Low Levels Of Physical Activity Research Articles

Early Online

Background. The personal health behaviours and lifestyle habits of health professionals influence their counselling practices related to non-communicable diseases (NCDs). There is limited evidence on the prevalence of modifiable NCD risk factors among medical students in South Africa (SA). Objectives. To determine the prevalence of modifiable behavioural and metabolic NCD risk factors in first-year medical students at a SA university. Methods. This cross-sectional observational study included 256 first-year students. Participants completed five online questionnaires regarding lifestyle behaviours (physical activity, dietary habits, smoking, alcohol consumption and sleep quality). NCD-related metabolic markers including body composition, blood pressure, total cholesterol and random glucose concentrations, were measured. The prevalence of risk factors was calculated using internationally accepted criteria, and sex differences were reported using one-way ANOVA or χ2 test (p<0.05). Results. The prevalence of poor sleep quality was 79.7%, followed by low-to-moderate diet quality (66.8%), low levels of physical activity (64.1%), overweight/ obesity (26.2%), current/past smoking (13.3%) and harmful use of alcohol (12.5%). Most (88.3%) participants had two or more NCD-related risk factors. The prevalence of multiple NCD risk factors differed significantly between male and female participants, with more male participants having ≥2. Conclusions. This study found that first-year medical students at a South African university have a high prevalence of lifestyle-related risk factors, specifically poor sleep quality, low levels of physical activity and low-to-moderate diet quality. Sleep hygiene, regular activity and good nutrition should be promoted, and interventions focusing on nutrition, smoking cessation and alcohol consumption could be targeted by sex.

EMG-assessed paratonia: A novel approach to investigating motor response inhibition in healthy subjects.

Paratonia is an involuntary muscle activity that occurs during passive joint mobilization and is common in people with dementia. It includes oppositional paratonia, in which muscle activity resists passive movement, and facilitatory paratonia, in which it assists movement. This phenomenon reflects a defect in motor response inhibition. In a recently published paper, we demonstrated that paratonia can be detected using surface electromyography (EMG) not only in patients with dementia but also in healthy individuals, the majority of whom do not exhibit clinically observable paratonia. This finding suggests that EMG-assessed paratonia may provide a novel approach to studying motor response inhibition in healthy subjects. The present study investigates this possibility for the first time. We recruited 120 healthy subjects under the age of 30, divided equally into three groups: sedentary, amateur, and professional athletes with low, moderate, and high levels of physical activity, respectively. Paratonia was assessed in the triceps and biceps brachii muscles during passive forearm movements performed manually. The results indicate that paratonia is more pronounced during fast and continuous passive movements, with facilitatory paratonia being more prevalent than oppositional paratonia. It is also more pronounced in the biceps than in the triceps. These findings, which mirror those previously observed in patients with dementia, suggest a similarity between paratonia in healthy subjects and those with cognitive impairment, supporting the hypothesis that paratonia in healthy individuals represents a form of impaired motor response inhibition. Furthermore, the comparison between groups showed that paratonia decreased with increasing physical activity, being least evident in athletes, more noticeable in amateurs, and most pronounced in sedentary individuals. This pattern confirms a key feature of motor response inhibition that has been shown in studies using traditional methods. Overall, our findings suggest that EMG-assessed paratonia provides a new method for studying motor response inhibition in healthy individuals.

'I can't relate to it': Exploring autistic and non-autistic adults' perceptions of the Australian Physical Activity and Sedentary Behaviour Guidelines.

