Level Of Everyday Physical Activity Research Articles

Atrial Fibrillation: the Association with Physical Activity and the Effects of Cardiac Rehabilitation

The purpose of this review was to present modern studies that examine the relationship of physical activity and risk of atrial fibrillation (AF) development and the impact of cardiac rehabilitation programs in patients with all forms of AF. Data of 52 Russian and foreign scientific sources published in 1998- 2020 were presented. In our study, 48 patients with paroxysmal AF after radiofrequency ablation (RFA) were randomly assigned to a physical rehabilitation/standard therapy or control (standard therapy) group. Aerobic physical training was conducted for 6 months 3 times a week. AF is one of the most common cardiac arrhythmias. Despite modern advances, results of treatment of this disease are far from optimal. Many problems of patients with AF can be addressed through enrolment in multidisciplinary cardiac rehabilitation programs. But this question remains open. This is mainly due to the complexity of selection of physical rehabilitation program for patients with AF. It is known that physical activity can trigger an episode of AF. In the following review article, the approaches to functional capacity assessment of patient with AF are described, recommendations for prescribing safe exercise training to achieve a therapeutic effect are presented. Various aspects of the effects of physical rehabilitation are discussed, including its impact on cardiovascular risk factors, influence on atrial remodeling processes and associated biomarkers, prevention of AF progression and occurrence of cardiovascular complications. Results of our own research indicate effectiveness of physical training in patients with AF after RFA: increase in exercise duration by 18.6% (p<0.001) and load by 24.8% (p<0.01) during exercise test, increase in level of everyday physical activity by 23.8% (p=0.001); left atrium dimensions remain stable comparing with control group. That was combined with a decrease of post ablation atrial arrhythmias: after 6 months, they were registered in 4.5% of trained patients vs 17.4% of control group patients (p<0.01). Steady growth in the number of patients with AF and catheter ablation procedures around the world dictates the need for organization of multi-purpose medical rehabilitation.

Physical Activity and Mobility Differentially Predict Nondemented Executive Function Trajectories: Do Sex and APOE Moderate These Associations?

Background: In nondemented aging, higher levels of everyday physical activity (EPA) and mobility performance are associated with better executive function (EF) trajectories. However, these associations may be moderated by both sex and Alzheimer’s disease (AD) genetic risk. Objectives: In a longitudinal study, we investigate sex differences in (a) EPA and mobility effects on EF performance (level) and change (slope) and (b) AD genetic risk moderation of these associations. Methods: The longitudinal design included nondemented adults (n = 532, mean age = 70.4 years, range 53–95) from the Victoria Longitudinal Study. Using structural equation analyses on an EF latent variable, we tested (a) sex moderation and (b) interactive effects of sex and APOE on observed EPA-EF and mobility-EF performance and change relationships. Results: First, we observed independent sex effects for the EPA-EF and mobility-EF predictions. Whereas EPA had a significant effect on EF performance and change only for females, mobility had a significant effect for both sexes. Notably, males with lower mobility levels experienced steeper EF decline than females with lower mobility levels. Second, we observed significant sex × APOE interaction effects. The combination of lower genetic risk and higher EPA benefitted females but not males. In contrast, lower genetic risk and higher mobility benefited both sexes, although male APOE no-risk carriers with lower mobility levels had EF decline patterns that were similar to APOE risk carriers. Conclusions: Longitudinal analyses across a broad band of aging show that sex moderates the effects of both EPA and mobility on EF performance and change. Notably, this moderation occurs differentially across the AD genetic risk status. These results point to a precision health approach to observational and interventional research in which effects of physical activity and mobility on EF trajectories and dementia are examined in the personalized and interactive context of sex and AD risk.

Alzheimer's Disease Biomarkers Interactively Influence Physical Activity, Mobility, and Cognition Associations in a Non-Demented Aging Population.

