Increasing Leisure Time Physical Activity Research Articles

Joint associations of leisure time physical activity and screen sitting time with long-term sickness absence due to mental and musculoskeletal diseases: a registry linked follow-up study

ObjectivesTo examine joint associations of leisure-time physical activity (LTPA) and screen sitting time with subsequent sickness absence among the adult population. Study designRegistry linked follow-up study. MethodsA representative sample of Finnish adults (n = 10,300) were asked to fill out a questionnaire for the FinHealth 2017 survey. Self-reported LTPA was classified into three groups: inactive, moderately active, and active, and screen sitting time into two groups: 3 h or less and over three hours a day, yielding a six-category variable for the joint analyses. Questionnaire data were linked to the Finnish Social Insurance Institution's register data on sickness benefits (over 9 days), including diagnoses (follow-up 2.9 years). The analytical samples were restricted to working age (18–64 years), which included 5098 participants. Associations were examined using logistic regression analysis adjusting for covariates with SPSS 29. ResultsThe inactive and high sitting time had a higher risk for sickness absence due to mental disorders (OR 2.07, 95% CI 1.03–4.18) compared with the physically active, low-sitting time group. Additionally, the inactive and low sitting time (OR 1.69 95% CI 1.12–2.55) and the moderately active and high-sitting time groups (OR 2.06 95% CI 1.15–3.67) had a higher risk. No significant associations were found for all-cause and musculoskeletal diseases sickness absence. ConclusionEmployers and policymakers could support reducing sitting in front of a screen and increase LTPA outside working hours to prevent mental health problems and related sickness absences.

Enhancing feedback by health coaching: the effectiveness of mixed methods approach to long-term physical activity changes in nurses. An intervention study

BackgroundAlthough knowledge of the barriers and motivators to physical activity participation among nurses is increasing, the factors influencing motivation methods’ effectiveness are not completely defined. This study aimed to identify the methods that support increasing the level of daily physical activity and the factors that influence the effectiveness of motivation methods among nurses.MethodsThis study was based on an intervention study protocol. All registered nurses in clinical settings were invited to participate in the study. The study involved 71 professionally active nurses. A self-reported questionnaire was used to collect sociodemographic and employment data. The level of physical activity was assessed using the International Physical Activity Questionnaire, and the daily number of steps was assessed using a pedometer. Body composition was measured using a bioimpedance method, and the 5-year risk of cardiovascular events was assessed using the Harvard Score. The intervention included self-monitoring daily steps using a pedometer and completing a diary daily for one month. Additionally, a few-minute speech was sent to each participant via email on the intervention’s 7th, 14th, and 21st days.ResultsThe analysis revealed a higher value of physical activity recorded in the follow-up compared to the initial and final measurement in the Recreation domain [Met] (p < 0.001) and a higher value of daily steps in the follow-up compared to the final measurement (p = 0.005). Participants with a higher Harvard Score were more likely to increase their daily number of steps (OR = 6.025; 95% CI = 1.70-21.41), and nurses working in hospital wards were less likely to do so (OR = 0.002; 95% CI = 0.00-0.41).ConclusionsRecommendations for physical activity in the nursing population should focus on increasing leisure time physical activity and regular risk assessment of cardiovascular events. A mixed methods approach, such as feedback enhanced by health coaching, effectively achieves long-term physical activity changes in nurses.

Sarcopenia Among Patients With Nonalcoholic Fatty Liver Disease (NAFLD) Is Associated With Advanced Fibrosis

