Physical Activity Outcomes Research Articles

Exploring Acceptability, Feasibility, and Impact of Heart Rate Variability to Provide Physical Activity Guidance Postpartum

ABSTRACT Introduction Women report lower levels of physical activity (PA) postpartum due to numerous barriers to engagement such as lack of time, energy, motivation, social support, and fatigue. Despite these noted barriers, PA recommendations are universal and do not allow for a tailored PA approach. Therefore, we assessed the acceptability, feasibility, and impact of individualized postpartum PA guidance. Method Participants measured heart rate variability (HRV) for 3 min every morning for 2 wk. These baseline measures were used to create individualized HRV-guided PA recommendations. The goal was to create HRV-based zones with appropriate options for PA. Participants were instructed to measure and record their HRV daily for the 8-wk intervention period and choose a daily activity that was appropriate to their reading. A mixed-methods approach of pre- and post-intervention questionnaires and qualitative interviews were used to assess the impact of the intervention on participants and whether they felt the intervention was acceptable and feasible. Results The average age of women in the study was 33 (3.7) yr, and participants were, on average, 29 (7.4) wk (7.2 (1.9) months) postpartum. Participants reported recording their daily HRV on an average of 49 of the 56 d (88%) comprising the 8-wk intervention period. Participants reported completing, on average, 27 sessions (48%) in the correct categories (i.e., the zone indicated by the daily HRV reading). From baseline to post-intervention, there were significant improvements in PA, fatigue, and sleep. Participants noted high acceptability but low feasibility of the HRV method for individualized PA guidance. Conclusions Although a relatively simple intervention (i.e., daily HRV readings) may enhance PA and other outcomes, this intervention was only somewhat feasible and left women desiring greater support and accountability.

Effectiveness of a Telephone-Delivered Walk With Ease Program on Arthritis-Related Symptoms, Function, and Activity: A Randomized Trial.

Walk With Ease (WWE) is a 6-week arthritis-appropriate evidence-based physical activity program traditionally offered in a face-to-face format. As many populations encounter participation barriers to in-person programs, WWE was modified for telephone delivery (WWE-T). The short- and long-term effects of this program on physical activity and arthritis-related outcomes were examined. Participants (n=267) with arthritis were randomized to WWE-T or waitlist control. WWE-T participants received 2 telephone calls/week (1 group and 1 individual call) for 6 weeks. Group calls focused on arthritis education and social support. Individual calls focused on problem solving and goal setting. Physical function tests, patient-reported outcomes, and physical activity were assessed at baseline, 6 weeks, 6 months, and 12 months. Participants were 92% female, 60% Black, 64.1±9.4 years with a BMI of 34.2±7.7 kg/m2. Retention ranged from 93.6% at 6 weeks to 83.8% at 12 months. Participants attended 9.8±2.6 calls. At 6 weeks, WWE-T participants had greater improvements in physical function (p=0.03), fatigue (p=0.03), self-efficacy (p≤0.0001), and activity impairment due to health (p=0.01) as compared to the control. By 12 months, WWE-T participants had better physical function (p=0.02), higher arthritis self-efficacy (p≤0.0001), lower depression symptoms (p=0.02), and lower impairment of daily activities (p=0.02) than at baseline. A telephone-delivered WWE program led to improvements in physical function, self-efficacy, and impairment related to daily activities in adults with arthritis. Although changes were not seen in all outcomes, this remotely-delivered program may be an effective alternative for adults with arthritis who face barriers to in-person programs.

Evaluating the effectiveness of gamification in physical education: enhancing engagement through play and movement

Introduction: The increasing number of students who remain physically inactive creates dual health and educational problems that call for new PE strategies. Research demonstrates that gamification enhances student participation levels as well as their motivational factors while increasing their physical movement. Objective: The research evaluates how gamified PE classes affect student participation levels together with their internal drive and physical movement. Methodology: A six-week quasi-experimental study examined middle school student participation through an examination of 120 subjects. The PE activities used competition-enhancing game elements including goals and feedback systems and leaderboards. The researchers evaluated engagement through cognitive behavioral and emotional domains and used the Intrinsic Motivation Inventory to measure motivation. Wearable fitness trackers tracked the number of steps students took as well as the length of their activities and their expended energy. Results: Tests yielded significant findings showing that engagement showed substantial growth (t = 5.47, p < 0.001) especially in cognitive engagement aspects. The participants exhibited significant enhancement in their perception of competence as well as their sense of autonomy and relatedness between subjects (p < 0.001). The participants achieved better physical activity outcomes through 1,600 additional daily steps and a 60-minute increase in active time and 600 kcal increase in expended energy. Conclusion: Gamified PE interventions help boost student engagement while improving their motivation toward health activities and active behavior changes. Short-term evaluations in this research have proven effective yet long-term results alongside educational strategy combinations need additional research.

