Changes In Self-reported Physical Activity Research Articles

The mSQUASH is a feasible and valid measurement tool to uniformly assess daily physical activity in patients with rheumatic diseases

BackgroundThe modified Short QUestionnaire to ASsess Health-enhancing physical activity (mSQUASH) was originally developed and validated in Dutch patients with axial spondyloarthritis (axSpA). To support world-wide distribution, applicability and comparability of...

O86 EFFECTIVENESS OF A MHEALTH (MOBILE-BASED) INTERVENTION FOR THE MANAGEMENT OF CARDIOVASCULAR DISEASES IN SOUTH ASIAN COUNTRIES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: Cardiovascular disease (CVDs) is the leading cause of preventable death and disability, accounting for 18.6 million deaths and 393 million DALYs in 2019. The effectiveness of mobile health (mHealth) interventions for managing CVD in South Asia is poorly documented. This systematic review evaluates the impact of mHealth on cardiovascular health outcomes in this region. Methods: We conducted a systematic search of MEDLINE, EMBASE, CINAHL, Web of Science, and Scopus, covering the period from January 2000 to December 2023. Our search focused on studies employing mobile-based interventions, such as apps, SMS, video conferencing, or phone calls, to improve cardiovascular outcomes, including blood pressure, medication adherence, and physical activity. Data were synthesised using a random-effects meta-analysis, estimating summary hazard ratios (HRs) and 95% confidence intervals (CIs). This review was registered in PROSPERO (CRD42022340907). Results: We identified 1483 studies, of which 14 met our inclusion criteria, encompassing 30,939 participants (17,240 intervention; 14,984 control). Participants ages ranged from 46.4 to 60.6 years. Six studies reported improvement in systolic blood pressure (SBP), one reported improvement in cholesterol, two reported change in self-reported physical activity, and three reported improvement in medical adherence. Meta-analysis revealed a significant reduction in systolic blood pressure (SBP) by -2.32 (95% CI: -4.25 to -0.40; P=0.02) in the intervention arm. No significant changes were observed in diastolic blood pressure (DBP) or medication adherence, with DBP showing a reduction of -1.13 (95% CI: -1.69 to 1.42; P=0.87) and medication adherence an effect size of 0.44 (95% CI: -0.06 to 0.94; P=0.08). Conclusions: mHealth interventions in South Asia show promise in reducing SBP among individuals with CVD, though effects on DBP and medication adherence are less pronounced. The observed benefits are constrained by high heterogeneity and a limited number of studies, indicating the need for further research to consolidate these findings and explore additional CVD outcomes.

Changes in physical activity and sleep following the COVID-19 pandemic on a university campus: Perception versus reality

It has been hypothesized that key lifestyle behaviors of physical activity and sleep worsened in response to the Coronavirus disease (COVID-19) pandemic. However, there have been inconsistencies in findings of changes in these key lifestyle behaviors across populations likely due to the wide variety of assessment methods. The purpose of the study was to compare physical activity and sleep before and after the COVID-19 pandemic using accelerometers and self-reported behaviors. A longitudinal follow-up was conducted on students, faculty, and staff at a university campus in the United States. In the periods before March 2020 (covering the academic years of 2018–2019 or 2019–2020) and again in April–June 2021, participants completed surveys to evaluate their physical activity and sleep behaviors and wore an accelerometer. A total of 44 participants completed the survey at both timepoints and 32 completed accelerometer assessment at both timepoints. Fifty-seven percent of participants reported a perceived decline in physical activity, while 30% reported a worsening in sleep. From self-reported data, overall physical activity did not change, but there was a decrease in active transport (p ​< ​0.001) and increase in domestic physical activity (p ​= ​0.012). Sleep quality decreased as evidenced by an increase in Pittsburgh Sleep Quality Index scores (p ​= ​0.045). There were no changes in accelerometer measured physical activity or sleep. There were no changes in physical or mental health. While perceptions of physical activity declined from prior to the COVID-19 pandemic, there were no changes in device-measured physical activity, and changes in self-reported physical activity differed by domain.

