Physical Activity Measures Research Articles

Bone and muscle differences in children and adolescents with type 1 diabetes: The mediating role of physical activity

Children with type 1 diabetes (T1D) experience an increased risk of fracture, which may be related to altered bone development. We aimed to assess differences in bone, muscle and physical activity (PA), and explore if better muscle and PA measures would mitigate bone differences between children and adolescents with T1D and typically developing peers (TDP). We matched 56 children and adolescents with T1D (mean age 11.9 yrs) and 56 TDP (11.5 yrs) by sex and maturity from 171 participants with T1D and 66 TDP (6-17 yrs). We assessed the distal radius and tibia with high-resolution peripheral quantitative computed tomography (HR-pQCT), and the radius and tibia shaft bone and muscle with pQCT. We also measured muscle function from force-related measures in neuromuscular performance tests (push-up, grip test, countermovement and long jump). We compared PA based on questionnaire scores and accelerometers between groups. Bone, muscle, and neuromuscular performance measures were compared using MANOVA. We used mediation to explore the role of PA and muscle in bone differences. Children and adolescents with T1D had 6–10 % lower trabecular density, bone volume fraction, thickness and number at both distal radius and tibia, and 11 % higher trabecular separation at the distal radius than TDP. They also had 3–16 % higher cortical and tissue mineral density, and cortical thickness at the distal radius, 5–7 % higher cortical density and 1–3 % higher muscle density at both shaft sites compared to TDP. PA mediated the between-group difference in trabecular number (indirect effect −0.04) at the distal radius. Children and adolescents with T1D had lower trabecular bone density and deficits in trabecular micro-architecture, but higher cortical bone density and thickness at the radius and tibia compared to TDP. They engaged in less PA but had comparable muscle measures to those of TDP. PA participation may assist in mitigating deficit in trabecular number observed in children and adolescents with T1D.

Feeling Younger on Active Summer Days? On the Interplay of Behavioral and Environmental Factors With Day-to-Day Variability in Subjective Age.

Subjective age, that is, how old people feel in relation to their chronological age, has mostly been investigated from a macro-longitudinal, lifespan point of view and in relation to major developmental outcomes. Recent evidence also shows considerable intraindividual variations in micro-longitudinal studies as well as relations to everyday psychological correlates such as stress or affect, but findings on the interplay with physical activity or sleep as behavioral factors and environmental factors such as weather conditions are scarce. We examined data from 80 recently retired individuals aged 59-76 years (M = 67.03 years, 59% women) observed across 21 days. Daily diary-based assessments of subjective age, stress, affect, and sleep quality alongside physical activity measurement via Fitbit (steps, moderate-to-vigorous physical activity) and daily hours of sunshine were collected and analyzed using multilevel modeling. Forty-four percent of the overall variance in subjective age was due to intraindividual variation, demonstrating considerable fluctuation. Affect explained the largest share in day-to-day fluctuations of subjective age, followed by stress and steps, whereas sunshine duration explained the largest share of variance in interindividual differences. In our daily diary design, subjective age was most strongly related to self-reported affect as a psychological correlate. We, however, also found clear associations with objective data on daily steps and weather. Hence, our study contributes to contextualizing and understanding variations in subjective age in everyday life.

Identifying Person-Specific Drivers of Depression in Adolescents: Protocol for a Smartphone-Based Ecological Momentary Assessment and Passive Sensing Study.

