Moderate-to-vigorous Physical Activity Research Articles

Assessing the level of device-measured physical activity according to insomnia symptoms in 1,354 individuals with diabetes: the HUNT Study, Norway

BackgroundInsomnia symptoms that influence daytime functioning are common among adults with type 2 diabetes. However, no previous study has examined if levels of physical activity differ among adults with diabetes with and without insomnia symptoms. Thus, the aim of this study was to assess the difference in total physical activity (TPA) and moderate-to-vigorous physical activity (MVPA) levels in individuals with diabetes with and without insomnia symptoms.MethodsThis cross-sectional study included 1,354 participants with any type of diabetes who participated in the Norwegian HUNT4 Study, 2017-19. Participants were defined to have ‘insomnia symptoms’ if they reported difficulty initiating and/or maintaining sleep ≥ 3 nights/week during the last 3 months. MVPA (defined as moderate/brisk walking [> 4.0 km/h], running, and cycling), and TPA (MVPA including slow walking [≤ 4.0 km/h]) were determined from two accelerometers worn on the thigh and lower back. Analyses were stratified by age and sex.ResultsThe median age was 67 years and 491 (36%) had insomnia symptoms and 37 (3%) had insomnia disorder. Among women, 28% with one or more insomnia symptoms fulfilled the recommended minimum level of physical activity, as compared to 34% in women without insomnia symptoms. The corresponding proportions in men were 48% and 45%. Women above 65 years with insomnia symptoms performed less TPA (-73 min/week, 95% CI -122 to -24) and MVPA (-33 min/week, 95% CI -50 to -15), compared to women without insomnia symptoms in the same age group. There was no clear difference in physical activity levels according to insomnia symptoms in men or women below 65 years. Women and men with insomnia disorder had substantially lower TPA (women: -192 min/week, 95% CI -278 to -106; men: -276 min/week, 95% CI -369 to -193) and MVPA (women: -37 min/week, 95% CI -63 to -11; men: -67 min/week, 95% CI -83 to -50) than those without insomnia symptoms.ConclusionsThis study showed that women above 65 years with insomnia symptoms and individuals with insomnia disorder performed less physical activity, suggesting that these subgroups may suffer from additional challenges that prevent them from engaging in regular physical activity.

Association of moderate-to-vigorous physical activity with reduction of acute exacerbation in COPD patients using a dual ultra-long-acting bronchodilators

Inhaler therapy and physical activity (PA) are important methods of chronic obstructive pulmonary disease (COPD) management. This study aimed to investigate the additional benefit of moderate-to-vigorous PA (MVPA) in patients with COPD using a long-acting beta-agonists (LABA)/long-acting muscarinic antagonist (LAMA) combination. We emulated a target trial to estimate the benefit of MVPA in patients with COPD using a dual ultra-long-acting bronchodilators. We enrolled patients aged ≥ 40 who were diagnosed with COPD between 2014 and 2018, initiated a LABA/LAMA combination, and had not undergone regular MVPA. The main exposure was the initiation of MVPA, defined as vigorous aerobic exercise > 20 min per day on ≥ 3 days/week or moderate aerobic exercise > 30 min per day on ≥ 5 days/week. The main outcomes were the future usage of inhaled corticosteroids (ICS) and severe exacerbation. We identified 1,526 patients who initiated MVPA and 4,516 who did not. The median follow-up period was 3.0 years. The hazard ratio (HR) for future ICS usage in the MVPA initiation group was 0.83 (95% confidence intervals (CI): 0.72, 0.97) compared to the control group. The HR for severe exacerbation in the MVPA initiation group was 0.81 (95% CI: 0.68, 0.96) compared to the control group. Subgroup analyses by age, sex, body mass index, residence area, smoking and drinking status showed consistent benefits in these outcomes. Initiation of MVPA may offer an additional benefit for even COPD patients who use a dual ultra-long-acting bronchodilators.

Self-reported physical activity and gait in older adults without dementia: A longitudinal study.

