Physical Activity Assessment Tool Research Articles

Normative values and reference equations of the 4-meter gait speed test for Portuguese adults: a cross-sectional study

Purpose To determine the normative values and reference equations of the 4-Meter Gait Speed Test (4MGS) at usual and maximal speed for Portuguese adults. We also assessed the participant experience during the performance of the 4MGS. Materials and methods A cross-sectional study was conducted with individuals without disabilities. Sociodemographic, anthropometric, smoking habits and physical activity (Brief Physical Activity Assessment Tool [BPAAT]) data were collected. Individuals performed 3 repetitions of 4MGS at usual and maximal speeds, and the best performances were recorded. Speed values were calculated by age and sex. Stepwise multiple regressions were used for the reference equations. Participants rated their comfort from 0 (‘not comfortable at all’) to 5 (‘very comfortable’) for each modality and indicated their preferences. Results A total of 287 individuals (62.4% female; 47.8 ± 19.5 years) were recruited. Speed was significantly reduced after the sixth decade of life compared with the other decades (p < 0.001). Reference equations were: Usual speed = 1.598 – (0.006 x age) + (0.060 x BPAAT classification), R2= 27% and Maximal speed = 2.272 – (0.010 x age) + (0.157 x sex) + (0.73 x BPAAT classification), R2= 38%. Most participants felt ‘very comfortable’ performing the 4MGS at usual speed (94.8%), maximal speed (75.6%) and no preference in 4MGS modalities (69%). Conclusions Speed is significantly affected by age. For the reference equations, age and physical activity explain the results of usual speed, and both associated with sex explain the results of maximal speed. Most participants were highly comfortable and expressed no preference in 4MGS modalities.

Modern Trends, Examples and Methods for Assessing Physical Activity of City Residents

Introduction. A sufficient level of physical activity (PA) is crucial for maintaining population health. There is a wide range of methods and approaches to PA assessment, such as questionnaires that are a convenient tool for assessment of PA levels. Another modern way to assess PA is individual wearable devices, including accelerometers. Data obtained from accelerometers and other tools can contribute to questionnaire results used in PA studies. Purpose. This review was carried out with the aim of considering modern trends, examples and common methods of physical activity assessment of city residents. Materials and methods. Relevant information was collected using PubMed and E-Library databases. Google and Yandex search systems were used to obtain additional data. Results. This paper describes global trends in modern PA studies, presents the examples of Russian and foreign papers on PA of city population, as well as summarizes the main features of PA assessment tools. Notably, PA can be assessed using subjective and objective methods. International and national questionnaires are widely applied as a subjective assessment tool. At the same time, technologies for objective assessment based on digital systems, wearable devices and other approaches to PA monitoring are being developed. Methods for assessing PA can be selected in several stages using decision-making algorithms. Conclusions. Upon the obtained results we assume that modern study design and methods of assessment of FA level among city residents helps to identify factors influencing the formation and maintenance of healthy lifestyle in urban environment.

Development and validation of a healthy diet and physical activity tool based on health action process approach among patients undergone bariatric surgery.

The purpose of this study was to develop and evaluate the validity and reliability of a healthy diet and physical activity assessment tool among patients one year after bariatric surgery based on Health Action Process Approach. We compiled 53 items based on healthy diet and physical activity behaviors among patients undergone bariatric surgery through reviewing the literature. Using quantitative and qualitative methods, and a panel of experts, we evaluated the face and content validities of the tool. The reliability was evaluated by Intra-class correlation coefficient and Cronbach's alpha. The content validity ratio and the content validity index were 0.62 and 0.79, respectively. Exploratory factor analysis showed seven factors, including risk perception, outcome expectations, task self-efficacy, coping, recovery self-efficacy, action planning, coping planning, and behavioral intentions. The Intra-class correlation coefficient was between 0.8 and 0.91; and Cronbach's alpha for different constructs was between 0.8 and 0.95. The findings showed that the constructs of the Health Action Process Approach tool regarding healthy diet and physical activity had adequate validity and reliability in bariatric surgery patients.

