Waist-worn Accelerometer Research Articles

Calculation and Comparison of Step Guidelines for Preschooler Physical Activity While Indoors.

Preschooler physical activity (PA) is vital for growth and development. The World Health Organization PA guidelines state preschoolers should achieve ≥ 180 min/day of Total PA (TPA) of which ≥ 60 min is moderate-to-vigorous PA (MVPA). A step/day recommendation to match these guidelines may be a more practical metric for caregivers to promote PA. The purpose of our investigation is to improve upon existing step recommendations by creating one for indoor-based activities, acknowledging where preschoolers spend most of their time, and various cut-points for PA. In a laboratory study (Aim 1), a validated direct observation protocol was used to quantify preschooler PA intensity while performing indoor activities (n = 35). Actigraph GT3x accelerometers were placed on the waist, wrist, and ankle to measure step count. In a field study (Aim 2), habitual PA of 881 preschoolers (7113 valid days) via waist-worn accelerometers was used to assess the agreement between created guidelines (Aim 1) and other step recommendations with PA guidelines using Receiver Operating Characteristic and Area Under the Curve (ROC-AUC). In the laboratory study, calculated indoor step ranges were 6960-7440 (waist), 7200-8640 (wrist), and 7680-9120 (ankle) to align with existing PA guidance. In the field, the higher step guidelines (> 12 000) achieved very limited agreement, due to few preschoolers achieving this metric. The 6000 step/day guidelines had the highest agreement (AUCs: TPA: 0.637; MVPA: 0.751; TPA + MVPA: 0.761) with PA guideline. When preschoolers are indoors, 6000 steps may be the minimum for adequate PA.

Comparison of Physical Activity and Sedentary Behaviour Patterns by Sex, Geographical Location, and Time of the Week in Mexican Adolescents

Background: Excess sedentary behaviour (SB) and insufficient physical activity have been identified as risk factors for cardiometabolic diseases in adolescents, and some factors may affect how much time they spend on these activities. This study sought to compare the SB and PA patterns as well as compliance with PA recommendations by sex, geographical location, and time of the week in Mexican adolescents. Methods: In a cross-sectional design, we objectively assessed SB and PA in 106 adolescents (15 to 18 y) through waist-worn accelerometers for one week. The time spent in SB and in PA at different intensities was compared by sex, geographical location and time of the week with two-way and three-way repeated measures MANOVAs, while the compliance with physical activity recommendations (i.e., ≥60 min/day) was compared using chi-squared and McNemar tests. Results: Male participants spent more time in moderate, vigorous, and moderate to vigorous PA than females both during the whole week and on weekdays (all p < 0.05). There was no significant difference in SB nor PA by geographical location (i.e., metropolitan vs. non-metropolitan areas). Moreover, all participants spent more time on moderate, vigorous, and moderate to vigorous PA on weekdays than on weekends (p < 0.05). Compliance with international PA recommendations also showed a sex difference (males > females) and change between weekdays and weekends with no difference by geographical location. Conclusions: While geographical location does not seem to be a relevant factor, sex and time of the week appear to influence the SB and PA patterns in Mexican adolescents.

Effect of Dapagliflozin on Accelerometer-Based Measures of Physical Activity in Patients With Heart Failure: An Analysis of the DETERMINE Trials.

Wearable accelerometers can quantify the frequency and intensity of physical activity during everyday life and may provide complementary data to established functional outcome measures on the effect of heart failure therapies on functional limitations. In a voluntary substudy of the DETERMINE trials (Dapagliflozin Effect on Exercise Capacity Using a 6-Minute Walk Test in Patients With Heart Failure), patients wore a waist-worn triaxial accelerometer for as long as possible (ideally for 24 h/d for 7 days) at 3 points during the trial, between the screening visit and randomization (baseline data), and during weeks 8 and 14 to 16. Accelerometer outcomes included the change from baseline to week 16 in the total number of steps, time spent in light-to-vigorous physical activity, time spent in moderate-to-vigorous physical activity, movement intensity during walking, number of vector magnitude units' and total activity counts. Adequate baseline and week 16 accelerometer data were available for 211 of 817 (26%) randomized patients (defined as ≥10 hours of wear time for ≥3 days). Dapagliflozin had a favorable effect on the mean change from baseline at 16 weeks in the number of steps (between-group difference, 778 [95% CI, 240-1315]), time spent in moderate-to-vigorous physical activity (0.16 [95% CI, 0.03-0.29] hours), and in the mean vector magnitude units (25 [95% CI, 0.1-49] counts per minute). There were no between-group differences in the other accelerometer outcomes of interest. In this exploratory analysis of the DETERMINE trials, dapagliflozin had a beneficial effect on selected accelerometer-based measures of physical activity in patients with heart failure across the entire left ventricular ejection fraction spectrum, yet did not improve 6-minute walk distance, as previously reported. These data suggest that accelerometer-based measurements of everyday activity may provide complementary information to 6-minute walk distance and identify beneficial effects of treatment not detected by 6-minute walk distance. URL: https://www.clinicaltrials.gov; Unique identifiers: NCT03877237 and NCT03877224.