Physical activity (PA) is associated with higher gait speed. We aimed to examine the associations between PA and change in spatial and temporal gait measures as well as fall risk in community-dwelling individuals free of dementia. Longitudinal study among 4173 individuals aged ≥50 years (mean age 71 years; 2078 males; median follow-up 4 years) enrolled in the Mayo Clinic Study of Aging. Self-reported late-life PA was used to calculate overall PA and moderate-vigorous PA (MVPA) scores. Gait was assessed using GAITRite® and Zeno™ systems. Incident falls information was based on diagnostic codes retrieved from medical records. We ran linear mixed effects models to examine associations between z-scored PA variables and longitudinal gait parameters, adjusted for age, sex, education, body mass index (BMI), medical comorbidities, and including interactions between PA and time since baseline. In secondary analyses, we calculated Cox Proportional hazard models with age as time scale predicting incident falls by PA, adjusting for sex, education, BMI, medical comorbidities, and falls history. At baseline, higher PA was associated with higher velocity (overall PA: estimate 2.9935; MVPA: 2.2961; p < 0.001), higher cadence (overall PA: 1.0665; MVPA: 0.9073; p < 0.001), greater stride length (overall PA: 2.0805; MVPA: 1.4726; p < 0.001), shorter double support time (overall PA: -0.0257; MVPA: -0.0205; p < 0.001), and lower stance time variability (overall PA: -0.0204, p < 0.001; MVPA: -0.0152; p = 0.006). Overall PA was longitudinally associated with less decline in cadence, and MVPA with less increase in intraindividual stance time variability. Overall PA (Hazard ratio 0.892, 95% confidence interval 0.828-0.961, p = 0.003) and MVPA (HR 0.901; 95% CI 0.835-0.973, p = 0.008) were associated with a decreased risk of incident falls. Late-life PA was associated with favorable gait outcomes and decreased risk of incident falls. Thus, late-life PA may help to maintain gait performance and decrease fall risk in old age.

Changes in 24-h Movement Behaviors During Relationship and Parenthood Transitions: A Compositional Data Analysis.

There is scarcity of studies using device-based measures to examine how relationship and parenthood transitions modify 24-h movement behaviors. This study examined how the composition of 24-h movement behaviors changes during these life transitions. Young adults (n = 170, mean age 25.6 years, SD 0.6) from the Special Turku Coronary Risk Factor Intervention Project (STRIP) wore wrist-worn accelerometers for 1 week and completed questionnaire at ages 26 and 31 years. Participants were categorized by relationship status into single (16%), those transitioning from single to partnered (31%), partnered (47%), and separated (7%), and by parenthood status into non-parents (73%), new parents (19%), and parents (8%). Changes in daily movement behaviors, including sleep, sedentary behavior (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA), were examined using compositional linear mixed models. In general, LPA and MVPA decreased relative to sleep and SED (p = 0.007). Differences emerged between LPA and MVPA in relationship and parenthood groups (p for group × time interaction 0.008 and 0.001). Those transitioning to partnership decreased MVPA by 17 min/day, while partnered and separated individuals showed no notable MVPA change but decreased LPA by 14 and 43 min/day. Single individuals and non-parents decreased LPA and MVPA in similar proportions. New parents decreased MVPA by 20 min/day, while parents increased it by 19 min/day. Becoming first-time parent and starting relationship was associated with decline of MVPA. Our results suggest the importance of considering these life transitions and providing guidance for maintaining physical activity despite changes in life situations.

Using heart rate data from wrist worn activity trackers to define thresholds for moderate to vigorous physical activity in children and young people with cystic fibrosis

BackgroundChildren and young people with cystic fibrosis (CYPwCF) are encouraged to do an average of 60 min of moderate-to-vigorous physical activity (MVPA) daily. However, there are no agreed heart rate (HR) thresholds for defining MVPA, so it is difficult to ascertain whether these targets are actually achieved. Wearable activity trackers enable continuous monitoring of fitness-related measures such as HR and could be used to measure duration and intensity of habitual MVPA. We aimed to define personalized and responsive MVPA thresholds from HR in CYPwCF, to determine habitual time spent in MVPA during childhood and adolescence. MethodsContinuous daily HR data were collected from 142 CYPwCF wearing activity trackers over 16 months. Linear mixed-effects models were used to develop personalised estimates of resting heart rate (RHR), peak heart rate (PHR) and MVPA thresholds, which were defined using the American College of Sports Medicine heart rate reserve (HRR) method. Results309,926 days of physical activity data showed that both RHR and PHR declined with age in CYPwCF, with considerable variability within and between individuals. The HRR method produced personalised MVPA thresholds for each CYPwCF based on age, which inherently accounted for individual demographic variability and personal factors such as cardiovascular fitness or disease severity. ConclusionsBy accounting for within and between person variability in RHR and PHR, our novel method provides more accurate age-related personalised MVPA thresholds for CYPwCF than existing estimates. Our findings provide population-based estimates for RHR, PHR and MVPA thresholds at different ages in CYPwCF. This approach may help guide development of international standards for objective MVPA measurement in the era of remote HR and activity monitoring and facilitate accurate measurement of habitual physical activity in children and young people.

