Previous Physical Activity Levels Research Articles

Fear of reinjury after acute Achilles tendon rupture is related to poorer recovery and lower physical activity postinjury.

The aim of this study was to investigate how fear of reinjury to the Achilles tendon affects return to previous levels of physical activity and self-reported Achilles tendon Total Rupture Score (ATRS) outcomes. Data were collected from a large cohort of patients treated for an acute Achilles tendon rupture at Sahlgrenska University Hospital Mölndal between 2015 and 2020. The ATRS and additional questions concerning fear of reinjury, treatment modality, satisfaction of treatment and recovery were analyzed 1-6 years postinjury. Analysis was performed to determine the impact of fear of reinjury on patient-reported recovery and physical activity. Of a total of 856 eligible patients, 550 (64%) answered the self-reported questionnaire and participated in the follow-up. Of the participants, 425 (77%) were men and 125 (23%) were women. ATRS, recovery in percentage, satisfaction of treatment, recovery on a 5-point scale and physical activity level post- versus preinjury were significantly related to fear of reinjury (p < 0.001). Of the nonsurgically treated patients, 59% reported fear of reinjury compared to 48% of the surgically treated patients (p = 0.024) Patients that reported fear of reinjury had a 15-point lower median ATRS score than those who did not (p < 0.001). More than half of patients who have suffered an Achilles tendon rupture are afraid of reinjuring their tendon. Patients who reported fear of reinjury exhibited a significantly lower ATRS score. This indicates the importance of addressing psychological aspects in the treatment after this injury. Level II.

A Comprehensive Review of Graft Choices and Surgical Techniques in Primary Anterior Cruciate Ligament Reconstruction: An Outcome Analysis.

Anterior cruciate ligament (ACL) injuries are among the most prevalent knee injuries, particularly in athletes engaged in high-impact sports. ACL reconstruction is a widely performed surgical procedure to restore knee stability, prevent further knee damage, and enable patients to return to their previous physical activity levels. However, the success of ACL reconstruction is influenced by various factors, including the choice of graft and the surgical technique employed. This comprehensive review explores the outcomes of different graft options - autografts, allografts, and synthetic grafts - and various surgical techniques such as single-bundle versus double-bundle reconstruction and anatomic versus non-anatomic tunnel placement. The review analyzes the short- and long-term outcomes, including functional recovery, return to sports, complication rates, and the impact of patient-specific factors such as age, activity level, and comorbidities. Additionally, the review discusses the role of rehabilitation protocols in optimizing surgical outcomes. By synthesizing current evidence, this review aims to provide clinicians with insights into the most effective graft choices and surgical techniques for primary ACL reconstruction, ultimately guiding the optimization of patient outcomes and highlighting areas for future research.

Epidemiological study of pediatric ACL injuries

ACL rupture in children is a serious injury that exposes the knee to meniscal damage and then, in the medium term, to osteoarthritis. The incidence of this type of injury has been rising steadily since the 1990s with the everincreasing practice of "pivotal" sports such as football, basketball, handball, rugby and gymnastics. The aim was to study the characteristics of the population of subjects affected and to identify risk factors for meniscus and cartilage damage. This was a retrospective, descriptive and analytical epidemiological study of 80 children who had consulted an orthopaedic clinic for an ACL rupture. At the orthopaedic consultation centre at Haguenau Hospital, from March 2014 to November 2022, with an average age of 13.8 years. Diagnosis was based on questioning, clinical examination and MRI as paraclinical examinations. The 15 parameters analysed were as follows: age at the time of the initial trauma, sex, corrected body mass index (BMI), side, type of sport practised, sporting level, Tegner score, circumstances of the causal trauma, time to consultation, time to MRI, attempt at functional treatment, time to surgery, associated meniscal lesions. The age at the time of surgery, and at the end the operative report. There is still a debate on the optimal treatment of ACL ruptures. Most surgeons who specialise in this area support early surgery, with the aim of preventing secondary damage and returning to the previous level of physical activity as quickly as possible. Of the 80 cases, 88.75% were treated surgically and 11.25% functionally, with a median corrected BMI of 19.7. 41.25% of cases had associated meniscal lesions. The 3 most frequently practised sports were handball, rugby and football. We also found a close relationship between meniscal injury and corrected BMI. Our results are in line with the literature, which is in favour of early repair of the anterior cruciate ligament in adolescent athletes, especially those with a BMI.

