Objective Measures Of Physical Activity Research Articles

Improved vascular health linked to increased physical activity levels and reduced sedentary behavior in rheumatoid arthritis.

Rheumatoid arthritis (RA) is characterized by deteriorated vascular health and increased cardiovascular risk. Physical activity (PA) is recommended for cardiovascular management in RA, but evidence on the associations between objectively-measured PA and vascular health markers in RA is limited. In this cross-sectional study, eighty-two post-menopausal women with RA (62±7 years) undertook ultrasound assessments of vascular function and structure, including brachial and superficial femoral artery (BA and SFA) flow-mediated dilation; baseline and post-hyperemia peak diameters; and carotid intima-media thickness. Participants also performed a 7-day accelerometer-based assessment of PA and sedentary behavior (SB). Fitted regression models controlled for age, body mass index and disease activity were conducted to examine associations between vascular and PA outcomes. Regression analyses revealed that prolonged SB (bouts>60min) and total sedentary time were inversely associated with both baseline and peak BA diameters, with each additional hour of SB resulting in decreases of 0.08-0.1mm in these diameters (p≤0.01). Total sedentary time also showed similar negative associations with peak SFA diameters (β=-0.14[-0.24-0.05], p<0.01). Conversely, light-intensity PA and stepping time were positively associated with both baseline and peak BA diameters, with each additional hour increasing these diameters by 0.10-0.24mm (p≤0.02). Finally, standing time was positively associated with SFA peak diameter (β=0.11[0.01-0.20], p=0.02). No associations were found between moderate-to-vigorous PA and vascular outcomes. In conclusion, in patients with RA, SB was negatively, while light PA was positively, associated with BA and SFA diameters. These findings suggest that reducing SB and increasing PA, even at light intensities, may improve vascular health in RA.

Physical Activity in Mild Vascular Cognitive Impairment: Results of the AFIVASC Randomized Controlled Trial at 6 Months.

Vascular cognitive impairment is frequent, in mild (mVCI) or severe forms (vascular dementia). To do a randomized controlled-trial to evaluate the impact of physical activity on cognition (primary outcome), neurocognitive measures, quality of life, functional status, and physical function (secondary outcomes), in patients with mVCI. A hundred and four patients with mVCI (mean age 71.2 years; 53 women) were randomized for a six-month intervention of moderate physical activity (60-minute sessions, 3 times/week) (n = 53) or best-practice "usual care" (n = 51). Comprehensive evaluations of primary and secondary outcomes included an objective measure of physical activity through accelerometry at baseline and after intervention. Mean session attendance was 58%. Adverse events were negligible. After 6 months, no significant primary outcome change was observed, either in the intervention or 'usual care' group. The intervention group improved significantly in some secondary outcomes in physical function - aerobic capacity (U = 403; p = 0.000) and agility (U = 453; p = 0.005) after 6 months. Regardless of randomization arm, a post-hoc analysis based on fulfilling at least 21.5 minutes/day of moderate or 10.7 minutes/day of vigorous physical activity (World Health Organization-WHO standards) revealed improvements. These were not only in motor capacity but also on the global measure of cognition, executive functions and memory. Physical activity was safe and beneficial regarding domains of physical function. No significant cognitive decline was registered over 6-months, regardless of intervention allocation. Larger samples, longer follow-ups and focus on intervention adherence are needed to fully analyze the impact of WHO recommendations for physical activity in mVCI populations.

Effects of age on human skeletal muscle: A systematic review and meta-analysis of myosin heavy chain isoform protein expression, fiber size and distribution.

Human studies examining the cellular mechanisms behind sarcopenia, or age-related loss of skeletal muscle mass and function, have produced inconsistent results. A systematic review and meta-analysis were performed to determine the aging effects on protein expression, size and distribution of fibers with various myosin heavy chain (MyHC) isoforms. Study eligibility included MyHC comparisons between young (18-49 years) and older (≥ 60 years) adults, with 27 studies identified. Relative protein expression was higher with age for the slow-contracting MyHC I fibers, with correspondingly lower fast-contracting MyHC II and IIA values. Fiber sizes were similar with age for MyHC I, while smaller for MyHC II and IIA. Fiber distributions were similar with age. When separated by sex, the few studies that examined females showed atrophy of MyHC II and IIA fibers with age, but no change in MyHC protein expression. Additional analyses by measurement technique, physical activity, and muscle biopsied provided important insights. In summary, age-related atrophy in fast-contracting fibers lead to more of the slow-contracting, lower force-producing isoform in older male muscles, which helps explain their age-related loss in whole muscle force, velocity, and power. Exercise or pharmacological interventions that shift MyHC expression towards faster isoforms and/or increase fast-contracting fiber size should decrease the prevalence of sarcopenia. Our findings also indicate that future studies need to include or focus solely on females, measure MyHC IIA and IIX isoforms separately, examine fiber type distribution, sample additional muscles to the vastus lateralis, and incorporate an objective measurement of physical activity.