The Concussion, Exercise, and Brain Networks (ConExNet) study: a cohort study aimed at understanding the effects of sub-maximal aerobic exercise on resting state functional brain activity in pediatric concussion

BackgroundRecent scientific evidence has challenged the traditional “rest-is-best” approach for concussion management. It is now thought that “exercise-is-medicine” for concussion, owing to dozens of studies which demonstrate that sub-maximal, graded aerobic exercise can reduce symptom burden and time to symptom resolution. However, the primary neuropathology of concussion is altered functional brain activity. To date, no studies have examined the effects of sub-maximal aerobic exercise on resting state functional brain activity in pediatric concussion. In addition, although exercise is now more widely prescribed following concussion, its cardiopulmonary response is not yet well understood in this population. Our study has two main goals. The first is to understand whether there are exercise-induced resting state functional brain activity differences in children with concussion vs. healthy controls. The second is to profile the physiological response to exercise and understand whether it differs between groups.MethodsWe will perform a single-center, controlled, prospective cohort study of pediatric concussion at a large, urban children’s hospital and academic center. Children with sport-related concussion (aged 12–17 years) will be recruited within 4-weeks of injury by our clinical study team members. Key inclusion criteria include: medical clearance to exercise, no prior concussion or neurological history, and no implants that would preclude MRI. Age- and sex-matched healthy controls will be required to meet the same inclusion criteria and will be recruited through the community. The study will be performed over two visits separated by 24–48 h. Visit 1 involves exercise testing (following the current clinical standard for concussion) and breath-by-breath gas collection using a metabolic cart. Visit 2 involves two functional MRI (fMRI) scans interspersed by 10-minutes of treadmill walking at an intensity calibrated to Visit 1 findings. To address sub-objectives, all participants will be asked to self-report symptoms daily and wear a waist-worn tri-axial accelerometer for 28-days after Visit 2.DiscussionOur study will advance the growing exercise-concussion field by helping us understand whether exercise impacts outcomes beyond symptoms in pediatric concussion. We will also be able to profile the cardiopulmonary response to exercise, which may allow for further understanding (and eventual optimization) of exercise in concussion management.Trial registrationNot applicable.

Physical activity cut-points for older adults using the Zio XT onboard accelerometer

IntroductionThe Zio® XT continuous ambulatory electrocardiographic monitor (Zio) contains an accelerometer that can help quantify an individual’s physical activity in the free-living environment.Purpose(1) To estimate activity cut-points to estimate daily time spent performing very light, light, or moderate to vigorous physical activity (VLIPA, LIPA, MVPA) for the Zio accelerometer. (2) To describe how Zio’s 24-h wear protocol affects estimates of daily MVPA relative to a waist-worn accelerometer’s waking-wear protocol.MethodsThree hundred eighty one participants from the Atherosclerosis Risk in Communities (ARIC) study wore a waist-mounted ActiGraph GT3X (except while sleeping or water-based activities) and a Zio (24-h) simultaneously for three to seven days. For each person-minute, physical activity was summarized as the Mean Amplitude Deviation (MAD) for the Zio and Vector Magnitude Counts (VMC) for the GT3X. Cut points previously used in ARIC were mapped from GT3X VMC to Zio MAD using a conditional two-sample quantile–quantile approach.ResultsEvenson VMC cut-points for the GT3X (VLIPA≥76, LIPA≥903, MVPA≥2075 counts/min) were mapped to MAD for Zio (9.04, 28.2, and 58.1 mili-g). Daily hours spent in each intensity category were each strongly correlated (ICC > 0.7) between summaries produced by Zio and GT3X when restricting estimates to overlapping wear time. Zio and GT3X-estimated MVPA had high agreement (ICC = 0.77) when using device-specific wear time, but Zio measured one hour more of daily LIPA and VLIPA (95% CI = 0.83, 1.07 hrs/day).ConclusionsWe recommend the use of our cut-points for clinical research with Zio accelerometry in populations of older adults.

Examining and Comparing the Energy Expenditure of Two Modes of a Virtual Reality Fitness Game (Supernatural): Indirect Calorimetry Study.