Adolescence is marked by an increasing risk of depression and is an optimal window for prevention and early intervention. Personalizing interventions may be one way to maximize therapeutic benefit, especially given the marked heterogeneity in depressive presentations. However, empirical evidence that can guide personalized intervention for youth is lacking. Identifying person-specific symptom drivers during adolescence could improve outcomes by accounting for both developmental and individual differences. This study leverages adolescents' everyday smartphone use to investigate person-specific drivers of depression and validate smartphone-based mobile sensing data against established ambulatory methods. We describe the methods of this study and provide an update on its status. After data collection is completed, we will address three specific aims: (1) identify idiographic drivers of dynamic variability in depressive symptoms, (2) test the validity of mobile sensing against ecological momentary assessment (EMA) and actigraphy for identifying these drivers, and (3) explore adolescent baseline characteristics as predictors of these drivers. A total of 50 adolescents with elevated symptoms of depression will participate in 28 days of (1) smartphone-based EMA assessing depressive symptoms, processes, affect, and sleep; (2) mobile sensing of mobility, physical activity, sleep, natural language use in typed interpersonal communication, screen-on time, and call frequency and duration using the Effortless Assessment of Risk States smartphone app; and (3) wrist actigraphy of physical activity and sleep. Adolescents and caregivers will complete developmental and clinical measures at baseline, as well as user feedback interviews at follow-up. Idiographic, within-subject networks of EMA symptoms will be modeled to identify each adolescent's person-specific drivers of depression. Correlations among EMA, mobile sensor, and actigraph measures of sleep, physical, and social activity will be used to assess the validity of mobile sensing for identifying person-specific drivers. Data-driven analyses of mobile sensor variables predicting core depressive symptoms (self-reported mood and anhedonia) will also be used to assess the validity of mobile sensing for identifying drivers. Finally, between-subject baseline characteristics will be explored as predictors of person-specific drivers. As of October 2023, 84 families were screened as eligible, of whom 70% (n=59) provided informed consent and 46% (n=39) met all inclusion criteria after completing baseline assessment. Of the 39 included families, 85% (n=33) completed the 28-day smartphone and actigraph data collection period and follow-up study visit. This study leverages depressed adolescents' everyday smartphone use to identify person-specific drivers of adolescent depression and to assess the validity of mobile sensing for identifying these drivers. The findings are expected to offer novel insights into the structure and dynamics of depressive symptomatology during a sensitive period of development and to inform future development of a scalable, low-burden smartphone-based tool that can guide personalized treatment decisions for depressed adolescents. DERR1-10.2196/43931.

Physical Activity Interventions Framed by the Health Action Process Approach for Adults with Long-Term Conditions: A Scoping Review.

Interventions that use the Health Action Process Approach (HAPA) model show promise for increasing PA frequency, duration, and intensity. However, there is limited understanding of how HAPA model variables have been operationalized for PA interventions in chronic disease to promote behavior change and sustained PA or whether the phase or continuous form of the HAPA model was used. The aim of this scoping review is to describe how the HAPA model variables for PA interventions were operationalized and provide details of implementation. We searched five databases to identify studies published between January 1992 and March 2024. We aimed to describe (1) the characteristics of interventions including setting, delivery mode, duration, and content; (2) which HAPA variables were operationalized and the strategies used; and (3) the physical activity measures and outcome effects. The search identified 23 interventions in 30 papers (12 protocols, 3 quasi-experimental studies, and 15 randomized controlled trials (RCTs)). Seven of the 15 RCTs reported significant positive effects of the HAPA model on PA behavior outcomes. Interventions operationalized between three and nine HAPA constructs showed significant variability in how the HAPA model is used in intervention research. PA measures varied from self-report to validated objective instruments. We found a lack of clarity in decisions about which HAPA constructs were included in interventions. The wide variability in operationalized HAPA constructs made it challenging to compare interventions. Researchers should provide more detail about intervention design and implementation procedures to enhance transparency.

Association between Depressive Symptoms, Physical Activity, and Health Factors in Hispanic Emerging Adults.

Physical activity is a modifiable lifestyle behavior known for reducing symptoms of and being a risk factor for depression and mental health disorders. However, emerging adults (ages 18-25) struggle to meet recommended amounts. In this study, we explore the association between physical activity, depressive symptoms, and health factors in 137 Hispanic emerging adults. Using a cross-sectional survey design, sociodemographic information, depressive symptoms (CES-D score), physical activity (IPAQ score), body composition, and blood pressure measures were obtained. Statistical analyses included correlation and regression analyses. More than half of the participants demonstrated depressive symptomology (59.1%) and body fat percentage greater than 25% (64.2%). Body fat percentage, lean body mass, stress, and heart rate demonstrated notable associations with depressive symptoms and physical activity. When measured continuously and categorically, IPAQ was not a significant predictor of depressive symptoms. When used as a binary variable with a cutoff of 600 MET min/week, IPAQ score revealed a negative relationship with CES-D score (β = -0.169, SE = 2.748, p = 0.034). Our results indicate that a threshold of physical activity, 600 MET min/week, may confer protective effects against depressive symptoms. Future research should investigate the context and quality of physical activity to address mental health disparities in this underrepresented population.

