Self-reported Physical Activity Levels Research Articles

Impact of exercise training on cardiotoxicity and cardiac health outcomes in women with breast cancer anthracycline chemotherapy: a study protocol for a randomized controlled trial

BackgroundAnthracyclines are chemotherapeutic agents frequently used in breast cancer (BC) treatment. Although it improves disease-free and overall survival, the use of anthracyclines is associated with a cumulative risk of cardiac toxicity. Preventive strategies to optimize cardiac health are needed and exercise is proposed as a potential non-pharmacological approach for counteracting anthracycline-related cardiotoxicity (ARC). Most of the data on the effects of exercise to reduce ACT are from animal studies, with only a few studies in a limited number of patients indicating beneficial effects. To better understand the effectiveness of exercise in the mitigation of ARC, clinical, real-world trials claim require a larger sample size and more accurate and valuable clinical biomarkers. In this study, we intend to include a large sample and investigate cardiac function through serial measures of biomarkers and imaging techniques.MethodsThis protocol describes a two-arm, prospective, randomized controlled trial that will explore the cardioprotective effect of a structured exercise program in women with BC undergoing anthracycline-containing chemotherapy (ACT). Ninety adult women with early BC and recommended to receive ACT will be randomly assigned (1:1) to an intervention group or a control group. Patients allocated to the intervention group will perform a supervised exercise program three times per week, consisting of a combination of aerobic and resistance training with progressive intensity and volume, during the time period they receive ACT. The control group will receive standard BC care. Primary outcomes related to cardiac (dys)function will be circulating N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, resting left ventricular (LV) longitudinal strain, and resting LV ejection fraction. Secondary outcomes will include the assessment of resting blood pressure, resting heart rate (HR), resting HR variability (HRV), recovery HR, physical function outcomes, self-reported physical activity level, health-related quality of life, and fatigue. Data will be obtained at baseline (t0), after the end of anthracycline-treatment (t2), and 3 months after t2 (t3). Additionally, NT-proBNP will be measured 1–24 h prior to each anthracycline-treatment cycle (t1).DiscussionThe implementation of the present study design, using novel clinical biomarkers, will determine the effect of structured exercise interventions at mitigating ARC, with the overall aim of finding means to further improve BC care.Trial registrationISRCTN, ISRCTN32617901. Registered on 24 October 2018. Last updated on 11 January 2019.

Return to self-reported physical activity level after an event of acute low back pain.

BackgroundRegular physical activity participation is known to promote better mobility and coordination. Although previous research has established that lack of physical activity participation may increase the risk of developing low back pain, the role of physical activity as a predictor of recovery among symptomatic individuals remains unclear.ObjectiveTo evaluate whether: (i) the level of physical activity participation before an acute episode of low back pain predicts recovery within 12 months following the acute pain episode (i.e. index episode); and (ii) participants return to their pre-pain level of physical activity participation 12 months from the index episode.DesignThis study used longitudinal data from the TRIGGERS case-crossover study.SettingThis study was conducted through over-the-phone interviews to participants that presented to 300 primary care clinics with a new episode of acute low back pain.ParticipantsThis study included 999 consecutive patients, aged 18 years or older. Follow-up assessment was completed at 12 months following the index episode.MethodsThis is a cohort study where consecutive patients, aged 18 years or older, that presented with a new episode of acute low back pain were recruited between October 2011 and November 2012.Main outcome measurementsSelf-reported level of physical activity participation.ResultsA total of 830 participants completed the study. When comparing participants who reported pain at 12 months follow-up with those without pain, all participants reported similar levels of physical activity participation one week before (p = 0.449), one week after (p = 0.812) and 12 months after the index episode (p = 0.233). The level of physical activity participation before the index episode was not a reliable predictor of presence of pain at either 3 or 12 months follow-up (OR 0.99; 95% CI 0.993 to 1.003; p = 0.523 and OR 1; 95% CI 0.992 to 1.008; p = 0.923, respectively).ConclusionPhysical activity participation did not predict recovery from the pain episode. Also all participants returned to their pre-pain level of physical activity participation after 12 months.