Alzheimer's disease (AD) risk-reduction strategies (e.g., increasing physical activity, improving mobility) have garnered increasing attention in the literature. However, the effect of such modifiable factors on the preclinical trajectories of brain and cognitive health may be moderated by non-modifiable biomarkers associated with AD. In a longitudinal sample of non-demented older adults, we examine the independent predictors everyday physical activity (EPA) and mobility on executive function (EF) performance and change. Next, we test whether these predictions are modified by interactions between age and AD genetic risk. This accelerated longitudinal design included adults (n = 532, M age = 70.4, age range 53-95) from the Victoria Longitudinal Study. We tested the independent effects of EPA and Mobility (i.e., gait, balance), moderation by Apolipoprotein E (i.e., APOEɛ4+, ɛ4-) and age (young-old, middle-old, old-old), and interactions between APOE and age on performance and 9-year change in an EF latent variable. First, higher levels of both EPA and Mobility were associated with better EF performance and less decline. Second, the interaction between age and APOE showed that low EPA and older age was associated with poorer EF performance and steeper EF decline for APOEɛ4 + carriers, and low mobility was associated with poorer EF performance and steeper EF decline for APOEɛ4 + carriers than the non-risk carriers. In non-demented older adults, age moderated the effects of both EPA and Mobility on EF performance and change. However, this moderation occurs differentially across APOE4 status.

Associations between physical activity and semen quality in young healthy men

To evaluate whether the level of everyday physical activity is associated with semen quality in young men. Cross-sectional study. Universities, clubs, and societies. Young healthy men (aged 18-35years) with unknown fertility (n = 177). Collection of data on medical history, lifestyle factors (physical activity, nutrition, addictions), and environmental threats (exposure of gonads to cellular phones, laptops). Collection of semen samples. Semen parameters. Men who were physically more active (3rd and 4th quartiles) had a higher percentage of immotile sperm than less active subjects (1st and 2nd quartiles). The mean (95% confidence interval) percentages were, respectively: 53% (38%-69%) and 51% (41%-61%) versus 38% (28%-49%) and 39% (29%-48%). Other semen parameters were unrelated to physical effort. Physical activity might be associated with an altered percentage of immotile sperm in young, lean, educated men who have not fathered children.

Genetic factors moderate everyday physical activity effects on executive functions in aging: Evidence from the Victoria Longitudinal Study.

Everyday physical activity (EPA) is an important modifiable contributor to age-related variability in executive functioning (EF). However, its role may be moderated by nonmodifiable genetic factors. We tested independent and interactive effects of brain-derived neurotrophic factor (BDNF rs6265) and insulin degrading enzyme (IDE rs6583817) on EF and EPA-EF relationships. The sample consisted of genotyped older adults (N = 577; M age = 70.47 years) over 3 waves (∼9 years) of the Victoria Longitudinal Study. Analyses included (a) confirmatory factor analysis establishing a single latent EF factor from 4 standard EF tasks, (b) latent growth modeling over a 40-year band of aging (ages 53 to 95), and (c) structural regression to investigate the independent and interactive effects of BDNF, IDE, and EPA. First, higher levels of EPA were associated with better EF performance at the centering age (75 years) and less EF decline. Second, IDE G+ (protective) carriers exhibited better EF performance at Age 75 than their G- (nonprotective) peers. Third, within the IDE G+ carrier group, those with higher EPA exhibited better EF performance and slower decline over time than those with lower EPA. Fourth, for the BDNF homozygote Val group, higher EPA was associated with better EF performance and more gradual EF change; however, this beneficial effect was not seen for Met carriers. The effect of modifiable physical health factors on EF is moderated by biological mechanisms associated with risk-protection genetic polymorphisms.

Conflicted goal engagement: undermining physical activity and health in late life.

Pursuing health goals in very old age is a challenging task that may be undermined by conflicted goal engagement involving mismatched primary (behavior-focused) and secondary (motivation-focused) control striving. Our study explored whether one potentially detrimental combination of control strategies (low primary control/high secondary control) compromised 3-year indicators of everyday physical activity and blood oxygen saturation. We analyzed data from a representative sample of very old adults (n = 107) using simple slope regression analyses that tested the conditional effects of control striving on everyday physical activity and blood oxygen saturation. We found a conflicted engagement effect wherein primary control predicted our outcomes only when secondary control was high. The lowest levels of everyday physical activity and blood oxygen saturation were found for older adults high in secondary control but low in primary control. A supplemental mediation analysis suggested everyday physical activity was the mechanism through which conflicted engagement undermined blood oxygen saturation. Employing health maintenance strategies that promote motivation-focused thinking but discourage goal-directed behaviors (conflicted engagement) may compromise physical activity and health among very old adults. Further research is needed to determine whether control-enhancing interventions promote harmonious goal engagement and better health among these high-risk individuals.

What do we mean by a flare of rheumatoid arthritis?

