Leisure-Time Exercise Questionnaire Research Articles

Physical Activity and Health-related Quality of Life from Diagnosis to One Year After Radical Cystectomy in Patients with Bladder Cancer: A Longitudinal Cohort Study.

Emerging evidence shows a positive impact of physical activity (PA) on health-related quality of life (HRQoL) in cancer patients. However, longitudinal evidence on PA and HRQoL in patients with bladder cancer (BC) undergoing radical cystectomy (RC) is lacking. To investigate PA levels, HRQoL outcomes and their relationship from diagnosis to one year after RC in BC patients. A longitudinal cohort study in 90 BC patients was conducted at Ghent and Leuven University Hospitals between April 2017 and December 2020. The Godin Leisure-Time Exercise Questionnaire (GLTEQ) and the EORTC QLQ-C30 and BLM30 were used to measure PA and HRQoL, respectively, before RC, one, three, six and twelve months after RC. Linear mixed models were used for statistical analyses. The majority was physically inactive before RC (58%), at month one (79%), three (53%), six (61%) and twelve (64%). Among (moderately) active patients, light-intensity activities (mainly walking) were important contributors to the total amount of PA. Clinically important and low HRQoL outcomes in different domains were identified with lowest scores at diagnosis and one month after RC. Active patients before RC have better physical functioning (mean difference (MD) -22.7, standard error (SE) 8.7, p = 0.011), global health status (MD -15.9, SE 6.9, p = 0.023) and fatigue (MD 19.9, SE 9.5, p = 0.038) one month after RC, compared to inactive patients. Active patients at month have better physical functioning (MD -16.2, SE 6.9, p = 0.023) and sexual functioning (MD -16.8, SE 5.4, p = 0.003; MD -13.5, SE 5.5, p = 0.017) at month six and twelve, respectively, compared to inactive patients. Higher PA levels are associated with better HRQoL outcomes for BC patients undergoing RC. The data suggests that PA interventions could be an asset to improve BC patients' HRQoL, but should be tested in future trials.

A Survey-Based Study on Physical Activity Promotion for Individuals with a Current or Past Diagnosis of Cancer in Canada

To determine the prevalence and content of discussions regarding physical activity (PA) promotion between individuals with a current or past diagnosis of cancer and their oncology care team. Design and Procedure: A cross-sectional survey on PA discussion between individuals with a current or past diagnosis of cancer and their oncology care team was conducted at a single timepoint. Eligible participants were adults with a current or past diagnosis of cancer at any time point in their cancer treatment who had a pre-scheduled appointment with their oncology care team. A total of 100 participants completed the survey. PA-related discussions happened in 41% of the patient-provider interactions and 66% of respondents reported PA discussions at some point during care. No significant association occurred between cancer type, stage, or treatment status and PA discussions at any timepoint (all p's > 0.05). Most respondents were satisfied with the education provided on PA (54%); however, only 37% were sufficiently active. Those receiving education from their medical oncologist were more likely to be 'sufficiently active' (p = 0.020) according to the Godin Leisure Time Exercise Questionnaire. Most respondents discuss PA with an oncology care provider at some point during their cancer treatment; however, few are sufficiently active. Future research is needed to determine strategies to facilitate PA promotion and close the gap between discussions and actual physical activity behavior.

Knowledge to Practice in Oncology Rehabilitation: A Survey Evaluating Physical Activity Promotion for Cancer Survivors

<h3>Research Objectives</h3> To determine the prevalence and content of discussions regarding physical activity (PA) promotion between cancer survivors and their oncology care team at a cancer treatment institution in Canada. <h3>Design</h3> A cross-sectional survey was used to gather data on PA discussions between cancer survivors and their oncology care team. <h3>Setting</h3> Participants were recruited from the Juravinski Cancer Centre (JCC) in Hamilton, Ontario. The JCC is an outpatient facility administering cancer treatments including chemotherapy and radiation. <h3>Participants</h3> One hundred participants completed a survey following a regularly scheduled appointment. Eligible participants were adult cancer survivors (any stage and type) at any time point in their cancer treatment. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> The survey included thirteen questions regarding PA-related content discussed, satisfaction with PA education, and an assessment of PA level (using the Godin Leisure-Time Exercise Questionnaire). <h3>Results</h3> Most respondents were females (76%) diagnosed with breast cancer (61%). Overall, 66% of respondents had PA-related discussions with their care team at one point during care. Most (54%) said they were satisfied with the PA education provided during treatment. However, only 37% of respondents were considered ‘sufficiently active' based on the Godin Leisure Time Exercise Questionnaire. Of respondents who discussed PA, those receiving education from a medical oncologist were significantly more likely to be ‘sufficiently active' compared to those who received it from a different type of provider (p=0.02). <h3>Conclusions</h3> Most cancer survivors had discussions around PA with an oncology care provider at some point during their cancer treatment and were satisfied with the PA education provided. Further research is needed to determine optimal strategies for facilitating PA promotion and to close the gap between PA discussions and actual cancer survivor behaviour. <h3>Author(s) Disclosures</h3> The authors declare no conflicts. This project was supported by the Canadian Cancer Society and the Juravinski Hospital and Cancer Centre Foundation-BRIGHT Run Fund (grant #: T210).

