Increase In Daily Physical Activity Research Articles

Recommendations for Physical Activity in Segments of the School Day Support the Increase in Daily Physical Activity in Adolescents

Purpose: This study aimed to assess the impact of segment-specific physical activity (PA) recommendations during the school day on the daily PA in both boys and girls. Methods: A total of 426 Czech and 219 Polish adolescents participated in this study. They were divided into two groups: one receiving segment-specific PA recommendations for the school day and the other receiving general daily PA recommendations. The Youth Activity Profile questionnaire, the World Health Organization-5 Well-Being Index, and the wearable Garmin vívofit were used in the research. Results: The application of segment-specific PA recommendations during the school day was significantly associated with higher PA on school days. It also increased the odds of meeting the recommendations of 6,000 steps/day after school (odds ratio = 1.63, confidence interval [1.19, 2.24], p = .003) and 11,000 steps/day (odds ratio = 1.59, confidence interval [1.16, 2.18], p = .004) on school days. Conclusions: Segment-specific PA recommendations during the school day are effective and should be integrated into physical education curricula, comprehensive school PA programs, and broader school educational strategies.

Erratum. Recommendations for Physical Activity in Segments of the School Day Support the Increase in Daily Physical Activity in Adolescents

Erratum. Recommendations for Physical Activity in Segments of the School Day Support the Increase in Daily Physical Activity in Adolescents

The effect of a novel lifestyle intervention on autonomic and haemodynamic function in individuals with hypertrophic cardiomyopathy

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This project has received funding from the European Union’s Horizon 2020 Research and Innovation Programme under Grant Agreement no. 777204. Background Autonomic nervous system may play an important role in the pathophysiology of hypertrophic cardiomyopathy (HCM). Lifestyle interventions have been shown to improve signs and symptoms in individuals with heart failure. Purpose To evaluate the effect of a novel lifestyle intervention incorporating physical activity and dietary nitrate supplementation on cardiac autonomic and haemodynamic function in individuals with HCM. Methods Twenty-eight individuals with HCM were recruited into a single-centre pilot study (N=7 females, age 54±15 years) and randomised into the intervention (N=20) or control (N=8) group. Participants completed short-term (5-minute) non-invasive heart rate variability (HRV) measurements under resting (supine) conditions using the TaskForce (CNSystems, Graz, Austria). Frequency-domain HRV measures including spectral analysis of RR interval (i.e. absolute and normalised low frequency power (LF), high frequency power (HF) and LF/HF ratio) were recorded. Non-invasive haemodynamic variables including cardiac output (CO), and stroke volume (SV)were simultaneously recorded using bioimpedance technology integrated within the TaskForce. Intervention participants consumed 6 mmol of nitrate daily (concentrated beetroot juice) and increased and maintained their daily physical activity by ≥2000 steps/day above baseline for 16 weeks. Participants in the control group continued with their usual lifestyle and monitored daily step counts. Physical activity was evaluated objectively using pedometers (Omron Health, Japan). All participants were monitored weekly via telephone calls and average daily activity levels were recorded using diaries. However, participants in the control group were asked not to change their physical activity and dietary habits. Results Participants in the intervention group significantly increased their average physical activity by 3029 steps post intervention (i.e, 6234±2389 vs 9263± 3341 steps/day, p<0.01) compared to control (7559±3257 vs 7604± 2901 steps/day, p=0.96). There was a significant increase in post-intervention HF power (7.54±2.14 vs. 8.78±1.60 ms2, p<0.01) and LF power (6.89±2.33 vs. 8.17±1.55, p<0.01) respectively, but not in the control group (i.e., HF (7.05±3.39 vs. 7.64±2.56 ms2, p=0.33) and LF power (6.78±3.31 vs. 7.06±2.43 ms2 p=0.63)). There was a non-significant change in SV index in the intervention (33±9.83 vs. 29±8.56 ml/beat/m2, p=0.06) and control groups (34±6.27 vs. 33±8.1 ml/beat/m2, p=0.79). Similarly, there was no significant change in cardiac index in the intervention or control groups (intervention: 2.35±0.44 vs. 2.38±0.52 L/min/m2, p=0.77; control: 2.27±0.40 vs. 2.67±0.78, p=0.06). Conclusions Lifestyle intervention incorporating physical activity and dietary nitrate supplementation led to a significant increase in daily physical activity and improved parasympathetic activity in hypertrophic cardiomyopathy.

