Metabolic Equivalents Research Articles

Cardiovascular mortality in patients with atrial fibrillation and physical activity intensity: delineating the threshold of vigorous activity

Abstract Background/Introduction There is a correlation between light-to-moderate physical activity and reduced atrial fibrillation (AF) incidence and cardiovascular risk. Vigorous activities reduced the benefits and increased the risk of AF. The exact threshold at which physical activity increases the risk of cardiovascular death (CVD) in patients with AF remains to be determined. Purpose To determine the threshold of vigorous activity in patients with AF. Methods In this study, data from 23856 individuals from the Taiwan Biobank (2017) were analyzed. Physical activity levels were quantified in metabolic equivalent task (MET) hours/week and categorized into four groups based on 20 MET-hour increments. The study employed Kaplan-Meier survival analysis and an adjusted generalized additive model (GAM) to assess the impact of physical activity on CVD risk (adjusting for age, sex, diabetes, hypertension, chronic obstructive pulmonary disease, and chronic kidney disease), with follow-up data from 2017 to 2022. Results Over a median 5.51-year follow-up, 238 AF cases (cumulative rate of AF: 0.998%) were identified (48.7% female, mean age 61.7 years). The linear model indicated a lower CVD risk in participants engaging in moderate physical activity (20-40 MET-hours/week; adjusted hazard ratio [HR]: 0.38, 95% CI: 0.16-0.95) compared to the reference group (0-20 MET-hours/week). Notably, the GAM model demonstrated a significant increase in CVD risk for activities exceeding 40 MET-hours/week after multivariable adjustment. Conclusions Physical activity levels and CVD risk in AF patients are correlated in a J-shaped manner. The CVD risk of AF decreased with mild to moderate physical activity. For AF patients, it establishes a critical threshold of 40 MET-hours/week beyond which there is an increased risk of CVD, thus clarifying safe physical activity limits.Figure 1:KM sruvival curveFigure 2:Smooth model of GAM

Nonlinear dose-response association of moderate-to-vigorous physical activity with hyperuricemia in US adults: NHANES 2007-2018.

The relationship between physical activity and hyperuricemia (HUA) remains inconsistent, and the dose-response association between moderate-to- vigorous physical activity (MVPA) level and HUA still unclear. In this study, we aimed to investigate the dose-response association of MVPA with HUA, and to explore an appropriate range of MVPA level for preventing HUA. Data from the US National Health and Nutrition Examination Survey (NHANES) 2007-2018 were used, including 28740 non-gout adult Americans. MVPA level was self-reported using the Global Physical Activity Questionnaire and serum uric acid was measured using timed endpoint method. The dose-response relationship between MVPA level and HUA was modeled with restricted cubic spline analysis. Logistic regression analysis were applied to estimate odd ratios (ORs) and 95% confidence intervals (CIs) of the relationships between MVPA level and HUA. A total of 28740 adults were included in the study (weighted mean age, 47.3 years; 46.5% men), with a prevalence rate of HUA was 17.6%. The restricted cubic spline functions depicted a general U-shaped relationship between MVPA level and HUA. The MVPA level of 933 and 3423 metabolic equivalent (MET) -min/wk were the cut-off discriminating for the risk of HUA. Participants with MVPA levels in the range of 933-3423 MET-min/wk had lower risk of HUA and they had the lowest risk when MVPA levels at around 1556 MET-min/wk. Compared with the moderate-activity group (600-2999 Met-min/wk), the low-activity group (< 600 Met-min/wk) had a greater risk of HUA (OR, 1.13 [95%CI, 1.02-1.26]) after fully adjusting for potential confounders. Compared with the moderate MVPA level, the low MVPA level was associated with the higher risk of HUA. And there may be a U-shaped dose-response relationship between MVPA level and HUA. When MVPA level was approximately 933-3423 MET-min/wk, the risk of HUA may at a lower level and the risk reached the lowest when MVPA level at around 1556 MET-min/wk.