Muscle performance and fatigue in compensated chronic liver disease

Background: A common and debilitating symptom in patients with chronic liver disease is fatigue (CLD). Muscle dysfunction has been suggested to be a key mechanism of fatigue in CLD.Objective: We aimed to evaluate fatigue and the potential association with muscle performance and physical activity in outpatients with CLD.Methods: Two-hundred seventy outpatients with CLD were included, (52 ± 15 years, mean ± SD; 151 females) with autoimmune hepatitis (n = 49), primary biliary cholangitis (n = 45), primary sclerosing cholangitis (n = 46), chronic hepatitis B (n = 57) or C (n = 73). Patients with a Child-Pugh >6 were excluded. The questionnaire Fatigue Impact Scale (FIS) was used to evaluate fatigue, and physical activity was evaluated through a self-reported level of physical activity. Muscle function was assessed with four muscle tests, walking speed, handgrip strength, standing heel-rise test (SHT) and ‘Timed Up and Go’ test (TUG).Results: The median total FIS score was 30 (40% had FIS > 40, considered high-fatigue). Diminished muscle performance was observed in the SHT (% of predicted value: 53 ± 26%) and with maximum grip strength (85 ± 20%). The FIS score was significantly different between groups of CLDs (p = .004). In multivariate analysis the TUG (p = .001), SHT (p = .005), antidepressants (p < .001), and level of physical activity (p = .001) were associated with fatigue (R2 = 29%). Subjects with higher levels of physical activity had lower FIS (p < .001).Conclusions: In patients with CLD, fatigue was associated with low muscle performance and reduced level of physical activity, which could be a potential therapeutic target.

'No one ever asked us': a feasibility study assessing the co-creation of a physical activity programme with adolescent girls.

Globally, the poor activity level of adolescent girls is a public health concern. Little research has involved adolescents in the design of interventions. This study assessed the feasibility of involving girls in the co-creation of an activity programme. Thirty-one students (15-17 years old) were recruited from a post-primary school. The Behaviour Change Wheel guided intervention design, providing insights into participants' capability, opportunity and motivation for change. Step counts and self-reported physical activity levels were recorded pre- and post-intervention. Feasibility benchmarks assessed recruitment, data collection, acceptability and adherence. Activity and educational sessions were delivered for six weeks during physical education class. Average attendance was 87% (benchmark = 80%). Eligibility was 61% (benchmark = 60%). There was a 100% retention rate (benchmark = 90%). All participants (n = 31) completed baseline measures and 71% (n = 22) completed post-measures. 54% (n = 17) of students completed pedometer measurements, with 32% (n = 10) having complete data. Average daily steps were 13,121 pre-intervention and 14,128 post-intervention (p > 0.05). Data collection was feasible, receiving a mean score > 4/5 (benchmark > 3.5/5). The Behaviour Change Wheel can be used to co-create an activity programme with adolescent girls. Predetermined benchmarks, except for pedometer recordings, were reached or exceeded, providing evidence for the need of a randomised controlled trial to test effectiveness.

Physical Activity Levels in a Structured Physical Exercise Community Program in Elderly

PURPOSE: A decline in physical activity levels in older people is related with worsening of quality of life and a lower cardiorespiratory fitness level, which are associated with cardiovascular disease events and mortality from all causes. The aim of this study was to survey the level of self-reported physical activity in elderly people practicing different levels of physical activity program. An urban community of Sao Paulo was investigated. METHODS: This was a community-based cross-sectional study of a cohort of 50 individuals aged 60 or over, participating in a 6-month structured physical exercise community program and a control group of 50 sedentary elderly individuals age-matched. The structured physical exercise community program adheres to the Position Stand of the American College of Sports Medicine, as it included combined aerobic exercise, muscle strengthening exercises, and flexibility exercises. Physical activity levels were evaluated using the International Physical Activity Questionnaire (IPAQ). RESULTS: The group participating in a physical exercise program had significantly higher levels of physical activity in the moderate activity (318.8 ± 561.8 vs. 238.5 ± 831.6 MET-min/wk, p < 0.001), vigorous (125.8 ± 245.7 vs. 66.2 ± 228.9 MET-min/wk, p < 0.002) and total activity (846.0 ± 951.1 vs 691.0 ± 1239.1 MET-min/wk, p < 0.05). No differences between these groups were observed in walking activity (275.6 ± 289.8 vs. 320.1 ± 498.4 MET-min/wk, p = 0.6). CONCLUSIONS: Our structured physical exercise community program proved effective in order to overcome the decline in physical activity levels in elderly population.