Evaluation of the Effectiveness of a Whole-System Intervention to Increase the Physical Activity of Children Aged 5 to 11 Years (Join Us: Move Play, JU:MP): Protocol for a Quasiexperimental Trial.

Daily physical activity is vital for the health and development of children. However, many children are inactive. Previous attempts to achieve sustained increases in daily physical activity in children have been ineffective. Join Us: Move Play (JU:MP) is a whole-system, complex, community-based intervention aiming to increase the physical activity levels of children aged 7 to 11 years who live in areas of Bradford, England, which are multicultural and have high levels of deprivation. The purpose of this quasiexperimental controlled trial is to assess whether the JU:MP program increases primary school children's physical activity. The study has a 2-arm, quasiexperimental, nonblinded, nonequivalent group design and will be conducted with primary school children aged 5 to 11 years at 3 timepoints, including baseline (before intervention), 24 months (during intervention), and 36 months (after intervention). Children attending primary schools within the intervention area will be invited to participate. Children attending similar schools within similar neighborhoods based on school and community census demographics (deprivation, free school meals, and ethnicity) outside of the JU:MP geographical area will be invited to participate in the control condition. At each timepoint, consenting participants will wear an accelerometer for 7 consecutive days (24 hours a day) to measure the primary outcome (average daily moderate-to-vigorous physical activity). Multivariable mixed effects linear regression will be applied to estimate differences in the primary outcome between the 2 arms at 24 months and 36 months on an intention-to-treat basis. The secondary outcome analysis will explore changes in socioemotional well-being (teacher reported), quality of life (parental/carer reported), and other contextual factors (parents/carer reported), as well as segments of the day activity, sleep, sedentary screen time, frequency of places to be active, parent practices (nondirective support and autonomy support), social cohesion, and neighborhood walking/exercise environment. Recruitment occurred from July 2021 to March 2022, and baseline data were collected from September 2021 to March 2022. As of March 2022 (end of baseline data collection), a total of 1454 children from 37 schools (17 intervention schools and 20 control schools) have been recruited. The first follow-up data collection will occur from September 2023 to March 2024, and the second and final follow-up data collection will occur from September 2024 to March 2025. Data analysis has not begun, and the final results will be published in December 2025. This article describes the protocol for a quasiexperimental controlled trial examining a novel whole-system intervention. ISRCTN ISRCTN14332797; https://www.isrctn.com/ISRCTN14332797. DERR1-10.2196/43619.

EFECTOS DE UN PROYECTO INTERDISCIPLINAR DE PROMOCIÓN DE COMPORTAMIENTOS SALUDABLES EN ESTUDIANTES DE EDUCACIÓN PRIMARIA DE UN COLEGIO RURAL

Although the benefits associated with a healthy lifestyle are known, a large percentage of young people do not comply with the established recommendations for the different healthy behaviors, especially during Covid-19. Thus, the aim of this study was to design, implement, and evaluate the effects of a multicomponent and multilevel school-based program on multiple health-related behaviors in Primary Education students. For this, 12 students (M=10.33±1.07), from a multilevel Primary Education classroom of a rural school in Teruel, participated. This five-week program aimed to raise awareness about the importance of adopting a healthy lifestyle. The results showed an increase in daily physical activity and perceived health status after participating in the intervention program. Likewise, recreational screen time also showed a significant decrease. However, the students did not report significant differences in sleep duration, adherence to the Mediterranean diet, and quality of life. Thus, it seems convenient to develop multicomponent, multibehavioral, and multilevel school programs, involving different subjects and areas of action, as well as the entire educational community, to improve these healthy behaviors in young people from rural schools.