Despite sufficient physical activity (PA) being strongly associated with better health outcomes, half of the Australian population does not meet the Australian PA and Sedentary Behaviour Guidelines. This shortfall is more pronounced among autistic adults, who exhibit poorer health outcomes and lower PA levels than non-autistic adults. Despite these disparities, there is a limited understanding of how autistic and non-autistic individuals perceive and interpret the PA guidelines. This study investigated how autistic and non-autistic adults perceive and comprehend the Australian PA guidelines. This study used interpretative phenomenological analysis. A total of 15 autistic and 20 non-autistic adults were interviewed, and 4 themes that were largely similar between both groups were identified: (1) Lack of Awareness and Engagement with the PA Guidelines, (2) Misinterpretation of Key Terms and Concepts, (3) Perceived lack of Relevance and Relatability of the PA Guidelines and (4) Lack of Inclusivity. The findings underscore the importance of crafting health communication and promotion materials that are more visible, clear, inclusive and engaging for non-autistic and autistic individuals in Australia. SO WHAT?: This study highlights the potential for improving the number of people correctly understanding the PA guidelines by addressing dissemination methods, knowledge and interpretation of the guidelines as some components of the multifaceted process required to achieve behaviour change.

Особенности секреции интерлейкина-6 и скорость окисления жиров у детей с конституционально-экзогенным ожирением с различным уровнем физической активности

Physical inactivity is accompanied by a decrease of skeletal muscle mass and is one of the main reasons for obesity. Interleukin-6 (IL-6) acts as a paracrine and endocrine regulator of the intensity of carbohydrate and fat metabolism during exercises. The purpose of this research was to evaluate the fat oxidation rate and serum IL-6 in children with simple obesity depending on the level of daily physical activity (PA). Methods used: a cross-sectional, single-center sampling study that included 53 children aged 12 to 18 y/o (27 boys/26 girls) with obesity (SDS BMI 3.0 [2.6;3.3]) divided into two groups depending on the level of daily PA was conducted. The maximal fat oxidation (MFO) was assessed during ergometric stress testing with gas analysis. The IL-6 was assessed by ELISA at baseline and after a single physical activity. The level of daily PA was determined using the IPAQ international questionnaire Results: basal IL-6 level in children with obesity and low PA was 1.18 [0.42;1.55] pg/ml and was statistically significantly increased compared to the group of children without physical inactivity, 0.57 [0.22;0.8] pg/ml (p=0.029). The values of IL-6 after physical activity in both boys and girls with obesity and physical inactivity were statistically significantly increased compared with the group of children with obesity and moderate/high PA (p=0.032 and p=0.012 for boys and girls, respectively). The MFO in children with a low level of PA was 0.33 [0.22;0.41] g/min and did not significantly differ statistically from the group of peers with moderate or high PA (0.31 [0.25;0.36] g/min; p=0.431). Conclusion: a sedentary lifestyle in obese children leads to an increase in both basal and stimulated IL-6 secretion and is not accompanied by a decrease in maximal fat oxidation.

Health-Enhancing Physical Activity (HEPA) and Its Barriers Among Working Women at Mansoura University, Egypt

Background: Identifying physical activity (PA) and its barriers among middle-aged women may aid in the development of age-specific health promotion interventions. In Egypt, women, particularly those in the workforce, typically face numerous barriers that result in low levels of PA. This research seeks to assess the prevalence of health-enhancing physical activity (HEPA) among working women at Mansoura University and identify the associated barriers. Methods: This cross-sectional study employs a quantitative methodology that includes an analytic component. We studied a non-random sample of 760 Egyptian women employed at Mansoura University. Sociodemographic data were collected, and the international physical activity questionnaire (IPAQ) short form was used to assess the level of PA. Additionally, the Barriers to Being Active Quiz (BBAQ) was used to assess barriers to PA. Results: One-fourth of women engage in HEPA; 44.9% are classified as minimally active, while 30.1% are inactive. Multivariable logistic regression analysis showed the type of job is an independent predictor of HEPA, with ARR of 1.7 for manager and administrative roles. The total BBAQ score significantly predicts HEPA (ARR = 0.94). Social influences and lack of willpower scores are significant independent predictors of HEPA (ARR = 0.9 and 0.8, respectively). Most individuals encounter two to five barriers, with only 11.3% experiencing no PA barriers. The most frequently reported barrier is the lack of energy (80.4%), followed by the lack of resources, willpower, and time (74.04%, 69.6%, and 69.4%, respectively). Conclusions: The prevalence of HEPA is low among working women at Mansoura University. Policymakers can utilize findings to promote engagement with and adherence to physical activity.