Metabolic equivalents intensity thresholds for physical activity classification in older adults

BackgroundAlthough the metabolic equivalents (METs) system is a common procedure to quantify the intensity of physical activity in older adults, it remains unclear whether the conventional METs intensity thresholds (CTs) used for this purpose are appropriate in this population. Therefore, this study aimed (i) to derive overall and fitness-specific METs intensity thresholds in older adults ≥ 60 years old (OATs) expressed both in standard METs (VO2/3.5 mL O2·kg−1·min−1) and older adults METs60+ (VO2/2.7 mL O2·kg−1·min−1), and (ii) to compare them with the CTs.MethodsA total of 93 subjects were assessed for cardiorespiratory fitness. Graded exercise test protocols using indirect calorimetry were performed to calculate individual VO2max and categorize subjects as "very poor/fair" or "good/superior" fitness. Overall and fitness-specific OATs expressed in standard METs (OATsstandard) and METs60+ (OATs60+) were derived based on the %VO2max and the ventilatory thresholds (VTs) physical intensity categories.ResultsSignificantly higher VO2max, VO2 at VT1 and VO2 at VT2 (p < 0.001) were obtained in the "good/superior" subgroup compared to the "very poor/fair" fitness subgroup. Accordingly, OATs were approximately 69% higher in individuals with a "good/superior" fitness compared to those with a "very poor/fair" fitness. Furthermore, this study showed that OATsstandard were approximately 21–24% lower than OATs60+, and 10–22% higher OATs were observed when following the VTs intensity categories (heavy-intensity physical activity [HPA] and severe-intensity physical activity [SPA]) compared to the %VO2max categories (moderate-intensity physical activity [MPA] and vigorous-intensity physical activity [VPA]). When compared with the CTs, similar or higher OATsstandard and OATs60+ for MPA, and HPA were obtained compared to the conventional MPA threshold (3.0 METs). Conversely, for VPA and SPA, lower, similar, or higher OATs were obtained depending on the METs derivation approach (OATsstandard or OATs60+) or the intensity categories (VO2max or VTs), compared to the conventional VPA threshold (6.0 METs).ConclusionsNone of the derived OATs were concurrently similar to the CTs, suggesting that fitness-specific METs intensity thresholds adapted to the METs derivation approach should be used in older adults.Trial registrationFenotipAGING (Non-health-care intervention study), PRO-Training (NCT05619250).

Physical Activity and Quality of Sleep Among Patient with Chronic Kidney Disease on Hemodialysis: A Cross-Sectional Study.

Chronic kidney disease (CKD) patients on hemodialysis face issues like poor quality of sleep and reduced physical activity, which can impair their quality of life. This study aimed to assess the physical activity and quality of sleep among CKD patients on hemodialysis. This cross-sectional study was conducted at All India Institute of Medical Sciences (AIIMS), Jodhpur. Data from 66 participants selected consecutively using self-reported standardized tools, namely, Global Physical Activity Questionnaire (GPAQ) and Pittsburgh Sleep Quality Index (PSQI), were collected, along with sociodemographic variables. After receiving written informed consent, questionnaires were administered through face-to-face interviews. The majority of the individuals, 45 (68.2%), were found to be physically active with a mean score of 2280.8 metabolic equivalents (MET)-min/week. The average PSQI score was 9.24 ± 4, and 49 (74.2%) participants had a PSQI score as higher than 5, suggesting poor quality of sleep. Physical activity and quality of sleep were found to have a significant relationship (P = 0.03). Physical activity was found to have a significant relationship with age (P = 0.01), whereas quality of sleep was associated with smoking status (P = 0.04), alcohol consumption (P < 0.01), and body mass index (BMI; P = 0.03). Contrary to many studies where CKD patients on hemodialysis were found to be physically inactive, the present study showed a substantial portion of them to be physically active. Poor quality of sleep was common; hence, interventions to promote sleep quality recommended.

Motivation for physical activity in the Jordanian military: Possible determinants of physical activity in male and female recruits

ABSTRACT Given the obligatory nature of physical fitness training in the military and in order to guide intervention development, our study assessed possible motivational determinants as suggested by self-determination theory in addition to other possible determinants. A cross-sectional study was conducted among 218 military recruits during their basic training in Jordan. Physical activity and lifestyle behaviors were measured using the Arab Teens Lifestyle Study (ATLS). Psychosocial variables were assessed using the Exercise Self-Efficacy Scale (ESE), Behavioral Regulation Exercise Scale (BREQ-2) and Exercise Benefits/Barriers Scale (EBBS). Bivariate correlation analysis revealed that identified self-regulation, introjected regulation and exercise self-efficacy scores were positively associated with higher Metabolic Equivalent of Task (METs) and minutes per week of physical activity among male recruits and the overall sample respectively. Among females, only external regulation was positively associated with the total METs/week. Being a male was significantly associated with higher minutes of physical activity among the overall sample. Multivariate regression analyses showed that identified regulation was significantly and positively associated with higher minutes of physical activity among the overall sample and male recruits in addition to higher METs per week among the male recruits. Also, the amotivation score was significantly and positively associated with higher minutes of physical activity among the overall sample and male recruits. A multivariate regression analysis for female recruits showed no significant associations. Intervention developers are advised to increase autonomous forms of motivation through structured enjoyable physical fitness programs in order to enhance intrinsic motivation in the long term.

