Daily Activity Levels Research Articles

The Effects of COVID-19 Pandemic Lock Down on Body Weight and Risk Score for Diabetes Among Healthcare Students

Background: The COVID-19 pandemic necessitated widespread lockdowns, significantly altering daily routines and activity levels. This study hypothesizes that such changes might have exacerbated the health risks associated with type 2 diabetes (T2D). Objective: Given the prevalence of T2D among U.S. adults and the centrality of weight gain as a risk factor, this research aims to explore the potential ramifications of the pandemic on TGD risk. Such findings are important for preparations against future outbreaks, which might amplify T2D onset rates. Methods: Affiliates from three U.S. Touro college campuses were surveyed to assess the pandemic’s effects on dietary patterns, daily activity levels, and weight change. To gauge changes in T2D risk, a diabetes risk score was determined, comparing pre-pandemic levels to those observed during COVID-19 restrictions. The study used a survey research method and Qualtrics for data collection. The research proposal was approved by the University Institutional Review Board (M-0221). Results: Of the participants, 65.9% reported decreased activity levels, while 46.3% experienced weight gain. Notably, 64.2% of participants had an elevated risk score, signifying an increased vulnerability to T2D.

Sleep behavior and daily activity levels in people with metabolic syndrome: effect of 1 year of metformin treatment.

Impaired sleep and low daily activity levels increase the risk of developing metabolic syndrome (MS). Metformin (MET), an insulin sensitizer drug, is effective in regressing MS and has been recently studied as an adjuvant agent for managing sleep disorders. The present study aimed to assess whether 1,700 mg/day of MET treatment modifies sleep and daily activity levels in people with MS evaluated by Rest-Activity circadian Rhythm (RAR), which is the expression of 24 h of spontaneous activity parameters. A total of 133 subjects with MS, randomized into the MET (n = 65) or placebo (PLA, n = 68) group, underwent a clinical/anthropometric examination and carried out a continuous 7-day actigraphic monitoring to investigate sleep and RAR parameters at baseline and after 1 year of intervention. After 1 year of intervention, 105 subjects were analyzed. The MET group showed greater anthropometric and metabolic improvements compared with placebo, with a significant reduction in weight (p = 0.01), body mass index (p = 0.01), waist circumference (p = 0.03), and glucose (p < 0.001). With regard to sleep parameters, the MET group showed a significant increase in actual sleep time (p = 0.01) and sleep efficiency (p = 0.04) compared with placebo. There were no significant changes reported in the RAR parameters. Our study suggests that MET might be used as an adjuvant treatment for sleep disorders in people with MS.

The 6–Minute Pegboard and Ring Test (6PBRT) for Evaluation of Upper Limbs Functional Capacity in Hemodialysis Patients: A Validation Study

Objectives: To verify the 6–minute peg board and ring test (6PBRT) validity for functional evaluation in hemodialysis patients and upper limb (UL) functional capacity by the 6PBRT. Methods: In a cross–sectional study, patients on hemodialysis three times a week for at least 6 months performed the 6PBRT as well as handgrip strength and endurance. Health–related quality of life (HRQoL) by KDQOL–SF questionnaire, Human Activities Profile (HAP), and level of social participation were also evaluated. Convergent validity was verified by correlation analysis. Results: Thirty–seven individuals were evaluated, predominantly adult males (67.6%). The mean age was 50.1 ± 16.4 years old. The average number of rings moved during the 6PBRT was 306.2 ± 68.2. The 6PBRT correlated with handgrip strength ( r = 0.37; p = 0.025), the domain “Functional Capacity” ( r = 0.49; p = 0.008) of the KDQOL–SF questionnaire, and with HAP score ( r = 0.43; p = 0.01). There was no correlation between handgrip endurance ( r = 0.18; p = 0.281) and social participation ( r = −0.12; p = 0.48). Heart rate and dyspnea (modified Borg scale) increased by 13.3 bpm (95% CI: 9.8, 16.8) and 0.5 points (95% CI: 0.1, 0.9) during the 6PBRT. Conclusion: The 6PBRT is associated with UL strength, physical aspects related to HRQoL, and daily activity level, which accounts for its construct validity. Therefore, the test has potential value in the functional evaluation of the ULs in hemodialysis patients. However, in this population, the level of social participation seems to depend on other factors than the functional capacity of the UL itself.

Understanding Physical Activity Determinants in an HIV Self-Management Intervention: Qualitative Analysis Guided by the Theory of Planned Behavior.

