Optimal Level Of Physical Activity Research Articles

Self-assessment by doctors and patients of their adherence to a healthy lifestyle and their readiness to modify behavioral risk factors of cardiovascular diseases

Background. Poor adherence to risk factor behaviors management increases the risk for a further cardiac event. Unfortunately, poor adherence to behaviors recommended in lifestyle interventions is widespread, particularly over the long-term; thus, the “adherence problem” represents a significant challenge to the effectiveness of these interventionsObjective: The goal of the trial was the assessment of patient’s and physician’s attitude to a healthy lifestyle and evaluation of their stage of readiness for change in dealing with unhealthy behavior with the goal of cardiovascular disease risk factors modification particularly smoking cessation, physical activity, healthy dietMethods: We performed a poll of 158 patients who visited the outpatient clinic of the State Institution of Sciences “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department with the purpose of preventive services and of 65 physicians – employees of our clinic – about their adherence to healthy lifestyle habits. As the determination of the readiness to deal with an unhealthy behavior allows making individualized preventive counseling, we used a special questionnaire for standardizing approaches to determining the stage of change of three major behavioral risk factors of cardiovascular diseases – smoking, unhealthy diet, and low level of physical activity. The readiness to change was identified according to the Transtheoretical Model (TTM) of Behavior Change. The results of physicians questionnaire (n=65) were compared to the results of patients questionnaire (n=158). Results. Most of the participants – 87,3±2,6 % of patients and 93,6±3,1 % of physicians – were non-smokers. Only 26,6±3,5 % of patients and 20,6±5,1 % of physicians reported following a healthful diet and only 8,9±2,3% of patients and 20,6±5,1 % of physicians perform regular physical activity. The prevalence of optimal level of physical activity among physicians was significantly higher (p<0,05). 72,5± 6,3 % of physicians were on action stage in the matter of healthy diet and 74±6,2 % – in the matter of physical activity regimen, it was significantly higher (р < 0,05) that among patients – 45,7±4,6 % and 41,0±4,1% respectively. Conclusions: Our findings highlight poor adherence to healthy lifestyle habits among physicians and patients, especially in the matter of healthy eating and optimal level of physical activity, and needs for targeted strategies that improve long-term adherence to health behaviors and enhance physician’s knowledge about lifestyle-based health promotion interventions.

Discapacidad y nivel de actividad física. Barranquilla, Colombia. 2017

Introducción: la actividad física es una estrategia emanada desde la OMS, para el control del riesgo cardiovascular relacionado con el sedentarismo especialmente en condiciones que pueden ser vulnerables como es el caso de la discapacidad, especialmente física. Objetivo: determinar el nivel de actividad física de un grupo de personas en condición de discapacidad en Barranquilla, Colombia. Materiales y métodos: estudio descriptivo-observacional de corte transversal se trabajó con población diana (60 individuos) que acudían a un escenario deportivo de Barranquilla. Se utilizó el Global Physical Activity Questionnaire. Se hizo análisis de estadísticas descriptivas con el software Epi Info 7.2.2.6. Resultados: la edad promedio fue 36 años; 85 % eran hombres y 15 %, mujeres; procedentes de estratos 1, 2 y 3, con mayor participantes del estrato 2 (48 %). Con respecto al nivel de actividad física, la mayoría de los individuos se ubicó en nivel vigoroso (38 %), seguido de nivel bajo (35 %) y nivel moderado (27 %). El 65 % de los individuos en situación de discapacidad tenía un nivel de actividad física óptimo que favorece su condición de salud. Conclusiones: la población objeto de estudio se caracterizó por ser de bajos recursos económicos pero además con barreras para la adopción de estilos de vida saludable, a pesar de ello presentan un alto nivel de actividad física, lo que indica que el estrato social y la discapacidad no son impedimentos para la práctica de la actividad física.

A study of physical activity levels of pregnant women using the Polish version of Pregnancy Physical Activity Questionnaire (PPAQ-Pl).

