Walking Intensity Research Articles

Do Older Adults Achieve Moderate Intensity When Walking At Their Self-selected Pace?

Walking at a cadence of ≥100 steps/min consistently corresponds to minimally moderate intensity physical activity (PA). While current PA guidelines emphasize the importance of PA intensity for positive health outcomes, most young adults already naturally walk at cadences ≥100 steps/min. It is unknown whether older adults select these same cadences and intensities when they freely select their walking pace. PURPOSE: To determine cadence and intensity of self-paced walking in older adults, and to evaluate the accuracy of using ≥100 steps/min to indicate moderate intensity in this population. METHODS: Twenty-six healthy, ambulatory older adults (10M,16W; mean±SD; age=68.3±4.8 years; height=1.67±.08 m; mass=73.4±12.3 kg) walked continuously for 5min at their self-selected pace back and forth along a 13m pathway that included a 7m gait mat. Oxygen uptake (VO2; mL/kg/min) was determined using indirect calorimetry and converted to absolutely-defined metabolic equivalents (METs; VO2/3.5). Average cadence was quantified using the gait mat. Prevalence of cadences ≥100 and METs ≥3 was calculated as the number of participants above the respective thresholds divided by total participants (n=26). Classification Accuracy (ACC; true positive + true negative / total participants) determined the accuracy of ≥100 steps/min indicating ≥3 METs. RESULTS: The majority of participants (23/26, 83.3%) walked at a cadence ≥100 steps/min (cadence=113±9 steps/min), and many (20/26, 76.9%) achieved moderate intensity (METs=3.43±0.59). A cadence of ≥100 steps/min was a strong indicator of moderate intensity during self-paced walking (i.e., ≥3 to <6 METs, ACC = 80.8%). CONCLUSION: Most healthy older adults attain at least moderate metabolic intensity during self-paced walking. These findings further suggest that “going for a walk” can be recommended, even in the absence of specific PA intensity guidelines. However, these results are preliminary and include only healthy, ambulatory, and relatively young (i.e., only one participant >75 years old) older adults. Future studies should continue to explore self-paced walking in a more representative sample of older adults, and include more of the oldest adults (i.e., >75 years), or those with disease or ambulatory limitations. FUNDING:NIH-NIA-5R01AG049024

Moderate Intensity Walking Cadence (Steps/min) in 61-85 Year Old Adults

Consistent evidence supports a strong relationship between walking cadence (steps/min) and intensity. However, this relationship has primarily been examined in young adults. PURPOSE To identify a heuristic (evidence based, reasonable, rounded) cadence threshold associated with absolutely-defined moderate intensity defined as 3 METs (metabolic equivalents; MET=3.5 mL/kg/min) in older adults (61-85 years of age). METHODS Thirty-seven participants (23 women; age=71.6±14.0 years; BMI=25.8±4.7 kg/m2) completed a progressive treadmill walking test. The protocol included 5 minute bouts increasing by 0.5 mph increments from 0.5 to 6.0 mph until: 1) the participant naturally selected to jog or run, 2) reached >75% of their age-predicted maximum heart rate, or 3) reported a Borg scale rating of perceived exertion (RPE) >13. Oxygen consumption (VO2; mL/kg/min) was measured using indirect calorimetry and cadence was determined by dividing directly-observed steps by bout duration. METs were calculated as the average VO2 over the last two minutes of each bout, divided by 3.5 mL/kg/min. Receiver Operator Characteristic (ROC) curves and Youden’s index were used to determine moderate intensity based on cadence. Additionally, the cadence-intensity relationship was evaluated using a segmented regression model with random coefficients. RESULTS: All but three participants reached at least 3 METs during treadmill walking. The ROC cadence threshold for absolutely-defined moderate intensity was 100.3 steps/min. Specificity and sensitivity values were above 85% for moderate intensity. The cadence-intensity relationship was also explained by bi-linear relationship with a breakpoint at 94.4 steps/min, where cadence explained 74% of the variance. The cadence threshold for absolutely-defined moderate intensity was 101.3 (95% Prediction Intervals=68.2-112.8). CONCLUSION A growing number of studies have provided evidence supporting the utility of 100 steps/min as a reasonable heuristic threshold value associated with absolutely-defined moderate intensity walking in younger adults. This study confirms that 100 steps/min is also as an appropriate proxy threshold of absolutely-defined moderate intensity in ambulatory and ostensibly healthy older adults. FUNDING: NIH-NIA-5R01AG049024

