Kaiser Physical Activity Survey Research Articles

Fatigue, sleepiness, perceived stress and physical activity in postpartum mothers according to the infants’ feeding method. A pilot study

Aim of the study: Early motherhood is the time when the female body must cope with sleep deprivation, fatigue, and stress associated with increased responsibilities following the birth of the baby. The aim of this paper was to investigate the psychological wellbeing and physical activity of healthy mothers in the first months postpartum according to the infants’ feeding method. Materials and methods: 24 healthy exclusively breastfeeding and 13 healthy exclusively formula-feeding mothers participated in this study. The results were based on the standardised scales: Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), Perceived Stress Scale (PSS), and Kaiser Physical Activity Survey (KPAS). Results: When comparing data between the two studied groups, we found that breastfeeding women reported lower levels of sleepiness (p = 0.011) and fatigue (p = 0.0006) than formula-feeding mothers. Perceived stress and physical activity did not differ between the groups. Positive correlation between PSS and FSS was found (r = 0.62, p < 0.005) in the group of breastfeeding mothers. Conclusions: 1) In breastfeeding mothers, fatigue and perceived stress reinforce each other. This relationship serves as an alarm signal to provide nursing mothers with optimal care in order to prevent them from stopping breastfeeding. 2) In a healthy population of mothers from 3 to 6 months postpartum, exclusively breastfeeding women are observed to have lower fatigue and sleepiness levels compared to those who decided to feed their children with formula only. These conclusions may be an additional source of information for the promotion of breastfeeding.

The impact of physical activity during pregnancy on labor and delivery

Physical activity in pregnancy is associated with decreased risks of adverse pregnancy outcomes such as gestational diabetes and preeclampsia. However, the relationship between the amount and type of physical activity during pregnancy and subsequent labor outcomes remains unclear. This study aimed to test the hypothesis that higher levels of physical activity across different lifestyle domains in pregnancy are associated with a shorter duration of labor. This study is a secondary analysis of a prospective cohort study in which patients with singleton pregnancies without a major fetal anomaly were administered the Kaiser Physical Activity Survey in each trimester. The Kaiser Physical Activity Survey was designed specifically to quantify various types of physical activities in women and includes 4 summative indices-housework/caregiving, active living habits, sports, and occupation. The study included women at full-term gestations admitted for induction of labor or spontaneous labor. The primary outcome of this analysis was duration of the second stage of labor. Secondary outcomes were duration of the active stage, prolonged first and second stage, mode of delivery, rates of second-stage cesarean delivery, operative vaginal delivery, severe perineal lacerations, and postpartum hemorrhage. These outcomes were compared between patients with and without high physical activity levels, defined as overall Kaiser Physical Activity Survey score ≥75th percentile in the third trimester. Multivariable logistic regression was used to adjust for obesity and epidural use. In addition, a subgroup analysis of nulliparous patients was performed. A total of 811 patients with complete Kaiser Physical Activity Survey data in the third trimester were included in this analysis. The median Kaiser Physical Activity Survey score was 9.5 (8.2-10.8). Of the 811 patients, 203 (25%) had higher levels of physical activity in pregnancy. There was no difference in the duration of the second stage of labor between patients with and without higher physical activity levels (1.29±2.94 vs 0.97±2.08 hours; P=.15). The duration of active labor was significantly shorter in patients with higher levels of physical activity (5.77±4.97 vs 7.43±6.29 hours; P=.01). Patients with higher physical activity levels were significantly less likely to have a prolonged first stage (9.8% vs 19.4%; P<.01; adjusted relative risk, 0.55; 95% confidence interval, 0.34-0.83). However, rates of prolonged second-stage cesarean delivery, operative vaginal deliveries, and perineal lacerations were similar between the 2 groups. Patients who are more physically active during pregnancy have a shorter duration of active labor.

Dual trajectories of physical activity and blood lipids in midlife women: The Study of Women’s Health Across the Nation

