Increase Physical Activity Levels Research Articles

Self-reported And Device Measures To Evaluate Commuting-related Physical Activity In College Students: The Ucactive Study

Insufficient level of physical activity (PA), and higher sedentary behaviour are a serious health concern among university students. Active commuting, such as walking or cycling, provides an opportunity to increase PA levels, and decrease time spent in sedentary behaviour. PURPOSE: This study aims to describe, compare and identify associations between self-reported commuting behaviours and commuting-related device-measured PA and sedentary behaviour for each mode of commuting to and from university (i.e., active, public and private). METHODS: A total of 63 university students (65.1% women) participated (20.6 ± 3.8 years old) from a public university in Cadiz, Spain. Mode of commuting, PA and sedentary behaviour were self-reported, and device measured. Differences in commuting self-reported measures and the commuting-related device-measured PA and sedentary behaviour were analysed using the Kruskal–Wallis test. Additionally, to ascertain differences between groups, the Mann-Whitney test was used. Associations between commuting-related device-measured PA and sedentary behaviour to and from university with self-reported were studied using linear regression. RESULTS: Commuting time, commuting distance, and commuting speed to and from university were lower in active than public and private commuters (all, p < 0.001). The commuting energy expenditure per minute was higher in active commuters followed by public and private commuters (all, p < 0.001). Active commuters displayed significant differences (p < 0.05) with public and private commuting in all PA levels and the sedentary behaviour to and from university. Active commuters presented positive associations in commuting time, commuting distance and total commuting energy expenditure with MVPA to university (B; 95% CI = 0.08; 0.04, 1.25; 0.01; 0.00, 0.02; and 3.70; 1.98, 5.42 respectively) and from university (B; 95% CI = 0.87; 0.41, 1.33; 0.07; 0.03, 0.10; and 3.16; 1.47, 4.85 respectively). CONCLUSION: Active commuting involved the highest levels of energy expenditure per minute and contributes to 44% weekly of the moderate-to-vigorous PA (MVPA) recommendations to obtain health benefits. Based on self-reported questions, this study presents new evidence to obtain a quantitative measure (METs) to delve into variables of commuting behaviours.

P04-07 Factors associated with maintenance of physical activity in older adults undertaking a strength and balance programme for falls prevention

BackgroundFalls are a major cause of mortality and morbidity in older adults worldwide, yet those who are more physically active have a lower risk of falling. There is little information on which participants are most likely to complete falls prevention exercise programmes and increase their levels of physical activity (PA). This study aims to identify factors associated with completion of, and PA levels, at the end of the Falls Management Exercise (FaME) falls prevention exercise programme, a programme designed to increase balance and functional capacity, increase bone and muscle mass and reduce fear of falling.Methods356 community-dwelling adults provided routine data. Characteristics of participants were compared at baseline. Comparison of activity levels between completers and non-completers were carried out, and a regression analysis performed to identify factors associated with programme completion and achievement of 150 minutes of moderate to vigorous physical activity (MVPA) per week.Results143 participants completed the FaME programme. This group was significantly younger (range 50-96; mean=75.3, SD=8.1 in completers vs. mean=77.8, SD=8.3 in non-completers) and had significantly lower scores on the FRAT (median=1, IQR=0-2 in completers vs. median=2, IQR=1-3 in non-completers) and FES-I risk assessments (median=10, IQR=7-13 in completers vs. median=11, IQR=8-16 in non-completers) at baseline, and a significantly higher level of physical activity (PA) per week (median=673 minutes, IQR=252-1252 in completers vs. median=558, IQR=120-1127 in non-completers). Completers significantly increased their total minutes of PA per week, and the converse was true for non-completers. Multivariate regression analyses showed that FRAT score was significantly associated with completion of FaME, and 180 degree turn and FES-I score were significantly associated with achieving the recommended 150 minutes of MVPA per week.ConclusionsThis study has shown that a significant increase in PA levels is only demonstrated in those who complete the FaME programme. Scores from selected functional measures and risk assessments are associated with FaME completion and achievement of 150 minutes of MVPA. This information can be used to provide targeted support to improve completion rates and physical activity levels of participants.