People living with HIV have long life expectancy and are experiencing more comorbid conditions, being at an increased risk for developing cardiovascular disease (CVD) and diabetes, further exacerbated due to the HIV or inflammatory process. One effective intervention shown to decrease mortality and improve health outcomes related to CVD and diabetes in people living with HIV is increased regular physical activity. However, people living with HIV often fall short of the daily recommended physical activity levels. While studies show that mobile health (mHealth) can potentially help improve people's daily activity levels and reduce mortality rates due to comorbid conditions, these studies do not specifically focus on people living with HIV. As such, it is essential to understand how mHealth interventions, such as wearables, can improve the physical activity of people living with HIV. This study aimed to understand participants' experiences wearing a fitness tracker and an app to improve their physical activity. In total, 6 focus groups were conducted with participants who completed the control arm of a 6-month randomized controlled trial (ClinicalTrials.gov NCT03205982). The control arm received daily walk step reminders to walk at least 5000 steps per day and focused on the overall wellness of the individual. The analysis of the qualitative focus groups used inductive content analysis using the theory of planned behavior as a framework to guide and organize the analysis. In total, 41 people living with HIV participated in the focus groups. The majority (n=26, 63%) of participants reported their race as Black or African American, and 32% (n=13) of them identified their ethnicity as Hispanic or Latino. In total, 9 major themes were identified and organized following the theory of planned behavior constructs. Overall, 2 major themes (positive attitude toward tracking steps and tracking steps is motivating) related to attitudes toward the behavior, 2 major themes (social support or motivation from the fitness tracker and app and encouragement from family and friends) related to participant's subjective norms, 1 theme (you can adjust your daily habits with time) related to perceived behavioral control, 2 themes (reach their step goal and have a healthier lifestyle) related to participant's intention, and 2 themes (continuing to walk actively and regularly wearing the fitness tracker) related to participant's changed behavior. Participants highlighted how the mHealth interface with the avatar and daily step tracking motivated them to both begin and continue to engage in physical activity by adjusting their daily routines. Findings from this study illustrate how features of mHealth apps may motivate people living with HIV to start and continue sustained engagement in physical activities. This sustained increase in physical activity is crucial for reducing the risk of comorbid conditions such as diabetes or CVD. ClinicalTrials.gov NCT03205982; https://classic.clinicaltrials.gov/ct2/show/NCT03205982.

Phenotypic Characterization of Female Carrier Mice Heterozygous for Tafazzin Deletion.

Barth syndrome (BTHS) is caused by mutations in tafazzin resulting in deficits in cardiolipin remodeling that alter major metabolic processes. The tafazzin gene is encoded on the X chromosome, and therefore BTHS primarily affects males. Female carriers are typically considered asymptomatic, but age-related changes have been reported in female carriers of other X-linked disorders. Therefore, we examined the phenotype of female mice heterozygous for deletion of the tafazzin gene (Taz-HET) at 3 and 12 months of age. Food intakes, body masses, lean tissue and adipose depot weights, daily activity levels, metabolic measures, and exercise capacity were assessed. Age-related changes in mice resulted in small but significant genotype-specific differences in Taz-HET mice compared with their female Wt littermates. By 12 months, Taz-HET mice weighed less than Wt controls and had smaller gonadal, retroperitoneal, and brown adipose depots and liver and brain masses, despite similar food consumption. Daily movement, respiratory exchange ratio, and total energy expenditure did not vary significantly between the age-matched genotypes. Taz-HET mice displayed improved glucose tolerance and insulin sensitivity at 12 months compared with their Wt littermates but had evidence of slightly reduced exercise capacity. Tafazzin mRNA levels were significantly reduced in the cardiac muscle of 12-month-old Taz-HET mice, which was associated with minor but significant alterations in the heart cardiolipin profile. This work is the first to report the characterization of a model of female carriers of heterozygous tafazzin deficiency and suggests that additional study, particularly with advancing age, is warranted.