Effect of high-intensity interval training in physiotherapy primary care for patients with inflammatory arthritis: the ExeHeart randomised controlled trial

ObjectivesTo assess the effect of high-intensity interval training (HIIT) delivered in physiotherapy primary care on the primary outcome of cardiorespiratory fitness (CRF) in patients with inflammatory arthritis (IA). Additionally, to...

Sustained Effectiveness of the Walk Across Texas Program: A Follow-up Study

Objectives: In this study, we used a follow-up assessment to determine the sustained effectiveness of Walk Across Texas, a web-based community physical activity program. Methods: We recruited a sample of adult participants (N=291) who completed program assessments across 3 time periods (pre-, post-, follow-up) in 2018. We assessed changes in self-reported physical activity (days/week). Statistical analysis incorporated paired-samples t-tests, repeated measures ANOVA, and an assessment of participants' overall physical activity changes during the program and follow-up. Results: Overall, there were statistically significant differences (p &lt; .05) between self-reported physical activity pre-program (4.12 ± 2.10), post-program (5.06 ± 2.04), and at follow-up (4.40 ± 1.98). Notably, a defined Low Active pre-program activity group significantly increased from pre- (1.21 ± 0.87) to post-program (4.29 ± 2.06). Despite a decrease from post-program to follow-up (3.06 ± 1.86; δ = -1.24 days), the difference remained higher and statistically significant from pre-program. Further analysis explored limitations associated with estimating one's physical activity change in behavior. Conclusions: The results support the sustained effectiveness of the Walk Across Texas program. Overall, participants showed increased and maintained physical activity for up to 150 days from pre-program.

O.1.1-4 The relationships of mental well-being with physical activity during the COVID-19 in older adults

Abstract Purpose Negative mental well-being may hinder, and positive mental well-being facilitate physical activity (PA) when one’s daily routines are compromised. COVID-19 posed challenges to both mental well-being and PA, in Finland especially for those over 70, who faced the strictest restrictions. Therefore, the aim was to investigate the relationships of mental well-being with PA during the COVID-19 in two cohorts of different ages. Methods Data came from two population-based studies. Participants of the longitudinal TRAILS study (N = 162, 58% women, 60-61 years) were representative of their age cohort. Participants of the randomized controlled trial PASSWORD (N = 272, 60% women, 72-88 years) had attended a year-long multicomponent physical training intervention during 2017-2019. Self-reported changes in PA (increased vs. no change/decreased; decreased vs. no change/increased) and PA frequency (1-7; from “not at all” to “approximately daily”) during the COVID-19 were collected from April 2020 to June 2020 (PASSWORD) or July 2021 (TRAILS). Positive mental well-being was assessed by positive affect from the International Positive and Negative Affect Schedule Short Form (I-PANAS-SF, score 1-5). Negative mental well-being indicators were negative affect (I-PANAS-SF, score 1-5) and depressive symptoms (TRAILS: General Behavioral Inventory, score 0-3; PASSWORD: Geriatric Depression Scale, score 0-15). Relationships between mental well-being and PA were analyzed using logistic and linear regression models, adjusted by sex and, in PASSWORD, age. Results Positive affect was positively associated with increased PA (odds ratio (OR)=1.751-2.661, p = 0.013-0.034) and PA frequency (B = 0.489-0.550, p &amp;lt; 0.001-0.009) in both studies, and inversely with decreased PA in the PASSWORD (OR = 0.633, p = 0.024). Higher negative affect and depressive symptoms were associated with decreased PA in the PASSWORD (OR = 2.134, p = 0.004 and OR = 1.310, p &amp;lt; 0.001, respectively). Additionally, depressive symptoms were associated with lower PA frequency in both studies (TRAILS: B=-0.876, p = 0.004; PASSWORD: B=-0.105, p = 0.002). Conclusions Positive mental well-being was consistently and positively associated with PA during COVID-19 in older adults. Higher negative mental well-being was more clearly associated with poor PA behaviors in the older cohort facing stronger restrictions. Supporting positive mental well-being may be as important as reducing negative mental well-being to facilitate physically active lifestyle among older adults during exceptional circumstances. Funding The Academy of Finland (323541; 296843).