BackgroundPhysical activity (PA) has the potential to attenuate cardiovascular disease risk in midlife women through multiple pathways, including improving lipid profiles. Longitudinal patterns of PA and blood lipid levels have not been studied in midlife women. Our study identified trajectories of PA and blood lipids across midlife and characterized the associations between these trajectories. MethodsWe evaluated 2,789 participants from the Study of Women’s Health Across the Nation (SWAN), a longitudinal cohort study with follow-up over the menopause transition. Women reported PA using the Kaiser Physical Activity Survey at seven study visits across 17 years of follow-up. Serum high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides were measured at eight study visits across the same 17-year follow-up period. We used group-based trajectory models to characterize trajectories of PA and blood lipids over midlife and dual trajectory models to determine the association between PA and blood lipid trajectories adjusted for race/ethnicity, body mass index category, smoking, and lipid-lowering medication use. ResultsWomen were 46 years old, on average, at study entry. Forty-nine percent were non-Hispanic white; 32 % were Black; 10 % were Japanese; and 9 % were Chinese. We identified four PA trajectories, three HDL cholesterol trajectories, four LDL cholesterol trajectories, and two triglyceride trajectories. The most frequently occurring trajectories were the consistently low PA trajectory (69 % of women), the low HDL cholesterol trajectory (43 % of women), the consistently moderate LDL cholesterol trajectory (45 % of women), and the consistently low triglycerides trajectory (90 % of women). In dual trajectory analyses, no clear associations were observed between PA trajectories and HDL cholesterol, LDL cholesterol, or triglycerides trajectories. ConclusionsThe most frequently observed trajectories across midlife were characterized by low physical activity, low HDL cholesterol, moderate LDL cholesterol, and low triglycerides. Despite the absence of an association between long-term trajectories of PA and blood lipids in this study, a large body of evidence has established the importance of clinical and public health messaging and interventions targeted at midlife women to promote regular and sustained PA during midlife to achieve other cardiovascular and metabolic benefits.

714 The impact of physical activity in pregnancy on perinatal outcomes

Physical activity in pregnancy decreases the risk of adverse maternal and neonatal outcomes, but few studies have utilized an objective tool, such as Kaiser Physical Activity Survey (KPAS), to identify patients at risk for poor outcomes. This study evaluates the association between KPAS scores and adverse pregnancy outcomes. This is a secondary analysis of a prospective cohort study in which pregnant patients were administered the KPAS in each trimester. The primary outcome for this analysis was gestational diabetes. Secondary outcomes were gestational hypertension, preeclampsia, preterm delivery <37 weeks and gestational weight gain. These outcomes were compared between patients with and without high physical activity levels, defined as overall KPAS score ≥75th percentile in the 3rd trimester. Multivariable logistic regression was used to adjust for obesity. There were 811 patients with a complete KPAS included in this analysis. The median KPAS score was 9.5 (8.2, 10.8). 203 patients (25%) had high physical activity levels in pregnancy. There was no difference in gestational diabetes between patients in either physical activity level (5.3% vs 5.4%, p=1.0, RR 1.03 [95% CI 0.53, 2.01]). Patients with high physical activity levels were significantly less likely to develop gestational hypertension (14.1% vs 7.9%, p=0.04, RR 0.56 [0.33, 0.92]) and preeclampsia (12.7% vs 4.9%, p=0.002, RR 0.39 [0.20, 0.74]), even after controlling for obesity. Rates of preterm delivery and inadequate or excess weight gain were similar between groups. Patients with high physical activity during pregnancy are less likely to develop hypertensive disorders of pregnancy. Future research should address interventions to improve physical activity in pregnancy and their impact on hypertensive disorders.

45 Physical activity in pregnancy: Predictive of labor outcomes?

Physical activity in pregnancy is associated with decreased risks of adverse pregnancy outcomes such as gestational diabetes and preeclampsia. However, the relationship between physical activity during pregnancy and subsequent labor outcomes is unknown. Since labor is a physically arduous process, we tested the hypothesis that increased physical activity in pregnancy is protective against adverse labor outcomes. This is a secondary analysis of a prospective cohort study in which pregnant patients were administered the Kaiser Physical Activity Survey (KPAS) in each trimester. The primary outcome for this analysis was duration of the 2nd stage of labor. Secondary outcomes were duration of active stage, prolonged 1st and 2nd stage, mode of delivery, rates of 2nd stage cesarean section, operative vaginal delivery, severe perineal lacerations and postpartum hemorrhage. These outcomes were compared between patients with and without high physical activity levels, defined as overall KPAS score ≥75th percentile in the 3rd trimester. Multivariable logistic regression was used to adjust for obesity. There were 811 patients with a complete KPAS included in this analysis. The median KPAS score was 9.5 (8.2, 10.8). 203 patients (25%) had high physical activity levels in pregnancy. There was no difference in the duration of 2nd stage of labor between patients with and without high physical activity levels (0.97 ± 2.08 vs 1.29 ± 2.94 hours, p=0.15). The duration of active labor was significantly shorter in patients with increased physical activity (7.43 ± 6.29 vs 5.77 ± 4.97 hours, p=0.01). Patients with high physical activity levels were significantly less likely to have a prolonged 1st stage (9.8% vs 19.4%, p<0.01, RR 0.51 [95% CI 0.32, 0.79]). Rates of prolonged 2nd stage, cesarean section, operative vaginal deliveries and perineal lacerations were similar between groups. Patients that are physically active in pregnancy may have a shorter duration of active labor. Further research should investigate the impact of initiatives to increase physical activity in pregnancy on labor.

