Multidisciplinary Physical Activity Research Articles

Determinants of instrumented sedentary and physical activity behavior in geriatric rehabilitation inpatients: RESORT

BackgroundPhysical inactivity in hospitalized older adults is highly prevalent and associated with detrimental health outcomes. Understanding its determinants is important for prognosis and tailoring interventions in geriatric rehabilitation inpatients. MethodsWithin the REStORing health of acutely unwell adulTs (RESORT) observational, longitudinal cohort, geriatric rehabilitation inpatients wore an inertial sensor (ActivPAL4) for one week to objectively assess instrumented sedentary behavior (i-SB) and physical activity (i-PA). Determinants were grouped in five geriatric domains: morbidity, cognition/psychology, physical performance, functional performance, and nutritional status. Their association with i-SB (mean sitting, lying, non-upright time) and i-PA (mean number of steps, sit-to-stand transitions and upright time) quintiles were examined using multivariate ordinal logistic regression analyses with Bonferroni correction (p < 0.006). ResultsA total of 145 inpatients were included (mean age 83.0, SD 7.7 years; 55.9% females). More comorbidities were associated with a lower daily number of steps (OR:0.91, 95%CI: 0.86–0.96) and lower upright time (OR:0.93, 95%CI: 0.88–0.98). Depressive symptoms (higher Hospital Anxiety and Depression Scale score) were associated with higher non-upright time (OR: 1.12, 95%CI: 1.03–1.21) and lower upright time (OR: 0.89, 95%CI: 0.83–0.96). Better physical performance (higher Functional Ambulation Classification, gait speed, and Short Physical Performance Battery score) was associated with lower i-SB measures (OR range: 0.07–0.78, p < 0.0005) and higher i-PA measures (OR range: 1.35–19.50, p < 0.0005). Higher functional performance (Katz index of Activities of Daily Living score) was associated with lower i-SB measures (OR range: 0.61–0.69, p ≤ 0.003) and higher i-PA measures (OR range: 1.60–3.64, p < 0.0005). Being malnourished was associated with lower i-PA measures (OR range: 0.29–0.32, p ≤ 0.004). ConclusionsWorse morbidity, depressive symptoms, worse physical and functional performance, and worse nutritional status were associated with higher i-SB and lower i-PA. These determinants should be taken into account while designing and promoting multidisciplinary physical activity interventions.

Establishing the multidisciplinary Imperial Physical Activity and Diabetes clinic

AbstractIncreasing numbers of people with diabetes are adopting exercise programmes. Fear of hypoglycaemia, and hypoglycaemia itself, are major issues for many people with diabetes undertaking physical activity. The risk of hypoglycaemia is exacerbated by endurance exercise. In addition, soft tissue injuries are more common in people with diabetes.We have established a multidisciplinary physical activity and diabetes clinic with the aim of empowering, educating and enabling people with diabetes to enjoy sport and exercise without fear of hypoglycaemia or frustration at glycaemic variability or soft tissue injuries. The multidisciplinary team (MDT) includes a diabetologist, sports and exercise physician, radiologist, dietitian, diabetes specialist nurse, and psychologist.Between October 2015 and September 2017, we undertook 19 clinics and saw 66 patients (48 new and 18 follow‐up). Of the 48 new referrals (median age 35; range 20–72) 47 had type 1 diabetes and 27 (56%) used an insulin pump. Attendees had a median 18 years of diabetes (range 1–50). Diabetes distress was variable (median PAID score 18; range 0–64). Twenty‐five patients attended for glycaemic management, 15 for musculoskeletal issues and eight for both. Sixteen (33%) required physiotherapy and nine (19%) were referred for joint imaging.It is possible to establish a new service to support physical activity in diabetes. To meet demand and enhance the MDT, physiotherapy will be added. A means of assessing the effects of diabetes on physical activity and outcome measures that matter to people with diabetes must be developed. Copyright © 2018 John Wiley &amp; Sons.

Managing diabetes at high altitude: personal experience with support from a Multidisciplinary Physical Activity and Diabetes Clinic

ObjectivePhysical activity is important for well-being but can be challenging for people with diabetes. Data informing support of specialist activities such as climbing and high-altitude trekking are limited. A 42-year-old...