Scale Up Project Evaluating Responsiveness to Home Exercise And Lifestyle Tele-Health (SUPER-HEALTH): Preliminary Findings

<h3>Research Objectives</h3> To evaluate the effectiveness of a home-based movement-to-music (M2M) exercise program for increasing physical activity among adults with mobility disabilities. <h3>Design</h3> Preliminary analysis of data from an RCT. <h3>Setting</h3> All outcome measures and delivery of the interventions were entirely performed online. <h3>Participants</h3> 200 participants (mean age of 52±12) completed (1) the 24-week intervention and (2) the baseline and 24-week physical activity recall questionnaire. The participants predominantly consisted of women (80%) and Caucasians (60%). The participants presented various types of disability (e.g., multiple sclerosis, arthritis, spinal cord injury) and a wide range of mobility limitations. <h3>Interventions</h3> The 48-week study consisted of a 24-week M2M program (48 to 150 minutes/week for 3x/week) and a 12-week follow-up period. The M2M program was designed to improve fitness and function. A series of movements with music targeted specific training components (flexibility, muscle strength, cardiorespiratory fitness, balance). Three levels of functional variations were provided for standing, seated, and hemiparesis. Participants received a tablet that contains a customized study app. The app released a set of pre-recorded exercise videos each week. <h3>Main Outcome Measures</h3> Physical activity was measured using the health contribution score of the Godin Leisure-Time Exercise Questionnaire (a sum of the weighted moderate and vigorous physical activity scores). <h3>Results</h3> The effect of the M2M intervention on physical activity post-trial was determined using analysis of covariance with condition (group: intervention or control) as the between-subject factor, and corresponding pre-trial outcome scores were the covariate. There was a significant effect of the intervention on physical activity outcome (intervention: 18.15±19.71, n=127; control: 12.29±14.81, n=73; p=0.014). <h3>Conclusions</h3> Our results provide preliminary evidence that the M2M intervention might improve physical activity (moderate-to-vigorous intensity) in people with mobility disabilities. Such findings are important considering that physical activity is a modifiable behavior with the potential long-term benefits for the prevention and management of secondary health conditions and comorbidities among those with mobility disabilities. <h3>Author(s) Disclosures</h3> The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this abstract.

Characterizing fluid intake and physical activity in university students within the United States during the COVID-19 pandemic.

This study determined fluid intake and physical activity behaviors among college students during the COVID-19 pandemic. College students (n = 1014; females, 75.6%) completed an online survey during the Spring 2020 academic semester following the initial global response to the COVID-19 pandemic. Academic standing, habitation situation, and University/College responses to COVID-19 were collected. Participants completed the Godin Leisure-Time Exercise Questionnaire and a 15-item Beverage Questionnaire (BEVQ-15) to determine physical activity level and fluid intake behaviors, respectively. Females (1920 ± 960mL) consumed significantly less fluid than males (2400 ± 1270mL, p < 0.001). Living off-campus (p < 0.01) and living with a spouse/partner (p < 0.01) was associated with increased consumption of alcoholic beverages. 88.7% of participants reported being at least moderately active; however, Black/African American and Asian participants were more likely to be less active than their Caucasian/White counterparts (p < 0.05). Participants reporting no change in habitation in response to COVID-19 had a higher fluid intake (p = 0.002); however, the plain water consumption remained consistent (p = 0.116). While there was no effect of habitation or suspension of classes on physical activity levels (p > 0.05), greater self-reported physical activity was associated with greater fluid intake (std. β = 0.091, p = 0.003). Fluid intake among college students during the initial response to the COVID-19 pandemic approximated current daily fluid intake recommendations. Associations between COVID-19-related disruptions (i.e., suspension of classes and changes in habitation) and increased alcohol intake are concerning and may suggest the need for the development of targeted strategies and programming to attenuate the execution of negative health-related behaviors in college students.