PHYSICAL ACTIVITY, FALLS, AND FALL INJURIES: THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION

Physical activity (PA) is positively associated with physical functioning, but relations of domain-specific PA with falls is less clear. In 2015, women (n=1,962) self-reported fall history and PA. The Kaiser Physical Activity Survey (KPAS) assessed sports, non-sports leisure, household/caregiving, and total activity. Risk ratios (RR) were generated from poisson regression. One-third (29.7%) of women (mean age=65.1 years [SD 2.7]) reported ≥1 fall and 18.3% reported ≥1 fall injury in the previous 12 months. Women in the highest quartile of sports activity had an increased risk of ≥1 fall (RR=1.19;95%CI:1.00,1.41;p=0.049). Women in the highest quartile of total activity had an increased risk of injurious falls (RR=1.31;95%CI:1.04,1.65;p=0.021), but there was no association for domain-specific indices. KPAS may identify women and activity domains, such as sports, at high risk for falls and injuries. Future work should incorporate device-based PA assessments within domains to understand fall patterns among community-dwelling older adult women.

The Effect of Interval Training on Oxidative Stress Indices Among Women in Preterm Labor Underwent Coronary Artery Bypass Graft

Objectives: Oxidative stress indices are one of the factors that cause and exacerbate cardiovascular diseases in postpartum women, which can be changed with interval training. Therefore, the current study aimed at investigating the effect of interval training on oxidative stress indices among women in preterm labor undergoing the coronary artery bypass graft (CABG). Materials and Methods: This randomized clinical trial was conducted on 21 participants (the sample size was determined based on a similar study) from December 2018 to May 2019 at Shahid Madani hospital of Tabriz, Iran. After the random allocation of subjects to the training (n=11) and control (n=10) groups, demographic information was collected and their physical activity level was assessed using the Kaiser physical activity survey before and after the intervention. In addition, the levels of oxidative stress indices were measured 24 hours before and after the intervention using the blood sample. The participants completed an eight-week invention including 24 one-hour sessions according to the available protocol. Finally, data were analyzed by means of statistical tests such as the Shapiro-Wilk, Leven, and Student’s t-test at a significant level of &lt;0.05. Results: The effect of the aerobic exercise program on body weight loss, as well as body mass index (BMI) and body fat percentage changes was significant in the training group (P=0.011, P=0.004, and P=0.001, respectively). Based on the results, the serum and urine levels of 8-hydroxy-2-deoxyguanosine reduced significantly after the completion of the intervention (P=0.002 and P=0.001, respectively) in the training group. Conclusions: In general, aerobic exercise after CABG decreased the fat percentile, BMI, and oxidative stress indices in the subjects. Thus, these trainings could reduce oxidative stress indices by increasing tissue metabolism and oxygen consumption.

The Reliability and Validity of the Turkish Kaiser Physical Activity Survey for Pregnant Women.

Evaluation of physical activity by condition-specific surveys provides more accurate results than generic physical activity questionnaires. The aim of this study was to investigate the reliability and validity of the Kaiser Physical Activity Survey (KPAS) in Turkish pregnant women. In the translation and cultural adaptation of the KPAS, the 6-phase guidelines recommended in the literature were followed. The study included a total of 151 pregnant women who were assessed using the Turkish version of KPAS, the Pregnancy Physical Activity Questionnaire, and the SenseWear Pro3 Armband. To determine the test-retest reliability, the KPAS was reapplied after 7 days. The psychometric properties of KPAS were analyzed with respect to internal consistency, test-retest reliability, and concurrent validity. Cronbach α coefficient indicating the internal consistency of the Turkish KPAS was found to be .60 to .80, showing moderate reliability. The intraclass correlation coefficient for test-retest reliability was very strong (intraclass correlation coefficient: .96-.98). The total KPAS scores were found to be moderately correlated with the total Pregnancy Physical Activity Questionnaire score and the total energy expenditure value on the SenseWear Pro3 Armband. This study showed that KPAS is a valid and reliable instrument for evaluating physical activity in Turkish pregnant women in different aspects.

Factors Influencing Longitudinal Stair Climb Performance from Midlife to Early Late Life: The Study of Women's Health Across the Nation Chicago and Michigan Sites.

