Objective Assessment Of Physical Activity Research Articles

Objective Assessment of Physical Activity at Home Using a Novel Floor-Vibration Monitoring System: Validation and Comparison With Wearable Activity Trackers and Indirect Calorimetry Measurements.

The self-monitoring of physical activity is an effective strategy for promoting active lifestyles. However, accurately assessing physical activity remains challenging in certain situations. This study evaluates a novel floor-vibration monitoring system to quantify housework-related physical activity. This study aims to assess the validity of step-count and physical behavior intensity predictions of a novel floor-vibration monitoring system in comparison with the actual number of steps and indirect calorimetry measurements. The accuracy of the predictions is also compared with that of research-grade devices (ActiGraph GT9X). The Ocha-House, located in Tokyo, serves as an independent experimental facility equipped with high-sensitivity accelerometers installed on the floor to monitor vibrations. Dedicated data processing software was developed to analyze floor-vibration signals and calculate 3 quantitative indices: floor-vibration quantity, step count, and moving distance. In total, 10 participants performed 4 different housework-related activities, wearing ActiGraph GT9X monitors on both the waist and wrist for 6 minutes each. Concurrently, floor-vibration data were collected, and the energy expenditure was measured using the Douglas bag method to determine the actual intensity of activities. Significant correlations (P<.001) were found between the quantity of floor vibrations, the estimated step count, the estimated moving distance, and the actual activity intensities. The step-count parameter extracted from the floor-vibration signal emerged as the most robust predictor (r2=0.82; P<.001). Multiple regression models incorporating several floor-vibration-extracted parameters showed a strong association with actual activity intensities (r2=0.88; P<.001). Both the step-count and intensity predictions made by the floor-vibration monitoring system exhibited greater accuracy than those of the ActiGraph monitor. Floor-vibration monitoring systems seem able to produce valid quantitative assessments of physical activity for selected housework-related activities. In the future, connected smart home systems that integrate this type of technology could be used to perform continuous and accurate evaluations of physical behaviors throughout the day.

Exploring the Interrelationships Between Physical Function, Functional Exercise Capacity, and Exercise Self-Efficacy in Persons Living with HIV.

To determine if there were differences between the subjective and objective assessments of physical activity while controlling for sociodemographic, anthropometric, and clinical characteristics. A total of 810 participants across eight sites located in three countries. Subjective instruments were the two subscales of Self-efficacy for Exercise Behaviors Scale: Making Time for Exercise and Resisting Relapse and Patient-Reported Outcomes Measurement Information System, which measured physical function. The objective measure of functional exercise capacity was the 6-minute Walk Test. Both univariate and multivariant analyses were used. Physical function was significantly associated with Making Time for Exercise (β = 1.76, p = .039) but not with Resisting Relapse (β = 1.16, p = .168). Age (β = -1.88, p = .001), being employed (β = 16.19, p < .001) and race (βs = 13.84-31.98, p < .001), hip-waist ratio (β = -2.18, p < .001), and comorbidities (β = 7.31, p < .001) were significant predictors of physical functioning. The model predicting physical function accounted for a large amount of variance (adjusted R2 = .938). The patterns of results predicting functional exercise capacity were similar. Making Time for Exercise self-efficacy scores significantly predicted functional exercise capacity (β = 0.14, p = .029), and Resisting Relapse scores again did not (β = -0.10, p = .120). Among the covariates, age (β = -0.16, p < .001), gender (β = -0.43, p < .001), education (β = 0.08, p = .026), and hip-waist ratio (β = 0.09, p = .034) were significant. This model did not account for much of the overall variance in the data (adjusted R2 = .081). We found a modest significant relationship between physical function and functional exercise capacity (r = 0.27). Making Time for Exercise Self-efficacy was more significant than Resisting Relapse for both physical function and functional exercise capacity. Interventions to promote achievement of physical activity need to use multiple measurement strategies.