Factors associated with meeting physical activity guidelines during the COVID-19 pandemic

IntroductionThe COVID-19 pandemic impacted individual physical activity levels. Less is known regarding how factors such as sociodemographic and built environment were associated with physical activity engagement during the pandemic. Understanding these factors is critical to informing future infectious disease mitigation policies that promote, rather than hinder physical activity. The purpose of this study was to assess predictors of physical activity levels during the beginning of the pandemic (April-June 2020), including Stay-at-Home length and orders, neighborhood safety, and sociodemographic characteristics.MethodsData included 517 participants who responded to an anonymous online survey. Physical activity was assessed with a modified Godin Leisure-time exercise questionnaire. We used logistic regression models to estimate unadjusted and adjusted odds ratios (aOR) and their 95% confidence intervals (CI) for the associations between independent variables (e.g., demographic variables, neighborhood safety, COVID Stay-at-Home order and length of time) and physical activity levels that did not meet (i.e., < 600 metabolic equivalents of task [MET]-minutes/week) or met guidelines (i.e., ≥ 600 MET-minutes/week). We used R-Studio open-source edition to clean and code data and SAS V9.4 for analyses. ResultsMost participants were 18–45 years old (58%), female (79%), Hispanic (58%), and college/post-graduates (76%). Most (70%) reported meeting physical activity guidelines. In multivariate-adjusted analyses stratified by income, in the highest income bracket (≥ $70,000) pet ownership was associated with higher odds of meeting physical activity guidelines (aOR = 2.37, 95% CI: 1.23, 4.55), but this association did not persist for other income groups. We also found lower perceived neighborhood safety was associated with significantly lower odds of meeting physical activity guidelines (aOR = 0.15, 95% CI:0.04–0.61), but only among individuals in the lowest income bracket (< $40,000). Within this lowest income bracket, we also found that a lower level of education was associated with reduced odds of meeting physical activity guidelines.DiscussionWe found that perceived neighborhood safety, education and pet ownership were associated with meeting physical activity guidelines during the early months of the COVID-19 pandemic, but associations differed by income. These findings can inform targeted approaches to promoting physical activity during subsequent waves of COVID-19 or future pandemics.

Prevalence of fatigue and its explicative variables among people with multiple sclerosis.

Fatigue is the most prevalent symptom among people with multiple sclerosis (PwMS). Although exercise effectively reduces fatigue, the relationship between daily physical activity and fatigue has only recently been demonstrated. The aim of this study was to evaluate the prevalence of fatigue and to understand the relationship with several variables in French PwMS. Data were collected from 191 PwMS using Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) for fatigue, and the Godin Leisure-Time Exercise Questionnaire (GLTEQ) for physical activity. 110 PwMS (57%), 35 PwMS (18%) and 46 PwMS (24%) were considered as fatigued, non-fatigued and in the grey zone, respectively. Greater physical activity was observed in non-fatigued PwMS (20.2±19.8) compared to fatigued PwMS (12.5±14.1). FSS and MFIS scores were associated with physical activity (r = -0.28 and r = -0.25, respectively, p < 0.05). Using multivariate analysis, disability, physical activity and being unemployed explained 21% of the variance of the MFIS. The present study confirms that physical activity and fatigue are associated. Disability and unemployment status should also to be consider when assessing fatigue. Activity-oriented health policies should be redesigned to improve fatigue among PwMS.

Objective and subjective measures of daily physical activity in persons with Multiple Sclerosis beginning a rehabilitation regime: A cross-sectional study

IntroductionFatigue, and balance and gait disorders can impact on physical activity (PA) levels in persons with Multiple Sclerosis (pwMS). To date, several studies have examined PA in pwMS during daily life, but little is known about PA levels in pwMS during a rehabilitation period. The present study investigated PA levels (daily steps, light physical activity (LPA), and moderate-vigorous physical activity (MVPA)) in inpatient and outpatients with MS during their rehabilitation period and described the relationship between objectively measured PA and levels of disability, quality of life, fatigue, and self-efficacy. MethodsIn this exploratory cross-sectional study, we examined 40 pwMS during their inpatient or outpatient rehabilitation regime. Participants included in the study (N = 34) wore a Fitbit Versa tracker for one week recording daily steps, minutes of LPA, and minutes of MVPA (primary outcomes). They underwent a clinical assessment of physical activity levels (Godin Leisure-Time Exercise Questionnaire(GLTEQ)), fatigue (Fatigue Severity Scale(FSS)), walking ability (10 Meter Walk Test(10MWT), 2-Min Walk Test(2MWT), 12-item Multiple Sclerosis Walking scale(MSWS-12)), quality of life (12-Item Short Form Survey (SF-12)), and self-efficacy (Self-Efficacy in Multiple Sclerosis scale (SEMS)) (secondary outcomes).Multiple linear regressions (MLR) models were used to test whether the demographic difference between the two groups influenced the estimation of objective variables measured by Fitbit. Finally, correlations between objectively measured physical activity and subjective clinical scales were estimated with Spearman correlations. ResultsOur sample consisted of 21 females and 13 males with a mean (interquartile range) age of 52 (20) years and an Expanded Disability Status scale(EDSS) score of 6.0 (1.50) points; baseline characteristics of inpatients (N = 18) and outpatients (N = 16) differed statistically only in EDSS levels (p-value = 0.008) and use of assistive devices (p=0.007). The whole sample performed (mean±standard deviation) 3969±2190 steps per day, with no significant difference between inpatients (3318±1515) and outpatients (4660±2606). No statistical difference was found between the groups in LPA (p-value=0.064). A significant difference in MVPA (p-value < 0.001) was found between inpatients and outpatients, 1.52±3.98 and 14.69±11.56 min per day, respectively. Significant correlations were found between FSS and MVPA both in the whole sample (r(32)= -0.62, p < 0.001) and in the outpatients group (r(14) = -0.66, p = 0.005), and between 10MWT and daily steps (whole sample:(r(32) = 0.48, p = 0.005), outpatients:(r(14)= -0.51, p = 0.05)). ConclusionsPwMS in our study overall engaged in reduced and less intense levels of daily PA with respect to the guidelines with inpatients performing almost no vigorous activities. Considering the importance of PA in improving physical and mental well-being, clinicians and researchers should develope strategies to increase daily PA of PwMS during their rehabilitation programs and daily life.