Optimal lifestyle patterns for delaying ageing and reducing all-cause mortality: insights from the UK Biobank

BackgroundWith the rapid aging of the global population, identifying lifestyle patterns that effectively delay aging and reduce mortality risk is of paramount importance. This study utilizes the UK Biobank to analyze the associations of the Dietary Inflammatory Index, physical activity, and sleep on biological aging and all-cause mortality.MethodsA prospective cohort study was conducted using data from over half a million UK Biobank participants. Two datasets were created by subjective and objective measurements of physical activity: the Subjective Physical Activity (SPA) and Objective Physical Activity (OPA) datasets. Lifestyle patterns, including diet habits, exercise levels, and sleep quality, were assessed within these datasets. Biological aging was quantified using validated methods, including Homeostatic Dysregulation, Klemera-Doubal Method Biological Age, Phenotypic Age, and Telomere Length. All-cause mortality data were obtained from the National Health Service. Statistical analyses included weighted linear regression and Cox proportional hazard models, adjusted for a range of covariates.ResultsThe findings indicate that, in most cases, maintaining an anti-inflammatory diet, engaging in at least moderate physical activity, and ensuring healthy sleep conditions are associated with delayed physiological aging (Cohen’s d ranging from 0.274 to 0.633) and significantly reduced risk of all-cause mortality (HR-SPA: 0.690, 95% CI: 0.538, 0.884; HR-OPA: 0.493, 95% CI: 0.293, 0.828). These effects are particularly pronounced in individuals under 60 years of age and in women. However, it was observed that the level of physical activity recommended by the World Health Organization (600 MET-minutes/week) does not achieve the optimal effect in delaying biological aging. The best effect in decelerating biological aging was seen in the high-level physical activity group (≥ 3000 MET-minutes/week). The study also highlights the potential of biological age acceleration and telomere length as biomarkers for predicting the risk of mortality.ConclusionsChoosing healthy lifestyle patterns, especially an anti-inflammatory diet, at least moderate physical activity, and healthy sleep patterns, is crucial for delaying aging and reducing mortality risk. These findings support the development of targeted interventions to improve public health outcomes. Future research should focus on objective assessments of lifestyle to further validate these associations.

Comparison of a guided assessment and an app-based assessment of physical activity using the Global Physical Activity Questionnaire (GPAQ)

Introduction &amp; Purpose The Global Physical Activity Questionnaire (GPAQ; Armstrong &amp; Bull, 2006) is commonly used to assess frequency, duration and intensity of physical activity (PA) in three domains: work, travel and recreation. It is frequently used as a self-administered questionnaire; however, the execution was originally designed for an interviewer. With the continuous development of app-based technology, the evaluation of PA online-assessment is relevant (Mosa et al., 2012). The objective of the study was to compare an online self-administered version of the GPAQ with the original version administered by an interviewer. Methods The physical activity behaviour of 533 participants (70% female, average age 44, ± 13.9) from the LIFE-Tirol Study (Lasting Health through Intermittent Fasting, Emotional Firmness and Exercise) was assessed by an interviewer using the GPAQ. The interviewer used generic show cards for explaining different levels of exercise intensities as recommended in the analysis guidelines (Armstrong &amp; Bull, 2006). After two months, participants were asked to fill in the GPAQ via online app without show cards. Participant were advised not to change their usual physical activity levels during the two months. The movement domains and intensities of the two versions were compared with Jamovi v2.3 using a series of Wilcoxon W-tests and a series of 2 × 2 mixed ANOVAs to analyse gender- and age-specific aspects. Results Total metabolic equivalent task (MET) minutes were significantly different between interview and self-assessed online version (1,971 ± 2,590 vs. 4,143 ± 4,370 MET minutes; p &lt; .001, d = 0.670). Significantly more MET minutes were reported in the online version compared to the interview version across all three PA-domains and both vigorous and moderate intensities (F(1, 552) = 167, p &lt; .001, ƞ² = .232). This difference was not influenced by gender. 18–34-year-old participants reported significantly less MET minutes during recreational PA than participants older than 55 years in both versions (F(1, 551) = 113, p &lt; .001, ƞ²= .170). No further gender/age × assessment interaction effects were found. Male participants tend to report higher intensity minutes more likely than females in both assessment versions (F(1, 551) = 4.43, p = 0.360, ƞ²= .008). Discussion The amount of PA as well as its intensities seem to differ between the self-assessed online version compared to the interview assessment of the GPAQ, although the interview was conducted as the first measurement and PA as well as intensities were explained in detail to participants using generic show cards. It was previously reported that show cards have no significant impact on the results of the self-administered version of the GPAQ (Rudolf et al., 2020). Therefore, the authors suggest that the main differences between both assessments were caused by the presence of the interviewer independent of age or gender. Conclusion Regardless of the use of show cards and detailed explanations of PA, the main difference between guided and self-administered PA-assessments may result from the presence or absence of an interviewer. Therefore, it is important to interpret self-administered app-based GPAQ evaluations with caution. Future studies should validate app-based GPAQ data by using objective PA measurements, such as accelerometers.