Financial incentives for physical activity in adults: Systematic review and meta-analysis update.

Financial incentives for physical activity in adults: Systematic review and meta-analysis update.

Unmasking the Complex Interplay of Obesity Hypoventilation Syndrome, Heart Failure, and Sleep Dysfunction: A Physiological and Psychological Perspective in a Digital Health World

Obesity hypoventilation syndrome (OHS) is a multifaceted condition characterized by significant respiratory, cardiovascular, and psychological consequences. Positive airway pressure (PAP) therapy remains the cornerstone treatment, improving respiratory function, neurocognition, and mental health disorders such as depression and anxiety. However, its long-term impact on quality of life, physical activity, and broader health outcomes is not fully understood. Challenges such as residual apnoea/hypopnea index, reduced physical activity, and impaired quality of life persist despite high adherence rates. Factors like hypercapnia and daytime respiratory symptoms play a pivotal role in patient outcomes, underscoring the need for strategies beyond adherence alone. This review explores the interplay between OHS, heart failure, and sleep dysfunction, advocating for personalized PAP settings, targeted management of residual respiratory events, and enhanced patient education. Digital health technologies, including remote monitoring and feedback systems, present promising tools to optimize care delivery and foster holistic management. By integrating physiological, psychological, and digital health perspectives, this narrative review aims to advance understanding and improve outcomes for patients with OHS and other complex sleep-disordered breathing conditions.

Sedentary behavior and physical activity one year after colorectal cancer diagnosis: results from the ColoCare Study.

Physical activity plays key roles in colorectal cancer survivorship; however, the impact of different clinicodemographic outcomes on cross-sectional and longitudinal objectively measured physical activity 12 and 24months post-diagnosis are unclear. ColoCare study participants (n = 165) wore an Actigraph GT3x accelerometer for 4-10 consecutive days to objectively assess activity levels 12 and 24months after colorectal cancer diagnosis and resection. Associations between these clinical/demographic exposures and physical activity outcomes and longitudinal changes were determined using t-test, ANOVA F-test, and linear regression modeling, adjusting for common confounders (e.g., sex, age, stage). Key physical activity and sedentary behavior variables significantly differed by demographic status, including minutes of weekly exercise by sex and age (age < 50: 364min ± 303min; age 50-70: 232min ± 263min; age > 70: 93min ± 135min, p < 0.001) and (%) daily sedentary time by age (age < 50: 64 ± 10%; age 50-70: 67 ± 7%; age > 70: 71 ± 7%, p = 0.003). Within the multivariate model, age was the primary measure consistently associated with activity differences. Participants who wore accelerometers 12- and 24-month post-resection (n = 52) significantly increased weekly exercise minutes (214min ± 208min vs. 288min ± 316min, p = 0.04). Age is the primary clinicodemographic determinant separating physical activity levels in colorectal cancer survivors, and increases in exercise from 12 to 24months are likely due to consolidation of sporadic daily physical activity into bouts of exercise. Colorectal cancer survivors experience different volumes and changes in accelerometer-derived physical activity based on some (e.g., age) but not all (e.g., stage) clinicodemographic variables.

The Association Between Preoperative Physical Activity and Postoperative Surgical Outcomes and Survival Following Pelvic Exenteration