53% at age 16–24 to 16% at 65 plus. Similarly only 12% of women over 65 meet the recommended levels compared with 28–36% of younger women. Older people with musculoskeletal pain, commonly caused by OA and allied disorders, or less frequently by inflammatory arthropathies such as gout or RA, have reduced levels of everyday physical activity. The impact of chronic pain assessed by pain interference with daily activities increases throughout life into the oldest years. It is clear that regular physical activity improves both pain and quality of life, increases functional independence and reduces the risk of further chronic illness in those with joint pain, and should therefore be a target for intervention in older people with chronic pain. Developing interventions that increase rates of physical activity in older people with chronic musculoskeletal pain is challenging since they need to address pain-related factors such as fear of injury and fear of falling. There is also considerable patient uncertainty about the benefits of exercise, and interventions need to be implementable. While increasing exercise levels is a national and international priority, the mechanisms to achieve this remain unclear. Two recent systematic reviews and meta-analyses reported that exercise referral schemes in primary care were ineffective, but advice and counselling interventions were associated with small to medium short-term increases in selfreported physical activity. Walking is one way of increasing physical activity and has been described as near perfect exercise. Walking is already the most common form of exercise employed by older adults and has been identified as a priority for research by patients with joint pain. Interventions to promote walking have the potential to be successful since walking is perceived to be popular, familiar, convenient, social and free. Despite this there is a lack of effective interventions to promote walking for older people who have chronic pain. This presentation will summarize the current state of knowledge on behavioural interventions to increases walking in older people by addressing three main questions: What intervention should be delivered to promote walking in older people with chronic pain? How should the intervention be delivered? Who should deliver the intervention? Disclosure statement: The author has declared no conflicts of interest.

Cardiovascular disease risk in adults with spastic bilateral cerebral palsy

To explore: (i) cardiovascular disease risk factors and the 10-year clustered risk of a fatal cardiovascular event in adults with spastic bilateral cerebral palsy; and (ii) relationships between the 10-year risk and body fat, aerobic fitness and physical activity. Cross-sectional study. Forty-three adults with spastic bilateral cerebral palsy without severe cognitive impairment (mean age 36.6 years (standard deviation 6); 27 men). Biological and lifestyle-related risk factors and the 10-year risk according to the Systematic Coronary Risk Evaluation (SCORE) were assessed. Relationships were studied using multivariable linear regression analysis. The following single risk factors were present: hypertension (n = 12), elevated total cholesterol (n = 3), low high-density lipoprotein cholesterol (n = 5; all men), high-risk waist circumference (n = 11), obesity (body mass index; n = 5; all men), reduced aerobic fitness (on average 80% of reference values), reduced level of everyday physical activity (on average 78% of reference values) and smoking (n=9). All participants had a 10-year risk <1%. Corrected for gender, participants with higher waist circumference (β = 0.28; p = 0.06) or body mass index (β=0.25; p = 0.08) tended to have a higher 10-year risk. In this relatively young adult sample of people with spastic bilateral cerebral palsy several single cardiovascular disease risk factors were present. The 10-year fatal cardiovascular disease risk was low, and higher body fat tended to be related to higher 10-year risk.

The profile of Sense of Positive Health and Survival Abilities indices (subjective assessment) as a diagnostic tool used in health-related training

Background The main objective of the article is a methodic of the profile of the sense of positive health and survival abilities indices in relation “patient (client) personal trainer (leader)”. The objective of empiric sphere was the profile based on subjective assessment of young women possessing different level of everyday physical activity. The question is whether there is a significant difference in the profile of sense of positive health indices in all its dimensions and own survival abilities between young women who declare engagement in everyday physical activity and their peers, who are occasionally active? Material/Methods: The profile based on the subjective sense of various positive health indices covers three dimensions: somatic A, mental B, social C and D dimension, which represents sense of indices and assessment reflecting individual’s survival abilities. The sense of intensity of particular indices is evaluated in the 1 to 5 scale (where its value is as follows: 1 very low, 2 low, 3 average, 4 high, 5 very high). The “0” index is used for the purpose of evaluation of specific abilities (D dimension). The arithmetic mean of indices (after decomposition to diagnostic values) calculated for particular dimensions (from A to D) constitutes a general measure of a given health dimension and survival abilities. The arithmetic mean calculated for A to D indices represents the most general index of Sense of Positive Health and Survival Abilities (SPHSA). The study group consisted of 23-year old female students of the 2-cycle university program in physiotherapy, (22 declared engagement in everyday physical activity whereas 100 were occasionally active). Results: Women who reported engagement in everyday physical activity possess higher values of SPHSA than their peers, who are occasionally active (respectively 3.641 and 3.479; p<0.05). The highest value was recorded for social health sense (4.12 and 4.14), whereas the lowest value was noted for the survival abilities (2.956 and 2.828). Students who are active on daily basis possess statistically higher values than women who occasionally engage in physical activity as far as the following indices are concerned: muscular strength (p<0.01) and aerobic capacity, reduced aggressiveness, swimming ability, precision skills in various status of organism (p<0.05). Conclusions: From the methodological point of view the assumption that the profile indices do not directly reflect the sense of health but rather the imaginative value of a specific virtue, ability etc. proved positive. Diversification of assessment is higher in the case of indices, for which the reliability of an individual’s assessment is considered to be relatively high (especially in the A, B and D dimensions).

