Exercise Vital Sign Research Articles

Providing Estimates Of Fitness May Influence Subjects’ Exercise

PURPOSE: We investigated if providing measurements of cardiorespiratory and muscular fitness would influence subsequent self-reported physical activity. METHODS: The Exercise Vital Sign and current types of physical activity were obtained from 1315 individuals attending the 2014 and 2015 Minnesota State Fairs. The baseline mean Exercise Vital Sign was 213 min/week. Subjects were randomized in 1:1 fashion to control and intervention groups. The 656 intervention subjects were provided with personal measurements and age appropriate norms of cardiorespiratory fitness using a validated non-maximal step test to estimate VO2max and muscular strength using a hand grip dynamometer. All subjects were provided exercise recommendations based on current standards and follow up surveys conducted to determine subsequent physical activity. Follow up Exercise Vital Sign and physical activity type was obtained from 823 subjects (62.5%) over the following year. RESULTS: No significant changes in the Exercise Vital Sign were noted in the control group or intervention group at 3 months, 6 months or 1 year of follow-up. At 3 months resistance training activity was reported to increase in the intervention group from 29.1% to 42.8% while unchanged in the control group (26.3% to 31.4%) (p<0.05). The increase in resistance training was driven by a significant increase in those with grip strengths below normative values. Lifestyle physical activity was also reported increased in the intervention group at both 3 months (27.7% to 29.1%) and 6 months (25%) whereas it declined in the control group from 24.4% to 20.1% at 3 months and 18.7% at 6 months(p<0.05). Among the subjects who were less active at baseline (Exercise Vital Sign<150) we observed a significant increase in their Exercise Vital Sign from a baseline of 86 to 146 at 6 months (p<0.05). CONCLUSIONS: Recording the Exercise Vital Sign and providing exercise recommendations appears effective in increasing physical activity in less active individuals. In an already very active population measuring grip strength and estimating VO2max using a step test may have short term positive effects on lifestyle activity and resistance training. Wider adoption of these measures could be effective in promoting physical activity and resistance training.

An “Exercise Vital Sign” Is a Valid Proxy Measure of Physical Activity in COPD in Routine Clinical Care

ABSTRACT Measurement of physical activity (PA) during routine care is currently not performed in most health systems. An “exercise vital sign” (EVS) is routinely assessed and entered into the electronic medical records at Kaiser Permanente. The purpose of this article is to examine the construct validity of the EVS for measuring PA in patients with chronic obstructive pulmonary disease (COPD). Patients with COPD who had a history of a COPD exacerbation requiring an admission, observational stay, or emergency department visit in the previous 12 months were included in the study. Baseline data of patients with COPD who were included in a pragmatic trial of a PA coaching intervention were used. Patients were classified as being inactive (0 min · wk−1 of moderate to vigorous PA), insufficiently active (1–149 min · wk−1), and active (150+ min · wk−1) using all available EVS data in the 12 months before identification for the study. The relationship between the EVS and standardized measures of COPD disease severity, functional performance, quality of life and symptoms were examined to establish construct validity. Because of the variable data collection scheme, data were available for 172 to 1834 patients. Patients with higher levels of PA, as categorized by the EVS, tended to have fewer comorbidities and less airway obstruction, used less supplemental oxygen, had higher 6-min walk test distance, and had more objectively measured PA, higher quality of life, and lower depressive symptoms compared with inactive and insufficiently active patients. In conclusion, the EVS provides a valid proxy measure of PA in patients with COPD and may be an efficient measure to assess PA during routine care compared with lengthy questionnaires or objectively measured PA.

Physical Activity as a Vital Sign: A Systematic Review.