The aim of the present study was to determine the optimal level of physical activity during pregnancy and discuss whether and to what extent biological, social and demographic variables affect the level of total physical activity in studied women. The respondents were 267 pregnant women from Poland aged 28.16 ± 4.67 years. The majority of women under study had a higher and a secondary education and lived in villages near Poznań, i.e. a large urban agglom- eration in Poland. Most of the women were in the first or second pregnancies, at the mean gestational age of 24th week. The study used the Polish version of PPAQ questionnaire to determine the weekly energy expenditure (MET hour/week -1) (Krzepota, Sadowska 2017). The respondents self-assessed their physical activity levels by filling in a questionnaire consist- ing of 33 items grouped into the following activity categories: household/caregiving (15 items), occupational (5 items), sports/exercises (7-9 items), transportation (3 items), and inactivity (3 items). Pregnant women prefer physical exercises of low and moderate intensity. The test results indicated a significant im- pact of variables such as age, trimester of pregnancy, and number (sequence) of pregnancies on the women's physical activity. The results of the present study confirm that actions propagating active lifestyles among pregnant women are necessary. It also appears that the recommendations of the Polish Society of Gynecologists and Obstetricians regarding the physical activity of pregnant and postnatal women require adjustments and improvements.

Relationships between maternal characteristics and infant birth weight.

Nowadays, the importance of infant birth weight (IBW) as a key factor in determining the future of physical and mental development of children is a growing concern. The purpose of this paper is to investigate the relationship between maternal characteristics and IBW among pregnant women who were referred to health centers in Qazvin city in the year 2016. A descriptive-analytical study was conducted among pregnant women in 28-36 weeks of gestation who referred to healthcare centers and facilities affiliated by the Qazvin University of Medical Sciences in April-June 2016. The associations between maternal physical activity, mothers' socioeconomic status and birth weight were examined by SPSS Software Package version 16 through linear and logistic regression tests. Linear regression modeling suggested that maternal weight (p=0.001), income (p=0.04), gestational age of delivery (p=0.00) and pre-pregnancy BMI (p=0.02) were positively associated with birth weight, while occupational and heavy physical activity (p=0.003 and 0.008, respectively) were negatively associated with IBW. In this study, low birth weight infants are compared to those with normal weight belonged to mothers who have spent more time in doing heavy physical activities (OR=1.11, 95% CI 1.01-1.23). Also infants with low birth weight compared to others in the normal weight category were born from mothers with lower pre-pregnancy BMI (OR=0.65, 95% CI 0.62-0.78), gestational age of delivery (OR=0.82, 95% CI 0.79-0.86), maternal weight (OR=0.86, 95% CI 0.84-0.88) and income (OR=0.79, 95% CI 0.69-0.83). The study findings revealed that certain maternal characteristics could play a significant role in IBW. Despite the importance, in most of developing countries (particularly Iran), future mothers are not advised about an appropriate weight gain during pregnancy or the optimal level of physical activity in such a period of time. Therefore, counseling pregnant women and giving them proper information on appropriate perinatal care would be helpful in order to have pregnancies with optimal outcomes. The authors applied several statistical methods to analyze IBW among mothers with different maternal characteristics and predict birth weight based on contributing factors.

Abstract TP527: Baseline Physical Activity Profiles in CREST-2 Trial Participants

Background: The importance of physical activity in preventing major vascular events has received increased attention in the past decade. Due to the inclusion of the INTERVENT lifestyle modification program, the CREST2 trial provides a unique opportunity to study physical activity profiles in patients with severe asymptomatic extracranial carotid stenosis. Hypothesis: Based on data from a trial of intracranial stenosis patients, we aimed to evaluate the hypothesis that <40% of carotid stenosis subjects will have optimal physical activity levels. We also assessed key subgroups to determine patterns of physical activity. Methods: We analyzed 1087 CREST2 participants with baseline data on physical activity. The Physician-based Assessment and Counseling for Exercise (PACE) score is recorded for each patient and dichotomized as “in target” (4-8 points) or “out of target” (<4 points). A PACE score of <4 indicates a subject who does not engage in regular exercise. Results are analyzed for the entire trial. Chi square testing and t-tests were performed for evaluation of subgroup differences. Results: The mean age of the study population is 69.5±7.8 years (60% male). The median PACE score at baseline is 4.0 (mean 3.8±2.1; IQR 2 to 6). The Table shows baseline characteristics of patients by mean PACE score. Being male, not having diabetes mellitus, having a body mass index <30kg/m2, being a non-smoker, and not having a history of peripheral arterial disease were associated with significantly higher mean PACE scores (P<0.01). Conclusions: We have defined several patient groups with asymptomatic carotid stenosis that have suboptimal physical activity. These results provide opportunities for targeted efforts to improve primary stroke prevention. These baseline data will also allow investigators to determine if trial involvement and the INTERVENT program leads to improvement in the level of physical activity.