The Effect of Regular Physical Activity on the Cardiovascular System in Students

It has been noticed that dosed muscle activity in the form of regular physical culture exercises is capable of providing a pronounced general health-improving effect at any age. Neglect of systematic rational physical activity always contributes to a persistent weakening of the state of health and especially often leads to the formation of various dysfunctions of the heart and blood vessels. The study was carried out in 2019-2020 on young men living in Central Russia (the city of Moscow and the Moscow region). In the work carried out, it was found that regular muscle activity in healthy adolescents and those with dysfunctions in the cardiovascular system provides a stable normalization of the parameters of cardiac activity. As a result of regular dosed physical training, all those under observation had a statistically significant increase in the vital capacity of the lungs. All physically training young men showed an increase in the level of general physical fitness. In all cases, the boys who increased their physical activity showed an increase in speed-strength capabilities and an increase in overall endurance. It can be considered that an increase in daily physical activity due to an increase in the distance covered on foot is a very effective means of improving the health of adolescents, including when they begin to develop disorders of the cardiovascular system.

App-assured essential physical activity for the prevention of cognitive decline: changing paradigms in public health – a study protocol for a randomised controlled trial

This study aims to assess the effect of an increase in daily physical activity to prevent cognitive decline, sustain brain volumes and maintain healthy biomarker levels in previously inactive (< 7,000 steps/day) mild cognitive impairment (MCI) subjects aged 50-65 years. In total, 198 subjects with MCI (assessed using the Montreal Cognitive Assessment test) will be recruited and randomised into two groups: active and passive. The active group will be instructed, encouraged and motivated to increase their physical activity to a moderate level (≥ 10,000 steps/day), while the passive group should maintain their normal activity levels. All subjects will undergo cognitive assessment, neuroimaging and biomarker tests before and after a one-year intervention. During the intervention, physical activity will be measured by the Fitbit Inspire HR wristband. The study was registered in the German Clinical Trials Register database (registration no. DRKS00020943, date of registration: 09.03.2020, protocol version: 1.0).

Active Longevity program as important element of rehabilitation of elderly patients in primary health care

Progressive increase in the proportion of elderly patients in the population of many countries actualizes the issues of preserving physical and mental health, working capacity and quality of life of retirees. As a part of preventive geriatric rehabilitation, ‘the Active Longevity’ program has been operating in many cities of Russia over the past three years, one of the aspects of the program is the involvement of elderly patients in active life, including an increase in physical activity. This study included 744 patients who attended face‑to‑face physical training sessions. According to the results of the survey, 41% of pensioners noted an increase of daily physical activity, 94% reported an improvement in health and mood, the level of total blood cholesterol decreased. Almost all patients, both with and without clinical and subclinical manifestations of anxiety and depression, reported a good and very good mood immediately after exercise. Increasing physical activity in elderly patients improves the quality of life and prolongs its duration, and is also an effective method of non‑drug treatment of anxiety‑depressive disorders.

Abstract P200: Effects Of A 2-year Randomized Controlled Trial Physical Activity Intervention On Accelerometer-measured Sleep Characteristics Among Older Adults In Senior Center Communities