To quantify the longitudinal change in stair climb performance (a measure indicative of both physical function and muscle power), determine whether physical activity is related to slower decline in performance, and to identify factors that modify the longitudinal change in performance among women from midlife to late life. Longitudinal cohort study with up to 15 study visits. Two sites of the Study of Women's Health Across the Nation. Black (n=411) and white (N=419) women followed from median age 47.0 (44.6-49.6) to 62.0 (55.8-65.3) years. N/A. Performance on a stair climb test (ascend/descend 4 steps, 3 cycles) was timed. Physical activity (PA) was assessed using the Kaiser Physical Activity Survey (KPAS; possible range 0-15 points). Sociodemographic and health factors were assessed via self-report. BMI was calculated with measured height and weight. Mixed-effects regression modeled longitudinal change in stair climb performance. Average baseline stair climb time was 18.12 seconds (95% CI: 17.83-18.41), with 0.98% (95% CI: 0.84%-1.11%) annual slowing. In fully adjusted models, higher levels of PA were associated with faster stair climb times (2.09% faster per point higher, 95% CI: -2.87%- -1.30%), and black women had 5.22% (95% CI: 2.43%-8.01%) slower performance compared to white women. Smoking, financial strain, diabetes, osteoarthritis, fair/poor health, and stroke were associated with 3.36% (95% CI: 0.07%-6.65%), 7.56% (95% CI: 4.75%-10.37%), 8.40% (95% CI: 2.89%-13.92%), 8.46% (95% CI: 5.12%-11.79%), 9.16% (95% CI: 4.72%-13.60%), and 16.94% (95% CI: 5.37%-28.51%) slower performance, respectively. In separate models, higher BMI (per 1-unit), osteoarthritis, fair/poor health, and diabetes, were each associated with 0.06% (95% CI:0.04%-0.08%), 0.48% (95% CI:0.12%-0.84%), 0.81% (95% CI:0.35%-1.28%), and 0.84% (95% CI:0.22%-1.46%), additional slowing per year over time. Significant declines in function were evident as women transitioned from midlife to early late life. Declines were amplified by indicators of poor health, emphasizing the importance of health in midlife for promoting healthy aging.

1445-P: Physical Activity and Insulin Resistance in Midlife Women: 17-Year Longitudinal Associations in SWAN

Insulin resistance increases starting in midlife due to decreasing estrogen production and other aging-related factors. Higher intensity physical activity (PA) has the potential to attenuate rising insulin resistance; however, longitudinal associations of PA and insulin resistance have not been studied in midlife women. We used data from the Study of Women’s Health Across the Nation (SWAN, N=3,230), a cohort study with up to 17 years of follow-up, to estimate longitudinal associations of higher intensity PA with insulin resistance. Women reported PA using the Kaiser Physical Activity Survey at 7 study visits (V0, V3, V5, V6, V9, V12, V13). We used the sports and exercise physical activity index score (range: 1-5) to assess leisure-time moderate to vigorous intensity PA (MVPA). SWAN measured glucose and insulin in blood collected at 8 study visits (V0, V1, V3-V7, V12, V13). We used generalized estimating equations to estimate the adjusted longitudinal associations of MVPA with homeostatic model assessment of insulin resistance (HOMA-IR) overall, by baseline body mass index (BMI) category, and by race/ethnicity. Women were 46 (SD=3) years old at baseline. Forty-seven percent were non-Hispanic white; 28% black; 9% Japanese; 8% Chinese, and 8% Hispanic. Each additional one-unit increase in reported MVPA was associated with an average 0.2 unit lower HOMA-IR (95% CI: -0.3, -0.1) over time. Associations differed by baseline BMI (interaction P&amp;lt;0.001). Reported MVPA was associated with a 0.1 lower HOMA-IR (95% CI: -0.1, -0.02) in normal weight women, a 0.2 lower HOMA-IR (95% CI: -0.3, -0.1) in overweight women, and a 0.4 lower HOMA-IR (95% CI: -0.6, -0.1) in obese women. MVPA was not associated with HOMA-IR in underweight women (mean difference=0.0; 95% CI: -0.1, 0.1). Associations did not differ by race/ethnicity (interaction P=0.39). Our findings support longitudinal associations of MVPA with lower insulin resistance in midlife women, with the strongest associations in obese women. Disclosure S.E. Badon: None. K. Pettee Gabriel: None. C.A. Karvonen-Gutierrez: None. B. Sternfeld: None. J. Lee: None. E. Gold: None. E. Waetjen: None. M. Hedderson: None. Funding National Institutes of Health; U.S. Department of Health and Human Services; National Institute on Aging; National Institute of Nursing Research; Office of Research on Women’s Health (U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495); National Center for Research Resources; National Center for Advancing Translational Sciences (UCSF-CTSI UL1RR024131)