S14-5 Girls Active and Change4Life Sports Club - two effective programmes to increase physical activity in schools and colleges

Abstract Purpose Girls Active aims to tackle declining participation in physical activity of girls aged 10 to 18 and its associated implications on health, wellbeing and education. Change4Life Sports Clubs are designed to address inactivity in 7 to 11 year olds and improve healthy lifestyle behaviours with exercise, food and hydration. Both projects aim to reduce physical inactivity of those children suffering the greatest challenges to achieving the recommended daily physical activity level of an average of 60 minutes of moderate to vigorous physical activity every day. Project description Both programmes were developed from evidence reviews and principles that work to engage, inspire and motivate targeted groups of children to be active. They were both developed by the children’s charity Youth Sport Trust, who have used sport and play to improve the lives of children and young people since 1995. They were co-designed with children and implemented through a national network of 450 School Games Organisers. Youth Sports Trust’s ‘content, delivery, structure’ model was used. For Girls Active we used the Active Lives Children Data from Sport England and Change4Life Sports Clubs were aligned to the Department of Health’s National Child Measurement Programme data to target where the programmes were most needed and to ensure that the right groups of children and young people were included in the interventions. Both programmes have been externally evaluated through academic partners using pre and post survey data, case studies and control elements and achieved high quality evidence scores. Both programmes have been scaled through a variety of funding streams including London 2012 Olympic Legacy, Sport England Lottery, Corporate Social Responsibility budgets and local public health funding. Girls Active has been adopted in Wales, Scotland and Northern Ireland. Conclusions We will share the evidence-based principles that have made these two approaches highly effective in addressing inactivity in primary school aged children and adolescent girls that can be applied in multiple contexts and will share resources and content that can be accessed following the session.

Immune challenge reduces daily activity period in free-living birds for three weeks.

Non-lethal infections are common in free-living animals and the associated sickness behaviours can impact crucial life-history trade-offs. However, little is known about the duration and extent of such sickness behaviours in free-living animals, and consequently how they affect life-history decisions. Here, free-living Eurasian blackbirds, Turdus merula, were immune-challenged with lipopolysaccharide (LPS) to mimic a bacterial infection and their behaviour was monitored for up to 48 days using accelerometers. As expected, immune-challenged birds were less active than controls within the first 24 h. Unexpectedly, this reduced activity remained detectable for 20 days, before both groups returned to similar activity levels. Furthermore, activity was positively correlated with a pre-experimental index of complement activity, but only in immune-challenged birds, suggesting that sickness behaviours are modulated by constitutive immune function. Differences in daily activity levels stemmed from immune-challenged birds resting earlier at dusk than control birds, while activity levels between groups were similar during core daytime hours. Overall, activity was reduced by 19% in immune-challenged birds and they were on average almost 1 h less active per day for 20 days. This unexpected longevity in sickness behaviour may have severe implications during energy-intense annual-cycle stages (e.g. breeding, migration, winter). Thus, our data help to understand the consequences of non-lethal infections on free-living animals.

Using accelerometer Analysis to Assess Physical Activity and Sedentary Behavior in Syrian Adults

Background: Overweight and obesity has become a serious public health problem in the world. Changes in daily physical activity (PA) levels may help moderate the health risks of sedentary behavior (SB). The aim of the present study was to determine PA and SB by triaxial accelerometer (ActiGraph GTX3 GT3X+, ActiGraph, Pensacola, FL. 32502 USA) in Syrian adults that affected by age, marital, body mass index (BMI), education, and smoking status.Methods: We used cross-sectional baseline data from 97 participants of adults (18-60 years). Subjects wore an accelerometer for 7 consecutive days. Magnitude counts/minute was extracted to determine time in inactivity, in low-intensity, moderate, and vigorous-to-very-vigorous activity.Results: Higher age was associated with more time in all categories of PA (light, moderate vigorous MVPA with bouts, MVPA without bouts, and step per day), while higher BMI was related to less time in PA, overweight/obese subjects, on daily average, spent less, but not significantly, time standing and little more time spent in sitting than the normal weight groups. Participant comparing to non-smoking peoples tended to spent less time in PA; however, this synchronization was not considerable.Conclusion: Finally, our investigation demonstrated a positive synchronization between sedentary time and educational level. In this cohort of adults, most of men and women fulfilled the WHO recommendations. The levels of PA in 18–60-year-old adults are similar to previous data reported in adults.

Competitive Sports Participation is Associated with Decreased Risk of Obesity in Children with Bicuspid Aortic Valve.