Physical activity among indigenous Australian children and youth in remote and non-remote areas

Sport and physical activity (PA) hold particular significance in Australian Indigenous communities, and have the potential to address many of the health and education challenges faced by Indigenous communities. Optimal levels of PA are an important foundation in efforts to build healthy communities and reduce social disadvantage experienced to date. Yet little evidence relating to the current levels of PA within these communities, or the relationship between PA and outcomes, has been available.Drawing on national survey data from the Australian Bureau of Statistics, we examine levels of PA in the Australian Aboriginal and Torres Strait Islander Health Survey 2012-13. These data describe PA levels among Indigenous Australians, aged 5–17 years, in remote and non-remote communities. We also examine the relationship between PA and participation in education and self-reported health among 15–17 year olds.Overall, participation rates appear to be high, with 64–84% of youth reporting at least 60 min of PA on the previous day. A gender gap was also evident, with lower levels of activity among girls. PA decreased with age, particularly at or around the age of puberty. There were no significant associations between PA and either self-reported health or engagement in study. There was a relationship between high PA and low area-level socio-economic status in remote areas, but no association in non-remote areas.The differences between remote and non-remote areas highlight the importance of disaggregated analysis of Indigenous populations and are consistent with qualitative studies identifying locally contextualised factors influential in promoting PA.

Abstract P276: Activity Tracker Increases Daily Step Count Post-Cardiac Rehabilitation Compared to Placebo Device

Introduction: Despite optimal levels of physical activity (PA) among patients immediately post-cardiac rehabilitation, little is known about PA levels long-term. Further, interventions to maintain recommended PA levels and functional capacity achieved during cardiac rehabilitation are lacking. Objective: To test the effect of wearing a Garmin vÍvofit for 3 months post-cardiac rehabilitation on PA levels and functional capacity compared to a placebo device. Methods: Change in daily step count and 6-minute walk test (6MWT) were assessed over 3 months using the vÍvofit activity tracker in 35 patients (mean age 62±8 years; 83% male; 94% Caucasian) post-cardiac rehabilitation. Goal was 10,000 steps for all participants. Patients were randomized into the control or intervention group with control devices displaying a digital clock. VÍvofit step data were recorded continuously; the 6MWT was conducted at 0, 9, 12, and 15 weeks. Comparisons between the 2 groups were made using test of proportions, t-test, and logistic and linear regression. Results: Control and intervention groups were balanced with respect to age, gender, education, baseline step count, and body composition. Although all participants exhibited above average daily step counts (>8,000 steps at 3, 9, and 15 weeks); step counts for intervention group participants were higher at 3, 9, and 15 weeks (by 2,537 steps, 2,022 steps, and 1,545 steps, respectively). Intervention group participants (N=17) increased the distance covered during the 6MWT by 138 feet (sd=28), compared to a 48 foot (sd=18) improvement among control group participants (p=0.500); although not statistically significant, but perhaps clinically relevant. Conclusion: These data provide preliminary support for using wrist-worn activity tracking devices to continuously monitor and maintain PA levels post-cardiac rehabilitation. There is a need for larger trials testing the effectiveness of these devices with a more diverse sample over a longer period of time. Wrist worn activity tracking devices should be coupled with other components known to support long-term behavior change (e.g., social support and text messaging) to develop effective interventions for secondary cardiovascular disease prevention.

Abstract MP31: State-Level Impact of Low Physical Activity on All-Cause Disease Burden

Introduction: While a consensus for the beneficial effects of physical activity exists, the optimal level of exercise and its effect on the disease burden across all states of the United States has not been evaluated. Objective: To systematically quantify the attributable burden to physical inactivity in all states of the United States by age, sex, year, and cause. Methods: We obtained data on categorical prevalence of domain-specific and total physical activity levels from nationally or subnationally representative surveys. Risk-outcome effect sizes of total physical activity were gathered from a meta-analysis of prospective cohort studies. The optimal level of physical activity was determined based on the activity levels associated with lowest risk of mortality in prospective observational studies. A comparative risk assessment analysis then quantified the proportion of death and disability attributable to low physical activity. The variation of physical activity levels and its associated burden was further evaluated across each state of the United States. Results: In 2016, physical inactivity accounted for 87 (95% UI: 122.6- 44.5) thousand DALYs in the United States (84.4% from CVD, 9.1% from DM, and 6.5% from cancers), with 59% of DALYs coming from men and 41% in women. Only 5 states (WY, ME, MT, AK, VT) demonstrated mean total physical activity levels above our suggested physical activity level of 3500 MET-mins per week. The highest burden attributable to physical activity was seen in Mississippi, while the lowest was seen in Colorado (955 & 458 DALYs per 100,000, respectively). Conclusion: Our findings suggest that population inventions to increase physical activity at the population level could save hundreds of thousands of life years across the United States.

