Measurement Of Daily Physical Activity Research Articles

Relevance of the anterior cingulate cortex volume and personality in motivated physical activity behaviors

Some recent theories about the origins and maintenance of regular physical activity focus on the rewards of the properties of practicing this activity. Animal and human studies have demonstrated that mesolimbic dopamine plays a crucial role in the involvement in voluntary physical activity. Here, we test this possible role in a sample of 66 right-handed healthy young adults by studying the influence of personality and the volume of reward-related brain areas on individual differences in voluntary physical activity, objectively measured by accelerometer and subjectively self-reported by questionnaire. Our results show that a smaller volume of the right anterior cingulate cortex and lower scores on reward sensitivity contributed to explaining low levels of daily physical activity. Moreover, the volume of the right anterior cingulate cortex correlates positively with self-reported total physical activity. Results are discussed by highlighting the need to use objective measures of daily physical activity, as well as the important role of the anterior cingulate cortex and personality in promoting effortful and invigorating actions to obtain rewards.

Wrist Accelerometer Estimates of Physical Activity Intensity During Walking in Older Adults and People Living With Complex Health Conditions: Retrospective Observational Data Analysis Study.

Accurate measurement of daily physical activity (PA) is important as PA is linked to health outcomes in older adults and people living with complex health conditions. Wrist-worn accelerometers are widely used to estimate PA intensity, including walking, which composes much of daily PA. However, there is concern that wrist-derived PA data in these cohorts is unreliable due to slow gait speed, mobility aid use, disease-related symptoms that impact arm movement, and transient activities of daily living. Despite the potential for error in wrist-derived PA intensity estimates, their use has become ubiquitous in research and clinical application. The goals of this work were to (1) determine the accuracy of wrist-based estimates of PA intensity during known walking periods in older adults and people living with cerebrovascular disease (CVD) or neurodegenerative disease (NDD) and (2) explore factors that influence wrist-derived intensity estimates. A total of 35 older adults (n=23 with CVD or NDD) wore an accelerometer on the dominant wrist and ankle for 7 to 10 days of continuous monitoring. Stepping was detected using the ankle accelerometer. Analyses were restricted to gait bouts ≥60 seconds long with a cadence ≥80 steps per minute (LONG walks) to identify periods of purposeful, continuous walking likely to reflect moderate-intensity activity. Wrist accelerometer data were analyzed within LONG walks using 15-second epochs, and published intensity thresholds were applied to classify epochs as sedentary, light, or moderate-to-vigorous physical activity (MVPA). Participants were stratified into quartiles based on the percent of walking epochs classified as sedentary, and the data were examined for differences in behavioral or demographic traits between the top and bottom quartiles. A case series was performed to illustrate factors and behaviors that can affect wrist-derived intensity estimates during walking. Participants averaged 107.7 (SD 55.8) LONG walks with a median cadence of 107.3 (SD 10.8) steps per minute. Across participants, wrist-derived intensity classification was 22.9% (SD 15.8) sedentary, 27.7% (SD 14.6) light, and 49.3% (SD 25.5) MVPA during LONG walks. All participants measured a statistically lower proportion of wrist-derived activity during LONG walks than expected (all P<.001), and 80% (n=28) of participants had at least 20 minutes of LONG walking time misclassified as sedentary based on wrist-derived intensity estimates. Participants in the highest quartile of wrist-derived sedentary classification during LONG walks were significantly older (t16=4.24, P<.001) and had more variable wrist movement (t16=2.13, P=.049) compared to those in the lowest quartile. The current best practice wrist accelerometer method is prone to misclassifying activity intensity during walking in older adults and people living with complex health conditions. A multidevice approach may be warranted to advance methods for accurately assessing PA in these groups.