Background: Targeting daily increases in physical activity (PA) is a common lifestyle strategy for cardiovascular disease (CVD) risk reduction. While less targeted in lifestyle interventions, poor sleep is also consistently linked to CVD. Emerging evidence connects changes in daily PA to beneficial changes in sleep; however, little is known about the impact of community-based PA interventions on habitual sleep among older adults. We leveraged accelerometer data from the Peer Empowerment Program for Physical Activity in Low Income & Minority Seniors (PEP4PA) randomized controlled trial to examine the effect of a PA intervention on accelerometer-measured sleep characteristics among older adults in low income and diverse senior center communities. Methods: PEP4PA participants (N=476; mean age=71.0 ± 9 years, 75% female, 60% low income, 36% non-white) were recruited from senior centers and randomized to a healthy control condition(n=209) or a peer-lead walking intervention (N=267). The peer-led PA intervention included self-monitoring techniques, health coach counseling, group walks, and community advocacy to improve walking conditions. Participants wore Actigraph GT3X+ accelerometers on the wrist at baseline, 6, 12, and 24 months. Data were processed for sleep characteristics including weekly average sleep duration and sleep efficiency. Mixed effects regression models provided estimates of the intervention effect on sleep characteristics at each time point. Models were adjusted for age, sex, and race. Three way interaction terms (time*treatment*sleep duration status) were used to assess differential intervention effects by short (<7) and long (>8 hours) sleep duration status at baseline. Results: At baseline, the average sleep duration of participants was 7 hours (SD: 1.07 hours) and the average sleep efficiency was 87.0% (SD: 6.2%). Compared to participants in the control group, participants in the intervention group had shorter sleep durations (7.1 hours vs 7.0 hours; p value: 0.08) and poorer sleep efficiency 86.0% vs 88.2%; p<0.001) at baseline. At 12 or 24-months, there was no intervention effect on participants’ average sleep duration or efficiency. Although not significant, at 6 months, long sleepers in the intervention group experienced an average 6-minute reduction in sleep duration (-B: 6.25, p=0.45) compared to those in the control group. Conclusions: Over the 2-year period, the PA intervention did not appear to have an impact on participants’ average sleep duration or quality. More investigation is needed into the temporal and daily relations of PA and sleep among older adults in interventions to understand if increases in daily PA are associated with better sleep characteristics at night.

Effects of participation level and physical activity on eating behavior and disordered eating symptoms in the Brazilian version of the New Moves intervention: data from a cluster randomized controlled trial.

Childhood and adolescent obesity is a worldwide public health concern. The New Moves program aims to change eating behavior (EB) and physical activity (PA). To evaluate the effectiveness of an intervention and predictors of better outcomes relating to EB and PA levels. Secondary data from a cluster randomized controlled trial in 10 public schools in São Paulo, Brazil. 270 female adolescents, aged 12 to 14 years, were analyzed. Participation levels were categorized as presence in 1 to 9 sessions or 10 to 17 sessions, or control. Effectiveness was evaluated through improvement in disordered EB (DEB) and EB. Predictors of better outcomes relating to PA levels were evaluated through clustering of individual characteristics that affected changes in PA scores. Participation level was not significantly associated with changes in DEB or EB. Girls with higher body mass index percentile (BMI-P) percentile tended to have increases in sedentary lifestyles through the program. Girls with less body image dissatisfaction presented higher increases in daily PA. Girls with higher BMI-P percentile and higher self-esteem showed reductions in sedentary lifestyles. The program seemed to have more effect on daily PA among older girls than among younger girls. This program could be used as a structured action plan in schools, with the aims of improving eating behaviors and physical activity, in addition to promoting self-acceptance. The results indicate the importance of evaluating determinants of adherence, as these metrics might influence the effectiveness and future design of lifestyle programs.

School-based physical activity interventions in rural and urban/suburban communities: A systematic review and meta-analysis.

Disparities in physical activity and health outcomes exist between urban and rural youth. School settings can be utilized to promote physical activity in youth regardless of urban-rural status. This systematic review and meta-analysis aimed to assess and compare the effect of rural and urban/suburban school-based physical activity programs on total physical activity in youth. A search of five databases was conducted. A total of 33 studies remained after the exclusion process, 28 of which took place in urban/suburban schools and five of which took place in rural schools. The DerSimonian and Laird random effects model was employed with the estimates of heterogeneity taken from the inverse-variance fixed-effect model. For rural studies, the Hartung-Knapp-Sidak-Jonkman method was used to obtain error estimates. Results from the total sample indicated a significant but small pooled increase in daily physical activity (Hedge's g = 0.12, 95% confidence interval [CI]: 0.06-0.18), which held for interventions conducted in urban/suburban schools (Hedge's g = 0.12, 95% CI: 0.06-0.19). For rural school-based interventions, there was no significant pooled effect (Hedge's g = 0.06, 95% CI: -0.50 to 0.61). This meta-analysis provides evidence that school-based interventions can be marginally effective for increasing daily physical activity in children and adolescents; however, no effect was observed for interventions implemented in rural settings.