Association of aerobic and muscle-strengthening physical activity with chronic kidney disease in participants with hypertension

BackgroundIn Korea, chronic kidney disease (CKD) is increasingly prevalent among adults with hypertension, of which approximately 30% of the population is affected. Despite the recognized benefits of adherence to physical activity (PA) recommendations, including aerobic and muscle-strengthening activities (MSA), the impact of such adherence on the prevalence of CKD in individuals with hypertension has not been extensively studied. This study aimed to investigate the association between aerobic PA and MSA levels, and the prevalence of CKD in individuals with hypertension.MethodsThis study included 5,078 individuals with hypertension using data from the Korean National Health and Nutrition Examination Survey (2019–2021). PA levels were measured as min/week of moderate-to-vigorous PA (MVPA) based on self-reports, and MSA was quantified as the number of days per week. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². Logistic regression analysis evaluated the association between meeting PA guidelines and CKD after adjusting for potential confounders. Additionally, a joint analysis was conducted to assess the combined effects of MVPA and MSA on CKD.ResultsAfter adjusting for all covariates, higher MVPA was associated with a lower prevalence of CKD. Compared to the group with inactive, the group with MVPA 1–149 min/week had an odds ratio (OR) of 0.80 (95% confidence interval [CI], 0.61–1.05), the group that met the MVPA 150–299 min/week criteria had an OR of 0.85 (95% CI, 0.62–1.17), and the group that met the MVPA ≥ 300 min/week criteria had an OR of 0.53 (95% CI, 0.37–0.76). MSA alone did not show a significant association with CKD. In the joint analysis, the group that met the MVPA and MSA guidelines had the lowest OR of 0.54 (95% CI, 0.34–0.86), compared to the group that did not meet either.ConclusionsMVPA was associated with the prevalence of CKD in participants with hypertension but not in those with MSA alone. However, compared with the group that did not meet both guidelines, the group that met both guidelines showed the lowest prevalence of CKD.

Association of Objectively Measured Sedentary Behavior With Arterial Stiffness: Findings From the Nijmegen Exercise Study.

Sedentary behavior (SB) may affect arterial stiffness, preceding the development of cardiovascular disease. We investigated the association of objectively measured SB with arterial stiffness. We also investigated factors that affected this association. We recruited adult volunteers and measured SB with thigh-worn accelerometery for 24 hrs/day for eight consecutive days. Central (carotid-femoral pulse wave velocity, cfPWV, gold standard) and local carotid arterial stiffness (stiffness index Beta and pressure-strain elasticity EP) were measured with ultrasound. Linear regression was used and adjusted for demographics, cardiometabolic factors, and moderate-to-vigorous physical activity (MVPA) volume. Effect modification was studied with interaction terms. Participants (N = 664, 64 (standard deviation: 11, range: 23-89) years, 397 (59.8%) male) demonstrated 9.1 (1.6) hrs/day of SB, and arterial stiffness was 8.6 (3.0) m/s for cfPWV, 6.4 (2.9) for Beta, and 87 (43) kPa for EP. SB was not associated with cfPWV (β = 0.04 95% CI (-0.11, 0.18), p = 0.60). The association of SB with local arterial stiffness was modified by systolic blood pressure (SBP) and MVPA volume. Stratified analyses revealed positive associations of SB with Beta (β = 0.29 (0.05, 0.53), p = 0.016) and EP (β = 4.83 (1.39, 8.27), p = 0.006) in participants with SBP > 134 mmHg or > 103 min/day of MVPA (β = 0.23 (0.03, 0.42), p = 0.024 and β = 3.55 (0.82, 6.29), p = 0.011, respectively). We found no association of objectively measured SB with central arterial stiffness. However, SB was positively associated with local carotid stiffness in participants with higher SBP or MVPA levels. In certain subgroups, SB may affect carotid arterial stiffening, reinforcing the relation between SB and cardiovascular disease.

Exploring the effects of multi-dimensional geographic environment on daily sleep and physical activity based on the Actigraph data

Understanding the interplay between people’s daily sleep and physical activity and how geographic environment influences them are important for developing healthy cities. However, such research has been limited. This study aims to explore the bidirectional and nonlinear relationship between daily sleep and physical activity, and further investigate the comprehensive influences of multi-dimensional geographic environment on these health behaviors. Based on the objective data on sleep and physical activity over seven consecutive days using wrist-based accelerometers in Beijing, China, we developed a series of models to analyze the mutual influences between people’s daily sleep and physical activity, and employed the generalized additive model (GAM) to examine their potential nonlinear relationships and how geographic environment – including meteorological conditions, built environment, and social environment – influences them. The results show that sleep and physical activity exhibit notable bidirectional relationship. Moderate-to-vigorous physical activity (MVPA) is observed to improve sleep quality, but it decreases sleep duration. In contrast, total sleep time (TST) exhibits an inverted U-shaped pattern with both MVPA and total step counts, with the optimal sleep duration at 5 hours. Furthermore, meteorological factors, built environment characteristics, and social environment have significant linear or nonlinear effects on people’s daily sleep and physical activity. The outcomes of this study offer valuable insights for enhancing residents’ health and developing healthy cities.