Association of Coloproctology of Great Britain & Ireland (ACPGBI): Guidelines for the Management of Cancer of the Colon, Rectum and Anus (2017) - Follow Up, Lifestyle and Survivorship.

Association of Coloproctology of Great Britain & Ireland (ACPGBI): Guidelines for the Management of Cancer of the Colon, Rectum and Anus (2017) - Follow Up, Lifestyle and Survivorship.

Daily Total Physical Activity and Incident Stroke: The Japan Public Health Center-Based Prospective Study.

There is limited evidence on the association between total physical activity and stroke in Asian populations experiencing a greater burden of hemorrhagic stroke than Western populations. We aimed to understand their optimal level of physical activity for stroke prevention. A total of 74 913 Japanese people 50 to 79 years of age without histories of cardiovascular disease or cancer were followed from 2000 to 2012. During the 698 946 person-years of follow-up, we documented a total of 2738 incident cases of stroke, including 1007 hemorrhagic strokes (747 intraparenchymal and 260 subarachnoid hemorrhages) and 1721 ischemic strokes (1206 nonembolic and 515 embolic infarctions). Individuals in the second or third metabolic equivalents of task-hours per day quartile had the lowest risks of total stroke (hazard ratio [HR], 0.83; 95% confidence interval [CI], 0.75-0.93), intraparenchymal hemorrhage (HR, 0.79; 95% CI, 0.64-0.97), subarachnoid hemorrhage (HR, 0.78; CI, 0.55-1.11), and nonembolic infarction (HR, 0.78; CI, 0.67-0.92), whereas those in the fourth quartile had the lowest risk of embolic infarction (HR, 0.76; CI, 0.59-0.97). Cubic spline graphs revealed a steep decrease in stroke risk (30% risk reduction) from the lowest level to a plateau at 5 to 10 metabolic equivalents of task-hours per day (50th percentile). The associations of total physical activity level with hemorrhage stroke showed U or J shape, which were because of vigorous-intensity activities, whereas the association with ischemic stroke showed L shape. For Japanese people, moderate levels of total physical activity, particularly achieved by moderate-intensity activities, may be optimal for stroke prevention because excessive vigorous-intensity activities might not be beneficial or even disadvantageous for prevention of hemorrhagic stroke.

Exercise Preferences and Perceived Benefits and Barriers of Physical Activity among US Veterans with PTSD

Objective: Veterans are at an increased risk for Posttraumatic Stress Disorder (PTSD) and are less likely to respond to traditional PTSD treatments. Exercise has not been extensively studied in veterans, but there is increasing evidence that exercise interventions can be implemented as an adjunctive treatment for the management of PTSD. The purpose of this study was to determine levels of physical activity, perceived barriers to exercise, and specific exercise preferences among veterans with PTSD. Method: Ninety-seven veterans (83% male, mean age of 56.6 years) currently receiving PTSD treatment completed a brief survey of their current exercise practices and preferences. Results: Approximately half (47.4%) of veterans reported exercising regularly during the last 3 months, and 32% of veterans reported no physical activity at all. The majority of inactive veterans expressed interest in initiating an exercise program. Perceived barriers to exercise included: not having enough energy, feeling unmotivated, not having anyone to exercise with, not enough spare time, being overweight, and not being able to keep up. Inactive veterans reported the following exercise preferences: exercising with friends, exercising at the VA hospital, and exercising with structured/supervised help. Conclusions: Findings suggest that while veterans with PTSD are not engaging in optimal levels of physical activity, they are interested in initiating an exercise program. In addition, the identified barriers and specific exercise preferences may help inform the development of effective, adjunctive physical activity programs for veterans with PTSD.