Longitudinal study examining the relationship between physical activity and psychiatric hospitalizations in canadian adolescents and young adults utilizing record linkage

Overwhelming evidence suggests that physical activity among youth can prevent mental illness; however, few studies have explored its effects on mental healthcare utilization. This study aimed to examine the longitudinal associations between physical activity among Canadian adolescents and young adults (AYAs; 12–24 years) and incidence of psychiatric hospitalizations. Physical activity was measured in the 2001–2014 Canadian Community Health Survey (CCHS) and was linked to the Discharge Database. Negative binomial regression analyses were performed on each CCHS cycle to obtain incidence rate ratios (IRRs) for psychiatric hospitalizations by level of physical activity, which were subsequently meta-analyzed to obtain pooled estimates. In total, 96,100 participants were recruited across eleven cycles. Adolescents were more physically active (52%) compared to young adults (39%). The most common cause of hospitalization was mood or anxiety disorders (38%). Fully adjusted models found that moderately active (IRR = 1.30; 95% CI: 1.02–1.66; p = 0.01) and inactive (IRR = 1.33; 95% CI: 1.06–1.66; p = 0.01) participants had higher rates of psychiatric hospitalizations compared to active participants. Our findings suggest that lower levels of physical activity among AYAs were associated with an increased incidence of psychiatric hospitalizations, providing valuable insights for stakeholders and laying the groundwork for future research.

Do Patients with Rheumatoid Arthritis Have an (In)Adequate Level of Physical Activity? A Latent Class Analysis Approach

Introduction: Regular physical activity (PA) has a beneficial effect on joint pain, stiffness, strength, flexibility, and aerobic capacity in patients with rheumatoid arthritis (RA). Objective: The aim of this study was to assess the level of PA in patients with rheumatoid arthritis and to identify potential barriers to this activity. Material and Methods: The study involved 132 patients with RA. Participants completed the International Physical Activity Questionnaire (IPAQ), the Functional Assessment of Chronic Illness Therapy—Fatigue Scale (FACIT-F), the Tampa Scale for kinesiophobia (TSK), Strength, Ambulation, Rising from a chair, Stair climbing and history of Falling questionnaire (SARC-F) for sarcopenia assessment, and the Patient Health Questionnaire-9 (PHQ-9) for depression. Basic socio-epidemiological data, disease activity score in 28 joints (DAS28), duration of disease, and therapy information were retrieved from electronic patient records. Latent class analysis (LCA) was used to identify subpopulations of patients. Results: The study included 109 women (82.6%) and 23 men (17.4%). Low levels of PA were observed in 16 patients (12%), moderate levels in 70 patients (53%), and high levels in 42 patients (35%). Symptoms of pronounced fatigue were significantly associated with low PA (28.5 ± 11.3 vs. 37 ± 7 vs. 37 ± 10; p = 0.002). The risk of sarcopenia was significantly higher in RA patients with low PA (p = 0.05). Kinesiophobia was present in all three groups (65.2%). LCA identified two classes. In the first class, patients were more likely to be non-exercisers compared to the second class. Patients in the first class were characterized by a higher probability of being female, obese, with lower education levels. Patients in the first class had pronounced fatigue, kinesiophobia and more frequent symptoms of depression. The second class (65% of the total population) included patients who exercised moderately to frequently (93%) and were middle-aged. They were less obese, highly educated, employed, and majority of them achieved low disease activity or remission. In addition, they had lower risks for sarcopenia, depression, fatigue, and kinesiophobia. Conclusions: This study showed that RA patients with moderate and high levels of PA have better disease control, fewer symptoms of fatigue and depression, and a lower risk of sarcopenia. However, kinesiophobia was significantly present in all three groups, indicating a need for further promotion of this non-pharmacological treatment.

