Increase Physical Activity In Adults Research Articles

Adaptive Goals and Reinforcement Timing to Increase Physical Activity in Adults: A Factorial Randomized Trial

Potent lifestyle interventions to increase moderate-to-vigorous physical activity are urgently needed for population-level chronic disease prevention. This trial tested the independent and joint effects of a mobile health system automating adaptive goal setting and immediate financial reinforcement for increasing daily walking among insufficiently active adults. Participants were randomized into a 2 (adaptive versus static goal setting) X 2 (immediate versus delayed financial incentive timing) condition factorial trial to increase walking. Participants (N=512 adults) were recruited between 2016 and 2018 and were 64.5% female, aged 18-60 years, 18.8% Hispanic, 6.1% African American, and 83% White. Principles of reinforcement and behavioral economics directed intervention design. Participants wore accelerometers daily (133,876 day-level observations) that remotely measured moderate-to-vigorous physical activity bout minutes of ≥3 minutes/day for 1 year. Primary outcomes were between-condition differences in (1) engaging ≥1 bout of moderate-to-vigorous physical activity on each day and (2) on days with ≥1 bout, daily total moderate-to-vigorous physical activity minutes. Mixed-effects hurdle models tested treatment group X phase (time) interactions using an intent-to-treat approach in 2021. Engaging in any ambulatory moderate-to-vigorous physical activity was greater for Adaptive than for Static Goal groups (OR=2.34, 95% CI=2.10, 2.60 vs OR=1.66, 95% CI=1.50, 1.84; p<0.001) and for Immediate than for Static Reinforcement groups (OR=2.16 95% CI=1.94, 2.40 vs OR=1.77, 95% CI=1.59, 1.97; p<0.01). The Immediate Reinforcement group increased by 16.54 moderate-to-vigorous physical activity minutes/day, whereas the Delayed Reinforcement group increased by 9.91 minutes/day (p<0.001). The combined Adaptive Goals+Immediate Reinforcement group increased by 16.52 moderate-to-vigorous physical activity minutes/day, significantly more than that of either Delayed Reinforcement group. This study offers automated and scalable-behavior change strategies for increasing walking among adults most at-risk for chronic diseases attributed to sedentary lifestyles. This study is registered at www.clinicaltrials.gov (ClinicalTrials.gov Identifier: NCT02717663).

The impact of yoga on components of energy balance in adults with overweight or obesity: A systematic review.

BackgroundYoga may reduce body weight in individuals with overweight or obesity, but whether this occurs through decreased energy intake (EI) or increased energy expenditure (EE)/physical activity (PA) is unclear.MethodsA systematic search of PubMed, Web of Science, Embase, and PsychINFO was conducted from inception until April 26, 2021. Eligible studies included randomized controlled trials or single‐arm pre‐post studies with any type and duration of yoga intervention in adults with overweight or obesity. Studies with measures related to EI , EE, or PA were eligible. The review initially identified 1,373 articles.ResultsOf the 10 included studies, one used indirect calorimeter measures of resting EE, while nine used self‐reported measures of EI and PA. Of the seven studies measuring parameters related to EI, only one found greater decreases in EI relative to the control group, although three other investigations reported trends toward improved dietary intake. Of the eight studies measuring PA, two reported greater increases in resting EE or PA in the yoga group relative to the control group. Two reported significant within‐group increases in PA from pre‐post intervention, and four studies reported a trend for increased PA with no p‐values reported.ConclusionsLimited evidence suggests yoga may reduce EI and increase PA in adults with overweight or obesity. Additional studies that investigate the effects of yoga interventions on energy balance parameters using objective techniques are warranted.

Do activity monitors increase physical activity in adults with overweight or obesity? A systematic review and meta-analysis.

To systematically assess contemporary knowledge regarding behavioral physical activity interventions including an activity monitor (BPAI+) in adults with overweight or obesity. PubMed/MEDLINE, Embase, CINAHL, PsycINFO, CENTRAL, and PEDro were searched for eligible full-text articles up to 1 July 2015. Studies eligible for inclusion were (randomized) controlled trials describing physical activity outcomes in adults with overweight or obesity. Methodological quality was independently assessed employing the Cochrane Collaboration's tool for risk of bias. Fourteen studies (1,157 participants) were included for systematic review and 11 for meta-analysis. A positive trend in BPAI+ effects on several measures of physical activity was ascertained compared with both wait list or usual care and behavioral physical activity interventions without an activity monitor (BPAI-). No convincing evidence of BPAI+ effectiveness on weight loss was found compared with BPAI-. Behavioral physical activity interventions with an activity monitor increase physical activity in adults with overweight or obesity. Also, adding an activity monitor to behavioral physical activity interventions appears to increase the effect on physical activity, although current evidence has not yet provided conclusive evidence for its effectiveness.