Predictive Relationship Between Body Mass Index and TGMD-3 Performance in Disadvantaged Children

Acquiring motor skills are an important part to childhood development. The better a child is able to develop their motor skills the more likely they will be able to utilize the skills and participate in optimal levels of physical activity. PURPOSE: The purpose of this study was to assess the predictive relationship between BMI classification and gross motor skills assessed using the TGMD-3 instrument in a sample of ethnic minority elementary school-aged children from low-income families. METHOD: The participants were a convenience sample of 525 children (Mean age = 9.4 ± 1.8 years; 1st - 6th grades; 246 girls, 279 boys; 93% low-income; 86% ethnic minority) recruited from a Title I school located in a metropolitan area from the Mountain West region of the U.S. Motor skills were assessed using the TGMD-3 instrument during physical education classes in the Fall of 2015. Height and weight measurements were recorded approximately 2 weeks prior to assessing motor skills. BMI was stratified into underweight (<18.5 kg/m2), healthy weight (18.5−25 kg/m2; reference) and overweight or obese (>25 kg/m2) categories. Multi-level mixed-effects models were used to examine the predictive relationship between BMI classification and performance on the locomotor sub-test, ball skill sub-test, and total TGMD-3 scores controlling for grade level, sex, and the clustering of students within classrooms. Alpha level was adjusted using the Bonferroni method because of multiple dependent variables. RESULTS: Children who were overweight or obese performed 8.6 points lower on the TMGD-3 compared to children who had healthy BMI (β = −8.6, p < 0.001) and performed 5.9 points lower on the locomotor sub-test compared to children who had healthy BMI (β = −5.9, p < 0.001) after controlling for grade level, sex, and classroom-level clustering. There were no significant predictive relationships between BMI classification and the ball skill sub-test scores (p > 0.01). CONCLUSION: Overweight and obese disadvantaged children tended to have poorer performance on the locomotor sub-test of the TGMD-3 compared to children with a healthy BMI, suggesting the importance of learning these fundamental skills at an early age.

Prediction of Optimal Daily Step Count Achievement from Segmented School Physical Activity in Children

Optimizing physical activity in childhood is needed for prevention of disease and for healthy social and psychological development. There is limited research examining how segmented school day physical activity patterns relate to a child achieving optimal physical activity levels. PURPOSE: The purpose of this study was to examine the predictive relationship between step counts taken during specific school segments and achieving optimal school (6,000 steps/day) and daily (12,000 steps/day) step counts in children. METHODS: Participants included 1,714 school-aged children (Mean age = 9.7 ± 1.0 years) recruited across six elementary schools from the Mountain West Region of the U.S. Physical activity (step counts) was monitored for one school week using the Yamax SW-200 pedometer. Steps counts were recorded during each school segment (i.e., recesses, lunch, activity breaks, and physical education), during the entire school day between the hours of 8am and 3pm, and during the entire day between wakeup and going to bed for five days. Generalized linear mixed effects models were used to determine the adjusted odds ratios (ORs) of achieving both school and daily step count standards for every 1,000 steps taken during each school segment. RESULTS: The school segment that related strongest to a student achieving 6,000 steps during school hours was afternoon recess (OR = 40.03; P < 0.001) and for achieving 12,000 steps for the entire day was lunch recess (OR = 5.03; P < 0.001). CONCLUSION: The school segment that related the strongest to achieving the school step count cut-point was afternoon recess and the school segment that related the strongest to achieving the daily step count cut-point was lunch recess. School segments including lunch and afternoon recess play an important role for optimizing daily physical activity in children.

Habitual physical activity levels predict treatment outcomes in depressed adults: A prospective cohort study

ObjectiveExercise is an efficacious stand-alone therapy for mild-to-moderate depression, but little is known about the influence of physical activity levels on responses to depression treatment. This study aimed to prospectively assess the association between self-reported habitual physical activity levels and depression severity following a 12-week intervention. Method629 adults (75% women; aged 18–71years) with mild-to-moderate depression were recruited from primary care centres across Sweden and treated for 12weeks. The interventions included internet-based cognitive behavioural therapy (ICBT) and ‘usual care’ (CBT or supportive counselling). One third of all participants were taking anti-depressant medication. The primary outcome was the change in depression severity assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS). Habitual physical activity levels were self-rated and based on the estimated frequency, duration and intensity of total physical activity, including planned exercise, ‘during a typical week’. Prospective associations were explored using linear regression models (percentage change) with 95% confidence intervals (CI's). ResultsFollowing adjustment for relevant covariates, high levels of habitual physical activity were associated with larger relative reductions in depression severity compared to low physical activity (β=−9.19, 95% CI=−18.46, −0.09, p=0.052) and moderate physical activity (β=−10.81, 95% CI=−21.09, −0.53, p<0.05), respectively. ConclusionAdults who routinely engage in high levels of physical activity respond more favourably to CBT-focused depression treatments than adults who engage in low-to-moderate levels of activity. The optimal level of physical activity associated with reductions in depression severity corresponds to consensus recommendations for maximizing general health. One limitation is the use of self-reported physical activity data.