The Effect of Physical Activity on Hemodynamic Response to Angiotensin Converting Enzyme Inhibition in Hypertension

PURPOSE: Physical activity (PA) can reduce blood pressure (BP) in hypertensive populations. Although underlying mechanisms remain unclear, an interaction with the renin-angiotensin-aldosterone system (RAAS) is a logical focus of exploration. We conducted a nested cohort analysis to determine if reported level of PA was associated with vascular responsiveness to acute angiotensin converting enzyme inhibition (ACEi). METHODS: Data were extracted from the HyperPATH dataset, which is an ongoing program to identify genetic mechanisms underlying cardiometabolic risk. Individuals with hypertension who completed a physical activity self-assessment and who had completed hormonal assessment (serum aldosterone [ALDO] and plasma renin activity [PRA]) and vascular response (BP) to a single dose of an ACEi (captopril 25mg) were included for analysis. All participants (n=144) were studied in a clinical research center after overnight, supine, fasting status and on a sodium, potassium, and calcium controlled diet for 7 days. PA was reported as 1) no additional PA, 2) little, 3) moderate, or 4) high amounts of exercise. The response to ACEi was evaluated by ANOVA or multivariate regression when appropriate, with all analyses adjusted for age, sex, race, and BMI. RESULTS: As expected, both acute ACEi and increased PA levels were significantly associated with reduced systolic BP (p<0.05). However, individuals who reported high amounts of exercise displayed a greater BP lowering effect from ACEi compared to those who reported moderate (-14.8 ± 8.1 mmHg vs -8.4 ± 9.9 mmHg, p<0.01) or no additional PA (-14.8 ± 8.1mmHg vs -2.6 ± 9.9 mmHg, p<0.001). Exploratory analyses indicated high amounts of PA were associated with: a reduced heart rate when compared to no PA (54.2±7.7 bpm vs 66.4±9.8 bpm, p<0.001), reductions in PRA (0.42±0.48 ng/ml/hr vs 0.59±0.52 ng/ml/hr, p<0.05), and reductions in ALDO (β=-0.44, CI=0.19-0.70, p=0.001). CONCLUSIONS: Higher levels of self-reported PA are associated with decreased BP, and acute ACEi resulted in an augmented BP lowering effect in hypertensive subjects. PA is inversely correlated with RAAS activity. These data shed light on how physical activity interacts with vascular function in RAAS activity and suggest that PA and ACEi medications may act synergistically.

Relationship between self-rated health status and physical activity in obese South Indian patients

Background: Regular physical activity can improve people's overall health and reduce various risks for morbidity and mortality due to a sedentary lifestyle. Although the evidence linking obesity with many chronic diseases is well established, the relationship with self-rated health is not clear. The study aimed to assess the relationship between physical activity and self-rated health and how it is related to obesity.Methods: The cross-sectional study included 132 individuals above18 years, of both genders, with BMI above 25kg/m2. Data was collected using a structured proforma which included apart from demographic parameters, anthropometry parameters, self-reported physical activity, health status and stress levels of the subjects. Chi-square test/Fisher's exact test was used to assess the association between BMI, physical activity and self-rated health.Results: A total of 132 subjects were included with a mean age of 48.44±11.23 years, with an almost equal proportion of males and females. The mean of BMI was 29.54±3.99. Most of them reported having normal physical activity (61.36%) with only 3% of them having high physical activity. The self-rated health of the subjects revealed 45.45% of them is having fair health and 43.18% of them having poor health. The mean a number of hours spent by sitting/sedentary activity in a week were 32.32±21.09.Conclusions: The study findings revealed that the irrespective of the degree of physical activity both overweight and obese subjects rated their health fair to poor.

