High Amounts Of Physical Activity Research Articles

Protective effect of regular physical activity against diabetes-related lower extremity amputation.

Foot ulcers are a major complication of diabetes mellitus that increase morbidity and mortality in patients with diabetes, affect their quality of life, and increase the overall social burden. A considerable number of patients with diabetic foot ulcers (DFUs) require amputations every year. This nation population-based study included 1 923 483 patients with diabetes who underwent regular health screening through the National Health Insurance Service during January 2009 and December 2012. We investigated the association between changes in physical activity (PA) status and the incidence of lower extremity amputation (LEA). Based on changes in PA status, participants were categorized into four groups: "remained inactive," "remained active," "active-to-inactive," and "inactive-to-active." Regular PA is an independent factor associated with a decreased risk of LEA in patients with diabetes. During the follow-up period, 0.23% (n = 4454) of the patients underwent LEA. Compared with the "remained inactive" group, the "remained active" group were at the lowest risk of LEA (adjusted hazard ratio 0.5888; 95% confidence interval 0.524-0.66). A protective effect of regular PA against LEA was observed in the "remaining active" group. Our findings suggest a protective role of PA against LEA in individuals with diabetes. This highlights the importance of recommending appropriate levels of PA for patients with diabetes. The study also showed a dose-response relationship, indicating that engaging in vigorous-intensity PA was most beneficial, and higher amounts of PA may provide additional benefits.

Physical Activity Influences the Relationship between Objectively Measured Hot Flashes and Endothelial Function in Perimenopausal Women

Hot flashes (HF) are disruptive symptoms experienced by approximately 80% of women undergoing menopause. The transition to menopause is associated with increases in CVD risk factors. The frequency and severity of HF have been associated with poorer cardiovascular health but most of these studies have quantified HF by self-report and have not considered physical activity (PA), known for its cardiovascular benefits. The association between HFs and CVD risk may be through their effect on endothelial health. The objective of this study was to evaluate the relationship between objectively measured HF and endothelial function and determine the effect of physical activity on the relationship in healthy perimenopausal women. We hypothesized that more HF would be associated with lower endothelial function and PA would influence this relationship. Healthy perimenopausal women (n=52, age 43-54) were included in this analysis. Perimenopause was defined as ≥7d difference in the length of consecutive cycles to <12 months of amenorrhea. Hot flashes were measured objectively using sternal skin conductance for 24 hours. The number of HF experienced and HF rate (normalized to actual wear time) were quantified. Endothelial function was assessed with measures of brachial artery flow mediated dilation (FMD, %) on the non-dominant arm. Moderate to vigorous physical activity (MVPA) was assessed with 7-days of actigraphy monitoring on the non-dominant wrist. The R package GGIR and Hildebrand (2016) cut points were used to quantify PA intensity and reported as sum of the average minutes of moderate and vigorous physical activity per day. Pearson correlations and multiple regression analyses were used to evaluate relationships between variables. Data met all assumptions for statistical tests. Modeling was performed to evaluate whether HFs were predictors of the main outcome of FMD (R version 4.2.3 and RStudio version 2023.06.2+561). Age and BMI were included in all models. Lower FMD was significantly correlated with a higher objective HF rate ( r (52) =-0.27, p=0.05). Objective HF rate predicted FMD (β=-3.91, p=0.04) when controlling for age and BMI (adj R2=0.100, F(3,48) =2.892, p=.05). When MVPA was added to the model, MVPA alone was not a significant predictor but the interaction between MVPA and HF was (β=0.12, p=0.04; adj R2=0.147, F(5,46) =2.761, p<0.03). This interaction was such that higher levels of MVPA were related to a less strongly negative relationship between objective HF rate and FMD. A simple slopes analysis found that the HF rate effect at one SD below the mean MVPA was significantly negative, (β=-8.64, p=0.004), whereas the HF rate effect at one SD above the mean MVPA was not significant, (β=0.18, p=0.95). These data provide strong evidence that support the hypothesis that a greater number of objectively-assessed hot flashes is associated with lower endothelial function in perimenopausal women and that higher amount of physical activity serves as a buffer against the negative relation between hot flashes and FMD. NIH NHLBI R15 Grant 1R15HL145650-01A1 (Witkowski); Smith College McKinley s Honors Fellowship (Tha Ra Wun); Smith College STRIDE (Buszkiewicz). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The Relationship between Physical Activity, Physical Fitness, Cognition, and Academic Outcomes in School-Aged Latino Children: A Scoping Review.