Accelerometry-Based Activity Spectrum in Persons With Chronic Physical Conditions

van den Berg-Emons RJ, Bussmann JB, Stam HJ. Accelerometry-based activity spectrum in persons with chronic physical conditions. Objectives (1) To give an overview of the impact of a variety of chronic physical conditions on accelerometry-based levels of everyday physical activity and to identify high-risk conditions; and (2) to compare these objectively assessed activity levels with the levels estimated by rehabilitation physicians. Interventions Not applicable. Design Cross-sectional study. Setting Participant's home environment. Participants Patients (n=461) with 18 chronic physical (sub)conditions and able-bodied subjects (n=96). Main Outcome Measures We summarized data on the level of everyday physical activity as objectively measured with an accelerometry-based activity monitor. Thirty-one rehabilitation physicians filled in a questionnaire designed to obtain their estimates of the level of physical activity in patients with the various conditions. Results Only 4 of the studied conditions had normal activity levels (≥90% of the able-bodied level). Persons with transtibial amputation (vascular), spinal cord injury, and myelomeningocele (wheelchair dependent) had the lowest levels of activity, less than 40% of the able-bodied level. In general, rehabilitation physicians were aware of the inactive lifestyles, but considerably underestimated the magnitude of inactivity in the high-risk conditions. Conclusions This is the first study to provide an objectively assessed activity spectrum in a variety of chronic physical conditions. We hope this study will increase the awareness of health professionals as to which chronic physical conditions are at increased risk for an inactive lifestyle, and will contribute to adaptation of patient management accordingly.

The mode of school transportation in pre-pubertal children does not influence the accrual of bone mineral or the gain in bone size--two year prospective data from the paediatric osteoporosis preventive (POP) study.

BackgroundWalking and cycling to school are one source of regular physical activity. The aim of this two years observational study in pre-pubertal children was to evaluate if walking and cycling to school was associated with higher total amount of physical activity and larger gain in bone mineral content (BMC) and bone width than when going by car or bus.Methods133 boys and 99 girls aged 7-9 years were recruited to the Malmö Prospective Paediatric Osteoporosis Prevention (POP) study. BMC (g) was measured by dual X-ray absorptiometry (DXA) in total body, lumbar spine (L2-L4) and femoral neck (FN) at baseline and after 24 months. Bone width was measured in L2-L4 and FN. Skeletal changes in the 57 boys and 48 girls who consistently walked or cycled to school were compared with the 24 boys and 17 girls who consistently went by bus or car. All children remained in Tanner stage I. Level of everyday physical activity was estimated by accelerometers worn for four consecutive days and questionnaires. Comparisons were made by independent student's t-tests between means and Fisher's exact tests. Analysis of covariance (ANCOVA) was used to adjust for group differences in age at baseline, duration of organized physical activity, annual changes in length and BMC or bone width if there were differences in these traits at baseline.ResultsAfter the adjustments, there were no differences in the annual changes in BMC or bone width when comparing girls or boys who walked or cycled to school with those who went by car or bus. Furthermore, there were no differences in the levels of everyday physical activity objectively measured by accelerometers and all children reached above the by the United Kingdom Expert Consensus Group recommended level of 60 minutes moderate to vigorous physical activity per day.ConclusionA physical active transportation to school for two years is in pre-pubertal children not associated with a higher accrual of BMC or bone width than a passive mode of transportation, possibly due to the fact that the everyday physical activity in these pre-pubertal children, independent of the mode of school transportation, was high.