Importance of the relationship between symptoms and self-reported physical activity level in stable COPD based on the results from the SPACE study

BackgroundThe burden of symptoms and risk of exacerbations are the main drivers of the overall assessment of the Chronic Obstructive Pulmonary Disease (COPD) and the adequate treatment approaches per current Global Initiative for Chronic Obstructive Lung Disease (GOLD). Physical activity has emerged as both functional outcome and non-pharmacological intervention in COPD patients, despite the lack of standardized measures or guidelines in clinical practice. This study aimed to explore in more depth the 24-h respiratory symptoms, the physical activity level (PAL) and the relationship between these two determinants in stable COPD patients.MethodsThis was a multinational, multicenter, observational, cross-sectional study conducted in ten European countries and Israel. Dedicated questionnaires for each part of the day (morning, daytime, night) were used to assess respiratory symptoms. PAL was evaluated with self- and interview-reported tools [EVS (exercise as vital sign) and YPAS (Yale Physical Activity Survey)], and physician’s judgement. Patients were stratified in ABCD groups by 2013 and 2017 GOLD editions using the questionnaires currently recommended: modified Medical Research Council dyspnea scale and COPD Assessment Test.ResultsThe study enrolled 2190 patients (mean age: 66.9 years; male: 70.0%; mean % predicted FEV1: 52.6; GOLD groups II-III: 84.5%; any COPD treatment: 98.9%). Most patients (> 90%) reported symptoms in any part of the 24-h day, irrespective of COPD severity. PAL evaluations showed discordant results between patients and physicians: 32.9% of patients considered themselves completely inactive, while physicians judged 11.9% patients as inactive. By YPAS, the overall study population spent an average of 21.0 h/week performing physical activity, and 68.4% of patients were identified as sedentary. In any GOLD ABCD group, the percentage of inactive patients was high. Our study found negative, weak correlations between respiratory symptoms and self-reported PAL (p < 0.001).ConclusionsDespite regular treatment, the majority of stable COPD patients with moderate to severe disease experienced daily variable symptoms. Physical activity level was low in this COPD cohort, and yet overestimated by physicians. With evidence indicating the negative consequences of inactivity, its adequate screening, a more active promotion and regular assessment of physical activity are urgently needed in COPD patients for better outcomes.Trial registrationNCT03031769, retrospectively registered, 23 Jan 2017.

Depressive symptoms, sleep patterns, and physical activity in adolescents with narcolepsy.

To evaluate the association between depressive symptoms, sleep patterns (duration and quality), excessive daytime sleepiness (EDS), and physical activity (PA) in adolescents with narcolepsy. This cross-sectional study included adolescents (ages 10-18 years) with narcolepsy attending a tertiary care facility (The Hospital for Sick Children, Toronto, Canada). Adolescents with narcolepsy completed questionnaires evaluating depressive symptoms (Children's Depression Inventory-2nd edition [CDI-2]), sleep quality (Pittsburgh Sleep Quality Index), EDS (Epworth Sleepiness Scale), and PA (Godin Leisure-Time Exercise Questionnaire). Wrist-based actigraphy was worn by adolescents for 1 week to measure total sleep time (over 24 hr) and sleep efficiency percentage. Thirty adolescents with narcolepsy (mean age = 13.8 ± 2.2 years, 76.7% male) participated. In this cohort of adolescents with narcolepsy, 23.3% had CDI-2 total scores in the elevated range. Greater CDI-2 total scores were associated with poor sleep quality (ρ = 0.571; p = 0.02), EDS (ρ = 0.360; p = 0.05), and lower self-reported PA levels (ρ = -0.512; p < 0.01). Adolescents with narcolepsy report experiencing depressive symptoms, which are associated with poor sleep quality, EDS, and low PA levels. Strategies to improve nocturnal sleep quality and symptoms of EDS as well as promoting increased PA levels in adolescents with narcolepsy may provide an opportunity to improve depressive symptoms in this population. Multidisciplinary care with mental health and sleep specialists for adolescents with narcolepsy is needed.

Hypermobility, developmental coordination disorder and physical activity in an Irish paediatric population.

