Recommended Levels Of Physical Activity Research Articles

P142 ADHERENCE TO PHYSICAL ACTIVITY GUIDELINES IN MAY MEASUREMENT MONTH 2021 AND 2022 PARTICIPANTS

Background and Objective: Physical activity (PA) lowers blood pressure (BP) and improves other cardiovascular risk factors, but many adults fail to achieve recommended PA levels. We aimed to evaluate adherence to the World Health Organisation's (WHO) PA guidelines and associations with BP treatment and control rates amongst adults screened in May Measurement Month (MMM) 2021 and 2022. Methods: Adults (≥18 years) were surveyed opportunistically from 74 countries. Each participant had three seated BP readings, using multiple imputation for any missing values. Participants who self-reported (yes/no) adherence to the WHO PA guidelines (75 minutes of vigorous exercise or 150 minutes of moderate exercise per week) were included. Hypertension was defined as a BP ≥140/90mmHg and/or taking BP-lowering medication. Results: Of 1,357,575 participants screened, 1,098,038 (80.9%) provided information on PA adherence. The mean (standard deviation) age was 46.8 (16.8) years and 52.9% were female. 333,214 (30.3%) participants adhered to PA guidelines. Of 394,444 (35.9%) participants with hypertension, PA adherence was higher in the 211,900 (53.7%) treated with BP-lowering medication (33.2% vs 27.4%, p<0.0001) than those untreated. Amongst treated hypertensives, adherence was higher in those with controlled BP (Table) and increased with age (p<0.0001). Of participants not taking BP-lowering medication, higher adherence was reported by the 703,594 (79.4%) normotensive participants (p<0.0001) and adherence was highest in the 18–29 age group. The absolute rates of PA adherence were 40.3%, 37.3% and 36.2% in those with a history of diabetes, stroke and myocardial infarction, respectively, compared to 29.7, 30.3, 30.2% in those without these respective conditions (all p<0.0001). Conclusions: Only 30% of MMM 2021 and 2022 participants worldwide adhered to WHO PA guidelines. Compared with untreated hypertensive participants, adherence was higher amongst those taking BP-lowering medication. PA adherence was significantly higher in those with diabetes. Those adhering to PA guidelines were more likely to have BP <140/90 mmHg, regardless of taking BP-lowering medication, emphasising the importance of PA for BP control.

DE-PASS best evidence statement (BESt): determinants of adolescents’ device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis

BackgroundAlthough physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents’ device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings.MethodsA search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents’ device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID: CRD42021282874.ResultsFourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual–psychological, four individual–behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found.ConclusionsWeak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents’ device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents’ PA/SB, including policy and environmental variables.

Association between the recommended volume of leisure-time physical activity and erectile dysfunction: A cross-sectional analysis of the national health and nutrition examination survey, 2001–2004

ObjectivePhysical activity-related interventions alleviate the severity of erectile dysfunction (ED), but it is unknown whether the recommended volume of physical activity (PA) or a higher level of physical activity reduces the likelihood of ED in adult males. We aimed to evaluate the association between the recommended volume of PA and ED among US male adults. DesignA nationally representative cross-sectional survey. SettingNational Health and Nutrition Examination Survey 2001–2004. ParticipantsA total of 2509 men aged ≥20 years were enrolled. Primary and secondary outcome measuresED and PA were assessed by a standardised self-report questionnaire. Weighted logistic regression analysis and spline fitting were used to assess the relationship between PA volume and the odds of ED. ResultsAmong 2509 US adult males, the mean (standard error) age was 43.7 (0.46) years. A total of 61.1 % of men reached the recommended volume of aerobic PA. Compared with participants not meeting the PA guidelines, individuals who had recommended aerobic activities demonstrated a 34 % reduction in the odds of having ED (OR 0.66, 95 % CI 0.48–0.90; p = 0.011). Notably, according to the restricted cubic spline, we revealed a dose‒response pattern between PA volume and reduced odds of ED, even when exceeding the recommended PA levels. When compared to males with moderate-equivalent PA of less than 150 min/week, the odds of ED in those with moderate-equivalent PA levels of 150–300 min/week and >300 min/week decreased by 22 % and 39 %, respectively. Compared with participants who did not meet the PA guidelines, the multivariable-adjusted ORs (95 % CIs) of ED associated with adequate PA volumes were 0.37 (0.22–0.61) among non-smokers and 0.85 (0.57–1.25) among current smokers (p for interaction = 0.023). Conclusions and RelevanceOur findings supported the benefit of meeting the guideline-recommended PA equivalents or higher volumes for ED prevention. However, PA-related benefit might be significantly diminished by smoking.