The effectiveness of virtual reality (VR) fitness games as a form of moderate to vigorous physical activity has yet to be thoroughly quantified through gold standard energy expenditure measures. The purpose of this study was to examine the energy expenditure of 2 medium-intensity modes ("Flow and "Boxing") of a VR fitness game, Supernatural, using indirect calorimetry. Indirect calorimetry was used to examine relative and objective maximal oxygen consumption (VO2 max), metabolic equivalents of task (METs), and calories burned during medium-intensity bouts of both Flow and Boxing gameplay modes in young (mean age 25.42, SD 3.25 years), active individuals (n=12 female and n=11 male). METs and calories were also compared using a triaxial waist-worn accelerometer, an Apple smartwatch, and a VR headset. Mood states were assessed pre- and postbout using the shortened Profile of Mood States Questionnaire. Paired 2-tailed t tests were used to examine differences in game modes, between sexes, and pre-post exercise sessions. Objective and relative VO2 max averaged 1.93 (SD 0.44) L/min and 27.61 (SD 5.60) mL/kg/min, respectively, between modes. Flow (mean 8.2, SD 1.54 METs) and Boxing (mean 7.6, SD 1.66 METs) are both classified as high energy expenditure, vigorous activities. Calorie expenditure data of the accelerometer and VR headset differed significantly from the metabolic cart. Mood changes pre- to post exercise were consistent with expected values for moderate- to vigorous-intensity physical activity, with participants reporting that they felt more "active," "full of pep," "vigorous," and "lively" (P<.05) following bouts. Male individuals reported higher objective oxygen consumption (VO2) for both Flow and Boxing modes; no other sex-specific differences were observed. Both Flow and Boxing gameplay modes of Supernatural classify as vigorous physical activity and demonstrate the potential to promote mental and physical health benefits. Supernatural may be an effective exercise modality in a VO2 training program.

Temporal relationships in the movement behaviour of adolescents: Testing and methodological considerations of the ActivityStat hypothesis

ABSTRACT The study aimed to investigate the ActivityStat hypothesis by examining the presence and the timeframe of the temporal relationships among physical activity (PA) levels and stationary time (ST) in adolescents. A secondary analysis was performed on data involving 356 adolescents in Dunedin, New Zealand. Participants wore a waist-worn accelerometer for several consecutive days to assess PA levels [i.e. light PA (LPA), and moderate-to-vigorous PA (MVPA)] and ST. Bayesian continuous-time structural equation modelling (CT-SEM) was used to examine the relationship between the behaviours over time and the timeframe during which these relationships occur. Increases in LPA, MVPA, and ST were positively associated with their later behaviours until 2.5, 1.7, and 2 days later, respectively. A cross-behavioural reciprocal and negative relationship between LPA and ST was demonstrated 0.4 days later. A positive relationship between ST and MVPA was observed until about 0.4 days later. This is the first study to investigate the ActivityStat hypothesis using Bayesian CT-SEM in adolescents, examining the multivariate relationships among different behaviours and the associated timeframes. To conclude, evidence of activity synergy was suggested for the within-behavioural relationships, while behavioural compensation was noted for ST. Thus, the findings provide some support for the ActivityStat hypothesis in adolescents.

Older versus Younger Females Matched for Body Composition Have Lower Sympathetic Transduction at Rest

