SenseWear Mini Research Articles

Cross-sectional and longitudinal neural predictors of physical activity and sedentary behaviour from a 6-month randomized controlled trial

A sedentary lifestyle offers immediate gratification, but at the expense of long-term health. It is thus critical to understand how the brain evaluates immediate rewards and long-term health effects in the context of deciding whether to engage in moderate-to-vigorous physical activity (MVPA) or sedentary behaviour (SB). In this secondary analysis of a 6-month randomized controlled trial to increase MVPA and reduce SB among community-dwelling adults, we explored how neural activity during an executive control task was associated with MVPA and SB levels. At baseline, a subset of participants (n = 26/61) underwent task-based functional magnetic resonance imaging (fMRI) to examine neural activity underlying executive control using the Now/Later task. MVPA and SB were measured objectively using the Sensewear Mini at baseline, and 2, 4, and 6 months follow-up. We then examined the associations of baseline neural activation underlying executive control with: (1) baseline MVPA or SB; and (2) changes in MVPA and SB over 6 months. Our results determined that there is a complex neurocognitive system associated with MVPA levels, while SB appears to lack any neurocognitive control. In other words, MVPA appears to require neurocognitive effort, while SB may be the default behavioural pattern in adults.

The independent associations of physical activity and sleep with neural activity during an inhibitory task: cross-sectional results from the MONITOR-OA study.

Sleep and physical activity (PA) are important for the maintenance of executive functions. Whether these lifestyle factors independently contribute to associated neural correlates of executive functions is unknown. We therefore investigated the independent associations of PA and sleep with neural activity during executive performance using task-based functional magnetic resonance imaging (fMRI). Baseline data from a subset of participants (n=29) enrolled in a randomised trial were used for this cross-sectional analysis. We measured PA, sleep duration and efficiency for 7 days using the SenseWear Mini and examined neural activity underlying response inhibition using the Go/NoGo executive performance task. Brain activation patterns during the NoGo condition were contrasted to activation patterns during the Go condition (i.e., NoGo-Go). We constructed two separate models (controlling for age, sex, and education) to examine the independent associations of (i) PA and sleep duration; and (ii) PA and sleep efficiency with brain activation. Significant clusters were corrected for multiple comparisons (p < 0.05) to determine region-specific activation patterns. The mean (SD) participant age was 61(9)years, and 79% were female. PA was independently associated with greater task-related blood-oxygen-level dependent (BOLD) signal activity in the left cingulate gyrus; longer sleep duration was independently associated with greater BOLD signal activity in the left putamen. Higher sleep efficiency was independently associated with increased BOLD signal activity in the left hippocampus. PA, sleep duration, and efficiency are each independently associated with greater neural activity underlying response inhibition, which further illustrates that PA and sleep are each uniquely important for brain health.

Association with Temperature Variability and Physical Activity, Sedentary Behavior, and Sleep in a Free-Living Population.

The present study examines the temperature variability in physical activity (PA), sedentary behavior (SB), and sleep in a free-living population. A representative sample of 1235 adults (ages 21–70) from Iowa, U.S.A., wore a SenseWear Mini Armband (SWA) for a randomly assigned day. Koppen’s weather climate classification was used to precisely classify the temperature: cold (−13 to 32 °F), cool (32 to 50 °F), mild (50 to 64 °F), warm (64 to 73 °F), and hot (73 to 95 °F). The main effect of three-way ANOVA (age × gender × temperature) had differences for SB and sleep, with older adults having higher levels than younger adults (p < 0.05). However, moderate to vigorous PA (MVPA) did not vary systematically by age or gender, and contrary to expectations, the main effect of the weather was not significant for MVPA (p > 0.05). Participants spent more time participating in PA at cold than at hot temperatures. The results clarify the impact of temperature on shaping PA and SB patterns in adults. The variable impacts and differential patterns by age suggest that weather should be considered when interpreting differences in PA patterns in research or surveillance applications.

Objectively Measured Physical Activity Increases Only in Males During a Summer Camp for Obese Children.