The association between daily physical exercise and pain among women with fibromyalgia: the moderating role of pain catastrophizing.

Fibromyalgia (FM) is a condition marked by widespread chronic pain and an array of somatic and psychological symptoms. The primary objective of this study was to explore daily associations between physical activity and pain intensity among a sample of women with FM and the potential moderation of this association by pain catastrophizing. Women with FM (N = 107) completed questionnaires assessing pain, FM symptoms, and psychological measures and were then asked to report their levels of daily pain catastrophizing, physical activity, and pain intensity once per day for a period of 1 week using daily electronic diary-based tracking. In addition, objective measures of physical activity were collected using an activity tracker (Fitbit Flex), which measured step counts. Daily self-report physical activity was used as the independent variable and pain intensity (Brief Pain Inventory) was the outcome, whereas daily pain catastrophizing was tested in the model as the potential moderator. Moderation analyses demonstrated associations between physical activity and pain intensity, which were moderated by patient's level of catastrophizing (B = 0.003, SE = 0.001, P < 0.05), with patients scoring higher in daily catastrophizing showing a relatively stronger link between higher day-to-day physical activity and increased daily FM pain. Significant associations were observed between pain catastrophizing, pain intensity, and Fitbit Flex step count (P < 0.05). Our findings suggest that increases in daily physical activity is associated with more self-reported pain intensity in women with FM pain, particularly among those with higher levels of pain catastrophizing.

Can regular physical activity prevent obesity? 3: Empirical longitudinal evidence of its efficacy.

Objective. The objective of this narrative review is to examine longitudinal data pointing to the efficacy of adequate daily physical activity in the prevention of obesity. Methods. Information obtained from Ovid/Medline, Pub-Med and Google Scholar through to April 2019 has been supplemented by a search of the author's extensive personal files. Results. Babies that have a high level of spontaneous physical activity generally accumulate less body fat then their peers over the first few years of life. However, there is little evidence of a favourable response to supplementary exercise programmes in pre-school children, perhaps because of practical difficulties in augmenting habitual physical activity in this age group. Summer camps for older children usually induce a substantial immediate decrease of both body mass and tissue fat stores, but it is unclear how far this reflects dietary restrictions at the camp rather than an increase of physical activity in this environment. Five of 8 uncontrolled longitudinal studies of children and adolescents with subjective assessments of habitual physical activity found no beneficial changes of body composition in individuals who were physically more active, as opposed to 3 positive reports (one of these seeing benefits in girls only). However, perhaps because more accurate categorization of exercise levels was possible, benefit was demonstrated in 8 of 10 trials of children with objective assessments of habitual physical activity. Fifteen of 26 trials of children and adolescents with group programme assignment also found a better body composition in those assigned to groups that were more physically active, although participants in 9 of thes 15 trials were given not only an increase of physical activity, but also dietary advice and/or a restriction of food intake. Cohort studies in adults have found fairly consistently that regular physical activity reduces obesity or prevents the increase of body fat content usually associated with aging; benefit was seen in 14 of 17 studies of young adults, and 20 of 21 groups of middle-aged and older individuals. The portion of the day allocated to sedentary behaviour has also been associated with the development of obesity in 4 of 6 studies in children, and 10 of 13 trials in adults. Likewise, the transition from physically active hunting and gathering to an urban lifestyle has been associated with an accumulation of body fat in arctic Inuit. In children, randomized controlled trials have shown beneficial changes in body composition from interventions only when the intervention has been effective in achieving a substantial increase of daily physical activity. However 27 of 31 controlled studies of adults have demonstrated a reduction of body fat content in response to a variety of exercise initiatives. It is more difficult to assign a vigorous exercise programme to the frail elderly, and in this age group there has as yet been little study of the potential to reduce body fat by an increase in physical activity, although this would confer obvious functional benefit on those with limited muscle strength. Conclusions. Both in children and in adults, the bulk of prospective and controlled trials point to the efficacy of adequate volumes of regular exercise in both the prevention and the control of obesity. But as with initiatives based on rigorous dieting, the challenge to health professionals is to sustain the enthusiasm of clients over a sufficient period for a programme to take effect and to become a part of the individual's normal lifestyle.