Introduction: Pelvic cancers present significant health challenges and often require aggressive treatment strategies. Pelvic exenteration, which involves the resection of multiple pelvic organs, is currently the only curative option for advanced or recurrent pelvic malignancies. Due to its extensive nature, it carries a high risk for postoperative complications and extended hospital stays. Current evidence suggest that improved preoperative fitness is associated with better postoperative outcomes. This study explored the relationship between preoperative self-reported physical activity levels and surgical outcomes following pelvic exenteration. Methods: This retrospective cohort study included consecutive adult patients undergoing pelvic exenteration at Royal Prince Alfred Hospital between May 2017 and December 2023. Eligible participants completed the International Physical Activity Questionnaire—Short Form (IPAQ-SF) preoperatively. Primary outcomes included postoperative morbidity, length of hospital stay, and survival. Univariate and multivariate logistic regression analyses explored the association between preoperative physical activity and postoperative outcomes. Results: A total of 256 participants were included, of which 115 (44.9%) were classified as active. Active patients experienced fewer postoperative complications (p = 0.047) and shorter hospital stays (p = 0.007), compared to inactive participants. There was no significant association between preoperative physical activity levels and survival outcomes (p = 0.749). Younger age, preoperative physical activity level, and advanced primary malignancy were significantly associated with fewer complications and shorter hospital stays. Conclusions: Higher levels of preoperative physical activity is associated with fewer postoperative complications and shorter hospital stays in patients undergoing pelvic exenteration. These findings support the potential benefits of incorporating prehabilitation programs to improve surgical outcomes and reduce healthcare costs.

Self-reported and tracker-estimated physical activity outcomes in women with chronic pelvic pain disorders: A longitudinal evaluation of construct validity.

This study aims to evaluate the short form International Physical Activity Questionnaire (IPAQ) for use in women with chronic pelvic pain disorders (CPPDs) by comparing its scores against objectively-estimated physical activity (PA) outcomes. We investigated IPAQ components that are most consistently predictive of habitual PA behavior. The study sample included 966 weeks of data from 112 women with CPPDs who enrolled in a 14-week mHealth-based self-tracking study. Participants wore Fitbit devices and completed the IPAQ every week. We compared the IPAQ-reported minutes of walking, total activity, sitting, light-, moderate-, and vigorous intensity PA for concordance and divergence against their corresponding Fitbit estimates. We used linear mixed-effects regression models (MLMs) for all analyses and quantified the between-participant variance in the magnitude of agreement between the two methods via random slope terms. We further evaluated temporal consistency in scores using intraclass correlation coefficients (ICCs). IPAQ-reported walking minutes were strongly associated with Fitbit step counts (B = 3952.36; p = 0.006), minutes of moderate PA (B = 15.498; p = 0.0113), and moderate-to-vigorous PA (MVPA; B = 28.973; p = 0.007). IPAQ total activity minutes were associated with Fitbit minutes of vigorous PA (B = 15.183; p = 0.007) and MVPA (B = 25.658; p = 0.010). IPAQ moderate activity minutes were predictive of Fitbit vigorous PA minutes (B = 9.060; SE = 3.719; p = 0.0151). There was substantial between-individual variance in these point estimates based on the significant random-effect terms, and average weekly PA level was a significant moderator of the association between IPAQ-reported and Fitbit-estimated scores for these variables. IPAQ-reported sitting minutes were inversely associated with Fitbit step counts (B = - 3125.61; p = 0.004), and minutes of MVPA (B = -21.848; p = 0.007), vigorous AP (B = -10.854; p = 0.042), and moderate PA (B = -10.985; p = 0.004). These findings provide support for using IPAQ-reported walking and total activity minutes to monitor several PA domains in women with CPPDs, given their concordance with several tracker-estimated PA outcomes. However, the item on "sitting time" may not be a suitable for assessing sedentary time.