Childhood obesity is a major public health challenge. Summer camps for children with obesity represent an alternative setting to improve eating and physical activity habits. Here we evaluated if the participation in the camp improves objectively measured physical activity and sedentary behavior and whether there are differences between male and female participants. Twenty-eight children, 13 males and 15 females (body mass index >97° centile, weight excess >30%, Tanner stage I), agreed to participate in an 8-day camp. During the summer camp, children participated in sports-like games and outdoor activities for at least 3 h a day, and the school-camp staff also provided a theoretical nutritional learning plan. Accelerometry-derived physical activity was measured through the SenseWear Mini Armband during a week at home and during the camp experience. Before camping, the participants were far above the minimum daily values of moderate- to vigorous-intensity physical activity (MVPA) to be considered sufficiently active (≥60 min/day), but male participants were more active than females (MVPA: 186.2 ± 94.2, 111.0 ± 64.7; P = 0.020). Male participants increased their MVPA (234.3 ± 114.8, P = 0.020), whereas females not (111.9 ± 52.9, P = 0.020). No difference emerged for the sedentary behavior either before or during the camp. This study suggests that participation in a summer camp for obese children can determine different responses in physical activity levels, depending on the sex of young participants. Thus, summer camps for obese children should put particular attention on female participants, besides reducing sedentary behavior in both males and females.

Physical activity and sleep are each independently associated with brain function during an inhibitory task: Cross‐sectional results from the monitor‐OA study

AbstractBackgroundThere is a growing body of evidence that sleep and physical activity (PA) are critical for the maintenance of brain functions that decline with age. However, few studies have examined how these lifestyle factors are independently associated with brain function. To this end, we investigated the associations of objectively‐measured PA and sleep with patterns of activation in the brain during an executive performance task using baseline data from a randomized controlled trial (RCT).MethodsAt baseline, we measured PA and sleep for 7 days using the SenseWear Mini in 61 participants. A subset of the RCT participants (n= 29) underwent a 3T MRI scan, during which we examined brain activation patterns using the Go/No‐Go executive performance task. We contrasted brain activation patterns during the GO and NOGO conditions (i.e., NOGO – Go) of accurate trials. We then performed three separate models (each controlling for age, sex, and education) wherein we examined the associations of brain activation during an inhibitory task with: 1) PA; 2) sleep duration; and 3) sleep efficiency (i.e., ratio of time spent sleeping to time spent trying to sleep). Significant clusters were corrected for multiple comparisons (p&lt; 0.05) to determine region‐specific activation patterns.ResultsTable 1 describes our participants at baseline. Participants had a mean age of 61 years (SD= 9 years), and 79% were female. We determined that greater PA was associated with greater blood‐oxygen‐level dependent (BOLD) signal activity in the insular cortex (Figure 1A). Longer sleep duration was associated with increased BOLD signal activity in the precuneus, lingual gyrus, and lateral occipital cortex (Figure 1B). However, we did not find that sleep efficiency was associated with greater BOLD signal activity in any brain region.ConclusionsPA and sleep duration are each associated with greater brain activation in regions which are 1) associated with executive performance; and 2) susceptible to age‐associated decline. However, sleep efficiency does not appear to be related to brain activity patterns associated with executive functions.

Not Just for Joints: The Associations of Moderate-to-Vigorous Physical Activity and Sedentary Behavior with Brain Cortical Thickness.

Cortical thinning is associated with aging; however, lifestyle factors can moderate this relationship. Two distinct lifestyle behaviors associated with brain health are regular moderate-to-vigorous physical activity (MVPA) and limited sedentary behavior (SB). However, it is unclear whether MVPA and SB levels contribute to cortical thickness independent of each other. We therefore investigated the independent relationships of MVPA and SB with cortical thickness using baseline data from a randomized controlled trial. At baseline, we measured MVPA and SB for 7 d using the SenseWear Mini. A subset of the randomized controlled trial participants (n = 30) underwent a 3T magnetic resonance imaging scan, wherein region-specific cortical surface morphometric analyses were performed using T1-weighted structural magnetic resonance imaging. We conducted regression analyses using a surface-based cluster size exclusion method for multiple comparisons within FreeSurfer neuroimaging software to determine if MVPA and SB are independently correlated with region-specific cortical thickness. This subset of participants had a mean age of 61 yr (SD = 9 yr), and 80% were female. Higher MVPA was associated with greater cortical thickness in the temporal pole (cluster size, 855 mm; cortical thickness range, 2.59-3.72 mm; P < 0.05) and superior frontal gyrus (cluster size, 1204 mm; cortical thickness range, 2.41-3.15 mm; P < 0.05) of the left hemisphere, independent of SB. Sedentary behavior was not associated with greater cortical thickness in any region, independent of MVPA. Our results indicate that adults with greater MVPA-independent of SB-are associated with greater cortical thickness in regions, which are susceptible to age-associated atrophy.