Predictors of left ventricular mass and coronary artery calcium phenotypes

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): National Medical Research Council, Ministry of Health, Singapore and the Lee Foundation Background Left ventricular (LV) mass and coronary artery calcium score (CACS) are both independent predictors of cardiovascular risk. There is paucity of data on the interplay of risk factors on LV mass in the presence or absence of subclinical coronary atherosclerosis. Purpose The objective of this present study was to explore the relationship of risk factors to indexed LV mass and CACS in a healthy Southeast-Asian population. Methods This study recruited volunteers with no known cardiovascular disease. LV mass, measured by cardiovascular magnetic resonance, was indexed to body surface area (LVMI), and CACS determined by non-contrast CT scanning. Blood pressure (BP) was measured via both office and ambulatory monitoring, and physical activity assessed through wearable devices. Analysis of LVMI was stratified into high, normal and low defined as more than one standard deviation away from the mean for each sex, with inter-group differences evaluated using chi-squared or ANOVA statistical tests. Subjects in each LVMI group were further subdivided by the presence and absence of coronary calcification (total 6 subgroups; LVMI/CACS phenotypes). Results A total of 880 subjects were included, including 428 males and 452 females. There was no significant difference in prevalence of coronary calcification across the LVMI groups for males, while females with high LVMI had significantly greater proportion of positive CACS (p = 0.036). Higher LVMI was observed in younger male subjects, but not in females. In both sexes, body mass index was positively associated with LVMI (p = 0.004 for males, p = 0.037 for females), but not CACS. Waist circumference was associated with higher LVMI in males only. Greater amounts of weekly self-reported exercise (p = 0.006) and daily calories burned (p = 0.022) were associated with increased LVMI for males only. However, wearable-derived measures of daily physical activity and step counts did not significantly affect LVMI or LVMI/CACS phenotypes in both sexes. BP was a strong predictor of LVMI in both sexes regardless of office or ambulatory readings, in both day and night-time. The association was also observed with LVMI/CACS phenotypes: higher systolic or diastolic BP was significantly associated with positive CACS across all risk groups. Notably, subjects with low LVMI and positive CACS were normotensive (office BP 129/82 for males, 123/77 for females). Higher HDL cholesterol levels correlated to absence of coronary calcification in males only (p = 0.010). In females, lower levels of total (p = 0.001) and LDL (p = 0.005) cholesterol were associated with absence of coronary calcification across all LVMI categories. Conclusion Only BP was strongly associated with LVMI and LVMI/CACS phenotypes in both sexes. There appears to be no correlation between physical activity and LVMI/CACS phenotypes. There is a need for causative studies to better evaluate the varying influence of risk factors on LVMI and CACS.

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

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

Development and performance of a sleep estimation algorithm using a single accelerometer placed on the thigh: an evaluation against polysomnography.

Accelerometers placed on the thigh provide accurate measures of daily physical activity types, postures and sedentary behaviours, over 24 h and across consecutive days. However, the ability to estimate sleep duration or quality from thigh-worn accelerometers is uncertain and has not been evaluated in comparison with the 'gold-standard' measurement of sleep polysomnography. This study aimed to develop an algorithm for sleep estimation using the raw data from a thigh-worn accelerometer and to evaluate it in comparison with polysomnography. The algorithm was developed and optimised on a dataset consisting of 23 single-night polysomnography recordings, collected in a laboratory, from 15 asymptomatic adults. This optimised algorithm was then applied to a separate evaluation dataset, in which, 71 adult males (mean [SD] age 57[11]years, height 181[6]cm, weight 82[13]kg) wore ambulatory polysomnography equipment and a thigh-worn accelerometer, simultaneously, whilst sleeping at home. Compared with polysomnography, the algorithm had a sensitivity of 0.84 and a specificity of 0.55 when estimating sleep periods. Sleep intervals were underestimated by 21 min (130 min, Limits of Agreement Range [LoAR]). Total sleep time was underestimated by 32 min (233 min LoAR). Our results evaluate the performance of a new algorithm for estimating sleep and outline the limitations. Based on these results, we conclude that a single device can provide estimates of the sleep interval and total sleep time with sufficient accuracy for the measurement of daily physical activity, sedentary behaviour, and sleep, on a group level in free-living settings.