Utility of the low physical activity questionnaire for hemodialysis patients with frailty: a cross-sectional study

BackgroundThe low physical activity questionnaire (LoPAQ), which has been developed to assess the low levels of physical activity in patients on dialysis, is so far available only in English. Moreover, no study has examined whether the LoPAQ can be used to screen for frailty in patients on hemodialysis. The purpose of this study was to translate the original LoPAQ into Japanese and evaluate its utility in screening for frailty among patients on hemodialysis.MethodsFor this cross-sectional study, we enrolled patients from two hemodialysis facilities in Japan between April 2018 and June 2019. We used the LoPAQ to calculate physical activity for one week, with pedometer steps (steps/week) as the standard reference. We used Spearman’s rank test and two multiple linear regression models to assess the relationship between the Japanese LoPAQ results and pedometer step counts. Finally, we examined whether the LoPAQ had the ability to screen for frailty (Fried scale ≥ 3) using area under the curves.ResultsIn total, 220 patients on hemodialysis completed the LoPAQ and wore a pedometer for one week. Their mean age was 67.8 ± 11.6 years, and 59.1% were men. The LoPAQ showed a total physical activity of 825.0 kilocalories/week and walking activity of 315.0 kilocalories/week. The LoPAQ total physical activity and walking activity were significantly correlated with pedometer step counts (r = 0.37–0.53, P < 0.01). Furthermore, LoPAQ total physical activity and walking activity were associated with pedometer step counts despite adjusting for covariates (β: 3.33–5.45, P < 0.001, β: 8.63–16.80, P < 0.001, respectively). In addition, the LoPAQ total physical activity and walking activity showed good values in the area under the curves to identify frailty (0.72 and 0.73, respectively).ConclusionsPhysical activity assessed using the LoPAQ significantly correlated with pedometer step counts in Japanese patients on hemodialysis. Furthermore, the LoPAQ total physical activity and walking activity had a moderate screening ability for frailty. The results indicate that the LoPAQ questionnaire is useful as a physical activity assessment tool and as a screening tool for frailty in patients on hemodialysis.

O.6.3-10 Investigating the impact of a school garden intervention on children’s school motivation, climate literacy, food literacy and physical activity: the FoodACT protocol

Abstract Background Globally, too many children are not sufficient physically active and have unhealthy food habits with the highest prevalence seen in families with low socio-economic-status (SES). Previous research has stated that schools are considered a key setting for promoting children physical activity (PA), food literacy (FL) and to improve their social health. School gardens is exactly such an intervention where teaching is relocated to an outdoor setting. Relocation of teaching, which is a central ingredient of school gardens, has shown to be positively related to increased PA in both boys and girls during the school day. School gardens aim towards practical experience and education in food and climate. PA is not I focus, but the school garden learning environment provides pupils opportunities to be active. Therefore, the FoodACT study aims to investigate how a school gardening intervention impact pupils school motivation, CL, FL and PA with a special attention on children with low SES. Methods The FoodACT study is designed in three sub-studies. An efficacy study, quantifying the effects of school gardens using a pre-post quasi-experimental design measuring the pupils’ FL, CL and SM. A within-subject-design association study, quantifying the influence of the school garden activities on pupils PA at two sessional periods during the intervention. An association study, investigating the contextual characteristics of the school garden activities using the systematic observations instrument, The Physical Activity Research and Assessment tool for Garden Observation (PARAGON), which can capture pupils’ movements and motions categorised in ‘overall PA-level’, ‘garden-related tasks’, ‘garden related motions’, ‘social associations’, and ‘interaction’. The observations is supplemented by pupil focus-group interviews about their experience of the school garden intervention. Results Study design, recruitment experience and pilot-study data on PA and garden activity observations will be presented. Funding The FoodACT study is funded by the Novo Nordisk Foundation (Grant no: 077522).

Measurement properties of physical activity in adults with bronchiectasis: A systematic review protocol.