E-cycling intention versus behavioral change: Investigating longitudinal changes in e-cycling intention and actual behavior change in daily commuting

By offering the opportunity to make longer trips at a lower level of physical activity, the e-bike provides a promising alternative to car use. Despite all advantages (e-)cycling brings to urban accessibility, the environment, physical and mental health, not all car commuters regard the e-bike as a suitable alternative yet in their daily activity patterns. This study reports on changes in behavioral intention and actual e-cycling brought about by an e-cycling incentive program in the province of Noord-Brabant, the Netherlands. The impact of the program on behavioral intention and the actual change to e-cycling were analyzed based on a longitudinal three-wave survey design on past, intended, and actual commuting behavior. To explore the changes in behavioral intentional, the differences between intention and actual behavior and the factors influencing them, descriptive and ordinal logistic regression analyses were conducted. To explore the dynamics between e-cycling intentions and behavior a longitudinal structural equation model was developed. In general, this study shows that the incentive program has a positive impact on participants’ behavioral change to e-cycling during the incentive program. Results show that two-third of the participants actually use the e-bike as much as they intended at the start of the program. People who were used to taking the conventional bicycle to work before the stimulation program, are more consistent between their intention and behavior. Results also show that personal beliefs, habits, and goal-related variables do not influence the intention–behavior consistency.

Biopsychosocial factors associated with physical activity among Resettlers of the former Soviet Union in Germany: a cross-sectional analysis

ObjectivePrevious research suggests an overall lower cardiovascular disease mortality among ethnic German Resettlers from the Former Soviet Union. However, evidence points to a high burden of metabolic risk factors and...

The association between physical activity levels and quality of life in elderly lung cancer patients undergoing chemotherapy in China: a cross-sectional study

ObjectiveThis study aimed to investigate the association between physical activity (PA) levels and quality of life (QOL) in elderly lung cancer patients undergoing chemotherapy in China.MethodsTwo hundred eight elderly lung cancer patients undergoing chemotherapy were recruited by convenient sampling at two tertiary A hospitals in Guangxi from October 2023 to March 2024. The evaluation of PA Levels by the International Physical Activity Questionnaire Short Form (IPAQ-SF) was conducted, and the Functional Assessment of Cancer Therapy-Lung (FACT-L) was utilized to measure the QOL. Multiple linear regression was used to identify factors correlated with QOL.ResultsOut of 208 elderly patients with lung cancer who were undergoing chemotherapy, 119 (57.20%) had low-level PA, 79 (38.00%) had moderate-level PA, and 10 (4.80%) had high-level PA. The mean score of FACT-L was 95.41 ± 15.01, and FACT-L was correlated with age, residency, education level, and per capita monthly household income (P < 0.05). Moderate to high PA levels explained 19.4% of the variation in QOL among elderly patients undergoing chemotherapy for lung cancer.ConclusionElderly lung cancer patients undergoing chemotherapy exhibited lower levels of PA. The increase in PA levels was associated with better QOL. Treatment options for elderly lung cancer patients undergoing chemotherapy may involve PA plans to boost their QOL. It is vital to evaluate the patient’s physical condition and functional level when creating these plans to ensure safety and effectiveness, thereby increasing patient engagement and maximizing enhancements in their QOL.

The impact of COVID-19-induced distance learning on physical activity and dietary habits of female students in the Qassim Region

ABSTRACT Background: The COVID-19 pandemic has profoundly affected the physical activity (PA) levels and dietary habits of individuals, particularly children and adolescents in Saudi Arabia, owing to widespread closures and social distancing measures, including school closures. Methods: A cross-sectional study was conducted to assess the impact of distance learning (DL) on PA and dietary habits among public middle school girls during the pandemic. The Arab Teens Lifestyle Questionnaire (ATLS) was used to assess habitual PA, sedentary behavior, and dietary habits. Results: A total of 300 middle school female students, with an average age of 14 years, participated in the study. The results indicated a generally low level of PA among students during DL and after school reopening, with a significant decrease in specific types of PA, such as walking and stair climbing during DL. However, after schools reopened, there was a significant increase in students’ participation in activities such as swimming, dancing, and housework (P &lt; 0.05). Moreover, sleep hours and TV-watching time increased compared to the DL period. Despite the prevalence of students frequently consuming soft drinks, sugary treats, fried and fast foods, as well as sweets and chocolates during the lockdown, middle school girls also consumed a lot of fruits and vegetables. Conclusion: Assessing students’ habitual PA and dietary habits during the lockdown may provide insights into their future health and well-being post-pandemic. This assessment can help in identifying strategies to redirect current PA levels to maintain health and prevent potential long-term health implications.