Effectiveness of behavioural interventions with motivational interviewing on physical activity outcomes in adults: systematic review and meta-analysis

ObjectiveTo evaluate the effectiveness of behavioural interventions that include motivational interviewing on physical activity outcomes in adults.DesignSystematic review and meta-analysis.Study selectionA search of seven databases for randomised controlled trials published...

Walk to recovery: an evaluation of adventure therapy in an early intervention for psychosis service

ABSTRACT Background It was considered useful to describe service-users’ and staff’s experience of Adventure Therapy (AT) in an Early Intervention for Psychosis (EIP) service, exploring the impact on personal wellbeing and feasibility of use. Method Focus groups were conducted with 14 participants, immediately following, and three months after a four day hiking trip. Transcripts were analysed using inductive thematic analysis. Questionnaires were administered pre and post trip to describe service-users’ physical activity, recovery and personal goals. Results A majority of participants reported progress towards personal goals on the AT trip and improvements in confidence and connectedness. Questionnaire items did not show improvements in physical activity and recovery measures at 3- and 6-month follow-up. Four key themes emerged from the focus groups. The themes centred around the social experience of being in relation to others and a more personal emotional experience: (a) social connectedness, (b) challenging perceptions of self-capabilities, (c) positive reaction to new experiences and (d) motivation for more. Discussion AT was positively experienced by both staff and service-users. Key areas of benefit were recognised and considered for utilisation in services in different ways. Further studies are warranted exploring maintaining and supporting benefits gained following AT.

A Bayesian semi-parametric scalar-on-function regression with measurement error using instrumental variables.

Wearable devices such as the ActiGraph are now commonly used in research to monitor or track physical activity. This trend corresponds with the growing need to assess the relationships between physical activity and health outcomes, such as obesity, accurately. Device-based physical activity measures are best treated as functions when assessing their associations with scalar-valued outcomes such as body mass index. Scalar-on-function regression (SoFR) is a suitable regression model in this setting. Most estimation approaches in SoFR assume that the measurement error in functional covariates is white noise. Violating this assumption can lead to underestimating model parameters. There are limited approaches to correcting measurement errors for frequentist methods and none for Bayesian methods in this area. We present a non-parametric Bayesian measurement error-corrected SoFR model that relaxes all the constraining assumptions often involved with these models. Our estimation relies on an instrumental variable allowing a time-varying biasing factor, a significant departure from the current generalized method of moment (GMM) approach. Our proposed method also permits model-based grouping of the functional covariate following measurement error correction. This grouping of the measurement error-corrected functional covariate allows additional ease of interpretation of how the different groups differ. Our method is easy to implement, and we demonstrate its finite sample properties in extensive simulations. Finally, we applied our method to data from the National Health and Examination Survey to assess the relationship between wearable device-based measures of physical activity and body mass index in adults in the United States.

Patterns of physical activity of people with COPD during participation in a pulmonary rehabilitation program

IntroductionVery few studies have examined patterns of physical activity (PA) during a pulmonary rehabilitation (PR) program in people with COPD. AimsTo compare the patterns of PA in: 1) the week before commencing PR (pre-PR) with a week during PR (PR week); 2) PR days and non-PR days during a PR week; 3) pre-PR and the week following PR completion (post-PR). MethodsThis was a multicenter, prospective cohort study. Participants attended twice weekly supervised PR for 8–12 weeks. Daily step count (primary outcome), time in light activities, time in moderate to vigorous PA (MVPA), total sedentary time and sit-to-stand (STS) transitions were measured using a thigh worn accelerometer for seven days, at each assessment time point: pre-PR, PR week and post-PR. Results29 participants, mean age (SD) 69years(7), FEV1 53%pred(16). The PR week compared to pre-PR, showed higher daily: step count (mean difference (95%CI)), 941steps(388–1494); and MVPA, 11mins(6–15), with no difference in: time in light activities, -1min(-6–5); total sedentary time, 7mins(-21–36); or STS transitions, 0(-5–6). PR days compared to non-PR days showed higher: step count, 2810steps(1706–3913); time in light activities 11mins(1–20); time in MVPA, 27mins(17–35) and STS transitions, 8(4–12), with no difference in total sedentary time: −33mins(-80–15). There were no differences in any PA measures post-PR compared to pre-PR (p < 0.05). ConclusionDaily step count and time spent in MVPA increased significantly during the PR week, solely due to increased PA on days participants attended PR.