Device-specific Cadence (steps/min) Thresholds For Metabolic Intensities of Walking

In studies where steps are directly observed, walking cadences of 100 steps/min and 130 steps/min have emerged as thresholds for absolutely-defined moderate (MOD; 3 metabolic equivalents [METs]) and vigorous (VIG; 6 METs) intensities, respectively. However, there is limited information regarding device-specific cadence thresholds provided for guidance. PURPOSE: To estimate device-specific cadence thresholds for MOD and VIG in 61-85 year old adults. METHODS: Thirty-seven healthy older adults (62.3% women; age=68.5±4.6 years; BMI=26.3±3.8 kg/m2) walked on a treadmill for 5-min bouts. The first bout was conducted at 0.5 mph. Speed increased in 0.5 mph increments until participants reached 75% of their age-predicted maximum heart rate, started to run, or reported a Borg Rating of Perceived Exertion > 13. Cadence (steps/min) was measured across all speeds with multiple devices: ActiGraph GT9x (hip and wrist), activPAL (thigh), StepWatch (ankle), Fitbit Zip (waist), and Garmin vívoactive® 3 (wrist). Oxygen uptake was measured with indirect calorimetry and converted to METs. Receiver Operator Characteristic (ROC) analysis was used to determine optimal cadence thresholds associated with MOD and VIG intensity using Youden’s index. RESULTS: Device-specific cadence thresholds for MOD and VIG intensity are presented in Table 1. The optimal device-specific cadence thresholds were associated with very good to excellent classification accuracy for both intensities (AUC > 0.8). Except for the wrist-worn ActiGraph, which had relatively lower specificity for identifying thresholds, optimal cadence thresholds for all devices ranged from 86-104 steps/min for MOD and 125-140 steps/min for VIG intensity. CONCLUSION: Device-specific cadence thresholds appear to be acceptable indicators of MOD and VIG walking intensities. FUNDING: NIH-NIA-5R01AG049024Table 1: Device- specific cadence thresholds by intensity

Dose-related Effects of Moderate Intensity Walking Exercise on Sensitivity to Pain in Healthy Humans

Dose-related Effects of Moderate Intensity Walking Exercise on Sensitivity to Pain in Healthy Humans

Dog Walking Intensity And Its Contribution To Owners’ Total Moderate-to-vigorous Physical Activity

Approximately half of American households own a dog, and dog ownership is associated with higher levels of physical activity (PA). These increased PA levels are assumed to be dog-related, but there is limited scientific evidence to support this assumption. Though dog walking is classified as moderate intensity PA (3 METS) in the PA compendium, few studies have used objective PA measures to track intensity during dog walking bouts. PURPOSE: To 1) determine the % of daily accelerometer-estimated moderate-to-vigorous PA (MVPA) minutes that are accumulated during self-reported dog walking bouts, and 2) quantify the % of dog walking minutes that qualify as MVPA. METHODS: Thirty-three healthy dog owners (30 female; BMI 27.2±5.3; age 45.2±15.3) wore an ActiGraph GT3X+ accelerometer on their right hip for 7 days. Dogs were a mean age of 5.85±3.7 (size: 11 small, 12 medium, 9 large). Participants were asked to maintain their normal routine, log leisure-time activity with and without their dog, and ActiGraph on/off periods. T-tests were used to compare differences in MVPA for dog age (<7 vs. >7) and size (med/large vs. small). RESULTS: Thirty-three participants averaged 56.62 ±31.1 min/day in MVPA. An average 42.12 ±25.25% of this time was spent dog walking. Of time spent dog walking, 65.19 ±26% was MVPA. There was no significant difference in % of MVPA min/day attributable to dog walking or % of dog walking in MVPA based on dog age or size (p≥0.4). Combined ActiGraph and self-report data provides context for participants’ PA, and further insight for investigation (Figure 1). CONCLUSION: The sample demonstrated large variability, with some participants accumulating almost all MVPA from dog walking, and others accumulating little or none. Two-thirds of dog walking minutes were MVPA, but also varied by individual. Variations were not explained by dog size or age. Given the prevalence of dog ownership in America, further investigation into how dog ownership affects PA is warranted.Figure 1.: Combined ActiGraph and self-reported data of sample participant.