Exploring how people achieve recommended levels of physical activity, despite self-reported economic difficulties: a sense of coherence perspective

BackgroundThe salutogenic theory forms the basis for health promotion and describes health as a continuum from a dis-ease pole of health to an ease pole. The core concept for the salutogenic theory is sense of coherence (SOC). For a strong SOC, general resistance resources, such as solid economic situation, are essential. The aim was to explore how people – despite self-reported economic difficulties – comprehend, manage and find it meaningful to achieve the level of physical activity recommended by World Health Organisation (WHO).MethodThe study is based on interviews with people achieving the recommended physical activity (PA) level despite economic difficulties. The interviews were conducted at primary health care centres and family centres after a targeted health dialogue. We used a qualitative deductive content analysis based on sense of coherence as the main category, with the three generic categories of comprehensibility, manageability and meaningfulness.ResultThe findings elucidate a pattern of a process. In this process, the participants comprehend their knowledge of the health benefits of PA and have a plan for performing their PA. They utilise their resources in order to manage to apply their knowledge and plan for PA in their lives despite their challenges. When PA becomes meaningful to them, they have an intrinsic motivation to perform it and experience its benefits.ConclusionThis study suggests a possible process that might help in achieving the recommended PA level among people with economic difficulties and other challenges. The findings might be used in health promotion work, such as targeted health dialogues in primary health care, to reduce health inequalities when supporting people who are not achieving the recommended levels of PA.Trial registrationNot applicable.

What influences stroke survivors with physical disabilities to be physically active? A qualitative study informed by the Theoretical Domains Framework.

Although the benefits of regular physical activity (PA) after stroke are well established, many stroke survivors do not achieve recommended PA levels. To date, studies exploring determinants to PA have not used a behaviour change theory and focused on stroke survivors with physical disabilities. As a precursor to an intervention development study, we aimed to use the Theoretical Domains Framework (TDF) to identify factors influencing PA in stroke survivors with physical disabilities in Singapore. Between November 2021 and January 2022, we conducted interviews with 19 community-dwelling stroke survivors with a weak arm and/or leg. An interview guide based on the TDF was developed. We analysed the data deductively by coding interview transcripts into the theoretical domains of the TDF, and then inductively by generating themes and belief statements. To identify relevant TDF domains, we prioritised the domains based on the frequencies of the belief statements, presence of conflicting belief statements and evidence of strong belief statements. Eight of the 14 TDF domains were relevant, and included environmental context and resources, knowledge, social influences, emotion, reinforcement, behavioural regulation, skills and beliefs about capabilities. The lack of access, suitable equipment and skilled help often limited PA participation at public fitness spaces such as parks, gyms and swimming pools (environmental context and resources). While a few stroke survivors expressed that they had the skills to engage in regular PA, most expressed not knowing how much and how hard to work, which exercises to do, which equipment to use and how to adapt exercises and equipment (knowledge and skills). This often left them feeling afraid to try new activities or venture out to new places for fear of the unknown or adverse events (e.g., falls) (emotion). For some, doing the activities in a group encourage them to get out and engage in PA (social influences). In stroke survivors with physical disabilities, environmental context and resources had a significant influence on PA participation, and this often had a spill over effect into other domains. Our results inform a complex behaviour change intervention to improve PA after stroke, and has implications for intervention design for people with physical disabilities.

Exploring the Major Barriers to Physical Activity in Persons With Multiple Sclerosis: Observational Longitudinal Study.

