Moderate-to-vigorous Physical Activity In Adults Research Articles

Assessing Moderate to Vigorous Physical Activity in Older Adults: Validity of a Commercial Activity Tracker.

Purpose: Despite the potential for commercial activity devices to promote moderate to vigorous physical activity (MVPA), limited information is available in older adults, a high-priority target population with unique gait dynamics and energy expenditure. The study purpose was to investigate the content validity of the Garmin Vivosmart HR device for step counts and MVPA in adults ≥65 years of age in free-living conditions.Methods: Thirty-five participants (M age= 73.7 (6.3) years) wore Garmin and ActiGraph GT3X+ devices for a minimum of 2 days. Accuracy and intra-person reliability were tested against a hip worn ActiGraph device. Separate analyses were conducted using different accelerometer cut-off values to define MVPA, a population-based threshold (≥2,020 counts/minute) and a recommended threshold for older adults (≥1,013 counts/minute).Results: Overall, the Garmin device overestimated MVPA compared with the hip-worn ActiGraph. However, the difference was small using the lower, age-specific, MVPA cut-off value [median (IQR) daily minutes; 50(85) vs. 32(49), p = 0.35] in contrast to the normative standard (50(85) vs. 7(24), p < 0.001). Regardless of the MVPA cut-off, intraclass correlation showed poor reliability [ICC (95% CI); 0.16(-0.40, 0.55) to 0.35(−0.32, 0.7)] which was supported by Bland-Altman plots. Garmin step count was both accurate (M step difference: 178.0, p = 0.22) and reliable [ICC (95% CI; 0.94) (0.88, 0.97)].Conclusion: Results support the accuracy of a commercial activity device to measure MVPA in older adults but further research in diverse patient populations is needed to determine clinical utility and reliability over time.

The promotion of physical activity for the prevention of Alzheimer's disease in adults with Down Syndrome: Rationale and design for a 12 Month randomized trial

Nearly all individuals with Down Syndrome (DS) display pathology associated with Alzheimer's disease (AD) beginning as early as age 30. Previous research in typically developed adults suggests that increased moderate-to-vigorous physical activity (MVPA) may improve cognitive function and protect against age-related structural and functional changes in the brain; however, the potential impact of increased MVPA on the development of AD in adults with DS has not been evaluated. Despite the potential positive impact of MVPA on cognition and AD risk, participation in MVPA among young adults with DS is low. The limited research evaluating strategies for increasing MVPA in adults with DS has been unsuccessful in increasing MVPA. Results from our preliminary investigation where we remotely delivered real-time MVPA, led by a trained health educator, to groups of adults with DS in their homes via video conferencing on a tablet computer demonstrated high attendance, increased MVPA during group sessions, and improvements in cognitive function. However, the sustainability, impact on total daily MVPA, optimal session frequency, and potential impacts on cognitive function and brain health of remotely delivered group MVPA sessions in adults with DS are unknown. Therefore, we will conduct a trial in 80 non-demented adults with DS to determine the feasibility and potential efficacy of remotely delivered group MVPA sessions to increase daily MVPA, relative to a usual care control. Secondarily we will assess the impact of MVPA on cardiovascular fitness, quality of life, cognitive function and brain parameters related to AD. NCT registrationNCT04048759.

The Relationship between Polypharmacy and Physical Activity in Those with or at Risk of Knee Osteoarthritis.

Physical activity is associated with improved pain, functional status, and less disability in persons with knee osteoarthritis (KOA). Because polypharmacy is related to several adverse health outcomes in older persons, we hypothesized that it might also be associated with decreased physical activity in those with KOA. This study evaluates the relationship between the number of prescription medications and weekly moderate to vigorous physical activity (MVPA). We used hierarchical median quantile regression analysis to examine the cross-sectional association between the number of prescription medications taken in the past 30 days and the median objectively measured MVPA minutes controlling for demographic and clinical variables. Four Osteoarthritis Initiative (OAI) recruitment centers in Providence, Rhode Island; Columbus, Ohio; Baltimore, Maryland; and Pittsburgh, Pennsylvania. Accelerometer monitoring occurred in 2,127 OAI participants. Of these, 1,889 participants had 4 or more days of valid physical activity monitoring data and complete medication/covariate data. Data were collected at the 48-month OAI follow-up visit (2008-2010). The outcome was weekly minutes of MVPA measured with an accelerometer. Number/type of prescribed medications and covariate data (age, sex, race/ethnicity, body mass index, presence of comorbidities, pain, depressive symptoms, and radiographic KOA severity) were taken from the public OAI database. Polypharmacy was defined as taking five or more prescribed medications. The prevalence of polypharmacy in the study population was 28.2%. Each additional prescription medication was related to a decrease of 3.6 minutes (95% confidence interval [CI] = -4.8 to -2.1) in median weekly MVPA minutes. Participants meeting the polypharmacy criterion exhibited a decrease of 12.6 minutes (95% CI = -21.2 to -4.7) in median weekly MVPA minutes compared with those not meeting the criterion. An increased number of prescription medications and polypharmacy are associated cross-sectionally with decreased MVPA in adults with KOA. Further study is necessary to establish the causal nature of this association.