This scoping review provides an overview of the relationship between physical activity, physical fitness, cognition, and academic outcomes in Latino school-aged children and identifies areas for future research. A primary search was conducted in PubMed, PsycINFO, Web of Science, and ERIC for original-research articles meeting the inclusion criteria; the search results were uploaded into PICO Portal and assessed by two independent reviewers. Of the 488 initial search results, 50 articles were eligible for full-text review, and 38 were included in this review. Most studies were cross-sectional, conducted in the United States or Chile, and included children 5-18 years old. Overall, the majority of articles reported positive associations between physical activity or physical fitness and cognitive outcomes (n = 11/12; 91.7%), and physical activity or physical fitness and academic outcomes (n = 22/28; 78.6%). In sum, this review provided consistent evidence for higher amounts of physical activity and greater physical fitness to be associated with various positive cognitive and academic outcomes in a school-aged Latino population. This scoping review also elucidated a substantial gap in the research regarding study design, with a discernible lack of interventional efforts. Future studies should test physical activity interventional strategies to optimize cognitive and academic outcomes in school-aged Latino populations.

Physical activity during pregnancy and the risk of gestational diabetes mellitus: a systematic review and dose–response meta-analysis

BackgroundPrevious research has indicated the inverse association between physical activity (PA) and gestational diabetes mellitus (GDM). However, the dose–response relationship currently remains undetermined. This study aims to explore the dose–response relationship between PA during the first and second trimesters of pregnancy and GDM risk.MethodsStudies on the relationship between PA during pregnancy and GDM risk published before April 25, 2023, were searched for in six databases. According to the inclusion and exclusion criteria, all literature was screened for eligibility. The Newcastle-Ottawa Scale (NOS) was used to assess risk of bias. Publication bias was examined using funnel plots, Begg’s and Egger’s tests, as well as trim-and-fill analysis. We harmonized exposure estimates of PA during pregnancy to the common unit of the metabolic equivalent of task (MET)-h/week. Restricted cubic splines were used to model the dose–response relationship. The criteria from the World Cancer Research Fund were used to assess the certainty of evidence across outcomes. All analyses were performed using Stata 15.1.ResultsThe results indicated that in contrast with the lowest level of PA, promoting the highest PA level lowers the risk of GDM by 36% (RR = 0.64, 95%CI: 0.53 ~ 0.78). We found a curvilinear dose–response association between PA during the first trimester and incident GDM (Pnonlinearity = 0.012). Compared to inactive pregnant women, for those who achieved the guidelines-suggested minimum level (10 MET-h/week) of PA during the first trimester, the GDM risk was decreased by 13% (RR = 0.87, 95%CI: 0.79 ~ 0.96). A linear relationship was found between PA during the second trimester and the GDM risk (Pnonlinearity = 0.276). The results with a restricted cubic spline model suggested that pregnant women who accumulate 10 MET-h/week have a 1% reduced risk of GDM compared to completely inactive individuals. Twice (20 MET-h/week) or a higher amount of PA (50 MET-h/week) contributed to further reductions in GDM risk.ConclusionThere is a dose–response relationship between higher levels of PA in both the first and second trimesters and reduced risk of GDM; the relationship is stronger in the first trimester. Increasing PA during pregnancy can prevent the development of GDM.PROSPERO registration numberCRD42023420564.