Ten-Year Cardiovascular Risk Estimation through the Framingham Risk Score among Commercial Motor Vehicle Drivers with High and Low Risk of Obstructive Sleep Apnea

Abstract Objective Obstructive sleep apnea (OSA) and cardiovascular disease (CVD) are both major medical causes of road accidents among commercial motor vehicle (CMV) drivers. The present study aimed to determine the association of the ten-year risk of developing CVD and other cardiac risk factors with the risk of developing OSA among apparently healthy CMV drivers. Materials and Methods The present cross-sectional study was conducted on 315 male CMV drivers. Demographic characteristics were collected, and the Epworth Sleepiness Scale (ESS), the Snoring, Tiredness, Observed Apnea, High Blood Pressure, Body Mass Index (BMI) &gt; 35 kg/m2, Age &gt; 50 Years, Neck Circumference &gt; 40 cm, and Male Gender (STOP-Bang) questionnaire, and International Physical Activity Questionnaire-Short Form (IPAQ-SF) were filled out, and the ten-year CVD risk was calculated through the Framingham Risk Score (FRS) for each individual. Laboratory tests also were performed. The participants were divided into two groups based on the STOP-Bang score and FRS, and other CVD risk factors were compared, accordingly. The Chi-squared test, the Student t-test, analysis of variance (ANOVA), and logistic regression were used for the analysis. Results The mean age of the drivers was of 45.57 (range: 30 to 70) years. In the univariate analysis, the mean age, years of driving experience, FRS, vascular age, blood pressure, diabetes mellitus, metabolic syndrome, ESS score, BMI, and circumference of the waist and hip presented a significant association with STOP-Bang score ≥ 3 (p &lt; 0.05). The metabolic equivalents of task (METs) for total physical activity and walking (min/week), time spent sitting (h/day), lipid profiles, smoking history, vehicle type, and shift type were statistically similar in both groups. In the multivariate analysis, a high risk of OSA was independently associated with higher FRS (odds ratio: 1.92; p &lt; 0.001). Conclusion The STOP-Bang score presented a direct correlation with the estimated ten-year CVD risk in CMV drivers. The high risk of developing OSA among CMV drivers is accompanied by higher CVD risk factors such as old age, diabetes, hypertension, BMI, and waist and hip circumference. The FRS was statistically higher in CMV drivers with high OSA risk.

Physical activity levels of pregnant women at the time of diagnosis with gestational diabetes attending a tertiary care hospital in Lucknow City, Uttar Pradesh

: Gestational Diabetes Mellitus (GDM) is one of the pregnancy complications characterized by carbohydrate intolerance that develops or is discovered during pregnancy. Physical inactivity and excessive gestational weight gain have been identified as independent risk factors for maternal obesity and pregnancy-related disorders, such as gestational diabetes. Awareness of the significance of physical activity for bodily and psychological health is vitally essential. The woman and her family members need to be swayed to change with time and let go of their myths and false cultural perceptions that exercise can harm the baby. : To determine the physical activity pattern of pregnant women at the time of diagnosis with GDM. : 188 pregnant women diagnosed with gestational diabetes mellitus was selected for the study. Pregnancy Physical Activity Questionnaire was used to calculate the duration; frequency, intensity, and type of physical activity during current gestational period. An average weekly energy expenditure in Metabolic Equivalent of Task (MET-h-week) was calculated. Demographic data including age, socioeconomic status, parity, literacy and working status were collected. Data was analysed on 188 pregnant women diagnosed with GDM. The physical activity of moderate intensity was less performed by the pregnant women. None of the pregnant women were involved in vigorous type of physical activity. Only light intensity activities were performed by the study participants. The study concluded light intensity activity was commonly carried by pregnant women thus a low level of physical activity was observed during the pregnancy.