Physical activity (PA) represents a low-cost and readily available means of mitigating multiple sclerosis (MS) symptoms and alleviating the disease course. Nevertheless, persons with MS engage in lower levels of PA than the general population. This study aims to enhance the understanding of the barriers to PA engagement in persons with MS and to evaluate the applicability of the Barriers to Health Promoting Activities for Disabled Persons (BHADP) scale for assessing barriers to PA in persons with MS, by comparing the BHADP score with self-reported outcomes of fatigue, depression, self-efficacy, and health-related quality of life, as well as sensor-measured PA. Study participants (n=45; median age 46, IQR 40-51 years; median Expanded Disability Status Scale score 4.5, IQR 3.5-6) were recruited among persons with MS attending inpatient neurorehabilitation. They wore a Fitbit Inspire HR (Fitbit Inc) throughout their stay at the rehabilitation clinic (phase 1; 2-4 wk) and for the 4 following weeks at home (phase 2; 4 wk). Sensor-based step counts and cumulative minutes in moderate to vigorous PA were computed for the last 7 days at the clinic and at home. On the basis of PA during the last 7 end-of-study days, we grouped the study participants as active (≥10,000 steps/d) and less active (<10,000 steps/d) to explore PA barriers compared with PA level. PA barriers were repeatedly assessed through the BHADP scale. We described the relevance of the 18 barriers of the BHADP scale assessed at the end of the study and quantified their correlations with the Spearman correlation test. We evaluated the associations of the BHADP score with end-of-study reported outcomes of fatigue, depression, self-efficacy, and health-related quality of life with multivariable regression models. We performed separate regression analyses to examine the association of the BHADP score with different sensor-measured outcomes of PA. The less active group reported higher scores for the BHADP items Feeling what I do doesn't help, No one to help me, and Lack of support from family/friends. The BHADP items Not interested in PA and Impairment were positively correlated. The BHADP score was positively associated with measures of fatigue and depression and negatively associated with self-efficacy and health-related quality of life. The BHADP score showed an inverse relationship with the level of PA measured but not when dichotomized according to the recommended PA level thresholds. The BHADP scale is a valid and well-adapted tool for persons with MS because it reflects common MS symptoms such as fatigue and depression, as well as self-efficacy and health-related quality of life. Moreover, decreases in PA levels are often related to increases in specific barriers in the lives of persons with MS and should hence be addressed jointly in health care management.

PHYSICAL ACTIVITY AND FITNESS LEVEL OF HEALTHCARE WORKERS IN A TERTIARY TEACHING HOSPITAL

Introduction: Physical activity (PA) and health-related fitness (HRF) level are currently considered key factors in public health promotion, and as such, is healthcare workers need to be well because they are not only responsible for themselves, but of their clients as well. To determine the PA and HRF levels of healthcare workers in a tertiary hospital, disaggregated to age, sex, work assignments, and job tenure. Methods: A cross-sectional research design was utilized to assess healthcare employees from the administrative, medical, nursing, and paramedical cohorts. ALPHA-FIT Test Battery was used to determine PA levels and assess cardiorespiratory fitness, muscular strength, lower extremity power and strength, upper body muscle endurance, balance, and body composition. Results: A total of 282 participants were tested, with mean age 37.4 years, 62.54% females, 52.13% perceives average health status, and the following fitness scores (One-Legged Stance: 2.67/3; Figure-of-8 run: 2.45/3; Shoulder-neck mobility: 4.58/5; Modified push-up: 2.05/4; Hand grip strength: 2.5/5; Jump and Reach: 2.82/4; Dynamic sit-up: 2.62/3; Six-minute walk test: 475.38 meters distance covered). Physical activity levels of HCWs are generally light (at least once a week). There were no significant differences in PA and HRF levels across cohorts. The results show significant inverse correlation between balance and shoulder-neck mobility and age. Discussion: Physical activity levels of HCW on average did not meet the World Health Organization’s recommended PA levels. Healthcare professionals who are expected to be well aware of benefits of PA and HRF have shown low to mid-fit levels of grip strength, upper extremity endurance, core strength, and cardiorespiratory endurance. Significance: Information on PA and HRF may aid in policy making on employee wellness such as appropriate workload and wellness facilities, which could highly impact health service delivery to the clients.