Associations between adherence to 24-Hour Movement Guidelines with continuous metabolic syndrome score among Chinese children and adolescents

ObjectivesThe objective of this study was to evaluate the associations between adherence to 24-Hour Movement Guidelines (24-HMG) with continuous metabolic syndrome score (cMetS) among Chinese children. Study designCross-sectional study. MethodsWe conducted a cross-sectional study among 4604 children aged 6–17 years from Shenzhen, China. The 24-HMG was constructed using the self-report information on moderate-to-vigorous physical activity (MVPA), screen time (ST), and sleep duration. The cMetS was calculated based on waist circumference, homoeostatic model assessment for insulin resistance, mean arterial blood pressure, high-density lipoprotein cholesterol, and triglyceride. Multivariate linear regression models were used to assess the associations between adherence to recommendations of 24-HMG and cMetS. ResultsAmong the participants, 563 (12.23%) students adhered to 3 recommendations of the 24-HMG. We found that adhering to more recommendations was negatively associated with cMetS (P for trend: <0.001). For specific combinations, meeting the ST + MVPA recommendations was negatively associated with cMetS (coefficients [β]: −0.686; 95% confidence interval [CI]: −1.148, −0.223). Individuals who adhered to all recommendations had a lower cMetS (β: −0.693; 95% CI: −1.147, −0.238) than those who met none of the recommendations. ConclusionsOur study showed that adherence to more recommendations of the 24-HMG was associated with lower levels of cMetS in Chinese children and adolescents.

Randomised trial of Mentored ‘Planning to be Active+Family’ [MPBA+F] for Appalachian youth at risk for diabetes: virtual delivery protocol

IntroductionObesity (OB) in children remains a national epidemic. This trial targets children suffering from overweight (OW) and OB living in rural Appalachia. Rural Appalachia is fraught with unhealthy behaviours, high rates of OB, pre-diabetes and type 2 diabetes among children. Diabetes prevalence in Appalachia is nearly double that of other regions. The prevalence of Appalachian children suffering from OB and extreme obesity (EO) increases the severity of diabetes.Methods and analysisWe will conduct a stratified randomised-controlled trial to evaluateMentored Planning to be Active+Family (MPBA+F) among seventh grade children with OW/OB/EO from rural Appalachian counties. Based on the Social Cognitive Theory,MPBA+Fcurriculum is a self-regulation approach to physical activity (PA) developed at The Ohio State University and successfully tested for feasibility in rural Appalachian middle schools.MPBA+F(a) incorporates active skill-building activities; (b) reinforces self-regulating activities; (c) engages in individual and group PA; (d) builds the link between PA, hydration and physical health and (e) actively supports weekly PA goals. Weekly skills are incorporated into reinforcement assignments verified at the beginning the following week. The primary outcome is the average daily minutes of moderate-vigorous PA. We will stratify by sex assigned at birth and conduct intent-to-treat analysis. We use descriptive statistics to summarise cohort and group (MPBA+F or comparison) baseline characteristics and examine variable distributions. Bivariate tests examine the balance of baseline characteristics by intervention groups. Mixed-effects linear modelling will be our more primary regression strategy. A potential problem is loss of curricular integrity. Our process assessment, structured mentor training and Instructor’s Guide reduce this concern. Another concern may be the lack of reliable broadband access. Participating counties exceed 75% broadband access. Those who lose internet access may have materials mailed to their home or accessed on the study website.Ethics and disseminationThis study was reviewed and approved by the American Diabetes Association Grants Review Committee (Grant number 11-22-ICTSN-30), the host institution’s Social and Behavioral Human Subjects Review Committee (Protocol 2022B0149) and is registered on ClinicalTrials.gov (ProtocolNCT05758441). All data that can be shared without compromising human subject protections will be shared to an approved open data repository within six months of publication or 18 months of the conclusion of the funding period (November 2025) if the study remains unpublished. Dissemination to families and stakeholders is by project newsletters. Public presentation of findings will be shared at the Annual Appalachian Translational Research Network and local health department meetings.Trial registration numberNCT05758441.