Repair of Bone Defect of the Talus with Calcaneus Autograft and Autologous Matrix-Induced Chondrogenesis: A Case Report

Background. The question of choosing a treatment strategy for full-thickness osteochondral defects of the tarsal bone remains relevant. When choosing a treatment strategy, two key points should be considered: restoring the architecture of the tarsal bone and achieving long-term restoration of cartilage-like coverage in the area of the osteochondral defect.&#x0D; Case report. A 34-year-old physically active patient sustained an ankle injury in 2011 and was treated conservatively. In 2020, he complained of pain and reduced activity. Initial assessment scores were: VAS (Visual Analog Scale) — 6 points, AOFAS-AHS (American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score) — 49 points, FAAM (Foot and Ankle Ability Measure) — 55 points. An MRI revealed an osteochondral defect in the medial part of the tarsal bone dome, measuring 16.4×9.4 mm and with a depth of 20.8 mm. The patient underwent the replacement of the bone defect with an autograft taken from the heel bone, using autologus matrix induced chondrogenesis (AMIC) procedure. After 6 months, a follow-up examination was performed, including ankle arthroscopy and removal of metal fixators. Arthroscopic findings showed that the chondroplasty area was almost identical to intact joint cartilage. One year after chondroplasty, the patient returned to his previous level of physical activity. Assessment scores were: VAS — 1 point, AOFAS-AHS — 94 points, FAAM — 83 points.&#x0D; Conclusion. The proposed method allows for the restoration of the architecture of the tarsal bone along with the cartilage surface. The use of a bone autograft helps to fill the tarsal bone defect, and covering the autograft with a collagen membrane contributes to the formation of hyaline-like cartilage tissue in the defect area.

Changes in the oxidative-antioxidant status of blood in freestyle wrestlers under the influence of physical exertion

Purpose of the study: to evaluate the “lipid peroxidation-antioxidant protection” system in freestyle wrestlers under the influence of intense physical activity in order to identify the nature of oxidative processes and the antioxidant status of the athletes’ body.Materials and methods: the study involved athletes — freestyle wrestlers, boys 18–22 years old, with sports qualifications: candidate master of sports or master of sports, regularly involved in freestyle wrestling. The control group consisted of students who did not have a sports category and were not involved in sports activities, comparable in gender, age, weight category with the comparison group. The material for the study was plasma and red blood cells. Blood sampling from athletes was carried out twice, at the end of the preparatory and competitive periods, in the morning, on an empty stomach from the ulnar vein, in accordance with generally accepted requirements. Components of lipid peroxidation and antioxidant defense were determined using spectrophotometric and fluorometric methods.Results: it was found that in athletes after intense physical activity (competitive period), there is a significantly significant decrease in substrates with double bonds by 61 %, primary products by 59 % and intermediate products by 44 %, an increase in the final products of lipid peroxidation by 25 % against the background of inhibition activity of antioxidant protection components: retinol by 40 %, superoxide dismutase by 7 % and reduced glutathione by 11 %.Conclusion: The level of free radical processes increases during physical activity due to the accumulation of oxygen in organs and tissues, and depends on the intensity and duration of the exercise. In the course of the study, it was established that the preparatory and competitive periods, in comparison with the control group, among freestyle wrestlers, depending on the previous level of physical activity, are characterized by activation of lipid peroxidation processes and inhibition of enzymatic and non-enzymatic components of antioxidant protection. The established changes are recommended to be taken into account when conducting comprehensive rehabilitation of athletes, when developing recommendations for improving the training process, as well as when using antioxidant complexes for athletes aimed at restoring various parts of the body’s antioxidant defense.

Influence of Pokémon Go Playing Style on Physical Activity and Its Effect on Kinanthropometry Variables and Body Composition in Adolescents.