The primary aim of the study was to explore the prevalence of generalized joint hypermobility (GJH) and generalized hypermobility spectrum disorder (gHSD) using the new classification system in a community paediatric physiotherapy service in Ireland. The second aim was to explore the relationship between GJH, gHSD and physical activity level, while considering the association of probable developmental coordination disorder (pDCD). A case-controlled cross-sectional study of children aged 6-12 years, recruited from the community paediatric physiotherapy department (n = 32) and a local school (n = 41), was carried out. A Beighton score of ≥6/9 distinguished GJH. The new framework for hypermobility spectrum disorder (HSD) was used. Self-reported physical activity level was measured using the Physical Activity Questionnaire-Older Children. A parent-reported validated questionnaire screened for pDCD. The prevalence of GJH was 21.9% of children attending physiotherapy. One child in the physiotherapy group was identified as having gHSD, with a prevalence of 3.1%. There was no significant difference in physical activity level between children with and without GJH attending physiotherapy (independent samples t-test, p = 0.28). Probable developmental coordination disorder (pDCD) was observed in 71.9% of children attending physiotherapy. There was no significant difference in the number of children with pDCD in those with and without GJH (Fisher's exact test, p = 0.370). This study was the first to explore the prevalence of GJH and gHSD in the paediatric physiotherapy population in Ireland. The presence of GJH did not affect self-reported physical activity level or motor coordination in children attending physiotherapy.

The role of exercise in improving patient‐reported outcomes in individuals on dialysis: A scoping review

Exercise improves objective measures of physical function in individuals on hemodialysis, but its effect on patient-reported outcomes (PROs) is largely unknown. We performed a scoping review to characterize the existing knowledge base on exercise and PROs in dialysis patients to make recommendations for future research. We searched Medline, Embase, Cochrane Database of Systematic Reviews; Cochrane Central Register of Controlled Trials, CINAHL, and SPORT Discus from inception to November 28, 2018 and then screened results for randomized controlled trials comparing aerobic/resistance exercise, or both, with no exercise in individuals on dialysis that reported results of any PRO. Of 1374 eligible studies, 25 studies met inclusion criteria. Study interventions included aerobic exercise (11 intradialytic and 3 home-based trials); intradialytic resistance exercise (seven studies) and combined aerobic and resistance exercise (six intradialytic and one facility-based trial). The PROs measured included health-related quality of life (n=19), depression (n=6), anxiety (n=3), symptom burden (n=4), sleep quality (n=2), restless legs syndrome (n=2), disability (n=2), and self-reported physical activity level (n=4). Only five studies included a PRO as a primary outcome. Studies primarily used broad/generic measures of health-related quality of life and the effect of exercise on symptoms remains relatively unexplored, particularly in peritoneal dialysis populations. Although limited, the role of exercise in improving restless legs was consistent and is a promising outcome for future study. A critical step to improving the quality of the research on this topic includes the use of validated and consistent PRO measures.

Blood pressure, sympathovagal tone, exercise capacity and metabolic status are linked in Turner syndrome.

We studied cardiac autonomic changes in relation to metabolic factors, body composition and 24-hour ambulatory blood pressure measurements in Turner syndrome patients without known hypertension. Cross sectional. Participants were 48 TS women and 24 healthy female controls aged over 18years. Short-term power spectral analysis was obtained in supine-standing-supine position. Bedside tests included three conventional cardiovascular reflex tests of heart rate response to standing up, heart rate response to deep breathing and blood pressure response to standing up. Mean heart rate during the last 2minutes of work was used to calculate the maximal aerobic power (VO2max ). We found a significantly higher mean reciprocal of the heart rate per second (RR) in TS. Testing for interaction between position and status (TS or control), there were highly significant differences between TS and controls in high-frequency (HF) power, the coefficient of component variation (square root of HF power/mean RR) and low-frequency (LF): HF ratio, with a dampened decline in vagal activity among TS during standing. Bedside test showed TS had a significantly higher diastolic BP in the supine position compared to controls, and the adaptive rise in BP, when changing to upright position was reduced. VO2max and self-reported level of physical activity were significantly correlated to systolic ambulatory blood pressure both 24-hour and night diastolic ambulatory blood pressure. Vagal tone and modulation of the sympathovagal balance during alteration in body position are impaired in TS. These changes can be risk factors for cardiovascular disease.