Describing Physical Activity Patterns of Truck Drivers Using Actigraphy

BackgroundTruck driving is a highly sedentary occupation that places workers at risk for chronic health conditions, such as obesity and high blood pressure. The primary purpose of this study was to objectively describe truck drivers' typical physical activity (PA) patterns. MethodsWe used ∼7–10-day baseline PA actigraphy data samples from drivers in the Safety & Health Involvement For Truckers (SHIFT) study (n = 394). Driver PA patterns (e.g., average number of ≥10 minute Freedson bouts per week, time in bouts, and common days/times for PA) were summarized with descriptive analyses. We also compared objective accelerometer data to self-reports. ResultsDrivers' weekly PA averaged 14.4 minutes (SD = 37.0), and most PA occurred between 5–6 pm on Tuesdays and Wednesdays. Drivers overestimated self-reported weekly exercise by over 60 min/week compared to accelerometer data. ConclusionOur results suggest that objective PA assessment may be warranted over self-report when possible, and timing may be key in future PA intervention work with truck drivers.

Validation Study of Physical Activity and Sedentary Behavior in African-American Men and Women.

Self-reported data of physical activity are practical and inexpensive ways to collect data, although, subject to significant measurement errors. Most physical activity questionnaires used in the USA have been predominately validated among non-Hispanic White American populations with limited attention paid to the validity of the measures among racial/ethnic minorities. Additionally, there are limited studies that have evaluated factors related to over- and under-reporting errors linked to self-reported physical activity data, particularly among African Americans. The primary objectives of this study were to validate self-reported levels of physical activity and sedentary behavior among African-American men and women against objective measurements and to identify the factors related to under- and over-reporting. This study was a 7-day, cross-sectional study conducted on African-American men and women (n = 56) who were between 21-70years of age. Participants were required to attend two study visits for the collection of self-reported and objective measurements of physical activity and sedentary behavior (VO2max, DEXA scan, anthropometrics, ActivPal accelerometer, resting metabolic rate (RMR) and International Physical Activity Questionnaire (IPAQ) questionnaire. Overall, energy expenditure measured by ActivPal was 24.1 MET/hr/week whereas self-reported (IPAQ) energy expenditure was 52.66 MET/hr/week. Self-reported sedentary time was 40.37h/week, whereas sedentary time measured by ActivPal was 63.03h/week. Obese participants tended to over-report their physical activity levels more so than non-obese participants (Obese, Activpal-23.89 MET/hr/week vs IPAQ-58.98 MET/hr/week; Non-obese, Activpal - 24.48 MET/hr/week vs IPAQ - 42.55 MET/hr/week). Both obese and non-obese participants underestimated their sedentary time (Obese, Activpal - 66.89h/week vs IPAQ-43.92h/week; Non-obese, Activpal -56.07h/week vs IPAQ - 33.98h/week). The results of this study found that the ActivPal validated physical activity and sedentary behavior among African-Americans. Self-reported data were found to be highly variable, whereas the objective assessments of physical activity and sedentary behavior had limited variability. It was also found that obese individuals over-estimated their self-reported physical activity levels and under-estimated sedentary behavior in comparison to the ActivPal. These findings strongly support the need to measure physical activity and sedentary behaviors objectively, particularly among African-Americans.

Monitoring physical activity using wearable technology in people with Achilles tendinopathy undergoing physiotherapy treatment: A feasibility prospective cohort study

ObjectivesPhysical activity modification is an important part of the management of Achilles tendinopathy. However, to our knowledge, there is a lack of evidence on objective physical activity assessment in Achilles tendinopathy. The purpose of this study is to (1) assess feasibility of using an inertial measurement unit (IMU) to monitor physical activity and IMU-derived biomechanical measures over 12-week treatment course by a physiotherapist; (2) conduct a preliminary analysis of changes in physical activity over 12-weeks. DesignA feasibility prospective cohort study SettingA community setting. ParticipantsPeople with Achilles tendinopathy who had recently commenced (≤2 sessions), or were about to commence, treatment with a physiotherapist Main outcome measuresParticipants wore a shank-mounted IMU on the affected side for one week at baseline, 6-, and 12-week follow-ups. The outcomes were pain/symptom severity, IMU-derived physical activity and biomechanical measures (stride rate, peak shank angular velocity, and peak shank acceleration). ResultsThirty participants were recruited. There was a high retention rate (97%), response rate (97%), and IMU wear compliance at each timepoint (>93%). For pain/symptom severity, a significant time effect was observed between baseline and 12-week follow-up. Physical activity and IMU-derived biomechanical measures did not change over 12 weeks. Physical activity decreased at the 6-week follow-up but only returned to the baseline level at 12-week follow-up. ConclusionsA larger-scale cohort study assessing clinical outcomes and physical activity appears feasible. Preliminary data indicate that physical activity may not change significantly over 12-weeks in people undergoing physiotherapy management for Achilles tendinopathy. Contribution of the paper•A larger-scale cohort study assessing physical activity using wearable technology over 12 weeks of treatment by a physiotherapist appears feasible.•Preliminary findings indicate physical activity may not change significantly over 12-weeks of treatment by a physiotherapist for people with Achilles tendinopathy.•Changes in pain and symptom severity after 12 weeks of treatment by a physiotherapist are not correlated with changes in physical activity level.