A229 THE ASSOCIATION OF MENTAL HEALTH DISORDERS WITH FATIGUE AND PHYSICAL ACTIVITY IN PERSONS WITH IBD

Abstract Background Fatigue is one of the most common symptoms among persons with inflammatory bowel disease (IBD) that impairs their quality of life. Fatigue acts as one of the greatest barriers of physical activity (PA) participation in adults with chronic disease, while PA is a strong contributor to improving fatigue symptoms. Aims The aim of this study was to assess the relationship between fatigue and PA in patients with IBD. A secondary aim was to assess the impact of mental health and disease activity on both PA and fatigue outcomes. Methods Participants from the University of Manitoba IBD Research Registry (n=2740) were invited to complete a cross-sectional survey to understand how persons with IBD experience PA and exercise. The international Physical Activity questionnaire (IPAQ) was used to define low vs. moderate/high levels of PA. The Modified Fatigue Impact Scale (MFIS) was used to define participants as Fatigued (MFIS ≥38) vs. non-fatigued (MFIS&amp;lt;38). Mental health and disease activity were defined based on Generalized Anxiety Disorders-7 (GAD), Patient Health Questionnaire (PHQ-9) and Inflammatory Bowel Disease Symptom Inventory (IBDSI). Descriptive statistics, bivariate and logistic regression analysis were used to assess the relationships defined in the aims. Results Among 1257 (46%) who completed the survey, there was 1075 (86%) and 1119 (89%) completed data for fatigue and PA, respectively. 93/706 (13%) of persons participated in low PA and were fatigued. Older patients were both less fatigued &amp; less active than younger patients (median IQR: 62 (53-70) vs 60 (50-68), p=0.045). Nonactive to low physically active and high fatigued patients were more likely to have an education of high school degree or less (39% vs 25%, p&amp;lt;0.01), an income less than $50,000 (32% vs 14%, p&amp;lt;0.0001), not in a relationship (27% vs 17%, p&amp;lt;0.01), have an ostomy bag (14% vs 7%, p=0.02), and ever smoked (19% vs 6%, p&amp;lt;0.0001) compared to moderate/high physically active non-fatigued patients. The odds of low PA and high fatigue were greater for persons with anxiety [aOR 95%CI; 3.0 (1.2-7.2)], depression [23.5 (10.8-53.6)], and active disease [3.97 (1.9-8.3)]. Conclusions Patients with IBD are more likely to be participating in low levels of PA &amp; be fatigued when they have a lower education &amp; income, not in a relationship, have an ostomy bag and are a current or previous smoker. The odds of low PA and fatigue are up to 23 times greater for persons with a mental health disorder. New insights on PA and fatigue provide an impetus for PA intervention as it may help alleviate fatigue symptoms and enhance quality of life among persons with IBD. Funding Agencies CAGn/a

DOES RETURN TO PHYSICAL ACTIVITY DIFFER BETWEEN ANKLE ARTHRODESIS AND TOTAL ANKLE ARTHROPLASTY: ONE-YEAR FOLLOW-UP STUDY

BackgroundThe ability to return to physical activity is an important indicator of surgical success for end-stage ankle arthritis. There is paucity of literature comparing outcomes between surgical procedures. This study aimed to compare outcomes for physical activity and return to function between total ankle replacement (TAR) and ankle arthrodesis (AA) at 1-year follow-up.MethodsThis was a single-centre prospective follow-up study. Patients who underwent TAR (n=33) or AA (n=25) between 2022–2023 completed questionnaires on FAOS scores (Pain, Symptoms, ADL and QOL domains), International Physical Activity Questionnaire (IPAQ), satisfaction scores and return to work/driving. IPAQ physical activities were compared across domains of work, transportation, domestic and leisure activities.ResultsAA patients were younger (59.1 vs. 65.8). The AA group had better average FAOS scores for pain, symptoms, ADL, and QOL compared to TAR (51.2 vs. 29.2; 40.6 vs. 67.8, 46.8 vs. 66.4, 31.3 vs. 48.3) (p=0.526), but the TAR group reported higher overall satisfaction (77% vs. 66.6%). Earliest return to work was reported at 2 weeks (TAR) vs. 3 weeks (AA) group and driving at 3 weeks (TAR) vs. 4 weeks (AA). More TAR patients returned to vigorous (25%) and moderate (17.6%) physical activity versus AA (0% and 0%). For transport, 4 AA patients vs. 12 TAR patients returned to this activity. AA patients travelled 30 minutes to 2 hours per week, while TAR patients travelled 30 minutes to 5 hours. For household activities, 15.7% of TAR patients reported vigorous activity versus 0% in AA. AA patients spent less time on average leisure walking (1.25 hrs vs. 2 hrs), and more time sitting per day (9.2 hrs vs. 5.9 hrs).ConclusionThe TAR group demonstrated earlier return to work, driving, and higher levels of physical activity compared to AA patients at 1-year follow-up, despite the AA group having better FAOS scores.

Effectiveness of Physical Activity Interventions on Acute Inpatient Mental Health Units on Health Outcomes: A Systematic Review.

