Metabolic Equivalent Values Research Articles

Associations between walking parameters and subsequent sleep difficulty in older adults: A 2-year follow-up study

PurposeThis 2-year follow-up study aimed to examine the associations between total volume, frequency, duration, and speed of walking with subsequent sleep difficulty in older adults. MethodsA total of 800 older adults aged 65 years and over participated in the first survey in 2012 and 511 of them were followed 2 years later. The 5-item Athens Insomnia Scale (AIS-5) was used to measure sleep difficulty. Frequency, duration, and speed of outdoor walking were self-reported. Walking speed was assigned a metabolic equivalent value (MET) from 2.5 to 4.5. Total walking volume in MET-h/week was calculated as frequency × duration × speed. Negative binomial regressions were performed to examine the associations between volume and components of walking with subsequent sleep difficulty with covariates of age, sex, education, marital status, living arrangement, smoking, alcohol consumption, mental health, Charlson Index, exercise (excluding walking), and sleep difficulty at baseline. ResultsParticipants with low walking volume had a higher level of sleep difficulty 2 years later compared with those with high walking volume (incident rate ratios = 1.61, p = 0.004). When speed, frequency, and duration of walking were simultaneously entered into 1 model, only walking speed was significantly associated with subsequent sleep difficulty (after the model was adjusted for covariates and baseline sleep difficulty). Sensitivity analyses showed that walking duration emerged as a significant predictor among 3 walking parameters, with 2-year changes of sleep scores as dependent variable. ConclusionTotal amount of walking (especially faster walking and lasting for more than 20 min) is associated with less subsequent sleep difficulty after 2 years among older adults.

Determining activity count cut-points for measurement of physical activity using the Actiwatch2 accelerometer

Study objectivesSleep and physical activity are important contributors to many aspects of health. Obtaining accurate, objective measures of both behaviours is critical to health research. The Actiwatch2 is a wrist-worn sleep-monitoring device that has the potential to measure physical activity. Currently, interpretation of the Actiwatch2 physical activity data is limited by a lack of published thresholds for interpreting exercise intensity. This limits the ability to collect information on both behaviours simultaneously using one monitor. This study aims to develop thresholds to differentiate between light, moderate and vigorous-intensity physical activity and sedentary time for the Actiwatch2. MethodsThirty females, 40±14.9years, completed eight exercise tasks while wearing a Cosmed portable metabolic cart, the Actiwatch2 and the Actigraph GT3X+. Correlations between 1) activity counts from both the Actiwatch2 and Actigraph and metabolic equivalent (MET) values, and 2) activity counts from the two monitors were calculated. Area Under the Curve (AUC) was calculated, and cut points that maximized sensitivity and specificity were determined. ResultsThe correlations between MET values and Actiwatch2 counts (r=0.69) and Actigraph (r=0.69) were strong. Correlation between the two activity monitors was very strong (r=0.84). The discrimination of sedentary behaviour was almost perfect (AUC=0.96) using a threshold of 145cpm. Discrimination of moderate (AUC=0.92) and vigorous (AUC=0.77) activity was acceptable using a threshold of 274 and 597cpm respectively. ConclusionsThe Actiwatch2 demonstrated the ability to discriminate different intensities of physical activity among adult females. With these reported cut points, the Actiwatch2 can be used to simultaneously measure sleep and physical activity – two key outcomes in health research.

Meeting Recommended Levels of Physical Activity in Relation to Preventive Health Behavior and Health Status Among Adults.