Digitally enabled cardiac rehabilitation following coronary revascularization: results from a single centre feasibility study.

Wearable activity monitors, together with smartphone-based health and fitness applications (apps), are becoming more accessible and their widespread use provides an additional opportunity for the recording of cardiovascular metrics in patients with cardiovascular disease. The use of selected metrics by cardiac rehabilitation (CR) programmes allows the facilitation of individualized and tailored positive lifestyle changes to patients and places the patient at the centre of their recovery programme. To investigate the role of such devices on outcomes with patients on a CR programme, a cohort/case-control study was conducted. Patients post-myocardial infarction who were treated with either percutaneous coronary intervention or surgical coronary revascularisation at a single centre were invited to use a physical activity monitor linked to a customized app at their initial assessment for the rehabilitation programme. Those who accepted were allocated to the treatment group. The control group was selected from a larger pool of 400 historical and concurrent patients. Propensity matching was used to associate each case with their closest control. The changes in self-reported physical activity were similar for both groups at the end of the CR programme (EOP). The digitally monitored group tended to achieve greater METS (metabolic equivalent of task - a measure of exercise intensity) at 12 weeks (P < 0.059); however, no difference was observed in the overall change in METS at EOP (P < 0.333). Although no difference was noted in diastolic blood pressure, a statistically significant drop in the systolic blood pressure in the digitally monitored group (P < 0.004) was detected. In this study, the innovative combination of technology and face-to-face CR showed promising results and assisted the individualization of delivered content. This intervention could easily be replicated and expanded. Challenges are the recruitment of the elderly population, those who may be less engaged with or have less access to technology, and the underrepresentation of women in the study sample.

Perceived Impact of the COVID-19 Pandemic on Physical Activity Among Adult Patients With Rheumatologic Disease.

The objective of this cross-sectional study was to investigate the impact of the COVID-19 pandemic on physical activity (PA) levels of patients with rheumatic and musculoskeletal diseases (RMDs) and to examine factors associated with decreased PA. A sample of adult patients with RMDs (n=7,776) was identified through electronic medical records from an academic health care system in North Carolina. Invitations to participate in an online survey were sent between July 2020 and September 2020 to assess self-reported changes in PA during the COVID-19 pandemic. Descriptive statistics, age-adjusted prevalence odds ratios (PORs), and 95% confidence intervals (CIs) were computed to examine patient characteristics associated with decreased PA. A total of 893 eligible participants completed the survey (mean age 57.8 ± 14.9 years, 75.8% female). The most common primary diagnoses reported among participants included rheumatoid arthritis (27.3%), osteoarthritis (16.0%), and systemic lupus erythematosus (SLE) (13.0%). More than half of participants (56.8%) reported engaging in less PA since the pandemic began. Factors associated with engaging in less PA included lower self-reported general health (POR, 2.21; CI, 1.64-2.97) and a diagnosis of SLE (POR, 1.57; CI, 1.03-2.38). Comorbidities associated with decreased PA included chronic pain (POR, 1.38; CI, 1.04-1.82), depression (POR, 1.48; CI, 1.09-2.01), and hypertension (POR, 1.44; CI, 1.10-1.90). The COVID-19 pandemic has exacerbated barriers to PA in patients with RMDs. There is a critical need to provide resources, support, and multifaceted programs to encourage PA in patients with RMDs during the COVID-19 pandemic.

Do the Self-Reported Changes in Physical Activity After the Emergence of the COVID-19 Pandemic Associate With Major Depression According to Moderate to Vigorous Physical Activity Status?

