Moderate-intensity Physical Activity Research Articles

Socioeconomic and clinical risk factors associated with moderate intensity physical activity before and during the COVID-19 pandemic

Although moderate intensity physical activity (MIPA) improves general mental health, morbidity, and mortality, the COVID-19 pandemic may have adversely impacted individuals’ ability to engage in MIPA. We examined the extent of socioeconomic factors, body mass index, anxiety/depression, and cancer diagnosis associated with MIPA before and during the COVID-19 pandemic. Multivariable logistic regression models were conducted on 4,551 U.S. adults aged 18–64 years using nationally representative samples from the 2019 and 2020 Health Information National Trends Survey datasets. The prevalence of MIPA before the pandemic was higher (77.07%) than during the pandemic (76.21%). Before the COVID-19 pandemic, lower odds of MIPA were observed for individuals with fair/poor health (OR = 0.24, 95% CI = 0.27, 0.63), obesity (OR = 0.51, 95% CI = 0.33, 0.79), anxiety/depression (OR = 0.60, 95% CI = 0.42, 0.85), or a cancer diagnosis (OR = 0.56, 95% CI = 0.32, 0.98). During the pandemic, lower odds were observed among those with obesity (OR = 0.44, 95% CI = 0.28, 0.70), anxiety/depression (OR = 0.61, 95% CI = 0.43, 0.86), less than high school education (OR = 0.33, 95% CI = 0.16, 0.70), or family income of $20,000 - $34,999 (OR = 0.42, 95% CI = 0.24, 0.74). There was a decline in MIPA during the pandemic, with certain subgroups, such as individuals of lower socioeconomic and physical and mental health status, less likely to engage in MIPA. This study highlights the need for concerted physical activity educational strategies aimed at improving access to and utilization of MIPA within subgroups to reduce MIPA disparities, particularly among disadvantaged groups during pandemics.

The Mediating Role of Physical Activity Self-Efficacy in Predicting Moderate-Intensity Physical Activity in Pregnant People at High Risk for Gestational Diabetes.

Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. Moderate-intensity physical activity during pregnancy can lower the risk of GDM. However, the relationship between moderate-intensity physical activity and correlated factors among pregnant people at high risk for GDM remains unknown. A cross-sectional study was conducted in China. Two hundred fifty-two participants completed the Pregnancy Physical Activity Questionnaire, Pregnancy Physical Activity Self-Efficacy Scale, Physical Activity Knowledge Questionnaire, Physical Activity Social Support Scale, 7-item Generalized Anxiety Disorder Scale, Edinburgh Postnatal Depression Scale, and a sociodemographic data sheet. Structural equation modeling was used to explore the direct and indirect associations between the study variables. A total of 51.6% of the participants did not meet the current physical activity guidelines. Only physical activity self-efficacy was significantly correlated with moderate-intensity physical activity. Physical activity self-efficacy mediated the relationship between moderate-intensity physical activity and knowledge of physical activity, social support for physical activity, and anxiety symptoms. Furthermore, knowledge of physical activity was also associated with improved moderate-intensity physical activity mediated by reduced anxiety symptoms and increased physical activity self-efficacy. Our study revealed a high prevalence of not meeting current physical activity guidelines among pregnant people at high risk for GDM. Physical activity self-efficacy played an important mediating role in predicting moderate-intensity physical activity. Future studies should focus on enhancing self-efficacy to improve moderate-intensity physical activity for pregnant people at high risk for GDM.

Abstract PR005: Preferences of older cancer survivors for integration of remote activity monitoring using wearable devices

Abstract Purpose: To describe the preferences for integration of wearable devices into their healthcare to remotely monitor physical activity among older adult cancer survivors. Methods: 89 cancer survivors, aged 65 and older, completed our preferences for wearable devices in healthcare questionnaire. Participants were asked to self-report demographic information, current physical activity participation, and preferences for inclusion of wearable devices as part of their care plan through a current provider (i.e. physician, physical therapist, etc.). Data are summarized and reported as mean ± standard deviation or percent. Results: Participants were on average 71±5 years old, 59% female, and mostly White, non-Hispanic (93%). 76.2% of participants reporting engaging in 0 days of vigorous intensity physical activity, with 31% reporting no moderate intensity physical activity. 59% of older cancer survivors report they already own a wearable device, with the most common device being a wrist-worn device (93%). For those that do not currently own a device, 94% report they would be interested in owning a wearable device. 94% of older cancer survivors state they would be interested in using a wearable device as part of their usual care plan for their provider to remotely monitor their health. 88% report having no privacy concerns with sharing their wearable data with their healthcare provider. Participants report they would be willing to purchase their own monitor if it meant future out of pocket healthcare costs (81%) or reduced time investment to travel to the clinic (63%). Conclusions: Results indicate older cancer survivors are interested in their care team remotely monitoring their activity levels. Further, the majority of older cancer survivors report they are willing to purchase their own device. Future research is warranted to determine an implementation plan to integrate these devices into current clinic workflows and determine optimal interaction among patients and providers. Citation Format: Whitney A. Morelli, Kelly Clohesey, Jessica Liu. Preferences of older cancer survivors for integration of remote activity monitoring using wearable devices [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr PR005.