Effect of Centrality on Physical Activity in Late Childhood: A 1-Year Prospective Cohort Study.

Engaging in physical activity (PA) is crucial for children's physical and mental health, with PA in childhood influencing lifelong activity levels. However, PA during childhood tends to decrease with age. Childhood friendship networks influence various health behaviors, including physical activity. Centralities are objective measures of an individual's position and role in friendship networks. The relationship between centrality and PA is inconsistent. This study aimed to determine how centrality affects changes in PA in late childhood longitudinally and to investigate the distribution of centrality in the network. This prospective cohort study recruited fourth- and fifth-grade children (9-11 years old). A total of 143 children participated. We calculated three centralities-in-degree, closeness, and betweenness-based on social network analysis (SNA). PA was assessed using the physical activity questionnaire for older children (PAQ-C). To explore the relationship between centralities and the percentage change in PA, a multivariate logistic regression analysis was performed. Children with higher closeness had a significantly higher rate of decrease in PA after adjusting for confounding factors. There was no significant association between betweenness and percentage change in PA (p = 0.66) or in-degree and percentage change in PA (p = 0.21). This study highlights the importance of considering social network dynamics in PA interventions, particularly for children with high social closeness. Future research should incorporate objective PA measures and explore broader social networks to enhance intervention strategies, especially for Generation Z and Alpha, who experience unique opportunities and motivations for PA due to pervasive digital environments.

Effect of acceptance and commitment therapy on fear of falling and physical activity in Parkinson’s disease: a randomised controlled trial

IntroductionThis study aimed to evaluate the efficacy of acceptance and commitment therapy (ACT) in reducing the fear of falling (FOF) and promoting physical activity in individuals diagnosed with Parkinson’s disease...

Investigating the causal impact of different types of physical activity on psychiatric disorders across life stages: A Mendelian randomization study

BackgroundPsychiatric disorders, including attention-deficit hyperactivity disorder (ADHD), depression, anxiety disorders, and dementia, manifest differently across life stages, impacting cognitive, emotional, and behavioral health. Understanding the causal relationships between various types of physical activity and these disorders is crucial for developing targeted interventions. MethodsThe summary level data from GWAS was utilized to conduct a two-sample Mendelian Randomization (MR) analysis. We assessed the potential causal relationships between different types of physical activity including light do it yourself (DIY) activities, heavy DIY activities, strenuous sports, and aerobic exercises/other exercises and the prevalence of psychiatric disorders (ADHD, depression, anxiety disorders, and dementia) across different life stages. ResultsThe MR analysis showed no causal relationship between light DIY activities and any of the psychiatric disorders studied. Heavy DIY activities showed a significant negative association with anxiety disorders but no links with ADHD, depression, or dementia. Strenuous sports did not demonstrate any causal relationship with the psychiatric disorders examined. Aerobic exercises were notably correlated with a reduced risk of depression, although no significant associations were found with ADHD, anxiety disorders, or dementia. ConclusionsThe findings indicate that heavy DIY activities might contribute to reducing anxiety disorders, while aerobic exercises potentially lower the risk of depression. These results emphasize the potential benefits of promoting specific types of physical activity to improve mental health outcomes across different life stages. Future research could further investigate the mechanisms underlying these relationships and consider diverse populations and objective measures of physical activity.

Daily steps are a predictor of, but perhaps not a modifiable risk factor for Parkinson's Disease: findings from the UK Biobank.