Physical activity and its impact on cardiovascular health in pediatric kidney transplant recipients

BackgroundCardiovascular (CV) morbidity after kidney transplantation (KTx) in childhood is of increasing importance. In light of a high prevalence of CV risk factors, protective measures such as physical activity (PA) come into focus. Our aim was to comprehensively assess PA in pediatric KTx recipients and evaluate its impact on CV health.MethodsForty-eight patients were assessed for frequency, duration, intensity, and setting of PA using the “Motorik–Modul” PA questionnaire. Walking-based activity was measured by accelerometer in a subgroup (n = 23). CV risk factors and subclinical CV organ damage were determined. The impact of PA on CV parameters was analyzed using linear regression models.ResultsFifty-two percent of pediatric KTx recipients did not reach WHO recommended PA level; 54% did not engage in PA with vigorous intensity (VPA). Twenty-nine percent indicated an extremely inactive lifestyle (< 120 min/week of moderate to vigorous intensity PA, MVPA). Compared to the healthy German KiGGS cohort, KTx recipients specifically lacked engagement in sport activities (KTx: 129 min/week; 95%CI, 97–162 vs. KiGGS, 242 min/week; 95%CI, 230–253). VPA was associated with lower systolic blood pressure (p = 0.024) and resting heart rate (p = 0.005), MVPA with fewer components of the post-transplant metabolic syndrome (p = 0.037), and better left ventricular diastolic function (p = 0.006).ConclusionsA considerable lack of PA, especially VPA, exists in young KTx recipients. PA was positively associated with important parameters of CV health. While long-term CV protection through PA seems promising in pediatric KTx recipients, specific educational approaches are most likely needed to increase patients’ engagement in sport activities.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information

Development of mobile health-based interventions to promote physical activity in patients with head and neck cancer: a qualitative study.

Despite the well-grounded benefits of physical activity (PA), poor compliance with the PA guidelines has been reported among head and neck cancer (HNC) patients. Mobile health (mHealth)-based interventions can help cancer survivors increase their PA levels and increase the reach or efficiency of rehabilitation services. However, there is limited knowledge about the needs and perceptions of HNC patients regarding these interventions. This study explored the perceptions and needs of HNC patients regarding mHealth-based PA programs before developing such interventions to ensure their improved effectiveness. A constructivist qualitative study. We purposively selected 17 adult HNC patients aged 40-80 years to determine their needs and perceptions of future mHealth-based PA programs. Semi-structured face-to-face interviews were conducted, and the data were analyzed via thematic analysis. The report followed the Consolidated Criteria for Qualitative Research Reports guidelines. Four themes were analyzed from the interview transcripts regarding the needs and perceptions of mHealth-based PA programs: (1) functionality needs; (2) system usage requirements; (3) social support; and (4) perceived barriers and facilitators. HNC patients expect highly customized and specialized mHealth interventions that consider individual factors, address their concerns about security, network, and cost, and prefer improved comfort. Moreover, they expect to receive support from their healthcare providers, families, and peers. The study provides pragmatic ready-to-use recommendations to design interventions for inactive HNC patients to achieve the recommended PA levels. Future mHealth interventions should be tailored according to the needs of the HNC patients by utilizing perceived facilitators and removing perceived barriers to help them engage in PA actively.

DURATION, INTENSITY, AND CONTENT OF PHYSICAL EDUCATION CLASSES IN A REPRESENTATIVE SAMPLE OF CHILDREN ATTENDING 5TH AND 6TH GRADES OF PRIMARY EDUCATION

Physical Education (PE) is an educational process that develops the knowledge, skills, attitudes, and well-being of children, through games, sports, exercises, etc. The study aimed to evaluate the parameters of physical activity (PA) during PE class and to investigate the content, time, and intensity of children who participated in PE class, by gender and obesity status. PA and PE items were assessed by a self-administrated PA checklist, proper for children. A representative sample of Greek boys and girls aged 10 to 12 years (N=3195) participated in the study. Boys incorporated higher levels of moderate to vigorous PA (MVPA) (62 ± 45 min/d) than girls (27 ± 33 min/d, p&amp;lt;0.05). Students, who participated in PE classes, presented increased total PA (139 ± 2 vs. 116 ± 51 min/d, p&amp;lt;0.05) and MVPA (62 ± 38 vs. 40 ± 32 min/d, p&amp;lt;0.05), and a higher percentage of them met (77 vs. 66%, p&amp;lt;0.05) the recommended PA levels than those who didn't participate. Among participants in PE classes, boys reported higher time of MVPA than girls (19.4 ± 23.9 vs. 10.3 ± 17.7 min/d, p&amp;lt;0.05), while girls had more time in light PA as compared to boys (15.1 ± 18.1 vs. 20.5 ± 21.3 min/d, p&amp;lt;0.05). There were no significant differences between normal-weight and overweight/obese participants in PE classes neither in PA sub-components (total PA, LPA, and MVPA) nor in sports/games did they participate. PE classes play a significant role in students' levels of PA, especially for overweight/obese children.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0012/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