Optimising Preconception Care

Women with PCOS are at an increased risk of infertility and a range of pregnancy complications. It is therefore important to understand how to optimise preconception care to reduce these risks. A reproductive life plan and age-appropriate education on optimising reproductive health is recommended in adolescents and women with PCOS. This should occur across the domains of appropriate nutritional intake (dietary and supplement sources), optimising physical activity, considering the effects of excess weight on fertility and being aware of the effects of substances on fertility. Dietary intake should be consistent with population guidelines for healthy eating with appropriate intake of core food groups and limited intake of discretionary foods high in added sugar, sodium, trans and saturated fats. Recommendations exist for preconception micronutrient supplementation including folic acid and iodine (in the Australian context) with others (e.g., vitamin D, iron, calcium and B12) as per deficiencies or other country specific guidelines. Recommendations for physical activity should also be consistent with general population guidelines comprising moderate intensity physical activity of >150 minutes/week or vigorous intensity physical activity of 75 minutes/week or a combination of both, engaging in muscle strengthening activities [Formula: see text]2 days/week and minimising the amount of time spent in prolonged sitting. The association of excess weight on reduced fertility are recognised from epidemiological literature and current guidelines highlight strategies of modest weight loss at higher BMIs. This is an important and emerging field of literature where future research can elucidate efficacy in randomised controlled trials across different interventions and populations. When working with all women preconception, and in particular women with PCOS, it is important to consider weight stigma, disordered eating and eating disorders when discussing the relationship of infertility and weight and potential modification of weight. Substance use can be considered across limiting high intake of caffeine and avoiding alcohol and illicit substance intake and smoking.

Effects of physical activity on the levels of remnant cholesterol: A population-based study.

Physical activity (PA) has the potential to bring about favourable changes in plasma lipid profile. However, the relationship between PA and remnant cholesterol (RC) remains unclear. We aimed to study the link between PA and RC using the database of the 2007-2020 National Health and Nutrition Examination Survey (NHANES). PA was categorized based on Physical Activity Guidelines for Americans. A multivariate linear regression model was used to determine the correlations between PA and RC. The study involved a total of 18,396 participants and revealed that individuals whose PA met the guidelines by engaging in moderate-intensity PA at least 150 min per week had lower body mass index and showed decreased levels of triglyceride, TC, and haemoglobin A1c compared to those who were physically inactive, exercising <150 min per week. Participants whose intensity of PA meets PA guidelines had a lower level of RC than those who did not met PA guidelines (β = -1.3, 95% confidence interval [CI]: -1.9 to -0.7, p < 0.001), even after adjusting for confounders. During subgroup analysis, we observed that race (pinteraction = 0.0089) emerged as a significant factor of interaction.

Cadence (steps/min) and relative intensity in 61 to 85-year-olds: the CADENCE-Adults study