BACKGROUND: Older female (OF) adults have the highest risk for hypertension and cardiovascular disease among any demographic in America. Therefore, there is a need to better understand the contributors to impaired blood pressure (BP) regulation in female aging. Bursts of spontaneously occurring muscle sympathetic nerve activity (MSNA) contribute to BP regulation on a beat-to-beat basis (i.e., sympathetic transduction). Previous work suggests that OF have attenuated resting sympathetic transduction but there is a need for additional work considering covariates that affect sympathetic transduction (e.g., body mass index (BMI) &amp; sodium intake). We tested the hypothesis that aging attenuates sympathetic transduction in OF (&gt;55 years) compared with young female (YF; 18-35 years) participants matched for body composition and pre-trial sodium intake. METHODS: We studied seven post-menopausal OF (65±6 years) and nine YF (24±4 years; tested in early follicular phase) participants with seated brachial BP &lt;140/90 mmHg after three days of specified sodium intake (target 2300mg/day). We measured mean BP (photoplethysmography) and MSNA (microneurography) during a 10-min rest period in the supine position. We also assessed BMI, body fat % (BF%; bioelectrical impedance), and habitual moderate-to-vigorous physical activity (MVPA) during ≥7 consecutive days using waist-worn accelerometers (ActiGraph). We compared the average change in BP for 10 cardiac cycles after an MSNA burst (i.e., signal-averaged sympathetic transduction) using mixed-effects models (group*time[repeated measure]). We compared other variables using unpaired, two-tailed t-tests for normally distributed data and Mann-Whitney U tests for non-normally distributed data (i.e., failed Shapiro-Wilk test). We compared sodium intake, BMI, BF% and MVPA using equivalence testing. Significance was set to α&lt;0.05. RESULTS: Sodium intake, BMI, BF% and MVPA were equivalent between groups (p&gt;0.06). The following data are presented as OF vs. YF with mean ± SD or median[IQR]. Mean BP (97[22] vs. 77[5] mmHg, p=0.008) and MSNA burst frequency (35±6 vs. 13±4 bursts/min, p&lt;0.0001) were higher in OF. OF had lower mean BP changes following MSNA bursts (time: p&lt;0.0001, group: p=0.013, interaction: p=0.026) with pairwise differences among cardiac cycles 4-10 (post hoc p-values: p≤0.012). Moreover, peak increases in mean BP following MSNA bursts were lower in OF (Δ1.9±0.4 vs. 4.9±2.2 mmHg, p=0.003). CONCLUSION: We found that OF have attenuated sympathetic transduction to BP when compared to YF matched for body composition and sodium intake. This extends past work suggesting that female aging is associated with attenuated sympathetic transduction to BP. National Institutes of Health K01HL160772 (JCW), American Heart Association 23CDA1037938 (JCW), &amp; Florida State University Graduate School Legacy Fellowship, 2023 (CD). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Effects of intensity, frequency, and time window of exercise on sleep quality among community-dwelling adults aged 65–86 years

BackgroundAlthough the effects of exercise training (ET) on sleep problem have been reported, the effects according to the components of exercise, including intensity, frequency, and time window, are unknown. Thus, in this study, we aimed to assess the effects of ET on sleep quality in community-dwelling older adults with sleep problems. MethodsWe evaluated individuals aged ≥65 years whose Pittsburgh sleep quality index was >5 points at baseline. The participants were allocated to either the control group or the ET group and underwent interval walking training (IWT) for 5 months. Information regarding intensity, frequency, and time window of ET were obtained using a waist-worn accelerometer. ResultsOverall, 63 participants (24 men [mean ± standard deviation age: 75.1 ± 4.6 years] and 39 women [74.7 ± 5.2 years]) and 65 participants (24 men [75.2 ± 4.0 years] and 41 women [73.6 ± 4.2 years]) were included in the ET and control groups, respectively. The change in Pittsburgh sleep quality index was not significantly different between the two groups for both sexes. In the ET group, women who exercised 3–8 h before bedtime, men who did ET > 8 h before bedtime and more than 1 h after waking up, and men who did ET ≥ 5.05 days/week experienced significant improvements compared to the baseline. ConclusionsIWT does not significantly improve sleep quality. To obtain improvements in sleep quality, it might be necessary to consider the time window of performing ET for both sexes and ET frequency for men.

Examining the relationship between meeting 24-hour movement behaviour guidelines and mental health in Chinese preschool children.

Limited research has explored the relationship between adhering to 24-h Movement Behaviour guidelines and mental health in Chinese preschool children. The objectives of this study encompassed two primary goals: (1) to investigate the adherence of preschool children in China to the 24-h Movement Behaviour guidelines; and (2) to analyze the relationship between fulfilling various combinations of these guidelines and mental health, identifying the most advantageous combination. Utilizing a convenience sampling approach, this study included 205 preschool children (117 boys and 88 girls, average age 4.8 ± 0.51 years) from five kindergartens in Hengyang, Hunan Province. The physical activity (PA) and sedentary behaviour of preschool children were objectively assessed using waist-worn accelerometers, while sleep duration and screen time were reported by the children's parents. To evaluate mental health, the parent version of the internationally validated Strength and Difficulties Questionnaire (SDQ) was employed, which measures externalizing problems, internalizing problems, and prosocial behaviour. Employing Mplus 8.0 for Structural Equation Modeling analysis, while controlling for demographic variables, the study explored the connection between preschool children's mental health and their adherence to the 24-h Movement Behaviour guidelines. Worryingly, merely 14.6% of preschoolers met the recommended guidelines for all three aspects (PA, sleep duration, and screen time). Positive correlations were identified between meeting PA guidelines and displaying prosocial behaviour (β = 0.184; p < 0.05), while screen time adherence exhibited a negative correlation with externalizing problems (β = -0.207; p < 0.05). Similarly, there was a negative association between sleep duration adherence and externalizing problems (β = -0.191; p < 0.05). Meeting all three recommended guidelines was notably linked to enhanced prosocial behaviour (β = 0.464; p < 0.05), while following the screen time and sleep duration guidelines was negatively associated with externalizing problems (β = -0.246; p < 0.05). This study underscores the limited adherence of Chinese preschoolers to the comprehensive 24-h Movement Behaviour guidelines. Noteworthy findings include the positive influence of PA on prosocial behaviour, alongside the significant roles that sleep duration and screen time play in mitigating externalizing problems within this age group. Alignment with the 24-h Movement Behaviour guidelines is associated with more favorable mental health indicators in preschoolers.