S06-2 GAP: The Girls Active Project

BackgroundAdolescent females Physical Activity (PA) participation rates are low globally, particularly among females of lower Socio-Economic Status (SES). Evidence suggests theory‐based, multi-component interventions are most effective at improving PA levels. This research aimed to co-design, with adolescent females, a theory-driven, multi-component, extracurricular school-based PA intervention, the Girls Active Project (GAP) and assess its feasibility.SettingOne single-sex, females-only, designated disadvantaged post-primary school in Dublin, Ireland.MethodsThe Behaviour Change Wheel (BCW) and Public and Patient Involvement (PPI) were used to develop the GAP. Mixed-methods with students (n = 287, aged 12-18) and teachers (n = 7) captured students’ self-reported PA levels and identified factors influencing PA behaviour at school. These data were subsequently used in discussion groups with PPI contributors (n = 8, students aged 15-17) to co-design the intervention. Mixed-methods were applied with multiple stakeholders to assess the feasibility of implementing and evaluating the GAP programme over a 12-week single-arm feasibility trial.ResultsJust 1.4% of the students in this sample (n = 287) reported meeting the recommended PA guidelines. Time, social influences, beliefs about capabilities, environmental context and resources, goals, reinforcement, and behavioural regulation emerged from the data as factors influencing PA behaviour. A peer-led, after-school PA programme was co-designed. The feasibility study encountered significant contextual barriers and challenges with recruitment. Recruitment (n = 8, 10%) was low, yet retention (88%) was high. Despite the COVID-19 pandemic hindering implementation, results suggested the GAP programme was implemented with high fidelity (87%), well-received by stakeholders and perceived as compatible with the after school-setting.ConclusionsPA levels of females in this sample were far below recommended guidelines for optimum health. The novel approach applied to systematically co-design the intervention could facilitate future replication. Whilst further thought must be given on how to increase enrolment, the in-person delivered PA programme showed promise as an intervention that can be feasibly implemented and evaluated. Future research should examine the GAP’s preliminary-effectiveness at increasing PA levels in a pilot-cluster randomised controlled trial.

P07-11 Physical activity promotion in the German healthcare system - Establishing pathways of exercise referral for persons with noncommunicable diseases

BackgroundExercise referral schemes (ERS) are embedded in the routine practice of healthcare systems in many countries (e.g. Sweden and New Zealand). In primary healthcare, ERS are recommended to sustainably increase physical activity (PA) levels among patients with noncommunicable diseases (NCD). Yet, the German health care system currently only incorporates interventions that primarily focus on improving functional outcomes but hardly aim at increasing PA levels. This presentation introduces an ongoing research project that aims to develop, implement and evaluate an ERS to promote PA for persons with NCD within the German healthcare system.MethodsIn the first phase of the project, a concept of an ERS was developed using a participatory research approach that involved relevant stakeholders such as physicians, funding agencies, PA providers, and patient representatives. The development process comprised three steps: 1) interviews to gather stakeholders' ideas of an ERS; 2) a literature review to collect evidence on key elements of international ERS; 3) three stakeholder meetings to combine scientific evidence with stakeholders' perspectives (co-creation). Subsequently, the ERS will be implemented, tested and evaluated in a regional pilot project using a pragmatic trial design. Finally, a concept for scaling-up the ERS to the German national level will be developed.ResultsAs result of the co-creation process, the following key elements were defined to be part of the ERS: Screening, short counselling and provision of a referral form by a physician; initial assessment, counselling, individual PA recommendations, re-assessment and follow-up by exercise professionals. Additional aspects considered important for the implementation of the ERS were ensuring good communication and feedback between all participating health professionals, as well as an overview of all local physical activity offers and exercise professionals (database). These preliminary findings were combined into a draft of the ERS.ConclusionsThe participatory research approach employed by our project yielded the first draft of an ERS with a specific focus on PA promotion among persons with NCD within the German healthcare system. In the upcoming project stage, this ERS concept will be further elaborated and prepared for implementation and evaluation at a regional level.

Communicating Physical Activity with Adolescents: What works? A scoping review protocol.