BackgroundWe previously demonstrated that a heuristic (i.e., evidence-based, rounded yet practical) cadence threshold of ≥ 100 steps/min was associated with absolutely-defined moderate intensity physical activity (i.e., ≥ 3 metabolic equivalents [METs]) in older adults 61–85 years of age. Although it was difficult to ascertain achievement of absolutely-defined vigorous (6 METs) intensity, ≥ 130 steps/min was identified as a defensible threshold for this population. However, little evidence exists regarding cadence thresholds and relatively-defined moderate intensity indicators, including ≥ 64% heart rate [HR] maximum [HRmax = 220-age], ≥ 40% HR reserve [HRR = HRmax-HRresting], and ≥ 12 Borg Scale Rating of Perceived Exertion [RPE]; or vigorous intensity indicators including ≥ 77%HRmax, ≥ 60%HRR, and ≥ 14 RPE.PurposeTo analyze the relationship between cadence and relatively-defined physical activity intensity and identify relatively-defined moderate and vigorous heuristic cadence thresholds for older adults 61–85 years of age.MethodsNinety-seven ostensibly healthy adults (72.7 ± 6.9 years; 49.5% women) completed up to nine 5-min treadmill walking bouts beginning at 0.5 mph (0.8 km/h) and progressing by 0.5 mph speed increments (with 2-min rest between bouts). Directly-observed (and video-recorded) steps were hand-counted, HR was measured using a chest-strapped monitor, and in the final minute of each bout, participants self-reported RPE. Segmented mixed model regression and Receiver Operating Characteristic (ROC) curve analyses identified optimal cadence thresholds associated with relatively-defined moderate (≥ 64%HRmax, ≥ 40%HRR, and ≥ 12 RPE) and vigorous (≥ 77%HRmax, ≥ 60%HRR, and ≥ 14 RPE) intensities. A compromise between the two analytical methods, including Youden’s Index (a sum of sensitivity and specificity), positive and negative predictive values, and overall accuracy, yielded final heuristic cadences.ResultsAcross all relatively-defined moderate intensity indicators, segmented regression models and ROC curve analyses identified optimal cadence thresholds ranging from 105.9 to 112.8 steps/min and 102.0-104.3 steps/min, respectively. Comparable values for vigorous intensity indicators ranged between126.1-132.1 steps/min and 106.7–116.0 steps/min, respectively. Regardless of the relatively-defined intensity indicator, the overall best heuristic cadence threshold aligned with moderate intensity was ≥ 105 steps/min. Vigorous intensity varied between ≥ 115 (greater sensitivity) or ≥ 120 (greater specificity) steps/min.ConclusionsHeuristic cadence thresholds align with relatively-defined intensity indicators and can be useful for studying and prescribing older adults’ physiological response to, and/or perceived experience of, ambulatory physical activity.Trial registrationClinicaltrials.gov NCT02650258. Registered 24 December 2015.

Promoting physical activity and a healthy active lifestyle in community-dwelling older adults: a design thinking approach for the development of a mobile health application.

Physical activity (PA) has wide-ranging, and well documented benefits for older adults, encompassing physical, cognitive, and mental well-being. The World Health Organization advocates for a minimum of 150-300 min of moderate intensity PA per week, supplemented by muscle-strengthening exercises. However, the rates of PA among older adults remain a concern. While portable technologies hold promises in promoting PA, sustaining long-term engagement continues to be a challenge. The aims of this study are to identify barriers and facilitators to PA in older adults, to develop an mHealth app promoting PA and an active healthy lifestyle in collaboration with community-dwelling older adults guided by the design thinking process, and to test it. A co-creative process was used, employing design thinking. Interviews were conducted to understand the needs of the target population and identify the problem of insufficient PA. Two cocreation sessions involving older adults and experts were conducted to generate innovative ideas. Participants were selected based on age (≥65 years), no severe illness, Dutch language proficiency, and active participation ability. Results were qualitatively analyzed and coded. Finally a prototype was developed and tested. Interviews with older adults highlighted diverse perceptions of PA but unanimous agreement on its importance. They recognized health benefits such as improved mobility, balance, and reduced fall risk, while emphasizing the social and mental aspects. Barriers included poor health, time constraints, weather conditions and fear of falling. Cocreation sessions identified key topics: perception of a healthy lifestyle, coping strategies, mHealth App features, screen visualization, and tailored notifications, which led to the development of a mobile app promoting PA and an active lifestyle. The app was stepwise prototyped. This study emphasizes the importance of promoting PA among older adults through a collaborative design thinking approach. However, the implementation of mHealth apps faces obstacles due to the digital divide, necessitating personalized solutions to bridge the gap. Moreover, it calls for further research to investigate the long-term impact of such interventions and explore behavior change patterns in this population.

Supporting physical activity for mobility in older adults with mobility limitations (SuPA Mobility): study protocol for a randomized controlled trial