ObjectivesThe purpose of this study was to examine the relationship of meeting the recommended levels of physical activity (PA) with health status and preventive health behavior in adults.MethodsA total of 5630 adults 18 years of age or older were included in this study. PA was assessed using a series of questions that categorized activities based on their metabolic equivalent values and then categorized individuals based on the reported frequency and duration of such activities. Participants reporting 150 minutes or more of moderate-intensity PA per week were considered to have met the PA guidelines. Multiple logistic regression was used to model the relationships between meeting PA guidelines and health status and preventive health behavior, while controlling for confounding variables.ResultsOverall, 53.9% (95% confidence interval [CI], 51.9 to 55.9%) of adults reported meeting the recommended levels of PA. Among adults with good general health, 56.9% (95% CI, 54.7 to 59.1%) reported meeting the recommended levels of PA versus 43.1% (95% CI, 40.9 to 45.3%) who did not. Adults who met the PA guidelines were significantly more likely not to report high cholesterol, diabetes, chronic obstructive pulmonary disease, arthritis, asthma, depression, or overweight. Furthermore, adults meeting the PA guidelines were significantly more likely to report having health insurance, consuming fruits daily, consuming vegetables daily, and not being a current cigarette smoker.ConclusionsIn this study, we found meeting the current guidelines for PA to have a protective relationship with both health status and health behavior in adults. Health promotion programs should focus on strategies that help individuals meet the current guidelines of at least 150 minutes per week of moderate-intensity PA.

Abstract 2552: Influence of age, sex, colorectal cancer status, and mutation carrier status on physical activity in families with Lynch syndrome

Abstract Lynch syndrome (LS) is due to inherited mutations that impair DNA mismatch repair (MMR) and predispose mutation carriers to an increased risk of colorectal (CRC) and other cancers. Physical activity (PA) reduces risk for sporadic CRC but little is known about the effect of PA on CRC risk in LS. We examined the influence of demographic and clinical characteristics on PA in LS mutation carriers and their unaffected relatives. Self-reported PA data by decades of life: during the 20's (early), 30-40's (mid), and 50's and older (late) decades, from a retrospective cohort of LS subjects and their relatives enrolled in the Colon Cancer Family Registry were analyzed. Metabolic equivalent (MET) PA values were derived for each activity and standardized to MET hours/week. Mean PA by decade was compared across 3 groups: MMR mutation carriers (MMR+) with and without cancer, and non-carrier relatives (MMR-). We analyzed 3,261 subjects (1,413 MMR-, 1052 MMR+ with no CRC and 796 MMR+ with CRC). PA was inversely associated with age. Men had higher levels of PA in the early and mid-decades than women. In their 20s, MMR- women had higher levels of PA on average than MMR+ women but there were no significant differences by MMR or CRC status in the mid and later decades. For men, there was no difference in mean PA by MMR+ status in the early or mid-decades, but in the later decades, MMR- men had higher PA than MMR+. Furthermore, mean PA in the mid-decades was significantly higher in MMR+ men with CRC than MMR+ with no CRC. In this descriptive analysis, men and women had higher levels of PA at younger ages, although men exercised more than women in the early and mid-decades. Levels of mean PA were comparable for MMR+ men and women with and without CRC except in the mid-decades where MMR+ men with CRC had higher levels of PA than MMR+ men without CRC. Recall bias for higher PA in CRC cases cannot be ruled out. Comparison of mean physical activity in early, mid and late decades of life by sex, MMR mutation carrier status, and colorectal cancer status Mean MET hours/week of Physical activityEarly decade (20s)Mid-decades (30s-40s)Later decades (50s and above)MaleFemaleMaleFemaleMaleFemaleSex33.5*25.6*20*16.7*11.110.8Non-carrier33.927.1*20.917.312.8*11.1MMR carrier33.224.4*19.216.29.8*9.3MMR carrier no cancer33.824.516.3*15.88.88.9MMR carrier with cancer32.624.522.2*16.910.89.8*starred pairs indicate a significant (p<0.05) difference in mean MET hours/week of PA between the groups Citation Format: Mala Pande, Stephen Glombicki, Karen Basen-Engquist, Mark A. Jenkins, Aung Ko Win, Y Nancy You, Susan K. Perterson, Patrick M. Lynch. Influence of age, sex, colorectal cancer status, and mutation carrier status on physical activity in families with Lynch syndrome. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2552.

