Self-reported Physical Activity Levels Research Articles

Feasibility and preliminary efficacy of a physical activity intervention in adults with lymphoma undergoing treatment

BackgroundTo determine the feasibility, acceptability, and preliminary efficacy of a 6-month tailored non-linear progressive physical activity intervention (PAI) for lymphoma patients undergoing chemotherapy.MethodsPatients newly diagnosed with lymphoma (non-Hodgkin (NHL) or Hodgkin (HL)) were randomized into the PAI or healthy living intervention (HLI) control (2:1). Feasibility was assessed by examining accrual, adherence, and retention rates. Participants completed assessments of exercise capacity (VO2 peak and 6-min walk distance (6MWD)), objective and self-reported levels of physical activity, MRI-derived cardiovascular functioning (Left Ventricular Ejection Fraction [LVEF], stroke volume, and cardiac output), and self-reported health-related and disease-specific quality of life and self-efficacy for exercise at baseline, 3, and 6 months.ResultsOne hundred and forty-five individuals were screened with 23 of 84 eligible patients agreeing to participate (27%). Three participants withdrew before baseline testing. Out of the 20 participants randomized to the PAI (n = 13) and HLI groups (n = 7), 18 completed the intervention resulting in an overall retention rate of 78%. The adherence rates to the PAI and HLI were 85% and 87%, respectively. One non-serious adverse event was registered. VO2 peak ranged from 15.5–28.0 ml/kg/min at baseline and participants in both groups improved by 6 months. Physical activity levels and cardiovascular function were reduced prior to treatment but did not deteriorate further.ConclusionsImplementing a tailored PAI in adults with lymphoma during active treatment is feasible, was well received by participants and shows preliminary efficacy for limiting a decline in function during treatment. Potential Implications for Cancer Survivors: Physical activity may be beneficial for improving exercise capacity and health-related quality of life in patients undergoing chemotherapy.Trial registration#NCT01719562 ClinicalTrials.gov. Registered July 2, 2019—retrospectively registered.

A138: Association of “Weekend Warrior” and Other Physical Activity Patterns with Cognition Function in Older Adults

Background/Purpose: WHO guidelines on physical activity (PA) and sedentary behavior recommend at least 150 minutes of moderate to vigorous PA per week for cognitive benefits, but the relative impacts of concentrated vs evenly distributed activity remain unclear. The “Weekend Warrior” (WW) pattern is characterized by achieving the recommended PA levels in one or two sessions. Despite its prevalence, the cognitive benefits of WW pattern are not well-established. More research is required to clarify the associations between PA and cognitive function in WW and other PA patterns (e.g., inactive, regularly active). The aim of this study was to explore the associations of WW pattern and other PA patterns with cognitive function in older adults. Method: Data of 2929 older adults with a mean age of 69.49 years (48.6% males) from NHANES 2011−2014 were used. Participants were categorized into 3 PA patterns (inactive, weekend warrior, and regularly active) by self-reported PA levels. They also completed the Word Learning subtest (WL), the Animal Fluency Test (AFT) and the Digital Symbol Substitution Test (DSST). Participant characteristics in different groups were tested using the χ2 test and ANOVA tests. Linear regression models were used to estimate the relationship between PA pattern and cognitive function. Finally, stratified and interaction analyses were conducted to investigate whether the association was stable among subgroups. Results: The participants’ PA pattern distribution was inactive 1524 (52.03%), WW 58 (1.98%) and regularly active 1347 (45.99%). After adjusting for these demographic covariates, behavioral factors, and disease conditions, there were significant associations between regularly active pattern and the scores of cognition function tests (β[95% confidence intervals] for WL, AFT, DSST was 0.55[0.10,0.99], 0.96[0.60,1.33], 2.23[1.29,3.18], respectively) when compared with inactive pattern. However, WW did not show significant effect on cognitive function whether compared with regularly active or inactive pattern. Further stratified analyses exhibited that WW pattern was significantly associated with cognitive function in females, the Non-Hispanic White elderly and those suffering from cancer. Age and race had significant interaction on the relationship between PA pattern and cognitive function. Conclusion/Discussion: Compared with inactive patterns, regularly active patterns could significantly improve cognitive function in the older adults, and WW pattern could improve cognitive function in some specific subgroup elderly. It is preferable for older adults to spread the recommended PA over the week; however, if time constraints exist, condensing the activity into fewer days is deemed acceptable for certain groups.

Physical activity and DNA methylation-based markers of ageing in 6208 middle-aged and older Australians: cross-sectional and longitudinal analyses.

