impact of miniport laparoscopic cholecystectomy versus standard port laparoscopic cholecystectomy on recovery of physical activity: a randomized trial.

We conducted a randomized trial comparing minilaparoscopic cholecystectomy (MLC) to conventional laparoscopic cholecystectomy (CLC) to determine whether MLC accelerated recovery of physical activity after elective surgery (NCT01397565). A total of 115 patients scheduled for elective cholecystectomy were randomized to either CLC or MLC. Both procedures used a 10-mm umbilical port, but the three upper abdominal ports were 5mm in CLC and 3mm in MLC. Primary outcome was self-reported physical activity 1month after surgery as estimated by Community Health Activities Model Program for Seniors questionnaire (kcal/kg/week). Secondary outcomes were umbilical pain, abdominal pain, nausea and fatigue (VAS, 1-10), and cosmetic result at one and 3months. Patients received identical surgical dressings for 1week, and assessors were blinded to group allocation. Forty-two patients randomized to CLC group and 33 patients randomized to MLC remained in the trial and were analyzed. Both groups were similar at baseline characteristics. In the MLC group, at least one 5-mm port was used in 17 (51.5%) mainly due to unavailability of ML equipment. Median (IQR) physical activity for the CLC and MLC groups was similar at baseline (23.4 [13.1, 44.6] vs 23.6 [14.2, 66.9] kcal/kg/week, p=0.35) and at 1month (20 [7.9, 52.5] vs 16.8 [11.8, 28.6] kcal/kg/week, p=0.90). One month post-op, umbilical pain and abdominal pain were similar, but the CLC group reported higher fatigue (4 [1-5] vs 1 [0-4], p=0.05) and worse scar appearance scores (4 [3, 4] vs 4.5 [4, 5], p=0.009). At 3months, the CLC group had worse scar appearance (4 [3-5] vs 5 [4-5], p=0.02) and lower scar satisfaction scores (4 [3, 4] vs 4 [3.5-4], p=0.04). Recovery of physical activity was similar after MLC and CLC. MLC resulted in less fatigue and better scar appearance and satisfaction. These benefits were seen despite the need to upsize one or more ports in more than half of patients related to availability of the miniature instruments.

Wearable-Sensor-Based Classification Models of Faller Status in Older Adults.

Wearable sensors have potential for quantitative, gait-based, point-of-care fall risk assessment that can be easily and quickly implemented in clinical-care and older-adult living environments. This investigation generated models for wearable-sensor based fall-risk classification in older adults and identified the optimal sensor type, location, combination, and modelling method; for walking with and without a cognitive load task. A convenience sample of 100 older individuals (75.5 ± 6.7 years; 76 non-fallers, 24 fallers based on 6 month retrospective fall occurrence) walked 7.62 m under single-task and dual-task conditions while wearing pressure-sensing insoles and tri-axial accelerometers at the head, pelvis, and left and right shanks. Participants also completed the Activities-specific Balance Confidence scale, Community Health Activities Model Program for Seniors questionnaire, six minute walk test, and ranked their fear of falling. Fall risk classification models were assessed for all sensor combinations and three model types: multi-layer perceptron neural network, naïve Bayesian, and support vector machine. The best performing model was a multi-layer perceptron neural network with input parameters from pressure-sensing insoles and head, pelvis, and left shank accelerometers (accuracy = 84%, F1 score = 0.600, MCC score = 0.521). Head sensor-based models had the best performance of the single-sensor models for single-task gait assessment. Single-task gait assessment models outperformed models based on dual-task walking or clinical assessment data. Support vector machines and neural networks were the best modelling technique for fall risk classification. Fall risk classification models developed for point-of-care environments should be developed using support vector machines and neural networks, with a multi-sensor single-task gait assessment.

Moderate-intensity physical activity is independently associated with lower-extremity muscle power in older women

ABSTRACTSkeletal muscle power is a salient determinant of physical function in older adults, but its relationship with habitual physical activity has not been well-characterized. The aim of this study was to examine the association between moderate-intensity physical activity and lower-extremity muscle power in community-dwelling older women. Older women (n = 96, mean age = 73.9 ± 5.6 years, mean body mass index = 26.5 ± 4.7 kg/m2) underwent assessments for body composition via dual-energy X-ray absorptiometry and lower-extremity muscle power (watts) using the Nottingham power rig. The Community Health Activities Model Program for Seniors questionnaire was used to estimate weekly caloric expenditure in moderate-intensity physical activity (kcals/wk). Linear regression indicated that moderate-intensity physical activity was independently related to muscle power (standardized β = 0.20, p = .03), and this relationship remained following adjustment for covariates. Analysis of covariance revealed that women in the highest tertile of volume of physical activity had significantly greater muscle power than those with the lowest volume (199.0 vs. 170.7 watts, p < .05). Moderate-intensity physical activity was independently associated with lower-extremity muscle power in older women. Future intervention trials should determine if increasing habitual physical activity is associated with improvements in lower-extremity muscle power in older women.

Non-exercise physical activity attenuates motor symptoms in Parkinson disease independent from nigrostriatal degeneration.