People with bronchiectasis reduce their physical activity (PA) due to muscle weakness, dyspnea, fatigue, reduced exercise capacity and frequent cough with expectoration. Patient-reported and objective physical assessment methods have been used to evaluate PA in people with bronchiectasis. In the literature, significant differences in the PA measured using patient-reported outcome measures when compared with the objective methods. Given the availability of many PA assessment tools, it is tedious for the clinician or researcher to choose an outcome measure for clinical practice or research. The evidence on validity and reliability in bronchiectasis are unclear. Objectives: To identify the PA assessment tools, describe and evaluate the literature on psychometric properties of instruments measuring and analyzing PA. Methods: The search will be conducted in PubMed/Medline, Cochrane Central Register of Controlled Studies, Scopus and EMBASE databases. The keywords, index terms and synonyms of the following words will be used: bronchiectasis, physical activity, and outcome measures. Published studies of adult with clinical and/ or radiologically diagnosed bronchiectasis, aged >18 years, any gender and studies that assessed PA and/or if there are reports on measurement properties of PA will be included in the review. Studies using qualitative research methods, narrative reviews, letters to editors and editorials will be excluded. The quality of the study will be assessed and data will be extracted. Any disagreement will be resolved in the presence of an author not involved in the screening or selecting studies. Discussion: By assessing the quality of studies on measurement properties, this review will help researchers choose the outcome measure to evaluate the effects of interventions on PA. This review will identify the suite of outcome measures of PA for people with bronchiectasis that can be used for research and clinical purpose.

Reference Equation of a New Incremental Step Test to Assess Exercise Capacity in the Portuguese Adult Population

Step tests are important in community- and home-based rehabilitation programs to assess patients' exercise capacity. A new incremental step test was developed for this purpose, but its clinical interpretability is currently limited. This study aimed to establish a reference equation for this new incremental step test (IST) for the Portuguese adult population. A cross-sectional study was conducted on people without disabilities. Sociodemographic (age and sex), anthropometric (weight, height, and body mass index), smoking status, and physical activity (using the brief physical activity assessment tool) data were collected. Participants performed two repetitions of the IST and the best test was used to establish the reference equation with a forward stepwise multiple regression. An analysis comparing the results from the reference equation with the actual values was conducted with the Wilcoxon test. A total of 155 adult volunteers were recruited (60.6% female, 47.8 ± 19.7 years), and the reference equation was as follows: steps in IST = 475.52 - (4.68 × age years) + (30.5 × sex), where male = 1 and female = 0, and r2 = 60%. No significant differences were observed between the values performed and those obtained by the equation (p = 0.984). The established equation demonstrated that age and sex were the determinant variables for the variability of the results.

Effect of physical activity on the risk of frailty: A systematic review and meta-analysis.

The relationship between physical activity (PA) and the risk of frailty has not reached a conclusive result. This systematic review with meta-analysis aimed to evaluate the effect of PA on the onset of frailty in the community-dwelling middle and older age adults by pooling data from cohort studies. A systematic literature search was performed via PubMed, Embase, and Web of Science up to June 01, 2021. Pooled adjusted effect estimates (ES) with 95% confidence interval (CI) were calculated by using the random-effect model and by comparing the highest with lowest levels of PA. Heterogeneity was tested using the I2 statistic and Q-test. The quality of evidence was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. A total of ten cohort studies with 14 records were selected, and the GRADE approach classified the quality of evidence as low. In comparison with the lowest level of PA, the highest level of PA was associated with 41% decreased odds of frailty (ES: 0.59, 95% CI: 0.51-0.67; I2 = 70.0%, P-heterogeneity < 0.001) after pooling results from included studies. In stratified analysis by frailty assessment approach, the highest level of PA was significantly associated with 37% (ES 0.63, 95% CI: 0.52-0.77, 49% (ES: 0.51, 95% CI: 0.41-0.63), and 30% (ES: 0.70, 95% CI: 0.65-0.75) reduced odds of frailty when pooling studies using criteria of physical frailty, multidimensional model, and accumulation of disability, respectively. Stratified analyses further by PA indicators and PA assessment tools yielded similar protective effects in any subgroups. This study with moderate-certainty evidence shows that a higher level of PA was associated with lower odds of frailty, and the benefits of PA for frailty prevention were independent of frailty assessment tools, PA indicators, and PA assessment methods. Findings from this study may help implement active exercise strategies to prevent frailty.

Bibliometric analysis of the top-50 cited articles on COVID-19 and physical activity.