Remote Exercise for Adults with Down Syndrome

ABSTRACT Adults with Down syndrome are less physically active than their typically developed peers. The purpose of this study was to assess the feasibility of delivering moderate-to-vigorous exercise sessions, led by a trained health educator using real-time video conferencing, to groups of young adults with Down syndrome in their homes. Participants were randomized to 30-min group exercise sessions either one or two times a week delivered on an iPad mini tablet computer using the Zoom video conferencing application, and were asked to attend individual support/education sessions once a week using FaceTime® on the iPad, for 12 wk. Minutes of moderate-to-vigorous physical activity (MVPA) during all group sessions were assessed using a Fitbit Charge HR activity/heart rate monitor. Participants were also asked to complete weekly homework assignments involving MVPA. Twenty-seven participants (n = 14, one session per week; n = 13, two sessions per week) with a mean age of 27.9 ± 7.1 yr (~41% female) enrolled in and completed the 12-wk intervention. Attendance at group exercise and individual support/education sessions did not differ significantly between those randomized to one session per week (exercise sessions, 89.9% ± 8.8%; support/education sessions, 81.2% ± 18.7%) or two sessions per week (exercise sessions, 88.8% ± 7.7% (P = 0.79); support/education sessions, 86.0% ± 20.9% (P = 0.87)). Participants averaged 27.7 ± 5.7 min per session of MVPA with no significant difference between the one- (26.6 ± 3.0 min per session) and two-session-per-week groups (28.8 ± 7.7 min per session, P = 0.16). The completion rate for homework assignments did not differ significantly between the one- (21.4% ± 26.3%) and two-session-per-week groups (37.7% ± 21.7%, P = 0.28). Exercise delivered by group video conferencing may be a feasible and potentially effective approach for increasing MVPA in adults with Down syndrome.

Examining acute bi-directional relationships between affect, physical feeling states, and physical activity in free-living situations using electronic ecological momentary assessment.

Current knowledge about the relationship of physical activity with acute affective and physical feeling states is informed largely by lab-based studies, which have limited generalizability to the natural ecology. This study used ecological momentary assessment to assess subjective affective and physical feeling states in free-living settings across 4days from 110 non-physically active adults (Age M=40.4, SD=9.7). Light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured objectively by an accelerometer. Multilevel modeling was used to test the bi-directional associations between affective and physical feeling states and LPA/MVPA minutes. Higher positive affect, lower negative affect and fatigue were associated with more MVPA over the subsequent 15min, while higher negative affect and energy were associated with more LPA over the subsequent 15 and 30min. Additionally, more LPA and MVPA were associated with feeling more energetic over the subsequent 15 and 30min, and more LPA was additionally associated with feeling more negative and less tired over the subsequent 15 and 30min. Positive and negative affective states might serve as antecedents to but not consequences of MVPA in adults' daily lives. Changes in LPA may be predicted and followed by negative affective states. Physical feeling states appear to lead up to and follow changes in both LPA and MVPA.

12 Month Behavioral Weight Loss Intervention With Varying Doses Of Physical Activity

Secondary data analysis from intervention studies has suggested that ≥250 min/wk of moderate-to-vigorous physical activity (MVPA) is associated with improved long-term weight loss within the context of a behavioral weight loss intervention; however, randomized clinical trials are needed to support these findings and to determine the feasibility of adults who are overweight or obese to achieve this recommended level of MVPA. PURPOSE: This study examined the ability of a behavioral intervention to achieve MVPA levels recommended for public health (150 min/wk) or weight control (250 min/wk). This study also examine whether weight loss, within the context of a comprehensive weight management program, varied by these prescribed levels of MVPA in adults who were overweight or obese across 12 months. METHODS: Data were examined from sedentary adults (N=230; BMI: 32.1±3.8 kg/m2; age=46.2±7.7 years) enrolled in a behavioral program and randomized to a reduced calorie diet (DIET, N=71), diet plus a moderate dose of MVPA (MOD-EX, N=82), or diet plus a high dose of MVPA (HIGH-EX, N=77). All groups received weekly intervention sessions in months 1–6 followed by 2 group and 2 telephone contacts per month in months 7–12, and were prescribed a diet to reduce energy intake (1200–1800 kcal/day). MOD-EX was prescribed unsupervised MVPA that progressed to 150 min/wk, whereas HIGH-EX was progressed to 250 min/wk. MVPA and weight were assessed at 0, 6, and 12 months. RESULTS: MVPA at 0, 6, and 12 months was 52.3±60.5, 82.3±93.4, and 85.7±110.6 min/wk in DIET; 53.8±78.7, 173.1±112.1, and 185.8±134.5 min/wk in MOD-EX, and 73.2±92.2, 254.1±127.8, and 236.0±154.9 min/wk in HIGH-EX (Group X Time p-value <0.001). Weight significantly decrease in all groups at 6 months (DIET: −9.2±5.8 kg, MOD-EX: −10.2±6.4 kg, HIGH-EX: −9.5±5.4 kg; p<0.001) and 12 months (DIET: −9.7±7.5 kg, MOD-EX: −11.0±8.2 kg, HIGH-EX: −9.7±7.1 kg; p<0.001), with no significant difference between groups. CONCLUSIONS: The MOD-EX and HIGH-EX interventions were successful at achieving the prescribed dose of MVPA in adults with obesity. The lack of additional weight loss with participation in higher amounts of MVPA may suggest that there is a compensatory response in factors influencing energy balance that warrant further investigation. Supported by: NIH (R01 HL103646)