Relationship between Physical Activity of Pregnant Women in the Third Trimester of Pregnancy with Preterm Birth Using Kaiser Physical Activity Survey (KPAS) Questionnaire

Abstract&#x0D; Objective: To examine the relationship between the intensity of physical activity of pregnant women with preterm birth and to know the relationship between types of physical activity of pregnant women with preterm birth.&#x0D; Method: This research was a case control study that was conducted at Dr. Cipto Magunkusumo Hospital and Karawang Hospital in January 2017 to June 2017 with KPAS questionnaire which was divided into two groups, preterm birth and term birth. The sample size was 127 subjects for each group. The analysis was done by multivariate analysis of etiologic concept.&#x0D; Result: In term birth, the most frequent physical activity intensities were: moderate intensity (64.6%, n = 82), light intensity (22%, n = 28), and vigorous intensity (13.4%, n = 17). In preterm birth, the most frequent physical activity intensities were: light intensity (40.1%, n = 51), vigorous intensity (33.9%, n = 43), and moderate intensity (26%, n = 33). Adjusted OR of preterm birth in light intensity versus moderate intensity was OR 5.32 (95% CI, 2.80-10.13;P = &lt; 0.001). While adjusted OR of preterm birth in vigorous intensity compared with moderate intensity was OR 6.29 (95% CI, 3.28- 13.46;P = &lt; 0.001). Work and sport have a significant association with preterm birth with OR 3.19 (95% CI, 1.62 - 6.28;P = 0.001) and OR 1.85 (95% CI,1.11 - 3.09; P= 0.017). Occupational conditions are also associated with preterm birth, including: weight lifting with OR 5.16 (95% CI, 1.10-24.08, P = 0.021), walking with OR 3.57 (95% CI, 1.61-7.92, P = 0.001), sitting with OR 2.79 (95% CI, 1.23-6.31, P = 0.011), and standing with OR 3.04 (95% CI, 1.40-6.59; P = 0.003).&#x0D; Conclusion: There is a significant relationship between the intensity of physical activity and type of physical activity in pregnant women with preterm birth.&#x0D; Keywords: intensity of physical activity, KPAS, physical activity, preterm labor&#x0D; &#x0D; Abstrak&#x0D; Tujuan: Mengetahui hubungan antara intensitas aktivitas fisik perempuan hamil dengan persalinan prematur dan mengetahui hubungan antara jenis aktivitas fisik perempuan hamil dengan persalinan prematur.&#x0D; Metode: Penelitian ini merupakan penelitian kasus kontrol yang dilakukan di RS Cipto Magunkusumo dan RS Karawang pada bulan Januari 2017 hingga Juni 2017 dengan kuesioner KPAS yang dikelompokkan menjadi dua, yaitu persalinan prematur dan persalinan cukup bulan. Jumlah sampel adalah 127 subjek untuk masing-masing kelompok. Analisis dilakukan dengan analisis multivariat konsep etiologik.&#x0D; Hasil: Pada persalinan cukup bulan, secara berurutan intensitas aktivitas fisik yang paling banyak dilakukan, antara lain : intensitas sedang (64.6%, n= 82), intensitas ringan (22 %, n = 28), dan intensitas berat (13.4 %, n = 17). Pada persalinan prematur, secara berurutan intensitas aktivitas fisik yang paling banyak dilakukan, antara lain : intensitas ringan (40.1 %, n = 51), intensitas berat (33.9 %, n = 43), dan intensitas sedang (26 %, n = 33). Hubungan antara intensitas aktivitas fisik ringan dibandingkan intensitas sedang untuk persalinan prematur memiliki OR 5.32 (IK 95% 2.80-10.13;P = &lt; 0.001). Sedangkan hubungan antara intensitas aktivitas fisik berat dibandingkan intensitas sedang untuk persalinan prematur memiliki OR 6.29 (IK 95% 3.28- 13.46;p = &lt; 0.001). Pekerjaan dan olahraga memiliki hubungan bermakna dengan persalinan prematur dengan OR 3.19 (IK 95% 1,62 – 6.28;p = 0.001) dan OR 1.85 (IK 95% 1.11 – 3.09;p= 0.017). Kondisi pekerjaan juga berhubungan dengan persalinan prematur, antara lain : angkat berat (OR 5.16; IK 95% 1.10-24.08; p = 0.021), berjalan (OR 3.57;IK 95% 1.61-7.92;p = 0.001), duduk (OR 2.79;IK 95% 1.23-6.31; p = 0.011 ), dan berdiri (OR 3.04 ;IK 95% 1.40-6.59;p = 0.003).