BackgroundSince the 2019 novel coronavirus (COVID-19) pneumonia outbreak in late 2019, an endless stream of research has emerged surrounding physical activity. This study analyzes the 50 most influential articles on COVID-19 and physical activity over the past 2 years to describe the research landscape and hotspots from bibliometric citation analysis.MethodsThe top-50 cited articles were extracted from the Web of Science Core Collection database, and bibliometric citation analysis was performed by Excel 2019 and VOSviewer software.ResultsThe top-50 articles were cited 160.48 ± 106.90 (range: 70–587). Most of the articles were from the United States (14), followed by Italy (11) and England (9). The International Journal of Environmental Research and Public Health (n = 10) is the journal with the top-50 cited articles. The collaboration between authors was mainly among three teams, including Smith L, Musumeci G, and Napoli C. The hotspot of research around COVID-19 and physical activity focused on lifestyle change (sedentary behavior, sitting time), mental health (depressive, anxiety, loneliness), the credibility of physical activity assessment tools (reliability, validity), and physical activity of different populations (gender, youth, children).ConclusionsBased on a bibliometric analysis of high-impact articles on COVID-19 and physical activity highlights physical activity as an essential lifestyle change and developments and hotspots in this field. These data will provide insights for future researchers regarding the direction of physical activity research in the COVID-19 pandemic.

Effectiveness of a healthcare-based mobile intervention on sedentary patterns, physical activity, mental well-being and clinical and productivity outcomes in office employees with type 2 diabetes: study protocol for a randomized controlled trial

BackgroundProlonged sedentary time is associated with an increased incidence of chronic disease including type 2 diabetes mellitus (DM2). Given that occupational sedentary time contributes significantly to the total amount of daily sedentariness, incorporating programmes to reduce occupational sedentary time in patients with chronic disease would allow for physical, mental and productivity benefits. The aim of this study is to evaluate the short-, medium- and long-term effectiveness of a mHealth programme for sitting less and moving more at work on habitual and occupational sedentary behaviour and physical activity in office staff with DM2. Secondary aims. To evaluate the effectiveness on glycaemic control and lipid profile at 6- and 12-month follow-up; anthropometric profile, blood pressure, mental well-being and work-related post-intervention outcomes at 3, 6 and 12 months.MethodsMulticentre randomized controlled trial. A sample size of 220 patients will be randomly allocated into a control (n = 110) or intervention group (n = 110), with post-intervention follow-ups at 6 and 12 months. Health professionals from Spanish Primary Health Care units will randomly invite patients (18–65 years of age) diagnosed with DM2, who have sedentary office desk-based jobs. The control group will receive usual healthcare and information on the health benefits of sitting less and moving more. The intervention group will receive, through a smartphone app and website, strategies and real-time feedback for 13 weeks to change occupational sedentary behaviour. Variables: (1) Subjective and objective habitual and occupational sedentary behaviour and physical activity (Workforce Sitting Questionnaire, Brief Physical Activity Assessment Tool, activPAL3TM); 2) Glucose, HbA1c; 3) Weight, height, waist circumference; 4) Total, HDL and LDL cholesterol, triglycerides; (5) Systolic, diastolic blood pressure; (6) Mental well-being (Warwick-Edinburgh Mental Well-being); (7) Presenteeism (Work Limitations Questionnaire); (8) Impact of work on employees´ health, sickness absence (6th European Working Conditions Survey); (9) Job-related mental strain (Job Content Questionnaire). Differences between groups pre- and post- intervention on the average value of the variables will be analysed.DiscussionIf the mHealth intervention is effective in reducing sedentary time and increasing physical activity in office employees with DM2, health professionals would have a low-cost tool for the control of patients with chronic disease.Trial RegistrationClinicalTrials.gov NCT04092738. Registered September 17, 2019.

Development of the learning disability physical activity questionnaire (LDPAQ)

PurposePeople with learning disabilities can be affected by complex health needs and their life expectancy is significantly reduced. Physical activity has a role in enhancing quality of life and better management of multiple health issues in this population especially if they are individually tailored to the service users’ abilities and care needs. Considering the complexities of communication, there is a need for a specific physical activity assessment tool in people with learning disabilities.Design/methodology/approachA multidisciplinary team of experts devised the Learning Disability Physical Activity Questionnaire (LDPAQ) as a tool to measure physical activity. The tool was tested within community and inpatient settings.FindingsAn easy-read, picture-based, self-reported and concise questionnaire with options relevant to people with learning disabilities was developed. Feedback from the audit confirmed ease of use and high levels of respondent satisfaction. A small-scale audit of the tool also confirmed the need for promoting physical activity within this population.Originality/valueThe LDPAQ is a novel questionnaire that aims to be a universally applicable tool for the assessment of physical activity status in people with learning disabilities. It is designed to be used by people with learning disabilities themselves, professionals and organisations. Further research is needed to explore the full potential of this tool.