The Association between Vegan Dietary Patterns and Physical Activity-A Cross-Sectional Online Survey.

A balanced diet and sufficient physical activity (PA) are known to have positive health effects. The relationship between a vegan diet and PA levels is understudied. This cross-sectional online survey aimed to analyze whether different vegan dietary patterns differ in PA. In total, 516 vegan participants were included (June to August 2022). Different dietary patterns were compiled through principal component analysis, while group differences were calculated using independent tests, or chi-squared tests as well as logistic regression analyses. The population had an average age of 28.0 (SD: 7.7) years and had been living vegan for 2.6 (95% CI: 2.5-3.0) years. Two dietary patterns, the "convenience" and the "health-conscious" group, were identified. People with a convenience dietary pattern had significantly higher odds of sitting more (OR 1.10, 95% CI 1.04-1.18) and not achieving aerobic PA (OR 1.81, 95% CI 1.18-2.79) or strength training recommendations (OR 1.81, 95% CI 1.26-2.61) than people with a health-conscious dietary pattern. This study suggests the heterogeneity of vegan diets and that dietary patterns must be differentiated, as they also differ in the level of PA. Additional studies involving complete dietary assessment with a focus on ultraprocessed foods, blood metabolite analysis, and objective PA assessment are required.

Outcome of bracing vs. surgical treatment in adolescents with idiopathic scoliosis based on device measured daily physical activity: a prospective pilot study.

Adolescent idiopathic scoliosis (AIS) can be treated with bracing or surgery, which may affect patient's physical activity (PA). However, there are limited objective assessments of PA in patients with AIS. This study aims to compare the outcome of spinal bracing vs. surgery in patients with AIS based on a device that measured daily PA. In total 24 patients with AIS participated, including 12 patients treated with bracing and 12 with spinal surgery. Daily PA was measured throughout 4 consecutive days using four tri-axial accelerometers and patient-reported functional status was reported using the SRS-22 questionnaire. The participants were assessed both before the treatment and after treatment at a 12-month follow-up. Patients with AIS had no significant change in their PA levels at the 12-month follow-up after surgical correction. On the contrary, patients with AIS following a year-long bracing treatment had significantly reduced time spent active ( P = 0.04) with an average reduction in walking steps by 2137 steps/day ( P = 0.005). There was no significant difference in function, pain, self-image and mental health domains following both treatments, as reported by the SRS-22. There was a significant improvement in satisfaction for both treatment groups ( P ≤ 0.02). Significantly reduced PA and increased sedentary time are reported in patients with AIS following bracing treatment. An objective PA assessment is recommended to track the effect of scoliosis treatment on PA. Patients with AIS should be actively encouraged to achieve and maintain their recommended daily PA levels irrespective of the type of treatment. Level of evidence: Level II.

Exploring The Relationships Between Gender Norms, Self-efficacy And Physical Activity In Young Women

The majority of adults do not accumulate sufficient amounts of physical activity (PA) to reduce chronic disease risk and women are consistently less active than men. Gender norms and self-efficacy (SE) for PA are known factors that impact women’s PA, but the antecedents of these factors are not fully understood. Benevolent sexism, a covert form of sexism, has been shown to decrease women’s SE and perpetuate restrictive gender roles, but has not been investigated in the PA domain. PURPOSE: To assess the relationships between benevolent sexism and SE, screen time, and PA in young women. METHODS: An online survey was administered to N=156 women that included the 22-item Ambivalent Sexism Inventory, International Physical Activity Questionnaire-Short Form, sedentary (sitting or laying down) screen time questions, and the Self-efficacy for PA questionnaire. Spearman correlations were calculated to assess the strength of association between benevolent sexism and SE, screen time, and PA outcomes [Moderate (MPA), Moderate-to-vigorous (MVPA), and Vigorous (VPA)]. RESULTS: Participants (N=156, 24±3.7 years old, 72.6% white, 10.8% Latino, 5.7% black, 7.7% Asian, 3.24% Other) were active (mins of MVPA/wk, Median (IQR)=561 (807.5)), accumulated (mean+SD) 11.6±5.3 hours of screen time/day, and reported an average benevolent sexism score of 1.6±0.8 (range 1 to 5). Associations among SE and MPA, VPA, and MVPA were r=0.06, 0.45, and 0.24, respectively; and r=-0.34 with screen time. No significant associations were observed between benevolent sexism and PA outcomes, screen time, or SE (r=-0.12 to 0.11). CONCLUSIONS: In this sample of young women, benevolent sexism was not associated with PA, screen time, or SE, a common psychosocial mediator. However, participants reported being extremely active, which may reflect significant over-reporting, and they reported very low benevolent sexism scores, which may reflect social desirability bias; neither may be generalizable beyond this sample. Future research should assess these relationships in more diverse populations and use an objective assessment of PA to better understand the role of benevolent sexism, if any, on women’s PA.