Physical Activity and Progression of Coronary Artery Calcification in Men and Women

ImportancePrior cross-sectional studies have suggested that very high levels of physical activity (PA) are associated with a higher prevalence of coronary artery calcium (CAC). However, less is known regarding the association between high-volume PA and progression of CAC over time.ObjectiveTo explore the association between PA (measured at baseline and during follow-up) and the progression of CAC over time.Design, Setting, and ParticipantsThis cohort study included data from 8771 apparently healthy men and women 40 years and older who had multiple preventive medicine visits at the Cooper Clinic (Dallas, Texas), with a mean (SD) follow-up time of 7.8 (4.7) years between the first and last clinic visit. Participants with reported PA and CAC measurements at each visit during 1998 to 2019 were included in the study. Data were analyzed from March 2023 to February 2024.ExposuresPA reported at baseline and follow-up, examined continuously per 500 metabolic equivalent of task minutes per week (MET-min/wk) and categorically: less than 1500, 1500 to 2999, 3000 or more MET-min/wk.Main Outcomes and MeasuresNegative binomial regression was used to estimate the rate of mean CAC progression between visits, with potential modification by PA volume, calculated as the mean of PA at baseline and follow-up. In addition, proportional hazards regression was used to estimate hazard ratios for baseline PA as a predictor of CAC progression to 100 or more Agatston units (AU).ResultsAmong 8771 participants, the mean (SD) age at baseline was 50.2 (7.3) years for men and 51.1 (7.3) years for women. The rate of mean CAC progression per year from baseline was 28.5% in men and 32.1% in women, independent of mean PA during the same time period. That is, the difference in the rate of CAC progression per year was 0.0% per 500 MET-min/wk for men and women (men: 95% CI, −0.1% to 0.1%; women: 95% CI, −0.4% to 0.5%). Moreover, baseline PA was not associated with CAC progression to a clinically meaningful threshold of 100 AU or more over the follow-up period. The hazard ratio for a baseline PA value of 3000 or more MET-min/wk vs less than 1500 MET-min/wk to cross this threshold was 0.84 (95% CI, 0.66 to 1.08) in men and 1.16 (95% CI, 0.57 to 2.35) in women.Conclusions and RelevanceThis study found that PA volume was not associated with progression of CAC in a large cohort of healthy men and women who were initially free of overt cardiovascular disease.

Association between self-reported functional capacity measures and postoperative myocardial injury in patients undergoing noncardiac surgeries.

Self-reported functional capacity measures have an uncertain role in the pre-operative cardiovascular risk stratification. This substudy aimed to evaluate whether self-reported metabolic equivalent (MET) could improve the prediction of postoperative myocardial injury (MI) over other well-established cardiovascular risk factors. This is a post hoc analysis of an international multicenter prospective cohort study. We recruited patients ≥45 years old who had elective elevated-risk noncardiac surgery in 45 centers across 17 countries between June 2017 and April 2020. The primary outcome was MI defined according to the Fourth Universal Definition of Myocardial Infarction. We measured the proportion of new prognostic information added by self-reported MET using multivariable logistic regression. In total, 860 (41.3%) patients suffered MI. In patients without systematic troponin surveillance, the odds ratio for MI with each 1-point increment in MET equaled 1.03 (95% confidence interval [CI], 0.99-1.07). The new prognostic information, according to the likelihood ratio adequacy index, accounted for 1.5%. Sensitivity analysis, including centers with >90% of patients with routine high-sensitivity troponin T monitoring, showed that MET added 21.8% of new information to the baseline model, and each additional point was associated with a lower risk of MI (odds ratio, 0.86; 95% CI, 0.81-0.91). In elevated-risk noncardiac surgery, self-reported functional capacity measures do not significantly improve the prediction of MI; however, they add new prognostic information in centers with routine perioperative troponin monitoring.

Physical Activity, Anxiety, Depression, and Body Image in Trans Individuals: An Exploratory Study.