Inactive lifestyle in adults with bilateral spastic cerebral palsy

To quantify the level of everyday physical activity in adults with bilateral spastic cerebral palsy, and to study associations with personal and cerebral palsy-related characteristics. Fifty-six adults with bilateral spastic cerebral palsy (mean age 36.4 (standard deviation (SD) 5.8) years, 62% male) participated in the study. Approximately 75% had high gross motor functioning. Level of everyday physical activity was measured with an accelerometry-based Activity Monitor and was characterized by: (i) duration of dynamic activities (composite measure, percentage of 24 h); (ii) intensity of activity (motility, in gravitational acceleration (g)); and (iii) number of periods of continuous dynamic activity. Outcomes in adults with cerebral palsy were compared with those for able-bodied age-mates. Duration of dynamic activities was 8.1 (SD 3.7) % (116 min per day), and intensity of activity was 0.020 (SD 0.007) g; both outcomes were significantly lower compared with able-bodied age-mates. Of adults with cerebral palsy, 39% had at least one period of continuous dynamic activities lasting longer than 10 min per day. Gross motor functioning was significantly associated with level of everyday physical activity (Rs -0.34 to -0.48; p </= 0.01). Adults with bilateral spastic cerebral palsy, especially those with low-level gross motor functioning, are at risk for an inactive lifestyle.

Everyday Physical Activity as a Predictor of Late-Life Mortality

The present study hypothesized that simple, everyday physical activity (EPA) would decline with advancing age; that women would have a more favorable EPA profile than would men; and that EPA would have a survival benefit. Community-dwelling participants (aged 80-98 years, n = 198) wore mechanical actigraphs in order for EPA to be assessed. Individuals were classified as active, inactive, and sedentary based on their level of EPA exhibited over a substantial part of the day. Survival status was available at approximately 2 years. Mean EPA scores decreased with advancing age and, in contrast to men, women in their early eighties appeared to be protected from declining EPA. This partially supported the hypothesis that women would have a more favorable EPA profile. What is most important is that mean EPA scores predicted mortality. Moreover, when compared with their less sedentary counterparts, sedentary adults were more than three times as likely to be deceased 2 years later. Researchers need to conduct new trials to determine whether or how physical activity is associated with mortality.

A school-curriculum-based exercise intervention program for two years in pre-pubertal girls does not influence hip structure.

BackgroundIt is known that physical activity during growth has a positive influence on bone mineral accrual, and is thus possibly one strategy to prevent osteoporosis. However, as bone geometry, independent of areal bone mineral density (aBMD), influences fracture risk, this study aimed to evaluate whether hip structure in pre-pubertal girls is also affected by a two-year exercise intervention program.MethodsForty-two girls aged 7–9 years in a school-curriculum-based exercise intervention program comprising 40 minutes of general physical activity per school day (200 minutes per week) were compared with 43 age-matched girls who participated in the general Swedish physical education curriculum comprising a mean of 60 minutes per week. The hip was scanned by dual energy X-ray absorptiometry (DXA) and the hip structural analysis (HSA) software was applied to evaluate bone mineral content (BMC, g), areal bone mineral density (aBMD, g/cm2), periosteal diameter, cross-sectional area (CSA, cm2), section modulus (Z, cm3) and cross-sectional moment of inertia (CSMI, cm4) of the femoral neck (FN). Annual changes were compared. Subjective duration of physical activity was estimated by questionnaire and objective level of everyday physical activity at follow-up by means of accelerometers worn for four consecutive days. All children remained at Tanner stage 1 throughout the study. Group comparisons were made by independent student's t-test between means and analyses of covariance (ANCOVA).ResultsAt baseline, the two groups did not differ with regard to age, anthropometrics or bone parameters. No between-group differences were observed for annual changes in the FN variables measured.ConclusionA two-year school-based moderately intense general exercise program for 7–9-year-old pre-pubertal girls does not influence structural changes in the FN.