Novel Smartphone Game Improves Physical Activity Behavior in Type 2 Diabetes

Many type 2 diabetes patients show insufficient levels of physical activity and are often unmotivated to change physical activity behaviors. This study investigated whether a newly developed smartphone game delivering individualized exercise and physical activity promotion through an elaborate storyline can generate sustained improvements in daily physical activity (steps/day). Thirty-six participants were enrolled in this 24-week RCT between August 2016 and April 2018. After baseline assessment, participants were randomized in equal numbers to the intervention or control condition. Data analysis was performed in May-June 2018. Inactive, overweight type 2 diabetes patients, aged 45-70 years, were recruited through advertising and from hospitals and diabetes care centers in the Basel, Switzerland, metropolitan area. Participants were instructed to play the innovative smartphone game (intervention group) or to implement the recommendations from the baseline lifestyle counseling (control group) autonomously during the 24-week intervention period. Primary outcomes were changes in daily physical activity (steps/day); changes in aerobic capacity, measured as oxygen uptake at the first ventilatory threshold; and changes in glycemic control, measured as HbA1c. Daily physical activity increased by an average of 3,998 (SD=1,293) steps/day in the intervention group and by an average of 939 (SD=1,156) steps/day in the control group. The adjusted difference between the two groups was 3,128 steps/day (95% CI=2,313, 3,943, p<0.001). The increase in daily physical activity was accompanied by an improved aerobic capacity (adjusted difference of oxygen uptake at the first ventilatory threshold of 1.9 mL/(kg·min), 95% CI=0.9, 2.9, p<0.001). Glycemic control (HbA1c) did not change over the course of the intervention. A novel, self-developed smartphone game, delivering multidimensional home-based exercise and physical activity promotion, significantly increases daily physical activity (steps/day) and aerobic capacity in inactive type 2 diabetes patients after 24 weeks. The ability of the game to elicit a sustained physical activity motivation may be relevant for other inactive target groups with chronic diseases. This study is registered at www.clinicaltrials.gov NCT02657018.

A secondary analysis of data from the OPTICARE randomized controlled trial investigating the effects of extended cardiac rehabilitation on functional capacity, fatigue, and participation in society

Objective: In this secondary analysis of data from the OPTICARE trial, we compared the effects of two behavioral interventions integrated into cardiac rehabilitation to standard rehabilitation with regard to functional capacity, fatigue, and participation in society. Design: This is a randomized controlled trial. Setting: This study was conducted in a cardiac rehabilitation setting. Subjects: A total of 740 patients with acute coronary syndrome were recruited for this study. Interventions: Patients were randomized to (1) three months of standard rehabilitation; (2) cardiac rehabilitation plus nine months after-care with face-to-face group lifestyle counseling; or (3) cardiac rehabilitation plus nine months after-care with individual lifestyle telephone counseling. Main measures: Functional capacity (6-minute walk test), fatigue (Fatigue Severity Scale), and participation in society (Utrecht Scale for Evaluation of Rehabilitation-Participation) were measured at randomization, 3, 12, and 18 months. Results: Additional face-to-face sessions resulted at 12 months in 12.49 m more on the 6-minute walk test compared to standard rehabilitation (P = .041). This difference was no longer present at 18 months. Prevalence of fatigue decreased from 30.2% at baseline to 11.9% at 18 months compared to an improvement from 37.3% to 24.9% after standard rehabilitation (between-group difference: odds ratio = 0.47; P = .010). The additional improvements in functional capacity seemed to be mediated by increases in daily physical activity. No mediating effects were found for fatigue. No additional improvements were seen for participation in society. Additional telephonic sessions did not result in additional intervention effects. Conclusion: Extending cardiac rehabilitation with a face-to-face behavioral intervention resulted in additional long-term improvements in fatigue and small improvements in functional capacity up to 12 months. A telephonic behavioral intervention provided no additional benefits.