Higher physical activity levels have been suggested as a potential modifiable risk factor for lowering the risk of incident Parkinson's disease (PD). This study uses objective measures of physical activity to investigate the role of reverse causation in the observed association. To investigate the association between accelerometer-derived daily step count and incident PD, and to assess the impact of reverse causation on this association. This prospective cohort study involved a follow-up period with a median duration of 7.9 years, with participants who wore wrist-worn accelerometers for up to 7 days. The study was conducted within the UK Biobank, a large, population-based cohort. The analysis included 94,696 participants aged 43-78 years (56% female) from the UK Biobank who provided valid accelerometer data and did not have prevalent PD. Daily step counts were derived using machine learning models to determine the median daily step count over the monitoring period. The primary outcome was incident PD, identified through hospital admission and death records. Cox proportional hazards regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between daily step count and incident PD, with adjustments for various covariates and evaluation of reverse causation by splitting follow-up periods. During a median follow-up of 7.9 years (IQR: 7.4-8.4), 407 incident PD cases were identified. An inverse linear association was observed between daily step count and incident PD. Participants in the highest quintile of daily steps (>12,369 steps) had an HR of 0.41 (95% CI 0.31-0.54) compared to the lowest quintile (<6,276 steps; HR 1.00; 95% CI 0.84-1.19). A per 1,000 step increase was associated with an HR of 0.92 (95% CI 0.89-0.94). However, after excluding the first six years of follow-up, the association was not significant (HR 0.96, 95% CI 0.92-1.01). The observed association between higher daily step count and lower incident PD is likely influenced by reverse causation, suggesting changes in physical activity levels occur years before PD diagnosis. While step counts may serve as a predictor for PD, they may not represent a modifiable risk factor. Further research with extended follow-up periods is warranted to better understand this relationship and account for reverse causation.

Physical Activity and Cognition: Longitudinal findings from the Thinking and Living with Cancer Study.

Physical activity can improve cognition; however, little is known regarding the relationships between longitudinal objectively-measured physical activity, cognition, and inflammation in older breast cancer survivors. Older (≥60 yrs) breast cancer survivors (n = 216) and frequency-matched non-cancer controls (n = 216) were assessed at baseline (pre-systemic therapy for survivors) and annually for up to five years. Assessments included hip-worn ActiGraphs worn for seven days, neuropsychological tests, the Functional Assessment of Cancer Therapy-Cognitive Function Perceived Cognitive Impairment (FACT-Cog PCI) subscale, and circulating levels of C-reactive protein (CRP) and interleukin-6 (IL-6). Data were analyzed using linear mixed-effect, random-effect contemporaneous fluctuation, and multi-level mediation models, considering covariates; p < .05 (two-sided) was considered significant. Survivors had fewer minutes of moderate-to-vigorous physical activity (MVPA) than controls at 36-, 48-, and 60-month time points (p < .03). Fewer survivors met Aerobic Physical Activity Guidelines at 36 months than controls (17.7% vs 33.0%, p = .030). When Guidelines were met (vs not), FACT-Cog PCI scores were 2.1 ± 1.0 (p = .034) points higher. Higher MVPA and meeting Aerobic Guidelines were not related to objective neuropsychological performance. MVPA was inversely associated with CRP and IL-6 (p < .001), but inflammation did not mediate physical activity effects on perceived cognition. Older breast cancer survivors were less physically active than older non-cancer controls, especially farther from baseline. Meeting Aerobic Guidelines was associated with better perceived cognition in survivors. Survivorship care should consider physical activity monitoring and referral to rehabilitation and supervised exercise programs to promote physical activity and improve recovery in older survivors.

Associations between total physical activity levels and academic performance in adults: A systematic review and meta-analysis.

Physical activity has been associated with positive health-related outcomes. Physical inactivity, conversely, has been associated with several negative health outcomes. One topic that has been consistently examined is the relationship between physical activity and academic performance in children; however, studies that involve university-level students have not been aggregated to date. It is therefore the aim of this systematic review to examine the relationship between physical activity and academic performance in university-level students. This systematic review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included any study published until September 2023 that examined associations between physical activity and any measure of academic performance. SPORTDiscus, ERIC, the British Education Index, Scopus, Embase, Web of Science, and PubMed were searched. A random effects meta-analysis was also undertaken, and risk bias was assessed using the Newcastle Ottawa Scale. After screening, 36 studies were included, with six studies being included in the meta-analysis. The meta-analysis found a significant association between physical activity (high versus low) and academic performance (high versus low performers) (odds ratio = 3.04; 95% CI = 1.84-5.02; P ≤ 0.001; I2 = 49.62). These results, however, were deemed to be of low credibility. The narrative analysis yielded mixed results, with 50% of studies reporting positive associations and the remaining studies reporting no significant associations. This trend did not differ depending on the subjective or objective measurement of physical activity. Although this review found meta-analytic significant associations between physical activity and academic performance, these results should be treated with caution, as the remaining studies yielded mixed results. Future studies should aim to focus on objective measurements of physical activity where possible to further explore this potential relationship.