Perceived Health Mediates Effects of Physical Activity on Quality of Life in Patients With a Fontan Circulation

Patients with a Fontan circulation are at risk of a sedentary lifestyle. Given the direct relationship between physical activity and health, promotion of physical activity has the potential to improve outcomes, including quality of life (QOL). This study aimed to describe self-reported physical activity levels in adult Fontan patients and examine associations between physical activity, perceived health status and QOL. The sample consisted of 177 Fontan patients (Mage = 27.5 ± 7.6 years, 52% male) who reported their physical activity, perceived health status, and QOL as part of the cross-sectional Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study. Descriptive statistics and univariate analyses of variance with planned contrasts were computed to describe physical activity characteristics. Mediation analyses tested whether perceived health status variables mediated the association between physical activity and QOL. Forty-six percent of patients were sedentary while only 40% met international physical activity guidelines. Higher physical activity was associated with younger age, lower NYHA class, higher perceived general health, and greater QOL. Patients who commuted by walking and engaged in sports reported better perceived health and QOL. Mediation analyses revealed that perceived general health but not NYHA functional class mediated the association between physical activity and QOL (αβ = 0.22, 95% confidence interval = 0.04 to 0.49). In conclusion, Fontan patients likely benefit from regular physical activity, having both higher perceived general health and functional capacity; greater perceived health status may contribute to enhanced QOL. In conclusion, these data support the pivotal role of regular physical activity for Fontan patients.

The Energy Cost of Sitting versus Standing Naturally in Man.

Prolonged sitting is a major health concern, targeted via government policy and the proliferation of height-adjustable workstations and wearable technologies to encourage standing. Such interventions have the potential to influence energy balance and thus facilitate effective management of body/fat mass. It is therefore remarkable that the energy cost of sitting versus standing naturally remains unknown. Metabolic requirements were quantified via indirect calorimetry from expired gases in 46 healthy men and women (age, 27 ± 12 yr; mass, 79.3 ± 14.7 kg; body mass index, 24.7 ± 3.1 kg·m, waist/hip, 0.81 ± 0.06) under basal conditions (i.e., resting metabolic rate) and then, in a randomized and counterbalanced sequence, during lying, sitting and standing. Critically, no restrictions were placed on natural/spontaneous bodily movements (i.e., fidgeting) to reveal the fundamental contrast between sitting and standing in situ while maintaining a comfortable posture. The mean (95% confidence interval [CI]) increment in energy expenditure was 0.18 (95% CI, 0.06-0.31 kJ·min) from resting metabolic rate to lying was 0.15 (95% CI, 0.03-0.27 kJ·min) from lying to sitting and 0.65 (95% CI, 0.53-0.77 kJ·min) from sitting to standing. An ancillary observation was that the energy cost of each posture above basal metabolic requirements exhibited marked interindividual variance, which was inversely correlated with resting heart rate for all postures (r = -0.5; -0.7 to -0.1) and positively correlated with self-reported physical activity levels for lying (r = 0.4; 0.1 to 0.7) and standing (r = 0.6; 0.3-0.8). Interventions designed to reduce sitting typically encourage 30 to 120 min·d more standing in situ (rather than perambulation), so the 12% difference from sitting to standing reported here does not represent an effective strategy for the treatment of obesity (i.e., weight loss) but could potentially attenuate any continued escalation of the ongoing obesity epidemic at a population level.

Can research align with service? Lessons learned from the Big Experiment and National Biomechanics Day

Public engagement is an important role for the university academic, but is often neglected due to perceived lack of time and prioritized commitments in research and teaching. Yet, public engagement events offer an untapped opportunity for researchers to collect data from members of the general public who arrive on site at university labs. These engagement events could allow for data collection as part of didactic and demonstrative outreach events to be used in research and science. In this proof of concept study, a collaborative group of international researchers investigated the feasibility of embedding research quality assessment into events surrounding National Biomechanics Day. The Big Experiment collected data on 501 secondary school students (age range: 13 to 18 years) across 9 university sites within a 24-hour period. Data included maximal vertical jump height and self-reported physical activity levels. Vertical jump height was positively correlated to participant height, but not age or body mass. Very physically active students had significantly higher vertical jump heights than individuals who reported being somewhat or not physically active. This feasibility project demonstrates that with substantial preparation and a simple research design, focused research questions can be incorporated into educational outreach initiatives and ultimately provide a rich data source.