Supervised exercise improves autonomic modulation in participants in cardiac rehabilitation programs

Background and ObjectivesAn attenuated heart rate recovery (HRR) response after exercise testing is a robust predictor of mortality. Regular exercise can enhance various physiological parameters. Studies indicate that participation in a cardiac rehabilitation program can improve heart rate recovery. The aim of this study was to analyze changes in functional capacity and autonomic modulation in patients following a cardiac rehabilitation program. MethodsBetween 2009 and 2014, 248 individuals were assessed through exercise testing, at baseline and after six months of participation in a cardiac rehabilitation program. The exercise test was performed on a treadmill using a ramp protocol. The first minute of active recovery was standardized at a speed of 1.5 mph and slope of 2.5%. The degree of parasympathetic modulation was assessed by the difference between peak exercise heart rate and heart rate at one minute of recovery. The subjects were divided into two groups according to pre-training HRR (≤12 bpm and >12 bpm). ResultsExercise training resulted in a similar increase in metabolic equivalent values in both groups, but only the HRR ≤12 bpm group showed improvement after training (F=16.13; p<0.001), with a mean increase from 7.4±3.69 bpm to 13.0±9.74 bpm. ConclusionsThe cardiac rehabilitation program had a positive impact in a group that had both low functional capacity and reduced parasympathetic activity, producing a favorable effect on these recognized prognostic markers.

Early Cardiac Involvement and Risk Factors for the Development of Arrhythmia in Patients With β-Thalassemia Major.

Cardiac iron overload is the most serious complication in thalassemia; even patients treated with intensive chelation suffer at a certain point from cardiomyopathy and arrhythmia. The aim of the study was to identify indicators of cardiac dysfunction in thalassemia as well as risk factors associated with the development of arrhythmia. A total of 45 patients with β-thalassemia major were enrolled in this cross-sectional study. Patients were divided into 2 groups according to the absence (group A) or the presence of arrhythmia (group B). Cardiac parameters in thalassemic groups were evaluated using 24-Holter recording, Stress electrocardiogram, and M-mode echocardiography. Serum ferritin and Cardiac T2* were used to assess the iron status. Group B showed significantly higher values of cardiac T2* and serum ferritin (P<0.05). Group B patients had significantly higher maximum heart rate with significant attacks of bradycardia and ST segment changes. In addition, they achieved a lower percentage of maximum age predicted heart rate and lower values of maximum metabolic equivalents (P<0.05). Significantly higher values of the left atrial diameter, the interventricular septum diameter, and the left-ventricle posterior wall diameter (P<0.05) were identified in group B. The increase in left atrial diameter, interventricular septum diameter, and left-ventricle posterior wall diameter seems to be related to the development of arrhythmia in patients with thalassemia, especially supraventricular arrhythmias.

Examining the energy cost and intensity level of prenatal yoga.

Context:A popular form of pregnancy physical activity (PA) is prenatal yoga. However, little is known about the intensity and energy cost of this practice.Aims:To examine the energy cost and intensity level of prenatal yoga.Methods:Pregnant women in a prenatal yoga class (n = 19) wore a Sense Wear Armband during eleven 60 min classes each, and self-reported demographic variables, height and weight, prepregnancy weight, and PA behaviors and beliefs. Sense Wear Armband data included kilocalories, metabolic equivalent (MET) values, and time spent in various intensities. Descriptive statistics and frequencies were utilized to describe energy expenditure and intensity.Results:Energy expenditure averaged 109 ± 8 kcals, and the average MET value was 1.5 ± 0.02. On average, 93% and 7% of classes were sedentary and moderate intensity PA, respectively.Conclusions:Time spent in a prenatal yoga class was considered to be primarily a sedentary activity. Future research should utilize larger samples, practice type, and skill level to increase generalizability.

Sedentary behaviors and light-intensity activities in relation to colorectal cancer risk.