ANXIETY AND MEMORY COMPLAINTS IN MIDDLE-AGED AND OLDER ADULTS: THE MODERATING ROLE OF PHYSICAL ACTIVITY

Abstract The relationship between anxiety and memory complaints is well established. Additionally, physical activity has been shown to improve anxiety symptoms and cognition. Little research, however, has examined if physical activity impacts associations between anxiety and memory complaints in cognitively healthy middle-aged and older adults. Given memory complaints are often the first indicator of subsequent cognitive decline, it is important to understand factors that impact complaints. The present study tested whether physical activity moderated associations between anxiety and memory complaints. Adults aged 50+ (N=271, Mage=64.5, SD=7.8, 124 women) completed the International Physical Activity Questionnaire, Hospital Anxiety and Depression scale (HADS), and the Cognitive Failures questionnaire (CFQ). Multiple linear regressions and simple slope analyses were conducted to examine if physical activity moderated associations between anxiety and memory complaints (CFQ-memory), covarying for age, sex, income, difficulty walking, number of medical conditions, number of medications, body mass index, and depressive symptoms (HADS-depression). Results revealed total physical activity (R2-change=.01, p=.04), vigorous activity (R2-change=.02, p=.02), and walking activity (R2-change=.01, p=.03) moderated associations between anxiety and memory complaints. Specifically, higher anxiety was associated with more memory complaints at all levels of physical activity, with the magnitude of the effect largest at highest levels of physical activity. The present findings suggest higher amounts of physical activity may exacerbate the relationship between anxiety and memory complaints. It is possible aging adults with greater perceived memory disruption experience more anxiety and engage in health enhancing behaviors, such as physical activity. Future studies should explore temporal patterns of this relationship.

Understanding Health Behaviors, Weight Perceptions, and Body Appreciation of Young Adult Women Engaged in the Body Positivity Movement.

The body positivity movement on social media is thought to foster body appreciation, but pervasive societal concern persists about the body positivity movement and the body image, health behaviors, and "normalization of obesity" of young adult women. This study explored the relationship between engagement in the body positivity movement on social media and weight status, body appreciation, body dissatisfaction, and the health behaviors of intuitive eating and physical activity in young adult women (18-35years). Participants (N=521; ∼64% engaged in body positivity content on social media) were recruited using Qualtrics online panels for this cross-sectional survey during February 2021. Outcomes included weight status, weight consideration, weight perception, body appreciation, body dissatisfaction, physical activity, and intuitive eating. Logistic and linear regression models adjusted for age, race, ethnicity, education level, and household income were used to assess the association between engagement in the body positivity movement and specified outcomes. Engagement in body positivity content was associated with greater body dissatisfaction (β=2.33, t(519)=2.90 p=.017), body appreciation (β=0.26, t(519)=2.90 p=.004), and greater likelihood of reporting high amounts of physical activity (odds ratio=2.28; p<.05) relative to nonengaged peers; these associations remained significant after further adjustment for weight status. Body positivity was not associated with weight status, weight perception, or intuitive eating. Engagement in the body positivity movement is associated with higher body dissatisfaction and body appreciation in young adult women, which suggests they may be drawn to and engage in the body positivity movement as a protective or coping mechanism for body dissatisfaction.

Role of the interaction between lumbar kinematics and accelerometer-measured physical activity in bodily pain, physical functioning and work ability among health care workers with low back pain.

The aim of this study was to examine the associations of spinal kinematics and physical activity (PA) with bodily pain, physical functioning, and work ability among health care workers with low back pain (LBP). Spinal kinematics and PA were measured with a wireless Inertial Measurement Unit system (ValedoMotion®) and a waist-worn tri-axial accelerometer (Hookie AM20), respectively. Their association was assessed in relation to Work Ability Index (WAI), bodily pain and physical functioning (RAND-36) in 210 health care workers with recurrent LBP. Greater lumbar movement variability/less deterministic lumbar movement (in angular velocity) during a "Pick Up a Box" functional task was correlated with higher amounts of step counts (r=-0.29, p=0.01) and moderate PA (r=-0.24, p=0.03). A higher amount of PA (p=0.03) as well as less movement control impairment (p=0.04) and movement variability (p=0.03) were associated with greater work ability, whilst greater vigorous PA was the only parameter to explain higher physical functioning (p=0.02). PA and movement variability were relative to each other to explain bodily pain (p=0.01). These findings show the importance of considering the interaction between lumbar kinematics and physical activity while planning strategies to improve bodily pain, physical functioning and work ability among health care workers with LBP.