Collection of free-living accelerometry data in large clinical studies before and during the COVID-19 pandemic

At the beginning of the COVID-19 pandemic, consuming media was critical to identify precautionary behaviors to reduce the spread of the virus, particularly for older adults. Media consumption leads to heightened awareness, but may also negatively affect mental health. We examined whether non-social and social media consumption impacted anxiety and depression relative to pre-COVID-19 symptoms. We conducted an anonymous, cross-sectional survey in May and June 2020. Participants (n=1,168, 73.2 years, 56.8% women, 94.9% White), were asked to estimate their amount of time spent consuming pandemic-related media each day, and to report on anxiety and depressive symptoms both before and after the pandemic onset. We characterized change in anxiety and depression by subtracting scores on current anxiety and depressive symptoms from their recalled symptoms prior to the pandemic. Respondents with high pandemic-related media consumption (>3hrs) were more likely to have increased anxiety, compared to those with low (<1hr) media consumption (OR:1.57, 95%CI:1.09-2.23). Similarly, respondents with increased social media consumption during the pandemic were 64% more likely to have depression, compared to those who did not use social media. This association was bi-directional— those who reduced their social media use were 45% less likely to have depression and 26% less likely to have anxiety, compared to those who never used social media. Older adults consuming more pandemic-related media had increased anxiety. Increased social media consumption was associated with elevated depression symptoms. The potential benefits of media consumption about the COVID-19 pandemic may have unintended negative consequences on mental health.

Objective Measurements of Physical Activity and Sedentary Behavior Using Wearable Devices in Patients With Axial Spondyloarthritis: Protocol for a Systematic Review.

BackgroundAxial spondyloarthritis (axSpA) is a subgroup of inflammatory rheumatic diseases. Practicing regular exercise is critical to manage pain and stiffness, reduce disease activity, and improve physical functioning, spinal mobility, and cardiorespiratory function. Accordingly, monitoring physical activity and sedentary behavior in patients with axSpA is relevant for clinical outcomes and disease management.ObjectiveThis review aims to determine which wearable devices, assessment methods, and associated metrics are commonly used to quantify physical activity or sedentary behavior in patients with axSpA.MethodsThe PubMed, Physiotherapy Evidence Database (PEDro), and Cochrane electronic databases will be searched, with no limit on publication date, to identify all the studies matching the inclusion criteria. Only original English-language articles published in a peer-reviewed journal will be included. The search strategy will include a combination of keywords related to the study population, wearable devices, physical activity, and sedentary behavior. We will use the Boolean operators “AND” and “OR” to combine keywords as well as Medical Subject Headings terms.ResultsSearch strategy was completed in June 2020 with 23 records obtained. Data extraction and synthesis are currently ongoing. Dissemination of study results in peer-reviewed journals is expected at the end of 2021.ConclusionsThis review will provide a comprehensive and detailed synthesis of published studies that examine the use of wearable devices for objective assessment of physical activity and sedentary behavior in patients with axSpA.Trial RegistrationPROSPERO CRD42020182398; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=182398International Registered Report Identifier (IRRID)PRR1-10.2196/23359

BrainWear: Longitudinal, objective assessment of physical activity in 42 High Grade Glioma (HGG) patients

