Self-reported Physical Activity Levels Research Articles

Implementation of a Shared Decision-Making Tool for Osteoarthritis Treatment to Reduce Decisional Conflict

Shared decision making is a key component of patient centered care where clinical evidence and the patient’s preference and values are considered. Physical activity and weight loss are often recommendations in the treatment plan, especially in mild to moderate stage of osteoarthritis (OA). Movement is Life (MIL) created an innovative SDM tool to provide a framework for patient-centered discussions. The tool leverages an underlying Markov Model and represents the likely pain, activity levels, and lost productivity at three future time points. By comparing the patient’s likely progression depending on treatment choices compared to doing nothing, the patient has an illustration of future state. A pilot of N=108 women, ages 45-64, with chronic knee pain for at least three months and at least one co-morbidity (obesity, hypertension, diabetes) were randomized to a control (n=54) or intervention (n=54) arm of the study at eight centers across the United States. Results showed the demographic profiles were similar between the groups. At one-month, n=47 control and n=50 intervention patients returned for evaluation. Self-reported level of physical activity increased in the intervention group (56% vs 34%, p = 0.0229). Qualitative feedback from the intervention group indicated high satisfaction with use of the tool. Both groups reported a high likeliness to recommend the provider to a friend or family member. Inclusion of the SDM tool added an average of one minute to the patient counseling time over the control group. The quasi script provides a consistent communication pathway and may reduce disparities by addressing unconscious bias.

Association of Self-Reported and Device-Measured Sedentary Behaviour and Physical Activity with Health-Related Quality of Life among European Older Adults.

Human movement behaviours such as physical activity (PA) and sedentary behaviour (SB) during waking time have a significant impact on health-related quality of life (HRQoL) in older adults. In this study, we aimed to analyse the association between self-reported and device-measured SB and PA with HRQoL in a cohort of community-dwelling older adults from four European countries. A subsample of 1193 participants from the SITLESS trial (61% women and 75.1 ± 6.2 years old) were included in the analysis. The association between self-reported and objective measures of SB and PA with HRQoL were quantified using Spearman’s Rho coefficients. The strength of the associations between self-reported and device-measured PA and SB with self-rated HRQoL (mental composite score, MCS; physical composite score, PCS) were assessed through multivariate multiple regression analysis. Self-reported and device-measured PA and SB levels showed significant but poor associations with PCS (p < 0.05). The association with MCS was only significant but poor with self-reported light PA (LPA) and moderate-to-vigorous PA (MVPA). In conclusion, the findings of this study suggest that both self-reported and device-measured PA of all intensities were positively and significantly associated, while SB was negatively and significantly associated with the PCS of the SF-12.

The "Super-Fontan" Phenotype: Characterizing Factors Associated With High Physical Performance.

Background: People with a Fontan circulation usually have moderately impaired exercise performance, although a subset have high physical performance (“Super-Fontan”), which may represent a low-risk phenotype.Methods: People with a “Super-Fontan” phenotype were defined as achieving normal exercise performance [≥80% predicted peak oxygen uptake (VO2) and work rate] during cardiopulmonary exercise testing (CPET) and were identified from the Australian and New Zealand Fontan Registry. A Fontan control group that included people with impaired exercise performance (<80% predicted VO2 or work rate) was also identified based on a 1:3 allocation ratio. A subset of participants were prospectively recruited and completed a series of physical activity, exercise self-efficacy, and health-related quality of life questionnaires.Results: Sixty CPETs (“Super-Fontan”, n = 15; control, n = 45) were included. A subset (“Super-Fontan”, n = 10; control, n = 13) completed a series of questionnaires. Average age was 29 ± 8 years; 48% were males. Exercise capacity reflected by percent predicted VO2 was 67 ± 17% in the entire cohort. Compared to the “Super-Fontan” phenotype, age at Fontan completion was higher in controls (4.0 ± 2.9 vs. 7.2 ± 5.3 years, p = 0.002). Only one (7%) person in the “Super-Fontan” group had a dominant right ventricle compared to 15 (33%) controls (p = 0.043). None of those in the “Super-Fontan” group were obese, while almost a quarter (22%) of controls were obese based on body mass index (p = 0.046). Lung function abnormalities were less prevalent in the “Super-Fontan” group (20 vs. 70%, p = 0.006). Exercise self-efficacy was greater in the “Super-Fontan” group (34.2 ± 3.6 vs. 27.9 ± 7.2, p = 0.02). Self-reported sports participation and physical activity levels during childhood and early adulthood were higher in the “Super-Fontan” group (p < 0.05). The total average time spent participating in structured sports and physical activity was 4.3 ± 2.6 h/wk in the “Super-Fontan” group compared to 2.0 ± 3.0 h/wk in controls, p = 0.003. There were no differences in self-reported current total physical activity score or health-related quality of life between groups (p ≥ 0.05).Conclusions: The “Super-Fontan” phenotype is associated with a healthy weight, lower age at Fontan completion, better exercise self-efficacy, and higher overall levels of sport and physical activity participation during physical development.