Pokémon Go is a mobile app that offers both continuous and intermittent (gamified) gameplay, but no previous research in adolescents is known to have addressed changes in physical activity and body composition according to playing style. For this reason, the aims of the present investigation were (1) to establish the differences in the level of physical activity, and its influence on the kinanthropometric and body composition, of the adolescent population, considering their Pokémon Go playing style; and (2) to analyze whether the practice of previous physical activity has an influence on the effects of the use of Pokémon Go on the level of physical activity and changes in kinanthropometric and body composition variables. A total of 94 adolescents (50 males and 44 females; mean age: 13.66 [1.17] years-old; mean body mass index: 20.82 [4.03] kg/m2) whose physical activity level and body composition were measured, participated in the investigation. Two groups of adolescents completed a 10-week intervention using Pokémon Go continuously (n = 30) or intermittently (n = 31), while the control group (n = 33) did not use any after-school app. A one-way analysis of variance (ANOVA), a multivariate analysis of variance, and 2 repeated-measures ANOVA were performed to analyze the data. Inactive adolescents in the continuous use group increased their physical activity between the pretest and posttest (P = .038), but this did not occur in the active group. Regarding body composition variables, the increase in body mass (P < .001) and body mass index (P = .006) in the control group was significantly higher than in the continuous use group of adolescents who were inactive, but not in the active group, while the decrease in fat mass (P < .001-.036) and sum of 3 skinfolds (P < .001-.003) was significantly higher in both Pokémon Go use groups as compared to the control group, regardless of the previous physical activity level. The continuous style of play seems to be more effective in increasing physical activity in adolescents, but the changes in body composition and kinanthropometric variables occur similarly with continuous and intermittent gameplay. Therefore, the playful use of Pokémon Go can be used in educational and health fields to produce changes in body composition in this population.

Postoperative Rehabilitation for Arthroscopic Management of Femoroacetabular Impingement Syndrome: a Contemporary Review.

Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain that may potentially lead to osteoarthritis. Operative management of FAIS seeks to arthroscopically reshape the abnormal hip morphology and repair the labrum. For rehabilitation following operative management, a structured physical therapy program is unanimously recommended for the patient to return to their previous level of physical activity. Yet, despite this unanimous recommendation, significant heterogeneity exists among the current recommendations for postoperative physical therapy programs. A four-phase postoperative physical therapy protocol is favored among current literature, with each phase being comprised of its own goals, restrictions, precautions, and rehabilitation techniques. Phase 1 aims to protect the integrity of the surgically repaired tissues, reduce pain and inflammation, and regain ~ 80% of full ROM. Phase 2 guides a smooth transition to full weightbearing, so the patient may regain functional independence. Phase 3 helps the patient become recreationally asymptomatic and restores muscular strength and endurance. Finally, phase 4 culminates in the pain-free return to competitive sports or recreational activity. At this time, there exists no single, unanimously agreed upon postoperative physical therapy protocol. Among the current recommendations, variation exists regarding specific timelines, restrictions, precautions, exercises, and techniques throughout the four phases. It is imperative to reduce ambiguity in current recommendations and more specifically define postoperative physical therapy following operative management of FAIS to more expeditiously return patients to functional independence and physical activity.

Determinants of the distance walked in the six-minute walk test at discharge from patients with heart failure

Background: The distance walked during the six-minute walk test (6MWD) is predicted measure for mortality and rehospitalization in patients with heart failure. Objective: To identify the determinants of 6MWD at discharge from patients with heart failure. Methods: This is a descriptive and cross-sectional clinical study. Patients aged 18 to 80 years and functional class I to II were eligible. Those who have a type of psychiatric, cognitive or locomotor disorder; atrial fibrillation; use of a fixed frequency heart pacemaker were not eligible. The following were collected from the medical records: name, age, sex, BMI (body mass index); ejection fraction of the left ventricle; hemoglobin; fasting blood glucose; etiology of stay; presence of risk factors for cardiovascular diseases; presence of infection. The muscle strength of the knee extension movement was evaluated by dynamometry, a quality of life with the Nottingham Health Profile (NHP), the previous physical activity level by the International Physical Activity Questionnaire (IPAQ) and the 6MWD. Results: Sixty patients from a final sample (58.3% males, mean age 56.23±10.44 years). Were selected as the variables selected from the multivariate analysis: age (p=0.057), dynamometry (p=0.004), Total NPH (p=0.017) and IPAQ (p=0.018). R=0.72 and R²=0.53 with p&lt;0.05 and the mean of the 6MWD was 393.16±42.80 meters. Conclusion: In this study the determinants of 6MWD were: age, total mean knee dynamometry, total NPH and IPAQ.