BackgroundLimited mobility in older adults consistently predicts both morbidity and mortality. As individuals age, the rates of mobility disability increase from 1.0% in people aged 15–24 to 20.6% in adults over 65 years of age. Physical activity can effectively improve mobility in older adults, yet many older adults do not engage in sufficient physical activity. Evidence shows that increasing physical activity by 50 min of moderate intensity physical activity in sedentary older adults with mobility limitations can improve mobility and reduce the incidence of mobility disability. To maximize the healthy life span of older adults, it is necessary to find effective and efficient interventions that can be delivered widely to prevent mobility limitations, increase physical activity participation, and improve quality of life in older adults. We propose a randomized controlled trial to assess the effect of a physical activity health coaching intervention on mobility in older adults with mobility limitations.MethodsThis randomized controlled trial among 290 (145 per group) community-dwelling older adults with mobility limitations, aged 70–89 years old, will compare the effect of a physical activity health coaching intervention versus a general healthy aging education program on mobility, as assessed with the Short Physical Performance Battery. The physical activity health coaching intervention will be delivered by exercise individuals who are trained in Brief Action Planning. The coaches will use evidence-based behavior change techniques including goal-setting, action planning, self-monitoring, and feedback to improve participation in physical activity by a known dose of 50 min per week. There will be a total of 9 health coaching or education sessions delivered over 26 weeks with a subsequent 26-week follow-up period, wherein both groups will receive the same duration and frequency of study visits and activities.DiscussionThe consequences of limited mobility pose a significant burden on the quality of life of older adults. Our trial is novel in that it investigates implementing a dose of physical activity that is known to improve mobility in older adults utilizing a health coaching intervention.Trial registrationClinicalTrials.gov Protocol Registration System: NCT05978336; registered on 28 July 2023.

Negative mood state in Kermanshah population during COVID-19 quarantine linked to low physical activity levels: a cross-sectional online survey study

One of the most significant consequences of the coronavirus disease (COVID-19) pandemic is the anxiety and stress it causes among the general population, which can be reduced by engaging in regular physical activity. The aim of this study was to estimate the levels of physical activity and mood state during the COVID-19 quarantine among the Kermanshah population. In this cross-sectional study, a total of 2471 subjects (1256 males and 1215 females) were selected in the population of Kermanshah in the west of Iran, using the convenience sampling method. Physical activity levels were assessed using the physical activity (PA) questionnaire short form (IPAQ-SF), and mood state was measured by the abbreviated form of the Iranian version of the standard POMS questionnaire (Bill Morgan 1979). Participants completed the online questionnaire between March 28th and May 20th, 2020. Descriptive statistics (mean, standard deviation, and percentage), and deductive (Chi-square and Spearman's correlation) were used for data analysis. our study found that the majority of participants reported decreased PA levels during the quarantine period. Specifically, 71.7% reported a decrease in moderate-intensity physical activity, 80.5% reported a decrease in high-intensity PA, and 71.3% reported a decrease in the total volume of PA. The results showed that there was a significant difference between the number of sessions (P=0.001), intensity (P=0.001), and duration of exercise (P=0.001) before and during the coronavirus. There was a significant positive relationship between low (r=0.93; P=0.001) and high (r=0.673; P=0.034) levels of PA and negative mood state. Additionally, there was a positive relationship between moderate PA level (r=0.82; P=0.001) and a positive mood states. The study suggests that the current quarantine has negatively affected the mood states of the participants. Overall, the study recommends regular PA to prevent COVID-19 while adhering to health and safety protocols.

The association between physical activity and sleep in adult ADHD patients with stimulant medication use

BackgroundAdults with attention-deficit/hyperactivity disorder (ADHD) may experience sleep problems doubly suffering from the disease and side effects of stimulant medications. Physical activity (PA) is known to produce numerous beneficial effects in adults. However, it was not well-characterized whether PA would still be effective in this situation. The main objective of the current study was to examine the relationship between PA and sleep among adult ADHD patients who were using stimulant medications and quantify the form of this association.MethodsAdult ADHD participants with stimulant medications use condition from the National Health and Nutrition Examination Survey (NHANES) database between January 1, 2013, and March 2020 (prepandemic) were included in the cross-sectional analysis. Weighted logistic regression was performed to assess the relationship between PA level and sleep. A restricted cubic spline model was used to relax the linear relationship assumptions and investigate the associations between the risk of trouble sleeping and time spent engaging in moderate-to-vigorous PA per week.ResultsA total of 162 eligible adult ADHD participants who reported using stimulant medicines were included. Participants who adhered to the general recommendation of guidelines in the US of 150 min per week of moderate-to-vigorous PA had a significant lower risk of complaining of trouble sleeping (OR: 0.26, 95% CI: 0.10–0.67, p = 0.006), and this association was seen in men (OR: 0.23, 95% CI: 0.09–0.56, p = 0.002), but was not seen in women (OR: 0.71, 95% CI: 0.27–1.88, p = 0.500). Restricted cubic spline analysis showed that the incidence of trouble sleeping gradually decreased after at least 105 min of moderate-intensity PA per week in participants (OR: 1.02, 95% CI: 0.92–1.14). A significant difference appeared after 341 min (OR: 0.87, 95% CI: 0.76–0.99), and the curve leveled after 1,250 min (OR: 0.60, 95% CI: 0.46–0.79).ConclusionOur findings observed associations between PA and sleep condition in the adult ADHD patients with stimulant medication use population. Moderate-to-vigorous PA may be beneficial to sleep in adults with ADHD who were using stimulants and thus should be recommended as part of a healthy lifestyle. Gender difference should be considered as an important factor for further studies to examine these associations and explore potential mechanisms.