Laparoscopic versus robotic inguinal hernia repair: 1- and 2-year outcomes from the RIVAL trial.

Robotic inguinal hernia repair is growing in popularity among general surgeons despite little high-quality evidence supporting short- or long-term advantages over traditional laparoscopic inguinal hernia repair. The original RIVAL trial showed increased operative time, cost, and surgeon frustration for the robotic approach without advantages over laparoscopy. Here we report the 1- and 2-year outcomes of the trial. This is a multi-center, patient-blinded, randomized clinical study conducted at six sites from 2016 to 2019, comparing laparoscopic versus robotic transabdominal preperitoneal (TAPP) inguinal hernia repair with follow-up at 1 and 2years. Outcomes include pain (visual analog scale), neuropathic pain (Leeds assessment of neuropathic symptoms and signs pain scale), wound morbidity, composite hernia recurrence (patient-reported and clinical exam), health-related quality of life (36-item short-form health survey), and physical activity (physical activity assessment tool). Early trial participation included 102 patients; 83 (81%) completed 1-year follow-up (45 laparoscopic vs. 38 robotic) and 77 (75%) completed 2-year follow-up (43 laparoscopic vs. 34 robotic). At 1 and 2years, pain was similar for both groups. No patients in either treatment arm experienced neuropathic pain. Health-related quality of life and physical activity were similar for both groups at 1 and 2years. No long-term wound morbidity was seen for either repair type. At 2years, there was no difference in hernia recurrence (1 laparoscopic vs. 1 robotic; P = 1.0). Laparoscopic and robotic inguinal hernia repairs have similar long-term outcomes when performed by surgeons with experience in minimally invasive inguinal hernia repairs.

Validation of the Apple Watch for Estimating Moderate-to-Vigorous Physical Activity and Activity Energy Expenditure in School-Aged Children.

The Apple Watch is one of the most popular wearable devices designed to monitor physical activity (PA). However, it is currently unknown whether the Apple Watch accurately estimates children’s free-living PA. Therefore, this study assessed the concurrent validity of the Apple Watch 3 in estimating moderate-to-vigorous physical activity (MVPA) time and active energy expenditure (AEE) for school-aged children under a simulated and a free-living condition. Twenty elementary school students (Girls: 45%, age: 9.7 ± 2.0 years) wore an Apple Watch 3 device on their wrist and performed prescribed free-living activities in a lab setting. A subgroup of participants (N = 5) wore the Apple Watch for seven consecutive days in order to assess the validity in free-living condition. The K5 indirect calorimetry (K5) and GT3X+ were used as the criterion measure under simulated free-living and free-living conditions, respectively. Mean absolute percent errors (MAPE) and Bland-Altman (BA) plots were conducted to assess the validity of the Apple Watch 3 compared to those from the criterion measures. Equivalence testing determined the statistical equivalence between the Apple Watch and K5 for MVPA time and AEE. The Apple Watch provided comparable estimates for MVPA time (mean bias: 0.3 min, p = 0.91, MAPE: 1%) and for AEE (mean bias: 3.8 kcal min, p = 0.75, MAPE: 4%) during the simulated free-living condition. The BA plots indicated no systematic bias for the agreement in MVPA and AEE estimates between the K5 and Apple Watch 3. However, the Apple Watch had a relatively large variability in estimating AEE in children. The Apple Watch was statistically equivalent to the K5 within ±17.7% and ±20.8% for MVPA time and AEE estimates, respectively. Our findings suggest that the Apple Watch 3 has the potential to be used as a PA assessment tool to estimate MVPA in school-aged children.

May the brief physical activity assessment tool accurately measure physical activity in patients with resistant hypertension?