Abstract Aims In patients with HGG, we know that QoL and physical function decline with progressive disease (PD) and fatigue is a strong predictor of survival in recurrent disease. Despite notable technical advances in therapy for in the past decade, survival has not improved. The role of physical function as a predictor of QoL, treatment tolerance and as an early indicator of worsening morbidity (e.g. tumour recurrence) is an area of growing importance. Recent advancements in wearable technology allow us the opportunity to gather high-quality, continuous and objective data BrainWear is a feasibility study collecting longitudinal physical activity (PA) data from patients with primary and secondary brain tumours and we hypothesise changes in PA over time, are a potentially sensitive biomarker for PD both at diagnosis and relapse. Method Here we show early analysis of this novel dataset of 42 HGG patients and will present: 1) feasibility and acceptability 2) how digitally captured PA changes through treatment and at PD/hospitalization 3) the correlation between patient reported outcomes (PRO) and PA data 4) how PA in HGG patients compares with healthy UK Biobank participants. PA data is collected via a wrist-worn accelerometer. Raw accelerometer data is processed using the UK Biobank Accelerometer Analysis pipeline in python 3.7, and evaluated for good quality wear-time. Overall activity is represented as vector magnitude in milligravity units(mg) and a machine-learning classifier classifies daily activity into 5 separate groups (walking, tasks-light, moderate, sedentary and sleep). Descriptive statistics summarise baseline characteristics and unadjusted mean used to present vector magnitude and accelerometer-predicted functional behaviours (in h/day) by age, sex, radiotherapy and weekend days. Mixed effect models for repeated measures are used for longitudinal data evaluation of PA. Results Between October 2018 and March 2021, 42 patients with a suspected HGG were recruited; 16 females and 26 males with a median age of 59. 40 patients had surgery and 35 patients had adjuvant primary radiotherapy, 23 of whom had a 6-week course. They have provided 3458 days of accelerometer data, 80% of which has been classified as good quality wear-time. There are no statistical differences in mean activity between gender, patients &amp;gt;60 years show statistical difference in time spent doing moderate activity compared to those &amp;lt;60 years, and there are significant differences in mean vector magnitude and walking between radiotherapy and non-radiotherapy days. In patients having a 6-week RT course, time spent in daily moderate activity falls 4-fold between week 1 and the second week following RT completion (70 minutes to 16 minutes). HGG versus healthy UK Biobank participants shows significant differences in all measures of PA. Conclusion Here we present preliminary analysis of this highly novel dataset in adult high grade glioma patients, and show digital remote health monitoring is feasible and acceptable with 80% of data classified as high quality wear-time suggesting good patient adherence. We are able to objectively describe how PA changes through standard treatments and understand the inter and intra-patient variation in PA, and whether there are correlates with patient-centred measures, clinical measures and early indicators of worsening disease. We will present further data on changes in PA prior to hospitalisation and at disease progression, and discuss some of the challenges of running a digital health trial. The passive and objective nature of wearable activity monitors gives clinicians the opportunity to evaluate and monitor the patient in motion, rather than the episodic snapshot we currently see, and in turn has the potential to improve our clinical decision making and potentially outcomes.

OS10.5.A BrainWear: Longitudinal, objective assessment of physical activity in 42 HGG patients

Abstract BACKGROUND In patients with High Grade Glioma (HGG), QoL and physical function decline with progressive disease (PD). Objective assessment of physical functioning is challenging as patients spend most of their time away from the hospital. Wearable technology allows measurement of objective, continuous activity data in a non-obtrusive manner. BrainWear is a phase II feasibility study, collecting longitudinal physical activity (PA) data from patients with primary and secondary brain tumours. MATERIAL AND METHODS All agreed to wear an Axivity AX3 triaxial accelerometer and completed the EORTC QLQ C30 and BN20, the Montreal Cognitive Assessment (MoCA) and Multidimensional fatigue inventory (MFI) questionnaires. Accelerometers were changed at 14-day intervals, and PRO questionnaires completed at pre-specified study intervals. Age-sex matched controls were identified from the UK Biobank 7-day accelerometer study. Raw accelerometer data was processed using UK Biobank accelerometer software and inclusion of high-quality wear time selected as ≥72 hours of data in a 7-day data collection and data in each 1-hour period of a 24-hour cycle over multiple days. We analysed variation in activity by patient demographics and treatment days. The wilcoxin-signed rank test was used to compare participant activity between radiotherapy treatment days and non-treatment days, mixed effects models were used to evaluate longitudinal changes in activity and we used k-means clustering to characterise clusters of PA behaviours. RESULTS We have collected 3458 days of accelerometer data from 42 HGG patients with a median age of 59, 80% of which has been classified as high quality. Patients &amp;gt;60 years spend more time doing moderate activity compared to those &amp;lt;60 years (52 vs 33 minutes/day, p=0.012), and there are significant differences in mean vector magnitude (17.12 vs 16.85 mg, p=0.013) and walking (91 vs 72 minutes/day) between radiotherapy and non-radiotherapy days. In patients having a 6-week RT course, time spent in daily moderate activity falls 4-fold between week 1 and the second week after RT completion (70 minutes to 16 minutes/day). Comparing HGG patients to healthy controls shows a significant difference in time spent across all activities (p&amp;lt;0.05). K-means clustering analysis shows three distinct clusters, with 87% of HGG patients falling into the very inactive or moderately active groups. CONCLUSION Digital remote health monitoring is feasible and acceptable with 80% of data classified as high-quality wear-time suggesting good patient adherence. Triaxial accelerometer data collection captures objective evidence of a significant reduction in moderate daily activity at the time of expected peak RT side-effects and patients walk almost 30% less on non-RT treatment days. HGG patients show significantly lower levels of activity compared to matched healthy controls.