Association between self-reported physical activity and incident atrial fibrillation in a young Korean population

The association between physical activity (PA) and atrial fibrillation (AF) remains unclear. We thus investigated association of PA with the development of AF. Type and duration data for PA were acquired from 211,992 AF-free individuals using the validated Korean version of the International Physical Activity Questionnaire Short From between March 2002 and December 2014. Individuals were divided into four groups according to self-reported PA level and previous international PA guidelines: no PA with a sedentary lifestyle, insufficient PA, sufficient PA, and health-enhancing PA. AF was diagnosed by annual 12-lead electrocardiogram. During a median follow-up of 5.6 years, AF occurred in 304 participants (annual AF incidence rate 2.5/10,000 person-years). After adjusting for age and sex, PA level was not associated with AF incidence (P for trend = 0.26). The multivariable-adjusted hazard ratios (95% confidence interval) for incidental AF was 1.00 (0.74–1.37) for the insufficient PA group, 1.34 (0.91–1.97) for the sufficient PA group, and 1.27 (0.72–2.23) for the health-enhancing PA group compared with the no PA group (P for trend = 0.18). Thus, our study does not support an association between the risk of AF and PA level in a young Korean population.

Prevalence and Preferences of Self-Reported Physical Activity and Nonsedentary Behaviors in Portuguese Adults.

This study describes levels of self-reported physical activity, frequency of selected opportunistic nonsedentary behaviors, and preferences of leisure-time activities in a representative sample of Portuguese adults, using data from a national survey on diet and activity behaviors (National Food, Nutrition and Physical Activity Survey, IAN-AF, 2015-2016). Participants were 3873 Portuguese adults (1827 men). They were interviewed face to face, and the short version of the International Physical Activity Questionnaire was used. Regular leisure-time programmed activities, and 6 additional items, forming the activity choice index questionnaire, were used to assess 6 discrete nonsedentary behaviors. Using the International Physical Activity Questionnaire categories, 42.3% of the sample were classified as low active, 30.6% as moderately active, and 27.1% as highly active. Walking, health/fitness activities, running, group gymnastics classes, swimming/pool activities, football/futsal, and cycling were the most popular leisure-time activities. Between 15% (parking further away from destinations) and 48% (using the stairs instead of elevators) of participants reported that they frequently adopted commonly recommended nonsedentary activities. This study updates self-reported physical activity prevalence for Portugal adults, including older adults. In addition, it uniquely describes leisure-time activity preferences in the population and also the relative frequency of several nonsedentary activities of daily living.

A pilot randomised controlled trial of physical activity facilitation for older adults: feasibility study findings

BackgroundMore people are living longer lives leading to a growth in the population of older adults, many of whom have comorbidities and low levels of physical function. Physical activity in later life can prevent or delay age-related disability. Identifying a cost-effective means of increasing physical activity in older adults therefore remains an important public health priority.Physical Activity Facilitation (PAF) is an intervention shown to increase physical activity in adults with depression. The PAF model was modified for a population of older adults at risk of disability. This study aimed to assess the feasibility of undertaking a definitive RCT of the PAF intervention in the target population.MethodsA pilot randomised controlled trial (RCT) was delivered through primary care. Patients at risk of disability and who were not meeting recommended levels of physical activity were recruited through postal invitation and direct approach in the practice waiting room. Those meeting eligibility criteria were enrolled and randomised at a 2:1 ratio to the PAF intervention and control. Behaviour change techniques were used by facilitators with participants over the telephone and face-to-face for 6 months. Outcome measures including physical function, physical activity, depression, social support, and quality of life were collected at baseline and at 6 months.ResultsA high proportion of patients responded to the initial invitation (68%), yet many were ineligible due to high levels of self-reported physical activity and baseline physical function. Fifty-one participants were recruited to the trial, with an average age of 74 years (range 65–89), and there were high rates of adherence and retention to the study (94% follow-up at 6 months). The majority of outcome data collected from participants was complete; however, the validated scale used to measure self-reported physical activity was associated with high levels of missing data.ConclusionsThe findings of this pilot RCT suggest that it is feasible to deliver a definitive RCT of the PAF intervention in this population. Further work is required to improve the efficiency of recruitment and to minimise missing data from self-reported physical activity measures.Trial registrationCurrent controlled trials ISRCTN80470273. Registered 25 October 2013.