Background: Worldwide, adolescents are not meeting the minimum recommended physical activity (PA) guidelines to achieve health benefits. Awareness of the guidelines among adolescents is low, only 3.6% can report them correctly. The school is an ideal PA promotion setting, no other institute has the same reach or influence on the adolescent population. There is a need for an effective communication strategy for PA messages for adolescents. The purpose of this review is to explore how, when, who, where and what i.e. the content, context and mode of delivery of PA messages to communicate with adolescents to improve their awareness and understanding of PA that will potentially lead to an increase in PA levels. Methods: A scoping review was selected as the most appropriate methodology due to the broad nature of the research question. The PCC mnemonic (Population, concept, context), recommended by the Joanna Briggs Institute, was used to develop the search strategy and research question. This review will follow the scoping review framework developed by Arksey and O'Malley (2005) which was later updated by Levac et al (2010) to ensure the methods are systematic. It will also follow the PRISMA extension for scoping reviews checklist. Sources include databases (CINAHL, Education Source, Scopus, PubMED), grey literature from the World Health Organisation, Global Index Medicus and the reference lists of extracted articles will be checked from the year 1995 onwards. Results: A PRISMA flow diagram will demonstrate the final articles included and results will be presented and summarised as recurring themes. The results will be discussed in relation to existing literature and future implications for research, policy and practice. Conclusion: This will be the first review to explore the PA messaging context among adolescents and the findings will help inform a strategy for communicating PA to adolescents.

The Impact of a Place-Tailored Digital Health App Promoting Exercise Classes on African American Women's Physical Activity and Obesity: Simulation Study.

BackgroundThe increasing prevalence of smartphone apps to help people find different services raises the question of whether apps to help people find physical activity (PA) locations would help better prevent and control having overweight or obesity.ObjectiveThe aim of this paper is to determine and quantify the potential impact of a digital health intervention for African American women prior to allocating financial resources toward implementation.MethodsWe developed our Virtual Population Obesity Prevention, agent-based model of Washington, DC, to simulate the impact of a place-tailored digital health app that provides information about free recreation center classes on PA, BMI, and overweight and obesity prevalence among African American women.ResultsWhen the app is introduced at the beginning of the simulation, with app engagement at 25% (eg, 25% [41,839/167,356] of women aware of the app; 25% [10,460/41,839] of those aware downloading the app; and 25% [2615/10,460] of those who download it receiving regular push notifications), and a 25% (25/100) baseline probability to exercise (eg, without the app), there are no statistically significant increases in PA levels or decreases in BMI or obesity prevalence over 5 years across the population. When 50% (83,678/167,356) of women are aware of the app; 58.23% (48,725/83,678) of those who are aware download it; and 55% (26,799/48,725) of those who download it receive regular push notifications, in line with existing studies on app usage, introducing the app on average increases PA and decreases weight or obesity prevalence, though the changes are not statistically significant. When app engagement increased to 75% (125,517/167,356) of women who were aware, 75% (94,138/125,517) of those who were aware downloading it, and 75% (70,603/94,138) of those who downloaded it opting into the app’s push notifications, there were statistically significant changes in PA participation, minutes of PA and obesity prevalence.ConclusionsOur study shows that a digital health app that helps identify recreation center classes does not result in substantive population-wide health effects at lower levels of app engagement. For the app to result in statistically significant increases in PA and reductions in obesity prevalence over 5 years, there needs to be at least 75% (125,517/167,356) of women aware of the app, 75% (94,138/125,517) of those aware of the app download it, and 75% (70,603/94,138) of those who download it opt into push notifications. Nevertheless, the app cannot fully overcome lack of access to recreation centers; therefore, public health administrators as well as parks and recreation agencies might consider incorporating this type of technology into multilevel interventions that also target the built environment and other social determinants of health.

Effects of an Online Supervised Exercise Training in Children with Obesity during the COVID-19 Pandemic.