Physical activity has been shown to improve outcomes across a range of physical and mental health conditions as an adjunct or standalone intervention for many mental disorders. The outcome and effectiveness of physical activity in acute mental health units are less well understood. Systematic searches were completed in three databases (CINAHL, MEDLINE, and PsycINFO). Eligible studies were published between March 2013 and February 2024, included a physical activity intervention for inpatients on acute mental health units, and reported primary quantitative, qualitative, or mixed methods data for patients between 18 and 65 years of age. Participants must have had a primary diagnosis of a mental health condition with or without physical comorbidities. Data extracted included reported components of the interventions and individual health outcomes. Methodological quality and risk of bias was assessed using the mixed methods appraisal tool and cochrane risk of bias tools for randomised and non-randomised controlled trials. Twelve studies were identified for review (combined sample size of 560). Seven studies reported improvements in mental health outcomes, and two reported improvements in physical health outcomes in favour of the intervention group. There was a large variation between intervention characteristics and clarity in reporting. Assessment and measurement of outcomes contributed to a high risk of bias among included studies due largely to self-assessment. Physical activity interventions on AMHUs have the potential to contribute to improvements in mental and physical wellbeing beyond that experienced from usual treatment practices (e.g., medication). However, further work is needed in the specific context of acute mental health units regarding the development and evaluation of physical activity interventions.

The physical activity paradox; exploring the relationship with pain outcomes. The Tromsø Study 2015-2016.

Paradoxical associations have been observed for leisure-time physical activity (LTPA) and occupational physical activity (OPA) and several health-related outcomes. Typically, higher LTPA is associated with health benefits and high OPA with health hazards. Using data from the Tromsø Study (2015-2016), we assessed how questionnaire-based LTPA and OPA (n = 21,083) and accelerometer-measured physical activity (PA) (n = 6778) relate to pain outcomes. Leisure-time physical activity and OPA were categorized as inactive PA, low PA, and moderate-to-vigorous PA and then aggregated into 9 levels, eg, inactive LTPA/inactive OPA. Accelerometer-measured PA included counts/minute, steps/day, and WHO PA recommendations from 2010 to 2020. Three binary pain outcomes (any pain, any chronic pain, and moderate-to-severe chronic pain) were constructed based on pain location, intensity, duration, and impact on daily activities. By using Poisson regression to estimate absolute and relative associations, we found that high LTPA was associated with lower pain prevalence and vice versa for OPA. Compared to inactive LTPA, prevalence ratio (PR) with 95% confidence intervals was lowest for moderate-to-vigorous LTPA, 0.93 (0.89-0.96) for any pain, 0.88 (0.84-0.93) for any chronic pain, and 0.66 (0.59-0.75) for moderate-to-severe chronic pain. Compared to sedentary OPA, the ratio was highest for moderate-to-vigorous OPA, 1.04 (1.01-1.07) for any pain, 1.06 (1.02-1.10) for any chronic pain, and 1.33 (1.21-1.46) for moderate-to-severe chronic pain. Aggregated LTPA and OPA showed lower outcomes for moderate-to-vigorous LTPA combined with lower levels of OPA. Higher levels of accelerometer-measured PA were associated with less pain. To summarize, we found inverse associations for LTPA and OPA. Benefits from LTPA seem to depend on low levels of OPA.

Using the Staircase Approach to increase movement: a systematic search and review to inform a novel sedentary behaviour intervention for older adults.

Traditional approaches to supporting older adults in adopting and maintaining an active lifestyle have largely failed. The previously proposed "Staircase Approach" offers a new foundation for developing interventions and public health strategies; this approach includes Step 1 (changing sedentary behaviour) and Steps 2 to 4 (incorporating more physical activity of increasing levels of intensity). In this systematic search and review, we aimed to inform the co-creation of a novel Staircase Approach intervention for community-dwelling, inactive older adults, primarily focussed on Step 1. A systematic search was performed across six databases (MEDLINE, PsycInfo, CINAHL, Cochrane CENTRAL, SPORTDiscus and Scopus). After duplicates were removed, 3427 titles and abstracts were screened. Fourteen articles (including 17 intervention groups) were included after full-text review. Five were randomized controlled trials, three compared two interventions and six were single-arm studies. Sample sizes ranged from 9 to 176 participants, and included 617 older adults at baseline. Mean age of samples ranged from 64.3 (standard deviation [SD] 3.8) to 85.1 (SD 6.2) years, while the intervention length ranged from less than one day to 6 months. Sedentary time interventions are well accepted; most studies had completion rates above 80%. Based on findings from within-group comparisons, half of the studies showed a reduction in sedentary time (6/12 groups) and half showed an increase in physical activity (6/12 groups). Based on findings from between-group comparisons, 2 out of 5 intervention groups showed improvements in sitting time and physical activity outcomes compared to controls. Satisfaction and adherence to interventions were generally high. Sedentary time interventions for older adults show promise and point to several components that may be included in an intervention focussed on Step 1 of the Staircase Approach.