Nonalcoholic fatty liver disease (NAFLD) and sarcopenia can be associated with advanced liver disease. Our aim was to assess the association between sarcopenia and the risk of fibrosis among patients with NAFLD. We used the National Health and Nutrition Examination Survey (2017-2018). NAFLD was defined by transient elastography without other causes of liver disease or excessive alcohol use. Significant fibrosis (SF) and advanced fibrosis (AF) were defined by liver stiffness greater than 8.0 kPa and greater than 13.1 kPa, respectively. Sarcopenia was defined using the Foundation for the National Institutes of Health definition. Of the total cohort (N= 2422), 18.9% had sarcopenia, 9.8% had obese sarcopenia, 43.6% had NAFLD, 7.0% had SF, and 2.0% had AF. Moreover, 50.1% had neither sarcopenia nor NAFLD, 6.3% had sarcopenia without NAFLD, 31.1% had NAFLD without sarcopenia, and 12.5% had NAFLD with sarcopenia. Compared with individuals without NAFLD or sarcopenia, individuals with sarcopenic NAFLD had higher rates of SF (18.3% vs 3.2%) and AF (7.1% vs 0.2%). In the absence of sarcopenia, compared with individuals without NAFLD, individuals with NAFLD have a significantly increased risk of SF (odds ratio, 2.18; 95% CI, 0.92-5.19). In the presence of sarcopenia, NAFLD was associated with an increased risk of SF (odds ratio, 11.27; 95% CI, 2.79-45.56). This increase was independent of metabolic components. The proportion of SF that is attributable to the interaction of NAFLD and sarcopenia was 55% (attributable proportion, 0.55; 95% CI, 0.36-0.74). Increased leisure time physical activity was associated with a lower risk of sarcopenia. Patients with sarcopenic NAFLD are at risk for SF and AF. Increased physical activity and a healthy diet targeted to improve sarcopenic NAFLD could reduce the risk of significant fibrosis.

Does Pokémon GO increase leisure-time physical activity according to World Health Organization physical activity guidelines?

Does Pokémon GO increase leisure-time physical activity according to World Health Organization physical activity guidelines?

Rheumatoid arthritis is a preventable disease: 11 ways to reduce your patients' risk.

New evidence shows that up to 40% of rheumatoid arthritis (RA) cases are attributable to exposure to potentially modifiable factors. We can now identify people at higher risk of RA (pre-RA) through their family history, risk factors, autoantibodies and symptoms. Counselling these patients to act to modify factors known to be associated with RA risk could prevent the development of RA, and evidence shows that informing individuals of their risk and of ways to reduce it leads to positive behavioural change and is not harmful. This consumer-focussed narrative review is targeted at primary care providers and physicians to describe 11 changes that can be made, based on current evidence linking potentially modifiable factors to RA risk. These evidence-based recommendations are: (i) cease smoking; (ii) reduce exposure to inhaled silica, dusts and occupational risks; (iii) maintain a healthy weight; (iv) increase leisure time physical activity; (v) maintain good dental hygiene; (vi) maximise breastfeeding if able; (vii) maximise dietary quality and avoid high-salt diets; (viii) consume high levels of omega-3 fatty acids and fish; (ix) reduce consumption of sugar-sweetened soft drinks; (x) consume moderate levels of alcohol; and (xi) remain vitamin D replete.

Hybrid high-intensity interval training using functional electrical stimulation leg cycling and arm ski ergometer for people with spinal cord injuries: a feasibility study

AimThe aim was to assess safety and feasibility of Hybrid High-Intensity Interval Training (HIIT) using Functional Electrical Stimulation (FES) leg cycling and arm ski ergometer in people with Spinal Cord Injuries (SCI).MethodEight outpatients (mean age 42.8 years; 7 men) with stable SCI paraplegia (mean 14.5 years since injury) participated in hybrid HIIT (90% peak watts; 4 × 4–min intervals), three times a week (over 8 weeks). Primary outcomes were Adverse Events (AE), participant acceptability, shoulder pain, training intensity (% peak watts), and attendance.Secondary outcomes were effect on peak oxygen uptake (VO2peak) during FES hybrid poling, mean watts, self-reported leisure time physical activity, quality of life, and fatigue.ResultsNo serious AE occurred; acceptability with the training modality was high, while shoulder pain increased by 9% (SD 95.2). During training, 50% of the participants reached > 90% peak watts during the intervals, three with the legs (FES cycle) and one with the arms (Ski-Erg). Overall, mean training intensity (% peak watts) was 92% (SD 18.9) for legs and 82% (SD 10.3) for arms. Proportion of fulfilled training minutes was 82% (range 36–100%); one participant dropped out after 6 weeks due to back pain. Mean VO2peak increased by 17% (SD 17.5). Participants reported increased leisure time physical activity and health-related quality of life, besides reduced fatigue.ConclusionHybrid HIIT was safe for people with SCI paraplegia. The majority of the criteria for feasibility were met with acceptable attendance rate, limited drop out, participants enjoyed training, and increased VO2peak and mean watts. However, the intensity of 90% peak watts was reached by < 60% of the participants despite high RPE ratings during training. The method of measuring and calculating intensity needs to be studied further before a study using this HIIT protocol is undertaken.Trial registrationClinicaltrials.gov, NCT04211311, registered 12 December 2019 retrospectively registered

