Objective Physical Activity Monitoring Research Articles

Feasibility of Remotely Monitoring Daily Physical Activity in Individuals with Acquired Brain Injury

<h3>Research Objectives</h3> Wearable physical activity monitors (PAM) are increasingly replacing traditional patient recall questionnaires to monitor physical activity in the community. Remote objective monitoring of physical activity is needed especially in the current times of the Covid-19 pandemic. While PAM are increasingly used in multiple populations, there is no information on the feasibility and challenges of using PAM to remotely monitor physical activity in individuals with acquired brain injury. The main goal of this research is to determine the usability, ease of use and identify challenges of using PAM for remotely monitoring objective physical activity in the community in individuals with acquired brain injury. <h3>Design</h3> Mixed methods research (4-weeks). <h3>Setting</h3> In the community (real-world). <h3>Participants</h3> Ten individuals with acquired-brain-injury (Stroke and TBI). <h3>Interventions</h3> All participants wore three (wrist, ankle, waist) ActiGraph GT9X Link PAM simultaneously for 4-weeks in the community and provided their feedback weekly. <h3>Main Outcome Measures</h3> Usability, ease of use, challenges. <h3>Results</h3> Participants rated all PAM to have good usability on the System Usability Scale. They gave the best possible score on the After Scenario Questionnaire after using the remote data hub which was used daily to transfer the data remotely to the research dashboard. Qualitative content analysis showed that most challenges reported were for wrist PAM and wear attachments were the most challenging aspect of using PAM in this population. <h3>Conclusions</h3> This research helps establish the framework and challenges of using PAM to remotely monitor objective physical activity in the community in individuals with acquired brain injury. Continuous monitoring of physical activity in the community is essential to evaluate the progress and the effect of rehab interventions and for tracking daily physical activity in individuals with acquired brain injury. <h3>Author(s) Disclosures</h3> No conflicts.

Postpartum blood pressure self-management following hypertensive pregnancy: protocol of the Physician Optimised Post-partum Hypertension Treatment (POP-HT) trial

IntroductionNew-onset hypertension affects approximately 10% of pregnancies and is associated with a significant increase in risk of cardiovascular disease in later life, with blood pressure measured 6 weeks postpartum predictive...

Classroom Movement Breaks Reduce Sedentary Behavior and Increase Concentration, Alertness and Enjoyment during University Classes: A Mixed-Methods Feasibility Study.

This mixed-methods study aimed to determine the feasibility of incorporating movement breaks into university classes in terms of acceptability (disruption, engagement, satisfaction), practicality (ease of scheduling and conducting breaks) and efficacy (sedentary time, concentration, alertness, enjoyment). Movement breaks of five to 10 min duration were scheduled after 20 min of sedentary time during 2-h classes. Classes without movement breaks were used as a comparison. Data were collected using surveys, objective physical activity monitoring and focus group interviews of students (n = 85) and tutors (n = 6). Descriptive statistics (quantitative data) and independent coding and thematic analysis (qualitative data) were completed. Students (mean age 23 ± 2 years, 69% female) actively engaged in movement breaks with no adverse events. Movement breaks were perceived to be beneficial for concentration, engagement and productivity. Timing of the break was perceived to be important to enhance the benefit and reduce disruption. Students preferred outdoor or competitive movement breaks. Students spent 13 min less time sitting (95%CI 10 to 17), took 834 more steps (95%CI 675 to 994) and had higher levels of concentration, alertness and enjoyment (p < 0.001) in classes with movement breaks compared to classes without. Classroom movement breaks are feasible and may be considered for incorporation into university classes to reduce sedentary behaviour and increase physical activity, alertness, concentration and enjoyment.

Optimization and Validation of a Classification Algorithm for Assessment of Physical Activity in Hospitalized Patients.