Individuals with bicuspid aortic valve (BAV) have historically been advised to avoid contact sports and isometric exercise for risk of increasing aortic dilation and valve disease. There is mounting evidence that current sports participation guidelines qualify children for a high rate of sports exclusion, and that this population is at increased risk of obesity. The primary aim of this study was to evaluate relationship between sports participation and aortic dilation in children with bicuspid aortic valve and secondarily the relationship between competitive sports participation and obesity. We performed a review of children between the ages of 8 and 17years with isolated BAV followed at Oregon Health & Science University. We excluded those with other congenital heart diseases, genetic conditions, prior cardiac intervention, and inability to ambulate independently. Parents completed a phone survey detailing their child's level of daily activity and participation in competitive sports. Demographic information and most recent echo findings were collected from the electronic medical record. We found no difference between the aortic diameters of athletes vs non-athletes. We also found that sports participation and daily activity were both associated with a decreased likelihood of obesity (OR 0.24, 95% CI 0.078-0.73 and OR 0.24, 95% CI 0.081-0.71 respectively). In summary, in our sample population, competitive sports participation was associated with a decreased risk of obesity. Competitive sports participation does not appear to be associated with an increased risk of aortic dilation in our population.

Activity level by clinical severity and sex differences in patients with Alzheimer disease and mild cognitive impairment.

To determine how to maintain activity in persons with dementia and mild cognitive impairment, we examined the daily activity level by different degrees of clinical severity and sex differences in patients with Alzheimer's disease and mild cognitive impairment. This study included 92 patients with Alzheimer's disease and 33 patients with mild cognitive impairment who visited our rehabilitation department. The Frenchay Activities Index was used to assess the level of activity. Women had high Frenchay Activities Index scores for household activities, such as meal preparation, washing clothes, and light housework, whereas men had high Frenchay Activities Index scores for social occasions and walking outside. Although activity decreased with the severity of dementia in women, there was no difference in men. Additionally, a negative correlation was observed between the number of people living together and activity in women. To maintain and improve activities in persons with Alzheimer's disease and mild cognitive impairment, it is important to suggest activities that fit the lifestyle of the individual and family caregivers and to provide lifestyle instructions that consider sex differences.

Possibilities neuroimaging and neurophysiological research methods to objectify rehabilitation potential in patients with ischemic stroke (analytical review of the literature)

Cerebral stroke (CS) remains the most important medical and social problem. According to available data, only 25% of stroke survivors return to the premorbid level of daily or work activity, most patients have residual neurological disorders of varying severity. Effective rehabilitation of patients with CS requires not only timely initiation of treatment, but also an individual choice of rehabilitation program. To optimize the rehabilitation strategy in each case, it is necessary to set goals and objectives taking into account the rehabilitation potential (RP) and the prognosis of the patient’s recovery. This paper provides a definition of RP and ways to describe it. The existing neurophysiological methods for assessing the RP of functional recovery after CS, such as electroencephalography, evoked potentials and diagnostic transcranial magnetic stimulation (TMS), are considered. Information about neuroimaging diagnostic methods – computer (CT) and magnetic resonance imaging (MRI) in the context of determining RP is presented. The possibilities of functional and diffusion-t ensor MRI of the brain for assessing RP in various periods of the disease are highlighted in detail. Other possible predictors of the restoration of impaired functions are also considered – the volume and localization of the brain lesion, the patient’s age, cognitive functions and laboratory parameters. Modern complex approaches to the formation of algorithms for the quantitative assessment of RP are described. In particular, the current algorithms for evaluating RP – PREP2 for the upper limb and TWIST for predicting the recovery of walking disorders are described. Currently, there are no generally accepted methods for determining and quantifying RP. The instruments proposed for this purpose are insufficiently sensitive and specific or are not suitable for routine clinical practice.

Clinical outcomes of intensive versus less intensive first-line chemotherapy for metastatic colorectal cancer.

Aims: Physicians determine the treatment regimen for metastatic colorectal cancer on a case-by-case bases, according to the individual disease characteristics. We retrospectively compared the baseline characteristics and efficacies of first-line treatment among patients with metastatic colorectal cancer who received intensive therapy involving fluoropyrimidine plus oxaliplatin and/or irinotecan, potentially with molecularly targeted agents as well, versus less intensive fluoropyrimidine and/or bevacizumab therapy. Materials & methods: Data were collected from a medical claims database. The efficacy outcomes were: time to treatment failure, time to first subsequent therapy and overall survival. Results: The less intensive therapy group (n=633) had higher median age, lower daily activity levels and shorter time to treatment failure, time to first subsequent therapy and overall survival than the intensive therapy group (n=3829). Combination therapy with molecularly targeted agents and bevacizumab improved treatment efficacy outcomes in the intensive and less intensive groups, respectively. Conclusion: Patient age and daily activity levels were important factors for determining treatment intensity.