All are equal, but some are more equal than others: social determinants of leisure time physical activity through the lens of intersectionality

BackgroundTo date, no research has investigated social determinants of leisure time physical activity through the lens of intersectionality in a low- and middle-income country. Therefore, the aim of this study was to explore the intersectionality in leisure time physical activity in a nationwide sample of Brazilian adults.MethodsData from the Brazilian National Health Survey conducted in 2013 were analysed (N = 58,429). Prevalence of sufficient leisure time physical activity (150+ minutes per week in moderate-to-vigorous physical activity) was estimated according to gender, racial identity, education and income, and according to multiple combinations of these sociodemographic characteristics (i.e., multiple jeopardy index).ResultsThe prevalence of sufficient leisure time physical activity was 22.9% (95%CI: 22.3 to 23.6). Overall, the prevalence of sufficient leisure time physical activity was highest among men, individuals with white skin colour, and among those in the highest group of education and income. Among men, white, with a university degree and in the highest quartile of income (3% of the population), the prevalence of sufficient leisure time physical activity was 48%. Among non-white women with low education and low income (8.1% of the population), the prevalence of sufficient leisure time physical activity was 9.8%.ConclusionInformed by the theory of intersectionality, findings of this study have shown that intersections of gender, racial identity and socioeconomic position of the Brazilian society strongly influence leisure time physical activity at the individual level. Targeted interventions to increase leisure time physical activity should address the complexities of social status intersections.

Promoting leisure-time versus occupational physical activity: socially biased or solutions to closing the socioeconomic gap?

We read with interest Straker et al ’s editorial1 arguing how a focus on leisure-time physical activity is socially biased, and that designing jobs with the right amount and nature...

Relationships between grit, physical activity, and academic success in university students: Domains of physical activity matter

ObjectiveTo examine the relationships between contexts of physical activity, grit, and GPA in a college population. Participants: 875 Undergraduate students from a large, southern university participated between October 2018 and March 2020. Methods: Participants completed an electronic survey evaluating physical activity and grit. The university provided official GPAs. Multiple linear regression models evaluated the correlations between grit, the different physical activity domains, and GPA. Results: Grit was positively associated with domestic physical activity, leisure time physical activity, and GPA. Consistency of interest had no associations with the domains of physical activity or GPA. Perseverance of effort was positively associated with walking, active transport physical activity, domestic physical activity, leisure physical activity, and GPA. Conclusion: Perseverance of effort is related to different domains of physical activity and GPA. Future studies should investigate if increasing leisure time physical activity causes increases in perseverance of effort.

Leisure time physical activity is associated with improved HDL functionality in high cardiovascular risk individuals: a cohort study.