Assessment of non-communicable disease risk factors, functional performance, and health-related quality of life in adults: a comparative analysis in low-resourced urban and rural areas of South Africa

BackgroundGlobally, disparities between non-communicable disease (NCD) risk factors, functional performance, and health-related quality of life (HRQoL) exist in people living in rural and low-resourced urban settings. Evidence of these health differences determined with objective NCD risk factors and functional performance measurements in South Africa, is scarce. Therefore, the study aimed to determine the differences in NCD risk factors, functional performance and HRQoL between rural and low-resourced urban areas.MethodsThe study recruited 311 adults (35–80 years) presenting with at least one NCD risk factor from low-resourced urban- (n = 183) and rural (n = 128) communities. Objective measurements of physical activity (PA) by means of combined heart rate and accelerometery, body composition employing skinfolds, peripheral lipid and glucose concentrations, blood pressure, functional performance indicators (handgrip, single leg stand, sit-to-stand, timed-up-and-go speed, predicted peak VO2 max); and HRQoL were measured according to standard procedures. Independent t-tests, Mann-Whitney U, and chi-square tests were performed to determine differences between the variables of low-resourced urban and rural settings.ResultsThe participants from the low-resourced urban setting were significantly older than the rural residents (59.1 ± 10.7 years vs. 52.8 ± 11.3 years; p = 0.001). NCD risk factors were significantly more prevalent in the low-resourced urban participants compared to rural participants, in particular for elevated systolic (85.8% vs. 62.5%; p = 0.001), and diastolic blood pressure (88.5% vs. 65.6%; p = 0.001), physical inactivity (95.9% vs. 87.7%; p = 0.026), increased cholesterol concentrations (22.1% vs. 8.7%; p = 0.002), and increased waist circumference (61.9% vs. 49.2%; p = 0.027). Low-resourced urban residents presented with a higher average body fat percentage (27.69% ± 7.65% vs. 12.23% ± 4.67%; p < 0.001), and lower moderate to vigorous PA levels (37.19 ± 49.55 [95% CI = 29.12–45.27] vs. 62.92 ± 60.43 min/week [95% CI = 47.95–77.90]; p = 0.003) compared to rural residents. Rural residents showed significantly better functional performance, including peak VO2 (23.99 ± 9.89 vs. 16.95 ± 7.64 ml/min/kg; p = 0.001) and single leg stand (right leg: 44.96 ± 18.47 vs. 20.87 ± 19.18 s; p = 0.001) as well as higher HRQoL for the physical (51.06 ± 8.14% vs. 45.62 ± 11.13%; p < 0.001) and mental (54.75 ± 8.24% vs. 48.91 ± 12.27%; p < 0.001) component scores compared to participants from the low-resourced urban areas.ConclusionNCD risk factors, functional performance, and HRQoL significantly differ in rural communities compared to low-resourced urban communities in South Africa. Urban areas’ most prevalent risk factors were elevated blood pressure, physical inactivity, and increased waist circumference. Participants from rural areas demonstrated significantly better functional performance, such as fitness and balance. HRQoL was better in rural settings than in urban settings. Future intervention programmes should be tailored for specific settings.

The associations of physical activity and sedentary behavior with self-rated health in Chinese children and adolescents.

The study aimed to analyze the independent and joint associations of physical activity (PA) and sedentary behavior (SB) with self-rated health (SRH) among Chinese children and adolescents. Cross-sectional data on moderate-to-vigorous physical activity (MVPA), school-based PA, extracurricular physical activity (EPA), screen time (ST), homework time, and SRH were assessed through a self-report questionnaire in the sample of 4227 Chinese children and adolescents aged 13.04 ± 2.62 years. Binary logistic regression was used to compare gender differences in PA, SB, and SRH among children and adolescents, and analyses were adjusted for age and ethnicity. In independent associations, boys and girls engaging in ≥60 min/day of MVPA and >1 hour/day of EPA reported optimal SRH. Only boys who participated in >1 hour/day of school-based PA were significantly more likely to have optimal SRH (OR = 1.49, 95%CI = 1.19-1.86). Only girls who had ≤2 hours/day of ST were significantly associated with optimal SRH (weekdays: OR = 1.38, 95%CI = 1.10-1.74; weekends: OR = 1.40, 95%CI = 1.14-1.71; whole week: OR = 1.42, 95%CI = 1.16-1.73). In joint associations, regardless of SB recommendation, meeting PA recommendation was significantly associated with optimal SRH in both boys (meet PA and SB recommendations, OR = 1.61, 95%CI = 1.03-2.50; meet PA but not SB recommendations, OR = 2.40, 95%CI = 1.57-3.65) and girls (meet PA and SB recommendations, OR = 3.72, 95%CI = 2.08-6.65; meet PA but not SB recommendation, OR = 4.27, 95%CI = 2.09-8.75). Increased PA and reduced SB were positively associated with optimal SRH in Chinese children and adolescents. Notably, lower ST positively influenced only girls' SRH. Meeting PA recommendation is more impactful than meeting SB recommendation for improving SRH in Chinese children and adolescents. Future studies could explore these associations using objective measures of PA and SB in China.