As the COVID-19 pandemic emerged, and social distancing increased, the physical activity (PA) of people decreased, which increased depression. The purpose of this study was to analyze the relationship between self-reported changes in PA with the COVID-19 pandemic and major depression according to moderate to vigorous physical activity (MVPA) status. This study included 228,457 adults and used data from the Korea Community Health Survey 2020. Multiple logistic regression analysis was performed to evaluate the relationship between self-reported changes in PA and major depression stratified by MVPA status. The percentage of participants who reported decreases in PA was 39.5% in men and 44.7% in women compared with the pre-COVID-19 pandemic period. Those who reported decreases in PA after the onset of COVID-19 had major depression (men odds ratio = 1.28; 95% confidence interval, 1.15-1.43 and women odds ratio = 1.35; 95% confidence interval, 1.25-1.46). Women who were moderately or vigorously physically active had higher odds of major depression when they reported decreases in PA (odds ratio = 1.31; 95% confidence interval, 1.06-1.62). People who reported decreases in PA were associated with major depression compared with the pre-COVID-19 pandemic period. Based on this, the government should encourage exercise to reduce major depression and provide guidelines for PA at home or outdoors.

The Effectiveness of a Computer-Tailored Web-Based Physical Activity Intervention Using Fitbit Activity Trackers in Older Adults (Active for Life): Randomized Controlled Trial.

BackgroundPhysical activity is an integral part of healthy aging; yet, most adults aged ≥65 years are not sufficiently active. Preliminary evidence suggests that web-based interventions with computer-tailored advice and Fitbit activity trackers may be well suited for older adults.ObjectiveThe aim of this study was to examine the effectiveness of Active for Life, a 12-week web-based physical activity intervention with 6 web-based modules of computer-tailored advice to increase physical activity in older Australians.MethodsParticipants were recruited both through the web and offline and were randomly assigned to 1 of 3 trial arms: tailoring+Fitbit, tailoring only, or a wait-list control. The computer-tailored advice was based on either participants’ Fitbit data (tailoring+Fitbit participants) or self-reported physical activity (tailoring-only participants). The main outcome was change in wrist-worn accelerometer (ActiGraph GT9X)–measured moderate to vigorous physical activity (MVPA) from baseline to after the intervention (week 12). The secondary outcomes were change in self-reported physical activity measured by means of the Active Australia Survey at the midintervention point (6 weeks), after the intervention (week 12), and at follow-up (week 24). Participants had a face-to-face meeting at baseline for a demonstration of the intervention and at baseline and week 12 to return the accelerometers. Generalized linear mixed model analyses were conducted with a γ distribution and log link to compare MVPA and self-reported physical activity changes over time within each trial arm and between each of the trial arms.ResultsA total of 243 participants were randomly assigned to tailoring+Fitbit (n=78, 32.1%), tailoring only (n=96, 39.5%), and wait-list control (n=69, 28.4%). Attrition was 28.8% (70/243) at 6 weeks, 31.7% (77/243) at 12 weeks, and 35.4% (86/243) at 24 weeks. No significant overall time by group interaction was observed for MVPA (P=.05). There were no significant within-group changes for MVPA over time in the tailoring+Fitbit group (+3%, 95% CI –24% to 40%) or the tailoring-only group (–4%, 95% CI –24% to 30%); however, a significant decline was seen in the control group (–35%, 95% CI –52% to –11%). The tailoring+Fitbit group participants increased their MVPA 59% (95% CI 6%-138%) more than those in the control group. A significant time by group interaction was observed for self-reported physical activity (P=.02). All groups increased their self-reported physical activity from baseline to week 6, week 12, and week 24, and this increase was greater in the tailoring+Fitbit group than in the control group at 6 weeks (+61%, 95% CI 11%-133%).ConclusionsA computer-tailored physical activity intervention with Fitbit integration resulted in improved MVPA outcomes in comparison with a control group in older adults.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12618000646246; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618000646246

Intervention Fidelity of Telephone Motivational Interviewing On Physical Activity, Fruit Intake, and Vegetable Consumption in Dutch Outpatients With and Without Hypertension