Quantification of Physical Activity and Sedentary Time in Adults with Cerebral Palsy.

The purpose of this study was to determine objective and subjective quantification of habitual physical activity (HPA) and sedentary time in ambulatory and nonambulatory adults with cerebral palsy (CP). We recruited a clinical sample of adults with CP (N = 42; 21 women; mean (SD) age, 33.5 (12.3) yr; Gross Motor Function Classification System (GMFCS) distribution: level I (n = 5), level II (n = 9), level III (n = 10), level IV (n = 11), and level V (n = 7). Objective measures of HPA and sedentary time were obtained by using ActiGraph GT3X accelerometers at both hip and wrist sites. Three previously established cut-point values distinguishing light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were evaluated across GMFCS levels. The concurrent validity of the self-report Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI) was assessed for LPA and MVPA intensities in GMFCS levels II-V. Participants showed little reluctance to wearing accelerometers; one participant reported discomfort. Nonambulatory adults (GMFCS levels IV-V) differed from ambulatory adults (GMFCS levels I-III) for recorded activity counts (hip and wrist sites), minutes of MVPA with each cut-point value, and breaks from sedentary time (all P < 0.05). For the same measures, adults in GMFCS level III also differed from GMFCS level I (all P < 0.05). The PARA-SCI correlated significantly with accelerometer-derived minutes of MVPA per day (r = 0.396; P = 0.014) and per hour of monitoring time (r = 0.356; P = 0.027). Our findings support the use of accelerometers to objectively measure HPA and sedentary behavior in adults with CP across the severity spectrum, regardless of cut-point implementation. The PARA-SCI is a valid tool to capture subjectively reported patterns of MVPA in adults with CP who are GMFCS levels II-V.

Combined influence of epoch length, cut-point and bout duration on accelerometry-derived physical activity

BackgroundIt is difficult to compare accelerometer-derived estimates of moderate-to-vigorous physical activity (MVPA) between studies due to differences in data processing procedures. We aimed to evaluate the effects of accelerometer processing options on total and bout-accumulated time spent in MVPA in adults.Methods267 participants from the ProActive Trial provided 1236 days of valid physical activity (PA) data, collected using a 5-s epoch with ActiGraph GT1M accelerometers. We integrated data over 5-s to 60-s epoch lengths (EL) and applied two-level mixed effects regression models to MVPA time, defined using 1500 to 2500 counts/minute (cpm) cut-points (CP) and bout durations (BD) from 1 to 15 min.ResultsTotal MVPA time was lower on longer EL and higher CP (47 vs 26 min/day and 26 vs 5 min/day on 1500 vs 2500 cpm on 5-s and 60-s epoch, respectively); this could be approximated as MVPA = exp[2.197 + 0.279*log(CP) + 6.120*log(EL) - 0.869*log(CP)*log(EL)] with an 800 min/day wear-time. In contrast, EL was positively associated with time spent in bout-accumulated MVPA; the approximating equation being MVPA = exp[54.679 - 6.268*log(CP) + 6.387*log(EL) - 10.000*log(BD) - 0.162*log(EL)*log(BD) - 0.626*log(CP)*log(EL) + 1.033*log(CP)*log(BD)]. BD and CP were inversely associated with MVPA, with higher values attenuating the influence of EL.ConclusionsEL, CP and BD interact to influence estimates of accelerometer-determined MVPA. In general, higher CP and longer BD result in lower MVPA but the direction of association for EL depends on BD. Reporting scaling coefficients for these key parameters across their frequently used ranges would facilitate comparisons of population-level accelerometry estimates of MVPA.