Low amounts of physical activity (PA) and prolonged periods of sedentary activity are common in hospitalized patients. Objective PA monitoring is needed to prevent the negative effects of inactivity, but a suitable algorithm is lacking. The aim of this study is to optimize and validate a classification algorithm that discriminates between sedentary, standing, and dynamic activities, and records postural transitions in hospitalized patients under free-living conditions. Optimization and validation in comparison to video analysis were performed in orthopedic and acutely hospitalized elderly patients with an accelerometer worn on the upper leg. Data segmentation window size (WS), amount of PA threshold (PA Th) and sensor orientation threshold (SO Th) were optimized in 25 patients, validation was performed in another 25. Sensitivity, specificity, accuracy, and (absolute) percentage error were used to assess the algorithm’s performance. Optimization resulted in the best performance with parameter settings: WS 4 s, PA Th 4.3 counts per second, SO Th 0.8 g. Validation showed that all activities were classified within acceptable limits (>80% sensitivity, specificity and accuracy, ±10% error), except for the classification of standing activity. As patients need to increase their PA and interrupt sedentary behavior, the algorithm is suitable for classifying PA in hospitalized patients.

Sex differences in the associations of physical activity and macronutrient intake with child body composition: A cross-sectional study of 3- to 7-year-olds in Samoa.

Overweight/obesity is prevalent among children in the Pacific Islands, but its aetiology is poorly understood. Few studies have considered body composition in addition to body mass index-based measures. To describe body composition among Samoan children and determine sex-specific associations among dietary intake, physical activity, and body composition. Body composition (percent body fat [%BF], lean mass, and trunk-to-peripheral fat ratio) of n = 83 Samoan children (3-7 y) was assessed using dual-energy X-ray absorptiometry. Children completed 7 days of objective physical activity monitoring. Mothers reported child nutritional intake using a 115-item food frequency questionnaire. Stepwise generalized linear regression was used to determine independent associations of nutritional intake and physical activity with body composition. Samoan children had higher average %BF than reported among other ethnic groups but lower trunk-to-peripheral fat ratios. In sex-stratified analyses, quartile of carbohydrate intake was negatively associated with %BF (β = -2.02 SE = 0.58; P < .001) in girls only. Among boys, physical activity (quartile of accelerometer counts per minute) was negatively associated with %BF (β = -1.66 SE = 0.55; P < .01). Sex differences in the associations among nutritional intake, physical activity, and body composition may be important to consider as interventions are developed to address overweight/obesity among Samoan children.

Comparing self-reported and objective monitoring of physical activity in Parkinson disease

IntroductionMonitoring physical activity is important in Parkinson disease (PD), but patient recall may be unreliable. We examined relationships between self-reported activity, objective monitoring, and clinical characteristics. MethodsParticipants completed the self-reported Physical Activity Scale in the Elderly (PASE) to determine subjective minutes of moderate-vigorous physical activity (MVPA); a subset wore an Actigraph monitor capturing step count and objective MVPA using a PD-specific algorithm. Relationships between subjective and objective measurements were determined using partial correlations controlling for age and disease stage. ResultsSixty-six subjects completed subjective reporting; median age (interquartile range [IQR]) was 70 (69–74) years and median disease duration (IQR) was 4 (1.5–7.5) years. Age-adjusted median PASE was 135.3. Median daily step count was 3615 (IQR 1772–4870), which was moderately well-correlated with PASE (ρ = 0.56, p = 0.003). Median MVPA was 8.1 min/day (IQR 2.2–23.2), which was not correlated with PASE (ρ = -0.003, p = 0.98). ConclusionsPhysical activity in this cohort of Veterans with PD is low and consists mostly of low-intensity steps rather than MVPA. The symptomatic and disease-modifying potential of lower intensity activity is uncertain. These data emphasize the need for interventions to increase MVPA in PD and the importance of objective monitoring using wearable technology.