LBSUN307 A Randomized Controlled Pilot Study Of The Food Order Behavioral Intervention In Prediabetes

Abstract Background and Objectives Ordering the ingestion of carbohydrate-rich foods after protein/vegetables (carbohydrate-last food order) significantly reduced postprandial glucose and insulin excursions over 180 min in patients with prediabetes and type 2 diabetes, compared with the reverse food order (carbohydrate-first) in previous research. We implemented a 16-week food order behavioral intervention, assessing its feasibility and impacts on glucose tolerance (GT), HbA1c, and weight (wt) in adults with prediabetes. Methods Participants with overweight/obesity and prediabetes (HbA1c 5.7-6.4%) were randomized to receive either standard nutritional counseling (control group) or standard nutritional counseling plus carbohydrate-last food order counseling (FO group). Participants were instructed to maintain their usual level of exercise throughout the study; this was assessed by the Godin Leisure-Time Exercise questionnaire at baseline and wk 16. Participants in both groups received 4 in-person brief counseling sessions at 1-month intervals. Due to the Covid-19 pandemic, later participants received some or all of their counseling via telemedicine. Oral GT was tested at baseline and week 16. Feasibility was assessed via a questionnaire. Results Of the 45 randomized subjects, 39 completed the study (control 21, FO 18). Demographics and baseline variables including wt (190.8 lbs vs 191.1 lbs) and HbA1c (6% vs 6%) were similar between groups. Exercise levels did not differ between groups at baseline and wk 16. Within FO group, body wt declined (-3.6 ±5.7 lbs, p=0. 017; -1.8% ±2.8, p=0. 012), and there was a trend towards improvement in HbA1c (-0.1 ±0.2, p=0. 054). Control group wt changed (-2.6 ±6.8 lbs, p=0.102; -1.6% ±3.5, p=0. 048) without altering HbA1c (-0. 03 ±0.3, p=0.605). Changes in wt, HbA1c, and GT were not significantly different between groups. At week 16, 17 FO group subjects (94%) reported high intervention adherence, 13 (74%) reported it was easy to eat protein/vegetables before carbohydrates, and 14 (78%) reported they would continue eating protein/vegetables before carbohydrates. Conclusions Carbohydrate-last food order is a feasible behavioral strategy in individuals with prediabetes. More research with a larger sample size and longer duration is needed to delineate its clinical impact. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Physical Activity and Quality of Life among Patients with Cystic Fibrosis.

Physical activity (PA) improves exercise capacity, slows the decline in lung function, and enhances Quality of Life (QoL) in patients with cystic fibrosis (pwCF). The study aimed to evaluate PA and QoL among children with CF compared to healthy controls; the secondary aim was to assess the correlation between PA, QoL, and lung function (FEV1). Forty-five children and adolescents with CF and 45 age-matched controls completed two self-administered validated questionnaires: The Godin Leisure-Time Exercise Questionnaire (GLTEQ) and the DISABKIDS for QoL. Moreover, pwCF performed spirometry and multiple breath washout tests (MBW). In addition, weight, height, and BMI were recorded. The Godin Leisure-Time Exercise Questionnaire was used to evaluate physical activity; QOL was assessed using the DISABKIDS Questionnaire. The correlation of PA with QOL was assessed as well. Mean age of the CF population was 13.22 (±4.6) years, mean BMI 19.58 (±4.1) kg/m2, mean FEV1% 91.15 ± 20.46%, and mean LCI 10.68 ± 4.08. 68% of the CF group were active, 27% were medium active, 5% were sedentary, while 83% of the control group were active and 17% were medium active. PwCF with higher PA scores showed significantly higher emotional health (r2: 0.414, p: 0.006) and total QOL score (r2: 0.372; p: 0.014). The PA score showed no significant correlation with FEV1% or LCI. The children with CF showed satisfactory PA levels, which positively correlated to their QoL. More research is needed on the effect of increased levels of habitual physical activity to establish the decline in pulmonary function among pwCF.