The combined association of adherence to recommended physical activity and glycemic control with depression: an exploratory study with mediation and moderation models

BackgroundBoth physical activity and dysglycemia are associated with depression. However, the combined association of adherence to recommended physical activity (RPA) and glycemic control with depression is unknown. Moreover, the extent to which glycemic control mediates the association between physical activity and depression is not established.MethodsThe sample included 31,302 adults from the National Health and Nutrition Examination Survey 2007-08 to 2017-18. Adherence to RPA for aerobic activity was defined according to the WHO 2020 guidelines. HbA1c was classified as < 5.7%, 5.7–6.4%, 6.5–6.9%, and ≥ 7.0%. Depression was evaluated according to the 9-item Patient Health Questionnaire. The odds ratio for depression stratified by adherence to RPA and HbA1c level were estimated by logistic regressions. Mediation analysis was performed to estimate the direct associations (not through glycemic control) and indirect associations (through glycemic control).ResultsA total of 2871 participants were diagnosed with depression. Compared to participants with HbA1c level < 5.7% who adhere to RPA, those with HbA1c level < 5.7%, 5.7-6.4%, 6.5-6.9%, and ≥ 7.0% who did not adhere to RPA had increased odds ratio for depression, especially in women and older adults. Individuals with HbA1c ≥ 7.0% still had an increased odds ratio for depression even though they were physically active. The results of the mediation analysis were insignificant.ConclusionThere was a combined association of adherence to RPA and glycemic control with depression in women and older adults. We did not find out evidence of glycemic control mediation on the pathway from physical activity to depression.

Levels of physical activity and sedentary behaviors in different universities of Bogotá

Abstract The global recommendations for physical activity (PA) advised by the World Health Organization WHO (2012) are 150 minutes of moderate intensity (at least 600 MET-min/week) or 75 minutes of vigorous intensity per week (at least 3000 MET-min/week). The objective were determine the levels of PA and sedentary behaviors (SB) in people at different universities in Bogotá (students, administrative personal). The dimensions IPAQ was applied (PA in the transportation PAT, PA in Leisure Time PALT and auto evaluation of sedentary behaviors ASB). Study was descriptive, correlational, with simple random sampling. The project had ethics considerations aproved by Ethic Comitee of Libre University. The data were analyzed with Rversion 4.2.3. Results were n = 717 distributed in 442 (61.6%) women and 275 (38.4%) men. 100 men (36.4%) with 120.9 ± 185.9 MET-min/week and 161 women (36.4%) with 313.9 ± 198.8 MET-min/week did not fulfill PAT recommendations. 109 men (36.5%) with 193.6 ± 217.0 MET-min/week and 141 women (31.9%) with 186.4 ± 194.5 MET-min/week did not fulfill PALT recommendations. 75 men (27.3%) report sedentary time (ASB) greater than 2 hour/day (2311.2 min/week ± 1487.7) and 104 women (23.5%) report 2255.1 min/week (±1316.4). Instead, people fewer than 2 hours were 200 men (72.7%) with 323.6 min/week (±320.7) and 338 women (76.5%) with 312.4 min/week (±308.8). Statistical tests for association were applied for the variables PAT and PALT which did not have significant statistical differences but between PALT and ASB were found significant statistical differences (p-value &amp;lt; 2.2e–16, CI 1032.740–1608.664), so they were related. Universities must promote and maintain recommended PA levels through strengthening programs and infrastructure oriented to PA in population, especially promoting forms of transportation such as bicycles and different forms of active leisure time differentiated between genders. However, sedentary times are a threat to health, due to its great increase in this population. Key messages • The global recommendations for physical activity (PAG) recommended by the WHO (2012) is 150 minutes of moderate intensity or 75 minutes of vigorous intensity per week.