IntroductionPhysical activity (PA) is strongly endorsed for managing chronic conditions, and a vital sign tool (indicator of general physical condition) could alert providers of inadequate PA to prompt counseling or referral. This systematic review examined the use, definitions, psychometric properties, and outcomes of brief PA instruments as vital sign measures, with attention primarily to studies focused on arthritis.MethodsElectronic databases were searched for English-language literature from 1985 through 2016 using the terms PA, exercise, vital sign, exercise referral scheme, and exercise counseling. Of the 838 articles identified for title and abstract review, 9 articles qualified for full text review and data extraction.ResultsFive brief PA measures were identified: Exercise Vital Sign (EVS), Physical Activity Vital Sign (PAVS), Speedy Nutrition and Physical Activity Assessment (SNAP), General Practice Physical Activity Questionnaire (GPPAQ), and Stanford Brief Activity Survey (SBAS). Studies focusing on arthritis were not found. Over 1.5 years of using EVS in a large hospital system, improvements occurred in relative weight loss among overweight patients and reduction in glycosylated hemoglobin among diabetic patients. On PAVS, moderate physical activity of 5 or more days per week versus fewer than 5 days per week was associated with a lower body mass index (−2.90 kg/m2). Compared with accelerometer-defined physical activity, EVS was weakly correlated (r = 0.27), had low sensitivity (27%–59%), and high specificity (74%–89%); SNAP showed weak agreement (κ = 0.12); GPPAQ had moderate sensitivity (46%) and specificity (50%), and SBAS was weakly correlated (r = 0.10–0.28), had poor to moderate sensitivity (18%–67%), and had moderate specificity (58%–79%).ConclusionFew studies have examined a brief physical activity tool as a vital sign measure. Initial investigations suggest the promise of these simple and quick assessment tools, and research is needed to test the effects of their use on chronic disease outcomes.

A Review of Current Literature on Vital Sign Assessment of Physical Activity in Primary Care.

To conduct an integrated review of the performance and implementation of two physical activity (PA) assessment tools, the exercise vital sign (EVS) and the physical activity vital sign (PAVS), in U.S. primary care practice. An integrative review following Whittemore and Knafl's methodology. Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched. Search terms were "exercise vital sign" OR "physical activity vital sign" AND "primary care". Additional inclusion criteria were studies conducted in the United States, published in English, in primary care, between 2010 and 2016. Nine studies met inclusion criteria. Five studies reported validity data of the EVS tool, while four studies reported data from the PAVS tool. Compared with the accelerometer, the EVS tool overestimated moderate-vigorous PA, while the PAVS tool demonstrated moderate agreement in identifying those not meeting national PA guidelines. The EVS tool was successfully implemented in large, integrated practices utilizing electronic health record systems. PA documentation increased compared to non-EVS practices. The predictive ability of the PAVS tool for clinical outcomes was shown. Studies of PA assessment tool use in children were not found. Preliminary evidence on the validity of both the EVS and PAVS tools support cautious use of each as a screening tool in primary care. There were no data on reliability, with limited data on tool use in diverse populations or settings. Data in children, older adults, and diverse population subgroups were lacking. Two brief exercise vital signs tools have each shown some initial validity for use by primary care clinicians as measures to identify patients not meeting PA guidelines.

Exercise Vital Sign and Health Care Utilization

Exercise Vital Sign and Health Care Utilization

Exercise Vital Sign and Health Care Utilization

Exercise Vital Sign and Health Care Utilization

Exercise Vital Sign Correlates With New Diagnosis of Depression

Exercise Vital Sign Correlates With New Diagnosis of Depression

Quantification Of Physical Activity As An Exercise Vital Sign In A Pediatric Population

Quantification Of Physical Activity As An Exercise Vital Sign In A Pediatric Population

Quantification Of Physical Activity As An Exercise Vital Sign In A Pediatric Population

Quantification Of Physical Activity As An Exercise Vital Sign In A Pediatric Population

Exercise Vital Sign Correlates with Acute Coronary Events

Exercise Vital Sign Correlates with Acute Coronary Events

Validity of two brief physical activity questionnaires with accelerometers among African-American women.