Resistance strategy to ageism-based frailty in Italian older women in the COVID-19 pandemic.

The objective of the present study was to examine the relationship between resistance to ageism-based frailty (A-BF) and physical activity (PA) and sport in a cohort of women, aged 65 and older, living in Central Italy. The study was conducted in the spring of 2021 when rigorous COVID-19 containment measures were in force across Italy. A quanti-qualitative investigation was carried out in the cohort. A questionnaire to evaluate older women's engagement in (PA) and sport was administered and subsequently semi-structured phone interviews with those subjects who were found to be physically active were conducted to evaluate their forms of resistance to the crisis. A total number of 88 subjects responded and participated in the survey. Two tools were used to determine the study outcomes in the quantitative investigation. An altered version of Godin and Shephard's Leisure-Time Exercise Questionnaire (GSLTPAQ) was used to evaluate the engagement of women in PA and sport. Moreover, subjects' motivation to exercise was evaluated when they completed the survey using the Behavioral Regulation in Exercise Questionnaire (BREQ-2), a tool that assesses exercise regulation according to the Self-Determination Theory (SDT) framework. The active women resulting from the quantitative investigation were then interviewed in the qualitative investigation, using an interview grid. In the quantitative investigation it was found that PA is correlated with autonomy. Identified and intrinsic regulations prevail in women who are engaged in medium or high PA, vice-versa external regulation, introjected regulation and amotivation prevail in women who are engaged in insufficient PA or who are sedentary. In the qualitative investigation it was found that the participants experienced ambivalence, conflicts and crises at multiple levels (individual, interpersonal and institutional), generating contrasting feelings, which they faced by developing an active, peaceful and silent form of resistance by caring for their bodies and minds engaging in PA and sport.

Physical activity and quality of life in children with well-controlled asthma

Background Asthma is the most common disease in childhood. Appropriate management and programs encouraging exercise enable children to enjoy a good quality of life (QoL). Objective To assess the association between lung function, physical activity (PA), and QoL in children with well-controlled asthma. Methods Fifty-four children aged 7–14 years attending a Pediatric Asthma Clinic were included. All children underwent spirometry and completed three self-administered validated questionnaires: The Godin Leisure-Time Exercise Questionnaire (GLTEQ), the ACT (Asthma Control Test), and the DISABKIDS for QoL. Results Mean age of the study population was 11.43(±2.1), BMI, kg/m2 (20.8 ± 3.9), FVCpp (97.1% ±12.4), and FEV1pp (99.7% ±12.43), ACT (23.4 ± 3). The GLTEQ revealed that only 3% of the studied population presented satisfactory activity, while 86% were sedentary. Both FEV1pp, and PA were significantly correlated to the children’s QoL ((r2: 0.55, p:0.0001), and (r2:0.45, p:0.003), respectively). Conclusions Despite reasonable asthma control, the children exhibited low physical activity levels, which negatively correlated to their QoL. Families of asthmatic children should be educated to highlight the benefits of exercise and increase the PA of their children.

Independent Exercise During A Supervised Exercise Intervention For Cancer Survivors

Purpose: Exercising independently (i.e., unsupervised outside of, or in addition to supervised exercise sessions) during a physical activity (PA) intervention can help participants achieve recommended levels of PA and encourage PA maintenance. This study described the amount, type, and context of independent exercise during a PA intervention for cancer survivors. Methods: The intervention consisted of videoconference-delivered group-based exercise 1x/week for 8-weeks, and three PA behavior change discussion sessions. Recordings of exercise sessions were provided to participants via a private YouTube channel. Each week, participants reported frequency and duration of independent aerobic and resistance exercise using a modified version of the Godin Leisure-Time Exercise questionnaire. In addition, type of exercise, where and with whom they exercised was reported. Means, standard deviations, and frequencies were calculated. Results: Participants (N = 39) were M = 59.9 ± 10.2 years old, 97.4% female and diagnosed with ovarian (56.4%), breast (30.8%), colorectal (7.7%), or other (5.1%) cancer. The majority of participants reported doing independent aerobic (83.5%) and resistance (70.5%) exercise outside of supervised sessions [M = 196.7 ± 182.9 mins/week of aerobic (range = 168-227), and M = 48.8 ± 63.4 mins/week of resistance (range = 34-60)]. Location included home (81.2%), neighborhood (47.5%), and outdoor recreation site (47.2%). Types of exercise were brisk walking (77.0%), weightlifting (55.0%), and body weight exercise (31.6%). Participants reported exercising with their spouse/partner (44.4%), friends (26.6%), and family members (17.4%). Most (74.3%) found the YouTube channel to be very or extremely helpful, and reported exercising with the videos a median of 2x/week (range = 0-7). Conclusion: Cancer survivors reported doing enough aerobic and resistance exercise outside of supervised sessions to achieve or exceed PA recommendations during the intervention. Most exercise was done at home or in the neighborhood, with a spouse, friend, or family member, and often utilizing the recorded intervention exercise sessions. Future studies will examine determinants of independent exercise during an intervention, and whether exercise habits continue after the intervention ends.