"Would you like to join me for a walk?" The feasibility of a supervised walking programme for people with dementia who wander.

Five of the eight focus areas of Bowen's Feasibility Framework were utilised to assess the feasibility of implementing the Safe Walking Program (SWP) with people with severe dementia who wander in long-term care (LTC). Dementia-related wandering in LTC is associated with adverse outcomes related to intensity (malnutrition, exhaustion and pain, injury) and type of walking (sleep deprivation, resident violence and elopement, death). There is little evidence guiding best practice for managing wandering in LTC. The SWP involved a three-week trial of taking residents (n=7) for a 30-min supervised walk, 30min before individual peak walking activity periods (PWAP), outside the care facility. Quantitative (real-time observation and 24/7 Actigraph™ data: not reported here) and qualitative data were collected pre-, during and postintervention. Feasibility to implement the SWP protocol was evaluated using a protocol fidelity checklist completed at the end of each scheduled intervention. Acceptability and sustainability of the programme were evaluated through staff interviews. Eighty per cent of scheduled walks commenced and were completed, with 91% of walks lasting the full 30min. Care staff reported benefits for participants and care staff. The perceived sustainability of the SWP in the LTC setting was impacted by the strict timing of the walk to coincide with participant's individual PWAP. The use of care staff to lead some scheduled walks was seen as interfering with care routines. To enhance the acceptability/sustainability of the SWP in LTC, further testing of the importance of dose and timing is required. Consideration needs to be given to suggested modifications to the protocol. The SWP is an acceptable and enjoyable activity for people with severe dementia who wander. Utilising walking tracks around the neighbourhood was perceived as being an important element of the programme.

Mobile Phone의 착용위치에 따른 운동 강도별 에너지소비량과 보행수의 타당성 연구

Sedentary lifestyle and a lack of physical activity are critically associated with chronic diseases, mental health and mortality. Many health-related organizations have contributed to improving healthy lifestyle with evidencebased guideline for disease prevention. Simultaneously, since new innovative technology has emerged to promote healthy lifestyle, mobile phone has played a key role in promoting health. Mobile phone installed with a physical movement tracker may motivate and support physical activity effectively. However there is limited research about validity of use of mobile phone in different locations on improvement of physical activities. Thus the purpose of this study was to validate the use of mobile phone at different locations to affect total energy expenditure and steps in different intensity walking exercise. The study population was male students who consent to participate to the study (n=18). Their body composition such as height, weight, total body fat and muscle mass was measured. Oxygen consumption was measured during 5-minute walking/running on a treadmill at the speeds of 4km/h, 6km/h and 8km/h based on the exercise protocol offered by ACSM. Number of steps was assessed from records of steps on the application. A eligible movement tracker that would be used in Iphone 6+ was selected. Mobile phone was equipped at the locations of upper left-arm and a pocket of pants. The study used one-way ANOVA to estimate differences in energy expenditure. A validity test was assessed wtih Pearson’s correlation and Bland & Altman. As a result, there was a significant different of calorie consumption at different intensity (p.05). Oxygen consumption was significantly different only in moderate-intensity walking when putting a phone at upper left-arm. Wearing phone on the upper left-arm showed significantly different number of steps by different intensity of exercise compared to having it in a pocket. In a validation test, two measurements showed a bias with different range of agreement limits. It indicates that different locations of mobile phone are associated with different measurement. The study found that putting a phone in a pocket may assess steps and energy consumption with better accuracy compared to wearing it on the upper arm. It may be explained by arm movement during different intensity activity. Higher intensity exercise moves more arms and legs and it may not show significant differences of energy consumptions and steps at different locations. It also indicates that number of steps showed increased trend as increased speeds of walking/running when putting it in a pocket. The further study is needed to evaluate energy consumption and number of steps in various forms of physical activity. Further study is needed to evaluate energy consumption and number of steps in various forms of physical activity.