The association between physical activity and cardiac performance is dependent on age: the Copenhagen City Heart Study

This study aimed to test the hypothesis that regular physical activity is associated with improved cardiac function measured by tissue Doppler imaging (TDI) in the general population. Within a large prospective community-based population study, cardiac function was assessed in 2221 persons by TDI. Longitudinal displacement (LD), early diastolic velocity (e’), and myocardial performance index (MPI) was obtained by TDI. Linear univariable and multivariable regression analyses were performed in relation to age groups (< 50 years, 50–65 years, > 65 years) and self-reported level of physical activity: I (inactivity), II (light activity), III (moderate activity), and IV (high-level activity). Participants < 50 years in the most active group had significantly better cardiac performance when compared to all other activity levels (higher levels of e’, LD, and lower levels of MPI). The findings remained with statistical significance after adjustment for sex, ischemic heart disease, diabetes, hypertension, and body mass index (e’ = 11.0, 95% CI (10.4–11.6), p < 0.001; LD = 12.8 (12.3–13.4), p < 0.003; MPI: 0.40 (0.38–0.42), p = 0.02). In age > 65 years, there was a tendency of impaired cardiac function in higher levels of exercise. Interaction analysis revealed that age significantly modified the association between physical activity and cardiac function (p < 0.001). We found a positive association between higher level of physical activity and improved cardiac function in younger persons (< 50 years). In the general population, however, the association interacted with age and amongst persons above 65 years there was a negative association between higher level of physical activity and cardiac function.

Riesgo de apnea obstructiva del sueño y nivel de actividad física y su asociación con riesgo cardiovascular elevado en adultos chilenos

Introduction: Obstructive sleep apnea (OSA) is associated with high cardiovascular morbidity and mortality. Subjects and methods: 3,657 subjects between 30 and 74 years-old (x: 50.1 ± 12.1 SD) from 2010 Chilean National Health Survey were selected. Risk of OSA was estimated using a clinical prediction rule (CPR) based on the variables of the STOP-Bang Questionnaire. According to their score they were classified as LOW (< 3), MEDIUM (3-4) and HIGH (? 5) risk of OSA. Their physical activity level (PAL) was classified into 3 levels: Low, Moderate and High, according to the self-reported results with the GPAQ questionnaire. To study the association between the risk of OSA and PAL with High / Very High CVR (? 10%, Framingham) we constructed a logistic regression model adjusted for sex, age, BMI, type 2 diabetes, high blood pressure, high total cholesterol, low HDL cholesterol, high triglycerides, educational level, smoking and self-reported sleep hours. Results: 3,098 subjects were classified as OSA risk: LOW 1.683 (54.3%), MEDIUM 1.116 (36%) and HIGH 299 (9.7%). The PAL was evaluated in 3,570 subjects and classified as: Low 1,093 (30.6%), Moderate 705 (19.7%), and High 1,772 (49.6%). The CVR was determined in 3,613 subjects, and 711 (19.7%) classified as High/Very High risk. The regression model shows: MEDIUM risk an OR = 1.75 (1.05 - 2.90, p = 0.03), HIGH risk an OR = 3.86 (1.85-8.06, p < 0.001). For the PAL Low an OR = 1.14 (0.75-1.74, p = 0.525), PAL Moderate an OR = 1.18 (0.73-1.92, p = 0.501). Conclusion: The MEDIUM and HIGH risk of OSA, but not the self-reported PAL, constitute an independent risk factor for high cardiovascular risk.