Epigenetic age quantifies biological age using DNA methylation information and is a potential pathway by which physical activity benefits general health. We aimed to assess the cross-sectional and longitudinal associations between physical activity and epigenetic age in middle-aged and older Australians. Blood DNA methylation data for 6208 participants (40% female) in the Melbourne Collaborative Cohort Study (MCCS) were available at baseline (1990-1994, mean age, 59years) and, of those, for 1009 at follow-up (2003-2007, mean age, 69years). Physical activity measurements (weighted scores at baseline and follow-up and total MET hours per week at follow-up) were calculated from self-reported questionnaire data. Five blood methylation-based markers of ageing (PCGrimAge, PCPhenoAge, bAge, DNAmFitAge, and DunedinPACE) and four fitness-related markers (DNAmGaitspeed, DNAmGripmax, DNAmVO2max, and DNAmFEV1) were calculated and adjusted for age. Linear regression was used to examine the cross-sectional and longitudinal associations between physical activity and epigenetic age. Effect modification by age, sex, and BMI was assessed. At baseline, a standard deviation (SD) increment in physical activity was associated with 0.03-SD (DNAmFitAge, 95%CI = 0.01, 0.06, P = 0.02) to 0.07-SD (bAge, 95%CI = 0.04, 0.09, P = 2 × 10-8) lower epigenetic age. These associations were attenuated after adjustment for other lifestyle variables. Only weak evidence was found for the longitudinal association (N = 1009) of changes in physical activity and epigenetic age (e.g. DNAmFitAge: adjusted β = - 0.04, 95%CI = - 0.08, 0.01). The associations were not modified by age, sex, or BMI. In middle-aged and older Australians, higher levels of self-reported physical activity were associated with slightly lower epigenetic age.

Tipping the scale: Effects of physical activity and body composition on cardiac parameters in postmenopausal females.

The risk of cardiovascular disease increases significantly after menopause. We sought to assess the impact of different activity levels on cardiac structure and function in postmenopausal women. We grouped age-similar, postmenopausal women by self-reported physical activity levels over two decades. The study involved 34 women (age 61 ± 1 years; 11 ± 2 postmenopausal years; body mass index 23 ± 3 kg/m2) categorized into three activity tiers: sedentary (SED; ≤1 h exercise weekly; n = 9); moderately active (MOD; ≥2 ≤6 h low/moderate intensity exercise weekly; n = 11) and highly active (HIGH; >4 h of moderate/high intensity exercise weekly; n = 14). Maximum oxygen uptake (VO2max) differed significantly (p < 0.05) between the groups (24.9 ± 5.8; 30.5 ± 5.8; 38.4 ± 4.4 mL O2/kg/min; SED, MOD and HIGH respectively). Conversely, there were no differences (p > 0.05) in height, Total fat-free mass, body surface area or in echocardiographic measures of left ventricular (LV) morphology, systolic function, diastolic function and right ventricular function. Contrary to our hypothesis, these findings reveal that marked differences in activity level and VO2max are not reflected in measures of LV morphology or echocardiographic indicators of cardiac diastolic or systolic function in postmenopausal women of similar body size.

Dose-response associations between physical activity and mental health among USA adolescents

Abstract Background Adolescent mental health is a critical public health concern. Physical activity has been shown to reduce risk of negative mental health outcomes. However, in adolescents little is known about the dose-response nature of this relationship. This study aims to fill this gap by examining the association between varying levels of self-reported physical activity and the odds of reporting depressive symptoms and poor mental health, among US high school students. Methods This is a cross-sectional study using data from the 2021 Youth Risk Behavior Survey. Physical activity exposure was assessed as students’ self-reported weekly frequency of ≥ 60min moderate-to-vigorous physical activity (MVPA), as well as frequency of participation in muscle-strengthening activities, sports teams, and physical education (PE) classes. For the dose-response analysis three categories were created for each item. Depressive symptoms and poor mental health were measured using established survey items. Multivariate logistic regression risk models were used. Results A total of 8,015 high-school students were included. Depressive symptoms were reported by 43% of students, and 28% reported poor mental health. Moderate doses (1-4 days) of muscle-strengthening activities reduced the odds of depressive symptoms by 23% and the odds of poor mental health by 38% compared to low doses (0 days). Higher reductions were observed for higher doses (5-7 days). Similar results were observed for sports teams (1 vs 0 teams). Moderate doses (1-4 days) of MVPA ≥60min showed a significant reduction in the odds for poor mental health (38%) but not depressive symptoms compared to low doses (0 days). No effect was observed for any dose of PE attendance. Conclusions The findings suggest a dose-response pattern in the association between physical activity and mental health in adolescents. Any increase in physical activity levels among young adults would be valuable in preventing poor mental health. Key messages • A dose-response pattern was observed between self-reported mental health and physical activity exposure in adolescents. • Moderate levels of physical activity significantly reduced the risk of self-reported poor mental health among adolescents.