Association between physical activity and health-related quality of life in middle-aged and elderly individuals with musculoskeletal disorders: Findings from a national cross-sectional study in Korea.

This study aimed to identify the association between physical activity and health-related quality of life (HRQoL) in middle-aged and elderly individuals with musculoskeletal disorders. This study used data from the 2016-2020 Korea National Health and Nutrition Examination Survey (KNHANES). We included only those over 40 years of age diagnosed with one or more of the following: osteoarthritis, rheumatism, and osteoporosis. In total, 4,731 participants (783 men and 3,948 women) were included as the study population. Multiple logistic regression analysis was performed to examine the association between physical activity and HRQoL. In the case of middle-aged and elderly individuals with musculoskeletal disorders, the likelihood of HRQoL worsening was significantly lower for those who regularly engaged in physical activity compared with that of those who did not engage in physical activity at all (men: OR 0.58, 95% CI 0.37-0.90; women: OR 0.64, 95% CI 0.53-0.79). Stratified analysis by the type and intensity of physical activity revealed that the possibility of poor HRQoL was lowest when leisure-related moderate-intensity physical activities were performed (men: OR 0.44, 95% CI 0.22-0.89; Women: OR 0.50, 95% CI 0.36-0.69). Our findings suggest that engaging in regular physical activity contributes to preventing exacerbation of HRQoL, even if the individual suffers from musculoskeletal disorders. It is necessary to provide an appropriate type and intensity of physical activity in consideration of the patients' pain and severity.

Do the American guideline-based leisure time physical activity levels for civilians benefit the mental health of military personnel?

This study aimed to clarify the association of American guideline-based leisure time physical activity (PA) level with mental health in 4,080 military personnel in Taiwan. The moderate intensity PA level was assessed according to the total running time per week (wk) reported in a self-administered questionnaire over the previous 6 months and was categorized into PA level <150, 150-299, and ≥300 min/wk. Mental stress was assessed by the Brief Symptom Rating Scale (BSRS)-5 for which ≥15 points were classified as great mental stress. Suicide ideation (SI) was graded as 1 for mild, 2 for moderate, and 3 or 4 for severe. Multivariable logistic regression analysis was employed to determine the association between PA and mental health while adjusting for demographics, smoking, alcohol intake, betel nut chewing, and obesity. As compared to participants with a PA level of <150 min/wk., those with PA levels 150-299 min/wk. and ≥ 300 min/wk. had a lower possibility of SI ≥1 [odds ratios (ORs) and 95% confidence intervals (CIs): 0.58 (0.40-0.83) and 0.23 (0.14-0.36), respectively] and SI ≥1 and/or BSRS-5 ≥ 15 [ORs: 0.55 (0.39-0.79) and 0.21 (0.13-0.34), respectively]. The possibilities were more significantly lower for SI ≥2 [ORs: 0.37 (0.20-0.68) and 0.10 (0.04-0.26), respectively] and SI ≥2 and/or BSRS-5 ≥ 15 [ORs: 0.35 (0.20-0.62) and 0.10 (0.04-0.25), respectively]. Our findings indicate that participating in moderate-intensity leisure time PA level for ≥150 min/wk. may have a positive effect on mental health among military personnel. The impact appears to be even more significant when engaging in a higher PA level of ≥300 min/wk.

Effect of Daily Activity Record-Based Self-monitoring Intervention on the Perception of Physical Sensations in Patients With Chronic Heart Failure: A Randomized Controlled Trial.

To prevent rehospitalization for heart failure (HF), patients need to be able to perceive physical changes that occur at the onset of HF exacerbation and seek early help. The aim of this study was to evaluate the effect of a self-monitoring intervention on patients' perceptions of physical sensations during daily activities in the context of HF via a randomized controlled trial. Participants (N = 70) were randomly assigned to the intervention (received daily activity record-based self-monitoring intervention support; group A) or control (only explained the measured results from the records; group B) group. Group A reflected on and described the physical sensations in their daily activities within 1 month after discharge. Outcome measures were assessed at 1 month after the intervention using the European Heart Failure Self-care Behavior Scale, Evaluation Scale for Self-Monitoring by patients with Heart Failure, clinical events, physical activity, and sleep. There was no significant difference in the change in the "asking for help" subscale score of the European Heart Failure Self-care Behavior Scale between the groups (+0.7 vs +0.4 points, P = .716). Group A had improved score on the self-monitoring subscale related to "concern about how movements affect body" from baseline (from 12.7 to 14.0 points, P = .026). There was no significant effect of self-monitoring intervention support on the first rehospitalization related to HF and all-cause death (log-rank χ 2 = 0.432, P = .511). A significant difference in moderate-intensity physical activity between the groups was observed (+4.6 vs -0.5 minutes, P = .029). A focused strategy that enables patients to perceive their physical sensations and promotes early help-seeking behavior is needed.