Physical activity has consistently been shown to improve cardiovascular health and high-density lipoprotein-cholesterol levels. However, only small and heterogeneous studies have investigated the effect of exercise on high-density lipoprotein functions. Our aim is to evaluate, in the largest observational study to date, the association between leisure time physical activity and a range of high-density lipoprotein functional traits. The study sample consisted of 296 Spanish adults at high cardiovascular risk. Usual leisure time physical activity and eight measures of high-density lipoprotein functionality were averaged over two measurements, one year apart. Multivariable linear regression models were used to explore the association between leisure time physical activity (exposure) and each high-density lipoprotein functional trait (outcome), adjusted for cardiovascular risk factors. Higher levels of leisure time physical activity were positively and linearly associated with average levels over one year of plasma high-density lipoprotein-cholesterol and apolipoprotein A-I, paraoxonase-1 antioxidant activity, high-density lipoprotein capacity to esterify cholesterol and cholesterol efflux capacity in individuals free of type 2 diabetes only. The increased cholesterol esterification index with increasing leisure time physical activity reached a plateau at around 300 metabolic equivalents.min/day. In individuals with diabetes, the relationship with cholesteryl ester transfer protein followed a U-shape, with a decreased cholesteryl ester transfer protein activity from 0 to 300 metabolic equivalents.min/day, but increasing from there onwards. Increasing levels of leisure time physical activity were associated with poorer high-density lipoprotein vasodilatory capacity. In a high cardiovascular risk population, leisure time physical activity was associated not only with greater circulating levels of high-density lipoprotein-cholesterol, but also with better markers of high-density lipoprotein functionality, namely cholesterol efflux capacity, the capacity of high-density lipoprotein to esterify cholesterol and paraoxonase-1 antioxidant activity in individuals free of diabetes and lower cholesteryl ester transfer protein activity in individuals with type 2 diabetes.

Physical education, leisure time physical activity, and psychological distress in adolescence

Abstract Background Participation in physical education classes can positively affect mental and physical well-being in children and adolescets. The current study focused on the relationship between participation in gym and swimming classes and psychological distress symptoms in Icelandic adolescents. Methods The analysis is based on a national school-based study, conducted in Iceland every fourth year, as part of the WHO collaborative cross-national survey titled Health Behavior in School-Aged Children (HBSC). Data collection took place between November 2013 and February 2014. Students filled out an anonymous study questionnaire in the classroom. The data is based on responses from 15 year old (10. grade) students attending the final year of compulsory school (N = 3618; response rate 81%). Results Positive associations were observed between participation in curriculum-based gym and swimming classes and lower psychological distress symptoms. A closer multivariate path analysis suggested that beneficial effects of PE classes were direct, and also indirect because participation in such classes were positively related to leisure time physical activity. Conclusions The study suggests that school-based physical activity enhances psychological well-being in adolescence. The benefits may be both direct and indirect through increased leisure time physical activity. Key messages School-based physical activity enhances psychological well-being in adolescence. The benefits may be both direct and indirect through increased leisure time physical activity.

Pilot randomized trial of a volitional help sheet‐based tool to increase leisure time physical activity in breast cancer survivors

To develop and test a volitional help sheet-based tool to improve physical activity in breast cancer survivors compared to a standard self-generated implementation intention intervention. Pilot randomized trial conducted online over 3months. Participants were randomized to an online volitional help sheet (n=50) or implementation intention (n=51) intervention. Measures were taken at baseline, 1 and 3months. The main outcome measure was moderate-strenuous leisure timephysical activity. Secondary outcomes were health-related quality of life and mood. Participants exposed to the volitional help sheet and implementation intention interventions showed similar effects after 1month, with both groups reporting a significant increase in moderate-strenuous physical activity. After 3months, the initial increase in physical activity was maintained by the volitional help sheet group, but not the implementation intention group. Improvements were also found for negative affect and emotional quality of life. While both interventions show promise in promoting physical activity in breast cancer survivors, the volitional help sheet may be more effective for facilitating lasting change and emotional well-being. Findings suggest that the volitional help sheet may have potential to offer a cost-effective contribution to consumer-led tertiary preventive health. Future research should test these initial findings in a definitive trial. Statement of contribution What is already known on this subject? Physical activity is important for optimizing health in breast cancer survivors. Despite this, physical activity in this cohort remains low. Theory-based strategies are needed to help breast cancer survivors independently manage and maintain regular physical activity over the long term. What does this study add? Online planning interventions can improve physical activity in breast cancer survivors. Volitional help sheets, but not implementation intentions, show sustained effects for 3months. The intervention shows promise as a potential low-cost addition to long-term survivorship care plans.

Mode of Delivery according to Leisure Time Physical Activity before and during Pregnancy: A Multicenter Cohort Study of Low-Risk Women.