Self-Reported and Objective Monitoring of Physical Activity in Parkinson Disease (P2.8-009)

Self-Reported and Objective Monitoring of Physical Activity in Parkinson Disease (P2.8-009)

Trial of Exercise to Prevent HypeRtension in young Adults (TEPHRA) a randomized controlled trial: study protocol

BackgroundHypertension prevalence in young adults has increased and is associated with increased incidence of cerebrovascular and cardiovascular events in middle age. However, there is significant debate regards how to effectively manage young adult hypertension with recommendation to target lifestyle intervention. Surprisingly, no trials have investigated whether lifestyle advice developed for blood pressure control in older adults is effective in these younger populations.Methods/DesignTEPHRA is an open label, parallel arm, randomised controlled trial in young adults with high normal and elevated blood pressure. The study will compare a supervised physical activity intervention consisting of 16 weeks structured exercise, physical activity self-monitoring and motivational coaching with a control group receiving usual care/minimal intervention. Two hundred young adults aged 18–35 years, including a subgroup of preterm born participants will be recruited through open recruitment and direct invitation. Participants will be randomised in a ratio of 1:1 to either the exercise intervention group or control group. Primary outcome will be ambulatory blood pressure monitoring at 16 weeks with measure of sustained effect at 12 months. Study measures include multimodal cardiovascular assessments; peripheral vascular measures, blood sampling, microvascular assessment, echocardiography, objective physical activity monitoring and a subgroup will complete multi-organ magnetic resonance imaging.DiscussionThe results of this trial will deliver a novel, randomised control trial that reports the effect of physical activity intervention on blood pressure integrated with detailed cardiovascular phenotyping in young adults. The results will support the development of future research and expand the evidence-based management of blood pressure in young adult populations.Trial RegistrationClinicaltrials.gov registration number NCT02723552, registered on 30 March, 2016.

Physical Activity Level Assessed by Accelerometer and PAQ-C in Tunisian Children

Background: Physical activity (PA) is an important agent in the prevention of chronic diseases such as obesity. Objectives: To provide preliminary data on PA among school children and to correlate the PA with weight status. Material and Methods: A total of 40 children aged between 8 and 11 years and attending Tunisian schools were recruited. The body composition was determined by using the deuterium oxide dilution technique. PA was determined by the PAQ-C (PA Questionnaire for Older Children). An objective monitoring of PA and sedentary time was achieved by using ActiGraph GT3X + accelerometers. Results: PAQ-C data demonstrate that 20% of the sample had light PA levels and 80% had moderate PA levels. Times spent in sedentary (62.37%) and light (30.80%) activities were higher than that spent in moderate and vigorous (6.83%) activities. Furthermore, almost half of the sample spent more than 60 min per day in moderate-to-vigorous intensity PA (MVPA). The average MVPA was significantly higher in normal weight than overweight and obese groups (67.68 ± 20.98 vs. 49.07 ± 19.09, p = 0.007). The proportion of overweight children who spent more than 60 min per day in MVPA was significantly higher than that of normal-weight (60.9 vs. 29.4%; p = 0.049). Conclusion: This study indicates that half of school children comply with the health-based guidelines for PA and sedentary behavior. Our findings also suggest that obesity was associated with decrease in PA in Tunisian children.

Arresting frailty and sarcopenia in cirrhosis: Future prospects.

Arresting frailty and sarcopenia in cirrhosis: Future prospects.

Apps and wearables for monitoring physical activity and sedentary behaviour: A qualitative systematic review protocol on barriers and facilitators.