The activity advantage: Objective measurement of preoperative activity is associated with postoperative recovery and outcomes in patients undergoing surgery with gynecologic oncologists

ObjectiveTo examine the association between objectively-measured preoperative physical activity with postoperative outcomes and recovery milestones in patients undergoing gynecologic oncology surgeries. MethodsProspective cohort study of patients undergoing surgery with gynecologic oncologists who wore wearable actigraphy rings before and after surgery from 03/2021–11/2023. Exposures encompassed preoperative activity intensity (moderate- and vigorous-intensity metabolic equivalent of task-minutes [MAVI MET-mins] over seven days) and level (average daily steps over seven days). Intensity was categorized as <500, 500–1000, and >1000 MAVI MET-mins; level categorized as <8000 and ≥8000 steps/day. Primary outcome was 30-day complications. Secondary outcomes included reaching postoperative goal (≥70% of recommended preoperative intensity and level thresholds) and return to baseline (≥70% of individual preoperative intensity and level). ResultsAmong 96 enrolled, 87 met inclusion criteria, which constituted 39% (n = 34) with <500 MET-mins and 56.3% (n = 49) with <8000 steps preoperatively. Those with <500 MET-mins and <8000 steps had higher ECOG scores (p = 0.042 & 0.037) and BMI (p = 0.049 & 0.002) vs those with higher activity; all other perioperative characteristics were similar between groups. Overall, 29.9% experienced a 30-day complication, 29.9% reached postoperative goal, and 64.4% returned to baseline. On multivariable models, higher activity was associated with lower odds of complications: 500–1000 MET-mins (OR = 0.26,95%CI = 0.07–0.92) and >1000 MET-mins (OR = 0.25,95%CI = 0.07–0.94) vs <500 MET-mins; ≥8000 steps (OR = 0.25,95%CI = 0.08–0.73) vs <8000 steps. Higher preoperative activity was associated fewer days to reach postoperative goal. ConclusionPatients with high preoperative activity are associated with fewer postoperative complications and faster attainment of recovery milestones. Physical activity may be considered a modifiable risk factor for adverse postoperative outcomes.

Physical literacy is associated with children's adherence to physical activity guidelines during COVID-19

ABSTRACT Background: Despite the benefits of physical activity, children’s compliance with physical activity recommendations is very low and this situation worsened during the COVID-19 pandemic. Physical literacy has been theorised as a factor that can enhance and sustain children’s engagement with physical activity. This study aimed to investigate whether physical literacy is associated with children’s adherence to the physical activity guidelines during COVID-19. Methods: Data for this cross-sectional study were collected from 648 Australian children (60% boys) aged 7–12 years (M = 10 years; SD = 1.7) and their parents/carers. Recruitment was conducted through social media and panel sampling. Self-perceived physical literacy was measured using the pictorial Physical Literacy in Children Questionnaire. Children’s adherence to physical activity guidelines was collected using a two-item questionnaire asking parents/guardians about the number of days their children were active for at least 60 min in a typical week before and during COVID-19. The association between physical literacy (predictor) and physical activity (binary outcome: meeting/not meeting guidelines before/during COVID-19) was tested with logistic regressions while adjusting for relevant confounders. Results: Most parents spoke English at home (91%), over half had a university education (62%) and three quarters had paid employment (75%). Children’s physical literacy scores ranged from 32–120 (M = 94; SD = 16). Physical literacy overall score was associated with significantly higher odds of meeting the physical activity recommendations during COVID-19 (OR = 1.03, 95% CI [1.02; 1.05]). Each of the physical literacy subdomains (i.e. physical, psychological, social, cognitive) was also significantly associated with children’s adherence to the physical activity guidelines (ORs = 1.07–1.22). Conclusions: These findings indicate that physical literacy is a predictor of physical activity and may act as a protective factor of such behaviour during limiting events, such as the COVID-19 pandemic. Further research could confirm this relationship using objective measures of physical activity and exploring whether interventions designed to improve physical literacy can benefit physical activity.