Objectives. To examine the association between maternal leisure time physical activity and mode of delivery. Study Design. Population-based multicentre cohort. From the Danish Dystocia Study, we included 2,435 nulliparous women, who delivered a singleton infant in cephalic presentation at term after spontaneous onset of labor in 2004-2005. We analysed mode of delivery according to self-reported physical activity at four stages, that is, the year before pregnancy and during first, second, and third trimester, in logistic regression models. Further, we combined physical activity measures at all four stages in one variable for a proportional odds model for cumulative logits. Main Outcome Measures. Mode of delivery (emergency caesarean section; vacuum extractor; spontaneous vaginal delivery). Results. The odds of emergency caesarean section decreased with increasing levels of physical activity with statistically significant trends at all four time stages except the third trimester. This tendency was confirmed in the proportional odds model showing 28% higher odds of a more complicated mode of delivery among women with a low activity level compared to moderately active women. Conclusions. We found increasing leisure time physical activity before and during pregnancy associated with a less complicated delivery among low-risk, nulliparous women.

Individualized vs. group exercise in improving quality of life and physical activity in patients with cardiac disease and low exercise capacity: results from the DOPPELHERZ trial

Purpose: Important goals of cardiac rehabilitation maintenance programs (CMP) are to increase leisure time physical activity (LTPA) and improve health-related quality of life (HRQoL). Elderly patients with cardiac disease and low exercise capacity are simultaneously the most severely affected and have the most to gain from exercise-based rehabilitation. Individualized combined exercise (ICE) may be an effective modality to achieve these goals. We compared six months of ICE to CMP in their effects on LTPA and HRQoL.Methods: Sixty patients (70 ± 9 years, 39% female) with cardiac disease and low exercise capacity (<6 MET) were randomly allocated to six months of once-weekly ICE or CMP. The patients in ICE performed moderate endurance and resistance exercise on machines, based on intensities from individual peak exercise testing. Patients in CMP performed weekly sessions of calisthenics, flexibility, coordination and relaxation activities. LTPA and HRQoL were assessed with accelerometry and questionnaires at baseline and six months.Results: Sixty patients completed the trial. ICE increased vigorous PA (ICE: Δ + 12 MET-min/d, CMP: Δ –5 MET-min/d, p = .02) and steps per day (ICE: +1586 steps/d, CMP: –838 steps/d, p < .01) compared to CMP after six months. ICE significantly improved in several components of HRQoL (vitality, emotional health, social health, positive and negative affect (all p < .05) compared to CMP.Conclusions: ICE resulted in significant improvements in physical activity levels and health related quality of life in moderate to high-risk patients compared to CMP.Implications for rehabilitationRelatively low volumes and intensities of exercise may lead to substantial improvements in both physical activity levels and health-related quality of lifeExercise modes in cardiac rehabilitation maintenance programs should not be limited to calisthenics and large group-based exerciseSupplemental resistance exercise may improve health-related quality of life and increase physical activity levels in patients with low exercise capacityModerate to high-risk elderly patients also benefit from individualized endurance-resistance exercise

Low back pain and physical activity--A 6.5 year follow-up among young adults in their transition from school to working life.

BackgroundThe association between leisure time physical activity and low back pain in young adults is unclear and is in the need of prospectively obtained evidence. This study examined the course of low back pain and the association between low back pain and leisure time physical activity in a cohort of young adults in their transition from school to working life.MethodsBoth low back pain and leisure time physical activity was monitored over a 6.5 year period in 420 subjects starting out as students within hairdressing, electrical installation and media/design. The association between physical activity and low back pain was investigated through the follow-up period by using linear mixed models analysis.ResultsLow back pain was significantly influenced by time and overall there was a decreasing trend of low back pain prevalence throughout the follow-up. Analysis showed a weak trend of decreasing low back pain with moderate/high physical activity levels, but this association was not significant.ConclusionsLow back pain decreased during follow-up with baseline as reference. Findings in our study did show non-significant trends of reduced low back pain with increased leisure time physical activity. Still, we could not support the theory of moderate/high levels of physical activity acting protective against low back pain in young adults entering working life. Our results, in combination with previous relevant research, cannot support a clear relationship between physical activity and low back pain for young adults. Thus, recommendations regarding effect of physical activity on reducing low back pain for this group are not clear.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2446-2) contains supplementary material, which is available to authorized users.