Personalized app-based coaching for improving physical activity in heart failure with preserved ejection fraction patients compared with standard care: rationale and design of the MyoMobile Study

Abstract Aims Patients suffering from heart failure with preserved ejection fraction (HFpEF) often exhibit a sedentary lifestyle, contributing to the worsening of their condition. Although there is an inverse relationship between physical activity (PA) and adverse cardiovascular outcomes, the implementation of Class Ia PA guidelines is hindered by low participation in supervised and structured programmes, which are not suitable for a diverse population of HFpEF patients. The MyoMobile study has been designed to assess the effect of a 12-week, app-based coaching programme on promoting PA in patients with HFpEF. Methods and results The MyoMobile study was a single-centre, randomized, controlled three-armed parallel group clinical trial with prospective data collection to investigate the effect of a personalized mobile app health intervention compared with usual care on PA levels in patients with HFpEF. Major inclusion criteria were age ≥ 45 years, a diagnosis of HFpEF, LVEF &amp;gt; 40%, and current HF symptoms (NYHA Class I–III). Major exclusion criteria included acute decompensated HF, non-ambulatory status, recent acute coronary syndrome or cardiac surgery, alternative diagnoses for HF symptoms, active cancer treatment, and physical or medical conditions affecting mobility. Participants were recruited from hospitals, general practices, and practices specialized in internal medicine and cardiology in the Rhine-Main area, Germany. Participants underwent an objective 7-day PA measurement with a 3D accelerometer (Dynaport, McRoberts) at screening and after the 12-week intervention period. Following the screening, eligible participants were randomized into one of three groups: standard care (PA consulting), the intervention arm with app-based PA tracking and coaching, or the intervention arm with tracking but without coaching. The primary efficacy endpoint was the change in average daily step count between the average step count at baseline and at the end of the intervention, comparing standard care to a 12-week app-based PA coaching intervention. Conclusion Exercise intolerance is a primary symptom in HFpEF patients, leading to poor quality of life and HF-related adverse outcomes due to physical inactivity. The MyoMobile study was designed to investigate the use of app-based coaching to improve PA in patients with HFpEF with a personalized, home-based intervention, focusing on simple step counts for flexibility and ease of integration into daily routines. Clinical trial registration URL: https://clinicaltrials.gov/ct2/show/NCT04940312. Unique identifier NCT04940312.

The relationship between body appreciation and weight-related health behaviors among Chinese adolescents.

Research on body appreciation has flourished globally in recent years. College students and adults, rather than adolescents have been mainly focused in China. Therefore, this study aims to investigate the current status of body appreciation and weight-related health behaviors among Chinese adolescents, and elucidate their multifaceted relationships. A total of 487 students from two junior high schools were selected through stratified cluster sampling for this cross-sectional study conducted in Hangzhou city, China. Data were collected by using the questionnaire including the Body Appreciation Scale-2 (BAS-2), the Physical Activity Questionnaire for Adolescents (PAQ-A), and the self-designed Food Frequency Questions. The study showed current status of body appreciation among Chinese adolescents, with a majority categorized as physically inactive and having unhealthy dietary behaviors, leading to abnormal weight. Notably, this study provided novel evidence linking body appreciation with positive weight-related behavioral outcomes in both physical activity and dietary behaviors (such as sufficient fruit and vegetable consumption and reduced fried food intake) among Chinese adolescents. Besides, this study also revealed the impact of gender, mother's education, and household income on weight-related health behaviors among adolescents. This study emphasized the significant relationships between body appreciation and weight-related health behaviors among Chinese adolescents. These findings present empirical evidence for the development of intervention programs aimed at fostering body appreciation and promoting weight-related health behaviors in adolescents.

Accelerometer-Assisted Physical Activity Outcomes During the First Year of Recovery After Anterior Cruciate Ligament Reconstruction: A Prospective Cohort Pilot Study.