In a cross-sectional study, 75 Portuguese transgender individuals (M = 23.68; SD ± 6.59) were recruited to participate in this study. The participants completed three questionnaires related to the assessment of physical activity (IPAQ), depressive and anxious symptomatology (HADS), and satisfaction with body image (BISQp). Trans individuals showed a total energy expenditure of 3316.40 metabolic equivalent tasks (METS), had a moderate level of anxiety symptomatology, and low levels of satisfaction with body image. Satisfaction with body image was negatively associated with anxiety (r = -0.441, p < 0.01) and depression symptomatology (r = -0.600, p < 0.01). The implementation of inclusive programs that promote body acceptance and coping strategies, particularly within the context of physical exercise, may help alleviate distress related to body image dissatisfaction while also addressing underlying anxiety and depression symptoms.

High-level physical activity provides protection against all-cause mortality among U.S. adults with depression

BackgroundRegular physical activity (PA) offers numerous benefits, decreasing all-cause mortality (ACM) among the general population. However, its impact on individuals with depression remains unknown. The present study aimed to investigate the correlation between various PA levels and ACM among adult patients with depression in the United States. MethodsData from the National Health and Nutrition Examination Survey from 2007 to 2018, as well as relevant mortality data up to December 31, 2018 were extracted. 4850 adults with depression were incorporated into this cohort study. PA level was quantified based on weekly metabolic equivalent of task (MET-min/week) and categorized into four groups according to the Physical Activity Guidelines for Americans. Weighted Cox proportional-hazards models were leveraged to assess the association of different PA levels with ACM among adults with depression, and adjustments were made for various sociodemographic and health factors. ResultsAmong the 4850 patients with depression, 503 deaths were noted over a median follow-up of 6.6 years. The weighted Cox regression analysis showed that participants with high-level PA (>1200 MET-min/week) had a markedly lower risk of ACM (HR = 0.48, 95 % CI 0.33 to 0.68) compared to those with no PA (0 MET-min/week). The benefit conferred by the high-level PA group (HR = 0.65, 95CI 0.45 to 0.94) remained significant (p < 0.05) after adjustment for other confounders. LimitationsPA and some covariates were assessed through self-reported questionnaires. ConclusionHigh-level PA has the most pronounced effect on reducing ACM among adult patients with depression, which should be recognized in clinical and public health guidelines.

Sleep Quality and Interoception Are Associated with Generalized Anxiety in Baccalaureate Nursing Students: A Cross-Sectional Study.

Baccalaureate nursing students are at increased risk for anxiety and related mood disorders. We conducted a cross-sectional study to explore the relationships among anxiety symptoms measured by the Generalized Anxiety Disorder (GAD-7) questionnaire and lifestyle behaviors including habitual diet, sleep quality (Pittsburg Sleep Quality Index [PSQI]), and physical activity. Descriptive statistics were obtained for sample characteristics, and Pearson correlations and backward stepwise linear regression explored relationships between the GAD-7 scores, the Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2) subscales, and other variables. Sixty-eight students completed the survey, with 38% having moderate-to-severe anxiety. On average, respondents had moderate diet quality (Healthy Eating Index median 60/100 [range 51-75]), had high sleep quality (PSQI median 7/21 [range 4-10]), and were highly active, with a median of 43 (range 24-78) weekly metabolic equivalent (MET) hours. Sixty-seven out of 68 respondents indicated a willingness to change lifestyle behaviors; the most prevalent time-related factors were school and social commitments, with stress and financial constraints being reported among half or more of respondents. Regression analysis determined that PSQI (β = 0.446) and the MAIA-2 Not-Worrying subscale (β = -0.366) were significant (p < 0.001 for both) predictors of anxiety severity. These results indicate that mindfulness and sleep hygiene may be the most actionable foci for interventions to reduce anxiety in baccalaureate nursing students. This study was not registered as a clinical trial.

Case Report of Arthroscopic Anatomical Bone Glenoid Augmentation with Subscapularis Tendon Protection with A 24 Months Follow-Up and Literature Review of The Current Concepts of Glenoid Bone Augmentation

Background: The purpose of the present study was to examine the association between non-exercise Cardiorespiratory Fitness (eCRF) and all-cause mortality in cancer patients. Methods and Findings: A total of 2,404 participants from the Aerobics Center Longitudinal Study (622 women and 1,782 men) with a cancer diagnosis were followed for mortality. Non-exercise eCRF was calculated in Metabolic Equivalents (METs) with sex-specific algorithms at baseline. Multivariable Cox regression models were used to examine the association between CRF and risk of all-cause mortality. Hazard ratios and 95% confidence intervals were calculated as an index of strength of the association. More than 96% (2,323) of the 2,404 participants survived, while 81 (3.4%) died. In the multivariable adjusted model, each 1-MET increment was associated with a 17% decreased risk of all-cause mortality. Compared with the reference group, those in the middle CRF group had a 58% lower risk of death and those in the upper CRF group had a 78% lower risk of death than those in the lower CRF group (Ptrend=0.0002). Conclusion: CRF estimated using a non-exercise formula (non-exercise eCRF) is inversely associated with all-cause mortality in cancer patients.