The Alberta Diabetes and Physical Activity Trial (ADAPT):A Randomized Trial Evaluating Theory-Based Interventions to Increase Physical Activity in Adults with Type 2 Diabetes

Physical activity (PA) is associated with reduced morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM); however, most T2DM adults are insufficiently active. To explore the effectiveness of two innovative/theoretically based behavioral-change strategies to increase PA and reduce hemoglobin A1c (A1c) in T2DM adults. Participants (n = 287) were randomly assigned to a control group or an intervention group (i.e., print-based materials/pedometer group or print-based materials/pedometer plus telephone-counseling group). Changes in PA and A1c and other clinical measures were examined by Linear Mixed Model analyses over 18 months, along with moderating effects for gender and age. PA and A1c levels did not significantly change in intervention groups. Step counts significantly increased in the print-based materials and pedometer plus telephone counseling group, for women. No significant effects were found for PA or A1c levels for T2DM adults. The multi-component strategy including telephone counseling may have potential for women. The trial was registered on ClinicalTrials.gov identifier: NCT00221234.

Use of TV Commercial Stepping to Increase Physical Activity in Adults

The most common leisure-time activity is TV watching. An hour of TV contains ~16-20 min of commercials. Modifying TV watching behaviors by stepping in place during commercials (TV stepping) could increase physical activity (PA) (steps and time) in adults. PURPOSE: To evaluate the short-term effectiveness of TV stepping on adults' PA and TV viewing. A secondary aim was to test objective measures of PA under free-living conditions. METHODS: Twelve adults (36±15 y) participated in this study and wore 3 PA-monitoring devices [StepWatch-3 (criterion, on ankle), and Omron-HJ303 (on ankle and waist)] for 3 wk. During wk 1 (baseline), adults were asked to not alter their normal activity or TV habits to establish a baseline level of steps and TV viewing. In weeks 2 and 3 (TV stepping), adults received the same instructions, but with a goal of TV stepping for 120 min/day. Adults recorded daily steps, and self-reported time (min/day) spent TV viewing, and TV stepping in a logbook. RESULTS: Although the number of total daily steps was not significantly different between baseline (8054±3167), TV stepping 1 (8764±3122), and TV stepping 2 (8601±3011) (p=0.087), adults took more steps when watching TV during TV stepping 1 (1250±949) (p=0.019), and TV stepping 2 (871±475) (p=0.009) than at baseline (344±126). TV viewing time was reduced by about 34% to 109±55min/day (p=0.023) and 102±36min/day (p=0.005) during TV stepping 1 and 2 respectively, from 160±59min/day at baseline. TV stepping resulted in about 700 additional steps/day. There were no significant differences in any device's ability to count steps over the different conditions (p=0.66). On average, the StepWatch-3 (8473) counted more steps than the Omron ankle (5305), and Omron waist devices (4868) (p<0.05). The Omron ankle counted more steps than the Omron waist (p=0.022). CONCLUSION: TV stepping may be a useful strategy to increase activity levels of adults who find it difficult to find time in their day to exercise, but do spend time watching TV. It may also reduce TV viewing behavior. The Omron pedometers count about 40% fewer steps than the StepWatch-3, which we believe is due to the Omron under counting during free-living conditions. The effectiveness and efficacy of longer-term interventions focused on increasing the PA levels of adults with TV stepping should be investigated.

ACTIVE STEPS

Purpose/Hypothesis: The American Diabetic Association (ADA) states that adults with type II diabetes (T2DM) should have at least 150 min of moderate intensity physical activity (PA) per week. While the benefits of PA for people with T2DM are well documented, the ability to generalize the evidence is limited to adults without existing comorbidities. This is an important consideration because many older adults with T2DM have mobility impairments from comorbidity that limits their exercise capacity. Active Steps for Diabetes Management is a program for people with T2DM and impaired mobility who may not be able to achieve an optimal amount of exercise on their own but who can participate in medically-supervised exercise and gradually increase their PA. The purpose of this project is to evaluate Active Steps participant outcomes. Subjects: Active Steps participants were at least 18 yrs old and free of conditions where moderate intensity PA was contraindicated. People needing supervised exercise were encouraged to enroll. Twenty of 26 (mean age=60±3yrs) enrollees in Active Steps completed the program. Seventy percent of people who completed Active Steps required an assistive device for walking. Materials/Methods: Active Steps was 12 weeks and included two group meetings per week consisting of 15 min of diabetes education and 45 min of group exercise and a home program for gradually increasing PA. Outcome measures evaluated before and after Active Steps were: (1) Summary of Diabetes Self-Care Measure, (2) average number of steps walked/day measured by pedometers, (3) Six Minute Walk Test (6MWT), and (4) body mass index (BMI). Paired t-tests were used to compare pre and post-intervention means. Results: There were significant increases (p<.001) in the mean number of days per week that participants performed 30 min of continuous PA, number of steps walked/day, and the mean 6MWT distance. A small improvement in mean BMI was not significant. Conclusions: Seventy seven percent of Active Steps enrollees completed the program which was considered good because of the participant demographics. Analyses of outcome data suggest that Active Steps is effective in increasing daily PA and improving cardiovascular fitness in people with T2DM and impaired mobility. The mean number of days per week that participants performed 30 min of continuous PA increased bringing their PA closer to the amount recommended by the ADA. Pedometer-determined PA increased from sedentary to low active. Although the change in PA was significant, it is possible that the intensity of participants PA was not high enough to affect BMI. Clinical Relevance: Outcome measures suggest that Active Steps helps increase PA in adults with T2DM and impaired mobility. Further research is needed to determine the impact of Active Steps on glycemic control, cardiovascular health, and health care costs.