Multi-Context Strategies and Opportunities for Increasing Levels of Physical Activity in Children and Young People: A Literature Review

Background: In today’s society, low levels of physical activity are observed in the child and adolescent population, which can cause numerous pathologies, such as obesity and mental health problems. Objective: This article aims to compile all the contexts and scenarios where it is possible to increase the levels of daily physical activity of children and young people, and which have significant scientific support. Method. To do so, a literature review was carried out examining four key contexts for intervention: school, extracurricular, family, and socio-community. Results: The results indicate that the school context, with strategies such as physical education classes and active breaks, is crucial but insufficient on its own, so it is essential to complement it with interventions in extracurricular, family, and socio-community environments. The involvement of families, access to adequate infrastructure such as parks and green areas, and the responsible use of technology, including active video games and the role of influencers on social networks, are presented as key elements to combat a sedentary lifestyle. Conclusions: It is important to highlight the importance of establishing socio-educational programs that adopt a comprehensive approach to promote physical activity in children and youth, highlighting the scientific evidence that supports the effectiveness of intervening in multiple scenarios. This review concludes that a coordinated approach between different actors (schools, families, communities) is necessary to ensure that children and youth reach adequate levels of physical activity, which not only improves their physical health, but also their mental well-being and cognitive development.

Plasma triacylglycerol length and saturation level mark healthy aging groups in humans.

Complex lipids, essential components in biological processes, exhibit conserved age-related changes that alter membrane properties and cellular functions and are implicated as biomarkers and contributors to longevity and age-related diseases. While physical activity alleviates age-related comorbidities and physical impairments, comprehensive exploration of the underlying biological mechanisms, particularly at the level of complex lipids, remains limited. However, clinical studies suggest that physical activity may counteract these age-related lipidomic changes, presenting a promising avenue for intervention. We performed lipidomic profiling of plasma from an extensively characterized cohort of young and aged individuals. Annotating 1446 unique lipid species across 24 lipid classes, we found the most prominent difference in older adults was an accumulation of triacylglycerols (TGs), with lower physical activity levels associated with higher TG levels in plasma and reduced physical functionality. Remarkably, lipid species in the TG class did not accumulate uniformly. Rather, our study unveiled a negative correlation between higher physical activity levels and TGs with shorter chain lengths and more double bonds in this demographic. Overall, our research highlights that plasma TG length and saturation level can help mark healthy aging groups in humans. These findings deepen our understanding of how aging affects complex lipids and the influence of physical activity on this process.

Circadian Typology and Physical Activity in Young Adults with Gaming Disorder

Background and Objectives: Exploring daily lifestyle characteristics in individuals with gaming disorder (GD) might identify underlying causes and intervention points. However, integrative and subjective assessments are lacking in studies on this topic. This study aimed to assess circadian typology and physical activity in young adults with GD. Materials and Methods: We recruited 60 participants with GD and 120 age- and sex-matched controls. GD and delayed sleep phase syndrome (DSPS) were diagnosed through structured interviews. Physical activity and sleep patterns were measured using actigraphy. Self-reported measures were chronotype and insomnia by using composite scale of morningness (CSM) and the Pittsburg insomnia rating scale (PIRS). Results: We found that DSPS and eveningness chronotype was more prevalent in the GD group than in the control group. The GD group also contained more participants with insomnia with higher PIRS and a longer time to fall asleep compared with the control group. The GD group had lower physical activity levels for daily calorie expenditure, daily steps, and daily walking distance compared with the control group. No significant differences were observed in body weight and sleep duration between these groups. Conclusions: Individuals with GD, compared to HC, exhibit an eveningness chronotype, poorer sleep quality, lower physical activity, and higher obesity risk, suggesting that lifestyle adjustments like increased exercise and earlier sleep might help modify habitual behaviors and potentially further provide a way to treat GD.