117 Standardizing Wearable-based Real-life Physical Activity Monitoring in Patients Undergoing Surgery for Degenerative Lumbar Disorders

INTRODUCTION: Assessment of function in patients with degenerative thoracolumbar disorders (DTD) has traditionally relied solely on the patient’s subjective perception of disability. There is a clear need to better understand an objective measure of physical activity impairment in this patient cohort. METHODS: This analysis is part of the Stanford SpineTrak study, a RCT to assess the feasibility of using a commercially available smartwatch (AppleWatch) to monitor outcome in patients with DTD. Mean preoperative physical activity 2 weeks before surgery was expressed as raw step count, as well as in standardized z-scores that wre referenced to age- and sex-specific values of a control population from a large public database. Step counts were assessed for convergent validity with established patient-reported outcome measures (PROMs) and impairment in activity was stratified into performance groups based on z-score cut-off values. RESULTS: Of 67 patients with DTD, 65 patients (62% female) with a mean age (SD) of 63.8 (12.8) years were available for analysis with a mean (SD) daily step count of 5215 (3868). Physical activity showed significant correlation with the ODI (r = 0.28, 95% CI -0.49-0.03), SF36-PCS (r = -0.34, 95% CI 0.11-0.54) and PROMIS-PF (r = -0.48, 95% CI 0.27-0.65). No, Mild, moderate, and severe impairment in activity performance were defined as corresponding z-scores of &gt;0, 0 to -0.99, -1 to -1.99 and = -2, accounting for 20%, 29%, 43% and 8% of the study population. Each 1-step increase in activity impairment resulted in increased subjective disability as measured by the ODI, SF36-PCS and PROMIS-PF (all &lt; 0.05). CONCLUSIONS: This study establishes a new wearable-based objective measure of real-life physical activity as well as corresponding standard scores that allow for a direct comparison of test results between individual patients and different study populations.

(1338) - Perception vs. Reality: Reported and Objective Measures of Physical Activity in Children with Hypertrophic Cardiomyopathy (HCM)

(1338) - Perception vs. Reality: Reported and Objective Measures of Physical Activity in Children with Hypertrophic Cardiomyopathy (HCM)

The role of physical activity on obstructive sleep apnea severity and hypoxic load, and the mismatch between subjective and objective physical activity assessments.

Obesity is the primary risk factor for the development of obstructive sleep apnea, and physical inactivity plays an important role. However, most studies have either only evaluated physical activity subjectively or objectively in obstructive sleep apnea. The objectives of this study were: (i) to assess the relationship between obstructive sleep apnea severity (both apnea-hypopnea index and desaturation parameters) and both objectively and subjectively measured physical activity after adjustment for anthropometry and body composition parameters; and (ii) to assess the relationship between objective and subjective physical activity parameters and whether obstructive sleep apnea severity has a modulatory effect on this relationship. Fifty-four subjects (age 47.7 ± 15.0 years, 46% males) were categorized into groups according to obstructive sleep apnea severity: no obstructive sleep apnea; mild obstructive sleep apnea; and moderate-to-severe obstructive sleep apnea. All subjects were evaluated with subjective and objective physical activity, anthropometric and body composition measurements, and 3-night self-applied polysomnography. A one-way ANOVA was used to evaluate the differences between the three obstructive sleep apnea severity groups and multiple linear regression to predict obstructive sleep apnea severity. Differences in subjectively reported sitting time (p ≤ 0.004) were found between participants with moderate-to-severe obstructive sleep apnea, and those with either mild or no obstructive sleep apnea (p = 0.004). Age, body mass index and neck circumference explained 63.3% of the variance in the apnea-hypopnea index, and age, body mass index and visceral adiposity explained 67.8% of the variance in desaturation parameters. The results showed that the person's physical activity does not affect obstructive sleep apnea severity. A weak correlation was found between objective and subjective physical activity measures, which could be relevant for healthcare staff encouraging patients with obstructive sleep apnea to increase their physical activity.