Gait Event Detection and Travel Distance Using Waist-Worn Accelerometers across a Range of Speeds: Automated Approach.

Estimation of temporospatial clinical features of gait (CFs), such as step count and length, step duration, step frequency, gait speed, and distance traveled, is an important component of community-based mobility evaluation using wearable accelerometers. However, accurate unsupervised computerized measurement of CFs of individuals with Duchenne muscular dystrophy (DMD) who have progressive loss of ambulatory mobility is difficult due to differences in patterns and magnitudes of acceleration across their range of attainable gait velocities. This paper proposes a novel calibration method. It aims to detect steps, estimate stride lengths, and determine travel distance. The approach involves a combination of clinical observation, machine-learning-based step detection, and regression-based stride length prediction. The method demonstrates high accuracy in children with DMD and typically developing controls (TDs) regardless of the participant's level of ability. Fifteen children with DMD and fifteen TDs underwent supervised clinical testing across a range of gait speeds using 10 m or 25 m run/walk (10 MRW, 25 MRW), 100 m run/walk (100 MRW), 6-min walk (6 MWT), and free-walk (FW) evaluations while wearing a mobile-phone-based accelerometer at the waist near the body's center of mass. Following calibration by a trained clinical evaluator, CFs were extracted from the accelerometer data using a multi-step machine-learning-based process and the results were compared to ground-truth observation data. Model predictions vs. observed values for step counts, distance traveled, and step length showed a strong correlation (Pearson's r = -0.9929 to 0.9986, p < 0.0001). The estimates demonstrated a mean (SD) percentage error of 1.49% (7.04%) for step counts, 1.18% (9.91%) for distance traveled, and 0.37% (7.52%) for step length compared to ground-truth observations for the combined 6 MWT, 100 MRW, and FW tasks. Our study findings indicate that a single waist-worn accelerometer calibrated to an individual's stride characteristics using our methods accurately measures CFs and estimates travel distances across a common range of gait speeds in both DMD and TD peers.

Gait Characterization in Duchenne Muscular Dystrophy (DMD) Using a Single-Sensor Accelerometer: Classical Machine Learning and Deep Learning Approaches.

Differences in gait patterns of children with Duchenne muscular dystrophy (DMD) and typically developing (TD) peers are visible to the eye, but quantifications of those differences outside of the gait laboratory have been elusive. In this work, we measured vertical, mediolateral, and anteroposterior acceleration using a waist-worn iPhone accelerometer during ambulation across a typical range of velocities. Fifteen TD and fifteen DMD children from 3 to 16 years of age underwent eight walking/running activities, including five 25 m walk/run speed-calibration tests at a slow walk to running speeds (SC-L1 to SC-L5), a 6-min walk test (6MWT), a 100 m fast walk/jog/run (100MRW), and a free walk (FW). For clinical anchoring purposes, participants completed a Northstar Ambulatory Assessment (NSAA). We extracted temporospatial gait clinical features (CFs) and applied multiple machine learning (ML) approaches to differentiate between DMD and TD children using extracted temporospatial gait CFs and raw data. Extracted temporospatial gait CFs showed reduced step length and a greater mediolateral component of total power (TP) consistent with shorter strides and Trendelenberg-like gait commonly observed in DMD. ML approaches using temporospatial gait CFs and raw data varied in effectiveness at differentiating between DMD and TD controls at different speeds, with an accuracy of up to 100%. We demonstrate that by using ML with accelerometer data from a consumer-grade smartphone, we can capture DMD-associated gait characteristics in toddlers to teens.