A recent meta-analysis found that sedentary behaviors are associated with an increased colorectal cancer (CRC) risk. Yet, the finding on TV viewing time, the most widely used surrogate of sedentary behaviors, was based on only two studies. Furthermore, light-intensity activities (e.g., standing and slow walking), non-sedentary by posture but close to sedentary behaviors by Metabolic Equivalent Task values, have not been investigated in relation to CRC risk. Thus, we prospectively analyzed the relationships based on 69,715 women from Nurses' Health Study (1992-2010) and 36,806 men from Health Professionals Follow-Up Study (1988 - 2010). Throughout follow-up, time spent on sedentary behaviors including sitting watching TV and on light-intensity activities were assessed repeatedly; incidence of CRC was ascertained. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models from each cohort. A total of 1,119 and 913 incident cases were documented from women and men, respectively. The multivariable HR comparing ≥ 21 versus < 7 hr/week of sitting watching TV was 1.21 (95% CI = 1.02 to 1.43, ptrend =.01) in women and 1.06 (95% CI = 0.84 to 1.34, ptrend =.93) in men. In women, those highly sedentary and physically less active had an approximately 41% elevated risk of CRC (95% CI = 1.03 to 1.92) compared with those less sedentary and physically more active. The other sedentary behaviors and light-intensity activities were not related to CRC risk in women or men. In conclusion, we found that prolonged sitting time watching TV was associated with an increased CRC risk in women but not in men.

Atividade física supervisionada melhora a modulação autonómica de participantes de reabilitação cardíaca

Background and ObjectivesAn attenuated heart rate recovery (HRR) response after exercise testing is a robust predictor of mortality. Regular exercise can enhance various physiological parameters. Studies indicate that participation in a cardiac rehabilitation program can improve heart rate recovery. The aim of this study was to analyze changes in functional capacity and autonomic modulation in patients following a cardiac rehabilitation program. MethodsBetween 2009 and 2014, 248 individuals were assessed through exercise testing, at baseline and after six months of participation in a cardiac rehabilitation program. The exercise test was performed on a treadmill using a ramp protocol. The first minute of active recovery was standardized at a speed of 1.5 mph and slope of 2.5%. The degree of parasympathetic modulation was assessed by the difference between peak exercise heart rate and heart rate at one minute of recovery. The subjects were divided into two groups according to pre‐training HRR (≤12 bpm and >12 bpm). ResultsExercise training resulted in a similar increase in metabolic equivalent values in both groups, but only the HRR ≤12 bpm group showed improvement after training (F=16.13; p<0.001), with a mean increase from 7.4±3.69 bpm to 13.0±9.74 bpm. ConclusionsThe cardiac rehabilitation program had a positive impact in a group that had both low functional capacity and reduced parasympathetic activity, producing a favorable effect on these recognized prognostic markers.

Reliability and Validity of T-REX Accelerometer When Attached on Five Locations

PURPOSE : To examine the reliability and validity of T-REX accelerometer when it was attached five locations of body. METHODS: Fifty healthy volunteers (25 men; 23.5±1.7 yrs, 15 women; 22.4±2.0 yrs) participated in tests of 5 different modes of exercise. They walked or ran on a treadmill at 4 different speeds (4, 6, 8, and 10 km·h-¹ for men and 4, 6, 7.5, and 9 km·h-¹ for women) for 5 min at each speed. They also underwent a series of test of step box, jump rope, Hula hoop, and on-site walking at the intensity of 12-14 of rating of perceived exertion. During the test, they attached T-REX at five locations (ankle, arm, chest, waist, and wrist) of the body and the Actical at waist. Their oxygen uptake (VO[SUBSCRIPT TWO]) was measured using a portable device while they exercised and their metabolic equivalents (METs) were calculated. Pearson coefficients were used. Agreement between the T-REX and VO[SUBSCRIPT TWO] was tested using Bland-Altman plot. Regression was performed to compare the relationships between values of METs at each location of T-REX and VO[SUBSCRIPT TWO] measured. RESULTS: Correlation coefficient between METs at each location of T-REX and VO[SUBSCRIPT TWO] ranged between 0.848 and 0.935 when both men and women were compared on a treadmill (p<0.05). In Bland-Altman plot, T-REX showed smaller deviation of confidence interval than the Actical when VO[SUBSCRIPT TWO] was compared. Correlation coefficient of METs derived from each location of T-REX and VO[SUBSCRIPT TWO] was 0.628-0.830 for step box, 0.331-0.324 for jump rope, 0.444-0.519 for Hula hoop, and 0.417-0.624 for on-site walking tests (p<0.05). CONCLUSION: T-REX seems to be a reliable and valid device for assessing energy expenditure level during walking while placed on 5 different body locations; ankle, arm, chest, waist, and wrist. This device might be a reliable and alternative tool of conventional accelerometers.