Associations between total physical activity levels and academic performance in adults: A systematic review and meta-analysis.

Physical activity has been associated with positive health-related outcomes. Physical inactivity, conversely, has been associated with several negative health outcomes. One topic that has been consistently examined is the relationship between physical activity and academic performance in children; however, studies that involve university-level students have not been aggregated to date. It is therefore the aim of this systematic review to examine the relationship between physical activity and academic performance in university-level students. This systematic review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included any study published until September 2023 that examined associations between physical activity and any measure of academic performance. SPORTDiscus, ERIC, the British Education Index, Scopus, Embase, Web of Science, and PubMed were searched. A random effects meta-analysis was also undertaken, and risk bias was assessed using the Newcastle Ottawa Scale. After screening, 36 studies were included, with six studies being included in the meta-analysis. The meta-analysis found a significant association between physical activity (high versus low) and academic performance (high versus low performers) (odds ratio = 3.04; 95% CI = 1.84-5.02; P ≤ 0.001; I2 = 49.62). These results, however, were deemed to be of low credibility. The narrative analysis yielded mixed results, with 50% of studies reporting positive associations and the remaining studies reporting no significant associations. This trend did not differ depending on the subjective or objective measurement of physical activity. Although this review found meta-analytic significant associations between physical activity and academic performance, these results should be treated with caution, as the remaining studies yielded mixed results. Future studies should aim to focus on objective measurements of physical activity where possible to further explore this potential relationship.

Magnitudes of overweight and obesity among adult and associated factors in jigjiga town, Somali region, Ethiopia

Overweight and obesity are major worldwide health concerns, with serious consequences for mortality and morbidity. Overweight and obesity rates are frighteningly high in Sub-Saharan Africa, particularly Nigeria and Ethiopia, due to a variety of causes such as urbanization, greater affluence, and bad food habits. The purpose of this study was to determine the prevalence of overweight and obesity among people in Jigjiga Town, Somali Region, Eastern Ethiopia, as well as to investigate related factors in order to inform treatments and policy. A cross-sectional survey was done among persons aged 20 to 64 working in the government, non-governmental, and commercial sectors. Socio-demographic information, food habits, physical activity, and anthropometric measures were all recorded. The overall prevalence of overweight and obesity was shown to be 42.4 %, with significant correlations identified with profession and TV viewing habits. Employed people were less likely to be overweight or obese than those in commerce/trade, and those who watched TV for 2–3 h had a reduced risk than those who watched less than 2 h. The study found that khat chewing is significantly associated with an increased risk of overweight and obesity, with chewers being 1.56 times more likely to be overweight or obese compared to non-chewers. Additionally, there is an inverse relationship between snacking frequency and overweight/obesity risk; participants who snacked once a day were 2.5 times more likely to be overweight or obese than those who snacked three or more times a day. These findings highlight that khat chewing and snacking patterns are important modifiable risk factors for overweight and obesity in the studied population. These findings highlight the need of focused treatments targeting food choices, physical activity, and sedentary behavior in combating overweight and obesity in Eastern Ethiopia. Collaboration among academics, policymakers, healthcare professionals, and community stakeholders is critical for developing successful methods for promoting healthy lifestyles and lowering the region's overweight and obesity burden.

Measurement of Physical Activity Using Fitness Trackers Before and After Midurethral Sling.