Association of dog ownership with accelerometer-measured physical activity and daily steps in 70-year-old individuals: a population-based cross-sectional study

BackgroundDog ownership (DO) has been associated with higher levels of self-reported walking and physical activity. However, compared to device-based measures, self-reported measures of physical activity may suffer from bias due to recall and social desirability. They are also incapable of quantifying light-intensity physical activity (LPA) and step volume, both of which may have important health benefits, especially for older adults. In this study, we investigated the association of DO with accelerometer-measured physical activity of different intensities and daily steps in 70-year-old individuals.MethodsThis was a population-based cross-sectional study including 1406 participants aged 70 years [54.1% female] who participated in a health survey in Umeå, Sweden between February 2017–November 2019. All participants self-reported DO [yes/no]. Daily averages of LPA, moderate-to-vigorous-intensity physical activity (MVPA), and steps per day [steps/d] were measured for 1 week using hip-mounted Actigraph GT3X+ accelerometers. Associations were investigated using linear- and logistic regression models, adjusted for sociodemographic and health-related factors, date of examination, and accelerometer wear time.ResultsThe prevalence of DO was 14.1% [N = 199]. After adjustment for all covariates, DO was associated with 19.2 more minutes/d of LPA [95% CI, 8.8–29.6], 11.4 more minutes/d of MVPA [95% CI, 8.0–14.9] and 1738 more steps/d [95% CI, 1326–2149]. DO was also associated with twice the odds of meeting the physical activity recommendations [OR, 2.07, 95% CI, 1.48–2.90]. Exploratory interaction analyses showed that the association between DO and steps/d was stronger [Pinteraction = 0.030] in female [β = 2165, 95% CI, 1585–2744] than in male [β =1255, 95% CI, 664–1845], with a similar trend for MVPA [Pinteraction = 0.082].ConclusionsIn this study of community-dwelling 70-year-old individuals, DO was associated with higher levels of daily LPA, MVPA, and steps. With the limitation of the observational design of the study, these findings add knowledge regarding the beneficial role that DO may play for promoting physical activity in the older population. In turn, these findings could support the development and evaluation of targeted interventions seeking to promote dog-friendly environments and facilitate dog walking in the community.

Changes in patient activation following cardiac rehabilitation using the Active+me digital healthcare platform during the COVID-19 pandemic: a cohort evaluation

BackgroundRestrictions on face-to-face contact, due to COVID-19, led to a rapid adoption of technology to remotely deliver cardiac rehabilitation (CR). Some technologies, including Active+me, were used without knowing their benefits. We assessed changes in patient activation measure (PAM) in patients participating in routine CR, using Active+me. We also investigated changes in PAM among low, moderate, and high risk patients, changes in cardiovascular risk factors, and explored patient and healthcare professional experiences of using Active+me.MethodsPatients received standard CR education and an exercise prescription. Active+me was used to monitor patient health, progress towards goals, and provide additional lifestyle support. Patients accessed Active+me through a smart-device application which synchronised to telemetry enabled scales, blood pressure monitors, pulse oximeter, and activity trackers. Changes in PAM score following CR were calculated. Sub-group analysis was conducted on patients at high, moderate, and low risk of exercise induced cardiovascular events. Qualitative interviews explored the acceptability of Active+me.ResultsForty-six patients were recruited (Age: 60.4 ± 10.9 years; BMI: 27.9 ± 5.0 kg.m2; 78.3% male). PAM scores increased from 65.5 (range: 51.0 to 100.0) to 70.2 (range: 40.7 to 100.0; P = 0.039). PAM scores of high risk patients increased from 61.9 (range: 53.0 to 91.0) to 75.0 (range: 58.1 to 100.0; P = 0.044). The PAM scores of moderate and low risk patients did not change. Resting systolic blood pressure decreased from 125 mmHg (95% CI: 120 to 130 mmHg) to 119 mmHg (95% CI: 115 to 122 mmHg; P = 0.023) and waist circumference measurements decreased from 92.8 cm (95% CI: 82.6 to 102.9 cm) to 85.3 cm (95% CI 79.1 to 96.2 cm; P = 0.026). Self-reported physical activity levels increased from 1557.5 MET-minutes (range: 245.0 to 5355.0 MET-minutes) to 3363.2 MET-minutes (range: 105.0 to 12,360.0 MET-minutes; P < 0.001). Active+me was acceptable to patients and healthcare professionals.ConclusionParticipation in standard CR, with Active+me, is associated with increased patient skill, knowledge, and confidence to manage their condition. Active+me may be an appropriate platform to support CR delivery when patients cannot be seen face-to-face.Trial registrationAs this was not a clinical trial, the study was not registered in a trial registry.