Subjective Daily Physical Activity Measures in Heart Disease: A Systematic Review.

The measurement of daily physical activity (DPA) is important for the prognosis and quantifying clinical outcomes in individuals with heart disease. The measurement of DPA is more feasible using subjective measures when compared with objective measures. The purpose of this systematic review of the literature was to identify the subjective measures of DPA that have established reliability and validity in individuals with heart disease to assist clinician and researcher instrument selection. A systematic search of PubMed, CINAHL, MEDLINE, and ProQuest databases was performed. Methodological rigor was assessed using 3 different quality appraisal tools. Qualitative synthesis of included studies was performed. Twenty-two unique studies covering 19 subjective DPA measures were ultimately included. Methodological rigor was generally fair, and validity coefficients were moderate at best. Only 4 subjective measures that have established test-retest reliability and that provide an estimate of energy expenditure, metabolic equivalents, or minutes of DPA were compared against accelerometry or a DPA diary in patients with heart disease: SWISS Physical Activity Questionnaire, Total Activity Measure 1 and 2, and Mobile Physical Activity Logger. Depending on the clinician or researcher needs, instrument selection would depend on the recall period and the DPA construct being measured.

Daily physical activity in patients on chronic haemodialysis and its relation with fatigue and depressive symptoms.

Fatigue and depressed mood are considered main impediments to physical activity in haemodialysis (HD) patients. A better understanding of their interrelationships is crucial to develop effective therapies. Moreover, measurement of daily physical activity (DPA) in HD patients is tricky, as it is usually assessed by subjective self-report questionnaires. Therefore, we aimed to objectively measure sponteanous DPA with motion sensors and to explore its relation with fatigue and depressive symptoms. DPA was assessed for seven consecutive days in 37 HD patients based on their daily step count measured with the SenseWear™ Armband. The Fatigue Severity Scale (FSS) and Beck Depression Inventory-II (BDI-II) were administered to evaluate fatigue and depressed mood. Median DPA was 2424 steps/day, (IQR:892-4545). In 81% of subjects, DPA felt within a sedentary lifestyle classification, as they made < 5.000 steps/day. DPA did not correlate with fatigue (rs = 0.04, p = 0.832), and did not significantly differ between patients categorized as clinically fatigued (n = 23, FSS ≥ 4) or not (n = 14, FSS < 4) (p = 0.654, d = 0.20). Although low-depressed subjects (n = 19, BDI-II ≤ 13) made on average 1.7 times more steps/day than high-depressed subjects (n = 18, BDI-II > 13) (p = 0.111, d = 0.60), depressive mood did also not correlate significantly with DPA (rs = -0.23, p = 0.175). Objective assessment of DPA with motion sensors is feasible in HD patients and allows identifying a sedentary lifestyle. Our results suggest that spontanous DPA is determined by age rather than by fatigue or mood.

Evaluation of Clinical Outcomes and Simultaneous Digital Tracking of Daily Physical Activity, Heart Rate, and Inhalation Behavior in Patients With Pulmonary Arterial Hypertension Treated With Inhaled Iloprost: Protocol for the Observational VENTASTEP Study.