Effects of a 12-Week Multifaceted Wearable-Based Program for People With Knee Osteoarthritis: Randomized Controlled Trial.

BackgroundCurrent guidelines emphasize an active lifestyle in the management of knee osteoarthritis (OA), but up to 90% of patients with OA are inactive. In a previous study, we demonstrated that an 8-week physiotherapist (PT)-led counseling intervention, with the use of a Fitbit, improved step count and quality of life in patients with knee OA, compared with a control.ObjectiveThis study aimed to examine the effect of a 12-week, multifaceted wearable-based program on physical activity and patient outcomes in patients with knee OA.MethodsThis was a randomized controlled trial with a delay-control design. The immediate group (IG) received group education, a Fitbit, access to FitViz (a Fitbit-compatible app), and 4 biweekly phone calls from a PT over 8 weeks. Participants then continued using Fitbit and FitViz independently up to week 12. The delay group (DG) received a monthly electronic newsletter in weeks 1 to 12 and started the same intervention in week 14. Participants were assessed in weeks 13, 26, and 39. The primary outcome was time spent in daily moderate-to-vigorous physical activity (MVPA; in bouts ≥10 min) measured with a SenseWear Mini. Secondary outcomes included daily steps, time spent in purposeful activity and sedentary behavior, Knee Injury and OA Outcome Score, Patient Health Questionnaire-9, Partners in Health Scale, Theory of Planned Behavior Questionnaire, and Self-Reported Habit Index.ResultsWe enrolled 51 participants (IG: n=26 and DG: n=25). Compared with the IG, the DG accumulated significantly more MVPA time at baseline. The adjusted mean difference in MVPA was 13.1 min per day (95% CI 1.6 to 24.5). A significant effect was also found in the adjusted mean difference in perceived sitting habit at work (0.7; 95% CI 0.2 to 1.2) and during leisure activities (0.7; 95% CI 0.2 to 1.2). No significant effect was found in the remaining secondary outcomes.ConclusionsA 12-week multifaceted program with the use of a wearable device, an app, and PT counseling improved physical activity in people with knee OA.Trial RegistrationClinicalTrials.gov NCT02585323; https://clinicaltrials.gov/ct2/show/NCT02585323

Sedentary Time and Physical Activity in Older Women Undergoing Exercise Training.

This study aimed to examine the effects of a 16-wk aerobic exercise training on time spent being sedentary and on light-intensity PA (LPA) and moderate- to vigorous-intensity PA (MVPA) and step numbers in older women. Inactive women (n = 61; age = 65.5 ± 4.3 yr) participated in moderate-intensity walking of either a low or a moderate dose (33.6 and 58.8 kJ·kg body weight per week, respectively). They wore a SenseWear Mini Armband at baseline and at end intervention to determine sedentary, LPA, and MVPA time and step numbers. Time being sedentary, or spent on LPA and MVPA, did not change differently by exercise groups with different doses (all P values for group-time interaction >0.580). Overall, time being sedentary reduced from baseline to end intervention by approximately 39 min·d (P < 0.001), and LPA increased by 19 min·d (P = 0.003). MVPA time increased (P < 0.001), which was primarily accounted for by the supervised exercise. Interestingly, daily steps increased more in the moderate-dose than the low-dose group (P = 0.023 for group-time interaction; 33.6% and 19.8% median increase in moderate- and low-dose groups, respectively). Also, there were individual differences in these changes. Results indicated that, on average, older women did not reduce time of LPA or MVPA outside the exercise program or increase sedentary time as a result of participating in the exercise program.

The Length and Number of Sedentary Bouts Predict Fibrinogen Levels in Postmenopausal Women.