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.

Effects of walking training performed using continuous and interval methods on weight loss as effective strategies among postpartum women

Background: ‪Walking is a fundamental and affordable physical activity that improves entire body and helps women lose weight. However, some studies suggest that walking alone has little or no effect on improving or maintaining body mass and fat mass at the hip and spine. The objective of this study is to estimate the effect of walking intensity (interval training vs. traditional cardio) on weight loss after childbirth. Material and methods: ‪A total of 39 postpartum women [19 experimental subjects (ES) and 20 controls (CS)] participated in this study. Their homogenates were calculated based on their average age of 25 ±2.54 years. BMI obese moderate and waist circumference at high-risk, first deliveries to the same educational and social status. The subjects participated in this study to lose excess weight within three months after childbirth. Results: ‪Our results indicate that interval training with fast walking is a powerful tool for developing successful strategies for managing weight loss. Conclusions: ‪We recommend that postpartum women, who use walking to amplify their weight loss, use the following exercise schedule: at least three sets of 400 m (wf ≈ SR) × 5 per day, nine 400 m (wf ≈ SR) × 5 sets per week, and 36 sets of 400 m (wf ≈ SR) × 5 per month.

Factors Affecting Physical Activity Participation Among University Students

The Physical activities are indispensable to be healthy and away from illness, yet, students ignoring it. The factors affecting physical activity participation among university students in the Philippines examined in this study. Modified International Physical Activity Questionnaire adopted, Stata 13 and SPSS utilized to justify the objectives of study on a 470 samples. Findings revealed that participants who do physical activity for 3 days and accumulating at least 1500 metabolic equivalent tasks (MET) minutes per week or with combination of walking, moderate or vigorous intensity activities accumulating at least 3000 MET minutes were classified as highly active. Other participants were categorized as moderately active and low active/inactive. The results identified that lack of time due to busy lesson schedule was the most significant factors for not participating in physical activity among the samples. Priority on academic success over exercise was the most identified item that hinders individual to participate in physical activities. Thus, recommended the replication of this study to increase the generalizability of achieved results

Abstract P099: Heart Rate Variability Differences Between Green and Suburban Walking: A Pilot Crossover Study