Risk Factors and Implications of Childhood Obesity.

This review summarizes our current understanding of factors associated with childhood obesity, including latest prevalence rates, effectiveness of intervention strategies, and risk for concomitant disease later in life. Obesity has reached global dimensions, and prevalence of childhood obesity has increased eightfold since 1975. Interventions for obesity prevention have mainly focused on behavioral settings to date, i.e., interventions that have focused on behavioral changes of the individuum such as increasing daily physical exercise or optimizing diet. However, effects have been very limited worldwide and could not stop the increase of obesity prevalence so fare. Thus, community-based/environment-oriented measures are urgently needed, such as promotion of healthy food choices by taxing unhealthy foods, mandatory standards for meals in kindergarten and schools, increase of daily physical activity at kindergartens, and schools as well as ban on unhealthy food advertisement for children. Restructuring obesity interventions towards community-based/environment-oriented measures to counteract an obesogenic environment is mandatory for sustainable success and to stop the obesity epidemy. There is need to move fast, as already moderate overweight before the start of puberty is associated with significantly increased risk for type 2 diabetes and cardiovascular disease in midlife.

The Effect of Pain Relief on Daily Physical Activity: In-Home Objective Physical Activity Assessment in Chronic Low Back Pain Patients after Paravertebral Spinal Block.

This study evaluates the effect of paravertebral spinal injection (PSI), utilizing both subjective and objective assessments in chronic low back pain (LBP) associated with facet joint arthrosis over a one-month duration. Subjective questionnaires included the visual analogue scale (VAS) for pain, the Oswestry Disability Index, the Health Survey SF-12, and the short Falls Efficacy Scale International (FES-I). Objective assessments included in-clinic gait and Timed Up and Go (TUG) tests using wearable sensors, as well as 48 h daily physical activity (DPA) monitored using a chest-worn triaxial accelerometer. Subjective and objective measures were performed prior to treatment, immediately after the treatment, and one month after the treatment. Eight LBP patients were recruited for this study (mean age = 54 ± 13 years, body mass index = 31.41 ± 6.52 kg/m2, 50% males). Results show significant decrease in pain (~55%, p < 0.05) and disability (Oswestry scores, ~21%, p < 0.05). In-clinic gait and TUG were also significantly improved (~16% and ~18% faster walking and shorter TUG, p < 0.05); however, DPA, including the percentage of physical activities (walking and standing) and the number of steps, showed no significant change after PSI (p > 0.25; effect size ≤ 0.44). We hypothesize that DPA may continue to be truncated to an extent by conditioned fear-avoidance, a psychological state that may prevent increase in daily physical activity to avoid pain.

The Association Between Daily Physical Activity and Pain Among Patients with Knee Osteoarthritis: The Moderating Role of Pain Catastrophizing