Menopause is associated with adverse changes in coagulation homeostasis. We aimed to investigate the association between objectively measured sedentary behavior (SB) and SB bouts (i.e., number and length of SB bouts) vs. fibrinogen levels in post-menopausal women. Fifty-three post-menopausal women (age 59.8 ± 6.2 years, BMI 27.3 ± 4.4) wore a multisensory device (Sensewear Mini Armband, BodyMedia, Inc., Pittsburgh, PA) for 5 days, to measure SB and physical activity (PA). Blood samples were collected to measure serum fibrinogen. Fibrinogen was directly correlated with SB (r = −0.48, p < 0.01), lying down during awake time (r = −0.50, p < 0.01), and both medium (11–30 mins) and very long bouts (>1 h) of SB (r = −0.59, p < 0.01; r = −0.51, p < 0.01, respectively), and inversely correlated with moderate to vigorous-intensity physical activity (r = −0.39, p < 0.01). Furthermore, fibrinogen was also directly correlated with BMI (r = −0.28, p < 0.05). In postmenopausal women without prevalent cardiovascular disease, the number of prolonged and uninterrupted sedentary bouts is directly correlated with increased fibrinogen levels, regardless of PA and BMI. This result suggests the importance of delivering new strategies to counteract the increase of sedentariness and inactivity of the postmenopausal population.

Effectiveness of an online self-management tool, OPERAS (an On-demand Program to EmpoweR Active Self-management), for people with rheumatoid arthritis: a research protocol

BackgroundActive self-management is a process where patients are fully engaged in managing their health in daily life by having access to contextualized health data and tailored guidance to support a healthy lifestyle. This study aims to determine whether an e-health intervention that incorporates symptom/disease activity monitoring and physical activity counselling can improve self-management ability in patients with rheumatoid arthritis (RA).MethodsThe ‘Empowering active self-management of arthritis: Raising the bar with OPERAS (an On-demand Program to EmpoweR Active Self-management)’ project is a randomized controlled trial that uses a delayed control design. One hundred thirty-four participants with RA will be randomly assigned to start the intervention either immediately (immediate group) or 6 months later (delayed group). The intervention involves (1) use of a Fitbit-compatible web app to record and monitor their RA disease activity, symptoms, and time spent on physical activity and a Fitbit; (2) group education and individual counselling by a physiotherapist (PT); and (3) six phone calls with a PT. The primary outcome measure is self-management ability measured by the Patient Activation Measure. Secondary outcome measures include disease status, fatigue, pain, depressive symptoms, and characteristics of habitual behavior and also time spent in physical activity and sedentary activity with a wearable multi-sensor device (SenseWear Mini). After the 6-month intervention, we will interview a sample of participants to examine their experiences with the intervention.DiscussionThe results of this study will help to determine whether this technology-enhanced self-management intervention improves self-management ability and health outcomes for people living with RA. A limitation of this study is that participants will need to self-report their symptoms, disease status, and treatment use through questionnaires on the OPERAS web app. The user-friendly interface, reminder emails from the research staff, and tailored guidance from PTs will encourage participants to actively engage with the app.Trial registrationDate of last update in ClinicalTrials.gov: January 2, 2019. ClinicalTrials.gov Identifier: NCT03404245.

POOR SLEEP QUALITY IS RELATED TO DECREASED WHITE MATTER INTEGRITY IN BRAIN NOCICEPTIVE PATHWAYS IN OLDER ADULTS

Poor sleep quality, decreased physical activity (PA) and increased sedentary behavior (SB) are common characteristics of older adults. Notably, these factors play an important role in brain health. We examined the relationship between sleep quality, PA, SB and brain white matter integrity (WM) in older adults with osteoarthritis (OA). We retained data on 16 participants (mean age 60, SD=7.7) from a larger Monitor-OA cohort recruited from Metro Vancouver, BC, Canada. Sleep efficiency and duration, amount of time spent on PA and SB daily over a period of one week was acquired with an objective measure – the multi-sensor monitor SenseWear Mini which integrates tri-axial accelerometer data, physiological sensor data and personal demographic information. Brain WM tractography was calculated from fractional anisotropy data obtained with diffusion weighted magnetic resonance imaging. Voxelwise group-level statistics examined the effects of our variables of interest on the integrity of brain WM tracts while controlling for participants age. We found that lower sleep efficiency was related to decreased integrity in WM tracts of frontal, temporal lobes, precuneus and thalamus (Bonferroni corrected p<0.05). Shorter sleep was related to lower WM integrity in frontal regions, posterior cingulate and insula radiations (Bonferroni corrected p<0.05). No significant effects were noted for PA or SB. The identified brain regions are involved in sleep processes but further overlap with the nociceptive brain network. Our findings suggest that neural mechanisms related to sleep disturbance may also involve pain-related processing in older adults.