Health &amp; well-being experiences of patients with pulmonary fibrosis from dancing intervention

Abstract Patients with pulmonary fibrosis (PF) are recommended pulmonary rehabilitation which improves health outcomes. Such physical activity (PA) programmes are meant to promote sustainable behavioural change as exercise activities are valued, enjoyed and considered meaningful. Dance is one exercise form, but COVID-19 may have negatively impacted participation and quality of life of vulnerable populations due to lockdown and consequent isolation. This qualitative study aimed to investigate the perspectives of adults living with PF who had participated in a dance intervention. In partnership with the Irish Lung Fibrosis Association (ILFA), A group of 16 patients with PF, members of ILFA, participated in 75 minutes online dance intervention for eight weeks delivered by an experienced choreographer. An exploratory qualitative study using thematic analysis of semi structured interviews was carried out to understand feasibility as well as health and wellbeing impacts of dancing among the participants. Eight participants (6 Female, 2 male; mean age 72.3 years) completed one to one semi-structured qualitative interviews. Four key themes emerged: 1) Dance is fun - we're not exercising 2) Improved sense of wellbeing 3) Positive impact of own online social space 4) Connecting dance impacts to clinical health. Overall, participants mentioned that our virtual dance intervention was acceptable, enjoyable, preferable, and feasible. They strongly perceived health benefits especially breathing efficiency and mental health improvements for managing their day-to-day struggles with PF. Emerging themes could influence the development and evaluation of dance as an alternate form of PA for patients with PF, exploring its benefits and sustainability. As dance is a low-cost activity that can be done at home, dance interventions may be used as an exercise pathway for patients with pulmonary diseases. More organised and continuous events in future may reveal cost-benefit ratio and impact on health outcomes. Key messages • Dance – More favourable, higher adherence rate, better health and wellbeing outcomes and achieve higher targets of recommended PA levels in the community. • Social prescribing – Creating and promoting alternative exercise forms which patient’s can and should enjoy an activity of their choice and have a choice.

O.3.2-9 Sustaining activity with arthritis (SAWA) following an Arthritis Ireland Be active with arthritis (BAWA) exercise programme

Abstract Purpose Despite evidence demonstrating the health benefits of physical activity (PA), people with arthritis often do not meet recommended PA levels. Whilst various exercise programmes support these people to be active such as the ‘Be Active with Arthritis’ (BAWA) programme from Arthritis Ireland, most individuals reduce their PA after completion of prescribed programmes. Aim To co-develop and pilot test a PA maintenance intervention for those who have participated in BAWA. Methods This is a mixed methods project with four phases. Phase 1 An evidence synthesis will evaluate effectiveness of interventions for PA maintenance in people with arthritis and extract potential intervention components. Phase 2 An observational analysis of BAWA programmes will be undertaken to understand whether behaviour change components that might support PA maintenance are being currently used. This is followed by focus groups with 1) people with arthritis, 2) their carers, 3) the physiotherapists delivering the classes and 4) staff from Arthritis Ireland, to identify support needs and preference for development of a long-term PA programme. Phase 3 Data from Phases 1-2 will be triangulated and fed into participatory workshops, to co-develop an intervention. People with arthritis and healthcare/exercise professionals will be invited to these workshops. Phase 4 The PA programme, developed in Phase 3, will be piloted using a pre-post evaluation design with 25 people with arthritis in three separate waves. Interviews with programme attendees will explore facilitators of sustaining PA and identify implementation barriers. Public patient involvement will be embedded throughout this research with the formation of a PPI panel and an embedded Patient Researcher, to ensure that patients’ and carers’ lived expertise informs the various phases and final PA intervention. Results Given the early stage of this piece of research, we would welcome feedback from the HEPA community on our plans, and gain insights from similar studies. Conclusion By enhancing and developing service provision modalities, people with arthritis can remain physically active for as long as possible, improving quality of life, reducing pain, disability, co-morbidities and multi-service use. Funding This project is jointly funded by the Irish Health Research Board and Arthritis Ireland.