Increased Duration and Intensity of Physical Activity Are Associated With Increased Pain in Individuals With Femoroacetabular Impingement Syndrome: An Ecological Momentary Assessment Study

ObjectiveTo investigate the relation between accelerometer-measured physical activity and real-time pain in individuals with femoroacetabular impingement syndrome (FAIS). We tested the hypothesis that increased duration of high intensity activity would contribute to momentary increases in pain. DesignObservational study. SettingParticipants’ natural, day-to-day environment. ParticipantsPopulation-based sample of 33 individuals with unilateral FAIS. Important eligibility criteria included no concomitant hip disorders or previous hip surgery. Key sociodemographic features include that all participants were required to have a smartphone. InterventionsNot applicable. Main Outcome MeasuresDuration and intensity of physical activity as measured by a waist-worn accelerometer, and instantaneous pain reported in real-time smartphone-based ecological momentary assessment surveys. Physical activity variables included each person's average sedentary time, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) in the 90 minutes proceeding all pain surveys as well as fluctuation in sedentary, LPA, and MVPA above or below average prior to each individual survey. ResultsLinear mixed models revealed that the significant predictors of pain included fluctuation in sedentary time (B=-0.031, P<.001), average LPA (B=0.26, P=.035), and the interaction between fluctuation in LPA and fluctuation in MVPA (B=0.001, P<.001). Fluctuation in sedentary time above a person's average was associated with lower pain, while average LPA and fluctuations above average in both LPA and MVPA were associated with higher pain. ConclusionsThese results suggest that individuals with FAIS can engage in health-enhancing MVPA but should focus on avoiding concurrent increase above average in both high intensity and LPA in the same 90-minute period. Future work is warranted testing the efficacy of such an approach on pain. Additionally, given that high levels of LPA may arise from a host of socioeconomic factors, additional research is needed to disentangle the effect of LPA on pain in FAIS.

RACIAL DIFFERENCES IN THE ASSOCIATIONS BETWEEN SENSORY FUNCTIONS AND PHYSICAL ACTIVITY INTENSITY

Abstract Sensory functions decline in older age. Multisensory training has been shown to improve balance. We analyzed the race differences in the associations of sensory functions with physical activity (PA) intensity. The Healthy Aging and Neighborhood Study enrolled 379 community-dwelling persons aged 65 and over in Central Massachusetts (2018-2019). Data on sensory functions were assessed using self-report questionnaires, range from 0 (very poor) to 4 (very good). PA intensities were measured using waist-worn Actigraphy accelerometers for at least 8 hours per day and at least 5 days including 1 weekend day. PA intensity was categorized using Copeland cutoff points as sedentary (SB), light (LPA), moderate-to-vigorous-intensity PA (MVPA). Generalized linear models were used to assess the racial differences in the associations of sensory functions with PA intensity, adjusting for age, gender, education, income, general health, comorbidities, activities of daily living (ADL), and instrumental ADL. Average sensory functions of the participants were good to very good (mean±SD: hearing:2.9±1.1, vision:3.4±0.8, touch:3.7±0.6, smell:3.5±0.9, taste:3.6±0.7, balance:3.0±1.0). Two-thirds (66.7%) of participants met the PA guidelines of MVPA (mins/day) SB:465±114, LPA:248±66, MVPA:53±70). Compared to other races, Whites with better touch (b=52.1, SE=23.8) had significantly more SB. Better hearing (b=16.7, SE=7.2), vision (b=32.1, SE=10.5), smell (b=19.3, SE=7.8), taste (b=25.3, SE=9.9) were significantly associated with more LPA. Better vision (RR=1.6, 95%CI:1.1-2.4) and worse touch (RR=0.6, 95%CI:0.4-0.9) were significantly associated with more MVPA. Racial differences are significant in the associations between sensory functions and PA intensity among older adults. The underlying mechanisms should be further investigated to inform future interventions.

RACIAL DIFFERENCES IN ASSOCIATION OF OBJECTIVELY MEASURED PHYSICAL ACTIVITY WITH INDOOR AND OUTDOOR FALLS

Abstract Fall-related injury and hospitalization rates have been steadily increasing by 2% and 4% per year. Physical Activity Guidelines advise older adults to remain physically active to promote muscle strength, bone health, and balance. The Healthy Aging and Neighborhood Study enrolled 379 community-dwelling persons aged 65 years or older in Central Massachusetts (2018-2020). Participant physical activity (PA) levels were measured using waist-worn Actigraphy accelerometers for at least 8 hours per day for 5 or more days including 1 weekend day. Average daily PA intensities were categorized according to minutes of sedentary (SB), light (LPA), and moderate-to-vigorous-intensity PA (MVPA) using Copeland cutoffs. Falls, including the circumstances of the fall, were ascertained using monthly falls calendars and follow-up telephone interviews. Negative Binomial Regressions were used to estimate the associations of PA with rates of indoor and outdoor falls. Models were run overall and by race, with all models adjusting for age and gender. Mean age was 73.71(SD:6.41) years, 58.31%(n=221) were female, and 35.62%(n=135) were non-White. There was no significant difference in SB, LPA, and MVPA by race. White race was associated with higher rates of outdoor falls (RR(95% CI)=2.73 (1.51, 4.93)). Every 30 more minutes of MVPA was significantly associated with 25% lower rate of indoor falls (RR(95% CI)=0.74 (0.58, 0.97)) and 42% higher rate of outdoor falls (RR(95% CI)=1.42 (1.04, 1.95)) among non-White but not White (p for interaction=0.03, 0.07, respectively). Socioeconomic factors may explain the differences observed by race. Thus, future investigations should consider socioeconomic when examining indoor and outdoor falls.