Influence of sedentary behavior and physical activity in leisure and work on sleep duration: data from NHANES 2017–2018

ObjectiveTo evaluate the association between sedentary behavior (SB), moderate to vigorous physical activity (MVPA), and sleep duration.MethodsData from the 2017–2018 National Health and Nutrition Examination Survey (NHANES) was analyzed. SB was assessed based on the average daily sitting time, while MVPA was estimated by the frequency and duration of leisure and work-related activities. The ratio of time spent in MVPA to time in SB was analyzed, and a thresholds of ≥ 1.0, 2.5 and 10 min of MVPA per sedentary hour was used to determine sufficiency for mitigating the effects of a sedentary lifestyle. Sleep duration was measured by the average hours slept on weekdays and weekends, classified according to National Sleep Foundation guidelines. The measures of SB, MVPA, and sleep were self-reported. Descriptive statistics were used to characterize the sample, and multivariate logistic regression was applied to assess the associations between movement behaviors and sleep duration.ResultsThe study included 5,533 participants, with 51.8% women, predominantly aged 26–64 years (66.1%). Insufficient physical activity was reported by 59.6% at work and 62.5% during leisure time. Recommended sleep duration was observed in 84.4% of the sample. Adjusted multivariate analysis revealed that individuals engaging in ≥ 2.5 min of MVPA during leisure-time for each sedentary hour were 38.9% less likely to experience short-term sleep (OR:0.72;95%CI:0.53–0.97). Conversely, those who performed the same amount of MVPA at work were 57.0% more likely to have short-term sleep (OR:1.57;95%CI:1.16–2.12).ConclusionMeeting the MVPA threshold during leisure-time reduces the likelihood of short-term sleep, while higher MVPA levels at work increase the likelihood of short-term sleep.

The critical need for child and youth perceptions of active living in India: capturing context complexity in rural and urban regions.

The physical inactivity pandemic not only has a negative impact on the physical and mental health of children and youth, but it is also a key contributor to the non-communicable disease (NCD) burden, particularly among low- and middle-income countries. The widespread effects of climate change, ranging from extreme weather events to worsening air quality, are exacerbating the physical inactivity pandemic, highlighting the need to undertake holistic interventions to address environmental barriers while promoting physical activity. Despite the potential benefits of active school transportation (AST) on physical activity and the environment, no study has examined the intersection between perceptions of AST, environmental perceptions, and moderate-to-vigorous physical activity (MVPA) among children and youth in India from a child and youth perspective. As a part of this cross-sectional, observational study, digital survey links were administered to 1,042 children and youth aged 5 to 17 (50.3% boys; 49.7% girls). Participants were recruited from 41 schools across 28 rural and urban regions in India. Children and youth provided information on various sociodemographic factors, perceptions of crime and air pollution, and peer support factors. MVPA data were collected using an adapted version of the IPAQ short-form questionnaire. The overall sample was stratified by age, gender, and location, resulting in a total of seven multiple linear regression models to assess the association between AST and MVPA. Children and youth who engaged in AST were associated with higher MVPA than those who did not engage in AST (β=18.020, 95% CI [5.890 to 30.149], p=0.004), after adjusting for age, gender, and location. In contrast, perceptions of high crime in the neighbourhood (β=-21.921, CI [-36.195 to -7.647], p=0.003) and perceptions of air pollution (β=-12.472, CI [-23.797 to -1.147], p=0.031) were associated with lower MVPA. Moreover, having active friends was associated with higher MVPA (β=32.391, CI [9.264 to 55.518], p=0.006) than not having active friends. AST was significantly associated with higher MVPA in the boys, rural, and aged 13 to 17 models; however, this association was not statistically significant in the girls, urban, and aged 5 to 12 models. These findings highlight that promoting AST can potentially promote MVPA and contribute to mitigating the NCD burden among children and youth in India. Future policies and interventions should prioritize initiatives that promote AST, considering diverse sociodemographic factors, and addressing environmental challenges such as perceptions of crime and air pollution.