Predictors of meeting physical activity recommendation before and during COVID-19 pandemic in adults

Introduction: This study aimed to determine the variables that predict whether WHO's global recommendation for physical activity (PA) before and during the COVID-19 pandemic can be met among adults. Material and Methods: A total of 921 adults voluntarily participated in this study. A demographic information form and the Physical Activity Assessment Questionnaire for Turkish people were administered by self-report. The participants were also asked whether they regularly do PA and if the duration of PA is over 150 minutes. Results: The number of adults doing regular PA at the level recommended by WHO significantly decreased during the COVID-19 pandemic, and the rate of not doing regular PA significantly increased compared to the period before the COVID-19 pandemic (p&lt;0.05). Variables that reduce the likelihood of doing regular PA at the recommended level include being male, being under 45 years old, being married, having high school education or below, having a moderate and low-income, having a high BMI, and having a high recreational sedentary screen time (RSST) during the COVID-19 pandemic. Conclusions: The results of this study provide a priori information for implementations aimed at improving the recommended PA level for adults during social isolation or lockdown.

Association between physical activity and resistant hypertension in treated hypertension patients: analysis of the national health and nutrition examination survey

IntroductionCurrent guidelines suggest that regular aerobic training might lower blood pressure in hypertensive individuals. However, evidence linking resistant hypertension (RH) with total daily physical activity (PA), including work-, transport-, and recreation-related PA, is limited. Therefore, this study assessed the association between daily PA and RH.MethodA cross-sectional study was conducted using data acquired from a nationwide survey in the US (the National Health and Nutrition Examination Survey, NHANES). The weighted prevalence of RH was calculated, and moderate and vigorous daily PA was assessed using the Global Physical Activity Questionnaire (GPAQ). A multivariate logistic regression model determined the association between daily PA and RH.ResultsA total of 8,496 treated hypertension patients were identified, including 959 RH cases. The unweighted prevalence of RH among treated hypertension cases was 11.28%, while the weighted prevalence was 9.81%. Participants with RH had a low rate of recommended PA levels (39.83%), and daily PA and RH were significantly associated. PA exhibited significant dose-dependent trends with a low probability of RH (p-trends < 0.05). Additionally, participants with sufficient daily PA had a 14% lower probability of RH than those with insufficient PA [fully adjusted odds ratio (OR) = 0.86; 95% confidence interval (CI) = 0.74–0.99).ConclusionThe present study revealed that RH has an incidence of up to 9.81% in treated hypertension patients. Hypertensive patients tended to be physically inactive, and insufficient PA and RH were significantly associated. Sufficient daily PA should be recommended to reduce the RH probability among treated hypertension patients.

Association of Recess Provision With Elementary School-Aged Children's Physical Activity, Adiposity, and Cardiorespiratory and Muscular Fitness.

To identify associations between amount of school recess provision and children's physical activity (PA), weight status, adiposity, cardiorespiratory endurance, muscular strength, and muscular endurance. Data from 6- to 11-year-old participants (n = 499) in the 2012 National Youth Fitness Survey were analyzed. Parents/guardians reported children's PA levels and recess provision, categorized as no/minimal (9.0%), low (26.1%), medium (46.0%), or high (18.9%). Children wore a wrist-worn accelerometer for 7days and completed anthropometric measurements. Fitness was assessed using grip strength and treadmill, pull-up, and plank tests. Cross-sectional linear and logistic regression compared outcomes across levels of recess provision adjusting for the survey's complex sampling design. Children with high provision of recess were 2.31 times more likely to meet PA guidelines according to parent report than those with no/minimal recess. Accelerometer-measured PA followed a more U-shaped pattern, wherein PA was higher in children with high, compared to low, recess provision but comparable to those with no/minimal recess provision. There were no associations with weight status, adiposity, or fitness. Current recess recommendations (20min·d-1) may be insufficient as 30minutes per day of recess was associated with a 2-fold greater likelihood of achieving recommended PA levels. Additional research on recess quantity and quality is needed.