Bariatric Surgery Does Not Appear to Affect Women's Breast-Milk Composition

The breast-milk composition in the first 6 wk postpartum of women who have undergone bariatric surgery (BS) is unknown. The aim of this study was to examine 1) the breast-milk macronutrient and vitamin A composition in women who had and who had not undergone BS and 2) the impact of maternal diet on the breast-milk composition. We hypothesized that the milk of women who had undergone BS would be less energy dense and have a lower vitamin A concentration than that of other women. A multicenter prospective substudy was conducted at 2 university hospitals. Breast-milk samples were collected from 24 normal-weight [NW; mean ± SD body mass index (BMI; kg/m2): 21.5±1.7; mean ± SD age: 29±6 y], 39 overweight (OW; BMI: 26.9±1.5; aged 29±5 y), and 12 obese women (BMI: 35.0±5.7; aged 29±5 y) as well as from 11 women who had undergone BS (BMI: 28.0±4.4; aged 30±4 y) from day 3 until week 6 of lactation. Milk energy and macronutrients (Human Milk Analyzer; Miris) and vitamin A concentrations (iCheck Fluoro; BioAnalyt) were determined at the end of each week. Maternal diet (food-frequency questionnaire) and physical activity (Kaiser Physical Activity Survey) were measured during the third trimester of pregnancy and on day 3 or 4 and during week 6 of lactation. Statistical analyses include 1-factor ANOVA, Spearman and Pearson correlations, and multiple linear regression. In all women, a weekly increase in milk energy, total fat, and total carbohydrates was seen, whereas a weekly decrease in proteins and vitamin A was found during the first 2 wk of lactation, followed by a stable concentration of all nutrients. At week 4, milk protein concentrations were higher in women who had undergone BS (14 g/L) compared with NW (8 g/L; P=0.005) and OW (9 g/L; P=0.019) women. At week 5, milk carbohydrate concentrations were higher in women who had undergone BS (74 g/L) compared with NW women (68 g/L; P=0.042). Breast milk of women who have undergone BS appears to be adequate in energy, macronutrients, and vitamin A during the first 6 wk of lactation. This supports the conclusion that breast feeding should not be discouraged in this group of women. This trial was registered at http://www.clinicaltrials.gov as NCT02515214.

Improving menopausal symptoms through promoting physical activity: a pilot Web-based intervention study among Asian Americans.

Based on previous studies, a Web-based physical activity promotion program with educational modules on menopausal symptoms and physical activity has been developed for Asian American midlife women to reduce their menopausal symptoms through increasing their physical activity. The purpose of this pilot randomized intervention study was to determine the efficacy of the Web-based program in improving menopausal symptom experience of Asian American midlife women. This was a randomized repeated measures pretest/posttest (pretest, post 1 month, and post 3 months) control group study among 29 Asian American midlife women. Multiple instruments were used, including the Midlife Women's Symptom Index and the Kaiser Physical Activity Survey. The data were analyzed using a mixed-model growth curve analysis. Over time, total severity scores decreased for the control group (-0.53, P < 0.10), whereas they did not exhibit a meaningful change for the intervention group. Both study groups experienced improvement in active living habits over time, but such an improvement was greater for the intervention group (β = 0.29, P < 0.001) than for the control group (β = 0.08, P < 0.10). The time × group interactions for total severity scores were not statistically significant anymore after controlling for physical activity (-0.34 for the control group, P = 0.10). The findings supported the feasibility of a 3-month Web-based intervention for menopausal symptom management among Asian American midlife women and the preliminary efficacy of the program in increasing their physical activity.

Clusters of midlife women by physical activity and their racial/ethnic differences.