BackgroundPulmonary arterial hypertension (PAH)—a progressive, ultimately fatal disease—patients often experience dyspnea, which can limit their daily physical activities. Iloprost is an inhaled therapy for PAH that has shown efficacy in clinical trials. However, clinical trials in PAH have provided only limited data on daily physical activity. Digital monitoring of daily physical activity in PAH is therefore attracting growing interest. To fully understand a patient’s response to treatment, monitoring of treatment adherence is also required. The Breelib nebulizer for administration of iloprost saves inhalation data, thus allowing digital monitoring of adherence.ObjectiveThis study aims to perform parallel digital tracking of daily physical activity parameters, heart rate, and iloprost inhalation data in patients with PAH, before and after starting inhaled iloprost treatment. The primary objective is to investigate correlations between changes in digital measures of daily physical activity and traditional clinical measures. Secondary objectives are to assess iloprost inhalation behavior, the association between daily physical activity measures and time since last inhalation, changes in sleep quality and heart rate, the association of heart rate with daily physical activity measures and iloprost inhalation, and adverse events.MethodsVENTASTEP is a digital, prospective, observational, multicenter, single-arm cohort study of adults with PAH in Germany, starting inhaled iloprost treatment via the Breelib nebulizer, in addition to existing PAH therapy. The study comprises a baseline period without iloprost treatment (≤2 weeks) and an observation period with iloprost treatment (3 months±2 weeks). The Apple Watch Series 2 and iPhone 6s are used with a dedicated study app to continuously measure digital daily physical activity parameters and heart rate during the baseline and observation periods; the watch is also used with a 6-min walk distance (6MWD) app to measure digital 6MWD at baseline and the end-of-observation visit. Inhalation frequency, completeness, and duration are monitored digitally via the nebulizer and the BreeConnect app. Sleep quality is assessed using the Pittsburgh Sleep Quality Index at baseline and the end-of-observation visit. Changes in traditional outcome measures (6MWD, Borg dyspnea scale, EuroQol 5-dimensions questionnaire, functional class, and brain natriuretic peptide [BNP] or N-terminal proBNP) between baseline and the end-of-observation visit will be correlated with changes in digital daily physical activity parameters and digital 6MWD as the primary analysis.ResultsThe first participant was enrolled in February 2018 (estimated study completion by July 2019; planned sample size: 80 patients).ConclusionsThe VENTASTEP study will inform future research on the utility of digital parameters as outcome assessment tools for disease monitoring in PAH. The study will also provide insight into clinical outcomes, daily physical activity, and quality of life in patients adding inhaled iloprost, to existing PAH therapy.Trial RegistrationClinicalTrials.gov NCT03293407; https://clinicaltrials.gov/ct2/show/NCT03293407 (Archived by WebCite at http://www.webcitation.org/6ywPGcn4I)International Registered Report Identifier (IRRID)DERR1-10.2196/12144

Exploring the distances people walk to access public transport

ABSTRACTA shift from private motorised transport to more active transportation can, among other things, deliver significant health benefits. The main disadvantage of active transport (in particular walking) for most people compared to private motorised transport is the limited range. Public transport (PT) can complement the use of active modes and extend their range. Therefore, there might be potential to increase physical activity through an increase in PT use. This article takes a closer look at how walking relates to the use of PT by examining existing literature on the topic. It aims to study how far people walk to and from PT and what key factors influence this. Scopus, Transport Research International Documentation and Web of Science have been searched systematically for relevant articles, conference papers and books. After screening of titles and abstracts, 41 relevant publications were identified. Studies were included if they quantified the amount of walking (measured as either distance or time) that is directly related to the use of PT. Studies that quantified walking using general measures of daily physical activity or daily walking or that used stated preference designs were excluded. The PT systems considered in this paper are mass transport systems in urban areas, either road- or rail-based, with fixed schedules and stops. Demand responsive transport services, which can offer door-to-door travel, are not considered, as these systems can to a large extent eliminate the need to walk. In the identified publications, a large variety of walking distances and times have been reported, and these seem to be highly context-specific. The paper establishes the evidence for the wide range of factors that influence walking related to PT, which have been categorised as personal, PT-related, environmental, and journey-related. The different methods that have been used are discussed by critically analysing their advantages and limitations. Only a limited number of these methods used allow for an accurate assessment of the walking distances to and from PT. The paper concludes with suggestions for future research, such as a need for more accurate measurement of walking and research in different geographical areas to shed light on underlying influences of culture and climate.

No impact of exacerbation frequency and severity on the physical activity decline in COPD: a long-term observation.