Differences In Physical Activity Level Between The Congenital Heart Disease Associated PAH And Idiopathic PAH

PURPOSE: The aim of this study was to determine the differences between physical activty level in patients with congenital heart disease associated pulmonary arterial hypertension (PAH) and idiopathic pulmonary arterial hypertension. METHODS: 13 idiopathic pulmonary arterial hypertension and 10 congenital heart disease associated pulmonary arterial hypertension totally 23 patients were included into study. Physical activity level was measured by International Physical Acitivty Questionnaire (IPAQ) and sensewear armband (SWA) accelerometer. Metabolic equivalent values and total daily steps were compared by ındependent sample t test. RESULTS: The mean functional class was 2.53 ± 0.51 in patients with idiopathic PAH and 1.90 ± 0.56 in patients with congenital heart disease associated PAH. There was significantly difference between the groups according to functional class (p< 0.05). Additionally the physical activity level was 468.36 ± 180.29 MET in patients with idiopathic PAH and 1955.33 ± 2187.30 MET in patients with congenital heart disease associated PAH. The total daily steps was 3057.55 ± 2849.47 steps in patients with idiopathic PAH and 5693.00 ± 1876.39 steps in patients with congenital heart disease associated PAH. Both IPAQ and SWA results showed significantly difference between the groups (p < 0.05). CONCLUSIONS: Since functional class of idiopathic PAH patients was worse more than the congenital heart disease associated PAH; the physical activity level decreased as minimal active patients in idiopathic PAH. However congenital heart disease associated PAH showed better physical activity level. Becuase congenital heart disease survival rate is bettter with improved functional class than idiopathic pulmonary arterial hypertension.

Energy expenditure measurement of various physical activity and correlation analysis of body weight and energy expenditure in elementary school children

Purpose: There is a lack of data on the energy cost of childrens everyday activities, adult values are often used as surrogates. In addition, the influence of body weight on the energy cost of activity when expressed as metabolic equivalents (METs) has not been vigorously explored. Methods: In this study 20 elementary school students 9~12 years of age completed 18 various physical activities while energy expenditure was measured continuously using a portable telemetry gas exchange system (K₄b², Cosmed, Rome, Italy). Results: The average age was 10.4 years and the average height and weight was 145.1 ㎝ and 43.6 ㎏, respectively. Oxygen consumption (VO₂), energy expenditure and METs at the time of resting of the subjects were 5.41 mL/㎏/min, 1.44 ㎉/㎏/h, and 1.5 METs, respectively. METs values by 18 physical activities were as follows: Homework and reading books (1.6 METs), playing game with a mobile phone or video while sitting (1.6 METs), watching TV while sitting on a comfortable chair (1.7 METs), playing video game or mobile phone game while standing (1.9 METs), sweeping a room with a broom (2.7 METs) and playing a board game (2.8 METs) belong to light intensity physical activities. By contrary, speedy walking and running were 6.6 and 6.7 METs, respectively, which belong to high intensity physical activities over 6.0 METs. When the effect of body weight on physical activity energy expenditure was determined, R² values increased with 0.116 (playing a game at sitting), 0.176 (climbing up and down stairs), 0.246 (slow walking), and 0.455 (running), which showed that higher activity intensity increased explanation power of body weight on METs value. Conclusion: This study is important for direct evaluation of energy expenditure by physical activities of children, and it could be used directly for revising and complementing the existing activity classification table to fit for children.