ObjectiveMonitoring of physical activity and sedentary behaviours by mobile phone applications (apps) and wearable technology (wearables) may improve these health behaviours. This systematic review aims to synthesise the qualitative literature on the barriers and facilitators of using apps and wearables for monitoring physical activity and/or sedentary behaviour in adults.MethodsThis review protocol is registered in PROSPERO (CRD42017070194). Scientific databases including CINAHL Complete, MEDLINE, PsycINFO, SPORTDiscus, Cochrane Library and Scopus will be searched for relevant studies published from 1 January 2012 to the date the searches are conducted. Studies will be included if they incorporated adults who used an app or wearable for monitoring physical activity and/or sedentary behaviour; explored the barriers and/or facilitators of using an app and/or wearable; and were published in English. Following duplicate screening of titles and abstracts, full texts of potentially eligible papers will be screened to identify studies using qualitative approaches to explore barriers and facilitators of using apps and/or wearables for monitoring physical activity and/or sedentary behaviour. Discrepancies will be resolved through consensus or by consulting a third screener. Relevant excerpts (quotes and text) from the included papers will be extracted and analysed thematically. The Critical Appraisal Skills Programme Qualitative Research Checklist will be used to appraise included studies.ConclusionThe results of this work will be useful for those intending to monitor physical activity and/or sedentary behaviour using these technologies.

Pain worsening with physical activity during migraine attacks in women with overweight/obesity: A prospective evaluation of frequency, consistency, and correlates.

Background Migraine is a neurological disease involving recurrent attacks of moderate-to-severe and disabling head pain. Worsening of pain with routine physical activity during attacks is a principal migraine symptom; however, the frequency, individual consistency, and correlates of this symptom are unknown. Given the potential of this symptom to undermine participation in daily physical activity, an effective migraine prevention strategy, further research is warranted. This study is the first to prospectively evaluate (a) frequency and individual consistency of physical activity-related pain worsening during migraine attacks, and (b) potential correlates, including other migraine symptoms, anthropometric characteristics, psychological symptoms, and daily physical activity. Methods Participants were women (n = 132) aged 18-50 years with neurologist-confirmed migraine and overweight/obesity seeking weight loss treatment in the Women's Health and Migraine trial. At baseline, participants used a smartphone diary to record migraine attack occurrence, severity, and symptoms for 28 days. Participants also completed questionnaires and 7 days of objective physical activity monitoring before and after diary completion, respectively. Patterning of the effect of physical activity on pain was summarized within-subject by calculating the proportion (%) of attacks in which physical activity worsened, improved, or had no effect on pain. Results Participants reported 5.5 ± 2.8 (mean ± standard deviation) migraine attacks over 28 days. The intraclass correlation (coefficient = 0.71) indicated high consistency in participants' reports of activity-related pain worsening or not. On average, activity worsened pain in 34.8 ± 35.6% of attacks, had no effect on pain in 61.8 ± 34.6% of attacks and improved pain in 3.4 ± 12.7% of attacks. Few participants (9.8%) reported activity-related pain worsening in all attacks. A higher percentage of attacks where physical activity worsened pain demonstrated small-sized correlations with more severe nausea, photophobia, phonophobia, and allodynia (r = 0.18 - 0.22, p < 0.05). Pain worsening due to physical activity was not related to psychological symptoms or total daily physical activity. Conclusions There is large variability in the effect of physical activity on pain during migraine attacks that can be accounted for by individual differences. For a minority of participants, physical activity consistently contributed to pain worsening. More frequent physical activity-related pain worsening was related to greater severity of other migraine symptoms and pain sensitivity, which supports the validity of this diagnostic feature. Study protocol ClinicalTrials.govIdentifier: NCT01197196.

Accuracy of physical activity recognition from a wrist-worn sensor

Purpose: The EU-funded project “selfBACK” (http://www.selfback.net/) will utilise continuous objective monitoring of physical activity (PA) by a wrist-mounted wearable, combined with self-monitoring of symptoms and case-based reasoning. Together these will provide personalised self-management plans to people with low back pain via a novel digital health intervention. The purpose of this study was to determine the accuracy of PA recognition via wrist-mounted sensors compared to thigh-mounted sensors. Thigh or hip-mounted sensors have previously been shown to be the most accurate placement for single sensor-based PA monitoring. However, long-term adherence may be greatly enhanced with a less obtrusive wrist-worn sensor. It was therefore important to compare both locations.