Abstract MP94: Association of Physical Activity and Sleep Profiles with Framingham 10 year Cardiovascular Disease Risk in Finnish Men and Women

Introduction: Health behaviors including sleep, physical activity (PA) and sedentariness directly and indirectly affect CVD risk. Risk of CVD mortality and morbidity decreases with increasing leisure time PA. Sleep length deviant from population mean relates to increased CVD risk. Sleep quality and circadian preference are suggested to associate with CVD risk and metabolic risk factors. It is unclear how PA modifies health risks of poor sleep and vice versa. Higher PA may improve sleep and poor or short sleep may reduce PA. Our aim is to recognize people with the same profile of PA, sedentariness and sleep and to study if these subpopulations differ in their CVD risk. Material and methods: The National FINRISK 2012 Study comprised a stratified random sample of 10 000 Finns, aged 25 to 74 years, who participated in a health examination and filled in questionnaires. Participation rate was 65% (3041 men, 3383 women). We calculated the Framingham 10 year risk score for participants initially free from CVD and used latent class analysis (LCA) that identifies unobserved underlying subpopulations based on item response probabilities to determine how PA, sedentary and sleep behaviors interrelate. We fitted models with 1-5 classes and chose a 4 class model based on statistical criteria and interpretational judgment. Analyses were stratified by sex as measurement invariance was not fulfilled. Furthermore, we performed analysis of covariance, weighted by the posterior probabilities of the LCA, in order to compare the CVD risk in the 4 profiles. Results: We found 4 latent classes or PA and sleep profiles in men and women. The most important indicators were employment status, leisure time PA, sleep opinion and sleep duration. Likelihoods for employment, high leisure time PA and sufficient, longer sleep were combined in the most prevalent profiles and likelihoods for unemployment, physical inactivity and short, insufficient sleep occurred in the least prevalent profiles. When comparing the Framingham 10 year CVD risk score between the profiles, statistically significant differences, adjusted for age and education, were found. Lower CVD risk was associated with profiles that included likelihood for high leisure time or occupational PA and evening preference. In men, the profile with highest risk also included high screentime and long naps (risk score 20.7, p&lt;.001). In women the profile with highest CVD risk also included high screentime (risk score 9.5, p&lt;.001). Conclusions: PA, sedentary and sleep behavior patterns in the Finnish population are represented by 4 different profiles differ in the likelihood for leisure time PA, occupational PA, sleep length and satisfaction with sleep. The risk of CVD seems to be higher in the most sedentary and worst sleeping profile and in morning types, suggesting that lifestyle interventions should take into account not only one behavior but the clustering of health behaviors.

Editorial: Do We Have Effective Means to Treat Arterial Stiffness and High Central Aortic Blood Pressure in Patients with and without Hypertension?

The reduction or loss of arterial elasticity or distensibility leads to arterial stiffness (AS), which has a substantial predictive value for all-cause and cardiovascular disease (CVD) mortality, as well as for non-fatal CVD events [1]. A plethora of evidence consistently showed the prognostic value of aortic stiffness for fatal and nonfatal CVD events in various populations at different levels of CVD risk, including the general population, elderly subjects and patients with hypertension, type 2 diabetes mellitus (T2DM) and end-stage renal disease (ESRD) [2]. It has been reported that 1-SD increase in pulse wave velocity (PWV) is associated with a 47% increase in the risk for total mortality [95% confidence interval (CI), 1.31-1.64] and a similar 47% increase in the risk for CVD mortality (95% CI, 1.29-1.66) [2].