To investigate the relationship between time spent in non-exercise and exercise physical activity and severity of motor functions in Parkinson disease (PD). Increasing motor impairments of PD incline many patients to a sedentary lifestyle. We investigated the relationship between duration of both non-exercise and exercise physical activity over a 4-week period using the Community Health Activities Model Program for Seniors (CHAMPS) questionnaire and severity of clinical motor symptoms in PD. We accounted for the magnitude of nigrostriatal degeneration. Cross-sectional study. PD subjects, n = 48 (40 M); 69.4 ± 7.4 (56-84) years old; 8.4 ± 4.2 (2.5-20) years motor disease duration, mean UPDRS motor score 27.5 ± 10.3 (7-53) and mean MMSE score 28.4 ± 1.9 (22-30) underwent [(11)C]dihydrotetrabenazine (DTBZ) PET imaging to assess nigrostriatal denervation and completed the CHAMPS questionnaire and clinical assessment. Bivariate correlations showed an inverse relationship between motor UPDRS severity scores and duration of non-exercise physical activity (R = -0.37, P = 0.0099) but not with duration of exercise physical activity (R = -0.05, P = 0.76) over 4 weeks. Multiple regression analysis using UPDRS motor score as outcome variable demonstrated a significant regressor effect for duration of non-exercise physical activity (F = 6.15, P = 0.017) while accounting for effects of nigrostriatal degeneration (F = 4.93, P = 0.032), levodopa-equivalent dose (LED; F = 1.07, P = 0.31), age (F = 4.37, P = 0.043) and duration of disease (F = 1.46, P = 0.23; total model (F = 5.76, P = 0.0004). Non-exercise physical activity is a correlate of motor symptom severity in PD independent of the magnitude of nigrostriatal degeneration. Non-exercise physical activity may have positive effects on functional performance in PD.

Measurement of physical activity in older adult interventions: a systematic review

BackgroundInterventions to promote physical activity (PA) among older adults can positively impact PA behaviour and other health outcomes. Measurement of PA must be valid and reliable; however, the degree to...

Factors describing community ambulation after stroke: a mixed-methods study

Objective: To develop a model of community ambulation after stroke based on: Canadian data from community-dwelling individuals post-stroke; the experiences and opportunities for community ambulation expressed by individuals with stroke; and current literature. The model presents a visual depiction of the relationships between the different factors of community ambulation after stroke. Design: A quantitative/qualitative explanatory sequential mixed-methods design was utilized. Secondary data analysis with structural equation modeling resulted in a community ambulation model. Two focus groups of individuals with stroke were conducted to verify and explain the model. Setting: Community. Subjects: Quantitative data from 227 participants: 142 (63%) male; 63.4 (12.0) years of age and 2.6 (2.5) years post stroke. Eleven individuals participated in the focus groups: 6 (55%) male; 61.4 (6.9) years of age and 5.8 (3.3) years since stroke. Main measures: Model variables: items from the EuroQol, Preference Based Stroke Index, gait speed, Reintegration to Normal Living Index, the Community Health Activities Model Program for Seniors, and the Geriatric Depression Scale. Results: The model had reasonable fit with three latent variables: ambulation, gait speed, and health perceptions (normed χ2 = 1.8, root mean square error of approximation = 0.060 (0.043; 0.075)). Depression was also a component of community ambulation. Participants verified the model and added endurance and the environment as additional components. Participants used self-awareness and knowledge of the environment to engage in cognitive strategies related to community ambulation. Conclusions A model of community ambulation after stroke was developed and verified. Recognizing important components of community ambulation may assist physiotherapists in determining community ambulation goals, needs, and opportunities in partnership with clients.

Reliability and Validity of 2 Self-Report Measures to Assess Sedentary Behavior in Older Adults.

The purpose of this study was to examine the reliability and validity of 2 currently available physical activity surveys for assessing time spent in sedentary behavior (SB) in older adults. Fifty-eight adults (≥65 years) completed the Yale Physical Activity Survey for Older Adults (YPAS) and Community Health Activities Model Program for Seniors (CHAMPS) before and after a 10-day period during which they wore an ActiGraph accelerometer (ACC). Intraclass correlation coefficients (ICC) examined test-retest reliability. Overall percent agreement and a kappa statistic examined YPAS validity. Lin's concordance correlation, Pearson correlation, and Bland-Altman analysis examined CHAMPS validity. Both surveys had moderate test-retest reliability (ICC: YPAS = 0.59 (P < .001), CHAMPS = 0.64 (P < .001)) and significantly underestimated SB time. Agreement between YPAS and ACC was low (κ = -0.0003); however, there was a linear increase (P < .01) in ACC-derived SB time across YPAS response categories. There was poor agreement between ACC-derived SB and CHAMPS (Lin's r = .005; 95% CI, -0.010 to 0.020), and no linear trend across CHAMPS quartiles (P = .53). Neither of the surveys should be used as the sole measure of SB in a study; though the YPAS has the ability to rank individuals, providing it with some merit for use in correlational SB research.