Abstract 12491: Impact of Augmented Treatments on Physical Activity Outcomes in a Sequential Multiple Assignment Randomized Trial

Background: Nearly half of women do not meet aerobic physical activity (PA) guidelines. Despite proven efficacy of PA interventions, response varies. Little is known about when treatment should be augmented. The Working Women Walking Program is a Sequential Multiple Assignment Randomized Trial testing two initial treatments (Fitbit vs. Fitbit+text messages) for eight weeks and two augmented treatments (personal calls vs. group meetings) added at eight weeks for non-responders to the initial treatments. Aims: We aim to compare the two augmented treatments among non-responders to the initial treatments on PA after 34 weeks of the program. Methods: Participants ( N = 301; women ages 18-70) were randomly assigned to an initial treatment of either Fitbit ( n = 149) or Fitbit+text messages ( n = 152). Both groups received a Fitbit and PA prescription (increase daily steps by ≥600 above baseline). Response to treatment was defined as (a) wearing the Fitbit 10 hours per day 3 of 7 days weekly in weeks 6-8 and (b) reaching a step goal ≥600 steps above baseline for 2-3 weeks in weeks 6-8. Non-responders were randomly assigned to an augmented treatment with personal calls ( n = 72; 50.7%) or group meetings ( n = 70; 49.3%). Objective PA was assessed with the waist-worn ActiGraph accelerometer (≥4 days with one weekend day and ≥10 hours daily wear time) at baseline and 34 weeks to assess daily steps and minutes of light and moderate-vigorous intensity PA (MVPA). Self-report PA was measured with the International PA Questionnaire to assess daily MVPA and walking. Results: Across all PA measures, there were no significant differences between augmented treatments (personal calls vs. group meetings). Overall, both treatments showed non-significant increases in objective PA, including steps ( d = .15; p = .30), light PA ( d = .11; p = .39), and MVPA ( d = .22; p = .15), but showed significant increases in self-report PA, including ( d = 1.02; p &lt; .001) and walking ( d = .73; p = .30). Conclusion: In this sample of working women who were non-responsive to an initial PA treatment (Fitbit or Fitbit+texts), augmenting with personal calls or group meetings did not yield a difference in PA outcomes. Next, we will explore participant characteristics that may differentiate response to augmented treatments.

Revisiting Recess: A Mixed-Methods Study to Understand Physical Activity During Changing Recess Policies

ABSTRACT Background Recess is an integral part of a comprehensive school physical activity program. Immediately prior to the pandemic, state legislation doubled the amount of required recess, creating an opportunity to better understand how policies and practices influence recess. Purpose To describe changes to recess due to COVID-19 and extended recess legislation and to quantify student physical activity during recess following these changes. Methods This mixed-method study was conducted in Spring 2021 in four elementary schools. Recess physical activity was measured using waist-worn accelerometers, recess was observed, and researchers conducted interviews with teachers and principals. Results Females spent 41.7% (95%CI: 38.2, 44.5) and males spent 47.9% (95%CI: 44.6, 51.2) of recess in accelerometer-measured moderate-to-vigorous physical activity (n = 164). Participants (n = 13) discussed increased supervision, classroom separation on the playground, and benefits of extended recess. Discussion States should consider extending recess requirements but need to consider options for scheduling and indoor recess. Recess continues to be a key physical activity opportunity during school. Translation to Health Education Practice Health Educators considering changes to recess policies and practices may want to consider scheduling of recess including class integration, options for indoor recess, and professional development for recess supervision to help maximize the benefits of recess.

O.4.3-1 Girls with low motor competence may be particularly at risk of insufficient skeletal loading; latent profiles analysis of a four-year follow-up of Finnish adolescents