Oxygen Cost of Recreational Horse-Riding in Females.

The purpose of this study was to characterize the physiological demands of a riding session comprising different types of recreational horse riding in females. Sixteen female recreational riders (aged 17 to 54 years) completed an incremental cycle ergometer exercise test to determine peak oxygen consumption (VO₂peak) and a 45-minute riding session based upon a British Horse Society Stage 2 riding lesson (including walking, trotting, cantering and work without stirrups). Oxygen consumption (VO₂), from which metabolic equivalent (MET) and energy expenditure values were derived, was measured throughout. The mean VO₂ requirement for trotting/cantering (18.4 ± 5.1 ml·kg⁻¹·min⁻¹; 52 ± 12% VO₂peak; 5.3 ± 1.1 METs) was similar to walking/trotting (17.4 ± 5.1 ml·kg⁻¹·min⁻¹; 48 ± 13% VO₂peak; 5.0 ± 1.5 METs) and significantly higher than for work without stirrups (14.2 ± 2.9 ml·kg⁻¹·min⁻¹; 41 ± 12% VO₂peak; 4.2 ± 0.8 METs) (P = .001). The oxygen cost of different activities typically performed in a recreational horse riding session meets the criteria for moderate intensity exercise (3-6 METs) in females, and trotting combined with cantering imposes the highest metabolic demand. Regular riding could contribute to the achievement of the public health recommendations for physical activity in this population.

Effects of a Prolonged Exercise Program on Exercise Tolerance in Individuals with History of Acute Coronary Syndrome: A Retrospective Study

Objective : To verify the influence of a prolonged physical exercise program on physical fitness and cardiovascular parameters, as evaluated by exercise stress test (EST), in subjects with newly diagnosed acute coronary syndrome. Methods : The sample included 50 subjects distributed by an experimental group (EG; n = 25) and a control group (CG; n = 25). The EG was subject to a program of regular exercise during 52 weeks. All subjects performed two ESTs: one at the beginning and one at the end of the experimental protocol. The first test was performed 2-3 months after the cardiac event. During the EST fitness parameters (speed and incline of the treadmill and test time), cardiovascular parameters (maximum and resting heart rate, maximum and resting blood pressure, and maximum and resting double product), and metabolic equivalents were recorded. Results : Compared with the first test, in the second EST showed a significant increase (p <0.05) of the absolute values of metabolic equivalents and physical fitness indicators (testing time and maximum speed and incline of the treadmill) in the EG, with a percentage of variation of these parameters significantly higher than in CG. Despite the better physical performance demonstrated by the EG, there were no significant differences between the two groups with respect to cardiovascular parameters. Conclusion : In this study, the physical training program improved exercise tolerance in individuals with a history of acute coronary events, without an apparent increased cardiac work.

Exploring Physical Activity in Women with Multiple Sclerosis

The aim of this study was to conduct an exploratory analysis of fear of falling (FoF), balance, gait, and strength impairments and future physical activity in women with multiple sclerosis. This prospective study followed a convenience sample of 99 women with multiple sclerosis for 1 yr. The participants were assessed on FoF and perceived mental health by questionnaire. Objective measures included Limits of Stability, the Sensory Organization Test, and the Functional Ambulation Profile. Strength was quantified by knee extensor power asymmetry. Activity-specific metabolic equivalent values were used to determine minutes per week of moderate and vigorous physical activity. Future physical activity most strongly associated with baseline FoF (R = 0.09, P < 0.01), and baseline FoF associated with limits of stability and lower extremity strength asymmetry (R = 0.21, P < 0.001). Follow-up FoF is best predicted by initial levels of FoF independent of intervening falls (β = 3.26, P < 0.001). Future physical activity of women with multiple sclerosis was best predicted by FoF independent of physical and mental functioning. Increased FoF was associated with greater lower extremity strength asymmetry and decreased limits of stability rather than with the experience of falls.