A CNN Model for Physical Activity Recognition and Energy Expenditure Estimation from an Eyeglass-Mounted Wearable Sensor.

Metabolic syndrome poses a significant health challenge worldwide, prompting the need for comprehensive strategies integrating physical activity monitoring and energy expenditure. Wearable sensor devices have been used both for energy intake and energy expenditure (EE) estimation. Traditionally, sensors are attached to the hip or wrist. The primary aim of this research is to investigate the use of an eyeglass-mounted wearable energy intake sensor (Automatic Ingestion Monitor v2, AIM-2) for simultaneous recognition of physical activity (PAR) and estimation of steady-state EE as compared to a traditional hip-worn device. Study data were collected from six participants performing six structured activities, with the reference EE measured using indirect calorimetry (COSMED K5) and reported as metabolic equivalents of tasks (METs). Next, a novel deep convolutional neural network-based multitasking model (Multitasking-CNN) was developed for PAR and EE estimation. The Multitasking-CNN was trained with a two-step progressive training approach for higher accuracy, where in the first step the model for PAR was trained, and in the second step the model was fine-tuned for EE estimation. Finally, the performance of Multitasking-CNN on AIM-2 attached to eyeglasses was compared to the ActiGraph GT9X (AG) attached to the right hip. On the AIM-2 data, Multitasking-CNN achieved a maximum of 95% testing accuracy of PAR, a minimum of 0.59 METs mean square error (MSE), and 11% mean absolute percentage error (MAPE) in EE estimation. Conversely, on AG data, the Multitasking-CNN model achieved a maximum of 82% testing accuracy in PAR, a minimum of 0.73 METs MSE, and 13% MAPE in EE estimation. These results suggest the feasibility of using an eyeglass-mounted sensor for both PAR and EE estimation.

Association between Bone Quality and Physical Activity in Community-Dwelling Older Adults.

Bone quality is an essential factor determining bone strength. However, the relationship between physical activity (PA) and bone quality remains unclear. This study aimed to ascertain the relationship between bone quality and PA using a cortical bone quantitative ultrasound device that measures components of bone quality. In this cross-sectional study, bone quality was assessed in community-dwelling older adults by measuring the cortical speed of sound (cSOS) at the mid-tibia using a quantitative ultrasound device. Using a wrist-worn accelerometer, we calculated the daily duration of moderate-to-vigorous physical activity (MVPA) and light physical activity (LPA) based on estimated METs from the accelerometer data, without differentiating between types of activities. A multiple regression analysis was performed to examine the association between PA and the cSOS. The participants' physical activity averaged 42.0 min/day for MVPA and 483.6 min/day for LPA. No significant association was observed between PA and bone quality in either men or women in the crude models. Furthermore, PA was not significantly correlated with the cSOS in the models adjusted for age, body mass index, nutrient intake, number of medications, and kidney disease. This study was a cross-sectional study which focused on the association between bone quality in older adults and their current amount of PA. The cSOS, as a measure of bone quality, was not associated with PA in men or women. Higher amounts of daily PA, as estimated from metabolic equivalents with an accelerometer, may not necessarily maintain or improve bone quality in older adults. This study does not rule out the potential for a positive association between PA levels or types and bone quality in younger or middle-aged individuals. It was specifically targeted at older adults, and its findings should not be generalized to younger populations. Further longitudinal studies are required to better understand the relationship between PA and bone quality.

Energy expenditure and effort of patients with stroke during sit to stand: A pilot study.