Joint predictability of health related quality of life and leisure time physical activity on mortality risk in people with diabetes

BackgroundReduced health related quality of life (HRQOL) has been associated with increased mortality in individuals with diabetes. In contrast, increased leisure time physical activity (LTPA) has been associated with reduced mortality. The aim of this study was to investigate the combined relationship of HRQOL and LTPA on mortality and whether high levels of LTPA are associated with reduced risk of mortality in adults with diabetes and inferior HRQOL.MethodsWe analyzed data from a national sample of adults (18 years or older) with self-reported physician-diagnosed diabetes, who participated in the 2001 National Health Interview Survey in Taiwan (N = 797). A total of 701 participants had complete Short Form 36 (SF-36) and LTPA data and were followed from 2002 to 2008. Participants were divided into 3 groups based on their LTPA: (1) a regularly active group who reported 150 or more min/week of moderate-intensity activity; (2) an intermediately active group who reported engaging in LTPA but did not meet the criterion for the “regular” category; and (3) an inactive group who reported no LTPA. The physical component summary (PCS) and mental component summary (MCS) scores were dichotomised at the median (high vs. low) (PCS = 45.11; MCS = 47.91). Cox proportional-hazards models were used to investigate associations between baseline characteristics and mortality.ResultsAfter 4,570 person-years of follow-up, 121 deaths were recorded and the crude mortality rate was 26.5 per 1,000 person-years. Both PCS scores and LTPA were significant predictors of mortality, whereas no significant relationship was observed between MCS and mortality. After adjustment for other factors, participants with low PCS who reported no LTPA had a hazard ratio (HR) for mortality of 4.49 (95% CI = [2.15-9.36]). However, participants with low PCS who were active (including intermediate and regular LTPA) had a HR for mortality of 1.36 (95% CI = [0.64-2.92]).ConclusionsOur results show a significantly increased mortality risk of diabetes associated with reduced HRQOL in individuals who report no LTPA. Engaging in LTPA may be associated with improved survival in participants with diabetes with poor self-rated physical health status.

Does the Benefit on Survival from Leisure Time Physical Activity Depend on Physical Activity at Work? A Prospective Cohort Study

PurposeTo investigate if persons with high physical activity at work have the same benefits from leisure time physical activity as persons with sedentary work.MethodsIn the Copenhagen City Heart Study, a prospective cohort of 7,411 males and 8,916 females aged 25–66 years without known cardiovascular disease at entry in 1976–78, 1981–83, 1991–94, or 2001–03, the authors analyzed with sex-stratified multivariate Cox proportional hazards regression the association between leisure time physical activity and cardiovascular and all-cause mortality among individuals with different levels of occupational physical activity.ResultsDuring a median follow-up of 22.4 years, 4,003 individuals died from cardiovascular disease and 8,935 from all-causes. Irrespective of level of occupational physical activity, a consistently lower risk with increasing leisure time physical activity was found for both cardiovascular and all-cause mortality among both men and women. Compared to low leisure time physical activity, the survival benefit ranged from 1.5–3.6 years for moderate and 2.6–4.7 years for high leisure time physical activity among the different levels of occupational physical activity.ConclusionPublic campaigns and initiatives for increasing physical activity in the working population should target everybody, irrespective of physical activity at work.

Developing physical activity interventions for adults with spinal cord injury. Part 1: A comparison of social cognitions across actors, intenders, and nonintenders.

This article is the first in a three-part series focused on designing theory-based interventions to increase leisure time physical activity (LTPA) in persons with spinal cord injury (SCI). The purpose of this first study was to compare social cognitions for LTPA between people classified as LTPA actors, intenders, and nonintenders, as per Schwarzer's Health Action Process Approach (HAPA) model. Participants were 238 men and women living with a SCI (M age = 44.14, SD = 12.74; 44.5% paraplegic) who were subsequently classified as LTPA actors (n = 105), intenders (n = 73), or nonintenders (n = 60). Participants completed a questionnaire that assessed the following HAPA constructs: LTPA outcome expectancies, self-efficacy, intentions, planning, and action control. A MANCOVA revealed significant between-groups differences for all variables (ps < .001). For all of the measures, actors scored significantly higher than intenders who, in turn, scored significantly higher than nonintenders. It is both theoretically and practically important to distinguish between LTPA nonintenders, intenders, and actors when developing LTPA-enhancing interventions for people with SCI. These distinctions inform the design and testing of the interventions reported in the two accompanying articles.