Systematic Review and Meta-Analysis of Circulating Irisin Levels Following Endurance Training: Results of Continuous and Interval Training.

Irisin has been suggested as a helpful hormone for adverse metabolic conditions. However, the interaction between acute endurance exercises and irisin is still unclear. The purpose of this systematic review and meta-analysis was to determine the acute effect of endurance training, either continuous or interval training, on circulating irisin in healthy adults. Literature search was conducted in Web of Science, PubMed, Scopus and CINAHL until September 2022. Clinical trials measuring irisin levels following a single session of interval or continuous endurance training in healthy adults were eligible. Cohen's d effect size (95% confidence level), subgroup analyses and univariate meta-regression were calculated using a random-effects model. The procedures described by PRISMA were followed and the protocol was prospectively registered with PROSPERO (CRD 42021240971). Data of the 16 included studies comprising 412 individuals showed a significant increase following one session of continuous endurance training (d = 0.33, 95% CI: 0.20 to 0.46, p < 0.001), while interval training did not change circulating irisin (d = 0.16, 95% CI: -0.12 to 0.44, p = 0.202). Both subgroup and univariate meta-regression analyses showed non-significant differences in the change of circulating irisin comparing blood measurement, exercise mode or previous level of physical activity of the participants and circulating irisin at baseline, duration, or intensity of the exercise, respectively. Continuous method for endurance training increases circulating irisin in healthy adults, while studies measuring circulating irisin following interval training in healthy adults are still limited to be conclusive.

Abstract 10745: Return to Play After Covid-19 Infection: Cardiac Imaging Findings in Youth

Introduction: SARS CoV2 has been associated with acute and subacute myocarditis. Screening after COVID-19 has been recommended prior to returning to physical activity. The yield of such investigations, particularly in youth, remains unknown. Methods: Retrospective chart review was performed of patients evaluated in a cardiology clinic for return to play (RTP) after COVID-19 between 01/20 - 06/21. Iteratively updated guidance for testing was provided to ambulatory providers. Patients with MIS-C were excluded. We reviewed demographics, clinical evaluation, and cardiac imaging. Results: Of 429 patients (age 16.3 ± 2.7 [range 8-21] yrs, 44% male) evaluated including 9 with pre-existing heart disease, 318 underwent echocardiograms and 23 also had cardiac MRI. Cardiac MRI was performed for abnormal screening ECG or echocardiogram or cardiovascular symptoms. New echocardiographic abnormalities were detected in 69 patients: 4 were possibly related to COVID-19 infection, 3 were new structural heart disease (2 anomalous coronary, 1 bicuspid aortic valve), and 62 were normal variants or trivial findings. New ventricular dysfunction (right or left, qualitative dysfunction or LV ejection fraction [EF] &lt;55%) was noted in 11 patients (LV EF mean 52.7 ± 2.6%, minimum 46%). Eight underwent cardiac MRI confirming trivial to no ventricular dysfunction and none of the 23 MRIs demonstrated late gadolinium enhancement or met Lake Louise criteria for myocarditis. All patients without new diagnoses of structural heart disease were ultimately deemed safe to return to previous levels of physical activity. Conclusions: Cardiovascular evaluation for RTP of youth after COVID-19 demonstrated mild transient abnormalities and incidental findings, but no diagnoses of myocarditis. These data suggest early concerns about subclinical myocarditis may have been overestimated. Future studies should consider the costs and benefits of current society algorithms for such evaluations.