Wearable activity-measurement devices are increasingly popular among the public, but there is little information regarding their use among patients undergoing sports medicine procedures. The purpose of this study was to compare accelerometer-measured data with traditional patient-reported measures and to determine the trajectory of physical activity from before surgery to 1 year after anterior cruciate ligament reconstruction. Adult patients undergoing primary anterior cruciate ligament reconstruction were enrolled in this prospective cohort pilot study. The Tegner activity scale, Marx activity scale, International Physical Activity Questionnaire Short Form (IPAQ-SF), Knee injury and Osteoarthritis Outcome Score (KOOS), and EuroQoL-5D were administered preoperatively and 3, 6, and 12 months postoperatively. At these intervals, each patient was asked to wear an accelerometer for 7 consecutive days. Time spent in moderate-to-vigorous physical activity (MVPA min/wk), metabolic equivalents of physical activity, and average daily steps were calculated from the accelerometer output and correlated with patient-reported measures. Twenty-eight patients were included in this study. Of the 28 patients, 20 remained, and at the 12-month analysis, 18 patients were analyzed. There were significant improvements in Tegner activity scale score, KOOS symptoms, sports/recreation, and quality of life subscales, and IPAQSF MVPA min/wk at final follow-up. All accelerometer-based outcomes had improvements at 3, 6, and 12 months. The accelerometer may be a useful tool for understanding patients' activity levels at different time points during their recovery and for providing tangible targets for patients to achieve at least an average recovery. [Orthopedics. 202x;4x(x):xx-xx.].

Physical Activity, Steps, and Cardiovascular Disease: A Literature Review

Abstract Despite decades of literature on the benefits of physical activity (PA) on cardiovascular disease (CVD) and other health outcomes, rates of physical inactivity and sedentary time remain alarmingly high and are likely contributing to the global increase in CVD. Roughly one-third of the world’s population does not meet the World Health Organization (WHO) guideline recommended levels of aerobic PA, defined as ≥ 150 min of moderate-intensity PA or ≥75 min of vigorous-intensity PA, or an equivalent combination of both. This is in addition to recommending individuals perform at least 2 days of muscle-strengthening activities per week involving all major muscle groups, which provide additional CVD benefits beyond aerobic PA. Disparities by sex and between high- and low-income countries persist, with modeling studies suggesting a direct global economic cost of $5 billion dollars. To combat the global health crisis of physical inactivity, the WHO implemented a global action plan on PA in 2013, which set a target of a 15% relative reduction in physical inactivity by 2030. Barriers to attaining adequate PA levels are abundant, however, step counting represents a relatively novel metric of PA with a growing body of literature supporting their utility given mounting evidence of CVD benefits, with trends that mirror intensity-centric metrics of PA that are used in WHO guidelines. This manuscript provides an up-to-date review of the evidence on the benefits of PA, steps, and cardiovascular outcomes.

Motif clustering and digital biomarker extraction for free-living physical activity analysis

BackgroundAnalyzing free-living physical activity (PA) data presents challenges due to variability in daily routines and the lack of activity labels. Traditional approaches often rely on summary statistics, which may not capture the nuances of individual activity patterns. To address these limitations and advance our understanding of the relationship between PA patterns and health outcomes, we propose a novel motif clustering algorithm that identifies and characterizes specific PA patterns.MethodsThis paper proposes an elastic distance-based motif clustering algorithm for identifying specific PA patterns (motifs) in free-living PA data. The algorithm segments long-term PA curves into short-term segments and utilizes elastic shape analysis to measure the similarity between activity segments. This enables the discovery of recurring motifs through pattern clustering. Then, functional principal component analysis (FPCA) is then used to extract digital biomarkers from each motif. These digital biomarkers can subsequently be used to explore the relationship between PA and health outcomes of interest.ResultsWe demonstrate the efficacy of our method through three real-world applications. Results show that digital biomarkers derived from these motifs effectively capture the association between PA patterns and disease outcomes, improving the accuracy of patient classification.ConclusionsThis study introduced a novel approach to analyzing free-living PA data by identifying and characterizing specific activity patterns (motifs). The derived digital biomarkers provide a more nuanced understanding of PA and its impact on health, with potential applications in personalized health assessment and disease detection, offering a promising future for healthcare.

Functional Capacity at Rehabilitation Discharge Predicts Physical Activity Characteristics 24 Weeks Later for People With Total Knee Arthroplasty: A Secondary Analysis of a Randomized Controlled Trial.

Functional Capacity at Rehabilitation Discharge Predicts Physical Activity Characteristics 24 Weeks Later for People With Total Knee Arthroplasty: A Secondary Analysis of a Randomized Controlled Trial.

Longitudinal increase in physical activity and adverse cardiovascular outcomes following the diagnosis of acute coronary syndrome

ObjectivesPhysical activity (PA) provides protective effects against cardiovascular diseases, including ischaemic heart disease. However, recommending moderate to vigorous PA (MVPA) to patients with recent acute coronary syndrome (ACS) raises concerns...