IntroductionCOPD exacerbations are associated with a concomitant profound reduction in daily physical activity (PA). Thereby, exacerbation frequency and severity may have an amplifying effect. Whether the reduced level of PA returns to the level prior to exacerbation or has a sustained negative impact on activity behavior over time is unclear.MethodsThe number of steps per day over 1 week, as a measure of daily PA, was assessed annually in a cohort of patients with COPD. Exacerbation frequency and severity were documented. Uni- and multivariate mixed effect models were used to investigate associations between change in number of steps per day (dependent variable) and exacerbations. Stratification by possible confounders was performed.ResultsOne hundred and eighty one COPD patients (median [quartile] age 64 [59/69] years, 65% male, median [quartiles] FEV1 % pred. 46 [33/65]) suffered a total of 273 exacerbations during the observation period (median [quartiles] follow-up time of 2.1 [1.6/3.1] years). Neither the frequency nor the severity of exacerbations was significantly related to the overall decline in PA over time. Stratification by different possible confounders such as age, sex and disease severity did not yield a subgroup in which exacerbations enhance the decrease in PA over time.ConclusionThe drop in PA during the phase of an acute exacerbation seems not to be a lasting phenomenon leading to a fundamental change in activity behavior.Trial registrationwww.ClinicalTrials.gov, NCT01527773

Pedometer-assessed steps per day as a predictor of cognitive performance in older adults.

To examine associations between pedometer-assessed daily steps and several domains of cognitive functioning in cognitive healthy older adults. A total of 582 cognitively healthy older adults enrolled in a longitudinal aging study completed the Uniform Data Set (UDS) neuropsychological battery (n = 374) or the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; n = 208) and were asked to wear a pedometer for 1 week. Bivariate correlations revealed associations between average daily steps and attention, executive functioning, language, and memory on one or both cognitive batteries. Multiple regression analyses controlling for demographic, health, and mobility variables demonstrated a significant relationship between average daily steps and the executive functioning composite of the UDS battery and average daily steps and the attention index of the RBANS battery. Both of these composites include measures of processing speed and, therefore, the most robust link between daily steps and cognition may be its association with processing speed. Step counts as measured by a pedometer, a simple and inexpensive measure of daily physical activity, are robustly associated with aspects of cognition. As pedometer-based interventions have shown success in increasing daily physical activity in older adults, a greater number of future studies should consider measuring cognitive outcomes of these interventions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Daily Physical Activity in Total Hip Arthroplasty Patients Undergoing Different Surgical Approaches: A Cohort Study.

Muscle weakness due to trauma from the surgical approach is anticipated to affect the ability of the patient to undertake daily physical activity early after total hip arthroplasty (THA). The objective of this study was to compare daily physical activity on days 1 to 4 after discharge, in patients following THA performed by 1 of 3 surgical approaches. A cohort study included 60 hip osteoarthritis patients, scheduled for THA, allocated to direct lateral approach, posterior approach, or anterior approach. Daily physical activity was measured by an accelerometer, with upright time per 24 hours as primary outcome and walking time, number of steps, and number of upright events per 24 hours as secondary outcomes. There were no statistically significant group differences in any of the measures of daily physical activity (P > 0.290) or between days of follow-up (P > 0.155). Overall, the median participant had 3.50 hours (interquartile range, 2.85-4.81 hours) of upright time, and participants showed wide variation in all outcomes of daily physical activity. There were no differences in daily physical activity between THA patients undergoing different surgical approaches. The surgical approach may not be a limiting factor for daily physical activity early after surgery in a fast-track treatment course.

Fatigue Alters the Pattern of Physical Activity Behavior in Older Adults: Observational Analysis of Data from the Generation 100 Study.