Monitoring physical activity using wearable technology in people with Achilles tendinopathy undergoing physiotherapy treatment: A pilot prospective cohort study

Background: Physical activity modification and progressive loading exercises are key components of Achilles tendinopathy management. Over the course of rehabilitation, it is recommended to continue physical activities within the limits of pain tolerance and gradually and progressively recover the previous level of physical activity. This is important as symptomatic recovery does not guarantee physical activity recovery. However, the adoption of different physical activity modification strategies over time may interfere with the success of loading exercise programs.

Can Previous Levels of Physical Activity Affect Risk Factors for Cardiorespiratory Diseases and Functional Capacity after COVID-19 Hospitalization? A Prospective Cohort Study.

Purpose To evaluate the influence of previous levels of physical activity on hemodynamic, vascular, ventilatory, and functional outcomes after coronavirus disease 2019 (COVID-19) hospitalization. Methods Sixty-three individuals with COVID-19 had their clinical status and previous levels (12 month) of physical activity (Baecke Questionnaire of Habitual Physical Activity) assessed at hospital admission. Individuals were then allocated to lower levels of physical activity (ACTLOWER; N = 22), intermediate levels of physical activity (ACTINTERMEDIATE; N = 22), or higher levels of physical activity (ACTHIGHER; N = 19) groups, according to tertiles of physical activity. Resting hemodynamic (heart rate and brachial/central blood pressures) and vascular (carotid-femoral pulse wave velocity, augmentation index, and brachial artery flow-mediated dilation) variables, pulmonary function (spirometry), respiratory muscle strength (maximal respiratory pressures), and functional capacity (handgrip strength, five-time sit-to-stand, timed-up and go, and six-minute walking tests) were measured at 30 to 45 days after hospital discharge. Results ACTLOWER showed lower levels (P < 0.05) of forced vital capacity, forced expiratory volume in the first second, maximal voluntary ventilation, and maximal expiratory pressure than ACTHIGHER. ACTLOWER also had lower (P = 0.023) walking distance (~21%,) and lower percentage of predicted walking distance (~20%) at six-minute walking test during follow-up than ACTINTERMEDIATE. However, hemodynamic and vascular variables, handgrip strength, five-time sit-to-stand, and timed-up and go were not different among groups. Conclusion ACTLOWER showed impaired ventilatory parameters and walking performance when compared with ACTHIGHER and ACTINTERMEDIATE, respectively. These results suggest that previous levels of physical activity may impact ventilatory and exercise capacity outcomes 30 to 45 days after COVID-19 hospitalization discharge.

The effects of COVID-19 stay-at-home orders on physical activity of people with obesity.

ABSTRACTObjective To verify the association of changes on physical activity levels during coronavirus disease 2019 (COVID-19) outbreak of individuals with normal weight and overweight/obesity, and the influence of sex in this relationship.Methods This cross-sectional study (survey research) was conducted in Brazil between May 5 and May 17, 2020. Participants (n=1,828 / 1,062 women >18 years) were invited through social media to answer a structured questionnaire via Google Forms. The online assessment included self-reported responses to questions on physical activity, overall health, weight, and height. Binary logistic regression analyzed the relationship between overweight/obesity (body mass index ≥25kg/m2), the impact of COVID-19 on physical activity level, and the influence of sex.Results Compared to normal weight people, those with overweight/obesity practice less moderate to vigorous physical activity (p<0.001). There were associations between women and men with overweight/obesity and the impact of COVID-19 on the physical activity practice compared to normal weight people, adjusted by age, education level, social isolation, and previous physical activity level (p<0.017).Conclusion The study found an association of weight and changes in physical activity levels. Individuals with overweight/obesity were more likely to have a lower physical activity level during COVID-19 pandemic, regardless of sex.

Functional Complications of Patellar Instability Treatment with Medial Patellofemoral Ligament Reconstruction with the Medial Third of the Patellar Tendon with a Minimum 5-Year Follow-Up.