Urinary incontinence can be a barrier to performing physical activities for many women. A midurethral sling (MUS) has shown symptom improvement for women experiencing stress urinary incontinence (SUI), suggesting the hypothesis that physical activity rates should increase after treatment. The aim of this study was to determine the change in objectively measured physical activity levels in women following placement of MUS for SUI. In this prospective cohort study, patients undergoing MUS placement, with or without concomitant pelvic reconstructive surgery, were provided a commercial activity tracker. Physical activity was tracked for at least 1 week preoperatively and up to 6 months postoperatively. Participants were required to wear the tracker for at least 2 weeks in the postoperative period. The primary outcome, mean caloric daily expenditure (MCDE), was compared preoperatively and postoperatively. Seventy-two patients met criteria for data inclusion. The device was worn for a mean of 18.4 ± 12.1 days preoperatively and 91.7 ± 53.3 days postoperatively. Mean participant age was 51.9 ± 9.4 years. The MCDE was significantly higher postoperatively (preoperatively: 1,673 kcal/d vs postoperatively: 2,018 kcal/d; P < 0.01). There were no significant differences in postoperative MCDE in participants who had only MUS as the primary procedure versus participants who also had a concomitant procedure (2,020 ± 216 kcal/d vs 2,015 ± 431 kcal/d; P = 0.95). Of participants with class II/III obesity, 45% had at least a 500 kcal/d increase postoperatively. Treatment of SUI with MUS is associated with a significantly greater caloric expenditure in the postoperative period.

Daily standing time, dietary fiber, and intake of unsaturated fatty acids are beneficially associated with hepatic insulin sensitivity in adults with metabolic syndrome.

Obesity is associated with impaired glucose metabolism and hepatic insulin resistance. The aim was to investigate the associations of hepatic glucose uptake (HGU) and endogenous glucose production (EGP) to sedentary behavior (SB), physical activity (PA), cardiorespiratory fitness, dietary factors, and metabolic risk markers. Forty-four adults with metabolic syndrome (mean age 58 [SD 7] years, BMI ranging from 25-40kg/; 25 females) were included. HGU was measured by positron emission tomography during the hyperinsulinemic-euglycemic clamp. EGP was calculated by subtracting the glucose infusion rate during clamp from the glucose rate of disappearance. SB and PA were measured with hip-worn accelerometers (26 [SD3] days). Fitness was assessed by maximal bicycle ergometry with respiratory gas measurements and dietary intake of nutrients by 4-day food diaries. HGU was not associated with fitness or any of the SB or PA measures. When adjusted for sex, age, and body fat-%, HGU was associated with whole-body insulin sensitivity (β=0.58), water-insoluble dietary fiber (β=0.29), energy percent (E%) of carbohydrates (β=-0.32), saccharose (β=-0.32), mono- and polyunsaturated fatty acids (β=0.35, β=0.41, respectively). EGP was associated with whole-body insulin sensitivity (β=-0.53), and low-density lipoprotein cholesterol [β=-0.31], and when further adjusted for accelerometry wear time, EGP was associated with standing [β=-0.43]. (p-value for all< 0.05). Standing more, consuming a diet rich in fiber and unsaturated fatty acids, and a lower intake of carbohydrates, especially sugar, associate beneficially with hepatic insulin sensitivity. Habitual SB, PA, or fitness may not be the primary modulators of HGU and EGP. However, these associations need to be confirmed with intervention studies.

Heart rate variability modulates memory function in a virtual task

Heart rate variability (HRV) is considered one of the most relevant indicators of physical well-being and relevant biomarker for preventing cardiovascular risks. More recently, a growing amount of research has tracked an association between HRV and cognitive functions (i.e., attention). Research is still scarce on spatial orientation, a basic capability in our daily lives. It is also an important indicator of memory performance, and its malfunctioning working as an early sign of dementia. In this study, a total of 43 female students (M Age = 18.76; SD = 2.02) were measured in their lnRMSSD using the photoplethysmography technique with the Welltory smartphone app. They were also tested in their spatial memory with The Boxes Room, a virtual navigation test. Measures of physical activity were obtained with the International Physical Activity Questionnaire (IPAQ). Correlation analyses and repeated measures ANOVA were performed, comparing participants with high / low lnRMSSD in their spatial performance. Results showed that, at an equal level of physical activity, participants with a higher lnRMSSD were more effective in the early trials of The Boxes Room, being more precise in estimating the correct position of the stimuli. Moreover, a subsequent simple linear regression showed that a higher lnRMSSD was related to a smaller number of errors at the beginning of the spatial task. Overly, these results outline the relationship between HRV and navigation performance in early stages of processing, where the environment is still unknown and the situation is more demanding.