Interruption in physical activity bout analysis: an accelerometry research issue.

BackgroundThe purpose of the present investigation was to clarify the impact of the treatment of interruptions on the durations and the frequency of the physical activity (PA) bouts under free-living conditions.MethodsOne hundred and forty adults (50 ± 7 years) wore an accelerometer (Lifecorder) for seven consecutive days under free-living conditions. According to the minutes by minutes metabolic equivalents (METs) value, the PA was divided into one of three intensity categories: light intensity PA (LPA, < 3 METs), moderate intensity PA (MPA, 3 to 6 METs), vigorous intensity PA (VPA, > 6 METs), and the sum of the MPA and VPA was defined as moderate to vigorous intensity PA (MVPA, > 3 METs). Thereafter, based on the time series data, we defined MVPA bouts as PA that was maintained at no less than 3 METs completely for 10 minutes or longer with or without allowing for a one-minute or a two-minute break (<3METs).ResultsThe frequency and duration of the continuous MVPA bouts lasting longer than 10-min were significantly lower and shorter compared with that in the non-continuous MVPA bouts allowing a one- or two-minute interruption (4.11 ± 1.65, 6.58 ± 2.72 and 8.97 ± 3.55 bouts/day, 71.62 ± 33.66, 119.03 ± 49.35 and 169.75 ± 65.87 min/day, P < 0.05). The number of days with a total time of MVPA bouts of 30-min was significantly lower in the continuous MVPA bouts compared with that in the non-continuous MVPA bouts allowing a 1-min or 2-min interruption (5.36 ± 1.65, 6.39 ± 1.07 and 6.65 ± 0.85 days/week).ConclusionThe treatment of interruptions for the setting of the accelerometer affects the estimation of the MVPA bouts under free-living conditions in middle-aged to older adults. The best analysis process with regard to the accelerometer quantifying the break to reflect the real behavioral pattern and the physiological stress in such subjects remains unclear.

Validation and feasibility of a caloric expenditure measuring device in women with early-stage breast cancer.

The purpose of this study is to validate the Bodybugg (BB), a caloric expenditure measuring device, in breast cancer patients undergoing adjuvant and neoadjuvant chemotherapy for early-stage breast cancer. Twenty-five women with stages I-III breast cancer who wereto receive adjuvant dose-dense doxorubicin/cyclophosphamide were recruited. Participants were asked to wear the BB and record activity logs for seven pretreatment days (prior to commencing chemotherapy) and seven posttreatment days (upon completing cycle 4 of chemotherapy). The BB's caloric expenditure measurements were used to calculate metabolic equivalent (MET) values of patients' recorded activities. BB-calculated METs were compared with matching METs from the 2011 Compendium of Physical Activities Tracking Guide to assess accuracy of the device. The overall patient sample wore the device for an average of 5.32 (SD 1.75) pre- and 4.88 (SD 2.01) posttreatment days. The mean pairwise difference between BB and Compendium METs was 0.043 (SD 0.77) for 308 pretreatment activities recorded by 12 patients and 0.065 (SD 0.61) for 108 posttreatment activities recorded by 6 patients, indicating close to zero bias between the BB's and Compendium's measurements. Hierarchical linear modeling showed that Compendium METs strongly predict for BB METs (P < 0.00001). The BB is feasible to use in study designs involving defined time periods of measurement and provides accurate and objective measurements of caloric expenditure in breast cancer patients.