Sit-to-stand (STS) is a mechanically demanding task. Little is known about the energy expenditure (EE) and the perceived effort of patients with stroke during STS. The objectives of our study were to assess the perceived effort and EE of patients with stroke when moving from STS and to determine whether an association between actual energy expended and patient-perceived effort exists. This descriptive cross-sectional pilot study assessed participants' EE and perceived effort during STS, with a triaxial accelerometer and the modified Borg scale (MBS), respectively. The team screened 428 individuals for potential inclusion, with nine participants (n = 5 female, 55.5%) meeting the criteria for our pilot study. Participants had a mean age of 52.77 (standard deviation [SD] ± 11.33) years, the majority had a haemorrhagic stroke (n = 6, 66.6%) and left hemiplegia (n = 6, 66.6%), and they were assessed 9.11 (SD ± 6.57) days post-stroke. The mean EE during STS was 2.82 (SD ± 1.9) kCal. Most participants (n = 7, 77.77%) perceived STS as more than a 'moderate' effort on the MBS. The correlation coefficient between the metabolic equivalent of task (METs) and MBS was r = 0.34 (p = 0.38). Our study found a fair positive correlation between METs and MBS for patients with stroke during STS. The increased EE shown can be a key point for rehabilitation to lessen the extent of EE during STS. Further research is warranted.

Association between physical activity and thyroid function in American adults: a survey from the NHANES database

ObjectivePhysical activity (PA) is closely related to our lives, and the effects of PA on thyroid function have not been elucidated.MethodsUsing data from the National Health and Nutrition Examination Survey (NHANES) 2007–2012, we included 5877 participants and analyzed the associations of thyroid function with weekly physical activity (PAM, expressed in metabolic equivalents of task) and physical activity time (PAT) in American adults. Univariate and multivariate logistic analyses were used to demonstrate the associations of PAM and PAT with the primary outcome. Linear regression analysis was performed to determine the associations between thyroid biochemical indicators/diseases and PAM/PAT.ResultsOur study revealed noticeable sex differences in daily PA among the participants. The odds ratio of the fourth versus the first quartile of PAM was 3.07 (confidence interval, CI [1.24, 7.58], p = 0.02) for overt hypothyroidism, 3.25 (CI [1.12, 9.45], p = 0.03) for subclinical hyperthyroidism in adult men. PAT in the range of 633–1520 min/week was found to be associated with the occurrence of subclinical hyperthyroidism [p < 0.001, OR (95% CI) = 5.89 (1.85, 18.80)], PAT of the range of > 1520 min/week was found to be associated with the occurrence of overt hypothyroidism [p < 0.001, OR (95% CI) = 8.70 (2.80, 27.07)] and autoimmune thyroiditis (AIT) [p = 0.03, OR (95% CI) = 1.42 (1.03, 1.97)] in adult men. When PAM < 5000 MET*minutes/week or PAT < 1000 min/week, RCS showed an L-shaped curve for TSH and an inverted U-shaped curve for FT4. The changes in FT3 and TT3 in men were linearly positively correlated with PAM and PAT, while TT4 is linearly negatively correlated.ConclusionThe amount of daily physical activity of American adults is strongly associated with changes in thyroid function, including thyroid hormone levels and thyroid diseases. Thyroid hormone levels were varied to a certain extent with changes in PAM and PAT.

Impact of exercise on chemotherapy-induced peripheral neuropathy in survivors with post-treatment primary breast cancer.

Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating side effect of neurotoxic chemotherapy. Exercise activates neuromuscular function and may improve CIPN. We examined the association between exercise and CIPN symptoms in breast cancer survivors. In a retrospective cross-sectional study, we included patients completing a survey assessing exercise exposure and neuropathy symptoms in a tertiary cancer center survivorship clinic. We evaluated exercise duration and intensity using a standardized questionnaire quantified in metabolic equivalent tasks (MET-h/wk). We defined exercisers as patients meeting the National Physical Activity Guidelines' criteria. We used multivariable logistic regressions to examine the relationship between exercise and CIPN and if this differed as a function of chemotherapy regimen adjusting for age, gender, and race. We identified 5444 breast cancer survivors post-chemotherapy (median age 62years (interquartile range [IQR]: 55, 71); median 4.7years post-chemotherapy (IQR: 3.3, 7.6)) from 2017 to 2022. CIPN overall prevalence was 34% (95% confidence interval [CI]: 33%, 36%), 33% for non-taxane, and 37% for taxane-based chemotherapy. CIPN prevalence was 28% (95% CI: 26%, 30%) among exercisers and 38% (95% CI: 37%, 40%) among non-exercisers (difference 11%; 95% CI: 8%, 13%; p < 0.001). Compared to patients with low (<6 MET-h/wk) levels of exercise (42%), 11% fewer patients with moderate (6-20.24 MET-h/wk) to high (>20.25 MET-h/wk) levels of exercise reported CIPN. Exercise was associated with reduced prevalence of all CIPN symptoms regardless of chemotherapy type. CIPN may persist several years following chemotherapy among patients with breast cancer but is significantly reduced by exercise in a dose-dependent manner.