Characterizing Relationships Between Cognitive, Mental, and Physical Health and Physical Activity Levels in Persons With Multiple Sclerosis.

Although persons with multiple sclerosis (MS) are encouraged to engage in physical activity, they are less active than the general population and experience poorer emotional/cognitive health, underscoring the need for increased understanding of the factors independently associated with exercise in MS. Six hundred forty people with MS completed a detailed demographic survey, the Godin Leisure-Time Exercise Questionnaire, and Quality of Life in Neurological Disorders short forms. The average number of weekly sessions of exercise was examined as a count, as a binary variable (a weekly minimum of 4 sessions of physical activity), and as an ordinal variable of being active using multivariable zero-inflated negative binomial, logistic, and ordered logistic regression models, respectively. Primary predictors of interest included depression, cognitive function, positive affect, and lower extremity functioning as measured by the Quality of Life in Neurological Disorders short forms. The study sample was 91% White race, 83% female, 65% with a relapsing-remitting MS diagnosis. The mean participant age was 52 years. Across analyses, body mass index and disability were inversely associated with exercising. Greater lower extremity impairment was associated with decreased odds of exercising and being active. A greater burden of depression symptoms was correlated with lower odds of engaging in physical activity. People with MS with higher self-reported cognitive functioning were less likely to engage in any exercise, but it was not associated with frequency of activities. These results demonstrate associations between exercise and cognitive and emotional health in people with MS, underscoring the need to consider these factors when designing MS-targeted physical activity recommendations.

Associations between Perceived Teacher Autonomy Support, Self-Determined Motivation, Physical Activity Habits and Non-Participation in Physical Education in a Sample of Lithuanian Adolescents.

In this cross-sectional study, we tested the associations between teacher autonomy support, self-determined motivation for physical education (PE), physical activity habits and non-participation in physical education in a sample of adolescents. A total of 715 adolescents (of whom 371 (51.89%) were girls) participated. The ages ranged from 14 to 18 years, with mean ages of 16.00 (SD = 0.79) for girls and 15.99 (SD = 0.75) for boys. The study questionnaire consisted of demographic questions and the Learning Climate Questionnaire, Revised Perceived Locus of Causality in Physical Education Questionnaire, Behavioural Regulation in Exercise Questionnaire 2, Self-Report Habit Index for Physical Activity, Godin Leisure-Time Exercise Questionnaire, Rosenberg Self-Esteem Scale, perceived physical fitness and frequency of non-participation in PE classes. The results showed that perceived teacher autonomy support was directly positively associated with physical activity habits and negatively with non-participation in physical education classes. Autonomous motivation for PE was a mediator between perceived teacher autonomy support and physical activity habits, meaning that higher autonomous motivation was related to higher physical activity habits. Motivation for PE was also a mediator between teacher autonomy support and non-participation in PE. Higher autonomous motivation for PE was associated with less frequent non-participation in PE classes. The findings can inform PE teachers’ practice by showing that supporting students’ autonomy and strengthening their self-determined motivation can facilitate increased participation in PE classes and the formation of students’ physical activity habits.

Health-Related Quality of Life and Physical Activity in Older Adults With Multiple Sclerosis.

People with multiple sclerosis (MS) are living longer but not necessarily better lives, and this portends reduced health-related quality of life (HRQOL). Physical activity (PA) may be a correlate of HRQOL for people with MS. We examined differences in HRQOL and PA between older adults with and without MS to determine whether PA is associated with HRQOL and whether it accounts for group differences in HRQOL. Thirty-one older adults with MS and 30 age- and sex-matched controls without MS completed the 36-Item Short Form Health Survey (SF-36) and the Godin Leisure-Time Exercise Questionnaire (GLTEQ). Data were analyzed using the Baron and Kenny approach for examining PA via the GLTEQ as a mediator of group differences in HRQOL. The MS group had significantly lower component scores on the SF-36 and the GLTEQ than the control group. The GLTEQ scores were correlated with SF-36 physical component scores (r = 0.52), whereas the correlation with mental component scores (r = 0.23) was small and nonsignificant. Group assignment initially explained 31% of the variance in physical component scores (β = 0.55) and adding GLTEQ to the model accounted for an additional 12% of the variance in physical component scores. Thus, group (β = 0.42) and GLTEQ (β = 0.37) were both significant correlates of physical component scores. The group effect was modestly attenuated with the addition of GLTEQ in step 2 (step 1 β = 0.55; step 2 β = 0.42) and indicated partial rather than full mediation. These results provide cross-sectional support for future research examining approaches to increase PA to possibly improve the physical component of HRQOL in older adults with MS.