Objective To evaluate major complications after a minimum of 5 years of follow-up after acute or recurrent patellar dislocation treated with medial patellofemoral ligament (MPFL) reconstruction with the medial third of the patellar tendon, with or without associated medialization of the tibial anterior tuberosity (TAT). Methods A total of 50 patients were included, with a minimum follow-up of 5 years. The patients were evaluated regarding complications such as joint stiffness, recurrence of patellar dislocation, subjective instability reported by patients, and inability to return to the previous level of physical activity. Results The mean follow-up was of 8.9 ± 2.6 years, with a minimum of 6 and maximum of 15 years; 64% of the patients were women, with a mean age of 27 ± 11.2 years old; 24% were submitted to TAT osteotomy for simultaneous medialization; and 46% were acute cases. Only 9 poor results (18%) were found, all resulting from recurrence of dislocation (12%) and complaint of subjective instability (6%) at between 36 and 60 months of follow-up. No other complications occurred. Among the poor results, five occurred in cases of acute dislocation, and four in recurrent cases, and only one had undergone TAT osteotomy. Conclusion Reconstruction of the MPFL with the medial third of the patellar tendon, associated or not with TAT medialization osteotomy, is an alternative in the treatment of acute or chronic patellar instability, with a failure rate of only 18% in at least 5 years of follow-up. In addition, it is safe treatment, that does not present other complications.

Missing the Bull’s Eye: A Case Report of Tibialis Anterior Hernia

Objectives: Shin pain is a broad term used to describe lower leg pain. It is commonly seen in the athletic/sports population. Various conditions have been claimed to produce leg pain, and muscle herniation is one of these conditions. Muscle herniation is the protrusion of muscle through a defect in the overlying fascia. Although such herniation is common, it is often an underdiagnosed condition in the lower extremity. It usually occurs in athletes, especially in the anterior compartment of the leg, as a result of trauma or due to muscle hypertrophy secondary to strenuous exercise. Herniation diagnosis depends on its clinical presentation as it appears as a palpable soft tissue bulge through a fascia defect; radiological findings are used to confirm the diagnosis. Conservative treatment should be the initial approach, and surgery can be performed if conservative treatment fails. Methods: We present a case of symptomatic anterior lower leg pain, initially diagnosed as a psychosomatic disorder by two orthopedic physicians. However, tibialis anterior hernia in this patient was confirmed after physical examination by a physiotherapist and subsequent referral for ultrasonographic evaluation to a radiologist. The patient underwent an 8-week course of conservative treatment under the supervision of a physiotherapist. This treatment significantly improved the patient’s pain and function. Results: After eight weeks of conservative treatment using Minhaj protocol for Tibialis Anterior hernia, the patient has reported improvement in pain (reduction of score from eight to two on the NPRS scale) and function. The patient returned to his previous level of physical activity following eight weeks of rehabilitation. Discussion: Tibialis anterior hernia should be considered a differential diagnosis in chronic leg pain with palpable soft tissue protrusion. Conservative treatment can be chosen as the primary approach.

Lockdown measures for COVID-19 outbreak and variation in physical activity in patients with heart failure and cardiac implantable devices.

AimsThe present study analysed the patterns of physical activity pre-, during and post-lockdown measures for COVID-19 pandemic in patients with chronic heart failure (CHF) and cardiac implantable electronic devices (CIED) under remote monitoring (RM), and assessed the physical activity patterns during these periods.MethodsThe raw data from 95 patients with CHF (age 67,7 15,1 years, 71,5% male) corresponding to 2238 RM transmissions of the Medtronic Carelink™ network platform was obtained. The physical exercise profiles and the impact of the lockdown measures on the physical behaviour during and after the measures were analysed. According to the level of activity duration in the pre-lockdown, lockdown and post-lockdown periods, the patterns of behaviour were identified (non-recoverees, incomplete recoverees, recoverees and full-recoverees).ConclusionRM of CHF patients with CIED using the Carelink™ network is useful for close follow-up and identification of heart failure risk status variations. After relieving the confinement measures there were two groups of patients that did not recover the previous physical activity levels. Physical inactivity in patients with CHF can have a significant impact on outcomes.