Fatigue has been associated with reductions in daily activity of older people. Summary measures of daily physical activity provide limited understanding of how fatigue affects physical activity behavior. This study examined the hour-by-hour energy expenditure estimated from accelerometry data to provide insight into physical activity behaviors of older people experiencing fatigue. Fatigued participants were matched to 'not fatigued' participants by age, sex, and BMI. Each group consisted of 86 people with a mean age 73.8 years (SD 2.0), BMI 26.5 kg⋅m-2 (SD 3.9) and 61% female. The phase-space plot, constructed to express rate of change of average vertical axis counts per hour as a time series, showed fatigued participants deviated from the not fatigued participants during the morning period, when hour-by-hour activity was increasing. Older people who feel fatigued have a different morning activity pattern, which appears to lead to the lower overall levels of physical activity.

Abstract MP58: Objectively-measured Physical Activity and Incident Cardiovascular Events Among Mobility Limited Older Adults: The Life Study

Introduction: Objective measurement of daily physical activity (PA) is an important predictor of cardiovascular risk among young- and middle-aged adults. However, data are sparse regarding the value of activity monitoring among older adults [[Unable to Display Character: &amp;#8211;]] particularly among those with mobility limitations. Hypothesis: We hypothesized that objectively-measured daily PA would be associated with the incidence of cardiovascular (CV) events among older adults in the Lifestyle Interventions and Independence for Elders (LIFE) study [[Unable to Display Character: &amp;#8211;]] a Phase 3 randomized clinical trial comparing a structured exercise intervention (median 2.7 years) to health education among mobility-limited older adults. Methods: CV events (myocardial infarction, stroke, cardiovascular death, silent myocardial infarction, angina/symptomatic coronary artery disease, peripheral artery disease, abdominal aortic aneurysm) were adjudicated by medical records review. Free-living activity data were collected by hip-worn accelerometer at baseline and 6, 12, and 24 months post-randomization. Linear regression, adjusted for accelerometer wear time, demographic and cardiovascular disease-related covariates, was used to model the relationship of incident CV events with accelerometry variables (steps/day and minutes/day spent in activity registering ≥ 100 or ≥ 500 counts/minute) at baseline and in a time-dependent fashion. Results: Participants (n = 1618; age 78.9 ± [SD] 5.2 years; 67.2% female) had a cumulative CV event incidence rate of 14.5% (234 events). Event rates did not differ between randomized groups. At baseline, participants registered 2681 ± 1475 steps/day and spent 22.8 ± 8.2% of their time performing activities≥ 100 cts/min and 6.3 ± 4.3% of time in activities ≥ 500 cts/min. At baseline, CV event risk was10% lower for every 500 steps/day (HR: 0.90, 95% CI: 0.84-0.96, p=0.001). Each 30 minutes spent performing activities ≥ 100 cts/min (0.89, CI: 0.83-0.96, p=0.002) and ≥ 500 cts/min (HR = 0.76, CI: 0.65-0.90, p=0.001) was also associated with lower CV event risk. Across all follow-up visits, participants took 2544 ± 1592 steps/day and spent 21.3 ± 8.2% of their time performing activities&gt; 100 cts/min and 5.8± 4.3% of time in activities ≥ 500 cts/min. In time-dependent analyses, both steps/day (HR: 0.92, CI: 0.86-0.97, p=0.004) and duration of activity ≥ 500 counts/min (HR: 0.80, CI: 0.68-0.94, p=0.007) were associated with lower CV event rates. Longitudinal performance of activity ≥ 100 cts/min was not statistically significant (HR: 0.93, CI: 0.87-1.01, p=0.067). Conclusions: Objective measurements of PA collected via accelerometry predicted incident CV events among older adults with limited mobility. These data support the importance of daily PA in this population and suggest that accelerometry may be a useful tool to aid in assessing the risk of CV events.

Measurement of daily physical activity using the SenseWear Armband: Compliance, comfort, adverse side effects and usability.