Introduction: Heart rate variability (HRV) assesses the sympathetic and parasympathetic innervation of the heart. Lower HRV indicates greater sympathetic tone and is associated with adverse cardiovascular outcomes. During exercise, factors like activity intensity influence HRV. Yet, an environment’s inherent anxiety-/stress-promoting characteristics may also affect HRV. Hypothesis: Given nature’s calming characteristics, we hypothesized green (i.e., nature-based) walking would promote higher HRV and less HRV reduction than suburban walking. Methods: Twenty-four middle-aged adults (20 female; 49.3 ± 6.7 yrs; BMI: 30.7 ± 7.9 kg/m 2 ) participated in this nine-week crossover study comprised of once-weekly 50-minute moderate-intensity walking sessions. Participants walked for three weeks in each of two treatment conditions: (1) green walking: nature-based walking on trails of local arboretum; and (2) suburban walking: walking on sidewalks of a local suburb’s downtown area. Half were assigned to suburban walking in the first treatment period, and half completed green walking first. A two-week washout separated treatments. The Zephyr BioHarness 3 assessed HRV—reported as standard deviations of normal-to-normal RR intervals in milliseconds (ms) while also tracking activity intensity. For analysis, walks were split into 15-minute intra-walk phases with the first, second, and third phases representing each walk’s beginning, middle, and end. Five-minute pre- and post-walk sitting phases for HRV were also created. Linear mixed models with repeated measures evaluated HRV phase differences between treatments and HRV change between phases by treatment. Results: Lower HRV was observed during the pre-walk sitting phase in the green (56.5 ms) vs. the suburban walking treatment (62.4 ms; p = 0.04); however, a sequence effect was present ( p = 0.02). Due to lower walking intensity during green walking (0.31 g vs. 0.27 g; p &lt; 0.01), activity intensity was a covariate in all intra-walk analyses. Intra-walk phase analyses revealed higher green vs. suburban walking HRV during the second (29.1 ms vs. 24.2 ms, respectively; p &lt; 0.01) and third (33.9 ms vs. 23.8 ms, respectively; p = 0.03) phases. Further, less HRV reduction was seen between the first and second intra-walk phases during green (-7.6 ms) vs. suburban walking (-12.4 ms; p = 0.05). Between-treatment HRV differences were not found for the post-walk sitting phase. No sequence effects were observed for the intra-walk or post-walk phases. Finally, no carryover effects were observed—suggesting adequate washout between treatments. Conclusions: Green walking elicits higher HRV and less HRV reduction vs. suburban walking. Activity intensity did not explain these observations. Fully powered longer-term trials should rigorously evaluate green walking’s potential anxiety-/stress-reducing characteristics.

Effects of high intensity speed-based treadmill training on ambulatory function in people with chronic stroke: A preliminary study with long-term follow-up

High intensity treadmill training has shown to be beneficial for stroke survivors, yet the feasibility and long-term effects remain unclear. In this study, we aimed to determine whether a 4-week high intensity speed-based treadmill training (HISTT) is feasible for chronic stroke survivors, and we examined its effects on ambulatory function, and long-term retention. Sixteen individuals post-stroke participated in 40 minutes of HISTT for four weeks at a frequency of three sessions per week. Gait speed was measured using the 10-meter walk test, endurance was measured using the 6-minute walk test, and quality of life was assessed using the Stroke Impact Scale (SIS) at baseline, post-training, and at 3-month follow-up. All participants successfully completed the training without any serious adverse events. Participants significantly increased fastest walking speed by 19%, self-selected walking speed by 18%, and walking endurance by 12% after the training. These improvements were maintained for 3 months after the intervention. Our results indicate that this modified speed-based high intensity walking program has the potential to be a feasible and effective method of gait training for stroke survivors. However, the small sample size and lack of a control group warrant caution in interpretation of results. Further studies are recommended to better understand effectiveness of this protocol in combination with other physical therapy interventions for functional recovery after stroke.

Gait changes after weight loss on adolescent with severe obesity after sleeve gastrectomy

BackgroundIt has been highlighted that obesity influences the gait reducing walking velocity, stride length, ankle dorsal flexion at initial contact and ankle power generation. Meanwhile, step width, double support, hip flexion, knee extension during stance, hip moment and ankle power absorption was described increased. A tendency to the normalization of these parameters occur when subjects reduced their weight during growth. ObjectiveWe studied the effect of fast weight loss due to Sleeve Gastrectomy on gait pattern of adolescent with severe obesity. The aim is to assess the functional benefit of the surgery. SettingPediatric hospital, public health, Italy. Methods11 patients before and after 1 year from surgery and 10 controls participated to the study. We studied the gait with an optoelectronic system and two force plates. We evaluated both kinetics and kinematics of walking. Then we looked at the differences between the pre- vs post-surgery and with the control group. ResultsStep length and velocity were lower and step width was bigger in adolescent with obesity. Kinematic and kinetic parameters were altered. After surgery we observed the reduction of several gait alteration. Meanwhile, after 1 year alterations at the level of the foot, the knee and the pelvis persist. ConclusionThe sudden loss of weight highlighted the presence of long-term effects on the locomotor system. The results discourage intense walking activities before the weight loss and we suggest further studies for evaluating the necessity of a rehabilitative intervention.