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): FEDER Funds through the Operational Competitiveness Factors Program—COMPETE National Funds through the Portuguese Foundation for Science and Technology (FCT) “PTDC/DTP-DES/1725/2014”. SL is a PhD fellow supported by the FCT (Grant Ref: SFRH/BD/129454/2017). Introduction Resistant hypertension is a major health problem due to the increased risk of cardiovascular events and mortality. Physical activity and exercise reduces blood pressure in resistant hypertension and is associated with lower cardiovascular risk and mortality. It is presently recommended that physical activity assessment should be a priority in all visits to health settings Purpose This study aims to determine if the Brief Physical Activity Assessment Tool (BPAAT), a 2-question tool to assess physical activity, is a valid instrument to detect inactive patients with resistant hypertension. Methods Sixty patients with a diagnosis of resistant hypertension were recruited. Outcome measures included clinical data, blood pressure and daily physical activity. Physical activity was objectively measured over a 7-day period with an accelerometer and subjectively assessed (self-assessment) by the BPAAT. The association between the BPAAT and accelerometry, according to the BPAAT scoring categories, was assessed bythe percentage of agreement, Cohen’s Kappa and sensitivity and specificity. Results Patients (33 were male) had a mean age of 59.4 ± 9.1years, were on average overweight (BMI 29.5 ± 4.5 kg/m2) and on an average of 4.5 ± 0.7 antihypertensive medications. Forty-two patients (70%) were classified as insufficiently active by the BPAAT compared to the 38 (63.3%) insufficiently active patients identified by the accelerometry data. Regarding the questionnaire’s specificity and sensitivity, the BPAAT correctly identified 32 [84.2 (73.1 – 95.3) %] of the 38 ‘insufficiently active’ patients and 12 [54.5 (34.3 – 74.7) %] of the 22 ‘sufficiently active’ patients identified by accelerometry. The agreement between BPAAT and accelerometry to identify sufficiently/insufficiently active patients, according to the BPAAT’s cut-off values was fair to moderate (Kappa = 0.403 (0.162 – 0.674), with a percentage of agreement of 73.3%. Conclusion The BPAAT, a 2-question tool to assess physical activity, seems to be a valid and fast solution to identify insufficiently active adults with resistant hypertension during routine clinical visits.

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

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

Validity of the Exercise Vital Sign Tool to Assess Physical Activity

Assessment and counseling by healthcare providers can successfully increase physical activity; however, a valid instrument to effectively measure physical activity is needed. This study examines the validity of the Exercise Vital Sign tool by comparing Exercise Vital Sign data collected at Kaiser Permanente Northwest with accelerometry data. Participants (n=521) completed accelerometer monitoring and had ≥1 Exercise Vital Sign measurement in their electronic medical record. Using accelerometry as the gold standard, the association between moderate-to-vigorous physical activity minutes per week estimated through Exercise Vital Sign and that estimated through accelerometry was examined using the Spearman correlation coefficient. Comparability of moderate-to-vigorous physical activity categories (inactive, lowly active, moderately active, sufficiently active) was assessed using simple and weighted κ statistics. Sensitivity, specificity, and positive and negative predictive values were calculated. The study was conducted in 2012-2015, with analysis in 2019-2020. Average accelerometry-based moderate-to-vigorous physical activity was 212 minutes per week, and 57% of the participants were considered sufficiently active. Exercise Vital Sign‒based moderate-to-vigorous physical activity averaged 170 minutes per week, and 53% of the participants were active. There was a positive correlation between the moderate-to-vigorous physical activity minutes per week reported through Exercise Vital Sign and that reported through accelerometry (r =0.38, p<0.0001). A fair agreement was observed between Exercise Vital Sign‒ and accelerometry-based moderate-to-vigorous physical activity categories (weighted κ=0.29), with the highest agreement occurring for those with physical activity level ≥150 minutes per week. The positive correlation increased when moderate-to-vigorous physical activity was examined dichotomously (<150 or ≥150 minutes per week, κ=0.34). The sensitivity, specificity, positive predictive value, and negative predictive value for Exercise Vital Sign (when compared with those of accelerometry) were 67%, 68%, 61%, and 73%, respectively. The Exercise Vital Sign is a useful physical activity assessment tool that correctly identifies the majority of adults who do and do not meet physical activity guidelines.