Barriers to and facilitators of everyday physical activity in persons with a spinal cord injury after discharge from the rehabilitation centre

To determine the most important barriers to and facilitators of the level of everyday physical activity in persons with a spinal cord injury after discharge from the rehabilitation centre. Qualitative study with both cross-sectional and retrospective questions. Thirty-two persons with a spinal cord injury. Semi-structured interview with questions concerning the current situation (>9 months after discharge) and retrospective questions concerning the period shortly after discharge (=3 months). The interview consisted of 10 topic categories assumed to have an impact on the level of everyday physical activity and covering the main parts of the International Classification of Functioning, Disability and Health (ICF) model. In the current situation, the most important barriers were problems with accessibility of stores and buildings, physical health problems and mental health problems. Shortly after discharge, the most important barriers were emotional distress, problems with self-care, and mental health problems. The most frequently mentioned facilitators were preparation in the rehabilitation centre with respect to daily activities and social activities and stimulation to be physically active. Persons with a spinal cord injury experience important barriers to physical activity, particularly on the ICF component Body Functions and Structure.

Everyday Physical Activity and Adiposity in Prader-Willi Syndrome

The aim of this study was to assess the impact of Prader-Willi syndrome (PWS) on the level of everyday physical activity and to explore whether the activity level is related to adiposity. Measurements were performed with an accelerometry-based Activity Monitor during two consecutive schooldays in 12 children with PWS (7-16 years of age) and in 12 age- and gender-matched, healthy children. Adiposity was assessed by body mass index standard deviation scores and by percentage body fat (dual energy X-ray absorptiometry). Mean duration of dynamic activities (expressed as percentage of 24 h) was lower in children with PWS than in the comparison group (8.7 [2.5]% and 12.0 [3.1]%, respectively; p = 0.01). Six children with PWS had normal activity levels. Physical activity level was not related to adiposity. The results indicate that, as a group, children with PWS have an inactive lifestyle. However, children with PWS cannot be stereotyped as inactive since half of them had normal activity levels.

The relationship between gastroesophageal reflux disease and the level of physical activity.

Data on associations between physical activity and gastroesophageal reflux disease (GERD) have been inconsistent. Although experimental and clinical studies prove that exercise increases gastroesophageal reflux, epidemiological observations on the relationship between GERD and everyday physical effort deliver contradictory results. Our aim was to examine the association between the level of everyday physical activity and parameters of the disease (pH-metry, symptoms) in patients diagnosed with GERD. We assessed the level of physical activity in a survey of 100 consecutive GERD patients. All subjects had undergone 24-h pH monitoring in a tertiary setting and reported symptoms they experienced daily. Using the criteria of the short form of the International Physical Activity Questionnaire (7-day recall) we identified groups presenting with low (I), moderate (II) or high (III) levels of physical activity. The amount of physical activity was expressed as multiples of resting metabolic rate and minutes of performance during a week (METs-minute/week). For evaluation of relationships between everyday physical activity and pH-metric indices of GERD a multivariate regression analysis was performed. The parameters studied were adjusted for age, BMI, smoking and gender (as covariates). We did not observe any association between the amount of everyday physical activity (expressed as log base 10 METs-minute/week) and pH-metric parameters of GERD evaluated 5 cm and 15 cm above the lower oesophageal sphincter (LES). Furthermore, we analyzed relationships between investigated parameters and covariates: age, BMI, smoking and gender. We found significant correlations only between the number of reflux episodes 15 cm above LES and gender (beta -0.25; p <0.05) and between the number of reflux episodes 5 cm above LES and age (beta -0.24; p <0.05). The number of self-reported symptoms did not differ among the three groups of physical activity level. It reached 6 in groups I and II, and 7 in group III (p = 0.07). However we must note that we found a weak, positive correlation between the number of symptoms reported by patients and METs-minute/week (r = 0.21, p <0.05). In view of our results the level of everyday physical activity is not associated with symptoms of GERD. This observation should be confirmed in other populations with GERD diagnosed upon pH-metric criteria.

The relationship between gastroesophageal reflux disease and the level of physical activity.