COVID-19 restrictions have dramatically reduced the active lifestyle and physical activity (PA) levels in the whole population, a situation that can contribute to weight gain and to develop obesity. To improve physical fitness (PF) in children with obesity during COVID-19 restrictions, sport specialists started to deliver physical training through tele-exercise. For these reasons, the aim of this study was to evaluate the effects of a 12-week online supervised training program in children with obesity on different PF components and PA levels. We enrolled a total of 40 Caucasian children (9 F/31 M; aged 11 ± 1.9 years) with obesity. The data collection consisted of a series of anthropometric measures, the PAQ-C questionnaire, and PF tests, valid and reliable tools to assess PF in children. We used a Wilcoxon’s t-test and a Student’s t-test, as appropriate, to assess the differences before and after the training protocol. A total of 37 patients completed the training protocol and were considered in the analysis. Our results show an improvement in all the PF tests, a reduction in the BMI z-score, the waist circumference, and in the waist-to-height ratio, and an increased PA level. In conclusion, the results of our study show that an online supervised training program is effective to promote PA, improving PF and reducing the BMI z-score in children with obesity.

An evaluation of the 'bottom-up' implementation of the Active at school! programme in Quebec, Canada.

SummaryThe lack of physical activity (PA) amongst children is a public health concern in many industrialized countries. School-based daily physical activity (DPA) policies are a promising intervention for increasing PA levels amongst children. Informed by a logic model framework, this study examines the factors associated with meeting a ‘top-down’ DPA objective in the context of a ‘bottom-up’ implementation of a school-based DPA initiative in Quebec, Canada. An online survey assessing school-level inputs, outputs and outcomes was sent to all participating schools (415). Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression to evaluate potential associations between factors (inputs and outputs) and the school’s adherence to providing at least 60 minutes of DPA (outcome). Adjusted ORs (AORs) and 95% CIs were calculated using a multivariate logistic regression to identify the best set of factors to predict adherence to the DPA objective. A total of 404 schools completed the questionnaire, amongst which 71% reported meeting the DPA target by implementing school-tailored activities. Three factors were identified as the best set of school inputs and outputs to predict meeting the objective: financial resources (per student) (AOR = 1.02; 95% CI 1.01–1.03), a shared vision amongst the school-team members that PA benefits learning outcomes (AOR = 1.94; 95% CI 1.04–3.19) and having conducted a detailed situational analysis (AOR = 1.89; 95% CI 1.00–3.58). Given that ‘bottom-up’ implementation might favour the development of policies that are more acceptable to stakeholders, our results should be considered by decision-makers and school administrators when implementing DPA initiatives.

Australian University Nursing and Allied Health Students' and Staff Physical Activity Promotion Preparedness and Knowledge: A Pre-Post Study Using an Educational Intervention.

The promotion of physical activity (PA) by health professionals is a key strategy to increase PA levels in the population. In this study, we investigated PA promotion, preparedness, and knowledge among university nursing and allied health students and staff, as well as PA resource usage within curricula, before and after an educational intervention. Students and staff from 13 health disciplines at one Australian university were invited to complete an online survey, and a curriculum audits were conducted before and after PA teaching resources were promoted by academic PA champions (n = 14). A total of 299 students and 43 staff responded to the survey pre-intervention, and 363 and 32 responded to the post-intervention, respectively. PA promotion role perception (≥93%) and confidence to provide general PA advice (≥70%) were high throughout the study. Knowledge of PA guidelines was poor (3–10%). Students of physiotherapy, sport and exercise science, as well as more active students, were more likely to be aware of the PA guidelines (p < 0.05). Over 12 months, PA promotion preparedness and knowledge did not change significantly, nor was there a change in the amount of PA content delivered, despite a significant increase in the use of the teaching resources across a number of disciplines (p = 0.007). Future research should be carried out to investigate the implementation of the resources over time and to develop additional strategies for PA promotion and education scaffolded across curricula.

Increasing Children’s physical Activity by Policy (CAP) in preschools within the Stockholm region: study protocol for a pragmatic cluster-randomized controlled trial