Physical activity trajectories are associated with the risk of all-cause and cardiovascular disease mortality in patients with coronary heart disease. A systematic review and meta-analysis

Abstract Background Current guidelines recommend that adults with chronic health conditions should engage in regular physical activity (PA), and avoid inactivity. Yet, the exact role of PA trajectories in the mortality risk of patients with coronary heart disease (CHD) remains unclear. Purpose We aimed to perform a systematic review and meta-analysis on the association of longitudinal trajectories of PA with all-cause and cardiovascular disease (CVD) mortality in patients with CHD. Methods We performed a systematic review and meta-analysis based on PRISMA statement. Six electronic databases were searched for cohort studies that analysed the association of PA trajectories (inactive over time, active over time, increased activity over time, and decreased activity over time) with the risk of all-cause and CVD mortality in patients with CHD. Study quality was evaluated by the Newcastle Ottawa scale. We used the inverse variance weighted method to combine summary measures using random-effects models to minimize the effect of between-study heterogeneity. The study is registered in PROSPERO. Results We meta-analyzed nine longitudinal cohorts involving 33,576 patients (25010 acute CHD, 8566 chronic CHD, mean age 62.5 years, 34% women, median follow-up duration 7.2 years), according to four PA trajectories. All studies assessed PA through validated questionnaires. The definitions of activity and inactivity at baseline and follow-ups were in agreement with current PA guidelines. Trajectories were calculated based on comparison of activity status at baseline and follow-up. All the studies defined increased activity over time as moving from the inactive to the active category, and decreased activity over time as moving from the active to the inactive category. Compared to patients remaining inactive over time, the lowest risk of all-cause and CVD mortality was observed in patients remaining active over time (HR [95% CI]: 0.50 [0.39–0.63] and 0.48 [0.35–0.68], respectively), followed by patients who increased their PA over time (HR [95% CI]:0.55 [0.44–0.7] and 0.63 [0.51–0.78], respectively), and patients who decreased activity over time (HR [95% CI]: 0.80 [0.64–0.99] and 0.91 [0.67–1.24], respectively). These results were consistent both in the acute and chronic CHD settings. The overall risk of bias was low, and no evidence of publication bias was observed. Multiple sensitivity analyses provided consistent results. Conclusions In patients with CHD, the risk of all-cause and CVD mortality is progressively reduced from being inactive over time, to decreased activity over time, to increased activity over time, to being active over time. These findings highlight the benefits of adopting a more physically active lifestyle in patients with chronic and acute CHD, independent of previous PA levels. Future studies should clarify the complex interactions between motivations and disease severity as potential drivers for PA trajectories Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): University of Bern

The impact of physical activity on psychological well-being and perceived health status during coronavirus pandemic in university students

ObjectivesTo investigate changes in moderate and vigorous physical activity (PA), and find correlation with psychological well-being and perceived health status in university students prior to versus 4–6 weeks following the outbreak of coronavirus pandemic MethodsRegistered students to the 2020/2021 academic year participated in an online survey representing four Hungarian universities in the framework of “COVID-19 International Student Well-being Study” project. Moderate and vigorous PA were measured with a single question, psychological well-being was evaluated using the Center for Epidemiological Studies − Depression Scale (CES-D) short form and perceived health status on the 11-point Cantril ladder respectively. Statistical analyses were calculated using SPSS 26.0 software ResultsA total of 2779 Hungarian citizen students completed the questionnaire and 2162 (27.7% males) provided full information on PA. Mean age was 24.52 (SD = 7.15) years. A significant decrease was observed in moderate PA prior to and during social isolation (Z = -14.956; p < .001). Students mean well-being was 10.23, SD = 5.28)/32. After analyzing changes (decreased, unchanged, increased) of PA in the context of well-being, it was found students with reduced PA had significantly less favorable scores on well-being scale than students who unchanged or increased their PA level, both in moderate (F = 32.35; p < .001) and vigorous (F = 21.44; p < .001) PA. Regarding the perceived health status there was significant reduction during the pandemic (M = 7.58, SD = 2.19) compared to the preceding period (M = 7.94, SD = 1.85; p < .001). This reduction was most notable in the group that reduced PA ConclusionsThe closure of universities and sport facilities unfavorably influenced the students’ previous PA level. Based on the result, there is a negative relationship between PA and psychological wellbeing also between PA and perceived health status. Universities may pay more attention to keep their students physically active even during a pandemic as it may be far from being over yet.