Understanding Physical Fitness in Older Populations

Move for Health’ By Who’ S World Health Initiative Stated That • Low levels of physical activity are associated with an increased risk of mortality in people over the age of 65 years. • Low levels of physical activity are associated with an increased risk of developing chronic health conditions in people over the age of 65 years. • Each year at least 1.9 million people die as a result of physical inactivity. • At least 30 minutes of regular, moderate-intensity physical activity on 5 days per week reduces the risk of several non-communicable diseases [NCDs]. • Physical inactivity is an independent modifiable risk factor for common NCDs. • More than 35 million people died of NCDs in 2005 - this represented 60% of all deaths worldwide. • 80% of deaths from NCDs occur in low- and middle-income countries. • Without action to address the causes, deaths from NCDs will increase by 17% between 2005 and 2015

Physical Activity, Inactivity and Sleep in Individuals with Hypertrophic Cardiomyopathy.

Physical activity presents an important cornerstone in the management and care of individuals with hypertrophic cardiomyopathy (HCM). Twenty-one individuals with HCM (age: 52±15 years old, body mass index (BMI): 30±7 kg/m2) completed 7-day monitoring using wrist-worn triaxial accelerometers (GENEActiv, ActivInsights Ltd, UK) and were compared to age and sex-matched healthy controls (age: 51±14 years old, BMI: 25±4 kg/m2). For individuals with HCM, clinical parameters (left atrial diameter and volume, peak oxygen consumption, NTproBNP and Minnesota Living with Heart Failure (MLHF)) were correlated with accelerometry. After adjusting for BMI, individuals with HCM spent less time in moderate-vigorous physical activity (MVPA) (86 (55-138) vs. 140 (121-149) minutes/day, p<0.05) compared to healthy controls. Individuals with HCM engaged in fewer MVPA-5 min (6 (2-15) vs. 27 (23-37) minutes/day, p<0.01) and MVPA-10 min bouts (9 (0-19) vs. 35 (17-54) minutes/day, p<0.01) versus healthy controls. For HCM only, peak oxygen consumption was correlated with MVPA (r=0.60, p<0.01) and MVPA-5 min bouts (r=0.47, p<0.05). MLHF score was correlated with sleep duration (r=0.45, p<0.05). Individuals with HCM should be encouraged to engage in moderate-intensity physical activity bouts and reduce prolonged periods of inactivity in order to potentially improve exercise tolerance and reduce disease burden.

Assessing real-world implementability of a multimodal group-based tele-prehabilitation program in cancer care: a pragmatic feasibility study.

Multimodal prehabilitation is intended to optimize a patient's mental and physical health prior to surgery. Most multimodal prehabilitation interventions are delivered on a one-on-one format, which may limit benefits associated with social interactions that can be achieved in a group context, and are delivered in-person, which may limit the accessibility. The purpose of this study was to develop a group-based, multimodal, tele-prehabilitation intervention for individuals diagnosed with cancer (iACTIF) and assess its implementability in a "real-world" clinical setting by measuring feasibility, acceptability, fidelity, and preliminary effects. A prospective, single-group, pragmatic feasibility study was conducted with assessments at baseline, pre-surgery, and 12-weeks post-surgery. iACTIF consisted of three 90-min live videoconference sessions per week, including exercise and educational components. Descriptive statistics were used to document feasibility, acceptability, and fidelity indicators. Paired t-test, Wilcoxon test, and Cohen's D-test were conducted to assess changes in health-related outcomes. A total of 25 participants (mean age ± SD= 60.2 ± 14.0) were recruited. The feasibility assessment revealed a low referral rate (31.4%) and a high study retention (98%) and program attendance [session attended/possible session] (70.2%), with a prehabilitation window of 32.7 days (SD= 20.9, median= 28). Acceptability was high (84%-100%) according to satisfaction, utility and safety, delivery modality, and intention to continue physical activity and to recommend iACTIF to a relative. Pre-post-intervention assessments suggest positive changes on physical functional capacity based on the 2-min step test (mean difference= +18.9 steps, p=0.005), the 30-s sit-to-stand (mean difference= +1.1 repetition, p=0.011), and volume of moderate intensity physical activity per week (mean difference= +104.8 min, p<0.001). Fidelity was supported by conformity and coherence, with only minimal adjustments required to meet participants' needs. iACTIF implementability in a "real-world" clinical setting is promising, and preliminary outcomes suggest moderate benefits on physical health and small increase in mental health indicators.