Arthrodesis of ankle joint. Biomechanical aspects and algorithm of choice of methods of fixation

Objective: to improve the results of ankle joint arthrodesis by applying of biomechanical modification of the surgery technique and a differentiated approach to choice of methods of fixation. Methods: 348 patients (192 males, 156 females, middle age) were studied. Average age was (48.5 ± 3.8) years. In the main group (n1 = 176) modified method of arthrodesis of the ankle joint and differentiated approach for choosing means of fixation was applied, in the control group (n2 = 172) — t raditional m ethods of arthrodesis were used. Results: in the main group in 164 patients (93 %) the arthrodesis proved to be effective, the mean timeof bone fusion was (8.9 ± 0.4) weeks. In the control group bone fusion was observed in 138 patients (79 %) in (11.5 ± 0.9) weeks postoperatively. In (3.4 ± 1.8) years when we evaluated resultsaccording to AOFAS in the main group, the average index for the posterior part of the foot was (78.2 ± 1.2) points, for the middle part — (81.3 ± 1.3), which corresponds to good functional results at absolute absence of motion in ankle joint. In the control group, the average index of AOFAS for the posterior part of the foot was (57.1 ±1.3) points, for the middle — (53.7 ± 1.4). In the main group compare to control group wehave revealed a decreasing in total time of foot weight bearing by 17.8 %, increasing in time of rolling over the heel (average (23.8 ± 0.8) %), reduction of time of rollover through the anterior part to (27.1 ± 1.2) % and moderate elevation of the interjoging period (49.1 ± 1.2) %. Decreasing of strength impulse of the vertical component in the main group (3608 ± 2.4) compare to the control group (3982 ± 3.6) indicated to decreasing in the energy intensity of walking when we used a modified resection technique for arthrodesis. Conclusions: modified methodfor resection arthrodesis of ankle joint is shown to be better than traditional one. That is confirmed by functional, biomechanicaland X-ray studies.

Walking cadence (steps/min) and intensity in 21\u201340\u2009year olds: CADENCE-adults

BackgroundPrevious studies have reported that walking cadence (steps/min) is associated with absolutely-defined intensity (metabolic equivalents; METs), such that cadence-based thresholds could serve as reasonable proxy values for ambulatory intensities.PurposeTo establish definitive heuristic (i.e., evidence-based, practical, rounded) thresholds linking cadence with absolutely-defined moderate (3 METs) and vigorous (6 METs) intensity.MethodsIn this laboratory-based cross-sectional study, 76 healthy adults (10 men and 10 women representing each 5-year age-group category between 21 and 40 years, BMI = 24.8 ± 3.4 kg/m2) performed a series of 5-min treadmill bouts separated by 2-min rests. Bouts began at 0.5 mph and increased in 0.5 mph increments until participants: 1) chose to run, 2) achieved 75% of their predicted maximum heart rate, or 3) reported a Borg rating of perceived exertion > 13. Cadence was hand-tallied, and intensity (METs) was measured using a portable indirect calorimeter. Optimal cadence thresholds for moderate and vigorous ambulatory intensities were identified using a segmented regression model with random coefficients, as well as Receiver Operating Characteristic (ROC) models. Positive predictive values (PPV) of candidate heuristic thresholds were assessed to determine final heuristic values.ResultsOptimal cadence thresholds for 3 METs and 6 METs were 102 and 129 steps/min, respectively, using the regression model, and 96 and 120 steps/min, respectively, using ROC models. Heuristic values were set at 100 steps/min (PPV of 91.4%), and 130 steps/min (PPV of 70.7%), respectively.ConclusionsCadence thresholds of 100 and 130 steps/min can serve as reasonable heuristic thresholds representative of absolutely-defined moderate and vigorous ambulatory intensity, respectively, in 21–40 year olds. These values represent useful proxy values for recommending and modulating the intensity of ambulatory behavior and/or as measurement thresholds for processing accelerometer data.Trial registrationClinicaltrials.gov (NCT02650258).