Mediators of the association between physical activity and executive functions in primary school children

ABSTRACT There is growing interest in identifying the mechanisms underpinning the effects of physical activity on executive functions (e.g. inhibitory control, cognitive flexibility) in children. Our study examined cardiorespiratory fitness, muscular fitness, and motor competence as potential mediators of this relationship. The study used baseline data from the Learning to Lead (L2L) cluster randomised controlled trial. In total, 675 children (7–11 years, 49.5% girls) completed measures of moderate-to-vigorous physical activity (MVPA), cardiorespiratory fitness, muscular fitness, motor competence, and executive functions. Structural equation modelling was used to examine the potential mediating roles of cardiorespiratory fitness, muscular fitness, and motor competence in the cross-sectional association between MVPA and executive functions. Cardiorespiratory fitness (β = 0.06, SE = 0.021, p = 0.004) partially mediated the association between MVPA and cognitive flexibility. Muscular fitness was a significant mediator of the association between MVPA and both inhibitory control (β = 0.03, SE = 0.014, p = 0.027) and cognitive flexibility (β = 0.06, SE = 0.021, p = 0.005). No significant mediated effects were found for motor competence. Our findings suggest cardiorespiratory and muscular fitness (but not motor competence) mediate the association between physical activity and executive functions in children.

Association between sedentary behavior and bone mass, microstructure and strength in children, adolescents and young adults: a systematic review

Sedentary behavior (SED) research is currently receiving increasing attention in the field of public health. While it has been shown to have negative effects on cardiovascular or metabolic health, there is limited knowledge regarding the relationship between SED and bone health in children, adolescents, and young adults. Thus, the purpose of this review is to investigate the associations between SED and bone health status, specifically bone mass, microstructure, and strength. A comprehensive literature search was conducted across five electronic databases, including EMBASE, PubMed, Medline, Cochrane, Web of Science and CNKI. The inclusion criteria were as follows: healthy participants aged 24 years or younger, with measured SED and measured bone outcomes. The quality of the included articles was assessed using the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. After excluding, the final sample included 25 cross-sectional, 9 observational and 2 both cross-sectional and longitudinal studies. Among these, seven were rated as ‘high quality’, twenty-three were rated as ‘moderated quality’, and six were rated as ‘low quality’ according to the quality assessment criteria. After summarizing the evidence, we found no strong evidence to support an association between BMC or BMD and SED, even when considering gender or adjusting for moderate-to-vigorous physical activity (MVPA). However, a strong level of evidence was found indicating a negative relationship between objectively measured SED and cortical bone mineral density (Ct.BMD) in the tibia or stiffness index (SI) in the Calcaneus across all age groups. While the association between adverse bone health outcomes and SED still cannot be confirmed due to insufficient evidence, these findings suggest that bone microstructure and strength may be more sensitive to SED than bone mass. Thus, further evidence is needed to fully understand the connection between sedentary behavior and bone health, particularly regarding the relationship between SED and bone strength.

Influence of physical activity home environment on fundamental movement skills development in Chinese preschoolers: mediating role of moderate-to-vigorous physical activity.

Research on how the physical activity home environment affects fundamental movement skills (FMS) in preschool children in China is limited. However, the role of moderate-to-vigorous physical activity (MVPA) in this relationship is still unclear. This study aims to analyze gender differences in FMS, explore associations between the physical activity home environment, MVPA, and FMS, and investigate MVPA's mediating role in these relationships. We recruited 169 preschool children (95 boys, 74 girls; mean age 4.9 years) from four kindergartens in Hengyang, China. The Family Environment Scale on Motor Development for Preschool Urban Children (FESMPD) assessed physical activity home environment. Objective measurement of MVPA used ActiGraph wGT3-BT accelerometers. The Test of Gross Motor Development-3 (TGMD-3) evaluated FMS. Statistical analyses were conducted using the PROCESS macro in SPSS, with sociodemographic variables as controls. Boys exhibited significantly higher levels of MVPA, parenting style, locomotor skills, and object control skills compared to girls (P < 0.05). MVPA, parenting style, and FMS showed positive correlations (R = 0.355-0.568, P < 0.05). Similarly, MVPA was positively correlated with the physical activity home environment (β = 0.237-0.568, P < 0.05). Parenting style emerged as a significant predictor of children's MVPA levels (β = 0.956, P < 0.001), and MVPA was a predictor of the development ofFMS and its subdomains (β = 0.097-0.207, P < 0.05). Furthermore, MVPA partially mediated the relationship between parenting style and the development of FMS in preschool children. The physical environment was also a significant predictor of children's MVPA (β = 0.637, P < 0.05), and in turn, MVPA predicted the development of FMS and its subdomains (β = 0.188-0.343, P < 0.01). Notably, MVPA fully mediated the relationship between the physical environment and the development of FMS. Overall, this study highlights the important roles of physical activity home environments and individual levels of MVPA in developing FMS in preschool children, noting significant gender differences. Parenting style greatly affects both MVPA and FMS development, while the physical environment fully mediates this relationship. Collaborative efforts among kindergartens, families, and communities are essential to support MVPA and improve FMS development.