Young people’s perceptions of the objective physical activity monitoring process: A qualitative exploration

Objective: To explore young people’s perceptions of pedometers and investigate behaviours exhibited while being monitored. Design: Qualitative design using six focus groups with participants (mean age 14.7 years). Setting: Study participants ( n = 24) were randomly selected from a previous study of 123 young people aged 14–15 years from three secondary schools in New South Wales (NSW), Australia. Methods: Participants wore pedometers (Yamax CW700) and accelerometers (ActiGraph GT3X+) simultaneously for 7 days. Accelerometer output was used to categorise participants into one of six focus groups (three boys groups and three girls groups): (1) low active (&lt;30 minutes moderate to vigorous physical activity [MVPA]/day), (2) medium active (30–60 minutes MVPA/day), and (3) high active (≥60 minutes MVPA/day). Participants were questioned on their perceptions of the monitoring process and the behaviours that they exhibited while wearing pedometers. A hybrid approach to data analysis identified key concepts, which were thematically analysed. Results: The two main themes identified were (1) participants’ perceptions of the monitoring process and (2) behaviour exhibited while being monitored. Overall, participants’ attitudes towards objective monitoring were positive. A large proportion reported changing their levels of physical activity during the monitoring process, and 87.5% of focus group participants reported shaking their pedometers to increase their step counts. The medium and high active groups reported changing their activity patterns more than the low active groups. Conclusion: Our findings are consistent with previous quantitative studies that suggest reactivity and tampering are commonplace among young people. Pedometers may have more utility as an intervention strategy for increasing activity rather than as a method for assessing habitual activity levels.

The Objective Monitoring of Physical Activity

Epidemiologists have long recognized the significant limitations of physical activity questionnaires. Advances in the development of objective monitoring devices such as accelerometers have spurred hopes of defining more accurately the relationships between habitual physical activity and chronic disease. As yet, realization of these objectives has been curbed by the failure of accelerometers to record important sources of energy expenditure and the limitation of sample size by labor-intensive checking of output data for artifacts. But in the near future, more complex devices that link the measurement of body accelerations to other phenomena such as posture and GPS location, together with computer-assisted checking of records and processing of data may earn objective monitoring a key place in large-scale epidemiological investigations.

Physical Activity in Bariatric Surgery Patients: Does Temperament Matter?

Our aim was to investigate if physical activity (PA) in bariatric surgery patients is related to temperament. Preoperative (n = 70) and post-operative (n = 73) patients were categorized as being physically 'active' versus 'inactive' on the basis of objective PA monitoring. Assessment included the behavioural inhibition system (BIS)/behavioural activation system (BAS) scales, the effortful control (EC) subscale of the Adult Temperament Questionnaire-Short Form, a numeric pain rating scale and measures for depressive and eating disorder symptoms. 'Active' did not differ from 'inactive' patients with regard to temperament (BIS, BAS, and EC). Regressions with PA grouping as dependent variable (adjusted for age, gender, body mass index (BMI), depressive or eating disorder symptoms, or pain intensity) indicated an association between lower BMI and more PA in the preoperative and the post-operative group. In the post-operative group, in addition to lower BMI, also lower age and higher BIS reactivity contributed to more PA. Furthermore, there was a significant interaction between BMI and BIS suggesting that low BMI was only associated with more PA in post-operative patients with high BIS. The results indicate that temperament per se does not contribute to the level of PA in bariatric surgery patients. However, in post-operative patients, lower BMI was associated with a higher likelihood of being physically active particularly in patients with anxious temperament. These preliminary findings need further investigation within longitudinal studies. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