Adolescents with Atopic Dermatitis Have Lower Peak Exercise Load Capacity and Exercise Volume Compared with Unaffected Peers.

Background: Sweating and increased skin temperature caused by exercise can reduce physical activity and the willingness to exercise in adolescents with atopic dermatitis. This study was conducted to investigate the exercise load capacity of adolescents with atopic dermatitis and analyzed their exercise behavior and motivation. Methods: Adolescents with and without atopic dermatitis were assigned to the atopic dermatitis group and control group (n = 27 each). Both groups completed a cardiopulmonary exercise test and questionnaires to assess their exercise capacity, weekly exercise volume, exercise motivation, and self-efficacy, respectively. Results: The ratio of measured forced vital capacity to the predicted forced vital capacity and the peak oxygen consumption of the atopic dermatitis group were significantly lower than those of the control group. The Godin Leisure-Time Exercise Questionnaire scores of the atopic dermatitis group were significantly lower than those of the control group. As for the Behavioral Regulation in Exercise Questionnaire 2, the scores for the introjected and identified regulations of the atopic dermatitis group were significantly lower than those of the control group. Regarding the Multidimensional Self-Efficacy for Exercise Scale, the scheduling efficacy and total scores of the atopic dermatitis group were significantly lower than those of the control group. Conclusions: Adolescents with atopic dermatitis had lower peak exercise capacity and lower weekly exercise volume. Furthermore, they lacked the negative feelings toward inactivity and the self-confidence to plan regular exercise independently. The results of this study suggest that adolescents with atopic dermatitis should be encouraged to engage in regular indoor exercise.

Effects of Sex, APOE4, and Lifestyle Activities on Cognitive Reserve in Older Adults.

Background and ObjectivesLifestyle activities, such as physical activity and cognitive stimulation, may mitigate age-associated cognitive decline, delay dementia onset, and increase cognitive reserve. Whether the association between lifestyle activities and cognitive reserve differs by sex and APOE4 status is an understudied yet critical component for informing targeted prevention strategies. The current study examined interactions between sex and physical or cognitive activities on cognitive reserve for speed and memory in older adults.MethodsResearch participants with unimpaired cognition, mild cognitive impairment, or dementia from the Washington Heights-Inwood Columbia Aging Cohort were included in this study. Cognitive reserve scores for speed and memory were calculated by regressing out hippocampal volume, total gray matter volume, and white matter hyperintensity volume from composite cognitive scores for speed and memory, respectively. Self-reported physical activity was assessed using the Godin Leisure Time Exercise Questionnaire, converted to metabolic equivalents (METS). Self-reported cognitive activity (COGACT) was calculated as the sum of 3 yes/no questions. Sex by activity interactions and sex-stratified analyses were conducted using multivariable linear regression models, including a secondary analysis with APOE4 as a moderating factor.ResultsSeven hundred fifty-eight participants (mean age = 76.11 ± 6.31 years, 62% women) were included in this study. Higher METS was associated with greater speed reserve in women (β = 0.04, CI 0.0–08) but not in men (β = 0.004, CI −0.04 to 0.05). METS was not associated with memory reserve in women or men. More COGACT was associated with greater speed reserve in the cohort (β = 0.13, CI 0.05–0.21). More COGACT had a trend for greater memory reserve in women (β = 0.06, CI −0.02 to 0.14) but not in men (β = −0.04, CI −0.16 to 0.08). Only among women, APOE4 carrier status attenuated relationships between METS and speed reserve (β = −0.09, CI −0.22 to 0.04) and between COGACT and both speed (β = −0.26, CI −0.63 to 0.11) and memory reserves (β = −0.20, CI −0.50.0 to 093).DiscussionThe associations of self-reported physical and cognitive activities with cognitive reserve are more pronounced in women, although APOE4 attenuates these associations. Future studies are needed to understand the causal relationship among sex, lifestyle activities, and genetic factors on cognitive reserve in older adults to best understand which lifestyle activities may be most beneficial and for whom.