Not Just for Joints: Physical Activity is Associated with Greater Cortical Thickness among Adults with Osteoarthritis

PURPOSE: Preliminary evidence suggests osteoarthritis (OA) is a risk factor for dementia. One potential reason is 87% of adults with OA are inactive, and low moderate-to-vigorous physical activity (MVPA) and high sedentary behaviour (SB) are each risk factors for brain atrophy. While regular MVPA and low SB are thus critical for brain health, it is unclear 1) what aspects of brain structure are associated with these behaviours among adults with OA; and 2) whether the relationships of MVPA and SB with brain structure are independent of each other. Hence, we investigated the independent relationships of MVPA and SB with brain structure in adults with knee OA. METHODS: This was a secondary cross-sectional analysis of a six month, proof-of-concept randomized controlled trial (RCT) to promote MVPA and reduce SB among adults with knee OA. At study entry, we objectively measured MVPA and SB for 7 days using the SenseWear Mini. Following this observation period, participants (N= 30) underwent a 3T magnetic resonance image (MRI) scan, wherein T1-weighted structural MRIs were performed to measure cortical thickness. We performed regression analyses using a surface-based cluster size exclusion method for multiple comparisons within the FreeSurfer neuroimaging software to determine if 1) MVPA was associated with greater cortical thickness independent of SB; and 2) SB was associated with less cortical thickness independent of MVPA. RESULTS: Participants had a mean age of 61 years (SD= 9 years), and 80% were female. Higher MVPA was associated with greater cortical thickness in the temporal pole (cluster size= 855 mm2; p< 0.05) and superior frontal area (cluster size= 1204 mm2; p< 0.05) of the left hemisphere independent of SB. SB was not associated with greater cortical thickness in any region independent of MVPA. CONCLUSIONS: Higher MVPA is associated with greater cortical thickness in adults with OA, however SB does not appear to be strongly associated with brain structure. Promoting MVPA among adults with OA may thus be an important strategy for maintaining cognitive health among this population.

The test-retest reliability and criterion validity of the Sensewear mini and Actiheart in two climatologically different countries

Different environments might influence energy expenditure (EE) from physical activity (PA) monitors. We evaluated and compared the test-retest reliability and criterion validity of the Sensewear mini (SWAmini) and Actiheart (AH) to estimate EE in two climatologically different countries, i.e. Suriname (tropical rainforest climate) and Belgium (oceanic climate). Fifty-six healthy participants (18–40 years) were recruited (Suriname: n = 30; Belgium n = 26). On three occasions they completed a standardized protocol including sitting, standing, low (LOW), moderate (MOD) and vigorous (VIG) intensity walking on a treadmill whilst wearing both PA monitors and a metabolic measurement system. The first session was a familiarization test, the second and third were used for reliability [intraclass correlation (ICC)] and validity analysis (mean absolute percentage error calculations, Bland-Altman, and scatterplots). Comparisons between countries were done by independent sample t-tests. We found i) fair to excellent SWAmini reliability [ICC between 0.41 (0.04–0.70) and 0.97 (0.92–0.99)]; ii) good to excellent AH reliability [ICC between 0.72 (0.45–0.87) and 0.96 (0.92–0.98)]; iii) underestimation of EE for all activities except for LOW by SWAmini; iv) in Belgium EE underestimation was greater by the SWAmini for sitting (Suriname: 5% ± 20% vs Belgium: 15% ± 12%) and by the AH for VIG (Suriname:18% ± 26% vs Belgium:37% ± 16%) v) overall poor agreement between AH and metabolic measurement system. The reliability of the PA monitors is between fair and excellent in both environments. There is a difference in validity between the two environments for sitting activities by the SWAmini and for VIG by the AH.