Cardiovascular Disease Prevalence in Non-Hispanic Black Individuals: U.S. Territories vs. Stroke Belt and Non-Stroke Belt States.

Extensive research exists on the increased prevalence of cardiovascular disease (CVD) in the "Stroke Belt" states, compared to the remaining United States (U.S.). Social, environmental, and systemic factors and individual behaviors have been investigated, including Black race. This study aims to assess whether residing in the U.S. territories, Stroke Belt, or non-Stroke Belt states is associated with differences in CVD prevalence among non-Hispanic Black adults. We analyzed cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS). All non-Hispanic Black adults (18+) with complete information on key variables, including demographics, CVD outcomes, and relevant risk factors, were included. The prevalence of CVD was defined as self-reported coronary artery disease, stroke, or myocardial infarction. Univariate and multivariable logistic regression analyses were used to calculate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results:Of the 31,246 individuals included in our study, 87 (8.7%) residing in the U.S. territories reported experiencing a cardiovascular event, compared to 1487 (10.1%) in the Stroke Belt and 1872 (8.2%) in the non-Stroke Belt regions. Compared to non-Hispanic Black adults residing outside the Stroke Belt, those living in the Stroke Belt had 23% higher odds of reporting CVD (OR 1.23, 95% CI 1.10-1.44) after adjusting for age and gender. In the fully adjusted model, which accounted for additional factors such as comorbidities and socioeconomic status, the odds were slightly attenuated but remained elevated (OR 1.14, 95% CI 0.97-1.35). For Black adultsliving in the U.S. territories, the odds of reporting CVD were not significantly different from those outside the Stroke Belt in both the age- and gender-adjusted model (OR 1.07, 95% CI 0.66-1.73) and the fully adjusted model (OR 0.93, 95% CI 0.49-1.74). Independent of residence, individuals with high blood pressure (OR 2.85, 95% CI 2.05-3.96), diabetes (OR 1.45, 95% CI 1.20-1.75), and high cholesterol (OR 1.55, 95% CI 1.27-1.89) had significantly higher odds of CVD. In contrast, smoking and income were associated with prevalent CVD, while self-reported diet, physical activity, and education level were not. Contrary to our expectation, we found that non-Hispanic Black adults residing in the U.S. territories had similar self-reported CVD with those living in the non-Stroke Belt regions. Further research is needed to investigate the socio-behavioral factors influencing cultural and historical disparities among non-Hispanic Black individuals in the U.S. and its territories.

Age- and sex-dependent associations between self-reported physical activity levels and self-reported cardiovascular risk factors: a population-based cross-sectional survey

BackgroundThe amount of regular physical activity (PA) can modulate the prevalence of traditional risk factors for cardiovascular disease (CVD) such as obesity, systemic hypertension, hypercholesterolemia, and type 2 diabetes (T2D). However, how different PA levels either below (< 600 MET min/week), within (600–1200 MET min/week), or above (> 1200 MET min/week) the range of the minimal WHO recommendations impact the age- and sex-dependent prevalence of these risk factors remains to be elucidated.MethodsThis cross-sectional study was performed to evaluate these relationships using population-based self-reported data collected in a central European country (Austria, 2019). The sample included a total of 15,461 persons (7166 males: 16–95 + years, BMI 26.6 ± 4.4; 8295 females: 16–95 + years, BMI 25.1 ± 5.0). Besides various lifestyle factors (e.g., dietary habits, smoking, and alcohol consumption), variables of particular interest were the age- and sex-dependent amount of weekly PA and prevalence of risk factors for CVD. Sex-specific logistic regression analyses were applied to estimate adjusted odds ratios (ORs) for the associations between self-reported PA and risk factor prevalence.ResultsRelatively small beneficial effects were found regarding the prevalence of risk factors for CVD when achieving PA levels corresponding to 600–1200 MET min/week as compared to those who did not meet these recommendations. However, exceeding the WHO recommendations provided much more pronounced benefits, especially in younger and older age groups. Adjusted ORs revealed that high volumes of PA (> 1200 MET min/week) were associated with a 32–43% reduction in the prevalence of obesity and T2D compared to those who did not achieve the WHO recommendations (< 600 MET min/week), as well as with a lower prevalence of systemic hypertension only in women and a lower prevalence of hypercholesterolemia only in men.ConclusionsExceeding minimal WHO recommendations for PA promises large beneficial effects, particularly on the prevalence of obesity and T2D. Demonstrated sex differences in PA levels and their association with cardiovascular risk factors may provide an important basis for preventive health counseling.