BackgroundSystematic reviews suggest that preschool environmental/organizational changes may be effective in increasing physical activity (PA) levels of preschool children, but evidence is scarce regarding feasible, effective, and equitable interventions that can be scaled up. Specifically, it is essential to understand whether introducing a multicomponent organizational change in terms of policy in the preschool context may be beneficial for children’s PA levels and concomitant health outcomes. To bridge this knowledge gap, our main aim is to examine the feasibility and effectiveness of a policy package in increasing PA levels in preschool children, using a large-scale pragmatic cluster-randomized controlled trial.MethodsThis proposed study is a pragmatic cluster-randomized controlled trial with two conditions (intervention and control with a 1:1 ratio) with preschools as clusters and the unit of randomization. We aim to recruit approximately 4000 3–5-year-old children from 90 preschools and retain more than 2800 children from 85 preschools to provide adequate statistical power for the analyses. The intervention to implement is a co-created, multicomponent policy package running for 6 months in preschools randomized to intervention. Change in accelerometer measured PA levels in children between intervention and control from pre- and post-intervention will be the primary outcome of the study, while secondary outcomes include health outcomes such as musculoskeletal fitness, psychosocial functioning, and absence due to illness in children among others. Implementation will be studied carefully using both quantitative (dose, fidelity) and qualitative (interview) methodologies. The change in primary and secondary outcomes, from pre- to post-intervention, will be analyzed with linear mixed-effect models (to allow both fixed and random effects) nested on a preschool level.DiscussionThis is a large-scale co-creation project involving the City of Stockholm, childcare stakeholders, preschool staff, and the research group with the potential to influence more than 30,000 preschool children within the Stockholm area. The study will add reliable evidence for the implementation of PA policies at the organizational level of preschools and clarify its potential effect on objectively measured PA and health markers in children.Trial registrationClinicalTrials.govNCT04569578. Prospectively registered on September 20, 2020.

Let’s get active: patients with a recent coronary event are highly motivated to lose weight and increase physical activity levels

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NWO-grant Title (Dutch): Het centraal stellen van behandelvoorkeuren van de individuele patiënt met een chronische hartziekte. Subtitle: Persoonsgerichte zorg voor hartpatiënten Introduction Motivated patients are more likely to successfully improve unhealthy lifestyles. How patients perceive their risk factors and their willingness to improve is an integral part of this motivation. However, such preferences, and how they align with clinicians’ risk perception are seldom systematically assessed in patients with coronary artery disease (CAD). Purpose We aimed to investigate preferences in risk factor treatment in patients with CAD, and to compare this with clinicians’ perception of patients’ risks. Methods We administered a 10-item questionnaire on patients’ preferences on risk factor treatment in secondary prevention which was developed in consultation with end-users. We sent the questionnaire to approximately 450 patients who were referred to cardiac rehabilitation after recent (&amp;lt;3 months) admission to an acute coronary unit between Feb 2020 and Apr 2021. We demonstrate the results of 6 questions that covered the following subjects relevant to secondary prevention: Q1: risk factor perception, Q2: priority setting, Q3: wanting help, Q4: willingness to change, Q5: motivation to change, Q6: confidence to successfully change. We compared patients risk factor perception with clinicians’ report in the medical record. Results A total of 296 patients completed the survey (66% of eligible respondents) at mean (SD) age 64 (10) years on median (IQR) 38 (25-53) days after discharge. Physical activity was much more frequently reported as risk factor by patients (P 55%) compared to clinicians (C 31%), followed by other disparities such as for high cholesterol (P 48% vs. C 36%) and overweight (P 46% vs. C 59%) (Figure 1). Patients were asked which of their perceived risk factors on Q1 was most important to improve (Q2) and for which they wanted help (Q3). Top-3 risk factors chosen for improvement were overweight (87%), physical inactivity (81%), and stress (79%), for which 75% required help with any risk factor, again most frequently with increasing physical activity (64%), overweight (59%) and stress (51%) (Figure 2). Motivation and confidence for improvement of risk factors were high: 87% were willing to adapt their lifestyles, with motivation rates of median (IQR) 8 (7-9) out of 10, and estimated chance for successful improvement of median (IQR) 7 (6-8) out of 10. Conclusion(s) Patients who recently suffered from coronary event are highly motivated to lose weight and increase physical inactivity. The use of these patient preferences by the clinician will enable compliance and outcomes with respect to weight loss and improved physical activity.