The purpose of this study was to identify clusters of midlife women by physical activity and to determine racial/ethnic differences in physical activities in each cluster. This was a secondary analysis of the data from 542 women (157 non-Hispanic [NH] Whites, 127 Hispanics, 135 NH African Americans, and 123 NH Asian) in a larger Internet study on midlife women's attitudes toward physical activity. The instruments included the Barriers to Health Activities Scale, the Physical Activity Assessment Inventory, the Questions on Attitudes toward Physical Activity, Subjective Norm, Perceived Behavioral Control, and Behavioral Intention, and the Kaiser Physical Activity Survey. The data were analyzed using hierarchical cluster analyses, analysis of variance, and multinominal logistic analyses. A three-cluster solution was adopted: cluster 1 (high active living and sports/exercise activity group; 48%), cluster 2 (high household/caregiving and occupational activity group; 27%), and cluster 3 (low active living and sports/exercise activity group; 26%). There were significant racial/ethnic differences in occupational activities of clusters 1 and 3 (all P < 0.01). Compared with cluster 1, cluster 2 tended to have lower family income, less access to health care, higher unemployment, higher perceived barriers scores, and lower social influences scores (all P < 0.01). Compared with cluster 1, cluster 3 tended to have greater obesity, less access to health care, higher perceived barriers scores, more negative attitudes toward physical activity, and lower self-efficacy scores (all P < 0.01). Midlife women's unique patterns of physical activity and their associated factors need to be considered in future intervention development.

MEASURING PHYSICAL ACTIVITY IN PREGNANCY USING QUESTIONNAIRES: A META-ANALYSIS

Physical activity (PA) during normal pregnancy has various positive effects on pregnant women’s health. Determination of the relationship between PA and health outcomes requires accurate measurement of PA in pregnant women. The purpose of this review is to provide a summary of valid and reliable PA questionnaires for pregnant women. During 2013, Pubmed, OvidSP and Web of Science databases were searched for trials on measurement properties of PA questionnaires for pregnant population. Six studies and four questionnaires met the inclusion criteria: Pregnancy Physical Activity Questionnaire, Modified Kaiser Physical Activity Survey, Short Pregnancy Leisure Time Physical Activity Questionnaire and Third Pregnancy Infection and Nutrition Study Physical Activity Questionnaire. Assessment of validity and reliability was performed using correlations of the scores in these questionnaires with objective measures and subjective measures (self-report) of PA, as well as test-retest reliability coefficients. Sample sizes included in analysis varied from 45 to 177 subjects. The best validity and reliability characteristics (together with effect sizes) were identified for the Modified Kaiser Physical Activity Survey and Pregnancy Physical Activity Questionnaire (French, Vietnamese, standard). In conclusion, assessment of PA during pregnancy remains a challenging and complex task. Questionnaires are a simple and effective, yet limited tool for assessing PA.

Relationship between Type-D personality, physical activity behaviour and climacteric symptoms.

BackgroundA number of factors have been identified which might influence the variation observed in climacteric symptoms in peri- and post-menopausal women. We examined the role of the distressed or Type-D personality and mode of physical activity or exercise on the climacteric symptoms experienced by peri- or post-menopausal women.Methods213 Women (M age 52.2 years, SD = 5.9), 58% classified as peri- and 42% as post-menopausal completed a questionnaire pack consisting of demographic questions, the DS14 (Type-D personality), Kaiser Physical Activity Survey (assessing household care giving, occupational, active living and sport and exercise index) and the Greene Climacteric Scale (Psychological, somatic/physical, vasomotor and sexual symptoms).ResultsType-D personality and increased levels of household care-giving physical activity were both associated with increased bothersomness for all four climacteric factors. Increased levels of sport and exercise participation on the other hand resulted in less psychological, somatic/physical and sexual functioning problems whereas the active living index was inversely related to somatic/physical climacteric symptoms. Finally, lower income was associated with more psychological and somatic/physical symptoms and being peri-menopausal resulted in more vasomotor symptoms.ConclusionsThe results suggest that mode of physical activity is an important moderator in alleviating climacteric symptoms. In addition, our results support previous findings in that Type-D personality is associated with negative health outcomes. In particular menopausal women with Type-D personality would benefit from interventions (coping, mindfulness training) and regular sport and exercise participation to reduce climacteric symptomology.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-015-0176-3) contains supplementary material, which is available to authorized users.

Physical activity and depressive symptoms in four ethnic groups of midlife women.

The purpose of this study was to determine the associations between physical activity and depression and the multiple contextual factors influencing these associations in four major ethnic groups of midlife women in the United States. This was a secondary analysis of the data from 542 midlife women. The instruments included questions on background characteristics and health and menopausal status; the Depression Index for Midlife Women (DIMW); and the Kaiser Physical Activity Survey (KPAS). The data were analyzed using chi-square tests, the ANOVA, two-way ANOVA, correlation analyses, and hierarchical multiple regression analyses. The women's depressive symptoms were negatively correlated with active living and sports/exercise physical activities whereas they were positively correlated with occupational physical activities (p < .01). Family income was the strongest predictor of their depressive symptoms. Increasing physical activity may improve midlife women's depressive symptoms, but the types of physical activity and multiple contextual factors need to be considered in intervention development.