Influence of learning stress on anxiety levels among high school students in China: the chain-mediated role of physical activity and mobile phone addiction

ObjectivesThe objectives are to explore the relationship between study stress and anxiety in high school students and the mediating role of physical activity and mobile phone addiction.DesignA cross-sectional study.Setting129 high...

Trajectories of physical activity after ischaemic stroke: Exploring prediction of change.

Physical activity (PA) is associated with lower risk of stroke and better functional outcome. However, low levels of PA after stroke are prevalent. The aim was to identify predictors of PA change after first-time ischaemic stroke and to develop prediction models to predict change in PA. Pre-stroke and 6 months post-stroke PA were quantified with the Physical Activity Scale for the Elderly (PASE). Considered predictors were clinical data and demographics including data on socioeconomic status (SES). PASE change was analysed using mixed models of repeated measures. Elastic net regression models were used to predict decrease from higher PASE quartile to the lowest and increase from lowest to higher. A total of 523 first-time ischaemic stroke patients were included. Median (interquartile range, IQR) age was 69 years (IQR 59, 77), 181 (35%) were female and median National Institutes of Health Stroke Scale score was 3 (IQR 2, 5). Overall PASE score did not change, but 20% of patients decreased to the lowest PASE quartile whereas 48% from the lowest quartile increased to a higher. Prediction performance measured by area under the receiver operating curve was 0.679 for PA decrease and 0.619 for increase. SES factors were the most consistent predictors. Half of the least active patients increased PA level after stroke whereas a fifth decreased with SES being the most consistent predictor. Despite comprehensive data, the prediction models only performed modestly. Efforts to optimize PA should include all stroke survivors to increase PA for least active patients and to prevent PA decrease.

Sex Differences in Sleep and Physical Activity Patterns in Autism Spectrum Disorder.

Physical activity (PA) programs have been found to result in improved sleep in males with autism spectrum disorder (ASD), but little is known about the female characteristics. The aim of this work was to assess sex differences in sleep and PA indices using an accelerometer over 7 days and 7 nights. Sleep and PA variables were measured with questionnaires and with accelerometry in twenty-four children with ASD (16 boys, 10.3 ± 2.8; 8 girls, 11.1 ± 3.9). Some significant differences were reported between girls and boys. The total time in bed and wake time after sleep onset (WASO) were significantly higher in girls compared to boys (p < 0.01), whereas sleep efficiency was significantly lower in girls (p < 0.01). The results obtained from the sleep questionnaire (CSHQ) show averages above the threshold of 41 in both groups (the threshold indicates the presence of sleep disorders or low sleep quality). The number of daily steps was significantly lower in the girls' group (p < 0.01), and the PA volume for vigorous and strong vigorous intensities was significantly higher in the boys' group (p < 0.01 and p < 0.05, respectively). Our results show major alterations in girls, with a low level of PA and sleep alteration. PA is a relevant non-pharmacological approach to improve sleep quality and achieve sufficient sleep duration. However, particularly for girls with ASD, more personalized approaches to improve sleep may be needed to manage specific associated disorders.

Construction of physical activity promoting indicators system for older adults with subjective cognitive decline using Delphi method

BackgroundFor older adults with subjective cognitive decline (SCD), physical activity is now recognized as an effective means to reduce the risk of Alzheimer’s disease. However, this population often exhibits lower levels of physical activity. This study aimed to establish physical activity promoting indicators system for older adults with SCD, providing comprehensive targets for interventions and promoting relevant policies.MethodA modified Delphi technique was used to seek opinions from experts about what should be used and prioritised as indicators of promoting physical activity in older adults with SCD. Expert consultations were conducted from January to March 2024. Data were analyzed using SPSS 27.0 and Excel software. Descriptive statistics were used for expert demographics, while coefficients were calculated to assess expert authority (Cr), and coordination (Kendall’s W). Weights for indicators were determined through the order diagram.ResultsBased on a literature review and the Wuli-Shili-Renli system framework, we initially identified 59 indicators, comprising primary (3 dimensions), secondary (11 items), and tertiary (45 items) indicators. Fifteen expert panelists were invited to participate in the study. Of these, 11 out of 18 completed round 1 (61.1% response rate), all 11 completed round 2 (100.0% response rate), and all 11 completed the third and final round (100.0% response rate). Ultimately, consensus was reached on 3 primary, 9 secondary, and 44 tertiary indicators. The order diagram determined weights for primary indicators as follows: foundational system (0.4242), operational system (0.2879), and personnel system (0.2879).ConclusionThe system of 56 physical activity-promoting indicators constructed for older adults with SCD through the Delphi method provides theoretical support for policy formulation and allocation of funds to comprehensively promote physical activity behaviors among this population.