To evaluate the validity of the Stanford Brief Activity Survey (SBAS) and Exercise Vital Sign (EVS) questionnaire against accelerometer-determined time in moderate-to-vigorous physical activity (MVPA) among African-American (AA) women. Limited research has evaluated the validity of brief physical activity (PA) questionnaires among AA women. Since the validity of PA questionnaires may differ among members of varying racial/ethnic groups, research is needed to explore the validity of self-report PA measures among AA women. A total of 30 AA women [M age = 35.5 ± 5.3; M body mass index (BMI) = 31.1 ± 7.8] wore ActiGraph GT3X+ accelerometers (ActiGraph, LLC, Pensacola FL, USA) for seven days and completed both the SBAS and EVS at two different assessment periods (T1 and T2). Criterion validity was calculated using Spearman's rank order correlations between each questionnaire score and accelerometer-measured MVPA. Sensitivity, specificity, and positive and negative predictive values were calculated using accelerometer-measured MVPA as the criterion to determine the ability of each questionnaire to predict whether or not a participant was meeting the 2008 US PA Guidelines. Spearman correlation coefficients between questionnaire scores and minutes of accelerometer-measured MVPA were low (EVS, r = 0.27 at T1 and r = 0.26 at T2; SBAS, r = 0.10 at T1 and r = 0.28 at T2) and not statistically significant (P's > 0.05). The EVS had sensitivity, specificity, and negative and positive predictive values of 27, 89, 59, and 68% at T1 and 33, 74, 38, and 70% at T2, respectively. The SBAS had sensitivity, specificity, and negative and positive predictive values were 18, 79, 33, and 62% at T1 and 67, 58, 43, and 79% at T2. While both questionnaires may be useful in identifying AA women who do not meet the 2008 PA Guidelines, using the questionnaires to identify AA women meeting the PA Guidelines should be done with caution.

Accelerometer Validation of Questionnaires Used in Clinical Settings to Assess MVPA.

The exercise vital sign (EVS) and General Practice Physical Activity Questionnaire (GPPAQ) are questionnaires designed for clinical settings to identify individuals who are not meeting physical activity (PA) guidelines in the United States and United Kingdom, respectively. To date, neither has been objectively validated. Subjects (N = 76) from the United States (n = 38; age, 49 ± 20 yr) and United Kingdom (n = 38; age, 43 ± 21 yr) completed a health history questionnaire, wore an accelerometer for 7 d, and then completed the EVS and GPPAQ. Accelerometry, EVS, and GPPAQ data were scored to dichotomize subjects into groups of meeting (≥150 min of moderate-to-vigorous PA (MVPA) per week) or not meeting (<150 min of MVPA per week) the PA guidelines, and accelerometry was used as a criterion measure for comparing both questionnaires. The sensitivity and specificity of the EVS and GPPAQ were calculated to represent the ability of the questionnaires to identify subjects who did not and did meet the PA guidelines. Total MVPA accumulated in ≥10-min bouts were compared between accelerometry and the EVS using a 2 × 2 × 2 repeated measures ANOVA with one within-subjects effect (PA assessment method) and two between-subjects effects (gender and country). The alpha level was P = 0.05 for all analyses. The EVS had marginally better sensitivity (59% vs 46%) and specificity (77% vs 50%) than the GPPAQ. The EVS grossly overestimated the minutes of MVPA when compared to accelerometry (P < 0.05) for all subjects, except UK women. In practice, the EVS and GPPAQ may not identify ∼50% of patients who should be advised to increase their PA. Therefore, physicians should advocate that all of their patients adopt an active lifestyle, including the achievement of ≥150 min of MVPA per week.