RELATIONSHIP BETWEEN BREAKS IN SEDENTARY BEHAVIOR AND FREE LIVING PHYSICAL ACTIVITY ENERGY EXPENDITURE IN INDIVIDUALS WITH CORONARY ARTERY DISEASE

There is a significant association between sedentary behavior and mortality risk factors. Interrupting sedentary time with physical activity (PA) breaks has been shown to be beneficial in improving these risk factors. Further, there is evidence that free living physical activity energy expenditure (PAEE)>770 kcal/day is associated with significantly lower mortality risk. The purpose of this study was to investigate the relationship between breaks in sedentary time and PAEE, and to determine the number and duration of breaks associated with PAEE>770kcal/day. 132 patients (63 ± 9 years, Male: 77.3%) with a primary diagnosis of coronary artery disease (CAD) participated in this study. Sedentary behavior and PA were assessed using multi-sensor accelerometer (SenseWear Mini Armband). Participants wore the accelerometer for average of five days (21.9 ± 1.7 hrs/day) and the minute by minute data on PAEE (>1.5METs) were averaged over the recording period. The number and duration of PA breaks/sedentary hr (i.e., Break #/sedentary hr, Break duration/sedentary hr) were calculated. Pearson correlation analyses were performed and multiple linear regression analyses were used to investigate the relationship between Break #/sedentary hr and Break duration/sedentary hr with PAEE, while adjusting for age and gender. Receiver Operating Characteristic (ROC) curves were used to determine the cut-off values for Break #/sedentary hr and Break duration/sedentary hr associated with PAEE>770kcal/day. Analyses were conducted using SPSS (version 24). There were strong correlations between PAEE with Break #/sedentary hr (r=0.74, p=0.000) and Break duration/sedentary hr (r=0.87, p=0.000). When adjusting for age and gender, linear regression analyses showed significant associations between PAEE with Break #/sedentary hr (Beta=0.653, unstandardised (B)=234, adjusted R square=0.662, p=0.000) and Break duration/sedentary hr (Beta=0.792, unstandardised (B)=20.89, adjusted R square=0.829, p=0.000). ROC analyses showed that the cut-off values of Break #/sedentary hr = 3 and Break duration/sedentary hr = 21min were associated with PAEE>770kcal/day (Break #/sedentary hr: Sensitivity=0.73, Specificity=0.79, AUC=0.84, p=0.000; Break duration/sedentary hr: Sensitivity=0.94, Specificity=0.79, AUC=0.94, p=0.000). There were strong correlations between breaks in sedentary time and PAEE. For every increase (n=1) in the number of Breaks/sedentary hr, PAEE increased by 234 kcal; and for every minute increase in Break duration/sedentary hr, PAEE increased by ∼21 kcal. Findings indicate that spending 21min in PA, accumulated through 3 breaks, for every hour of being sedentary, is associated with meeting PAEE>770kcal/day. Thus, in order to improve PAEE, CAD patients should be encouraged to interrupt sedentary behavior every 20min with a PA break of seven minutes.

Effects of aerobic training on physical activity in people with stroke: protocol for a randomized controlled trial

BackgroundPost-stroke physical inactivity is explained by several factors related to the stroke, which have been suggested as the causes and consequences of functional declines and health problems. Therefore, it is important to increase physical activity levels and reduce the time spent in low-energy expenditure activities after a stroke. Since the maintenance of cardiorespiratory fitness is a significant predictor of physical activity levels post-stroke, it may be important to investigate whether aerobic training is effective in increasing physical activity levels and reducing the time spent in low-energy expenditure activities in this population. The efficacy of aerobic training on these variables is not well known. The primary objective of this trial will be to investigate the effects of aerobic treadmill training on physical activity levels and on time spent in low-energy expenditure activities in people with stroke. The secondary aim will be to evaluate the effects of the training on cardiorespiratory fitness, endurance, depression, mobility, quality of life, and participation.Methods/designA randomized controlled trial, with blinded assessments, will be performed in a community-based setting. Altogether, 22 adults with a diagnosis of stroke (>6 months) who are sedentary or insufficiently active will be included. Participants will be randomly assigned to either: (1) aerobic treadmill training (experimental group, at 60–80% of their heart rate reserve) or (2) walking outside (control group, below 40% of heart rate reserve). Both groups will attend 40-min training sessions, three times per week over 12 weeks, in groups of two to four participants, with a trained physiotherapist. Primary outcomes are physical activity levels and time spent in low-energy expenditure activities (Multi-sensor SenseWear Mini® and Human Activity Profile). Secondary outcomes are cardiorespiratory fitness (peak oxygen uptake VO2peak and ventilatory threshold), endurance, depression, mobility, quality of life, and participation. The effects of the training will be analyzed from the collected data using intention to treat. Between-group differences will be measured by two-way repeated measures ANOVA, considering the baseline, post-training, and 4-week follow-up.DiscussionThe results of this trial will likely provide valuable new information on the effects of aerobic treadmill training on physical activity levels and on time spent in low-energy expenditure activities of individuals with stroke, through changes in cardiorespiratory fitness.Trial registrationClinicalTrials.gov, NCT02798237. Registered on 13 June 2016.