Active Commuting to University Is Positively Associated with Physical Activity and Perceived Fitness

Background: Fitness is a powerful marker of health associated with physical activity (PA) in university students. However, insufficient PA is a serious health concern among university students. Active commuting provides an opportunity for increased PA levels. Therefore, the aims of this study were (a) to describe the mode of commuting, PA and fitness in university students; (b) to analyze the associations of mode of commuting with PA and fitness; and c) to analyze the relationship between mode of commuting, PA recommendations and fitness. Methods: This was a cross-sectional study. A total of 1257 university students (52.4% women) participated (22.4 ± 5.6 years old). Results: Public commuting was the main mode to and from university. Active and public commuters were more likely to meet the PA recommendations and reported higher muscular strength than those using private commuting. Active and public commuters who met PA recommendations present the highest fitness in most of its components. Conclusions: Achieving the PA recommendations was more relevant than adopting an active mode of commuting in order to have better fitness. Further research targeting a broader understanding of the mode of commuting, PA levels and fitness in university students is needed.

Associations of Physical Activity and Handgrip Strength with Different Domains of Quality of Life in Pediatric Cancer Survivors.

Simple SummaryPhysical activity has been targeted as a leading priority for health promotion in pediatric survivorship care. It is unclear whether regular physical activity can enhance the quality of life among Chinese pediatric cancer survivors. We researched this question in our study of 191 survivors of pediatric cancer. We found that the survivors who engaged in higher levels of physical activity reported higher scores across all domains of quality of life (i.e., physical, emotional, social, and school functioning). We also observed that the survivors with higher PA levels exhibited greater handgrip strength than the survivors with lower PA levels. Notably, the survivors with greater handgrip strength also had better physical and emotional functioning.There is a paucity of evidence about the associations of physical activity (PA) and handgrip strength (HGS) within different domains of quality of life (QoL) in Chinese pediatric cancer survivors. We, therefore, conducted this multicenter cross-sectional study aimed to investigate whether increased PA level and HGS are associated with higher scores in different QoL domains (i.e., physical, emotional, social, and school functioning) in pediatric cancer survivors. PA was assessed with a validated self-reported PA rating scale. In total, 191 Chinese pediatric cancer survivors aged 9 to 16 years were included in the analysis. Results showed that engaging in a higher level of PA was significantly associated with improved QoL in different domains, including physical (β = 0.543, p < 0.001), emotional (β = 0.449, p < 0.001), social (β = 0.434, p < 0.001), and school functioning (β = 0.407, p < 0.001). Greater HGS was also associated with better physical (β = 0.230, p ≤ 0.001) and emotional (β = 0.261, p ≤ 0.001) functioning. Findings from this study provide evidence of the significant beneficial impact of regular PA on pediatric cancer survivors’ QoL along their survivorship trajectory.

Relationship of Social Connectedness With Decreasing Physical Activity During the COVID-19 Pandemic Among Older Women Participating in the Women's Health Initiative Study.

BackgroundAging is generally accompanied by decreasing physical activity, which is associated with a decline in many health parameters, leading to recommendations for older adults to increase or at least maintain physical activity (PA).MethodsWe determined relationships between social connectedness and decreasing or increasing PA levels during the COVID-19 pandemic among 41,443 participants of the Women’s Health Initiative Extension Study. Outcomes of logistic regression models were decreasing PA activity (reference: maintaining or increasing) and increasing PA activity (reference: maintaining or decreasing). The main predictor was social connectedness as a combined variable: not living alone (reference: living alone) and communicating with others outside the home more than once/week (reference: once/week or less). We adjusted for age, race, ethnicity, body mass index, physical function level, and education.ResultsCompared with participants who were not socially connected, socially connected participants had lower odds of decreasing PA (adjusted odds ratio 0.91, 95% confidence interval 0.87-0.95). Odds of increasing PA (vs. decreasing or maintaining PA) were not significantly different among socially connected and not socially connected participants. Associations between social connectedness and decreasing PA did not significantly differ by age (<85 vs. ≥85 years), race/ethnicity (non-Hispanic White vs. other races/ethnicity), education (college vs. <college), use of technology to stay in touch with others, or RAND physical function score (≤75 vs. >75).ConclusionsSocial connectedness was associated with lower odds of decreasing PA among older women during the pandemic. These findings could inform the development of future interventions to help older women avoid decreasing PA..

The Cardiorespiratory Demands of Treadmill Walking with and without the Use of Ekso GT™ within Able-Bodied Participants: A Feasibility Study.