The Relationship Between Physical Activity and Non-Modifiable Risk Factors on Alzheimer's Disease and Brain Health Markers: A UK Biobank Study.

Modifiable (physical activity) and non-modifiable (sex and genotype) risk factors interact to affect Alzheimer's disease (AD) risk. Further investigation is necessary to understand if these factors influence brain volume and cognition. The study aimed to assess the effect of physical activity, APOE genotype, and sex on AD risk, brain volume, and cognition. UK Biobank data from 2006 to 2023 was accessed. Physical activity was measured by accelerometers, and International Physical Activity Questionnaire. Outcomes were AD incidence; brain volume (ventricular cerebrospinal fluid and total brain); and cognition (executive function, memory, visuospatial ability, processing speed, and reaction time). Logistic and linear regression models were conducted. 69,060 participants met inclusion criteria (mean age: 62.28 years, SD: 7.84; 54.64% female). Higher self-reported (OR = 0.63, 95% CI [0.40, 1.00], p = 0.047) and accelerometer-assessed (OR = 0.96 [0.93, 0.98], p = 0.002) physical activity was associated with lower disease incidence. Smaller ventricular cerebrospinal fluid volume (β= - 65.43 [- 109.68, - 17.40], p = 0.007), and larger total brain volume (β= 4398.46 [165.11, 8631.82], p < 0.001) was associated with increased accelerometer-assessed and self-reported physical activity respectively. Both brain volume analyses were moderated by sex. Increased accelerometer-assessed physical activity levels were associated with faster reaction time (β= - 0.43 [- 0.68, - 0.18], p = 0.001); though poorer visuospatial ability (β= - 0.06 [- 0.09, - 0.03], p < 0.001), and executive function (β= 0.49 [0.31, 0.66], p < 0.001; β= 0.27 [0.10, 0.45], p = 0.002) was related to self-reported physical activity levels. Higher levels of physical activity reduce AD risk independently of non-modifiable risk factors. Moderation of sex on brain volume highlighted the importance of incorporating non-modifiable risk factors in analysis.

Self-reported physical activity and fatigue and its associations to anxiety and depression in adult patients with idiopathic inflammatory myopathies: a MIHRA psychological impact and MIHRA exercise and rehabilitation scientific working groups collaboration.

To evaluate self-reported physical activity (PA) levels as well as the relationship between PA, anxiety, depression, quality of life, pain, fatigue, disease activity, and organ damage in patients with idiopathic inflammatory myopathies (IIM). All adult patients registered at the rheumatology clinic at Karolinska University Hospital in Stockholm, Sweden (2019-2022) were eligible to participate. Questionnaires measuring anxiety, depression (HADS), and PA (IPAQ) were provided during yearly check-up or by mail, due to reduced in-person visits amid the Covid-19 pandemic. Additional data was obtained from the Swedish Rheumatology Quality Registry. Of 488 invited patients, 336 agreed to participate, and 246 completed the questionnaires. Median (range) age was 64 (20-88) years, median disease duration five (0.3-61) years and two-thirds were women. Notably, 82% reported moderate/high level of PA. Probable anxiety and depression were experienced by 25% and 14%, respectively. The findings indicated a potential protective effect of PA against depression (OR 0.23, CI 0.06-0.95). Conversely, patients who were physically inactive had poorer mental health, reduced muscle function, increased organ damage, and fatigue. Fatigue demonstrated a progressive link to heightened risks of anxiety (2%, 2-4%) or depression (3%, 1-6%). Most patients with IIM reported being physically active. The study highlights the potential influence of PA on mental health and its role in mitigating risks associated with depression and fatigue among IIM-patients. It also underscores the importance of patient-reported outcomes, and their role in understanding and improving healthcare interventions. Further research is needed to uncover causes and confirm these associations.

Breast cancer risk and prevention in 2024: An overview from the Breast Cancer UK - Breast Cancer Prevention Conference.