Personalized cardiac rehabilitation in older geriatric patients: an analysis of age, heart failure subtypes, and physical metrics

Abstract Background While cardiac rehabilitation (CR) is recognized for enhancing physical fitness, psychological well-being, and overall quality of life in cardiac patients, its universal application often overlooks the heterogeneity within the geriatric population. This study delves into the effectiveness of CR among older geriatric patients, aiming to uncover the disparities in response across various demographics, heart failure subtypes, and angina classifications, thereby underscoring the imperative for personalized CR programs. Methods We retrospectively analyzed 438 CR participants from December 2020 to December 2023, stratifying them by age (median: 65.14 years, IQR: 57.23-72.64), sex (23.74% female), heart failure subtype, and CCS angina class to identify distinct response patterns to CR. The analysis included a comprehensive assessment of physical metrics pre- and post-12-week CR program following cardiac surgeries, transcatheter procedures, coronary events, and/or interventions. We employed the Wilcoxon Rank Sum test for statistical analysis, focusing on identifying non-responders and quantifying effect sizes (r) to determine the magnitude of change across various physical metrics. Results Notable improvements were observed in metabolic equivalents (METs) (+1.82), oxygen uptake (VO2 peak) (+6.36 mL/kg/min), Duke Activity Status Index (DASI) score (+14.79), moderate to vigorous physical activity (MVPA) (+131.28 minutes/week), sitting time (-1.21 hours/day), total activity (+145.65 minutes/week) and sit-to-stand repetitions (+2.65). The greatest effect sizes were observed in DASI score (r=0.750) and sit-to-stand (r=SIS) repetitions (r=0.610), consistent across demographics, heart failure, and CCS categories. Other metrics noted variable changes, with handgrip strength showing no consistent trend. Sensitivity analyses revealed that older geriatric patients (≥ 80 years) with HFpEF experienced significant improvements in DASI score (r=0.638), MVPA (r=0.636), and SIS (r=0.504), while those with HFrEF and HFmrEF showed no significant improvements in any physical metrics. CCS angina classification, common comorbidities, and initial referral events did not significantly influence outcomes. Conclusion This study reaffirms the efficacy of CR but crucially identifies the gaps in its universal application, particularly among older geriatric patients with diverse heart failure subtypes. Our analysis advocates for developing personalized CR programs tailored to patients' individual profiles to enhance effectiveness of rehabilitation. By addressing these specific needs, we can ensure more inclusive and optimized patient care, ultimately supporting the expansion of CR indications to foster a more holistic approach to cardiac health in the geriatric population.

Factors associated with physical activity in individuals with metastatic cancer: a UK cross-sectional survey.

Physical activity is safe and feasible for individuals with metastatic cancer and may support symptom management. We investigated the extent to which individuals with metastatic cancer are meeting the World Health Organisation (WHO) moderate-vigorous physical activity (MVPA) guideline, factors associated with meeting the guideline, and perceptions about physical activity and receiving physical activity advice. Data were from UK adults with metastatic breast, prostate, or colorectal cancer who completed the Healthy Lifestyle After Cancer survey (N = 588). Self-reported clinical, demographic, and physical activity (Godin Leisure-Time Exercise Questionnaire) data were collected. Logistic regression models assessed whether clinical and demographic factors were associated with meeting the MVPA guideline. Most (59%) individuals with metastatic cancer were not meeting the WHO guideline of 150min of MVPA per week. Adjusting for cancer type, the odds of meeting the MVPA guideline were lower for unemployed individuals (OR = 0.47, 95% CI = 0.23-0.77) and ethnic minorities (OR = 0.44, 95% CI = 0.22-0.89), but higher for those with a university education (OR = 1.89, 95% CI = 1.0-3.57). Most (63.5%) participants felt they should be doing more physical activity. However, 70.1% did not receive any physical activity advice or support, despite 73.6% wanting to receive it. People with metastatic cancer may need further support to address inadequate levels of physical activity. The differences observed between demographic sub-groups suggest this may be more beneficial for those less likely to engage in physical activity. Individuals with metastatic cancer are likely to benefit from increased physical activity support, which considers the needs of diverse demographic groups.