Construct validity of the brief physical activity assessment tool for clinical use in COPD.

Low physical activity (PA) levels are associated with poor health-related outcomes in Chronic Obstructive Pulmonary Disease (COPD). Thus, PA should be routinely assessed in clinical practice. This study assessed the construct validity of the Brief Physical Activity Assessment Tool (BPAAT) for clinical use in COPD and explored differences in age, sex and COPD grades. After linguistic adaptation of the tool to Portuguese, 110 patients (66.4±9.6yrs, 72.7% male, FEV1 =59.3±25.5%predicted) completed the BPAAT and received an accelerometer. The BPAAT includes two questions assessing the weekly frequency and duration of vigorous- and moderate-intensity PA/walking, classifying individuals as insufficiently or sufficiently active. The BPAAT was correlated with accelerometry (moderate PA, MPA=1952-5724 counts-per-min [CPM]); vigorous PA, VPA=5725-∞CPM; moderate-to-vigorous PA, MVPA=1952-∞CPM; daily steps), through: Spearman's correlations (ρ) for continuous data; %agreement, Kappa, sensitivity and specificity, positive and negative predictive values (PPV, NPV) for categorical data. The BPAAT identified 73.6% patients as "insufficiently active" and 26.4% as "sufficiently active". The BPAAT was weakly to moderately correlated with accelerometry (0.394≤ρ≤0.435, P<0.05), except for VPA (P=0.440). This was also observed in age (<65/≥65yrs), COPD grades (GOLD 1-2/3-4) and in male patients (0.363≤ρ≤0.518, P<0.05 except for VPA). No significant correlations were found in female patients (P>0.05). Agreement was fair to moderate (0.36≤κ≤0.43; 73.6%≤%agreement≤74.5%; 0.50≤sensitivity≤0.52; 0.84≤specificity≤0.91, 0.55≤PPV≤0.79, 0.72≤NPV≤0.82). The BPAAT may be useful to screen patients' PA, independently of age and COPD grade, and identify male patients who are insufficiently active. Care should be taken when using this tool to assess vigorous PA or female patients.

Depressive Symptoms, Fatigue and Social Relationships Influenced Physical Activity in Frail Older Community-Dwellers during the Spanish Lockdown due to the COVID-19 Pandemic.

Due to the dramatic impact of the COVID-19 pandemic, Spain underwent a strict lockdown (March–May 2020). How the lockdown modified older adults’ physical activity (PA) has been poorly described. This research assesses the effect of the lockdown on PA levels and identifies predictors of sufficient/insufficient PA in frail older community-dwellers. Community-dwelling participants from the +ÀGIL Barcelona frailty intervention program, suspended during the pandemic, underwent a phone-assessment during the lockdown. PA was measured before and after the lockdown using the Brief Physical Activity Assessment Tool (BPAAT). We included 98 frail older adults free of COVID-19 (mean age = 82.7 years, 66.3% women, mean Short Physical Performance Battery = 8.1 points). About one third of participants (32.2%) were not meeting sufficient PA levels at the end of the lockdown. Depressive symptoms (OR = 0.12, CI95% = 0.02–0.55) and fatigue (OR = 0.11, CI95% = 0.03–0.44) decreased the odds of maintaining sufficient PA, whereas maintaining social networks (OR = 5.07, CI95% = 1.60–16.08) and reading (OR = 6.29, CI95% = 1.66–23.90) increased it. Living alone was associated with the reduction of PA levels (b = −1.30, CI95% = −2.14–−0.46). In our sample, pre-lockdown mental health, frailty-related symptoms and social relationships were consistently associated with both PA levels during-lockdown and pre-post change. These data suggest considering specific plans to maintain PA levels in frail older community-dwellers.