The Breast Cancer UK-Breast Cancer Prevention Conference addressed risk from environmental pollutants and health behaviour-related breast-cancer risk. Epidemiological studies examining individual chemicals and breast cancer risk have produced inconclusive results including endocrine disrupting chemicals (EDCs) Bisphenol A, per- and polyfluorinated alkyl substances as well as aluminium. However, laboratory studies have shown that multiple EDCs, can work together to exhibit effects, even when combined at levels that alone are ineffective. The TEXB-α/β assay measures total estrogenic load, and studies have provided evidence of a link between multiple-chemical exposures and breast cancer. However, prospective studies using TEXB-α/β are needed to establish a causative link. There is also a need to assess real-life exposure to environmental-chemical mixtures during pregnancy, and their potential involvement in programming adverse foetal health outcomes in later life. Higher rates of breast cancer have occurred alongside increases in potentially-modifiable risk factors such as obesity. Increasing body-mass index is associated with increased risk of developing postmenopausal breast cancer, but with decreased risk of premenopausal breast cancer. In contrast, lower rates of breast cancer in Asian compared to Western populations have been linked to soya/isoflavone consumption. Risk is decreased by breastfeeding, which is in addition to the decrease in risk observed for each birth and a young first-birth. Risk is lower in those with higher levels of self-reported physical activity. Current evidence suggests breast-cancer survivors should also avoid weight gain, be physically active, and eat a healthy diet for overall health. A broad scientific perspective on breast cancer risk requires focus on both environmental exposure to chemicals and health behaviour-related risk. Research into chemical exposure needs to focus on chemical mixtures and prospective epidemiological studies in order to test the effects on breast cancer risk. Behaviour-related research needs to focus on implementation as well as deeper understanding of the mechanisms of cancer prevention.

Physical Activity Levels in Persons With Patellofemoral Pain: A Systematic Review and Meta-analysis.

Pain and symptoms of patellofemoral pain (PFP) are often exacerbated during daily activities, which may result in reduced overall physical activity levels. To summarize the evidence for physical activity levels among persons with PFP compared with pain-free controls. PubMed, Embase, CINHAL, Cochrane Library, and SPORTDiscus were searched from January 1, 2000 to February 22, 2024. Peer-reviewed studies published in English that measured physical activity subjectively or objectively in persons with PFP and pain-free controls. Systematic review with meta-analysis. Level 1. Standardized mean difference (SMD) with 95% CI are reported based on Hedges' g effect sizes. From 23,745 records, 41 studies met the eligibility criteria. There was high-to-moderate-certainty evidence that persons with PFP reported higher physical activity levels compared with pain-free controls using the International Physical Activity Questionnaire (SMD, 0.27; 95% CI 0.03, 0.51), whereas lower physical activity levels compared with pain-free controls using the Tegner Activity Scale (SMD, -0.31; 95% CI -0.57, -0.04). There was low-to-moderate-certainty evidence that there was no group difference in physical activity levels using the Baecke Physical Activity Questionnaire (SMD, 0.17; 95% CI -0.09, 0.44) or self-reported sports participation duration (SMD, -0.46; 95% CI -0.98, 0.05). There was high-certainty evidence that runners with PFP reported shorter running distances compared with pain-free runners (SMD, -0.36, 95% CI -0.57, -0.14). No data pooling was possible for objectively measured physical activity levels due to device heterogeneity (ie, different algorithms used to quantify the intensity of physical activity). Self-reported physical activity levels among persons with PFP were inconsistent depending on the physical activity measurement tool used or which specific physical activity was measured. Clinicians should integrate multiple physical activity assessment tools to determine the extent to which PFP influences physical activity levels. PROSPERO #CRD42022314598.

Effects of a digital intervention on physical activity in adults: A randomized controlled trial in a large-scale sample