BackgroundIn theory, Motivational Interviewing (MI) fidelity should be associated with client outcomes. Nevertheless, this fidelity-effectiveness association is rarely investigated. This study evaluated the extent to which Telephone Motivational Interviewing (TMI) fidelity is associated with change in self-reported physical activity (PA), fruit intake, and vegetable consumption.MethodAdults in primary care (45–70 years) participated in a study that compared the effect of tailor print communication, telephone motivational interviewing (TMI), and a combination of the two on PA, fruit intake, and vegetable consumption. MI fidelity was assessed using the behavioral coding method “Motivational Interviewing Treatment Integrity Code (MITI)” in 409 randomly selected audio-recorded sessions, representing 232 participants of the TMI group. The associations between MI fidelity scores and the behavioral changes from baseline to 47-week follow-up were examined using backward multiple linear regression analyses (adjusted for covariates).ResultsA significant and positive association between the percentage of MI adherent responses and improvements in PA and fruit consumption was found with respectively a small and medium effect size. The global rating “Spirit” (which resembles an all-at-once appraisal of the interviewer’s MI competence) was significantly, but inversely associated with progress in vegetable intake with a medium effect size.ConclusionThe finding that relatively lower MI competency was associated with higher vegetable consumption went against our expectations. Findings suggest that practicing MI-consistent skills was beneficial in promoting PA and fruit consumption, but moderated vegetable intake. This study contributes to the scientific confidence that TMI enables change in PA and fruit intake.

Associations Between Physical Activity, Self-reported Joint Function, and Molecular Biomarkers in Working Age Individuals With Hip and/or Knee Osteoarthritis.

Objective:Previous research has suggested an association between physical activity (PA), joint function, and molecular biomarkers, but more studies are needed. The aim of this study was to explore the associations between PA or self-reported joint function and molecular biomarkers of cartilage and inflammation in individuals with hip and/or knee osteoarthritis (OA). Specific objectives were to explore the correlations between (1) the change over 3 months in self-reported PA/joint function and the change in molecular biomarkers (2) objectively measured PA and molecular biomarkers measured at 3-month follow-up.Design:Working age participants (n = 91) were recruited from a cluster randomized controlled trial. Self-reported PA, joint function, and serum samples were collected at baseline and after 3 months. Serum concentrations of the inflammatory marker C-reactive protein (CRP) and the cartilage markers Alanine-Arginine-Glycine-Serine (ARGS)-aggrecan, cartilage oligomeric matrix protein (COMP), and type II collagen C2C were analyzed by immunoassays. Objectively measured PA (steps/day) was collected during 12 weeks from activity trackers used by 53 participants. Associations were analyzed with Spearman’s rank correlation.Results:There was a weak negative correlation between the change in self-reported PA and the change in COMP (rs = −0.256, P = .040) but not for the other molecular biomarkers. There were no correlations between the change in self-reported joint function and the change in molecular biomarkers or between the average steps/day and the molecular biomarkers at follow-up (rs ⩽ −0.206, P ⩾ .06).Conclusion:In general, no or only weak associations were found between PA/joint function and molecular biomarkers. Future research recommends including participants with lower PA, extend the follow-up, and use a design that allows comparisons.

Associations Between Change Over Time in Pandemic-Related Stress and Change in Physical Activity.

Physical activity (PA) mitigated psychological distress during the initial weeks of the COVID-19 pandemic, yet not much is known about whether PA had effects on stress in subsequent months. We examined the relationship between change over time in COVID-related stress and self-reported change in PA between March and July 2020. Latent growth modeling was used to examine trajectories of change in pandemic-related stress and test their association with self-reported changes in PA in an international sample (n = 679). The participants reported a reduction in pandemic-related stress between April and July of 2020. Significant linear (factor mean = -0.22) and quadratic (factor mean = 0.02) changes (Ps < .001) were observed, indicating a deceleration in stress reduction over time. Linear change was related to change in PA such that individuals who became less active during the pandemic reported less stress reduction over time compared with those who maintained or increased their PA during the pandemic. Individuals who experienced the greatest reduction in stress over time during the pandemic were those who maintained their activity levels or became more active. Our study cannot establish a causal relationship between these variables, but the findings are consistent with other work showing that PA reduces stress.