Patterns of physical activity over time in older patients rehabilitating after hip fracture surgery: a preliminary observational study

BackgroundTo investigate patterns of continuously monitored physical activity in older patients rehabilitating after hip fracture surgery and the association with patient characteristics.MethodsPhysical activity of surgically treated hip fracture patients aged 70 years or older, who were rehabilitating at a skilled nursing home, was continuously monitored using a tri-axial accelerometer. The intensity of physical activity per day was calculated from the accelerometer signals to describe the daily physical activity levels of the enrolled patients. The patterns of three different aspects of physical activity were investigated: overall physical activity, overall variability, and day-to-day variability. Two experts in the geriatric rehabilitation field helped identifying unique physical activity patterns for each aspect based on visual analysis. Eighteen healthcare professionals independently classified each patient in one of the predefined patterns for each aspect. Differences between physical activity patterns and patient characteristics were assessed using a Kruskal–Wallis or Fisher’s Exact Test.ResultsPhysical activity data from 66 older patients were used in this preliminary study. A total of six unique patterns were identified for overall physical activity and overall variability, and five unique patterns for the day-to-day variability. The most common pattern found for the overall physical activity and day-to-day variability had a S-shape, which first slowly increased, then steeply increased, and subsequently flattened (n = 23, 34.8%). A N-shape pattern was found the most common pattern for overall variability, which first slowly increased, then steeply increased, then decreased and lastly increased (n = 14, 21.2%). The functionality at admission to rehabilitation, measured with the Barthel Index, and the duration of rehabilitation stay differed between the patterns of physical activity.ConclusionsMultiple patterns of physical activity among older patients during hip fracture rehabilitation were found in this preliminary study. The functionality at admission to rehabilitation and the duration of rehabilitation stay were associated with the different patterns found in this study. Results of this study highlight the importance of personalized hip fracture treatment.

Clinical and biochemical changes and their correction in patients with metabolic phenotype of osteoarthritis and insomnia

BACKGROUND: Currently, OA is considered a polyetiological disease, where several phenotypes are distinguished based on the leading role of a specific risk factor. It is assumed that each clinical phenotype corresponds to its own fundamental changes in various organs and systems. Modern experimental evidence of chondro-osteogenic activity allows us to consider melatonin as a potential drug for various types of osteoarticular pathology.AIM: To study clinical and biochemical changes and effects of melatonin in the metabolic phenotype of OA and insomnia.MATERIALS AND METHODS: The study involved patients with a metabolic phenotype of OA and healthy volunteers. The subjects were collected complaints and anamnesis, as well as general clinical and orthopedic examination. In the blood serum, markers of bone and cartilage metabolism were determined. Patients were asked to answer the questions of clinical scales to assess the quality of sleep, the functional state of the joints and quality of life.RESULTS: The study involved 36 patients. Participants were divided into 3 groups: group health patients — patients without articular pathology, sleep quality disorders and normal body mass index; control group- patients with metabolic phenotype of OA, insomnia and basic treatment for 30 days; experimental group — patients with a metabolic phenotype of OA and insomnia, whose basic treatment included melatonin (Melaxen®) at a dosage of 3 mg for 30 days. Statistically significant differences were observed between the initial levels of acid phosphatase (AP), bone isoenzyme alkaline phosphatase (ALP) and calcium (Ca) in the control and experimental groups. According to the results of screening for the detection of insomnia among patients with the metabolic phenotype of, there were statistically significant insomnological disorders compared to the group health patients, as well as significant differences in terms of pain, symptoms, activity and quality of life in general according to the KOOS and SF-36 scales. Correlation analysis showed moderate correlations with biochemical parameters in patients with OA metabolic phenotype groups. After the treatment there was a certain increase in the level of Ca and a decrease in the activity of ALP and АP in patients of experimental group in comparison with patients of control groups. There was a positive trend in the range of criteria of the KOOS and SF-36 scale in experimental groups, pronounced decrease in pain syndrome (P), symptoms (S) and an increase in the levels of daily activity (A) and the total indicator (Sum) in comparison with patients of control groups. Also as improved sleep quality on all scales in comparison with the control group. In control group, problems with the quality and quantity of sleep remained at the same level.CONCLUSION: In patients with the most pronounced indicators of clinical manifestations of OA, more active processes of bone remodeling. The higher the level of bone resorption markers, the greater the severity of the clinical course in patients with osteoarthritis, and the worse the quality of sleep in general. The addition of melatonin to the treatment regimen was associated with a decrease in serum activity of the bone isoenzyme of alkaline phosphatase, acid phosphatase, an increase in calcium levels, as well as with an improvement in sleep and clinical symptoms ОА.