Active commuting and leisure-time physical activity among adults in western Nepal: a cross-sectional study

ObjectiveTo determine the prevalence and sociodemographic factors associated with active commuting and leisure-time physical activity (LTPA) among adults in western Nepal.DesignCross-sectional study.SettingAdults from semiurban areas in western Nepal.Participants2815 adults aged...

Move more – be happier? physical activity and health-related quality of life in children with congenital heart disease

This cross-sectional study aimed to determine whether there is an association between objectively assessed physical activity (PA) and health-related quality of life (HRQoL) in children with CHD. From September 2017 to January 2021, 343 children with CHD (12.1 ± 3.3 years, 135 girls) provided valid PA data after a 7-day objective PA assessment. PA was evaluated as average daily steps and moderate-to-vigorous physical activity (MVPA) minutes assessed via wearable bracelet Garmin vivofit Jr. These children also completed the KINDL - a 24 Likert-scaled item questionnaires assessing HRQoL in the six dimensions physical well-being, emotional well-being, self-esteem, family, friends and everyday functioning. Daily Steps (r=0.166, P=.003) and daily MVPA minutes (r=0.134, P=.017,) were both correlated to total KINDL score. Furthermore, both steps and MVPA were associated with the subscales physical well-being (steps: r=0.165 p=.003; MVPA: r=0.129, P=.022), friends (steps: r=0.210, P < .001, MVPA: r=0.179, P=.001), steps, and to everyday functioning (r=0.142, P=.012). Logistic regression showed each MVPA minute increase conferred to a 1% increase in reporting better HRQoL (OR: 1.009 [95% CI: 1.002 - 1.017], P=.019). PA was positively associated with HRQoL in children with CHD. Patients who move more are more likely to report better HRQoL. While the magnitude of this association needs to be further understood, continuous encouragement towards more PA seems to be crucial in a holistic approach to medical aftercare in children with CHD.

Objective Assessment of Physical Activity and Associated Contexts During High School Sport Practices.

Background: Organized sports provide children and adolescents with opportunities to achieve recommended amounts of moderate to vigorous physical activity (MVPA), and schools are a primary setting for sports programs. The main aims of this study were to examine participant physical activity (PA) levels during the most popular high school sports in the United States and to assess the influences of practice contextual factors on PA levels.Methods: Participant PA and its contexts were assessed during practices for the 10 most popular girls' and boys' high school sports in the United States. Data were obtained during 598 practice sessions in 12 schools in North Carolina using a validated direct observation instrument (System for Observing Fitness Instruction Time (SOFIT). A regression model was applied to understand the association between sport context and athletes' PA.Results: Overall, athletes were observed engaging in MVPA 60% of practice time. MVPA varied among sports and levels were highly influenced by practice contexts. Among girls' sports, cross country and soccer practices provided the highest proportion of MVPA and MVPA percent during boys' practice sessions was highest during cross country and track and field. Practice contexts were associated with MVPA accrual with time allocated for gameplay and fitness activities associated with the highest levels of PA.Conclusions: The results contribute to an understanding of which sports and how their practices are conducted facilitate increased PA. Findings indicate athletes accrue substantial amounts of PA during high school practices, but that it varies from sport to sport. As well, the context that characterizes sport practices is a significant determinant in how much PA occurs. Most sports that emphasized game simulation, fitness, and skill development drills had higher levels of MVPA. Given the length and frequency of practices and how the content is delivered, we can accurately predict how much PA athletes are likely to achieve during a given sport season. The findings from this study demonstrate that sport can make a useful, if not sufficient role in helping high school athletes reach recommended PA levels. PA engagement can be optimized by attending to the management of contexts surrounding the sports.