Recommending Physical Activity for People with Intellectual Disabilities: The Relevance of Public Health Guidelines, Physical Activity Behaviour and Type of Contact

People with an intellectual disability (ID) often exhibit more sedentary behaviour and are less physically active than the general population. While previous public health guidelines on physical activity (PA) did not specifically address the needs of people with an ID, the recent updates now include this population, with recommendations similar to those for the general population. However, it is unclear whether the information about these guidelines has reached the broader public and what factors may influence their implementation. To investigate these issues, an online survey was conducted in Austria, Germany and Switzerland, which examined the (a) PA recommendation for people with an ID, (b) awareness of current guidelines, (c) participants' own PA behaviour (IPAQ-SF) and (d) specific contact with people with an ID. Participants (n = 585) recommended similar levels of PA for people with an ID as for the general population, but knowledge of the guidelines did not affect their recommendation. However, participants' own PA behaviour and context-specific contact (e.g., in family or at work) were associated with the recommended PA levels. Therefore, promoting the relevance of PA and fostering contact with people with an ID might be suitable ways to increase PA in people with an ID.

The effect of combining nutrient intake and physical activity levels on central obesity, sarcopenia, and sarcopenic obesity: a population-based cross-sectional study in South Korea

BackgroundThis study was conducted to investigate the effects of combining nutritional and physical activity (PA) factors on four different categories, according to the presence or absence of sarcopenia and central obesity.MethodsFrom the 2008–2011 Korea National Health and Nutrition Examination Survey, 2971 older adults aged ≥ 65 years were included and divided into four groups based on their sarcopenia and central obesity status: healthy control (39.3%), central obesity (28.9%), sarcopenia (27.4%), and sarcopenic obesity (4.4%). Central obesity was defined as a waist circumference of ≥ 90 cm in men and ≥ 85 cm in women. Sarcopenia was defined as an appendicular skeletal mass index of < 7.0 kg/m2 in men and < 5.4 kg/m2 in women, and sarcopenic obesity was defined as the coexistence of sarcopenia and central obesity.ResultsParticipants who consumed more energy and protein than the average requirement had a lower likelihood of having sarcopenia (odds ratio (OR): 0.601, 95% confidence interval (CI): 0.444–0.814) than those who did not consume enough nutrients. The likelihood of central obesity and sarcopenic obesity decreased in groups with recommended PA levels, regardless of whether energy intake met or did not meet the average requirement. Whether PA met or did not meet the recommended level, the likelihood of sarcopenia decreased in groups with energy intake that met the average requirement. However, when PA and energy requirements were met, there was a greater reduction in the likelihood of sarcopenia (OR: 0.436, 95% CI: 0.290–0.655).ConclusionThese findings suggest that adequate energy intake that meets requirements is more likely to be effective as a major prevention and treatment goal for sarcopenia, whereas PA guidelines should be prioritized in the case of sarcopenic obesity.

Results from the United Arab Emirates 2022 report card on physical activity for children and adolescents

Background/ObjectiveThe United Arab Emirates (UAE) 2022 Report Card provides a systematic evaluation of the physical activity (PA) levels of children and adolescents in the UAE. MethodsThe 2022 Report Card utilized data from 2017 to 2021 to inform 10 core PA indicators that were common to the Global Matrix 4.0. ResultsOne in five (19%) UAE school children achieved the recommended amount of moderate-to-vigorous PA (i.e. ≥60 min/d; Total Physical Activity Grade F). Less than 1% of school children used active transport to and from school (Active Transportation Grade F). One in four (26%) secondary school children achieved the recreational screen time recommendations (i.e. ≤2 h/d; Sedentary Behaviours Grade D-). A quarter of adults reported achieving the recommended PA level (i.e. ≥150 min of moderate-intensity PA per week, or equivalent) (Family and Peers Grade D-). All school children are taught physical education (PE) by a specialist with at least a bachelor's degree in PE; however, the duration of weekly PE classes varied between schools (School Grade A-). The UAE Government has invested significant funds and resources into developing and implementing strategies and facilities that will increase PA across the entire population (Government Grade B+). Organised Sport and Physical Activity, Active Play, Physical Fitness, and Community and Environment indicators were graded ‘Incomplete’ (INC) due to a lack of available data. ConclusionsOverall, PA levels remain low and sedentary behaviours remain high amongst UAE children and adolescents. The UAE Government has sustained investment in further developing PA opportunities for all children and adults which should translate to increased PA and health improvements at a population level.