Agreement between self-reported and objectively assessed physical activity among out-of-hospital cardiac arrest survivors.

Low level of physical activity is a risk factor for new cardiac events in out-of-hospital cardiac arrest (OHCA)survivors. Physical activity can be assessed by self-reporting or objectively by accelerometery. To investigate the agreement between self-reported and objectively assessed physical activity among OHCA survivors HYPOTHESIS: Self-reported levels of physical activity will show moderate agreement with objectively assessed levels of physical activity. Cross-sectional study including OHCA survivors in Sweden, Denmark, and the United Kingdom. Two questions about moderate and vigorous intensity physical activity during the last week were used as self-reports. Moderate and vigorous intensity physical activity were objectively assessed with accelerometers (ActiGraph GT3X-BT)worn upon the right hip for 7 consecutive days. Forty-nineof 106 OHCA survivors answered the two questions for self-reporting and had 7 valid days of accelerometer assessment. More physically active days were registered by self-report compared with accelerometery for both moderate intensity (median 5 [3:7] vs. 3 [0:5] days; p < 0.001) and vigorous intensity (1 [0:3] vs. 0 [0:0] days; p < 0.001). Correlations between self-reported and accelerometer assessed physical activity were sufficient (moderate intensity: rs = 0.336, p = 0.018; vigorous intensity: rs = 0.375, p = 0.008), and agreements were fair and none to slight (moderate intensity: k = 0.269, p = 0.001; vigorous intensity: k = 0.148, p = 0.015). The categorization of self-reported versus objectively assessed physical activity showed that 26% versus 65% had a low level of physical activity. OHCA survivors reported more physically active days compared with the results of the accelerometer assessment and correlated sufficiently and agreed fairly and none to slightly.

Young Adult Physical Activity Trajectories and Midlife Nonalcoholic Fatty Liver Disease

Physical activity (PA) is recommended for preventing and treating nonalcoholic fatty liver disease (NAFLD). Yet, how long-term patterns of intensity-based physical activity, including moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), might affect the prevalence of NAFLD in middle age remains unclear. To identify distinct intensity-based PA trajectories from young to middle adulthood and examine the associations between PA trajectories and NAFLD prevalence in midlife. This population-based cohort of 2833 participants used the Coronary Artery Risk Development in Young Adults study data. The setting included field clinics in Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California. Data analysis was completed in March 2023. PA was self-reported at 8 examinations over 25 years (1985-1986 to 2010-2011) and separately scored for MPA and VPA. NAFLD was defined as liver attenuation values less than 51 Hounsfield units after exclusion of other causes of liver fat, measured using computed tomography in year 25 (2010-2011). Among a total of 2833 participants included in the sample, 1379 (48.7%) self-identified as Black, 1454 (51.3%) as White, 1206 (42.6%) as male, and 1627 (57.4%) as female from baseline (1985-1986) (mean [SD] age, 25.0 [3.6] years) to year 25 (2010-2011) (mean [SD] age, 50.1 [3.6] years). Three MPA trajectories were identified: very low stable (1514 participants [53.4%]), low increasing (1096 [38.7%]), and moderate increasing (223 [7.9%]); and 3 VPA trajectories: low stable (1649 [58.2%]), moderate decreasing (1015 [35.8%]), and high decreasing (169 [6.0%]). After adjustment for covariates (sex, age, race, study center, education, smoking status, and alcohol consumption), participants in the moderate decreasing (risk ratio [RR], 0.74; 95% CI, 0.54-0.85) and the high decreasing (RR, 0.59; 95% CI, 0.44-0.80) VPA trajectories had a lower risk of NAFLD in middle age, relative to participants in the low stable VPA trajectory. Adjustments for baseline body mass index and waist circumference attenuated these estimates, but the results remained statistically significant. The adjusted RRs across the MPA trajectories were close to null and not statistically significant. This cohort study of Black and White participants found a reduced risk of NAFLD in middle age for individuals with higher levels of VPA throughout young to middle adulthood compared with those with lower VPA levels. These results suggest the need for promoting sustainable and equitable prevention programs focused on VPA over the life course to aid in lowering NAFLD risk.

Objectively and subjectively measured physical activity levels in individuals with whiplash associated disorder and aged-matched healthy controls.