Gender Differences of Behavioral Risk Factors in Saint-Petersburg Inhabitants

In developed countries there are significant gender differences in lifetime expectancy that can be explained by behavioral risk factors (RF). The aim of our study was to estimate gender features of behavioral RF in general population of Saint-Petersburg, Russia. As a part of all-Russian epidemiology survey ESSE-RF a random sampling of 1600 Saint-Petersburg inhabitants (25-64 y.o.) stratified by age and sex was performed. All participants filled in the questionnaire. Anthropometry (weight, height, body-mass index (BMI), waist circumference (WC) and fasting blood-tests (lipids, glucose by Abbott Architect 8000 (USA)) were performed. There were examined 573 (36%) men and 1027 (64%) women. No gender differences in obesity were found according to BMI criteria--in 178 (31.2%) women and 352 (35.1%) men. Obesity was more often detected in females according to WC criteria: ATPIII--44.1 vs 30.3%; IDF 51.2 vs 66.4% (p < 0.001 for both). Linear regression analysis was performed and age was associated with BMI--1.6 kg/m2/decade, WC in women--5.2 cm/decade and WC in men--2.8 cm/decade, p < 0.001 for all anthropometric parameters. Optimal level of physical activity was equally documented in both genders--540 (61.2%) women and 286 (58.9%) men. Daily intake of sweets was lower in men--228 (39.8%) vs 539 (52.5%) in women (p < 0.001). 810 (50.6%) of trial subjects were non-smokers, 395 (24.7%) were former smokers, and 395 (24.7%) were smokers at the moment of trial. The higher number of female smokers was observed--194 (19.1%). A high prevalence of obesity is observed in sample of Saint-Petersburg inhabitants--it is higher among women according to WC criteria regardless of menopause, possibly due to bigger sweets consumption. Males smoke more often and consume less fresh fruits and vegetables which is accompanied by a higher prevalence of hyperglycemia and hypertriglyceridemia.

Behaviour change interventions to promote physical activity in rheumatoid arthritis: a systematic review.

Research has shown that people who have rheumatoid arthritis (RA) do not usually participate in enough physical activity to obtain the benefits of optimal physical activity levels, including quality of life, aerobic fitness and disease-related characteristics. Behaviour change theory underpins the promotion of physical activity. The aim of this systematic review was to explore behaviour change interventions which targeted physical activity behaviour in people who have RA, focusing on the theory underpinning the interventions and the behaviour change techniques utilised using specific behaviour change taxonomy. An electronic database search was conducted via EBSCOhost, PubMed, Cochrane Central Register of Controlled Trials and Web of Science databases in August 2014, using Medical Subject Headings and keywords. A manual search of reference lists was also conducted. Randomised control trials which used behaviour change techniques and targeted physical activity behaviour in adults who have RA were included. Two reviewers independently screened studies for inclusion. Methodological quality was assessed using the Cochrane risk of bias tool. Five studies with 784 participants were included in the review. Methodological quality of the studies was mixed. The studies consisted of behaviour change interventions or combined practical physical activity and behaviour change interventions and utilised a large variety of behaviour change techniques. Four studies reported increased physical activity behaviour. All studies used subjective methods of assessing physical activity with only one study utilising an objective measure. There has been varied success of behaviour change interventions in promoting physical activity behaviour in people who have RA. Further studies are required to develop and implement the optimal behaviour change intervention in this population.