Reproducibility of two, three, four and five 24-hour recalls in peri-urban African adolescents in the North West province

Background: The objective was to determine the reproducibility of two, three, four and five repeated 24-hour recalls among peri-urban African adolescents.Method: A prospective study design was used within the multidisciplinary PhysicaL Activity in the Young (PLAY) study. Eighty-seven Grade 9 learners (59 girls and 28 boys, aged 10–18 years) with a mean age of 14.7 ± 1.5 years, who had completed five 24-hour recalls, were investigated. The learners were from Seiphemelo Secondary School in Ikageng, a peri-urban area in the North West province of South Africa. Reproducibility coefficients (RCs) and 95% confidence intervals (CIs) were calculated, using the intraclass correlation coefficient formula for transformed values of selected nutrients and food groups, for two, three, four and five repeated 24-hour recalls. The RCs and 95% CIs were compared in order to identify the optimum number of 24-hour recalls to give the best reproducibility results.Results: The RCs were nutrient- and food-group sensitive and ranged from 0.25 (riboflavin) to 0.6 (carbohydrate). Although differences were not statistically significant, RCs for four and five 24-hour recalls were higher than those obtained for two and three 24-hour recalls. For most nutrients and food groups, four 24-hour recalls gave the highest RCs, with non-significant differences overall between the four and five 24-hour recalls.Conclusion: The results suggest that four 24-hour recalls would be sufficient to provide acceptable reproducibility of reported food group and nutrient intakes among peri-urban African adolescents.

Dietary intakes assessed by 24-h recalls in peri-urban African adolescents: validity of energy intake compared with estimated energy expenditure

The objective of this study is to determine the relative validity of reported energy intake (EI) derived from multiple 24-h recalls against estimated energy expenditure (EE(est)). Basal metabolic rate (BMR) equations and physical activity factors were incorporated to calculate EE(est). This analysis was nested in the multidisciplinary PhysicaL Activity in the Young study with a prospective study design. Peri-urban black South African adolescents were investigated in a subsample of 131 learners (87 girls and 44 boys) from the parent study sample of 369 (211 girls and 158 boys) who had all measurements taken. Pearson correlation coefficients and Bland-Altman plots were calculated to identify the most accurate published equations to estimate BMR (P<0.05 statistically significant). EE(est) was estimated using BMR equations and estimated physical activity factors derived from Previous Day Physical Activity Recall questionnaires. After calculation of EE(est), the relative validity of reported energy intake (EI(rep)) derived from multiple 24-h recalls was tested for three data subsets using Pearson correlation coefficients. Goldberg's formula identified cut points (CPs) for under and over reporting of EI. Pearson correlation coefficients between calculated BMRs ranged from 0.97 to 0.99. Bland-Altman analyses showed acceptable agreement (two equations for each gender). One equation for each gender was used to calculate EE(est). Pearson correlation coefficients between EI(rep) and EE(est) for three data sets were weak, indicating poor agreement. CPs for physical activity groups showed under reporting in 87% boys and 95% girls. The 24-h recalls measured at five measurements over 2 years offered poor validity between EI(rep) and EE(est).

A Randomized Trial to Increase Physical Activity in Breast Cancer Survivors

Interventions to increase physical activity among breast cancer survivors are needed to improve health and quality of life and possibly to reduce the risk of disease recurrence and early mortality. Therefore, we report the feasibility and preliminary outcomes of a pilot randomized trial designed to increase physical activity in sedentary breast cancer survivors receiving hormone therapy. Forty-one sedentary women on estrogen receptor modulators or aromatase inhibitors for stage I, II, or IIIA breast cancer were randomly assigned to receive a 12-wk multidisciplinary physical activity behavior change intervention or usual care. Recruitment was 34%, intervention adherence was 99%, and complete follow-up data were obtained on 93%. Most participants (93%) were white with mean age of 53 +/- 9 yr. Differences favoring the intervention group were noted for accelerometer physical activity counts (mean difference = 72,103; 95% confidence interval (CI) = 25,383-119,000; effect size (d) = 1.02; P = 0.004), aerobic fitness (mean difference = 2.9; 95% CI = -0.1 to 5.8; d = 0.64; P = 0.058), back/leg muscle strength (mean difference = 12.3; 95% CI = 0.4-15.9; d = 0.81; P = 0.017), waist-to-hip ratio (mean difference = -0.05; 95% CI = -0.01 to -0.08; d = -0.77; P = 0.018), and social well-being (mean difference = 2.0; 95% CI = 0.3-3.8; d = 0.76; P = 0.03). However, the intervention group also reported a greater increase in joint stiffness (mean difference = 1.1; 95% CI = 0.1-2.2; d = 0.70; P = 0.04). A behavior change intervention for breast cancer survivors based on the social cognitive theory is feasible and results in potentially meaningful improvements in physical activity and selected health outcomes. Confirmation in a larger study is warranted.

Influence d'un programme d'activité physique sur la perception de la contrainte de l'exercice chez le jeune enfant obèse vs non obèse

Introduction The aim of this study was to evaluate the effects of multidisciplinary physical activity program on rating of perceived exertion exercise in children according to their body mass index. Method Fifty-six children (28 obese vs 28 non-obese) took part in this study and they participated 2 sessions of one hour of multidisciplinary physical activity program per week during 11 weeks. Body composition and physical fitness (aerobic and anaerobic) were performed, and rating of perceived exertion was estimated. Results The intervention has a significant improvement of anthropometric parameters, anaerobic and aerobic performances, and the scores of rating of perceived exertion. Conclusion These findings suggested that body mass index profile must be taking into account during intervention program of obesity prevention, in order to promote the physical activity in obese children.