BackgroundPhysical inactivity is associated with health risks, contributing to various diseases and all-cause mortality. Despite recommendations for regular physical activity (PA), many adults remain inactive, influenced by socioeconomic and environmental factors. Digital interventions, particularly web-based PA programs, offer promising possibilities to promote PA across populations. These programs vary in their effectiveness, reflecting differences in design, user engagement, and behavior change techniques employed. ObjectiveThis study evaluates the effectiveness of the 12-week multimodal web-based TKFitnessCoach. The PA online program is part of the TK-HealthCoach. This study investigates the program's impact on self-reported PA levels, goal attainment, healthrelated quality of life, body weight, and eating behavior, comparing an interactive personalized web-based intervention and non-interactive web-based health information. MethodsIn a randomized controlled trial (RCT), participants were allocated to either the intervention group (IG), receiving access to the interactive TK-FitnessCoach, or the control group (CG) that was provided a static website with evidence-based information on PA. The study targeted a German-speaking adult population interested in improving health behavior. Data was assessed at T0 (beginning of the study), T1 (postintervention), T2, 6 months, and T3, 12 months follow-ups, focusing on self-reported PA at T3 and on various secondary outcomes. ResultsWe achieved equally distributed sociodemographics in both the IG and the CG with a mean age of 42.8 (IG), resp. 43.1 years (CG), and female participants of 76.1 % (IG), resp. 74.7 % (CG). PA at baseline was 277.9 min/week in the IG and 273.3 min/week in the CG. Both, the IG (n = 1153 in the Intention-to-treat (ITT) dataset) and CG (n = 1177 in the ITT dataset) exhibited significant increases in PA over time (IG(T3-T0) = 72.92 min/week; CG(T3-T0) = 74.12 min/week).However, the study did not find significant differences in the effectiveness of the interactive TK-FitnessCoach compared to the non-interactive control in terms of improving PA and related health outcomes. The intensity of using the TK-FitnessCoach was not associated with PA. ConclusionsBoth programs were effective in promoting PA among adults, with no significant differences observed between the two RCT groups. This highlights the potential of digital interventions in addressing physical inactivity, suggesting that the effectiveness of such programs may not solely depend on their interactivity but also on the quality and relevance of the information provided. Further research is needed to explore optimization strategies for such interventions, especially for persons with low PA, including user engagement, behavior change techniques, and the integration of objective PA tracking methods. Trial registrationGerman Clinical Trials Register DRKS00020249; https://drks.de/search/en/trial/DRKS00020249.

Exploring individual, social and environmental factors related to physical activity: a network analysis

ObjectivesInsufficient physical activity (PA) has long been a global health issue, and a number of studies have explored correlates of PA to identify the mechanisms underlying inactive lifestyles. In the...

Physical Activity, Fitness, and Long-Term Risk of Amyotrophic Lateral Sclerosis: A Prospective Cohort Study.

Observational studies have demonstrated an increased amyotrophic lateral sclerosis (ALS) risk among professional athletes in various sports. For moderately increased levels of physical activity and fitness, the results are diverging. Through a cohort study, we aimed to assess the relationship between indicators of physical activity and fitness (self-reported physical activity and resting heart rate) and long-term ALS risk. From a large Norwegian cardiovascular health survey (1985-1999), we collected information on self-reported physical activity in leisure time, resting heart rate, and other cardiovascular risk factors. Patients with ALS were identified through health registries covering the whole population. We fitted Cox proportional hazard models to assess the risk of ALS according to levels of self-reported physical activity in 3 categories (1: sedentary; 2: minimum 4 hours per week of walking or cycling; 3: minimum 4 hours per week of recreational sports or hard training), and resting heart rate modeled both on the continuous scale and as quartiles of distribution. Out of 373,696 study participants (mean 40.9 [SD 1.1] years at inclusion), 504 (41.2% women) developed ALS during a mean follow-up time of 27.2 (SD 5.0) years. Compared with participants with the lowest level of physical activity, the hazard ratio was 0.71 (95% CI 0.53-0.95) for those with the highest level. There were no clear associations between resting heart rate and ALS in the total sample. In men, the hazard ratio of ALS was 0.71 (95% CI 0.53-0.95) for those reporting moderate levels of physical activity and 0.59 (95% CI 0.42-0.84) for those reporting high levels, compared with those reporting low levels. Men with resting heart rate in the lowest quartile had 32% reduced risk of ALS (hazard ratio 0.68, 95% CI 0.49-0.94) compared with those in the second highest quartile. In women, no association was detected between neither self-reported levels of physical activity nor resting heart rate and ALS risk. Indicators of high levels of physical activity and fitness are associated with a reduced risk of ALS more than 30 years later in men, but not in women.

A Comparative Study of Mental Health, Body Composition, and Physical Activity in American vs Romanian College Students After COVID-19 Lockdown