Group-based physical activity interventions for postpartum women with children aged 0\u20135\xa0years old: a systematic review of randomized controlled trials

BackgroundIt is estimated that less than one third of women (28%) worldwide, are not sufficiently active, and there is evidence indicating physical activity (PA) participation is lower during pregnancy and the postpartum period. Despite the importance of educating and encouraging postpartum women to engage in PA, existing systematic reviews have only focused on examining the impact of individually tailored PA interventions and on specific postpartum populations such as women who are inactive (i.e., do not meet PA recommendations) or women at risk of gestational diabetes mellitus or postnatal depression. This review aims to fill this gap by examining the impact of group-based PA interventions on postpartum women’s PA levels or other health behavior outcomes.MethodsA systematic literature search was conducted using four electronic databases (MEDLINE, CINAHL, EMBASE and PsychInfo) of published studies between 1st January 2000 and 31st October 2020. Studies were included if they targeted postpartum women with no current health conditions, had children aged 0–5 years, and engaged postpartum women in a group-based PA program that reported PA or other health behavior outcomes. Out of a total of 1091 articles that were initially identified, six were included.ResultsGroup-based PA interventions were moderately successful in changing or increasing postpartum women’s self-reported PA levels and psychological wellbeing in the first 2 years of their offspring’s life. Overall, group-based PA interventions were not successful in changing or increasing postpartum women’s objectively measured PA levels, but only one study objectively measured postpartum women’s PA levels. Narrative synthesis highlights the heterogeneity of the outcomes and methodologies used, and the low to medium risk of bias in the included studies.ConclusionTo strengthen the evidence-base for group-based PA programs with postpartum women there is an on-going need for more rigorous randomised controlled trials of appropriate length (at least 3 months in duration) with an adequate dose of group-based PA sessions per week (to meet PA guidelines), and that utilise objective measures of PA. In addition, future PA interventions for this population should include, at the very least, fidelity and process data to capture the characteristics or design features that appeal most to postpartum women.

Quantitative Assessment of Physical Activity in Adults with Sickle Cell Disease

Cardiopulmonary disease is a leading cause of death for adults with sickle cell disease (SCD) and targeted therapies to modify cardiopulmonary disease currently do not exist. Physical fitness is an important predictor of cardiovascular morbidity and overall survival. More specifically, individuals who have lower fitness are at a higher risk for poor cardiovascular outcomes and premature death. Previous studies show that adults with SCD have lower physical fitness levels compared to the general population and deconditioning is one of the reasons cited for lower fitness in SCD. Fortunately, increasing physical activity can improve physical fitness and can result in better daily functioning, disease-related symptomatology, and cardiovascular outcomes in other chronic disease populations. Thus, evaluating the amount of physical activity in SCD provides an excellent opportunity to explore strategies to improve physical fitness which could have larger implications to cardiovascular health in SCD. The objective of this study is to determine physical activity levels in addition to identifying barriers, facilitators, and attitudes towards physical activity in an adult population with SCD.Methods: We obtained consent from 110 ambulatory adults with SCD (age=19-68 yrs; 69% female; 77% HbSS) during routine visits at an adult comprehensive sickle cell center. Participants completed validated quantitative assessments (International Physical Activity Questionnaire, CDC Barriers to Exercise Survey, and Determinants of Physical Activity) to determine weekly physical activity levels and to identify barriers, facilitators, and attitudes towards physical activity. High self-efficacy is a marker of resilience to sustaining physical activity, so we evaluated self-efficacy using a scale tailored to SCD, the Sickle Cell Self-Efficacy Scale. Information regarding genotype, gender, age, pain medication use, disease-modifying therapy, hospital admissions, and acute care visits were obtained from the electronic medical record. Physical activity levels were stratified into three groups: (1) sub-adequate( < 3 days of low to moderate-intensity exercise), (2) adequate(3 days of moderate-intensity activity or > 4 days of low-intensity activity), and (3) optimal ( ≥4 days of moderate-intensity activity). We compared proportions across the three groups using chi-square analysis. To compare scales across the three groups, we used the non-parametric Kruskal-Wallis test.Results: 94 completed entries and 16 partial entries were analyzed at the conclusion of the study. Only 21.8% (n=24) of the participants reported optimal levels of physical activity. There were more males in the optimal activity group (N=18/24, p=<0.0001) compared to the other groups, but there was not a significant difference between genotype and age among the three groups. Among the barriers evaluated, lacking energy was identified more often in the sub-adequate group compared to the other two (Table 1). Other important barriers to physical activity such as lack of time, social influence, and so forth were identified more often in the sub-adequate group than the optimal group but this was not statistically significant (Table 1). Facilitators to physical activity and self-efficacy scores did not differ tremendously between the three groups. Interestingly, participants in the optimal sub-category were more likely to use short-acting pain medications compared to the other groups (Table 1). However, there were no significant differences between use of long-acting pain medications, the use of disease-modifying therapy, and hospital admissions among the physical activity groups.Limitations: The quantitative surveys were validated in the general population which may not include the needs specific to SCD. Self-reported physical activity levels are subjective and consequently subjected to recall bias.Conclusion: This is the first report of physical activity levels in US adults with SCD. The majority of SCD participants reported sub-optimal levels of activity and currently do not meet the national guidelines of physical activity in the US. This study underscores the importance of implementing strategies such as regular exercise to increase physical activity in SCD. Gender-differences in physical activity, pain medication use, and fatigue as barriers and facilitators to physical activity will need to be studied further. [Display omitted] DisclosuresOgunsile: Global Blood Therapeutics: Consultancy, Other: Disease-Specific Presentations on SCD; Clearview Research Institute: Consultancy, Honoraria; Novartis: Consultancy, Other: Treatment-Specific Therapy on Crizanlizumab ; Forma: Consultancy, Other: Attended one Advisory Board Meeting . Lebensburger: Novartis: Consultancy; Bio Products Laboratory: Consultancy. Kanter: Fulcrum Therapeutics, Inc.: Consultancy; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Forma: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Agios: Honoraria, Membership on an entity's Board of Directors or advisory committees; Beam: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees; Graphite Bio: Consultancy; GuidePoint Global: Honoraria; Fulcrum Tx: Consultancy.