Little is known about the acceptability of wearing physical activity-monitoring devices. This study aimed to examine the compliance, comfort, incidence of adverse side effects, and usability when wearing the SenseWear Armband (SWA) for daily physical activity assessment. In a prospective study, 314 participants (252 people with COPD, 36 people with a dust-related respiratory disease and 26 healthy age-matched people) completed a purpose-designed questionnaire following a 7-day period of wearing the SWA. Compliance, comfort levels during the day and night, adverse side effects and ease of using the device were recorded. Non-compliance with wearing the SWA over 7 days was 8%. The main reasons for removing the device were adverse side effects and discomfort. The SWA comfort level during the day was rated by 11% of participants as uncomfortable/very uncomfortable, with higher levels of discomfort reported during the night (16%). Nearly half of the participants (46%) experienced at least one adverse skin irritation side effect from wearing the SWA including itchiness, skin irritation and rashes, and/or bruising. Compliance with wearing the SWA for measurement of daily physical activity was found to be good, despite reports of discomfort and a high incidence of adverse side effects.

The effects of progressive resistance training on daily physical activity in young people with cerebral palsy: a randomised controlled trial

Purpose: To examine if individualised resistance training increases the daily physical activity of adolescents and young adults with bilateral spastic cerebral palsy (CP). Method: Young people with bilateral spastic CP were randomly assigned to intervention or to usual care. The intervention group completed an individualised lower limb progressive resistance training programme twice a week for 12 weeks in community gymnasiums. The primary outcome was daily physical activity (number of steps, and time sitting and lying). Secondary outcomes included muscle strength measured with a one-repetition maximum (1RM) leg press and reverse leg press. Outcomes were measured at baseline, 12 weeks and 24 weeks. Results: From the 36 participants with complete data at 12 weeks, there were no between-group differences for any measure of daily physical activity. There was a likely increase in leg press strength in favour of the intervention group (mean difference 11.8 kg; 95% CI −1.4 to 25.0). No significant adverse events occurred during training. Conclusions: A short-term resistance training programme that may increase leg muscle strength was not effective in increasing daily physical activity. Other strategies are needed to address the low-daily physical activity levels of young people with bilateral spastic CP.Implications for RehabilitationProgressive resistance training may increase muscle strength but does not lead to increases in daily physical activity of young people with bilateral spastic cerebral palsy (CP) and mild to moderate walking disabilities.Other strategies apart from or in addition to resistance training are needed to address the low daily physical activity levels of young people with bilateral spastic CP and mild to moderate walking disabilities.

Telemetry Option in the Measurement of Physical Activity for Patients with Heart Failure

Abstract Measurement of physical activity among patients with heart failure typically requires a special approach due to the patients’ physical status. Nowadays, a technology is already available that can measure the kinematic movements in 3-D by a pacemaker and implantable defibrillator giving an assessment on software. The telemetry data can be transmitted to a central system. The research aims to elaborate the methods that help to compare of the data concerning physical activity both built-in an accelerometer in Cardiac Resychrinisation Therapy (CRT) devices and data obtained from an external Actigraph GT3XE-Plus Triaxial Activity Monitor. 5 persons participated in the pilot study (n=5); mean age: 57+- 13.37; BMI: 90.6+- 7.63. The Actigraph data from CRT device were examined in a 6-day-interval, between February 28 and March 5, 2014. The investigation started conducting a 6-minute walking test and continued with the measurement of daily physical activity. For data analysis descriptive statistics and linear regression analysis were used. It is clear from the data obtained from Actigraph that the MET values (mean: 1.17 ± 0.096) of the patients in the sample were extremely low due to their disease. However, some patients with higher physical activity than average (1.26; 1.28) seemed to be noteworthy, but they showed lower performance than healthy people. The physical activity of the patients during the 6-minute walking test corresponded to 1.9-2.48 MET. The physical activity of patients was found typically in the “light or moderate range” classifying the physical activity by Actigraph. Data from Actigraph are accurate and detailed making the physical activity of the patients measurable and appreciable. The results of the 6-minute walking test were in the category from moderate to very vigorous for individualized moderate physical performance based on Actigraph. It indicates the individual performance differences among patients. However, the daily physical performance is even lower than that of the 6- minute walking. We can conclude from the data related to the percentage of the average activity in CRT system to the average energy consumption and the improvement in the patients’ physical condition. Due to the limitations of the sampling frequency the different time intervals cannot be isolated in the different intensity ranges. Therefore, the percentage of the data of physical activity provided by the device may have a limited use.