Exercise Vital Sign Is Positively Associated With Cardiorespiratory Fitness In A Random State Fair Population

Exercise Vital Sign Is Positively Associated With Cardiorespiratory Fitness In A Random State Fair Population

Association between the Exercise Vital Sign and Blood Pressure

Association between the Exercise Vital Sign and Blood Pressure

Initial Validation of an Exercise “Vital Sign” in Electronic Medical Records

The objective of this study is to describe the face and discriminant validity of an exercise vital sign (EVS) for use in an outpatient electronic medical record. Eligible patients were 1,793,385 adults 18 yr and older who were members of a large health care system in Southern California. To determine face validity, median total self-reported minutes per week of exercise as measured by the EVS were compared with findings from national population-based surveys. To determine discriminant validity, multivariate Poisson regression models with robust variance estimation were used to examine the ability of the EVS to discriminate between groups of patients with differing physical activity (PA) levels on the basis of demographics and health status. After 1.5 yr of implementation, 86% (1,537,798) of all eligible patients had an EVS in their electronic medical record. Overall, 36.3% of patients were completely inactive (0 min of exercise per week), 33.3% were insufficiently active (more than 0 but less than 150 min·wk), and 30.4% were sufficiently active (150 min or more per week). As compared with national population-based surveys, patient reports of PA were lower but followed similar patterns. As hypothesized, patients who were older, obese, of a racial/ethnic minority, and had higher disease burdens were more likely to be inactive, suggesting that the EVS has discriminant validity. We found that the EVS has good face and discriminant validity and may provide more conservative estimates of PA behavior when compared with national surveys. The EVS has the potential to provide information about the relationship between exercise and health care use, cost, and chronic disease that has not been previously available at the population level.

Self Reported Exercise in Patients Using an Exercise Vital Sign

Self Reported Exercise in Patients Using an Exercise Vital Sign

A Retrospective Study of Nursing Diagnoses, Outcomes, and Interventions for Patients Admitted to a Cardiology Rehabilitation Unit

The aim of this study was to describe the use of nursing terminologies in the care plans made for patients in a cardiology rehabilitation unit. We retrospectively examined the clinical documentation for all patients admitted to a cardiology program in a small hospital in the northeast of Italy in 2008. The sample included 76 patients (87% male) with an average age of 60 years. Care plans included 21 NANDA-I nursing diagnoses and three collaborative problems, 45 Nursing Outcomes Classifications (NOC) and 46 Nursing Intervention Classifications (NIC). The most frequent diagnoses were the following: decreased cardiac output, activity intolerance, and risk for or presence of imbalanced nutrition (more than body requirements). The prevalent outcomes were related to cardiopulmonary physiological health and knowledge about cardiac disease management and diet. The most frequent nursing interventions were the following: exercise promotion, energy management, weight management, medication management, cardiac precautions, cardiac care (rehabilitative), teaching (prescribed activity/exercise and diet), and vital signs monitoring. CONCLUSIONS AND IMPLICATIONS FOR NURSING PRACTICE: Nurses in rehabilitative cardiology care are aware of patients' problems, but projects can improve the coherence between concepts, the attention to psychological problems, and self-care.

369: A Randomized Controlled Trial of the Effect of Energy Drinks on Exercise Performance, Dexterity, Reaction Time and Vital Signs Before and After Exercise

369: A Randomized Controlled Trial of the Effect of Energy Drinks on Exercise Performance, Dexterity, Reaction Time and Vital Signs Before and After Exercise

Are There “Healthy” and “Unhealthy” Reasons for Exercise? Examining Individual Differences in Exercise Motivations Using the Function of Exercise Scale

This study reports the psychometric development of a measure to assess individual differences in exercise motivations using a functionalist strategy (Snyder &amp; Cantor, 1997). Factor analyses revealed two subscales for the newly developed Function of Exercise Scale (FES): Weight and Appearance (WA), and Health and Enjoyment (HE). FES-HE scores correlated with better psychological well-being and predicted prospectively monitored as well as concurrently and longitudinally assessed exercise behavior. FES-HE scores also correlated with lower pulse, systolic blood pressure, and salivary cortisol readings, indicating its association with better physical health. In contrast, FES-WA scores correlated with greater depressive and eating disorder symptoms, as well as lower self-esteem, and predicted the later emergence of eating disorder, but not depressive, symptoms. FES-WA scores failed to show a relationship with measures of physical well-being, including exercise engagement and vital sign data. Overall, the FES appears to hold promise as a succinct and psychometrically sound heuristic for meaningfully relating exercise motivations to important indices of both physical and psychological well-being.