Opposing patterns in self-reported and measured physical activity levels in middle-aged adults

Physical activity brings significant health benefits to middle-aged adults, although the research to date has been focused on late adulthood. This study aims to examine how ageing affects the self-reported and accelerometer-derived measures of physical activity levels in middle-aged adults. We employed the data recorded in the UK Biobank and analysed the physical activity levels of 2,998 participants (1381 men and 1617 women), based on self-completion questionnaire and accelerometry measurement of physical activity. We also assessed the musculoskeletal health of the participants using the dual-energy X-ray absorptiometry (DXA) measurements provided by the UK Biobank. Participants were categorised into three groups according to their age: group I younger middle-aged (40 to 49 years), group II older middle-aged (50 to 59 years), and group III oldest middle-aged (60 to 69 years). Self-reported physical activity level increased with age and was the highest in group III, followed by group II and I (P < 0.05). On the contrary, physical activity measured by accelerometry decreased significantly with age from group I to III (P < 0.05), and the same pertained to the measurements of musculoskeletal health (P < 0.05). It was also shown that middle-aged adults mostly engaged in low and moderate intensity activities. The opposing trends of the self-reported and measured physical activity levels may suggest that middle-aged adults over-report their activity level as they age. They should be aware of the difference between their perceived and actual physical activity levels, and objective measures would be useful to prevent the decline in musculoskeletal health.

Concordance between Different Criteria for Self-Reported Physical Activity Levels and Risk Factors in People with High Blood Pressure in a Rural District in Bangladesh.

Self-reported assessment of physical activity (PA) is commonly used in public health research. The present study investigated the concordance of self-reported PA assessed using the global physical activity questionnaire (GPAQ) and two different measurement approaches. Participants (n = 307, aged 30–75 years with hypertension) were recruited from a rural area in Bangladesh. We analyzed the difference between the World Health Organization (WHO) recommendations of more than 600 metabolic-equivalent time-minutes (MET-min) and the self-reported active hours, at least 2.5 h per week. Tests of sensitivity and specificity were conducted to determine concordance between the two measures. According to the WHO criteria, 255 (83%) participants were active more than 600 MET-min per week and 172 (56%) people were physically active 2.5 h or more per week, indicating a 27% difference in self-reported PA. The sensitivity, specificity, positive and negative predictive values and concordance between the two measures were 64%, 92%, 98%, 34% and 70%, respectively. Considering the WHO MET-min as the appropriate measure, 89 (35%) were false negative (FN). Older age, professionals and businesspersons were associated with a higher proportion of FN. There is a gap between self-reported PA, thus a better estimate of PA may result from combining two criteria to measure PA levels.