Association of Leisure Time Physical Activity Types and Risks of All-Cause, Cardiovascular, and Cancer Mortality Among Older Adults

Higher amounts of physical activity are associated with increased longevity. However, whether different leisure time physical activity types are differentially associated with mortality risk is not established. To examine whether participation in equivalent amounts of physical activity (7.5 to <15 metabolic equivalent of task [MET] hours per week) through different activity types is associated with mortality risk and to investigate the shape of the dose-response association. Participants in this cohort were respondents from the National Institutes of Health-AARP Diet and Health Study who completed the follow-up questionnaire between 2004 and 2005. This questionnaire collected data on weekly durations of different types of physical activities. Mortality was ascertained through December 31, 2019. MET hours per week spent participating in the following activities: running, cycling, swimming, other aerobic exercise, racquet sports, golf, and walking for exercise. All-cause, cardiovascular, and cancer mortality. Separate multivariable-adjusted Cox proportional hazards regression models were fitted to estimate hazard ratios (HRs) and 95% CIs of mortality for each of the 7 types of leisure time physical activities, as well as the sum of these activities. A total of 272 550 participants (157 415 men [58%]; mean [SD] age at baseline, 70.5 [5.4] years [range, 59-82 years]) provided information on types of leisure time activity, and 118 153 (43%) died during a mean (SD) follow-up of 12.4 (3.9) years. In comparison with those who did not participate in each activity, 7.5 to less than 15 MET hours per week of racquet sports (HR, 0.84; 95% CI, 0.75-0.93) and running (HR, 0.85; 95% CI, 0.78-0.92) were associated with the greatest relative risk reductions for all-cause mortality, followed by walking for exercise (HR, 0.91; 95% CI, 0.89-0.93), other aerobic activity (HR, 0.93; 95% CI, 0.90-0.95), golf (HR, 0.93; 95% CI, 0.90-0.97), swimming (HR, 0.95; 95% CI, 0.92-0.98), and cycling (HR, 0.97; 95% CI, 0.95-0.99). Each activity showed a curvilinear dose-response association with mortality risk; low MET hours per week of physical activity for any given activity type were associated with a large reduction in mortality risk, with diminishing returns for each increment in activity thereafter. Associations were similar for cardiovascular and cancer mortality. This cohort study of older individuals found differences between different types of leisure time activities and mortality risk, but there were significant associations between participating in 7.5 to less than 15 MET hours per week of any activity and mortality risk.

Association between high levels of physical activity and improved glucose control on active days in youth with type 1 diabetes.

Sixty minutes per day of at least moderate to vigorous physical activity (MVPA) is recommended for children for a variety of physical and psychological reasons. Adherence to these guidelines is confounded by challenges with glucose control during exercise in type 1 diabetes (T1D). This study examined the potential association between physical activity level on active days and glucose control in youth with T1D. Blinded continuous glucose monitors (CGM: Abbott Libre Pro) and physical activity data as measured from a body monitor patch (Metria IH1) were collected for up to 3 weeks in youth aged 9-17 years with T1D. The association between physical activity levels, expressed as mean active metabolic equivalent minutes (MET-minutes) per day, with CGM-based mean glucose, percent time in range (TIR: 70-180 mg/dl), % time above range (TAR) and % time below range (TBR) were assessed using a linear regression model adjusted for age, gender, and baseline HbA1c. Study participants were deemed physically active, as defined by at least 10 min of continuous moderate-to-vigorous activity, on 5.2 ± 1.9 days per week, with a median accumulated physical activity time of 61 [IQR: 37-145] minutes per day. Higher physical activity levels were associated with lower mean glucose levels (r=-0.36; p=0.02) and lower TAR (r=-0.45; p=0.002) on active days. Higher activity levels were also associated with greater TIR (r=0.54; p < 0.001) without being associated with more, or less, TBR. Higher amounts of physical activity are associated with improvements in TIR without significantly increasing TBR. These data suggest that youth ages 9-17 years with T1D can benefit from a high level of physical activity without undue fear of hypoglycemia.

Objectively-measured out-of-home behavior and physical activity in rural older adults

This cross-sectional study investigated the association of out-of-home behavior measured by global positioning system (GPS) and amounts of physical activity. Rural older adults aged ≥ 65 years (n = 133) participated in this study. Daily step count and physical activity level were measured using an accelerometer. We monitored out-of-home behavior using a GPS sensor and calculated two indicators: out-of-home time and number of nodes (places) visited per day. In results, only the number of nodes visited was significantly associated with step count (B coefficient = 1,324; 95% CI = 622 to 2,026) and physical activity level (B coefficient = 0.05; 95% CI = 0.02 to 0.09) in the fully-adjusted model, while out-of-home time was not. A greater number of nodes visited, rather than out-of-home time, was associated with higher amounts of physical activity in older adults.