Individuals with neurological impairments tend to lead a predominantly sedentary lifestyle due to impaired gait function and mobility. This may be detrimental to health by negatively impacting cardiorespiratory fitness and muscular strength, and increasing the risk of developing secondary health problems. Powered exoskeletons are assistive devices that may aid neurologically impaired individuals in achieving the World Health Organisation’s (WHO) physical activity (PA) guidelines for health. Increased PA should elicit a sufficient cardiorespiratory stimulus to provide health benefits to exoskeleton users. This study examined the cardiorespiratory demands of treadmill walking with and without the Ekso GT™ among able-bodied participants. The Ekso GT™ is a powered exoskeleton that enables individuals with neurological impairments to walk by supporting full body mass with motors attached at the hip and knee joints to generate steps. This feasibility study consisted of one group of healthy able-bodied individuals (n = 8). Participants completed two 12 min treadmill walking assessments, one with and one without the Ekso GT™ at the same fixed speed. Throughout each walking bout, various cardiorespiratory parameters, namely, volume of oxygen per kilogram (kg) of body mass (O2·kg−1), volume of carbon dioxide per kg of body mass (CO2·kg−1), respiratory exchange ratio (RER), ventilation (E), heart rate (HR), and rate of perceived exertion (RPE), were recorded. Treadmill walking with Ekso GT™ elevated all recorded measurements to a significantly greater level (p ≤ 0.05) (except RER at 1 km·h–1; p = 0.230) than treadmill walking without the Ekso GT™ did at the same fixed speed. An increased cardiorespiratory response was recorded during treadmill walking with the exoskeleton. Exoskeleton walking may, therefore, be an effective method to increase PA levels and provide sufficient stimulus in accordance with the PA guidelines to promote cardiorespiratory fitness and subsequently enhance overall health.

Design and Validation of a Questionnaire to Assess the Leisure Time Physical Activity of Adult Women in Gipuzkoa.

Inactivity is higher among women than among men, and there are few specific questionnaires used to assess physical activity (PA) in women that are truly meaningful to them. This article tackles the design and validation process of an ad hoc multidimensional questionnaire to assess leisure time physical activity (LTPA) among adult women of Gipuzkoa. The questionnaire was completed by 3595 adult women (43.5 ± 12.1 years), 32% of which were inactive and 68% of which were active. Content validation, ecological validation, and internal consistency analysis results were satisfactory. The Gipuzkoa Women’s Physical Activity Questionnaire (GWPAQ) consists of four dimensions and 21 items. Barriers to PA were found related to intrapersonal, environmental, and socio-cultural aspects. The importance of family and spousal support in increasing PA levels was also observed. It is concluded that the GWPAQ is valid for obtaining evidence that can be used by public institutions to optimise women-specific PA promotion policies.

Effects of Cognitively Engaging Physical Activity on Preschool Children’s Cognitive Outcomes

ABSTRACT Research combining physical activity with the training of cognitive skills such as executive functions is emerging as a novel and fruitful intervention approach for children. Purpose: This study aimed to examine the impact of an intervention program including cognitively engaging physical activity on preschool children’s cognitive outcomes and physical activity. Methods:Children (N = 144, 65 female; M age = 4.41 years, SD = 0.61), randomly assigned to one of three groups: cognitively engaging physical activity (CPA; i.e., storytelling, cognitive activities, and motor tasks, n = 55), cognition (i.e., storytelling and cognitive activities without motor tasks, n = 48), or control (i.e., traditional storytelling, n = 41). Sessions lasted approximately 17 minutes, conducted twice a week, for 6 weeks. Children’s executive function, self-regulation, and related outcomes (i.e., numeracy) were assessed at baseline and again—along with perceived enjoyment—at the end of the program. Accelerometers measured children’s physical activity during each session. Teachers completed a logbook for each session, and two fidelity checks per preschool took place by the researcher. Main analyses used linear mixed models adjusted for covariates (age, sex) and clustering at the preschool level. Results: Results showed no significant group by time interaction for executive function, self-regulation, numeracy, enjoyment. During the sessions, children in the CPA group were more physically active than children in the cognition and control groups. Conclusion: While we did not find the expected amplified cognitive benefits, making storytelling more active has the potential to meet two needs (increase cognitive stimulation and physical activity levels) in one deed.