Need to Revise Classification of Physical Activity Intensity in Older Adults? The Use of Estimated METs, Measured METs, and V̇O2 Reserve.

Multiples of resting metabolic rate (RMR) are often used to classify physical activity intensity, a concept known as the metabolic equivalent of task (MET). However, the METs metrics may misclassify physical activity intensity in older adults because of age-related changes in RMR and maximal aerobic capacity (V˙O2max). This study aimed to (i) compare classifications of activity intensity by estimated (METsestimated) and measured (METsmeasured) METs and (ii) compare physical activity classified by absolute (METsmeasured) versus relative intensity (%V˙O2Reserve) in older adults. Ninety-eight adults aged 75-90 years participated in the study. RMR and V˙O2 during sitting, standing, daily activities, and 6-minute walking test were measured. V˙O2Reserve was defined as the difference between V˙O2max and RMR. Moderate and vigorous intensity was classified as 3 and 6 METs and 40% and 60% of V˙O2Reserve, respectively. Paired t tests and a confusion matrix were used to investigate aims 1 and 2, respectively. METsmeasured was 24% lower than the standard 1 MET of 3.5mL O2·min-1·kg-1. METsestimated underestimated the intensity during daily and walking activities when compared to METsmeasured. Nevertheless, when comparing METsmeasured to percentages of V˙O2Reserve, a mismatch was shown for moderate intensity in 47%-67% of the participants during daily activities and 21% of the participants during self-selected gait speed. Applying METsestimated for older adults leads to potential underestimation of physical activity intensity, suggesting that current classification metrics should be revised for older adults. V˙O2Reserve is a candidate metric for establishing precise physical activity intensity cut points for older adults. Clinical Trials Registration Number: NCT04821713.

Associations of Relative Intensity of Physical Activity with Incident Cardiovascular Events and All-Cause Mortality.

The relative intensity of a physical activity (PA) can be estimated as the percent of one's maximal effort required. We compared associations of relative and absolute intensity PA with incident major cardiovascular disease (CVD) and all-cause mortality in 5,633 women from the Objective Physical Activity and Cardiovascular Health Study (mean age 78.5±6.7). Absolute intensity was measured by accelerometry. Relative intensity was estimated by dividing accelerometer-estimated metabolic equivalents (METs) by maximal MET capacity. Both were aggregated into mean daily hours of light intensity PA (LPA) and moderate-to-vigorous PA (MVPA). Cox proportional hazards models estimated hazard ratios (HRs) for one-hour higher amounts of PA on outcomes. During follow-up (median=7.4 years), there were 748 incident CVD events and 1,312 deaths. Greater LPA and MVPA, on either scale, was associated with reduced risk of both outcomes. HRs for a one-hour increment of absolute LPA were 0.88 (95% CI:0.83-0.93) and 0.88 (95% CI:0.84-0.92) for incident CVD and mortality, respectively. HRs for a one-hour increment of absolute MPVA were 0.73 (95% CI:0.61-0.87) and 0.55 (95% CI:0.48-0.64) for the same outcomes. HRs for a one-hour increment of relative LPA were 0.70 (95% CI:0.59-0.84) and 0.78 (95% CI:0.68-0.89) for incident CVD and mortality, respectively. HRs for a one-hour increment of relative MPVA were 0.89 (95% CI:0.83-0.96) and 0.82 (95% CI:0.77-0.87) for the same outcomes. On the relative scale, LPA was more strongly, inversely associated with both outcomes than relative MVPA. Absolute MVPA was more strongly inversely associated with the outcomes than relative MVPA. Findings support the continued shift in the PA intensity paradigm towards recommendation of more movement, regardless of intensity. Relative LPA--a modifiable, more easily achieved behavioral target, particularly among ambulatory older adults--was associated with reduced risk of incident major CVD and death.