Impact of increased physical activity in patients after pulmonary vein isolation - BE-ACTION trial

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Medical School Brandenburg and Local Government Concil Brandenburg Background Pulmonary vein isolation (PVI) is one of the key therapies for patients with atrial fibrillation (AF), however, there are numerous recurrences after ablation. Improving cardiorespiratory fitness (CF) may result in fewer recurrences of AF. The aim of the present study (Brandenburg Enhance ACTIvity ONset after pulmonary vein isolation - BE-ACTION) was to evaluate the impact of increased physical activity in patients after PVI on the recurrence of AF. Methods From January 2018 to April 2021, 200 patients with scheduled PVI were randomized at 4 different centres and fitted with an activity tracker for 24-hour activity monitoring via mobile phone. Patients aged between 50 and 77 years with a BMI between 23 and 35 kg/m2 were included. Patients with orthopaedic limitations were excluded. Patients in the ACTION group (n=99) were contacted regularly by telephone by a physical therapist and intensively motivated if the steps fell below 6,000 steps per day. Patients in the No-ACTION group (n=101) received standard of care. A loop recorder was implanted in 74 patients; those who refused loop recorder implantation underwent 7-day Holter monitoring at 6 and 12 months after PVI. Recurrence was defined as any atrial arrhythmia &amp;gt;30 sec, cardioversion or need of redo ablation after blanking period (3 month) up to 12 month. Results The number of steps per day increased in all pts from 7,918 (5,725-10,989) at week 2 after PVI to 9,511 (7,230-12,800) at 6 months and to 9,788 (6,962-12,152) at 12 months (p&amp;lt;0.001; Friedman), figure 1. In the ACTION group, the number of steps per day continued to increase between 6 and 12 months, whereas it decreased in the No-ACTION group. In total, recurrence of arrhythmia was found in 58 patients (29.9%: 31 patients with loop recorder, 14 with Holter monitoring and 13 with ECG). Recurrence occurred in 24 patients (25%) in the ACTION group and 34 patients (35%) in the No-ACTION group (p=0.140), table 1. Conclusion The level of daily physical activity was unexpectedly high in this study. The use of an activity tracker led to an increased daily physical activity in patients with AF after PVI. A further increase of activity did not reduce the recurrence of atrial arrhythmia in the ACTION group.

The effect of a novel lifestyle intervention on autonomic and haemodynamic function in individuals with hypertrophic cardiomyopathy

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This project has received funding from the European Union’s Horizon 2020 Research and Innovation Programme under Grant Agreement no. 777204. Background Autonomic nervous system may play an important role in the pathophysiology of hypertrophic cardiomyopathy (HCM). Lifestyle interventions have been shown to improve signs and symptoms in individuals with heart failure. Purpose To evaluate the effect of a novel lifestyle intervention incorporating physical activity and dietary nitrate supplementation on cardiac autonomic and haemodynamic function in individuals with HCM. Methods Twenty-eight individuals with HCM were recruited into a single-centre pilot study (N=7 females, age 54±15 years) and randomised into the intervention (N=20) or control (N=8) group. Participants completed short-term (5-minute) non-invasive heart rate variability (HRV) measurements under resting (supine) conditions using the TaskForce (CNSystems, Graz, Austria). Frequency-domain HRV measures including spectral analysis of RR interval (i.e. absolute and normalised low frequency power (LF), high frequency power (HF) and LF/HF ratio) were recorded. Non-invasive haemodynamic variables including cardiac output (CO), and stroke volume (SV)were simultaneously recorded using bioimpedance technology integrated within the TaskForce. Intervention participants consumed 6 mmol of nitrate daily (concentrated beetroot juice) and increased and maintained their daily physical activity by ≥2000 steps/day above baseline for 16 weeks. Participants in the control group continued with their usual lifestyle and monitored daily step counts. Physical activity was evaluated objectively using pedometers (Omron Health, Japan). All participants were monitored weekly via telephone calls and average daily activity levels were recorded using diaries. However, participants in the control group were asked not to change their physical activity and dietary habits. Results Participants in the intervention group significantly increased their average physical activity by 3029 steps post intervention (i.e, 6234±2389 vs 9263± 3341 steps/day, p&amp;lt;0.01) compared to control (7559±3257 vs 7604± 2901 steps/day, p=0.96). There was a significant increase in post-intervention HF power (7.54±2.14 vs. 8.78±1.60 ms2, p&amp;lt;0.01) and LF power (6.89±2.33 vs. 8.17±1.55, p&amp;lt;0.01) respectively, but not in the control group (i.e., HF (7.05±3.39 vs. 7.64±2.56 ms2, p=0.33) and LF power (6.78±3.31 vs. 7.06±2.43 ms2 p=0.63)). There was a non-significant change in SV index in the intervention (33±9.83 vs. 29±8.56 ml/beat/m2, p=0.06) and control groups (34±6.27 vs. 33±8.1 ml/beat/m2, p=0.79). Similarly, there was no significant change in cardiac index in the intervention or control groups (intervention: 2.35±0.44 vs. 2.38±0.52 L/min/m2, p=0.77; control: 2.27±0.40 vs. 2.67±0.78, p=0.06). Conclusions Lifestyle intervention incorporating physical activity and dietary nitrate supplementation led to a significant increase in daily physical activity and improved parasympathetic activity in hypertrophic cardiomyopathy.