Physical Activity Interventions for Racial and Ethnic Minority Children: A Systematic Review

ABSTRACT Pediatric obesity is a growing epidemic, and children of ethnic or racial minority background are at greatest risk. The purpose of this review is to identify disparities in PA levels among racial and ethnic minority children and identify successful interventions. We searched MEDLINE (PubMed) for the following mesh terms: population groups, obesity, child, infant, adolescent, exercise, or sports. Studies were included if written in English and reported on racial and ethnic families, physical activity (PA) parameters, and children &lt;18 yr. Studies were excluded for lack of comparison with national recommendations or another racial group. Three main categories of studies (N = 24) were found: (a) assessment of PA levels by race/ethnicity, (b) analysis of PA interventions, and (c) parental influences on child PA. A variety of methods were used to measure the amount of PA. Studies using measured objective data for PA levels generally found no difference among races and ethnicities, whereas studies using self-reported PA levels suggested differences among them. The common strategies used in most successful interventions were tailoring activities to the specific target population, including family members, and making the activities enjoyable. Studies also indicated that parental behaviors were strongly associated with the behaviors of their children. The studies included in this systematic review suggest that children of racial and ethnic minority backgrounds may perform less PA than other populations and national recommendations. However, there are several different types of interventions and strategies that can increase PA in these children.

Low Physical Activity Levels Are Linked to Early Hypertension Risk in College-Going Young Adults.

Background: Sedentary behaviour and physical inactivity along with body mass are identified as critical determinants of vascular health along with body mass in young adults. However, the relationship between potential physical health and anthropometric variables with high blood Eid pressure remain unexplored in young adults from the United Arab Emirates region. Methodology: We administered a cross-sectional study in young adults assessing their self-reported physical activity levels, anthropometric variables (body mass index and waist circumference) and ambulatory blood pressure. The associations among potential physical health, anthropometric variables and high blood pressure were analysed through logistic regression after necessary transformation. Results: Of 354 participants (176 males, 178 females), we found 17.79% (n = 63) had higher mean arterial pressure. Males (n = 40; 22.73%) had higher risk of hypertension than females (n = 12.92%). Weekly physical activity levels (β = −0.001; p = 0.002), age (β = −0.168; p = 0.005) and gender (β = −0.709; p = 0.028) were found to be more strongly associated with hypertension risk than the body mass index (β = 0.093; p = 0.075), waist circumference (β = 0.013; p = 0.588) and the weekly sitting time (β = 0.000; p = 0.319) of the individuals. Conclusions: Lower physical activity was associated with hypertension risk compared to other modifiable risk factors such as waist circumference, body mass index and sedentary time in college-going young adults. Public health measures should continue to emphasise optimisation of weekly physical activity levels to mitigate vascular health risks at educational institution levels.

The Association of Physical Function Measures With Frailty, Falls History, and Metabolic Syndrome in a Population With Complex Obesity.

Background: Frailty, falls and metabolic syndrome are known to be associated with poorer physical function. This study builds on available research by further investigating the relationship between physical function measures, including those comprising frailty, with metabolic syndrome (MetS) and falls, in the context of complex obesity.Methods: Participants were recruited from the national Level 3 weight management service in Ireland. A retrospective audit of data gathered at initial assessment was performed. Data included past medical history, blood tests, blood pressure measurement, anthropometrics, falls history, self-reported physical activity levels (PALs) and physical function measures, including hand grip strength (HGS), “timed up and go” (TUG), functional reach (FR), sit to stand (STS) and gait speed. A modified version of the Fried Frailty Index was employed.Results: Of the 713 participants, 65.1% (n = 464) were female and 34.9% (n = 249) were male with a mean age of 44.2 (±11.7) years and body mass index (BMI) of 50.6 kg/m2 (±8.2). Frailty was identified in 3.4% (n = 24), falls in 28.8% (n = 205) and MetS in 55.1% (n = 393). Frailty was associated with older age (53.8 ± 14.3 vs. 43.9 ± 11.5 years), poorer PALs (27.29 ± 46.3 vs. 101.1 ± 147.4 min/wk), reduced grip strength (17.7 ± 4.6 vs. 34.2 ± 11.0 Kg) longer STS (21.7 ± 6.6 vs. 13.7 ± 5.7 s), shorter functional reach (29.7 ± 7.9 vs. 37.9 ± 8.2 cm) and slower gait speed (0.6 ± 0.2 vs. 1.1 ± 0.5 m/s). Those reporting a falls history had a reduced FR (35.8 ± 8.9 vs. 38.3 ± 7.8 cm) and slower STS (15.4 ± 8.0 vs. 13.3 ± 4.7 s). Participants with MetS had lower PALs (83.2 ± 128.2 vs. 119.2 ± 157.6) and gait speed (1.1 ± 0.3 vs. 1.2 ± 0.7 m/s). There was no difference in BMI between fallers and non-fallers (51.34 ± 8.44 vs. 50.33 ± 8.13 Kg/m2, p = 0.138), nor between those with or without MetS. Significant associations were found between BMI and all physical function measures except the TUAG.Conclusion: The associations between frailty, falls and MetS and their combined impact on physical function in people living with obesity demonstrates the need for appropriate screening. Utilising grip strength and gait speed to identify frailty in those with obesity and metabolic syndrome could help target therapies aimed at improving strength, physical function and ultimately quality of life.