Interactions between age, sex and visceral adipose tissue on brain ageing.

To examine the associations between visceral adipose tissue (VAT) and brain structural measures at midlife and explore how these associations may be affected by age, sex and cardiometabolic factors. We used abdominal and brain magnetic resonance imaging data from a population-based cohort of people at midlife in the UK Biobank. Regression modelling was applied to study associations of VAT volume with total brain volume (TBV), grey matter volume (GMV), white matter volume, white matter hyperintensity volume (WMHV) and total hippocampal volume (THV), and whether these associations were altered by age, sex or cardiometabolic factors. Complete data were available for 17 377 participants (mean age 63 years, standard deviation = 12, 53% female). Greater VAT was associated with lower TBV, GMV and THV (P < .001). We found an interaction between VAT and sex on TBV (P < .001), such that the negative association of VAT with TBV was greater in men (β = -2.89, 95% confidence interval [CI] -2.32 to -10.15) than in women (β = -1.32, 95% CI -0.49 to -3.14), with similar findings for GMV. We also found an interaction between VAT and age (but not sex) on WMHV (P < .001). The addition of other cardiometabolic factors or measures of physical activity resulted in little change to the models. VAT volume is associated with poorer brain health in midlife and this relationship is greatest in men and those at younger ages.

Physical Activity Perceptions and Participation of People With Type II Diabetes Mellitus in the Dominican Republic.

Physical activity (PA) improves health outcomes for people with type II diabetes mellitus (diabetes), but little is known about PA among Dominicans. The purpose was to evaluate PA participation and perceptions among people with diabetes in the Dominican Republic (DR). Participants (N=29) were recruited from an urban diabetes clinic in DR. PA was assessed via accelerometry and Godin Leisure Time Exercise Questionnaire (GLTEQ). Eighteen women and 11 men enrolled (age: 55 ± 13 years; BMI: 28.6 ± 4.5 kg·m-2). Twenty-seven participants reached acceptable wear time. Using a one-minute bout minimum, moderate- to vigorous-intensity PA (MVPA) was 152.2 ± 59.7 min·day-1; no vigorous PA was recorded. GLTEQ scores (103 ± 98) classified 25 participants as active. Around 93% reported that PA was "very important" for their health. There was no association between GLTEQ and MVPA (p>0.2). Participants who reported being "very active" (n=17) did more MVPA than those who were "rarely active" or "somewhat active" (n=10; p=0.02). Dominicans with diabetesare highly physically active but do very little vigorous PA. The GLTEQ was not an accurate measure of PA. Future research should develop validated questionnaires and evaluate structured exercise and dietary interventions.

Developing Methods for Assessing Mental Activity Using Human-Smartphone Interactions: Comparative Analysis of Activity Levels and Phase Patterns in General Mental Activities, Working Mental Activities, and Physical Activities.