Associations Between Actigraphy-Assessed Health Behaviors and Cognitive Performance in Older Adults

Lifestyle behaviors are important determinants of healthy brain aging. Research has not fully explored how sleep quality and physical activity may differentially influence specific domains of cognitive function. The present study aimed to estimate the relative influence of sleep quality and physical activity on cognitive performance in three domains in a sample of older adults. Older adults (ages 60-89, M = 74.74) without cognitive impairment (N= 160) wore an accelerometer for 7 days in a free-living environment. We used average vector magnitude counts per minute to measure total physical activity (TPA), and average wake after sleep onset (WASO) to measure sleep quality. We created cognitive composite scores (executive function, attention, and verbal memory) from neuropsychological data using confirmatory factor analysis. We regressed cognitive scores onto TPA and WASO with age and education entered as covariates. Higher amounts of physical activity and better sleep quality were associated with better executive function (R2 = 20.3%, F (4, 155) = 11.12, p < .001). Neither physical activity nor sleep quality was associated with verbal memory or attention. Results suggest that more physical activity and improved ability to stay asleep may benefit executive function, but not other cognitive domains. Future studies should clarify the interaction and mechanisms of action between health behaviors and cognitive performance in older adults.

The Relationship between Different Amounts of Physical Exercise, Internal Inhibition, and Drug Craving in Individuals with Substance-Use Disorders.

Purpose: To explore the relationship between different amounts of physical exercise and drug craving in individuals with substance-use disorders (SUD), and to reveal the mediating role of internal inhibition between physical activity and drug craving. Method: This study adopted the Physical Activity Rating Scale, Internal Inhibition Scale, and Drug Craving Scale to assess 438 cases of SUD in a compulsory isolation detoxification center in southwest China. Results: (1) The amount of physical exercise individuals with SUD engaged in was positively correlated with internal inhibition and negatively correlated with drug craving, while the amount of physical exercise was negatively correlated with drug craving. (2) The amount of physical exercise was able to negatively predict drug craving in addicts, the amount of physical exercise and internal inhibition were able to jointly predict drug craving, and internal inhibition played a mediating role between the amount of physical exercise and drug craving (the mediating effect was 0.22). (3) There was a dose-effect relationship regarding different amounts of physical exercises and drug craving. Internal inhibition did not mediate between a low amount of physical exercise and drug craving, it played a partial mediating role between a moderate amount of physical exercise and drug craving (the mediating effect was −0.19), and it played a partial mediating role between a high amount of physical exercise and drug craving (the mediating effect was −0.15). Conclusions: Physical activity has a positive effect on reducing drug craving in individuals with SUD. Moreover, in the process of sports rehabilitation for SUD, medium or high amounts of physical activity were required in order to effectively reduce and alleviate drug cravings.

Physical Activity And Mental Health In Injured Adolescents

PURPOSE: Approximately 20% of adolescents meet the minimal standards of moderate to vigorous physical activity (PA) national guidelines. Adolescents that accrue lower PA have greater depression and anxiety symptoms when compared to adolescents that engage in higher amounts of PA. Musculoskeletal injuries are common in adolescents and may exacerbate depression or anxiety symptoms that were decreased due to the ability to partake in PA. In addition, injuries may cause new anxiety and depression symptoms. While PA has generally been shown to help decrease and protect against both depression and anxiety symptoms in adolescents, some recent work has questioned the impact of PA on adolescent mental health. The purpose of this study was to determine if adequate levels of PA in adolescents that have experienced an injury had less anxiety and depression symptoms. METHODS: A total of 63 adolescents (59% female; mean age = 14.57 ± 1.52 years) between the ages of 12-18 that were being treated by a tertiary sports medicine clinic were enrolled. Participants filled out the Patient Health Questionairre-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) to measure depression and anxiety symptoms, respectively. Scores greater than 5 were considered elevated for each scale and prompted further evaluation by the attending physician. PA was self-reported by asking exercise vital sign questions to obtain days per week and minutes per day of moderate to vigorous physical activity from the past week. RESULTS: Average PHQ-9 score was 3.63 ± 4.11, average GAD-7 score was 3.33 ± 3.60 and average weekly PA was 319.37 ± 261.12 minutes. There were 22% with elevated PHQ-9 scores, nearly 24% with elevated GAD-7 scores and 35% reported meeting the PA guidelines in the last week. There were no differences between those who met or did not meet PA guidelines on the proportion of those with elevated depression or anxiety scores (p = .47, p = .93, respectively). CONCLUSIONS: While there were no differences between the prevalence of elevated depression or anxiety scores between those who met or did not meet PA guidelines, injured adolescents had high rates of elevated scores for anxiety and depression. Clinicians should consider screening injured adolescents for anxiety and depression to aid in early intervention.