Perceived Correlates of Domain‐Specific Physical Activity in Rural Adults in the Midwest

In response to calls for more specificity when measuring physical activity, this study examined perceived correlates of this behavior in rural adults separately by the domain in which this behavior occurs (ie, home care, work, active living, and sport). A cross-sectional survey was completed by 407 adults from 2 rural towns in the Midwest. The questionnaire assessed the perceived social and physical environment, including neighborhood characteristics, as well as barriers to being active. The Kaiser Physical Activity Survey captured domain-specific activity levels. The response rate was 25%. Multiple regression analyses were conducted to examine the associations between social and physical environment factors and domain-specific physical activity. Having a favorable attitude toward using government funds for exercise and activity-friendly neighborhood characteristic were positively associated with active living. Friends encouraging exercise was positively associated with participation in sport. Barriers were inversely associated with active living and sport. Total physical activity was positively associated with workplace incentives for exercise, favorable policy attitudes toward supporting physical education in schools and supporting the use of government funds for biking trails, and it was inversely associated with barriers. There were no factors associated with physical activity in the domains of work or home care. Correlates of physical activity are unique to the domain in which this behavior occurs. Programs to increase physical activity in rural adults should target policy attitudes, neighborhood characteristics, and social support from friends while also working to decrease personal barriers to exercise.

The Association Between Physical Activity and Maternal and Neonatal Outcomes: A Prospective Cohort

Some evidence, but not enough to be conclusive, suggests that physical activity in pregnancy reduces the risk of perinatal complications. Our objective was to examine if physical activity in the year before pregnancy and in the first half of pregnancy is associated with maternal and neonatal outcomes. Associations between physical activity and maternal and neonatal outcomes were examined in a prospective cohort (n = 1,749) in Halifax, Canada. The Kaiser Physical Activity Survey, completed at approximately 20 weeks' gestation, requested information regarding physical activity during the year before the pregnancy and the first 20 weeks of pregnancy. Outcomes were assessed by medical chart review. Multiple logistic regression was used to estimate odds ratios (OR) with 95 % confidence intervals (CI). Women with prepregnancy physical activity levels in the middle and highest tertiles were more likely to have high gestational weight gain relative to women in the lowest tertile [OR (CI): 1.40 (1.06-1.85) and 1.57 (1.18-2.09), respectively]. Higher physical activity in the first half of pregnancy decreased the odds of delivering a macrosomic infant (p trend = 0.005). Associations were not observed between total physical activity and gestational diabetes, gestational hypertension, pre-eclampsia, preterm birth, and low birth weight. Physical activity before, but not in the first half of pregnancy, is associated with high gestational weight gain. Physical activity in the first half of pregnancy may reduce the occurrence of macrosomia without affecting preterm birth or low birth weight.

Consistently High Sports/Exercise Activity Is Associated with Better Sleep Quality, Continuity and Depth in Midlife Women: The SWAN Sleep Study

To examine relationships between different physical activity (PA) domains and sleep, and the influence of consistent PA on sleep, in midlife women. Cross-sectional. Community-based. 339 women in the Study of Women's Health Across the Nation Sleep Study (52.1 ± 2.1 y). None. Sleep was examined using questionnaires, diaries and in-home polysomnography (PSG). PA was assessed in three domains (Active Living, Household/Caregiving, Sports/Exercise) using the Kaiser Physical Activity Survey (KPAS) up to 4 times over 6 years preceding the sleep assessments. The association between recent PA and sleep was evaluated using KPAS scores immediately preceding the sleep assessments. The association between the historical PA pattern and sleep was examined by categorizing PA in each KPAS domain according to its pattern over the 6 years preceding sleep assessments (consistently low, inconsistent/consistently moderate, or consistently high). Greater recent Sports/Exercise activity was associated with better sleep quality (diary "restedness" [P < 0.01]), greater sleep continuity (diary sleep efficiency [SE; P = 0.02]) and depth (higher NREM delta electroencephalographic [EEG] power [P = 0.04], lower NREM beta EEG power [P < 0.05]), and lower odds of insomnia diagnosis (P < 0.05). Consistently high Sports/Exercise activity was also associated with better Pittsburgh Sleep Quality Index scores (P = 0.02) and higher PSG-assessed SE (P < 0.01). Few associations between sleep and Active Living or Household/Caregiving activity (either recent or historical pattern) were noted. Consistently high levels of recreational physical activity, but not lifestyle- or household-related activity, are associated with better sleep in midlife women. Increasing recreational physical activity early in midlife may protect against sleep disturbance in this population.