Abstract Purpose Adequate skeletal loads during the adolescent growth spurt are elemental in building a robust skeleton. Adolescents with poorer motor competence are less active and develop a less robust skeleton compared to their peers with better develop motor competence. However, few longitudinal examinations of motor competence and skeletal loading through adolescence have been reported. Therefore, the purpose of the present study was to explore the association between motor competence and free-living bone-generating (osteogenic) skeletal load trajectories among adolescents. Methods A total of N = 562 5th graders (11 to 13 years-of-age) were initially included in the sample and were followed up annually for four years from 2017 to 2020 (N = 239 in 2020). The children were asked to wear a waist-worn accelerometer for 7 days and motor competence was assessed with 5-leap and side-to-side jumping tests once a year. Latent profiles were identified based on motor competence, and skeletal loading was estimated using an osteogenic index, which combines the number of loading peaks in particular intensity categories akin to counting steps but with accounting for the magnitude of the impact. Results Three motor competence groups arose from the data for both boys and girls and all groups exhibited persistent low, mid or high motor competence throughout the follow-up. The latent group with the low motor competence consistently exhibited the lowest skeletal loads (10 to 20% below the highest motor competence), and the highest motor competence group the highest with the mid-group in between. All latent groups declined in skeletal loads over the follow-up (from osteogenic index 420 SD[80] to 300[90]) with no difference in the steepness of the decline among boys. However, the lowest motor competence group among girls had a slightly steeper decline in skeletal loads than the other groups. Conclusions the finding that motor competence is associated with skeletal loading among adolescents was confirmed in this longitudinal study. Notably, girls with the lowest motor competence had the steepest decline in skeletal loading over the follow-up. Policies aiming to improve fundamental movement skills could be expected to improve skeletal development particularly among less motor competent girls.

Family asthma management and physical activity among urban children.

Urban, low-income, and Black and Latino children with asthma experience higher morbidity and poorer outcomes compared to their suburban, higher-income, and non-Latino White counterparts. This risk is further compounded by higher rates of co-occurring overweight or obesity. Physical activity contributes to both asthma and overweight/obesity status, however, little is known about factors that may promote/limit physical activity among youth from low-income, urban, and racial/ethnic backgrounds. This study evaluates associations between asthma management behaviors and physical activity among a sample of racially/ethnically diverse youth with asthma of both healthy weight and overweight/obesity status. 147 children with asthma (Mage = 8.3; 50% overweight/obese status, 58% Hispanic/Latino, and 26% Black) and their families completed the Family Asthma Management System Scale (FAMSS; McQuaid et al., 2005) between 2013 and 2015. Physical activity was measured with waist-worn accelerometers. Differences in FAMSS scores by physical activity levels and associations between FAMSS scores and physical activity for the total sample and by race/ethnicity and weight status were evaluated. Children who met recommended physical activity guidelines had higher FAMSS "medication adherence", t(89) = -2.04, p < .05, and "collaboration with health care provider", t(89) = -2.09, p < .05. More optimal "environmental control" related to lower levels of physical activity (β = -.21, p < .05) while more optimal "medication adherence" was associated with higher levels of physical activity (β = .21, p < .05). Differences in these associations were identified by race/ethnicity, though not weight status. Asthma management behaviors were associated with physical activity, with notable differences by race/ethnicity. Tailored interventions simultaneously addressing multiple health behaviors may be warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective assessment of the association between frailty and sedentary behavior in older adults: a cross-sectional study

BackgroundGiven the inconsistent findings of the association between frailty and sedentary behavior in older adults, this cross-sectional study investigated the aforementioned association using four different frailty criteria and two sedentary behavior indices in older adults.MethodsData from older adults (age ≥ 65 y) who participated in health examinations or attended outpatient integrated clinics at a medical center in Taipei, Taiwan, were collected. Frailty was measured using the modified Fried Frailty Phenotype (mFFP), Clinical Frailty Scale in Chinese Translation (CFS-C), Study of Osteoporotic Fractures (SOF) index, and Clinical Frailty-Deficit Count (CF-DC) index; sedentary behavior was assessed with a waist-worn accelerometer. Adjusted linear regression ascertained the association between frailty and both sedentary behavior outcomes.ResultsAmong the 214 participants (mean age 80.82 ± 7.14 y), 116 were women. The average total sedentary time and number of sedentary bouts were 609.74 ± 79.29 min and 5.51 ± 2.09 times per day, respectively. Frail participants had a longer total sedentary time (odds ratio [OR]: 30.13, P = .01 and 39.43, P < .001) and more sedentary bouts (OR: 3.50 and 5.86, both P < .001) on mFFP and CFS-C assessments, respectively. The SOF index revealed more sedentary bouts among frail than in robust participants (OR: 2.06, P = .009), without a significant difference in the total sedentary time. Frail participants defined by the CF-DC index were more likely to have frequent sedentary bouts (OR: 2.03, P = .016), but did not have a longer total sedentary time.ConclusionsRegardless of the frailty criteria adopted, frailty was positively associated with the number of sedentary bouts per day in older adults. A significant correlation between frailty and total sedentary time was detected only with mFFP and CFS-C indices. Further research may target decreasing the sedentary bouts in older adults as a strategy to improve frailty.