Energy Intake Derived from an Energy Balance Equation, Validated Activity Monitors, and Dual X-Ray Absorptiometry Can Provide Acceptable Caloric Intake Data among Young Adults

Assessments of energy intake (EI) are frequently affected by measurement error. Recently, a simple equation was developed and validated to estimate EI on the basis of the energy balance equation [EI = changed body energy stores + energy expenditure (EE)]. The purpose of this study was to compare multiple estimates of EI, including 2 calculated from the energy balance equation by using doubly labeled water (DLW) or activity monitors, in free-living adults. The body composition of participants (n = 195; mean age: 27.9 y; 46% women) was measured at the beginning and end of a 2-wk assessment period with the use of dual-energy X-ray absorptiometry. Resting metabolic rate (RMR) was calculated through indirect calorimetry. EE was assessed with the use of the DLW technique and an arm-based activity monitor [Sensewear Mini Armband (SWA); BodyMedia, Inc.]. Self-reported EI was calculated by using dietitian-administered 24-h dietary recalls. Two estimates of EI were calculated with the use of a validated equation: quantity of energy stores estimated from the changes in fat mass and fat-free mass occurring over the assessment period plus EE from either DLW or the SWA. To compare estimates of EI, reporting bias (estimated EI/EE from DLW × 100) and Goldberg ratios (estimated EI/RMR) were calculated. Mean ± SD EEs from DLW and SWA were 2731 ± 494 and 2729 ± 559 kcal/d, respectively. Self-reported EI was 2113 ± 638 kcal/d, EI derived from DLW was 2723 ± 469 kcal/d, and EI derived from the SWA was 2720 ± 730 kcal/d. Reporting biases for self-reported EI, DLW-derived EI, and SWA-derived EI are as follows: -21.5% ± 22.2%, -0.7% ± 18.5%, and 0.2% ± 20.8%, respectively. Goldberg cutoffs for self-reported EI, DLW EI, and SWA EI are as follows: 1.39 ± 0.39, 1.77 ± 0.38, and 1.77 ± 0.38 kcal/d, respectively. These results indicate that estimates of EI based on the energy balance equation can provide reasonable estimates of group mean EI in young adults. The findings suggest that, when EE derived from DLW is not feasible, an activity monitor that provides a valid estimate of EE can be substituted for EE from DLW.

Energy expenditure of type-specific sedentary behaviors estimated using sensewear mini armband

SenseWear Mini Armband, an accelerometer with multiple physiological sensors, could be a practical means to estimate energy expenditure (EE) of children and adolescents, but its validity reported for these age&amp;nbsp;groups has not been consistent within the literature. EE of twenty-six healthy Chinese 12-year-old adolescents was measured simultaneously using both SenseWear Mini Armband (SWMA) and metabolic chamber (MC) during a 16-hour stay in a MC. SWMA systematically underestimated the adolescents’ EE during sedentary behaviors, resting metabolic rate (RMR), basal metabolic rate (BMR), and total EE, with the absolute error rate ranging from 14.85% to 28.65%. The SWMA significantly underestimated EE compared with MC in Chinese adolescents. However, the amount of error can be reduced by applying correction equation proposed in this study.

Volume and Patterns of Physical Activity Across the Health and Heart Failure Continuum