Combined effects of sleep and objectively-measured daily physical activity on arterial stiffness in middle-aged and older adults

Although sleep quality and physical activity (PA) may influence on arterial stiffness, the combined effects of these two factors on arterial stiffness remain unknown. A total of 103 healthy middle-aged and older men and women (aged 50–83 years) with no history of cardiovascular disease and depression were included in this study. Arterial stiffness was measured using carotid-femoral pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), and femoral-ankle PWV (faPWV). Poor sleepers were defined as those with a Pittsburgh Sleep Quality Index score of >5.5. Using an accelerometer for seven consecutive days, low levels of PA were defined as low moderate-to-vigorous-intensity PA (MVPA) <19.0 min/day and low step counts <7100 steps/day, respectively. Poor sleepers with low PA levels, as determined by MVPA and daily steps, showed higher cfPWV, but not faPWV or baPWV, in middle-aged and older adults. Furthermore, in the analysis of covariance (ANCOVA) analyses adjusted for age, obesity, dyslipidemia, and sedentary behavior, the cfPWV result remained significant. Our study revealed that the coexistence of poor sleep quality and decreased PA (low MVPA or daily steps) might increase central arterial stiffness in middle-aged and older adults. Therefore, adequate sleep (good and sufficient sleep quality) and regular PA, especially at appropriate levels of MVPA (i.e., at least of 7100 steps/day), should be encouraged to decrease central arterial stiffness in middle-aged and older adults.

Comparison of patient-reported outcomes of physical activity and accelerometry in people with multiple sclerosis and ambulatory impairment: A cross-sectional study

BackgroundAccelerometers and patient-reported outcomes (PRO) are used to assess physical activity (PA) in people with multiple sclerosis (pwMS). So far it is unknown, however, whether these assessments represent mobility limitations in pwMS with mild and moderate to severe disability alike. The primary aim of the study was to assess the correlation between accelerometry and International Physical Activity Questionnaire (IPAQ) scores in pwMS with different degrees of ambulatory impairment. Taken its frequent use into account, the Godin Leisure Time Exercise Questionnaire (GLTEQ) was investigated as additional PRO. MethodsIn a prospective cohort of pwMS, correlational analyses were performed between the number of daily steps, time spent in light, moderate to vigorous PA (MVPA) and time spent sitting as assessed using accelerometry (ActiGraph®-GT3X), and the respective IPAQ and GLTEQ scores. Additionally, associations of PA with disease-specific characteristics, aerobic capacity (VO2peak), walking assessments (Timed 25-Foot Walk, T25FW; 2-Minute Walk Test, 2MWT) and walking perception (Multiple Sclerosis Walking Scale-12; MSWS-12) were explored. Patient subgroups with mild (Expanded Disability Status Scale; EDSS score <4.0) and moderate to severe disability (EDSS ≥4.0) were analysed for the impact of ambulatory impairment on PA. Multiple linear regression was used to determine predictors of PA. ResultsA total of 56 pwMS completed the study, with a mean (standard deviation, SD) age of 48.4 (10.3) years, disease duration of 14.8 (9.6) years and median (interquartile range) EDSS score of 3.5 (2.0 – 4.4). Moderate to weak correlations were found between daily step count and IPAQ total metabolic equivalent (MET) minutes/week (p < 0.001; r = 0.506), MVPA MET-minutes/week (p < 0.01; r = 0.479) and walking MET-minutes/week (p < 0.05; r = 0.372) in the total cohort. Time spent sitting was inversely correlated with total MET-minutes/week and MVPA MET-minutes/week (p < 0.05; r = -0.358 and r = -0.365). Subgroup analysis revealed, that daily step count was significantly correlated with total MET-minutes/week, MVPA MET-minutes/week and walking MET-minutes/week (p < 0.01, r = 0.569; p < 0.01, r = 0.531 and p < 0.05, r = 0.480, respectively) in the “mild disability” subgroup only, whereas time spent sitting was inversely correlated with total MET-minutes/week (p < 0.05; r = -0.582) in the “moderate to severe disability” subgroup. There was no association between objectively assessed PA and GLTEQ scores in any group. In the total cohort, moderate to weak correlations were found between daily step count and walking assessments (T25FW: p < 0.01, ρ = -0.508; 2MWT: p < 0.01, ρ=0.463) and MSWS-12 (p < 0.001; ρ = -0.609). Moderate to weak correlations were also observed between VO2peak and walking assessments (T25FW: p < 0.01; ρ = -0.516; 2MWT: p < 0.01, ρ=0.480). Multiple linear regression analysis identified disability and VO2peak as predictors of PA (p = 0.045; β=0.25 and p < 0.001; β=0.49). ConclusionSignificant associations of objective PA measurements using accelerometry with IPAQ were found only in pwMS with “mild disability”. In pwMS with “moderate to severe disability”, IPAQ did not reflect the objectively assessed amount of PA. In our cohort, GLTEQ showed no association with objectively assessed PA. Thus, an MS-specific self-reported questionnaire for assessing PA is warranted.