Measurement properties of UCLA Activity Scale for hip and knee arthroplasty patients and translation and cultural adaptation into Danish

Background and purpose — The UCLA Activity Scale (UCLA) is a questionnaire assessing physical activity level from 1 (low) to 10 (high) in patients undergoing hip or knee arthroplasty (HA/KA). After translation and cultural adaptation, we evaluated the measurement properties of the Danish UCLA. Patients and methods — After dual panel translation, cognitive interviews were performed among 55 HA/KA patients. An orthopedic surgeon and a physiotherapist estimated UCLA scores for 80 KA patients based on short interviews. Measurement properties were evaluated in 130 HA and 134 KA patients preoperatively and 1-year postoperatively. Results — To suit Danish patients of today, several adaptations were required. Prior to interviews, 4 patients were excluded, and 11 misinterpreted the answer options. Examiners rated the remaining 65 patients (mean age 67 years) 0.2–1.6 UCLA levels lower than patients themselves. The 130 HA and 134 KA patients (mean age 71/68 years) changed from 4.3 (SD 1.9)/4.5 (1.8) preoperatively to 6.6 (1.8)/6.2 (1.0) at 1-year follow-up. 103 (79%) HA and 89 (66%) KA patients reported increased activity. Effect sizes were large (1.2/0.96). Knee patients reaching minimal important change (MIC, ≥ 8 Oxford Knee Score points) had higher 1-year UCLA scores than patients not reaching MIC. Interpretation — Original scale development was undocumented. Content validity was questionable, and there was discrepancy between patient and examiner estimates. UCLA appears valuable for measuring change in self-reported physical activity on a group level. 4 out of 5 HA patients and 2 out of 3 KA patients were more physically active 1 year after joint replacement surgery.

Declining energy predicts incident mobility disability and mortality risk in healthy older adults.

The purpose was to examine whether longitudinal changes in self-reported energy predict incident mobility disability and mortality. We further explored whether changes in energy-related behaviors (physical activity, appetite, or sleep quality) would explain these associations. N=2021 participants from the Health, Aging and Body Composition Study free from mobility disability and with at least three energy assessments from years 2 to 10. The outcomes were time to first self-reported inability to walk a quarter of a mile (mobility disability) and death. Self-reported energy level (SEL) was a single-item indicator over the prior month, ranging from 0 to 10; person-specific slopes measured whether individuals increased or decreased in SEL across the total follow-up time (mean 7.09 years, +1.72, range 2-8 years). Potential energy-related mediators were baseline and change in self-reported physical activity, appetite, and sleep quality. Covariates were baseline levels and change in demographics, health characteristics and behaviors, tiredness, cognition, mood, and gait speed. A total of 947 developed disability and 567 died over the study follow-up. A one-point change in SEL over the follow-up (or an average 0.125 points/year) was inversely associated with a 35% risk of incident mobility disability (hazard ratio=0.65, 95% confidence interval [CI]=0.55, 0.76, p < 0.001) and 33% risk of death (hazard ratio=0.67, 95% CI=0.42, 0.87, p=0.003), independent of covariates. Potential energy-related mediators did not attenuate this association. In this longitudinal analysis of community-dwelling older adults, energy decline was common and a significant independent predictor of disability risk and mortality.

Self-reported changes in physical activity, sedentary behavior, and screen time among informal caregivers during the COVID-19 pandemic