Temporal patterns of physical activity in successful weight loss maintainers.

Individuals successful at weight loss maintenance engage in high amounts of physical activity (PA). Understanding how and when weight loss maintainers accumulate PA within a day and across the week may inform PA promotion strategies and recommendations for weight management. We compared patterns of PA in a cohort of weight loss maintainers (WLM, n = 28, maintaining ≥13.6 kg weight loss for ≥1 year, BMI 23.6 ± 2.3 kg/m2), controls without obesity (NC, n = 30, BMI similar to current BMI of WLM, BMI 22.8 ± 1.9 kg/m2), and controls with overweight/obesity (OC, n = 26, BMI similar to pre-weight loss BMI of WLM, 33.6 ± 5.1 kg/m2). PA was assessed during 7 consecutive days using the activPALTM activity monitor. The following variables were quantified; sleep duration, sedentary time (SED), light-intensity PA (LPA), moderate-to-vigorous intensity PA (MVPA), and steps. Data were examined to determine differences in patterns of PA across the week and across the day using mixed effect models. Across the week, WLM engaged in ≥60 min of MVPA on 73% of days, significantly more than OC (36%, p < 0.001) and similar to NC (59%, p = 0.10). Across the day, WLM accumulated more MVPA in the morning (i.e., within 3 h of waking) compared to both NC and OC (p < 0.01). WLM engaged in significantly more MVPA accumulated in bouts ≥10 min compared to NC and OC (p < 0.05). Specifically, WLM engaged in more MVPA accumulated in bouts of ≥60 min compared to NC and OC (p < 0.05). WLM engage in high amounts of MVPA (≥60 min/d) on more days of the week, accumulate more MVPA in sustained bouts, and accumulate more MVPA in the morning compared to controls. Future research should investigate if these distinct patterns of PA help to promote weight loss maintenance.

The course of physical functioning in the first two years after stroke depends on peoples' individual movement behavior patterns.

Background and purposeDeterioration of physical functioning after stroke in the long term is regarded as a major problem. Currently, the relationship between “peoples'” movement behavior patterns (the composition of sedentary behavior and physical activity during waking hours) directly after stroke and the development of physical functioning over time is unknown. Therefore, the objectives of this study were to investigate (1) the course of physical functioning within the first two years after returning home after stroke, and (2) the association between physical functioning and baseline movement behavior patterns.MethodIn the longitudinal RISE cohort study, 200 persons with a first-ever stroke discharged to the home-setting were included. Participants’ physical functioning was assessed within three weeks, at six months, and one and two years after discharge using the Stroke Impact Scale (SIS) 3.0 subscale physical and the five-meter walk test (5MWT). Three distinct movement behavior patterns were identified in a previous study at baseline and were used in the current study: (1) sedentary exercisers (sufficiently active and 64% of waking hours sedentary), (2) sedentary movers’ (inactive and 63% of waking hours sedentary), and (3) sedentary prolongers (inactive and >78% of waking hours sedentary accumulated in long prolonged bouts). The association between movement behavior patterns and the course of physical functioning was determined using longitudinal generalized estimating equations analyses.ResultsOverall participants’ physical functioning increased between discharge and six months and declined from six months up to two years. Physical functioning remained stable during the first two years after stroke in sedentary exercisers. Physical functioning improved during the first six months after discharge in sedentary movers and sedentary prolongers and deteriorated in the following six months. Only physical functioning (SIS) of sedentary prolongers further declined from one up to two years. A similar pattern was observed in the 5MWT.ConclusionMovement behavior patterns identified directly after returning home in people with stroke are associated with and are predictive of the course of physical functioning. Highly sedentary and inactive people with stroke have unfavorable outcomes over time than individuals with higher amounts of physical activity.