Human biological rhythms are commonly assessed through physical activity (PA) measurement, but mental activity may offer a more substantial reflection of human biological rhythms. This study proposes a novel approach based on human-smartphone interaction to compute mental activity, encompassing general mental activity (GMA) and working mental activity (WMA). A total of 24 health care professionals participated, wearing wrist actigraphy devices and using the "Staff Hours" app for more than 457 person-days, including 332 workdays and 125 nonworkdays. PA was measured using actigraphy, while GMA and WMA were assessed based on patterns of smartphone interactions. To model WMA, machine learning techniques such as extreme gradient boosting and convolutional neural networks were applied, using human-smartphone interaction patterns and GPS-defined work hours. The data were organized by date and divided into person-days, with an 80:20 split for training and testing data sets to minimize overfitting and maximize model robustness. The study also adopted the M10 metric to quantify daily activity levels by calculating the average acceleration during the 10-hour period of highest activity each day, which facilitated the assessment of the interrelations between PA, GMA, and WMA and sleep indicators. Phase differences, such as those between PA and GMA, were defined using a second-order Butterworth filter and Hilbert transform to extract and calculate circadian rhythms and instantaneous phases. This calculation involved subtracting the phase of the reference signal from that of the target signal and averaging these differences to provide a stable and clear measure of the phase relationship between the signals. Additionally, multilevel modeling explored associations between sleep indicators (total sleep time, midpoint of sleep) and next-day activity levels, accounting for the data's nested structure. Significant differences in activity levels were noted between workdays and nonworkdays, with WMA occurring approximately 1.08 hours earlier than PA during workdays (P<.001). Conversely, GMA was observed to commence about 1.22 hours later than PA (P<.001). Furthermore, a significant negative correlation was identified between the activity level of WMA and the previous night's midpoint of sleep (β=-0.263, P<.001), indicating that later bedtimes and wake times were linked to reduced activity levels in WMA the following day. However, there was no significant correlation between WMA's activity levels and total sleep time. Similarly, no significant correlations were found between the activity levels of PA and GMA and sleep indicators from the previous night. This study significantly advances the understanding of human biological rhythms by developing and highlighting GMA and WMA as key indicators, derived from human-smartphone interactions. These findings offer novel insights into how mental activities, alongside PA, are intricately linked to sleep patterns, emphasizing the potential of GMA and WMA in behavioral and health studies.

Remotely monitored physical activity from older people with cardiac devices associates with physical functioning

IntroductionAccelerometer-derived physical activity (PA) from cardiac devices are available via remote monitoring platforms yet rarely reviewed in clinical practice. We aimed to investigate the association between PA and clinical measures of frailty and physical functioning.MethodsThe PATTErn study (A study of Physical Activity paTTerns and major health Events in older people with implantable cardiac devices) enrolled participants aged 60 + undergoing remote cardiac monitoring. Frailty was measured using the Fried criteria and gait speed (m/s), and physical functioning by NYHA class and SF-36 physical functioning score. Activity was reported as mean time active/day across 30-days prior to enrolment (30-day PA). Multivariable regression methods were utilised to estimate associations between PA and frailty/functioning (OR = odds ratio, β = beta coefficient, CI = confidence intervals).ResultsData were available for 140 participants (median age 73, 70.7% male). Median 30-day PA across the analysis cohort was 134.9 min/day (IQR 60.8–195.9). PA was not significantly associated with Fried frailty status on multivariate analysis, however was associated with gait speed (β = 0.04, 95% CI 0.01–0.07, p = 0.01) and measures of physical functioning (NYHA class: OR 0.73, 95% CI 0.57–0.92, p = 0.01, SF-36 physical functioning: β = 4.60, 95% CI 1.38–7.83, p = 0.005).ConclusionsPA from cardiac devices was associated with physical functioning and gait speed. This highlights the importance of reviewing remote monitoring PA data to identify patients who could benefit from existing interventions. Further research should investigate how to embed this into clinical pathways.

Charting the cascade of physical activities: implications for reducing sitting time and obesity in children