Estimating the association between physical activity and health-related quality of life in individuals with multiple sclerosis

BackgroundHigher levels of total physical activity (PA) are associated with better health-related quality of life (HRQOL) in individuals with multiple sclerosis (MS). The benefits of PA across the activity continuum have not been well-studied. The goal of this study was to compare the associations between total PA, strenuous PA, moderate PA, and mild PA and HRQOL in a large cohort of individuals with MS using both generic and neurologic disease-specific questionnaires. Longitudinal changes in PA and HRQOL over two years were also examined MethodsSubjects enrolled in SysteMS completed the Godin Leisure Time Exercise Questionnaire (GLTEQ) to measure PA. Subjects also completed generic (SF-36) and neurologic disease-specific (NeuroQoL) HRQOL measures. GLTEQ and HRQOL measures were administered at baseline and 24 months. The associations between the GLTEQ total leisure activity (TLA), strenuous PA, moderate PA and mild PA and scores on NeuroQoL and SF-36 were estimated using Spearman's correlation coefficient and partial Spearman's correlation coefficient adjusting for age, sex and Expanded Disability Status Scale (EDSS) measured by a provider. To further investigate the associations between mild PA and HRQOL measures, the associations between mild PA and HRQOL were estimated in participants who reported no moderate or strenuous PA in the last week. The changes in GLTEQ TLA scores and each component score were compared to the changes in NeuroQoL and SF-36 over 24 months using Spearman's correlation coefficient and partial Spearman's correlation coefficient adjusting for age, sex and EDSS. ResultsStatistically significant weak correlations were observed between GLTEQ TLA and NeuroQoL and SF-36 domains, with higher levels of TLA being associated with better HRQOL outcomes. After adjusting for age, sex and EDSS, all correlations were attenuated. Strenuous and moderate levels of PA were similarly associated with many HRQOL outcomes, but mild PA was only weakly correlated with NeuroQoL Lower Extremity Function. There was limited change in PA over 24 months. In a subgroup of participants who reported mild PA, but no moderate or strenuous PA, there were no significant associations with NeuroQoL or SF-36 domains at baseline, but increases in mild PA over two years were moderately associated with improvement on NeuroQoL Upper Extremity Function and SF-36 Mental Health and Mental Component Summary. ConclusionThere were weak associations between TLA and HRQOL across a wide range of HRQOL variables. In addition, both strenuous PA and moderate PA were weakly associated with many HRQOL outcomes, but mild PA was only associated with lower extremity function. Increases in mild PA in a subgroup of individuals who reported no strenuous or moderate PA at baseline were associated with improvements in HRQOL at 24 months. These findings suggest that programs aimed at increasing PA across the activity continuum may lead to improvements in multiple areas of HRQOL in individuals with MS.

IMPACT: A Randomized Controlled Trial of an mHealth Physical Activity Intervention for Young Adult Cancer Survivors

Purpose: The IMPACT trial evaluated a theory-based mobile physical activity (PA) intervention on total PA (primary) and moderate-to-vigorous (MVPA) at 6 months in a nationwide sample of young adult cancer survivors (YACS). Methods: YACS (N=280) were randomized to either an intervention group or a self-help (control) group. All participants received digital tools (activity tracker, smart scale, Facebook group) and an individual videochat session. Intervention participants also received a 6-month mHealth program with components to promote increased PA (behavioral lessons, adaptive goal-setting, tailored feedback, tailored text messages, Facebook group prompts). PA was assessed via accelerometry and online questionnaire (Godin Leisure Time Exercise Questionnaire) at baseline and 6 months. Using linear mixed models and an intention-to-treat approach, we tested for group differences in changes from baseline to 6 months, adjusting for education, time since diagnosis, age, and accelerometer wear time. Results: Of 280 YACS (M=33.4 (SD 4.8) yrs, 81.8% women, 23.2% racial/ethnic minority individuals), 92.9% completed 6-month measures. Device-measured total PA min/wk (i.e., sum of light, moderate, and vigorous PA) increased from a mean of 1974.3 (SD=673.9) to 2024.3 (686.7) at 6 months in the intervention group (p=.26) and from 1814.9 (704.5) to 1877.7 (758.2) in the control group (p=.43), with no difference between groups (p=.84). Both groups increased MVPA min/wk over 6 months; increases were 24.7 min/wk (95% CI: 14.8, 34.6; p&amp;lt;.0001) in the intervention versus 11.4 min/wk (95% CI: 1.4, 21.4; p=.02) in the control (p=.07 between groups). Increases in MVPA were 99.7% and 41.6% over baseline in the intervention and control groups, respectively. Increases in self-reported total PA were significant; 123.3 min/wk (95 CI%: 94.5, 152.1; p&amp;lt;.0001) in the intervention versus 83.40 (95% CI: 49.30, 117.50; p&amp;lt;.0001) in the control (p=.08 between groups). Conclusions: While both groups increased total PA over 6 months, the intervention doubled the increase in MVPA min/wk relative to the control group, which is associated with important health benefits. Future research should examine moderators of effects to identify for whom, and under what conditions, the effectiveness varied.