BackgroundThe benefits of regular physical activity (PA) are well documented in patients with heart failure (HF), however the amount and intensity of objectively measured PA and sedentary behaviour in HF with preserved (HFPEF) or reduced ejection fraction (HFREF) is not well known. MethodsIn a cross-sectional observational study the energy expenditure of 151 participants (HFPEF: n = 53; HFREF: n = 16; at-risk for HF: n = 48; control participants: n = 34) using SenseWear Mini Armbands (Body Media, Inc, Pittsburgh, PA) were monitored. PA outcomes included time spent in different PA intensities (light and moderate-vigorous PA), sedentary time, steps per day, total daily energy expenditure, PA energy expenditure, and the patterns of PA in bouts of ≥ 10 minutes of moderate-vigorous PA. ResultsThe patients with HFPEF had the lowest volume of activity across the 4 groups. After adjusting for covariates, only steps per day remained significantly different across groups (P = 0.0005). A comparison of HFPEF vs HFREF indicated a higher amount of time in bouts of ≥ 10 minutes of moderate-vigorous PA for patients with HFREF (median, 2.4 [interquartile range, 0-13.5] vs 26 [3.7-46.8]; P = 0.0075). In the at-risk group, PA was lower than the recommended levels in the guidelines. ConclusionsOur findings suggest step count as the most robust outcome in evaluating daily PA in this population. Also, patients with HFPEF showed to be the least active group in the HF continuum. Monitoring volume and pattern of PA for those at risk of HF and patients with HFPEF could help to identify sedentary individuals and to develop tailored behavioural interventions for them.

Depressive Symptoms Are Positively Associated with Time Spent Sedentary in Healthy Young US Adults

Introduction: Sedentary time and depressive symptoms are positively associated in elderly adults and adults with chronic disease; however, little is known about this relationship in generally healthy young adults. The purpose of this study was to investigate the association between objectively measured sedentary time and depressive symptoms in a large sample of healthy young adults. Methods: Time spent sedentary and in moderate-to-vigorous physical activity (MVPA) was measured in 430 participants (49% men; 28 ± 4 years; 25.5 ± 3.3 kg/m2) using the SenseWear Mini Armband over a 10-day period. The Profile of Mood States depression scale was administered to assess depressive symptoms. Independent samples t tests investigated differences in MVPA, time spent sedentary, and Profile of Mood States scores between males and females. Linear regression analyses, adjusting for MVPA, sex, and body mass index, were employed to examine associations between sedentary time and depressive symptoms. Results: Mean time spent sedentary while awake was 681 ± 94 min/d. Holding MVPA constant, depressive symptoms were positively associated with sedentary time (β = 1.80; P < 0.01; R2 = 0.54). This association was statistically significant in males (β = 2.06; P < 0.01; R2 = 0.59) but not females (P = 0.10). Conclusions: Depressive symptoms are positively associated with time spent sedentary in healthy young US adults, independent of MVPA, particularly in men. A reduction in sedentary time may provide a valuable, low cost, option in the prevention of depressive symptoms.

Subjective and objective assessment of physical activity in multiple sclerosis and their relation to health-related quality of life

BackgroundPhysical activity (PA) is frequently restricted in people with multiple sclerosis (PwMS) and aiming to enhance PA is considered beneficial in this population. We here aimed to explore two standard methods (subjective plus objective) to assess PA reduction in PwMS and to describe the relation of PA to health-related quality of life (hrQoL).MethodsPA was objectively measured over a 7-day period in 26 PwMS (EDSS 1.5–6.0) and 30 matched healthy controls (HC) using SenseWear mini® armband (SWAmini) and reported as step count, mean total and activity related energy expenditure (EE) as well as time spent in PA of different intensities. Measures of EE were also derived from self-assessment with IPAQ (International Physical Activity Questionnaire) long version, which additionally yielded information on the context of PA and a classification into subjects’ PA levels. To explore the convergence between both types of assessment, IPAQ categories (low, moderate, high) were related to selected PA parameters from objective assessment using ANOVA. Group differences and associated effect sizes for all PA parameters as well as their relation to clinical and hrQoL measures were determined.ResultsBoth, SWAmini and IPAQ assessment, captured differences in PA between PwMS and HC. IPAQ categories fit well with common cut-offs for step count (p = 0.002) and mean METs (p = 0.004) to determine PA levels with objective devices. Correlations between specifically matched pairs of IPAQ and SWAmini parameters ranged between r .288 and r .507. Concerning hrQoL, the lower limb mobility subscore was related to four PA measures, while a relation with patients’ report of general contentment was only seen for one.ConclusionsBoth methods of assessment seem applicable in PwMS and able to describe reductions in daily PA at group level. Whether they can be used to track individual effects of interventions to enhance PA levels needs further exploration. The relation of PA measures with hrQoL seen with lower limb mobility suggests lower limb function not only as a major target for intervention to increase PA but also as a possible surrogate for PA changes.