Light Physical Activity Throughout the Day and Physical Function in Older Adults

Abstract Background Light physical activity (LPA) plays a crucial role in preventing muscle loss and disability in older adults. Since LPA makes up a significant portion of daily activity, understanding how the timing of LPA influences physical function is important for designing effective health interventions. Methods This cross-sectional study investigated the association between the timing of LPA and physical function among 200 older adults (mean age 76.3, 55.5% female) attending the geriatric outpatient clinic at National Taiwan University Hospital. LPA was objectively measured using wrist-worn accelerometers for seven consecutive days. Principal component analysis (PCA) was used to identify distinct patterns of LPA timing. Participants underwent assessments of grip strength, basic mobility, walking speed, and lower limb muscle strength. Multivariable linear regression models were adjusted for potential confounders, including gender, age, moderate-to-vigorous physical activity (MVPA), and accelerometer wear time. Results Our findings revealed that higher levels of LPA during the morning to noon period were positively associated with better performance across all four physical function tests. Moreover, after controlling for relevant confounders, increased LPA in the late afternoon and evening was positively associated with enhanced basic mobility, walking speed, and lower limb muscle strength. Conclusions This study highlights the importance of considering LPA timing when promoting physical function in older adults, independent of MVPA participation. Encouraging LPA, particularly during the morning to noon period, could be a valuable strategy for maintaining and improving physical capabilities in this population. These findings provide actionable insights for clinicians and health professionals when tailoring physical activity recommendations for older adults within geriatric care settings. Key messages • Morning LPA boosts physical function in seniors, enhancing grip, mobility, walking speed, and muscle strength. • Timing of light activity crucial for older adults’ physical health, with morning to noon activity showing most benefits.

Reallocating time between movement behaviors has implications for post-secondary students’ mental health and wellbeing

Objective: Examine the theoretical impact of reallocating time between self-reported moderate-to-vigorous physical activity (MVPA), recreational screen time, and sleep on psychological distress and mental wellbeing among post-secondary students. Participants: 24,742 post-secondary students (M age=24.3 ± 7.72 SD years; 66.4% women) from Cycle 1 of the Canadian Campus Wellbeing Survey. Methods: Cross-sectional isotemporal substitution modeling. Results: Replacing 20 min of screen time with either sleep or MVPA was associated with lower psychological distress, greater mental wellbeing, lower odds of reporting mild-to-severe psychological distress and low mental wellbeing, except for reallocating screen time to sleep among students who exceed the sleep guideline recommendations. Reallocating time between sleep and MVPA revealed noteworthy patterns: replacing sleep with MVPA was associated with greater mental wellbeing but not lower psychological distress. Conclusions: Findings highlight the potential mental health benefits of replacing screen time with sleep or MVPA as an integrative whole day approach to promote campus wellness.

A pilot randomized controlled trial of a virtual peer-support exercise intervention for female older adults with cancer

BackgroundRegular exercise can mitigate side effects of cancer treatment. However, only a small proportion of adults with cancer meet exercise guidelines, and older adults (> 65 years) are underrepresented in cancer rehabilitation research. Peer support facilitates health-promoting behaviours in general populations, but interventions merging exercise and peer support for older adults with cancer are not examined. The purpose of this study was to determine the feasibility and preliminary effectiveness of a virtual partner-based peer support exercise intervention for older adult female cancer survivors.MethodsOlder adult female cancer survivors with internet access and currently participating in < 150 min of moderate-vigorous physical activity per week were included in this study. Participants were matched with a partner and given a peer support guide, exercise guidelines, and a Fitbit Inspire©. In addition, intervention group dyads (AgeMatchPLUS) had weekly 1-h virtual sessions with a qualified exercise professional for 10 weeks. Dyads randomized to the control group (AgeMatch) independently supported their partner around exercise for 10 weeks. The primary outcome was feasibility, measured using retention and adherence rates. Secondary outcomes included exercise volume, social support, quality of life, physical function, and physical activity enjoyment. Descriptive statistics were used to report feasibility and an ANCOVA was used to explore between group differences on secondary outcomes at post-intervention (10 weeks post baseline) and post-tapering timepoints (14 weeks post baseline).ResultsEighteen participants (9 dyads; mean age 72 years (SD: 5.7 years)) were included in the pilot trial. Retention and adherence rates to the AgeMatchPLUS intervention were 100% and 95% respectively. All but one participant was satisfied with the quality of their peer match. Preliminary effects were seen between group, favouring AgeMatchPLUS for exercise-related social support post-intervention (effect size (d) = 0.27, 95% CI = 0,0.54) and physical activity enjoyment at post-tapering (d = 0.25, 95% CI = 0,0.52) and favouring the AgeMatch group for 30 s sit-to-stand repetitions at post-tapering (d = 0.31, 95% CI = 0.004, 0.57). No other effects were found.ConclusionsA virtual partner-based exercise intervention for older adults with cancer is feasible and shows preliminary effect benefits. Findings inform future trials aimed at increasing exercise in older adults with cancer.Trial registrationClinicaltrials.gov (ID: NCT05549479, date: 22/09/22).