Introduction: The COVID-19 pandemic and its lockdown restrictions forced college students to spend less time on campuses and more time indoors at home, increasing their sedentary behaviors. We aimed to better understand trends among assumed decreased physical activity levels, increased mental health symptoms, and increased poor nutritional habits. The results will serve healthcare clinicians in developing targeted interventions for improving overall health in college students. Methods: American college students (n = 90) and Romanian college students (n = 85) were assessed for current self-reported levels of physical activity, mental health symptoms, and body composition values in the post-COVID-19 lockdown era. Results: All participants (N =185; 100 females) reported being highly active (82.3%) and experiencing a current level of heightened depressive and anxious symptomatology (58.2%). Differences were seen between the measured body fat percentages (BF) and skeletal muscle masses (SKMM) of the American (BF: males 26.66 12.24%, females 32.88 10.13%) and Romanian (BF: males 11.76 6.68%, females 18.07 9.30%) college students. Despite these differences, all participants collectively displayed a positive relationship between depressive and anxious symptomatology and BF (R = 0.23; p = 0.0018) and a negative relationship between depressive and anxious symptomatology and SKMM (R = - 0.15; p = 0.04). Conclusions: Although cultural differences may help to explain the found differences among body fat percentages and skeletal muscle masses, both groups of college students did similarly struggle with symptoms of depression and anxiety. The post-lockdown coping mechanisms embraced by both groups of college students have not been fully effective in improving their mental health.

Amblyopia and physical activity in adolescents

ABSTRACT Introduction: Physical activity in adolescence plays an important role in reducing the lifetime risk of chronic disease. Recent studies have shown that individuals with amblyopia may have difficulties with coordinating balance and may be at greater risk of developing fine motor impairments. The purpose of this study was to determine if there is an association between the presence of amblyopia and physical activity (PA) in adolescents. Methods: Adolescent patients aged 12–18 years with a history of childhood amblyopia were age- and gender-matched to control patients with no other ocular pathology aside from refractive error. Each participant’s best corrected visual acuity and refractive error were recorded in addition to their height and weight to calculate body mass index (BMI). A 32-question electronic survey was used to calculate self-reported physical activity level (PAL) score and type of PA over the previous seven days. The Ainsworth Compendium of Physical Activities was taken as a reference to calculate Metabolic Equivalent of Task (MET) minutes for the most frequently performed activity. Results: A total of 26 adolescents with amblyopia (10 strabismic, 16 anisometropic) and 26 healthy controls were recruited. The MET-minute values were 2404.3 ± 2313.9 in the control group and 905.6 ± 1196.0 in the amblyopia group (p = .008). The PAL scores were similar between amblyopia and control groups (1.15 ± 0.70 versus 1.24 ± 0.60, p = .63); however, BMI was significantly higher in amblyopia participants (25.2 ± 6.3 versus 21.1 ± 5.4, p = .003). When compared with controls, amblyopes perceived physical activity to be of significantly lower importance in their lives compared to controls (p = .009). Discussion: Amblyopic adolescents may represent a population with increased vulnerability to significantly lower energy expenditure and higher BMI. Future studies with a larger number of participants and further investigation into the impact of refractive error on physical activity are warranted.

Monitoring handgrip strength to motivate lifestyle choices for patients with diabetes type 2 – a pragmatic randomised controlled trial

Physical strength can be an important parameter to monitor for patients with diabetes mellitus type 2 (T2DM) to promote healthy lifestyle choices. Functional measurements can contribute to healthcare advice and possibly motivate more active lifestyles. The aim of the study was to investigate whether adding measurement and feedback concerning handgrip strength (HGS) to the parameters measured for patients with T2DM at annual check-ups leads to change in physical activity (PA) level, HGS, HbA1c or waist circumference. Methods Measurement of HGS with Jamar dynamometers was added to annual check-ups for patients with T2DM by diabetes nurses in primary care with feedback about normal values for age and sex in the intervention group. The control group had standard check-ups. Change in self-reported PA level was measured with questionnaires. Results Seven clinics and 334 patients participated. The intervention led to similar effects on PA in both groups. Patients with T2DM had comparable HGS to the general public. Regression analyses showed statistically significantly higher HGS in the intervention group than in the control group at follow-up and no improvement in PA, HbA1c, or waist circumference. Increased HGS was found for older people, men, and people with normal-to-high inclusion HGS, while patients with low inclusion HGS reduced their strength levels. Conclusions Measuring HGS and giving feedback to patients with T2DM can lead to increased HGS but does not seem to affect general PA level, HbA1c, or waist circumference. People over 65 years, men, and people with normal-to-high HGS were influenced positively by the intervention. Patients with low HGS may need personalised support to increase physical activity and improve function. ClinicalTrials registration: NCT03693521

A cross-sectional analysis between physical activity levels, weight status and empathy-related behaviors in a sample of Tuscany primary school children.