Comparison between Self-Reported and Accelerometer-Measured Physical Activity in Young versus Older Children

Physical inactivity in children is a major public health challenge, for which valid physical activity assessment tools are needed. Wearable devices provide a means for objective assessment of children’s physical activity, but they are often not adopted because of issues such as cost, comfort, and privacy. In this context, self-reporting tools could be employed, but their validity in relation to a child’s age is understudied. We present the agreement of one of the most popular self-reporting tools, the Physical Activity Questionnaire for Children (PAQ-C) with accelerometer-measured physical activity in 9-year-old versus 12-year-old children, wearing an accelerometer-based wearable device for seven consecutive days. We study the relationship between the PAQ-C and accelerometer scores using Spearman’s rank correlation coefficients and Bland–Altman plots in a sample of 131 children included for analysis. Overall, there was correlation between PAQ-C score and physical activity measures for the 12-year-old children (rho = 0.47 for total physical activity, rho = 0.43 for moderate-to-vigorous physical activity, rho = 0.41 for steps, p &lt; 0.01), but not for the 9-year-old children (rho = 0.08 for total physical activity, rho = 0.21 for moderate-to-vigorous physical activity, rho = 0.19 for steps, p &gt; 0.05). All PAQ-C items other than item 3 (activity at recess) did not reach significance in correlation with accelerometry for the 9-year-old children (p &gt; 0.05). Therefore, the use of wearable devices for more objective assessment of physical activity in younger children should be preferred.

Intervention to improve quality of sleep of palliative patient carers in the community: protocol for a multicentre randomised controlled trial

BackgroundSleep disorders are commonly experienced by community caregivers for persons with cancer, with at least 72% reporting moderate to severe disorders. A consequence of this condition, which is associated with the presence of overload in the caregiver, is the increased risk of clinical depression. The aim of this study is to evaluate the effects of music on the sleep quality achieved by informal caregivers for cancer patients receiving home palliative care. In addition, we will assess the influence of specific variables that could modify these effects, analyse the correlates related to nocturnal wakefulness and consider the diurnal consequences according to the sleep characteristics identified.MethodsThis single-blind, multicentre, randomised clinical trial will focus on informal providers of care for cancer patients. Two samples of 40 caregivers will be recruited. The first, intervention, group will receive seven music-based sessions. The control group will be masked with seven sessions of therapeutic education (reinforcing previous sessions). Outcomes will be evaluated using the Pittsburgh Sleep Quality Index, a triaxial accelerometer, EuroQol-5D-5L, the Caregiver Strain Index, the Epworth Sleepiness Scale and the Client Satisfaction Questionnaire. The caregivers’ satisfaction with the intervention performed will also be examined.DiscussionThis study is expected to extend our understanding of the efficacy of music therapy in enhancing the sleep quality of caregivers for patients receiving home palliative care. To our knowledge, no reliable scientific investigations of this subject have previously been undertaken. Music is believed to benefit certain aspects of sleep, but this has yet to be proven and, according to a Cochrane review, high-quality research in this field is necessary. One of the main strengths of our study, which heightens the quality of the randomised clinical trial design, is the objective assessment of physical activity by accelerometry and the use of both objective and subjective measures of sleep in caregivers. Music therapy for the caregivers addressed in this study is complementary, readily applicable, provokes no harmful side effects and may produce significant benefits.Trial registrationThe IMECA study is registered at Clinical Trials.gov, ClinicalTrials.gov Identifier: NCT04491110. Registered 29 July, 2020.

Are Physical Activity and Sedentary Behavior Associated With Cancer-Related Symptoms in Real Time?: A Daily Diary Study.