Student Daily Calorie Intake and Physical Activity Levels during the COVID-19 Pandemic

The level of physical activity is an indicator of being active or inactive. This study aimed to determine students’ daily calorie needs according to their physical activity levels during the Covid-19 pandemic. This research was a quantitative descriptive research with a cross-sectional design. The population of this study included 588 FIK Cenderawasih University students. For the sample, the simple random sampling technique was used. The samples of this study involved 95 students aged 19–24 years, consisting of 60 males and 35 females. The data collection employed the International Physical Activity Questionnaire (IPAQ) and anthropometric measurements to determine BMI to calculate the student’s daily calorie needs. The results of data analysis showed that the level of physical activity of students was primarily in the moderate category, 52.6%, while the rest 47.4% of students were in the high category. The findings show that the average of student needs was 3101 calories/day. In addition, there were differences in calorie needs between males and females. The average energy intake for males was 3363 calories/day, while for females was 2389 calories/day. Based on the results obtained, the higher the physical activity, the higher the calorie intake.

COVID–19 lockdown effects on the anthropometrics, aerobic capacity, muscle function and metabolic control in children and adolescents with overweight and obesity

ObjectiveThe lockdown due to a novel coronavirus (COVID–19) pandemic negatively impacted the daily physical activity levels and sedentary behavior of children and adolescents. The purpose of this study was to determine the effects of lockdown on the anthropometric measurements, aerobic capacity, muscle function, lipid profile and glycemic control in overweight and obese children and adolescents. Methods104 children and adolescents with overweight and obesity were divided in a non-lockdown group (NL) (n = 48) and a lockdown group (L) (n = 56). Both NL and L groups were evaluated on three consecutive days, day one: anthropometric measurements; day two: aerobic capacity and muscle function and day three: lipid profile and glycemic control. Data are presented as mean ± standard deviation (SD) and median plus interquartile range (IQR) according to their assumption of normality. ResultsThe L group increased the body weight (81.62 ± 22.04 kg vs 74.04 ± 24.46 kg; p = 0.05), body mass index (32.54 ± 5,49 kg/m2 vs 30.48 ± 6.88 kg/m2; p = 0.04), body mass index by z-score (3.10 ± 0.60 SD vs 2.67 ± 0.85 SD; p = 0.0015), triglycerides [141.00 mg/dl IQR (106.00– 190.00 mg/dl) vs 103.00 mg/dl IQR (78.50– 141.50 mg/dl); p = 0.001], fasting insulin [31.00 mU/L IQR (25.01– 47–17 mU/L vs 21.82 mU/L IQR (16.88 – 33.10 mU/L; p = 0.001)] and HOMA index [6.96 IQR (6.90 – 11.17) vs 4.61 IQR (3.96 – 7.50; p = 0.001)] compared with NL group. ConclusionsThe lockdown due COVID–19 pandemic had a negative impact on the anthropometric measurements, lipid profile, and glycemic control of overweight and obese children and adolescents.

Monitoring of strength, inflammation and muscle function in allogenic stem-cell transplantation patients - a pilot study for novel biomarker and risk stratification determination.