Association of physical activity and sedentary behaviour with depressive symptoms in Chinese adults

ABSTRACT This study aims to examine the independent and joint associations of physical activity (PA) and sedentary behaviour with depressive symptoms. A population-based cross-sectional study conducted in China included 17,861 adults. PA and sedentary behaviour were assessed using the International Physical Activity Questionnaire. Depressive symptoms were determined by the 9-item Patient Health Questionnaire score ≥10. Logistic regression models were used to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs). The prevalence of depressive symptoms among all participants was 20.6% (3679/17861). Higher levels of PA were inversely associated with depressive symptoms, whereas prolonged sedentary behaviour was associated with increased odds of depressive symptoms. The positive associations between sedentary behaviour and depressive symptoms remained significant, regardless of PA levels. In joint analyses, the depressive symptoms OR comparing adults who reported low level of PA with the highest tertile of sedentary behaviour to those reporting high level of PA with the lowest tertile of sedentary behaviour was 1.99 (95% CI 1.64 to 2.40). This study indicated that high level of PA may not offset the increased risk of depressive symptoms associated with high amounts of sedentary behaviour, and therefore these behaviours should be considered jointly to obtain optimal prevention effects.

The Safety, Feasibility, and Efficacy of a Structured Individual Exercise Program for Community-Dwelling Stroke Patients.

Stroke is a leading cause of mortality and long-term disability worldwide, often resulting in low levels of physical activity post-discharge. A comprehensive exercise program could be a safe method to increase stroke patients' physical activity and exercise volume. This pilot study examines the effectiveness, safety, and feasibility of a comprehensive exercise regimen for stroke patients residing in the community after discharge. This single-group pilot study included patients who received inpatient rehabilitation for motor impairment following a stroke. Community-dwelling participants engaged in a comprehensive exercise program, which was structured and individualized, consisting of stretching, aerobic exercise, strength training, and balance exercises, conducted under the supervision of a health exercise specialist in a dedicated living lab within the hospital. The program involved 20 sessions, each lasting 50 min, conducted three to five times weekly. The pre- and post-intervention evaluations were comprehensive, including safety and validity assessments, along with physical function tests such as cardiopulmonary exercise testing and various fitness tests (6 min walk test, timed up and go test, chair stand test, figure-of-8 walk test, grip strength test, and sit-and-reach test). Depression levels were assessed using the Geriatric Depression Scale (GDS). A total of 22 subjects were recruited, with 21 completing the study after one dropout due to fatigue and visiting distance. Among the 21 completers, one subject experienced a mild adverse event (hypoglycemia), which was not serious, confirming the program's safety. The exercise participation rate was 95.5%, and the adherence rate averaged 95.2%, with all completers achieving over 80% adherence. Significant improvements were observed in VO2 peak (p = 0.000), 6 min walk test (p = 0.000), timed up and go test (p = 0.000), chair stand test (p = 0.000), figure-of-8 walk test (p = 0.000), and grip strength (p = 0.001). However, changes in the peak respiratory exchange ratio (p = 0.078), sit-and-reach test (p = 0.228) and GDS scores (p = 0.275) were not significant. This study demonstrates that the comprehensive exercise program is sufficiently safe and valid for stroke rehabilitation patients. The program significantly enhances cardiopulmonary endurance, walking ability, balance, muscle strength, muscle endurance, and coordination. Further research with larger sample sizes and control groups is needed to confirm these findings and explore additional benefits.