Balance and healthy aging: a close relationship

Objectives: This study explored the: i) correlations between the Balance Evaluation Systems Test (BESTest) and its short-versions (Mini-BESTest and Brief-BESTest), with functional ability, gait speed, physical activity, and health-related quality of life; ii) ability of the Five Times Sit to Stand (5STS), 10 Meter Walk Test (10MWT), Brief Physical Activity Assessment Tool (BPAAT) and World Health Organization Quality of Life-Bref (WHOQoL-Bref) to identify the prior history of falls in community-dwelling older people. Methods: An exploratory cross-sectional study was conducted with healthy older people living in the community. Balance (BESTest and its short versions), functional ability (5STS), gait speed (10MWT), physical activity (BPAAT), and health-related quality of life (WHOQoL-Bref) were assessed. Spearman correlation coefficient and receiver operating characteristics analysis were calculated. Results: One hundred and eighteen individuals (76[69-83.3] years; n=79, 66.9% female) participated in this study. Correlations between balance and functional ability (-0.61&lt; r &lt; -0.51, p&lt;0.001), gait speed (0.69 &lt; r &lt; 0.78, p&lt;0.001), physical activity (0.39 &lt; r &lt; 0.42, p&lt;0.001) and health-related quality of life (0.28 &lt; r &lt; 0.57, p≤0.002) were identified. The following cutoff points to differentiate between prior history of falls were established: 80.5 points for the BESTest, 16.5 points for the Mini-BESTest and 12.5 points for the Brief-BESTest, 13.5s for the 5STS, 1.2m/s for the 10MWT, 1.5 points for the BPAAT and 14.5/66; 14.5/66; 14/62.5; 15.5/72 points for domains I, II, III and IV, respectively, of the WHOQoL-Bref 0-20/100. Conclusion: The BESTest and its short versions correlated with functional ability, gait speed, physical activity, and health-related quality of life in older people. These outcomes can differentiate prior history of falls in community-dwelling older people.

A Mobile Technology for Collecting Patient-Reported Physical Activity and Distress Outcomes: Cross-Sectional Cohort Study.

BackgroundElectronic patient-reported outcome (PROs) provides a fast and reliable assessment of a patient’s health-related quality of life. Nevertheless, using PRO in the traditional paper format is not practical for clinical practice due to the limitations associated with data analysis and management. A questionnaire app was developed to address the need for a practical way to group and use distress and physical activity assessment tools.ObjectiveThe purpose of this study was to assess the level of agreement between electronic (mobile) and paper-and-pencil questionnaire responses.MethodsWe validated the app version of the distress thermometer (DT), International Physical Activity Questionnaire (IPAQ), and Patient Health Questionnaire–9 (PHQ-9). A total of 102 participants answered the paper and app versions of the DT and IPAQ, and 96 people completed the PHQ-9. The study outcomes were the correlation of the data between the paper-and-pencil and app versions.ResultsA total of 106 consecutive breast cancer patients were enrolled and analyzed for validation of paper and electronic (app) versions. The Spearman correlation values of paper and app surveys for patients who responded to the DT questionnaire within 7 days, within 3 days, and on the same day were .415 (P<.001), .437 (P<.001), and .603 (P<.001), respectively. Similarly, the paper and app survey correlation values of the IPAQ total physical activity metabolic equivalent of task (MET; Q2-6) were .291 (P=.003), .324 (P=.005), and .427 (P=.01), respectively. The correlation of the sum of the Patient Health Questionnaire–9 (Q1-9) according to the time interval between the paper-based questionnaire and the app-based questionnaire was .469 for 14 days (P<.001), .574 for 7 days (P<.001), .593 for 3 days (P<.001), and .512 for the same day (P=.03). These were all statistically significant. Similarly, the correlation of the PHQ (Q10) value according to the time interval between the paper-based questionnaire and the app-based questionnaire was .283 for 14 days (P=.005), .409 for 7 days (P=.001), .415 for 3 days (P=.009), and .736 for the same day (P=.001). These were all statistically significant. In the overall trend, the shorter the interval between the paper-and-pencil questionnaire and the app-based questionnaire, the higher the correlation value.ConclusionsThe app version of the distress and physical activity questionnaires has shown validity and a high level of association with the paper-based DT, IPAQ (Q2-6), and PHQ-9. The app-based questionnaires were not inferior to their respective paper versions and confirm the feasibility for their use in clinical practice. The high correlation between paper and mobile app data allows the use of new mobile apps to benefit the overall health care system.Trial RegistrationClinicalTrials.gov NCT03072966; https://clinicaltrials.gov/ct2/show/NCT03072966