Data on associations between physical activity and gastroesophageal reflux disease (GERD) have been inconsistent. Although experimental and clinical studies prove that exercise increases gastroesophageal reflux, epidemiological observations on the relationship between GERD and everyday physical effort deliver contradictory results. Our aim was to examine the association between the level of everyday physical activity and parameters of the disease (pH-metry, symptoms) in patients diagnosed with GERD. We assessed the level of physical activity in a survey of 100 consecutive GERD patients. All subjects had undergone 24-h pH monitoring in a tertiary setting and reported symptoms they experienced daily. Using the criteria of the short form of the International Physical Activity Questionnaire (7-day recall) we identified groups presenting with low (I), moderate (II) or high (III) levels of physical activity. The amount of physical activity was expressed as multiples of resting metabolic rate and minutes of performance during a week (METs-minute/week). For evaluation of relationships between everyday physical activity and pH-metric indices of GERD a multivariate regression analysis was performed. The parameters studied were adjusted for age, BMI, smoking and gender (as covariates). We did not observe any association between the amount of everyday physical activity (expressed as log base 10 METs-minute/week) and pH-metric parameters of GERD evaluated 5 cm and 15 cm above the lower oesophageal sphincter (LES). Furthermore, we analyzed relationships between investigated parameters and covariates: age, BMI, smoking and gender. We found significant correlations only between the number of reflux episodes 15 cm above LES and gender (beta -0.25; p <0.05) and between the number of reflux episodes 5 cm above LES and age (beta -0.24; p <0.05). The number of self-reported symptoms did not differ among the three groups of physical activity level. It reached 6 in groups I and II, and 7 in group III (p = 0.07). However we must note that we found a weak, positive correlation between the number of symptoms reported by patients and METs-minute/week (r = 0.21, p <0.05). In view of our results the level of everyday physical activity is not associated with symptoms of GERD. This observation should be confirmed in other populations with GERD diagnosed upon pH-metric criteria.

Bone mineral accrual and gain in skeletal width in pre-pubertal school children is independent of the mode of school transportation--one-year data from the prospective observational pediatric osteoporosis prevention (POP) study.

BackgroundWalking and cycling to school could be an important regular source of physical activity in growing children. The aim of this 12 months prospective observational study was thus to evaluate the effect of self-transportation to school on bone mineral accrual and gain in bone width in pre-pubertal children, both traits independently contributing to bone strength.MethodsNinety-seven girls and 133 boys aged 7–9 years were recruited as a part of the Malmö Pediatric Osteoporosis Prevention (POP) Study in order to evaluate the influence of self-selected school transportation for the accrual of bone mineral and bone width. Children who walked or cycled to school were compared with children who went by bus or car. Bone mineral content (BMC) was measured by dual energy X-ray absorptiometry (DXA) in the lumbar spine (L2–L4), third lumbar vertebra (L3) and hip, and bone width was calculated at L3 and femoral neck (FN). Changes during the first 12 months were compared between the groups. Subjective duration of physical activity was estimated by a questionnaire and objective level of everyday physical activity at follow-up by accelerometers worn for four consecutive days. All children remained in Tanner stage 1 throughout the study. Comparisons were made by independent student's t-tests between means, ANCOVA and Fisher's exact tests.ResultsThere were no differences in baseline or annual changes in BMC or bone width when the transportation groups were compared. No differences were detected in objectively measured daily level of physical activity by accelerometer. All children reached above 60 minutes of moderate to intense daily physical activity per day, the international recommended level of daily physical activity according to the United Kingdom Expert Consensus Group.ConclusionThe everyday physical activity in these pre-pubertal children seems to be so high that the school transportation contributes little to their total level of physical activity. As a result, the choice of school transportation seems not to influence the accrual of bone mineral or gain in bone size during a 12-month follow-up period.

Everyday physical activity and community participation of adults with hemiplegic Cerebral Palsy

Purpose. To assess the level and potential determinants of everyday physical activity and participation in various life areas of adults with hemiplegic cerebral palsy (CP) in comparison with healthy subjects.Method. In a cross-sectional study everyday physical activity was measured (Activity Monitor) in 16 adults with CP, aged 28 (3) years, and 16 age/gender matched healthy volunteers, aged 29 (3) years. Participation was assessed by means of validated questionnaires. Age, gender, body fat (skinfold thickness), muscle tone (Ashworth Scale), functional level and participation were assessed as potential determinants of everyday physical activity.Results. In adults with CP mean (SD) duration of dynamic activities during a day (10.6 [3.5]%) was comparable to healthy subjects (11.2 %) (p = 0.66). In most life areas the level of participation was comparable for both groups, although adults with CP spent more time on non-intensive leisure activities. Participation in sports appeared to be a determinant of everyday physical activity in both groups.Conclusions. The results indicate that the levels of everyday physical activity and community participation in adults with hemiplegic CP are comparable to levels in healthy comparison subjects.