Does increasing steps per day predict improvement in physical function and pain interference in adults with fibromyalgia?

To examine the concurrent and predictive associations between the number of steps taken per day and clinical outcomes in patients with fibromyalgia (FM). A total of 199 adults with FM (mean age 46.1 years, 95% women) who were enrolled in a randomized clinical trial wore a hip-mounted accelerometer for 1 week and completed self-report measures of physical function (Fibromyalgia Impact Questionnaire-Physical Impairment [FIQ-PI], Short Form 36 [SF-36] health survey physical component score [PCS], pain intensity and interference (Brief Pain Inventory [BPI]), and depressive symptoms (Patient Health Questionnaire-8 [PHQ-8]) as part of their baseline and followup assessments. Associations of steps per day with self-report clinical measures were evaluated from baseline to week 12 using multivariate regression models adjusted for demographic and baseline covariates. Study participants were primarily sedentary, averaging 4,019 ± 1,530 steps per day. Our findings demonstrate a linear relationship between the change in steps per day and improvement in health outcomes for FM. Incremental increases on the order of 1,000 steps per day were significantly associated with (and predictive of) improvements in FIQ-PI, SF-36 PCS, BPI pain interference, and PHQ-8 (all P < 0.05). Although higher step counts were associated with lower FIQ and BPI pain intensity scores, these were not statistically significant. Step count is an easily obtained and understood objective measure of daily physical activity. An exercise prescription that includes recommendations to gradually accumulate at least 5,000 additional steps per day may result in clinically significant improvements in outcomes relevant to patients with FM. Future studies are needed to elucidate the dose-response relationship between steps per day and patient outcomes in FM.

Validation of a compact motion sensor for the measurement of daily physical activity in patients with chronic obstructive pulmonary disease

Validation of a compact motion sensor for the measurement of daily physical activity in patients with chronic obstructive pulmonary disease

Impact of the Boston Active School Day Policy to Promote Physical Activity among Children

To test effectiveness of Active School Day policy implementation on physical activity outcomes and estimate school-level implementation costs. The design of the study was quasi-experimental (pretest-posttest matched controls). The study took place in six elementary schools with three matched pairs in Boston, Massachusetts, February to June 2011. Subjects were 455 consenting fourth- and fifth-grade students among 467 eligible. Active School Day policy implementation provided equipment, curricular materials, and training to physical educators and school wellness champions to promote 150 weekly minutes of quality physical education, recess, and physical activity integrated into classrooms. Accelerometer assessments of accumulated minutes and bouts of moderate, vigorous, and sedentary physical activity on 5 school days before and after implementation were used. Implementation costs were collected by record review and reported resource utilization. Analysis was conducted using multivariate mixed models estimated with repeated measures of daily physical activity, adjusted for student demographics and other confounding and design/clustering variables. Accelerometer data were provided by 201 intervention and 192 comparison students for an average of 4 days per period (84% response). During school time, students in intervention schools demonstrated greater increases in minutes per day of moderate-to-vigorous physical activity (3.9, 95% confidence interval [CI] 1.8-6.0; p < .001) and vigorous physical activity (1.8, 95% CI .7-3.0; p < .001), and greater decreases in minutes per day of sedentary time (-10.6, 95% CI -15.3- -5.8; p < .001) than controls. Ongoing annual implementation costs totaled $4,523/school ($14/student). Active School Day implementation increased student moderate-to-vigorous physical activity levels by 24% and decreased sedentary time during school at modest cost.