Low aerobic capacity is associated with an increased mortality risk in allogenic stem-cell transplantation (alloSCT) patients, but currently used risk scores in the pre-transplantation workup are still underestimating physical activity as a prognostic factor. To examine the physical condition, muscle function, blood inflammation and training adherence of alloSCT patients during inpatient time to identify potential biomarkers associated with development of myopathy and sarcopenia. Patients undergoing alloSCT were examined at four time points (T0: before alloSCT; Tha: hospital admission; T1: engraftment; T2: inpatient discharge). T0 included cardiopulmonary performance, body composition, grip and knee strength, motor skill tests (One-leg stand/Tinetti/Chair-rising), blood sampling (blood cell profiling and inflammation targets (Kynurenin/high sensitivity C-reactive Protein (hsCRP)/Tumor necrosis factor alpha (TNF-alpha)/Musclin/Galectin-3) and quality of life, state of health, fatigue, muscle weakness and physical activity by questionnaires (IPAQ/BSA/SARC-F/Fatigue). At T1 and T2, blood samples, grip strength and motor skill tests were repeated. Glucocorticoid dose and daily physical activity were documented during inpatient stay. 26 of 35 included patients (4 females; age 55.58 ± 12.32 years; BMI 24.70 ± 3.27 kg/m2; VO2peak 16.55 ± 4.06 ml/min/kg) could proceed to alloSCT. Grip strength and Tinetti decreased from T0 until T2, no difference in Chair-rising test, One-leg and Tandem stand. All patients engrafted after 24.9 days ± 3.9 days. HsCRP and Kynurenine increased from T0 to T1, decreased at T2. TNF-alpha (T0vsT2/T1vsT2) and Musclin (T0vsT1) decreased. At T2, Galectin-3 was higher compared to T0/T1. Correlation analysis of grip strength and inflammatory markers revealed a positive correlation with TNF-alpha at T2. 50% of patients documented physical activity and questionnaire and reported a 50%-reduction of daily endurance and strength training between T1 to T2. Allogeneic stem-cell transplantation is associated with immune system vulnerability due to conditioning, increased inflammation and fatigue, and loss of muscle strength and function. In addition to hsCRP, Kynurenine seems to be a reliable biomarker to monitor acute and regenerative inflammation status of alloSCT patients, while Musclin and Galectin-3 may be added to physiological assessment regarding myopathy and sarcopenia. Grip strength and daily activity level should be documented by professionals to identify risk patients early and support them with optimal (exercise) therapy.

149 Case Study: The Impact of a Fogging System on Dairy Cow Comfort in Cows Housed in a Barn with Tunnel Ventilation and an Automatic Milking System

Abstract Fogging systems control microclimatic parameters of barns to provide immediate cooling to dairy cows during heat stress conditions. However, the benefits of implementing a fogging system to cow comfort behaviors have not been thoroughly investigated in lactating cows. Therefore, the objective of this case study was to evaluate cow comfort behaviors and milk productivity in cows managed in a tunnel-ventilated barn in a commercial dairy farm that uses an automatic milk system. Sixty Holstein lactating dairy cows (45-90 days in milk; DIM) were monitored and housed in group pens (6 pens; n = 10 cows/pen). Four weeks before the fogging system installation, cows had pedometers (IceQube, IceRobotics, Inc., United Kingdom) and SCR rumination collars (SCR by Allflex; Israel) placed for continuous daily activity and rumination levels monitoring, respectively. Productivity information was acquired using automatic robotic milking technology (Lely Astronaut A5; Iowa, United States), and all variables were measured until four weeks after fogger system installation. Activity behavior (lying duration, daily step count, and number of transitions) and productivity (daily milk yield and milk speed) were evaluated before (PRE; 20-day pre-installation period), during (DURING; 2-day period), and after fogger installation (POST; 35-day post-installation period). Data were analyzed using PROC GLM in SAS 9.4 with cow as the experimental unit and temperature-humidity index (THI) included in the model as a covariate. Overall, cows spent more time lying (P &amp;lt; 0.01) in the POST period versus PRE and DURING. Cows performed fewer daily transitions between lying and standing (P &amp;lt; 0.01) in the POST versus PRE period, but no differences were detected (P = 0.67) among the step counts observed PRE, DURING, and POST fogger installation. Average milk speed and average milk yield were decreased (P &amp;lt; 0.01) in the POST period compared with the PRE and DURING periods. Temperature-humidity index significantly influenced (P &amp;lt; 0.01) lying time but did not have an effect on any other variables measured. In summary, installation of a fogger system in a commercial tunnel-ventilated barn improved cow comfort behaviors in lactating cows managed with an automated robotic milking system but did not offer immediate production performance benefits.