The present study aimed to investigate the relationship between physical activity (PA) and the development of relational empathy skills in children, taking into account weight status. Parents/guardians of primary school children were involved in filling out a questionnaire: the Empathy Questionnaire (EmQue-I13) and children were asked to complete the Physical Activity Questionnaire for Children (PAQ-C) to investigate the self-reported PA levels. The weight status was assessed using a self-reported Body Mass Index (BMI). Three hundred seventy parents or guardians of students who attended primary school (8.53±1.61 yrs) were recruited. The total score was 2.41±0.89 for PAQ-C and 41.17±6.32 for EmQue-I13. The three domains of EmQue-I13 were: contagion (8.16±2.67), attention to others' feelings (19.40±2.99) and prosocial actions (13.62±3.01). Linear regression models showed that a higher PAQ-C score was positively associated with empathy-related total score P<0.000. Weight status, age and gender were not associated with EmQue-I13. Our results underline the positive association between physical activity and the development of relational empathic skills.

Association between the 6MWT and other measurements of physical functioning in patients with cancer awaiting major surgery

BackgroundThe Six Minute Walk Test (6MWT) is a widely used measure of functional capacity in (p)rehabilitation of cancer patients, but it is time-consuming and requires specific space conditions. In this study we explore the association between the 6MWT with other measurements of physical functioning and their predictive value in classifying patients according to their estimated functional capacity. DesignThis prospective study included cancer patients referred to a prehabilitation programme prior to major surgery. For each patient, data on different measurements of physical functioning including the Duke Activity Status Index (DASI), the handgrip strength, the 30” Sit-to-Stand Test and self-reported physical activity levels were collected. Bivariate associations were performed to determine the association between the 6MWT and other variables. Multivariate analyses were performed to identify potential predictive factors of 6MWT in this population. A subsequent algorithm was developed to classify patients based on their functional capacity (good performance – 6MWT>400 m or poor performance 6MWT<400 m) ResultsBetween mid-2018 to mid 2022, 692 patients were assessed of whom the 6MWT was performed in 524 (75.7 %) (mean age 72.5 ± 11.8 years; 57.1 % men). Moderate-to-strong correlations were found between 6MWT and 30” Sit-To-Stand Test (r = 0.54, p < 0.001), DASI (r = 0.68; p < 0.001) and handgrip strength (r = 0.5; p < 0.001). Multivariate analyses confirmed that a combination of six variables were able to classify 80 % of patients in good (>400 m) or poor (<400 m) performance in the 6MWT. ConclusionThe 6MWT was moderately associated with several variables of physical functioning, a combination of which can be used to predict performance in the 6MWT.

Facilitators, barriers and support needs to GLA:D exercise adherence – a mixed method study

BackgroundKnee and hip osteoarthritis (OA) are among the most common musculoskeletal joint diseases worldwide. International guidelines recommend exercise and education as first-line interventions for their management. The Good Life with osteoArthritis Denmark (GLA:D) programme aims to achieve self-management using group exercise and education sessions. It also encourages participants to stay physically active and perform GLA:D exercises (GE) twice weekly after programme end. This study investigated the participants’ self-reported level of physical activity (PA) and self-reported adherence to the GE between five and 17 months after completion of the GLA:D programme and also explored the barriers, facilitators and support needs to achieve long-term adherence to GE.MethodsA mixed method study using an exploratory sequential design was performed. A qualitative phase, involving semi-structured interviews and a focus group, led to the development of a questionnaire on participants’ level of PA, as well as ratings of the barriers, facilitators and support needs for the achievement of long-term adherence to GE. In a second quantitative phase, the survey was conducted online with former GLA:D participants from Switzerland. Descriptive statistical analysis and a group comparison between adherent and non-adherent participants to the GE were performed using Fisher’s exact test, odds ratio, and confidence interval.ResultsEleven former GLA:D participants attended the interviews and focus group, and former GLA:D participants (30% response rate) participated in the survey. Of these, 84% (n = 285) reported to reach the recommended level of PA and 53% (n = 178) GE adherence. The top barrier to GE adherence was no/little self-discipline to perform GE (40%, n = 112) and the top facilitator was GE are easy to perform (93%, n = 300). The top 3 items regarding support needs to enhance GE adherence were a shortened version (max. 30 min) of the GE home programme (75%, n = 255), monthly continuation of small GE groups under GLA:D physiotherapists’ supervision (65%, n = 221), and monitoring with regular testing of individual progress (65%, n = 221).ConclusionsThe top barriers and facilitators should be considered by those responsible for the GLA:D programme and may need to be specifically addressed during and after the programme. The development of a shortened version of the GLA:D programme, a post-GLA:D group, and monitoring with regular testing seem crucial for enhancing GE adherence.Clinical Trial Registrationnot applicable.