A Scoping Review of Physical Activity in People With Lower-Limb Loss: 10,000 Steps Per Day?

After amputation, people with lower-limb loss (PLL) face challenges to regain their previous physical activity level. Assessing the scope of evidence regarding physical activity in PLL can identify sources of evidence and gaps within the literature that can influence amputation-related research, outcome assessment choices, and wellness activities. The purpose of this scoping review was to map the evidence regarding steps per day as a physical activity measure for PLL. Specific aims were to (1) identify research designs, (2) catalog population subgroups, (3) document steps per day measurement methods, and (4) provide descriptive data for steps per day in PLL. The MEDLINE, CINAHL, Embase, Web of Science, and AMED databases; and the Journal of Prosthetics and Orthotics archive were searched without language or time limits. Exclusion criteria included no PLL subjects, not peer-reviewed, and no direct step count measure. Inclusion criteria allowed any sample size, nonprosthetic use, and self-reported step count. As a scoping review, only descriptive statistics were compiled, and no methodologic quality assessment was performed. Twenty-one articles using crossover (8), cohort (4), cross-section (8), and case-study (1) designs were included that reported accelerometer (19) or pedometer (2) data. Studies often mixed amputation etiologies (15/21) and most (13/21) excluded transfemoral amputations. Studies primarily examined people with transtibial amputations (81.2%) and people at independent community walking levels (Medicare functional classifications: K3 = 49.2%, K4 = 36.3%). All 21 studies had fewer than 100 participants, and overall included 515 subjects (343, 66.6% male), mean (SD) age 53.2 (22.1) years. Mean (SD) number of pooled steps per day for PLL was 5087 (2998): 5929 (3047) for transtibial amputations and 3553 (2030) for transfemoral amputations. Most PLL have low activity levels compared with the 10,000 steps per day generally recommended or 6000 common in people with diabetes. Research with larger samples, defined subgroups, and data along the recovery continuum would enhance knowledge of physical activity level in PLL. This scoping review has identified gaps in the research related to steps per day as a measure of physical activity in people with lower-limb loss to guide future research. People with lower-limb loss take fewer steps per day than suggested for general health. Increasing steps per day may be a useful goal for this population, and this study is a first step in improving knowledge of physical activity levels in people with lower-limb loss.

The association between physicians' exercise counseling and physical activity in patients with cancer: Which roles do patients' satisfaction and previous physical activity levels play?

The purpose of this study was to examine the association between physicians' exercise counseling and post-diagnosis physical activity (PA) in patients with cancer by investigating the mediating role of patients' satisfaction with exercise counseling as well as the moderating role of patients' previous PA. The study sample consisted of 1002 people with cancer (503 breast, 265 prostate, and 234 colorectal cancer). Participants reported their pre- and post-diagnosis moderate-to-vigorous PA (MVPA) levels, indicated whether their physician had covered different steps of exercise counseling as defined by the 5A framework (Assess, Advise, Agree, Assist, and Arrange) and rated their satisfaction with exercise counseling. A conditional process analysis was used to determine the direct and indirect effects of counseling on post-diagnosis MVPA through satisfaction at different levels of pre-diagnosis MVPA. Physicians' exercise counseling was associated with post-diagnosis MVPA in patients with cancer. However, the association differed by patients' pre-diagnosis MVPA (P = .039). While counseling was directly associated with higher post-diagnosis MVPA for individuals with low pre-diagnosis MVPA (CI: 0.02-0.20, P = .014), the effect was mediated through satisfaction with exercise counseling for previously highly active individuals (Boot CI: 0.01-0.08). Our findings emphasize the relevance of physicians' exercise counseling for PA in patients with cancer. However, the results indicate that in order to effectively influence patients' PA, it appears important to provide a comprehensive counseling that is adjusted to the patients' exercise experiences.