Factors associated with lack of improvement in submaximal exercise capacity of patients with heart failure.

AimsImprovement in exercise capacity is the primary goal of physical activity programmes for patients with heart failure (HF). Although activity programmes are effective for some patients, others do not benefit. Identifying factors related to a lack of improvement in submaximal exercise capacity may help us interpret findings and design new interventions. The aim of this study is to identify factors contributing to a lack of improvement in submaximal exercise capacity 3 months after physical activity advice or an exergame intervention in patients with HF. Additionally, we aimed to assess differences in lack of improvement in submaximal exercise capacity of patients whose baseline exercise capacity predicted a worse compared with better prognosis of HF.Methods and resultsThis secondary analysis of the HF‐Wii study analysed baseline and 3 month data of the 6 min walk test (6MWT) from 480 patients (mean age 67 years, 72% male). Data were analysed separately in patients with a pre‐defined 6 min walking distance at baseline of <300 m (n = 79) and ≥300 m (n = 401). Among patients with a baseline 6MWT of ≥300 m, 18% had deteriorated submaximal exercise capacity. In the multiple logistic regression analysis, lower baseline levels of self‐reported physical activity [odds ratio (OR) = 0.77, 95% confidence interval (CI) = 0.60–0.97], lower baseline levels of cognitive function (OR = 0.87, 95%CI = 0.79–0.96) were significantly associated with lack of improvement in exercise capacity at 3 months. Not randomized to exergaming (OR = 0.63, 95%CI = 0.37–1.09) was likely (P = 0.097) to be associated with lack of improvement in exercise capacity at 3 months. Among the 79 patients with baseline 6MWT of <300 m, 41% (n = 32) did not improve 6MWT distance at 3 months. Independent predictors for the lack of improvement for 6MWT were New York Heart Association class III/IV (OR = 4.68, 95%CI = 1.08–20.35), higher levels of serum creatinine (OR = 1.02, 95%CI = 1.003–1.03), lower cognitive function (OR = 0.86, 95%CI = 0.75–0.99), and fewer anxiety symptoms (OR = 0.84, 95%CI = 0.72–0.98).ConclusionsLower self‐reported physical activity and cognitive impairment predict lack of improvement in submaximal exercise capacity in HF patients. Patients who have a worse prognosis (score <300 m at the 6MWT) are often frail and gain less in exercise capacity. These patients may need a more comprehensive approach to have an effect on exercise capacity, including an individually tailored exercise programme with aerobic exercise (if tolerated) and strength exercises.

Efficacy of the Motivational Interviewing-Walk Intervention for Chemotherapy-Induced Peripheral Neuropathy and Quality of Life During Oxaliplatin Treatment: A Pilot Randomized Controlled Trial.

Oxaliplatin-induced peripheral neuropathy (OIPN) is prevalent among gastrointestinal cancer survivors and often impairs quality of life (QOL). This pilot randomized controlled trial aimed to explore the effect of an 8-week home-based brisk walking (the "MI-Walk") intervention on (1) OIPN severity and (2) QOL at 8 weeks, compared with physical activity (PA) education alone in oxaliplatin-receiving adults with gastrointestinal cancer. Participants (N = 57) recruited from 5 infusion sites received PA education at their second oxaliplatin visit, followed by phone assessments of adverse events over 8 weeks. Half (n = 29) received additional MI-Walk intervention motivational supports (eg, a Fitbit Charge 2 and motivational enhancement therapy sessions). Self-reported OIPN, QOL, and PA were measured before and after intervention. The intervention compared with the control condition had no effect on sensory OIPN (mean difference [] = -0.01; P > .99), motor OIPN (=2.39; P = .17), and QOL (= -1.43; P > .99). Eight-week sensory (=11.48 ± 0.38) and motor OIPN severities ( = 7.48 ± 0.36) were mild but higher than baseline (P ≤ .01). Self-reported PA level increased over time in both groups (=44.85; P = .01). Averaging ≥225 moderate to vigorous PA minutes per week led to less sensory OIPN, particularly finger/hand tingling (= -26.35; P = .01). This study failed to detect beneficial effects of the MI-Walk intervention; however, the findings suggest that aerobic walking may blunt but not completely prevent OIPN. Further research is necessary. Although the effectiveness of brisk walking in reducing OIPN is unclear, this study supports prior evidence that moderate to vigorous PA is beneficial and safe during chemotherapy treatment.

Is the Polar M430 a Valid Tool for Estimating Maximal Oxygen Consumption in Adult Females?