Evaluation of Actiheart and a 7 d activity diary for estimating free-living total and activity energy expenditure using criterion methods in 1·5- and 3-year-old children

Accurate and easy-to-use methods to assess free-living energy expenditure in response to physical activity in young children are scarce. In the present study, we evaluated the capacity of (1) 4d recordings obtained using the Actiheart (mean heart rate (mHR) and mean activity counts (mAC)) to provide assessments of total energy expenditure (TEE) and activity energy expenditure (AEE) and (2) a 7d activity diary to provide assessments of physical activity levels (PAL) using three sets of metabolic equivalent (MET) values (PALTorun, PALAdolph and PALAinsworth) in forty-four and thirty-one healthy Swedish children aged 1·5 and 3 years, respectively. Reference TEE, PALref and AEE were measured using criterion methods, i.e. the doubly labelled water method and indirect calorimetry. At 1·5 years of age, mHR explained 8% (P=0·006) of the variation in TEE above that explained by fat mass and fat-free mass. At 3 years of age, mHR and mAC explained 8 (P=0·004) and 6 (P=0·03)% of the variation in TEE and AEE, respectively, above that explained by fat mass and fat-free mass. At 1·5 and 3 years of age, average PALAinsworth values were 1·44 and 1·59, respectively, and not significantly different from PALref values (1·39 and 1·61, respectively). By contrast, average PALTorun (1·5 and 3 years) and PALAdolph (3 years) values were lower (P<0·05) than the corresponding PALref values. In conclusion, at both ages, Actiheart recordings explained a small but significant fraction of free-living energy expenditure above that explained by body composition variables, and our activity diary produced mean PAL values in agreement with reference values when using MET values published by Ainsworth.

Assessing exertional dyspnea in patients with idiopathic pulmonary fibrosis

Dyspnea is a hallmark symptom of idiopathic pulmonary fibrosis (IPF), and dyspnea induced physical activity limitation is a prominent driver of quality of life impairment among IPF patients. We examined response data for the 21 physical activity items (the first 21 of 24) from the University of California San Diego Shortness of Breath Questionnaire (UCSD) collected at baseline in a recently conducted IPF trial. We used Rasch analysis and hypothesis testing with conventional statistical methodology to achieve three objectives: 1) to examine the items to identify the one characteristic that distinguishes one from another; 2) to asses these items for their ability to measure dyspnea severity in IPF; 3) to use the items to develop a dyspnea ruler. The sample comprised 178 subjects. The 21 items fit the Rasch model. There was very strong correlation between Rasch item severity and their metabolic equivalents (METS) values (r=-0.86, p<0.0001). With the sample stratified on scores from the 21 items, there were significant between group differences in FVC%, DLCO% and distance walked during the six-minute walk test. The dyspnea ruler can be used to put dyspnea levels in a more easily understood clinical context. The first 21 items from the UCSD compose a unidimensional dyspnea-with-activity scale and are both sensibly ordered and distinguished from each other by their METS values. These 21 items can be used confidently to formulate clinically-relevant inferences about IPF patients and should be considered for use as a meaningful endpoint in IPF research.

Metabolic Equivalent Determination in the Cultural Dance of Hula

Ethnic minorities share an unequal burden of cardiometabolic syndrome. Physical activity (PA) has been shown to be an important factor for improving the outcomes of these diseases. While metabolic equivalents (METs) have been calculated for diverse activities, most cultural activities have not been evaluated. Hula, the traditional dance of Native Hawaiians, is practiced by men and women of all ages but its MET value is unknown. To our knowledge, this is the first scientific evaluation of energy expenditure of hula. 19 competitive hula dancers performed 2 dance sets of low- and high-intensity hula. METs were measured with a portable indirect calorimetry device. Mean and standard deviations were calculated for all the variables. A 2-way ANOVA was conducted to identify differences for gender and intensity. The mean MET were 5.7 (range 3.17-9.77) and 7.55 (range 4.43-12.0) for low-intensity and high-intensity, respectively. There was a significant difference between intensities and no significant difference between genders. This study demonstrates that the energy expenditure of both low- and high-intensity hula met the recommended guidelines for moderate and vigorous intensity exercise, respectively, and that hula can be utilized as a prescribed PA.