BackgroundInformal caregivers providing unpaid assistance may be vulnerable to changes in health behaviors due to modifications in caregiving during the COVID-19 pandemic. Therefore, this cross-sectional study explored self-reported changes in physical activity (PA), sedentary behavior, and screen time among informal caregivers providing care for older adults aged 50+ during the pandemic.MethodsStudy participants were recruited via Amazon’s Mechanical Turk and reported their perceived changes (increased a lot, increased a little, remained the same, decreased a little, decreased a lot) in moderate-intensity PA (MPA), vigorous-intensity PA (VPA), sedentary behavior, and screen time (weekday and weekend) during the pandemic. For analytic purposes, response categories were categorized into three-level ordinal variables—increased (increased a lot, increased a little), no change (remained the same), decreased (decreased a little, decreased a lot). Multinomial logistic regression models assessed the likelihood of changes (vs. no change) in MPA, VPA, sedentary behavior, and screen time (weekday, weekend) based on caregiving and demographic characteristics.ResultsIn total, 2574 individuals accessed the study link, 464 of whom did not meet eligibility requirements. In addition, people who completed 80% or less of the survey (n = 1171) and/or duplicate IP addresse (n = 104) were excluded, resulting in an analytic sample of n = 835. The sample was 69% male, had a mean age of 34 (SD = 9.7), and 48% reported increased VPA, while 55% reported increased MPA. The majority also reported increased sedentary behavior, as well as increased screen time. Respondents living with their care recipient were more likely to report increased weekday screen time (Odds Ratio [OR] = 1.55, 95% CI 1.11–2.16) and sedentary behavior (OR = 1.80, 95% CI 1.28–2.53) than respondents not living with the care recipient. Those living with their care recipient were also more likely to reported increased MPA (OR = 1.64, 95% CI 1.16–2.32), and VPA (OR = 1.53, 95% CI 1.09–2.15), but also more likely to report a decrease in VPA (OR = 1.75, 95% CI 1.14–2.70).ConclusionThe majority of respondents reported that their MPA, VPA PA, sedentary behavior, and screen time had changed during the pandemic. Living with the care recipient was associated with both positive and negative changes in behavior. Future research can explore factors associated with these reported changes in behavior.

The mSQUASH; a valid, reliable and responsive questionnaire for daily physical activity in patients with axial spondyloarthritis

AimAdaptation of the Short QUestionnaire to Assess Health-enhancing physical activity (SQUASH) in order to improve measurement properties in axSpA patients. MethodsThe original SQUASH was adapted using a qualitative stepwise approach with in-depth interviews including healthcare professionals and patients. Content validity was explored by comparing modified-SQUASH (mSQUASH) and original SQUASH. Next, mSQUASH was validated according to the OMERACT filter. International Physical Activity Questionnaire (IPAQ) was used as comparator and tri-axial accelerometer as gold standard for criterion validity and classification accuracy of intensity. Construct validity was assessed using Spearman correlations with clinical outcome assessments. For test-retest reliability, intra-class correlation coefficients (ICCs) were calculated. Responsiveness was assessed using standardized response mean (SRM), stratified by Anchor method. ResultsThe mSQUASH measured a systematically higher activity count and had less missing values (8% vs. 16%) then SQUASH. mSQUASH correlated better with accelerometer compared to IPAQ (ρ = 0.60 vs. ρ = 0.34). Accelerometer measured most activity in light intensity, whereas mSQUASH and IPAQ predominately measured moderate intensity. Correlations with ASDAS, BASDAI, BASFI and ASQoL were better for mSQUASH then IPAQ. Test-retest reliability was good in both questionnaires. In contrast to IPAQ, responsiveness was in correspondence with self-reported changes in physical activity for mSQUASH (SRM -0.84 for improvement and 0.88 for decrease). The average completion time of the mSQUASH was 7 minutes. ConclusionsThe development of the mSQUASH resulted in an easy applicable, valid, reliable and responsive questionnaire for the assessment of daily physical activity in axSpA patients, which can be used in research and daily clinical practice.

Changes to Physical Activity during a Global Pandemic: A Mixed Methods Analysis among a Diverse Population-Based Sample of Emerging Adults in the U.S.