Synchronous and asynchronous remote exercise may improve motor and non-motor symptoms in people with Parkinson’s disease during the COVID-19 pandemic

BACKGROUND: Stay active is a good strategy to mitigate the negative effects of confinement in people with Parkinson’s Disease (PD). Synchronous (full-time class interaction) and asynchronous (without the live presence of the healthcare professional) exercises are two strategies to avoid the worsening of PD. AIM: To investigate the effect of the synchronous and asynchronous exercise on motor and non-motor symptoms in people with PD during the pandemic lockdown. METHOD: Fifty-eight people with PD responded to an online survey and were divided into synchronous, asynchronous, and no-exercise groups. The participants responded to questions regarding motor and non-motor symptoms, besides the questionnaire of quality of life, physical activity, anxiety and depression, and sleep quality. RESULTS: Synchronous group presents higher amounts of physical activity than the asynchronous and no-exercise groups. Also, the synchronous group presented lower anxiety symptoms, while the asynchronous group presented lower depression symptoms compared with the no-exercise group. Worse motor symptoms were presented by the three groups. CONCLUSION: Stay active during the pandemic lockdown, is beneficial to reduce anxiety and depression symptoms in people with PD. This population should be encouraged to perform synchronous classes to perform greater amounts of physical activity, which in the long-term could produce greater benefits.

Associations between Physical Activity and Liver Cancer Risks and Mortality: A Systematic Review and Meta-Analysis.

(1) Background: The purpose of this meta-analysis was to investigate associations between physical activity (PA) and risks and mortality of liver cancer (LC) to suggest a minimum physical activity threshold to reduce LC risks and morality. (2) Methods: A database search was performed to identify relevant studies on the associations between PA and risks and mortality of LC before August 2020. The PA amounts were divided into three groups (high: ≥3 h/week, moderate: 2–3 h/week, and low: <2 h/week). The pooled relative risks of LC were calculated. (3) Results: A total of 10 prospective cohort studies were included. LC risks and mortality were 26% and 25% lower with high amounts of PA and 23% and 19% lower in moderate amounts of PA, respectively, compared to low amounts of PA. At the vigorous intensity PA level, high and moderate amounts of PA reduced the LC risk by 54% and 45%, respectively. (4) Conclusions: PA helps to reduce LC risks and mortality in a dose-dependent manner. At a minimum, two hours/week PA are mandatory to reduce LC mortality.

Correlates of Physical Activity, Psychosocial Factors, and Home Environment Exposure among U.S. Adolescents: Insights for Cancer Risk Reduction from the FLASHE Study.

Background and aims: Physical activity (PA) can bring numerous health benefits to adolescents and can largely aid in reducing the various types of cancer risks in their lifespans. However, few adolescents meet the physical activity guidelines recommended by the National Cancer Institute in the United States. Our study aimed to examine the multilevel determinants potentially influencing adolescent’s PA participation. Methods: A secondary analysis of physical activity, home and school neighborhood, and other psychosocial data from 1504 dyads of adolescents and their parents who participated in the 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) study was performed. Analysis of variance and general linear model analyses were used to examine the correlates. Results: General linear modeling revealed that younger adolescents participated in greater levels of PA than older adolescents (p < 0.001). Adolescents whose parents reported meeting PA guidelines participated in greater amounts of PA (p < 0.001). Parental support of adolescent PA (p < 0.001) was also predictive of adolescent PA levels. Furthermore, parents who reported meeting moderate-to-vigorous physical activity (MVPA) guidelines were more likely to have teenagers that engaged in higher amounts of PA (p < 0.001). Discussion and Conclusions: Our findings imply a dynamic relationship between adolescent and parent MVPA levels. Interventions focused on increasing parental MVPA and encouraging parents to engage in promoting PA are merited in order to aid in increasing PA among adolescents while reducing the cancer risk.