Background: Previous research studies have found that heart rate monitors that predict maximal oxygen consumption () are valid for males but overestimate in females. Inaccurate self-reported physical activity (PA) levels may affect the validity of the prediction algorithm used to predict . Purpose: To investigate the validity of the Polar M430 in predicting among females with varying PA levels. Methods: Polar M430 was used to predict () for 43 healthy female study participants (26.9 ± 1.3 years), under three conditions: the participant’s self-selected PA category (sPA), one PA category below the sPA (sPA − 1), and one category above the sPA (sPA + 1). Indirect calorimetry was utilized to measure () via a modified Astrand treadmill protocol. Repeated-measures analyses of covariance using age and percentage of body fat as covariates were used to detect differences between groups. Bland–Altman plots were used to assess the precision of the measurement. Results: was significantly correlated with (r = .695, p &lt; .001). The mean values for and were 44.58 ± 9.29 and 43.98 ± 8.76, respectively. No significant differences were found between , , sPA – 1, and sPA + 1 (p = .492). However, the Bland–Altman plots indicated a low level of precision with the estimate. Conclusions: The Polar M430 was a valid method to predict across different sPA levels in females. Moreover, an under/overestimation in sPA had little effect on the predicted .

Physical activity levels, lifestyle behaviour and musculoskeletal health profiles among seated video gamers during COVID-19

ObjectivesThe aim of this research study was to determine the physical activity levels of non-active video gamers, and to determine how much other time was spent with sedentary behaviours, both...

Association of COVID-19 Mitigation Measures With Changes in Cardiorespiratory Fitness and Body Mass Index Among Children Aged 7 to 10 Years in Austria

Previous studies have shown reductions in self-reported physical activity levels in children associated with implementation of COVID-19 mitigation measures, and data on objectively assessed health parameters are limited. To examine the association of COVID-19 mitigation measures with changes in cardiorespiratory fitness (CRF) measures and body mass index (BMI) among primary schoolchildren. This cohort study included children aged 7 to 10 years from 12 randomly selected primary schools in urban and rural districts of Klagenfurt, Austria. Baseline CRF and BMI measurements were obtained in September 2019 before COVID-19 mitigation measures were implemented, and follow-up measurements were obtained in June and September 2020. COVID-19 mitigation measures. Cardiorespiratory fitness was measured with a 6-minute endurance run test. Height and weight were objectively measured. Standard deviation scores were calculated for CRF and BMI. Changes over time were analyzed using analyses of variance. Secondary analyses were performed for subgroups stratified by sex. A total of 764 children (383 girls [50.1%]) aged 7 to 10 years had all measurements completed. From September 2019 to September 2020, CRF SD scores changed by -1.06 (95% CI, -1.13 to -1.00), with a similar decrease in both boys and girls. Body mass index SD scores had increased by 0.12 (95% CI, 0.06-0.16) in June 2020 and by 0.16 (95% CI, 0.12-0.20) in September 2020 compared with September 2019. The increase in BMI SD scores (from September 2019 to September 2020) was greater among boys (0.23; 95% CI, 0.18-0.29) than among girls (0.09; 95% CI, 0.04-0.15). During the 1-year period, the percentage of children with overweight or obesity increased from 20.3% (155 children) to 24.1% (184 children) (difference, 3.8% [29 children]). In this cohort study of children in Austria, COVID-19 mitigation measures were associated with decreases in CRF measures and increases in BMI. The findings suggest that collaborative efforts are needed to reverse these changes in children's health to prevent long-term negative health outcomes.

Long-term air pollution exposure and diabetes incidence in two prospective cohorts of U.S. women

BACKGROUND AND AIM: Global prevalence of type 2 diabetes (T2DM) is increasing. Research has identified links between air pollution exposure and T2DM through metabolic and inflammatory pathways, but more large cohort studies are needed to help disentangle which pollutants are responsible and which individuals are most susceptible. Our aim was to prospectively evaluate the association between long-term exposure to fine particulate matter (PM₂.₅) and T2DM incidence in the US-based Nurses’ Health Study (NHS) and Nurses’ Health Study II (NHSII) cohorts. METHODS: Monthly PM₂.₅ exposures were predicted from spatiotemporal models and linked to participants’ residential addresses from 1989-2007. Biennial participant questionnaires provided rich individual level covariate data. Self-reported clinician diagnosis of T2DM was confirmed via a validated supplementary questionnaire. We used Cox proportional hazards models to assess the relationship between time-varying two-year average PM₂.₅ exposure and incident T2DM in each cohort. We adjusted for time-varying covariates including lifestyle factors, menopausal status and hormone use, and markers of individual and neighborhood socioeconomic status (nSES). Results were meta-analyzed and heterogeneity was assessed. We also examined interactions by self-reported physical activity level and nSES. RESULTS:Over follow-up, there were 10,108 incident T2DM cases during 1,182,400 and 1,574,821 person-years of follow-up among the 96,291 and 112,941 women in NHS and NHSII, respectively. In fully adjusted models, the meta-analysis HR for an interquartile range (4.8 µg/m³) increase in two-year PM₂.₅ exposure was 1.04 (95% CI: 1.01, 1.08) for incident T2DM. Results were similar in models for cumulative exposure. We found suggestive evidence of effect modification by physical activity level, but not by nSES. The association between PM₂.₅ and T2DM was stronger in more physically active women. CONCLUSIONS:Our results support the growing evidence of a positive association between air pollution and T2DM. KEYWORDS: air pollution, particulate matter, long-term exposure, incidence, obesity and metabolic disorders

Improving Physical Activity Levels in Prevocational Students by Student Participation: Protocol for a Cluster Randomized Controlled Trial.