Whiplash associated disorders (WAD) are the most common non-hospitalised injuries resulting from a motor vehicle crash. Half of individuals with WAD experience ongoing pain and disability. Furthermore, individuals with persistent WAD have lower levels of aerobic capacity and isometric strength compared with age-matched controls. It is not known whether these differences are associated with increased levels of pain and disability, or with reduced physical activity (PA) participation. Our primary aim was to compare PA levels in individuals with persistent WAD with healthy controls. Secondary aims were to: compare objective and subjective measurements of PA; explore factors that may influence PA; and describe proportions of these populations meeting World Health Organisation PA guidelines. Objective (ActiGraph accelerometer; seven days) and subjective (International Physical Activity Questionnaire (IPAQ)) PA data were collected for n = 53 age-matched participants (WAD n = 28; controls n = 25). Independent sample t-tests showed no significant difference in objectively measured PA (p>0.05) between WAD and controls. For the subjective measure (IPAQ), controls reported more overall weekly PA (t = 0.219, p<0.05), while WAD participants reported more weekly walking minutes (t = -0.712, p<0.05). Linear regression showed mental health quality-of-life predicted objectively measured moderate intensity PA (R2 = 0.225, F (2, 44) = 6.379, p<0.004) and subjectively reported overall PA (R2 = 0.132, F (1, 41) = 6.226, p<0.017). Bland-Altman analyses indicated that subjects over-reported MVPA and under-reported sedentary time using the IPAQ. Individuals with WAD had levels of physical and mental health quality-of-life significantly lower than controls and below population norms yet participated in similar levels of PA. Given that increased perceptions of mental health quality-of-life were positively associated with objectively measured MVPA and subjectively reported overall PA, strategies to help people with WAD achieve adequate doses of MVPA may be beneficial. ActiGraph-measured and IPAQ-reported PA were discordant. Hence, IPAQ may not be a reliable measure of habitual PA in WAD.

Optimal domain-specific physical activity and sedentary behaviors for blood lipids among Japanese children: a compositional data analysis

BackgroundOptimizing childhood domain-specific physical activity (PA) and sedentary behavior (SB) for blood lipid profile is not well understood. We aimed to (1) determine the associations between accelerometer-measured PA and SB for each domain (school time and out-of-school time) with blood lipid profile and (2) estimate predicted changes in blood lipid profile with hypothetical time-reallocation between domain-specific SB and PA among Japanese children using compositional data analysis (CoDA).MethodsThis cross-sectional study included 284 children (147 boys and 137 girls) aged 9–12 years (mean age [years]: 10.1 ± 1.2 for boys, 10.0 ± 1.1 for girls; mean body mass index: 18.2 ± 3.2 for boys, 17.5 ± 2.5 for girls). Time spent in domain-specific SB, light-intensity PA (LPA), moderate-intensity PA (MPA), and vigorous-intensity PA (VPA) was assessed using accelerometry. The non-fasting lipid profile considered measures of triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and non-HDL-C levels. CoDA and isotemporal substitution model were performed to examine the associations of domain-specific PA and SB with blood lipids.ResultsTime spent in out-of-school VPA relative to the other behaviors was negatively associated with non-HDL-C (boys: βilr1 = − 0.10, 95% confidence interval [CI] = − 0.19 to − 0.01), TG (boys: βilr1 = − 0.45, 95% CI = − 0.68 to − 0.22), and positively associated with HDL-C (girls: βilr1 = 0.09, 95% CI = 0.02 to 0.16) after adjusting for age, body mass index, and time spent in SB, LPA, and MPA. During the out-of-school period, a replacement of 1 min of any other behavior with VPA was associated with decreases in LDL-C in boys (predicted changes [95% CI] − 0.03 mmol/L [− 0.05 to − 0.00] for LPA), non-HDL-C in boys (predicted changes [95% CI] − 0.03 mmol/L [− 0.06 to − 0.01] for SB and LPA) and TG in boys (predicted changes [95% CI] − 0.04 mmol/L [− 0.06 to − 0.02] for SB and LPA, − 0.05 mmol/L [− 0.07 to − 0.02] for MPA) and in girls (predicted changes [95% CI] − 0.02 mmol/L [− 0.04 to − 0.00] for LPA), and increases in HDL-C in girls (predicted changes [95% CI] 0.02 mmol/L [0.00 to 0.04] for SB and LPA, 0.03 mmol/L [0.00 to 0.05] for MPA).ConclusionsIncreasing out-of-school VPA might be an effective approach to improve blood lipid profiles among Japanese children.