Change In Perceived Barriers To Physical Activity In A Weight Loss Intervention

Physical activity (PA) is an important aspect of behavioral weight loss programs, but the adoption of PA behavior is incumbent on overcoming individual level barriers. It is unclear whether perceptions of barriers change through the course of a behavioral weight loss intervention, or whether the dose of prescribed PA impacts perceived barriers. PURPOSE: To investigate the change in perceived PA barriers within a 12-month behavioral weight loss intervention with differing doses of prescribed PA. METHODS: 383 adults with overweight or obesity (age=46.2±7.7 years; BMI=32.1±3.8 kg/m2) were randomized into one of three 12-month intervention groups: Diet alone (DIET, n=127, no prescribed PA); Diet plus Moderate Dose PA (DIET+MOD, n=127, 150 min/week prescribed PA); Diet plus High Dose PA (DIET+HIGH, n=129, 250 min/week prescribed PA). All intervention conditions received the same prescribed diet (1200-1800 kcal/day) and behavioral intervention. Perceived PA barriers were assessed at baseline, 6 months, and 12 months. Barriers were analyzed on a Likert scale (1=strongly disagree; 5=strongly agree) as Total barriers and three subcategories of Time (e.g., too busy), Effort (e.g., lack of motivation), and Obstacles (e.g., family obligations) barriers. RESULTS: There was significant weight loss in all intervention conditions across the 12-months (DIET=-9.8 kg; DIET+MOD=-10.2 kg; DIET+HIGH=-10.3 kg) (p<0.05). Total barriers to PA decreased significantly across the 12 months (2.67 to 2.44; p<0.0001), with no difference between groups. A similar pattern was observed for obstacle barriers (2.11 to 2.01; p=0.0337). Effort barriers decreased significantly across the 12 months (p<0.001), with a Group X Time interaction (p=0.0133) also observed (DIET: 3.04 to 2.76; DIET+MOD: 3.00 to 2.51; DIET+HIGH: 2.97 to 2.32). CONCLUSION: Perceived barriers to PA decreased across a 12-month behavioral weight loss intervention, and this was observed regardless of the amount of PA that was prescribed within the intervention. It does not appear that prescribing a higher amount of physical activity within the context of a behavioral intervention negatively impacts perceived barriers to PA participation. However, time barriers appear to persist, which may have implications for interventions to promotion PA in adults with obesity.

Effectiveness of a Home-Based Telehealth Exercise Training Program for Patients With Cardiometabolic Multimorbidity: A Randomized Controlled Trial.

Exercise training has positive effects on the management of cardiometabolic conditions. Little is known about the effectiveness of home-based telehealth exercise training programs among patients with cardiometabolic multimorbidity, which is associated with functional decline and decreased health-related quality of life. The aim of this study was to determine the effectiveness of a 12-week home-based telehealth exercise training program designed to increase physical activity and exercise capacity and improve health-related quality of life in patients with cardiometabolic multimorbidity. A randomized controlled trial was conducted. Fifty eligible patients with 2 or more cardiometabolic conditions from outpatient clinics of a medical center in Northern Taiwan were randomized to either an experimental group (EG; received a 12-week home-based telehealth exercise training program) or a control group (CG; maintained usual lifestyles). The home-based telehealth exercise training program consisted of 36 individualized home-based exercise training sessions and a weekly reminder for maintenance of exercise and providing patient support. Amounts of physical activity, exercise capacity, and health-related quality of life were assessed at baseline and 12 weeks. Generalized estimating equations were used to examine the intervention effects via the interaction of time and group. The EG had higher amounts of physical activity (β = 1333, P = .004) and moderate-intensity physical activity (β = 330, P = .04) than the CG after the intervention. The EG had increased exercise capacity (VO2peak, β = 4.43, P = .04), as well as improved health-related quality of life (physical function, β = 7.55, P = .03; and physical component summary, β = 4.42, P = .03) compared with those in the CG. A 12-week home-based telehealth exercise training program is feasible and effective in increasing amounts of physical activity, elevating exercise capacity, and improving health-related quality of life in patients with cardiometabolic multimorbidity.