BackgroundA consistent finding in the literature is the decline in physical activity during adolescence, resulting in activity levels below the recommended guidelines. Therefore, promotion of physical activity is recommended specifically for prevocational students.ObjectiveThis protocol paper describes the background and design of a physical activity promotion intervention study in which prevocational students are invited to participate in the design and implementation of an intervention mix. The intervention is expected to prevent a decline in physical activity in the target group.MethodsThe effectiveness of the intervention was evaluated in a two-group cluster randomized controlled trial with assessments at baseline and 2-year follow-up. A simple randomization was applied, allocating 11 schools to the intervention group and 11 schools to the control group, which followed the regular school curriculum. The research population consisted of 3003 prevocational students, aged 13-15 years. The primary outcome measures were self-reported physical activity levels (screen time, active commuting, and physical activity). As a secondary outcome, direct assessment of physical fitness (leg strength, arm strength, hip flexibility, hand speed, abdominal muscle strength, BMI, and body composition) was included. An intervention-control group comparison was presented for the baseline results. The 2-year interventions began by mapping the assets of the prevocational adolescents of each intervention school using motivational interviewing in the structured interview matrix and the photovoice method. In addition, during focus group sessions, students, school employees, and researchers cocreated and implemented an intervention plan that optimally met the students’ assets and opportunities in the school context. The degree of student participation was evaluated through interviews and questionnaires.ResultsData collection of the SALVO (stimulating an active lifestyle in prevocational students) study began in October 2015 and was completed in December 2017. Data analyses will be completed in 2021. Baseline comparisons between the intervention and control groups were not significant for age (P=.12), screen time behavior (P=.53), nonschool active commuting (P=.26), total time spent on sports activities (P=.32), total physical activities (P=.11), hip flexibility (P=.22), maximum handgrip (P=.47), BMI (P=.44), and sum of skinfolds (P=.29). Significant differences between the intervention and control groups were found in ethnicity, gender, active commuting to school (P=.03), standing broad jump (P=.02), bent arm hang (P=.01), 10× 5-m sprint (P=.01), plate tapping (P=.01), sit-ups (P=.01), and 20-m shuttle run (P=.01).ConclusionsThe SALVO study assesses the effects of a participatory intervention on physical activity and fitness levels in prevocational students. The results of this study may lead to a new understanding of the effectiveness of school-based physical activity interventions when students are invited to participate and cocreate an intervention. This process would provide structured health promotion for future public health.Trial RegistrationISRCTN Registry ISRCTN35992636; http://www.isrctn.com/ISRCTN35992636International Registered Report Identifier (IRRID)DERR1-10.2196/28273

Correlation of symptoms and physical activity level in chronic obstructive pulmonary disease patients: results from the observational SPACE study

ABSTRACT Objectives Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and high symptom burden that interferes with physical activity and results in a vicious cycle of inactivity and symptom worsening. The aim of this multicenter, observational study was to determine the prevalence and severity of morning, daytime and night-time symptoms as well as patterns of physical activity levels (PALs) and their interrelation in Belgian COPD patients, enrolled in the multinational SPACE study (NCT03031769). Methods Socio-demographic, socio-economic and disease characteristics data were collected from patients’ medical records as part of a routine visit to their primary care practice or pulmonologist. Dedicated questionnaires were used to evaluate respiratory symptoms for each part of the day. PAL was assessed by means of self- and interview-reported tools, and physician’s judgment. Patients were also classified according to GOLD recommendations 2013 and 2017. Results Overall, 102 Belgian patients participated in the study (mean age 67 years, 60.8% males). Over 85% of patients experienced respiratory symptoms throughout the day and about one-third were considered as ‘active’ (PAL ≥150 minutes/week). Physician-assessed PALs were higher than self-reported PALs, categorizing fewer patients as ‘inactive’ (17.6% versus 42.2%, respectively). PALs and symptoms were weakly interrelated. Inactive patients were present in all GOLD classification groups. Conclusion Stable Belgian COPD patients enrolled in the SPACE study presented 24-hour respiratory symptoms and insufficient PALs. Physicians tended to overestimate patients’ physical activity. Inactive patients were present across all GOLD classification groups. New approaches are deemed necessary to objectively identify and activate sedentary patients.