ObjectiveTraditional intensity-based physical activity measures and variable-centered statistics may not fully capture the complex associations between sitting time, physical activity, and obesity indices. This study investigates the associations between device-measured sitting, standing and different modes of physical activity (i.e., slow walking, brisk-walking, cycling and high-intensity activity) and measured body mass index (BMI) in children using person-based latent profile analyses and Partial Least Squared-structural equation modeling (PLS-SEM).MethodsA total of 344 children (11.5 ± 0.81 years, boys n = 139) wore a triaxial accelerometer (Fibion®) on their thigh for eight days, and their weight and height were measured at school. Latent profile analysis formed profiles including BMI, total sitting time, and physical activities, and their associations were further studied with PLS-SEM.ResultsThe latent profile analysis indicates that high levels of physical activity always coincide with low sitting time. Both normal weight and overweight/obesity can coexist with low physical activity and prolonged sitting. The PLS-SEM results highlight a cascade-like sequence in the relationship between various types of physical activity, sitting time, and BMI. This sequence begins with light-intensity activities, such as standing, progresses to higher-intensity activities, and ultimately through reduced sitting time (sample mean= -0.01; effect size = 0.0001; p = 0.02), mediates a decline in BMI (sample mean= -0.06; effect size = 0.0036; p = 0.01). The most positive effects on sitting time and BMI occur when this pattern is adhered to consistently, suggesting that omitting steps could negatively impact the associations.ConclusionThese findings suggest that persuading children to increase physical activity incrementally, starting from low-intensity activities such as standing and slow walking to activity types with higher intensities, possibly influence BMI by mediating reduced sitting time. This approach is particularly inclusive for overweight and obese children, taking into account the potential challenges they may encounter when performing activity types with high intensity. These cross-sectional associations need to be verified with longitudinal and experimental designs.

Assessment of non-communicable disease risk factors, functional performance, and health-related quality of life in adults: a comparative analysis in low-resourced urban and rural areas of South Africa

BackgroundGlobally, disparities between non-communicable disease (NCD) risk factors, functional performance, and health-related quality of life (HRQoL) exist in people living in rural and low-resourced urban settings. Evidence of these health differences determined with objective NCD risk factors and functional performance measurements in South Africa, is scarce. Therefore, the study aimed to determine the differences in NCD risk factors, functional performance and HRQoL between rural and low-resourced urban areas.MethodsThe study recruited 311 adults (35–80 years) presenting with at least one NCD risk factor from low-resourced urban- (n = 183) and rural (n = 128) communities. Objective measurements of physical activity (PA) by means of combined heart rate and accelerometery, body composition employing skinfolds, peripheral lipid and glucose concentrations, blood pressure, functional performance indicators (handgrip, single leg stand, sit-to-stand, timed-up-and-go speed, predicted peak VO2 max); and HRQoL were measured according to standard procedures. Independent t-tests, Mann-Whitney U, and chi-square tests were performed to determine differences between the variables of low-resourced urban and rural settings.ResultsThe participants from the low-resourced urban setting were significantly older than the rural residents (59.1 ± 10.7 years vs. 52.8 ± 11.3 years; p = 0.001). NCD risk factors were significantly more prevalent in the low-resourced urban participants compared to rural participants, in particular for elevated systolic (85.8% vs. 62.5%; p = 0.001), and diastolic blood pressure (88.5% vs. 65.6%; p = 0.001), physical inactivity (95.9% vs. 87.7%; p = 0.026), increased cholesterol concentrations (22.1% vs. 8.7%; p = 0.002), and increased waist circumference (61.9% vs. 49.2%; p = 0.027). Low-resourced urban residents presented with a higher average body fat percentage (27.69% ± 7.65% vs. 12.23% ± 4.67%; p < 0.001), and lower moderate to vigorous PA levels (37.19 ± 49.55 [95% CI = 29.12–45.27] vs. 62.92 ± 60.43 min/week [95% CI = 47.95–77.90]; p = 0.003) compared to rural residents. Rural residents showed significantly better functional performance, including peak VO2 (23.99 ± 9.89 vs. 16.95 ± 7.64 ml/min/kg; p = 0.001) and single leg stand (right leg: 44.96 ± 18.47 vs. 20.87 ± 19.18 s; p = 0.001) as well as higher HRQoL for the physical (51.06 ± 8.14% vs. 45.62 ± 11.13%; p < 0.001) and mental (54.75 ± 8.24% vs. 48.91 ± 12.27%; p < 0.001) component scores compared to participants from the low-resourced urban areas.ConclusionNCD risk factors, functional performance, and HRQoL significantly differ in rural communities compared to low-resourced urban communities in South Africa. Urban areas’ most prevalent risk factors were elevated blood pressure, physical inactivity, and increased waist circumference. Participants from rural areas demonstrated significantly better functional performance, such as fitness and balance. HRQoL was better in rural settings than in urban settings. Future intervention programmes should be tailored for specific settings.