P216 Promoting physical activity using mobile health technology in people living with rheumatoid arthritis: MOTIVATE RA

Abstract Background/Aims People with rheumatoid arthritis (RA) commonly experience pain and stiffness which reduces engagement in physical activity (PA). The range of health benefits associated with PA are now well established, and include improvements in cardiovascular health and symptoms associated with RA. However, people with RA are more inactive than the general population and face unique barriers to becoming more active. Mobile health (mHealth) technology (i.e. fitness watches and apps) may provide an effective and economical solution to promoting PA in this population. Therefore, the aim of the current study is to assess the effectiveness of mHealth technology to increase PA levels and reduce disease activity in people living with RA. Methods Following ethical approval, 13 females diagnosed with RA were randomised to either an mHealth (n=7, age 47 ± 14 years; BMI 30 ± 5 kg/m2) or a conventional care (CC) intervention group (n=6, age 50 ± 11 years; BMI 25 ± 3 kg/m2). The CC group were provided with online educational material to increase PA whereas the mHealth group were provided with a personalised, progressive walking programme delivered via mHealth technology with ongoing support throughout the 12-week intervention. Prior to (week 0) and following (week 12) the intervention, participants conducted assessments remotely, with guidance from the research team. At each time point all participants wore a GT9X ActiGraph PA monitor for 7 days to quantify PA and completed a RADAI-5 questionnaire to monitor disease activity Change data between weeks 0 and 12 were analysed using independent t-tests and reported as mean difference (95% confidence intervals). Results Intervention groups were well matched in terms of age [3 years (95% CI= -12, 19); P=0.66] but differed for BMI [-5 kg/m2 (95% CI= -10, -0.1); P=0.05]. Preliminary analyses reveal no significant difference in steps per day between the mHealth vs. CC groups [323 steps/day (95% CI= -2273, 1632; P=0.72]. Similarly, no difference in RADAI-5 score was observed between the mHealth and CC groups [0.09 (95% CI= -0.28, 4.6); P=0.61]. Conclusion These preliminary data identify the potential effectiveness of a PA programme to increase PA levels in people with RA delivered via mHealth, though positive changes in mHealth are very small at this early stage. These data, in full, will be important in identifying whether this technology could be used as a cost effective, non-pharmacological management strategy for RA. Disclosure D.J. Bannell: None. M. Cocks: None. N. Goodson: None. C. Taylor: None. T. Peçanha: None. H. Jones: None. D.A. Low: None. V.S. Sprung: None.

EFFECT OF CYCLING ON CARDIOVASCULAR HEALTH ASSOCIATED WITH AGING PROCESS

ABSTRACTCycling is a healthy exercise that can be enjoyed by people of all ages, from young children to older adults. Cycling have great attention from the health sector because of aiming to increase levels of physical activity. The main pathways between cycling and health under two perspectives generalizable evidence for health effects and specific impact modeling to quantify health impacts in concrete settings. Risks from air pollution can be assumed to be small, with limited evidence for cycling specific mechanisms. Physical activity, particularly cycling, is known to reduce the risk of cardiovascular diseases, slow down aging, and help in reducing weight and even stress. Keywords: cardiovascular, aging, stress, exercise, cycling

Are Physically Active Breaks in School-Aged Children Performed Outdoors? A Systematic Review

(1) Background: Children spend an ever-increasing amount of time performing sedentary behaviors, and an important part of their daily life is at school. Learning in an outdoor environment improves children’s physical activity levels, and their cognitive and social spheres. Furthermore, physically active breaks are a solution to reduce sedentary behaviors and improve well-being and academic performance. The study evaluated the published literature on physically active breaks during school hours and explored (a) if the interventions were proposed in an outdoor context and (b) the outcomes of these interventions. (2) Methods: This review collected 31,559 articles from different electronic databases. After the screening, the results were analyzed narratively. (3) Results: 41 studies have been included in the analysis. As reported by the results, most of the interventions took place in the classroom, and only three studies were performed outside. A common aspect of all studies is the feasibility of active breaks, assessing positive outcomes. (4) Conclusions: Physically active outdoor breaks are poorly adopted, highlighting the necessity for deeper study on this topic. Although the protocols considered present differences, generally breaks increase physical activity levels, present positive learning outcomes, and improve social well-being. Furthermore, they are sustainable in terms of time, cost, and effort of the teacher.