Few studies have examined the real-time and dynamic relationship between lifestyle behaviors and treatment-related symptoms. The aim of this study was to examine the associations of daily physical activity and sedentary behavior with symptom burden, pain interference, and fatigue among patients who were undergoing active cancer treatment. A total of 22 (mean age = 57 years; 73% women; 55% Black) cancer patients were recruited from a local hospital and reported a daily diary of physical activity, sedentary behavior, symptom burden, pain interference, and fatigue over 10 days. Adjusted mixed-effects models were used to examine all associations. Body mass index moderated the relationship between physical activity and symptom burden (γ = 0.06, P < .01) and physical activity and fatigue (γ = 0.09, P < .05). On days where physical activity was higher than average, symptom burden and fatigue scores were lower among patients who had lower body mass index values. Also, age moderated the relationship between sedentary behavior and symptom burden (γ = -0.04, P < .05); on days where patients sat more, symptom burden was lower among patients who were younger than the average age. Overall, these data indicate that treatment-related symptoms vary daily within cancer patients and that physical activity may alleviate treatment-related symptoms for leaner patients. Larger samples and objective assessments of physical activity and sedentary behavior are needed to validate our results. Oncology nurses may be in the best position to promote physical activity during treatment as a strategy to manage symptom burden.

Can Instagram be used to deliver an evidence-based exercise program for young women? A process evaluation

BackgroundInstagram provides an opportunity to deliver low cost, accessible and appealing physical activity content. This study evaluated the feasibility of delivering an exercise program for young women using Instagram.MethodsA single-group pre- and post-intervention trial examined the feasibility and preliminary efficacy of a 12-week Instagram-delivered program with young inactive women (n = 16; M = 23 years), which prescribed running and body weight exercises to complete three times per week. Daily Instagram posts delivered the exercises, video demonstrations and motivational content. Feasibility was evaluated by examining exposure (Instagram posts viewed per week), engagement (likes, comments and tags on Instagram posts; number of exercise sessions completed per week; retention, defined as completion of the online survey at weeks 6 and 12), and acceptability [whether the program increased participants’ motivation to exercise (1 = strongly disagree-5 = strongly agree); satisfaction with the program (1 = not satisfied-5 = very satisfied)]. Preliminary efficacy was evaluated by comparing baseline and 12-week self-reported physical activity (IPAQ short-form) and fitness (cardiorespiratory and muscle strength; 1 = very poor-5 = very good, International Fitness Scale) using the Exact sign test.ResultsOn average, participants reported seeing six posts in their Instagram feed per week. Posts received an average of five likes (IQR = 3–6). A total of four comments and one tag were observed across all posts. On average, participants reported completing two exercise sessions per week. Retention was 88% at 6 weeks but dropped to 56% at 12 weeks. Participants reported increased motivation to exercise (Mdn = 4, IQR = 3–4) and were satisfied with the program (Mdn = 4, IQR = 3–4). Only self-reported cardiorespiratory fitness showed a meaningful, though nonsignificant, improvement (MdnΔ = 1, IQR = 0–1, p = .06).ConclusionsAlthough Instagram has the potential to deliver a low cost, convenient exercise program for young women, additional research is needed to identify methods of improving engagement (interaction with the Instagram content, exercise sessions completed, and retention in the program). Future research could examine the use of behaviour change theory and provide information that enables participants to tailor the exercises to their interests and needs. Additionally, the use of objective assessments of physical activity and fitness among a larger participants sample is needed.

Physical Activity and Its Associated Factors among Adolescents in Secondary Schools in Northeast Peninsular Malaysia

Background: The World Health Organization has estimated that 81% of adolescents worldwide are not sufficiently physically active. This study aimed to determine the level of physical activity and its associated factors among adolescents in secondary schools in northeast Peninsular Malaysia. Methods: A cross-sectional study was conducted that involved Form 1 and Form 2 students from six public secondary schools. The study included a multistage stratified cluster sampling and used the Malay version of the Physical Activity Questionnaire for Children and Body Image Contour Drawing Rating Scale. Data were analyzed by simple and multiple logistic regressions using IBM SPSS Statistics Version 22. Results: The study involved a total of 603 students who had a response rate of 89.7%. About 53% of the students were physically inactive. Being female [adjusted OR (95% CI): 5.07 (3.57, 7.20)] and allocating time for studying [adjusted OR (95% CI): 0.86 (0.75, 0.98)] were associated with physical inactivity. Conclusions: The majority of adolescents were physically inactive. To achieve a higher level of physical activity, intervention programs must consider the sex of adolescents and the amount of time they allocate for activities. Objective assessment of physical activity using pedometer or accelerometer is recommended.