The primary objective of this study was to examine the day-to-day association between physical activity and pain intensity among a sample of patients with knee osteoarthritis (KOA) and the potential moderation of this association by negative cognitive processes. In this micro-longitudinal daily diary study, KOA patients (N = 121) completed questionnaires assessing pain (Brief Pain Inventory) and psychosocial functioning (pain catrophizing scale, WOMAC McMaster Universities Osteoarthritis Index function, Patient-Reported Outcomes Measurement Information System [PROMIS; anxiety and depression], the Godin-Shephard Leisure-Time Physical Activity questionnaire, the six-minute walking test) and were then asked to report their levels of physical activity and pain intensity once per day for a period of seven days using an electronic diary. Multilevel modeling analyses indicated that day-to-day increases in physical activity were associated with heightened levels of pain intensity (B = 0.13 SE = 0.03, P < 0.001). In addition, it was revealed that the association between physical activity and pain intensity was moderated by catastrophizing (B = -0.01 SE = 0.002, P < 0.05), with patients scoring higher in catastrophizing showing a relatively stronger link between day-to-day physical activity and increased knee pain. This effect was specific to catastrophizing, as depression and anxiety did not moderate the activity-pain relationship (P > 0.05). Our findings suggest that increases in daily physical activity are associated with concurrent increases in KOA patients' levels of knee pain, particularly among patients reporting higher levels of pain catastrophizing. These results may have clinical implications for the design and testing of interventions targeted at reducing catastrophizing and increasing physical activity among patients with chronic osteoarthritis pain.

PCOS: phenotypes, visceral obesity and a personalized approach in the prescription of COC

Polycystic ovary syndrome (PCOS) is a complex of endocrine disease with several phenotypes, which determines the difficulties in its diagnostics (“diagnosis of exceptions”). This is an interdisciplinary disease, as the consequences of this syndrome can be serious (infertility, cardiovascular diseases, diabetes mellitus and their complications). The reason for this is the fact that PCOS occurs with metabolic disorders, manifested as violations of carbohydrate and fat metabolism.Determination of specific phenotypes of women with PCOS are justified from the point of metabolism. Metabolic disorders in PCOS can prevail throughout life. At the initial stages, these changes may be invisible and not diagnosed. PCOS is often characterized by the presence of insulin resistance and is associated with hyperinsulinemia in most obese patients.PCOS can occur with various forms of obesity, the most important is visceral obesity. This connected with the fact that visceral obesity may present in women with PCOS with no elevated body mass index. Therefore, timely diagnostics of obesity, especially visceral, determines the health consequences of this syndrome.There are certain difficulties in the diagnostics of visceral obesity, but many of them are surmountable in modern conditions. Women with PCOS need the use combined oral contraceptives with both contraceptive and curative purposes. Therefore, the choice of the medicine depending on the clinical situation, the peculiarities of redistribution of adipose tissue is important in clinical practice. With the correct choice of COC, there will be no significant adverse effects on the metabolic profile of patients with PCOS and, possibly, a positive effect on their lipid profile will be observed. And yet, weight loss can lead to spontaneous ovulation in women with PCOS and overweight or obese, so the first choice in treatment of such patients should be diet and lifestyle changes, including an increase of daily physical activity.

Objective Improvement in Daily Physical Activity in Heart Failure Remains Elusive: A Systematic Review

Purpose: The purpose was to comprehensively review the literature for exercise- and psychosocial-based rehabilitation interventions for improving daily physical activity (PA) in patients with heart failure (HF). Methods: A search of the PubMed/MEDLINE, CINAHL, ProQuest Medical, PsycINFO, and Web of Science databases was conducted. Articles were included if they (1) were written in English, (2) included subjects with HF, (3) assessed physical or psychosocial rehabilitation interventions to improve daily PA, and (4) measured daily PA qualitatively or quantitatively. Case reports, non–peer-reviewed research, and articles without full text available were excluded. Two authors completed the screening independently, and conflicts were resolved by a third author. Results: One thousand four hundred sixty-two unique records were identified, and of these, 47 were selected for full-text review. Ultimately 15 were included: 13 randomized controlled trials and 2 case series, published from 1999 to 2016. No studies using only exercise interventions resulted in objective increases in daily PA. All 3 studies using only psychosocial interventions resulted in an increase, but only 1 of these used an objective measure and that study was a case series. One study using a combination of exercise and psychosocial interventions showed an objective increase in daily PA, but that result was not replicated later in a similar study. Conclusions: Exercise interventions alone do not result in improvement in daily PA in patients with HF. Further investigation concerning psychosocial interventions, with objective outcome measurement, is warranted.