Emerging adults’ lives have changed because of the COVID-19 pandemic. Physical activity (PA) behaviors need to be examined to inform interventions and improve health. Responses to the C-EAT (COVID-19 Eating and Activity over Time) survey (N = 720; age = 24.7 ± 2.0 yrs) were analyzed. This mixed-methods study quantitatively examined changes in self-reported PA (hours/week of mild PA, moderate-to-vigorous PA (MVPA), and total PA) from 2018 to 2020. Qualitative responses on how COVID-19 impacted PA were analyzed using a grounded theory approach. Hours of PA were lower on average for all intensity levels during COVID-19 than in 2018 (p’s < 0.0001). Over half of the sample reported a decrease in MVPA (53.8%) and total PA (55.6%); 42.6% reported a decrease in mild PA. High SES were more likely to report an increase in total PA (p = 0.001) compared to those of lower SES. Most (83.6%) participants perceived that COVID-19 had influenced their PA. The most common explanations were decreased gym access, effects on outdoor PA, and increased dependence on at-home PA. Results suggest that emerging adults would benefit from behavioral interventions and health promotion efforts in response to the pandemic, with a focus on activities that can be easily performed in the home or in safe neighborhood spaces.

Changes in Physical Activity, Sleep, Mental Health, and Social Media Use During COVID-19 Lockdown Among Adolescent Girls: A Mixed-Methods Study.

To suppress the transmission of coronavirus, many governments, including that of the island of Ireland, implemented a societal lockdown, which included school closures, limits on social gatherings, and time outdoors. This study aimed to evaluate changes in physical activity (PA), mental health, sleep, and social media use among adolescent girls during lockdown. 281 female pupils (12-14y) taking part in the ongoing Walking In Schools study on the island of Ireland self-reported PA, mental health, sleep, and social media use before (September-October 2019) and during lockdown (May-June 2020), via questionnaires. These were supplemented with open-ended structured interviews conducted with 16 girls during lockdown. During the period of lockdown and school closures, pupils tried new forms of PA and undertook PA with family, but there was no significant change in self-reported PA. There was a decline in health-related quality of life and motivation for exercise; however, self-efficacy for walking and happiness with appearance increased. There was no change in sleep quality or social media usage. Despite the many challenges that schools face as they reopen, there is a need to continue to prioritize PA and motivation for exercise to support health and well-being in adolescent girls.

Changes in self-reported physical activity and health-related quality of life following 3-month astaxanthin supplementation in patients with heart failure: results from a pilot study.

Astaxanthin has a strong antioxidant effect. We recently demonstrated that following 3-month astaxanthin supplementation, cardiac contractility and exercise tolerance improved, possibly through the suppression of oxidative stress in a small pilot study involving patients with heart failure with left ventricular systolic dysfunction. This is a sub-study of our pilot study to investigate whether improvements of selfreported physical activity and health-related quality of life were observed following 3-month astaxanthin supplementation. We investigated the changes in physical activity by the Specific Activity Scale score and healthrelated quality of life by physical and mental component summary scores in Short Form-8 at baseline and after 3-month astaxanthin supplementation. Data from 17 patients with heart failure were assessed. Following 3-month astaxanthin supplementation, the Specific Activity Scale score increased from the median of 4.5 (interquartile range, 2.0) to 6.5 (interquartile range, 1.1) metabolic equivalent (P=0.001), and the physical and mental component summary scores increased from 46.1±9.2 to 50.8±6.8 (P=0.015) and from 48.9±9.1 to 53.8±4.8 (P=0.022), respectively. There was a linear relationship of the baseline heart rate, or mental component summary score with the percent change in the Specific Activity Scale score (r=0.523, P=0.031 and r=-0.505, P=0.039, respectively). In addition, there was a direct relationship of ischemic etiology with the percent change in the physical component summary score (r=0.483, P=0.049, respectively). Finally, there was a linear relationship between the percent change in the Specific Activity Scale score and that in the mental component summary score (r=0.595, P=0.012). Following 3-month astaxanthin supplementation, improvements of the self-reported physical activity level and health-related quality of life in both mental and physical components were observed. In patients with heart failure, those with higher baseline heart rate, ischemic etiology, and poorer baseline health-related quality of life have potentials to have greater improvement of physical activity and/or health-related quality of life.