SlamTracker Accuracy under Static and Controlled Movement Conditions

Abstract Accelerometry is the de facto standard in objective physical activity monitoring. However traditional accelerometer units undergo proprietary pre-processing, resulting in the ‘black-box’ phenomenon, where researchers are unaware of the processes and filters used on their data. Raw accelerometers where all frequencies related to human movement are included in the signal, would facilitate novel analyses, such as frequency domain analysis and pattern recognition. The aim of this study was to quantify the mean, standard deviation and variance of the SlamTracker raw accelerometer at a range of speeds. Four tri-axial accelerometers underwent a one minute static condition test nine movement condition tests. Accelerometers were assessed for mean, standard deviation, sample variance and coefficient of variation throughout in all axes for all experimental conditions. The sample variance was &lt;0.001g across all speeds and axes during the movement condition tests. In conclusion, the SlamTracker is shown to be an accurate and reliable device for measuring the raw accelerations of movement.

Changes in enjoyment, self-efficacy, and motivation during a randomized trial to promote habitual physical activity adoption in bariatric surgery patients

BackgroundThe Bari-Active trial found that a physical activity (PA) intervention (PAI), versus standard presurgical care control (SC), produced significant increases in daily bout-related moderate-to-vigorous PA (MVPA, in≥10-min bouts) preoperatively. The present study examined whether PAI also produces superior improvements in psychological and/or motivational processes that may be important for PA adoption. ObjectivesCompare PAI and SC on baseline to postintervention changes in PA-related enjoyment, self-efficacy, and motivations, and examine whether greater bout-related MVPA changes are associated with greater improvements in these variables. SettingUniversity hospital, United States. MethodsParticipants (87% female; body mass index = 45.0±6.5 kg/m2) were randomly assigned to 6 weeks of PAI (n = 40) or SC (n = 35). PAI received weekly counseling sessions to increase daily walking exercise. At baseline and postintervention, both groups completed 7-day objective PA monitoring and questionnaires to evaluate changes in bout-related MVPA and PA enjoyment, self-efficacy, and motivation. ResultsRetention was 84% at postintervention. Intent-to-treat analyses showed that PAI on average reported more favorable changes than SC in PA enjoyment, self-efficacy, amotivation (i.e., lack of PA motivation), and identified and intrinsic regulations (i.e., more autonomous PA motivations; P<.01). In PAI completers (n = 33), changes in bout-related MVPA and psychological/motivational variables were unrelated. ConclusionPAI produced greater improvements in PA-related enjoyment, self-efficacy, and motivations than SC. The lack of association between objectively measured PA changes and psychological/motivational processes highlights the need for future research to identify which processes are most important for PA adoption and maintenance in bariatric surgery patients, and to determine whether the method used to measure PA affects the pattern of association.

Camden active spaces: Does the construction of active school playgrounds influence children's physical activity levels? A longitudinal quasi-experiment protocol

IntroductionPhysical activity is essential for every facet of children's health. However, physical activity levels in British children are low. The school environment is a promising setting to increase children's physical...

Using Pedometers for Measuring and Increasing Physical Activity in Children and Adolescents

The science and practice of step counting in children (typically aged 6-11 years) and adolescents (typically aged 12-19 years) has evolved rapidly over a relatively brief period with the commercial availability of research-grade pedometers and accelerometers. Recent reviews have summarized considerations for assessing physical activity using pedometers in young people (both children and adolescents), but 3 areas have received little attention: pedometer monitoring protocols, minimal (as opposed to optimal) step counts necessary for maintaining basal levels of health, and appropriate pedometer-based interventions for young people. Therefore, the objective of this review was to evaluate the current evidence and identify future research directions in these areas. The challenges of objective monitoring of physical activity in children and adolescents reinforce the importance of using protocols that minimize participant burden and the potential for tampering/reactivity. Evidence for a sedentary lifestyle cut point is limited; researchers are therefore encouraged to investigate several cut points (ie, &lt;5000, &lt;6000, &lt;7000 steps/d) in children and adolescents to identify the health consequences of very low levels of ambulatory activity. Personalized messages may be necessary for health behavior change in pedometer-based interventions, but there is a need for more high-quality studies to develop the existing evidence base.