Effect Of Spark On Physical Activity, Cardiorespiratory Endurance, And Motivation In Middle-school Students

Optimal levels of physical activity (PA) during physical education (PE) are essential to promote health and wellbeing among children and adolescents. Additional evidence for the effectiveness of newly popular programs such as the Sports, Play, and Active Recreation for Kids (SPARK) is needed. PURPOSE: to examine the effect of the SPARK program on middle school students’ in-class PA, cardiorespiratory endurance, and motivation in PE as compared to the Traditional program. METHODS: Participants included 174 (82 boys, 92 girls; Mean age = 12.06 ± .85 years) students enrolled in two U.S. middle schools. Students were assigned to the Intervention Group (SPARK) or the Control Group (Traditional) with school as experimental unit. Baseline and Post-test measurements were conducted, measuring PA via pedometers, cardiorespiratory endurance via PACER, PA Enjoyment through the Sport Enjoyment Scale, and Perceived Competence (PC) through the PC Scale. A 2 (Group) × 3 (Grade) × 2 (Gender) MANOVA was employed to examine the change scores differences for the aforementioned outcomes from baseline to post-test. Post-hoc tests were then conducted if MANOVA yielded statistical significance. RESULTS: MANOVA yield a statistically significant three-way interaction for Grade x Gender x Group (Wilk’s Λ = 0.89, p < .001). Follow-up test for PA change scores revealed a Grade x Group interaction (F (2, 161) = 5.71, p < .01) with differences seen between grades 6 and 7 in SPARK (Mean Δ Grade 6–7 = 8.11, p < .01) and between grades 6 and 8 in Traditional (Mean Δ Grade 6–8 = −6.96, p < .01). Data also yielded a Gender x Grade x Group interaction (F (2, 161) = 5.70, p < .01) with greater PACER change scores seen for boys in grade 8 in Traditional group (p < .01) but greater PACER change scores in grade 8 girls in SPARK group (p < .01). For both Enjoyment and PC change scores, there was significant Group x Grade interaction effects. PC differences were seen between grades 6 and 8 (Mean Δ Grade 6–8 = 0.38, p < .05) in SPARK group, while Enjoyment differences were seen between grades 6 and 7 (Mean Δ Grade 6–7 = 0.67, p < .001), and between grades 6 and 8 (Mean Δ Grade 6–8 = 0.81, p < .001) in SPARK group. CONCLUSION: The SPARK program tended to increase PA levels and motivation in PE (PA enjoyment and PC) in younger students compared to the Traditional program after the nine-week intervention.

Prediction of Optimal Daily Step Count Achievement from Segmented School Physical Activity

Optimizing physical activity in childhood is needed for prevention of disease and for healthy social and psychological development. There is limited research examining how segmented school physical activity patterns relate to a child achieving optimal physical activity levels. The purpose of this study was to examine the predictive relationship between step counts during specific school segments and achieving optimal school (6,000 steps/day) and daily (12,000 steps/day) step counts in children. Participants included 1,714 school-aged children (mean age =9.7±1.0years) recruited across six elementary schools. Physical activity was monitored for one week using pedometers. Generalized linear mixed effects models were used to determine the adjusted odds ratios (ORs) of achieving both school and daily step count standards for every 1,000 steps taken during each school segment. The school segment that related in strongest way to a student achieving 6,000 steps during school hours was afternoon recess (OR = 40.03;P&lt;0.001) and for achieving 12,000 steps for the entire day was lunch recess (OR = 5.03;P&lt;0.001). School segments including lunch and afternoon recess play an important role for optimizing daily physical activity in children.

Using Targeted Messaging to Increase Physical Activity in Older Adults: A Review

Physical activity has many benefits for older adults; however, motivating older adults to engage in and maintain optimal levels of physical activity can be challenging for health care providers. A comprehensive literature review was performed to determine whether any evidence-based methods of delivery or particular content for targeted messaging exist that result in actual improvements in physical activity of older adults. Findings of the review demonstrate that messaging directed toward older adults to be physically active resulted in improvements in physical activity up to 1 year. Across studies many different modes of message delivery were shown to be effective. Message content, whether tailored or not, resulted in significant increases in physical activity. There is evidence to support the use of environmentally mediated messaging (i.e., local walking paths) for stronger results. Targeting the client's stage of change, having an activity partner if preferred, and scheduling physical activity also contribute to improved effects.

Models of senior school boys’ physical activity regimes

Three models of leisure time activities in 15–17 years old boys was distinguished. Relationship between these models and level of school students physical health was examined. Direct link was confirmed between the energy potential of the biosystem and its energy expenditure. Decline in the physical health of senior school boys was found to be associated with an increase in periods of staying in sitting position during a day. Maintaining of an optimal level of physical activity is not always enough to have high level of health.