Effect of frequent interruptions of sedentary time on nutrient metabolism in sedentary overweight male and female adults.

This study compared 24-h nutrient oxidation responses between a sedentary condition (SED) and a condition in which short 5-min bouts of moderate-intensity physical activity were performed hourly for nine consecutive hours over 4 days (MICRO). To determine whether any shifts in fuel use were due solely to increases in energy expenditure, we also studied a condition consisting of a single isoenergetic 45-min bout of moderate-intensity exercise (ONE). Twenty sedentary overweight or obese adults (10 men/10 women; 32.4 ± 6.3 yr; BMI, 30.6 ± 2.9 kg/m2) completed all three conditions (MICRO, SED, and ONE) in a randomized order. Each condition consisted of a 3-day free-living run-in followed by a 24-h stay in a whole-room calorimeter to measure total energy expenditure (TEE) and substrate utilization. Dietary fat oxidation was also assessed during the chamber stay by administering a [1-13C] oleic acid tracer at breakfast. Energy intake was matched across conditions. Both MICRO and ONE increased TEE relative to SED, resulting in a negative energy balance. HOMA-IR improved in both activity conditions. MICRO increased 24-h carbohydrate oxidation compared with both ONE and SED ( P < 0.01 for both). ONE was associated with higher 24-h total fat oxidation compared with SED, and higher 24-h dietary fat oxidation compared with both SED and MICRO. Differences in substrate oxidation remained significant after adjusting for energy balance. In overweight and obese men and women, breaking up sitting time increased reliance upon carbohydrate as fuel over 24 h, while a single energy-matched continuous bout of exercise preferentially relies upon fat over 24 h. NEW & NOTEWORTHY Insulin sensitivity, as assessed by HOMA-IR, was improved after 4 days of physical activity, independent of frequency and duration of activity bouts. Temporal patterns of activity across the day differentially affect substrate oxidation. Frequent interruptions of sedentary time with short bouts of walking primarily increase 24-h carbohydrate oxidation, whereas an energy-matched single continuous bout of moderate intensity walking primarily increased 24-h fat oxidation.

The effectiveness and cost-effectiveness of a complex community sport intervention to increase physical activity: an interrupted time series design

ObjectivesAn effectiveness and cost-effectiveness analyses of two-staged community sports interventions; taster sports sessions compared with portfolio of community sport sessions.DesignQuasi-experiment using an interrupted time series design.SettingCommunity sports projects delivered by...

Changes in Intensity and Duration of Walking among Older Adults from In-Patient Geriatric Rehabilitation to Home

Purpose: We compared walking in hospital and on discharge from in-patient geriatric rehabilitation. Method: Participants included 28 adults (22 women) with a mean age of 85.4 (SD 6.8) years, ambulating independently with planned discharge to the community. Steps per day, short and long walking bouts, and cadence (steps per minute) were measured using an ActiGraph GT3X+ activity monitor (5 d in hospital, 5 d at home). Results: Steps per day did not differ between hospital and home (median difference=401; 95% CI: -364, 1,215; p=0.10). Long walking bouts (≥5 min) were infrequent in both locations (1/d) but lasted longer in hospital. Short walking bouts (≥15 s) were more frequent and shorter at home. Daily peak 1-minute cadence and peak 30-minute cadence were greater in hospital. Conclusions: Older adults in geriatric rehabilitation take longer walks and walk at faster paces in hospital, and they engage in more frequent, shorter walks at home. Although further research is needed, older adults would benefit from the opportunity to walk at different paces and different distances on discharge. Outpatient rehabilitation or other community-based programmes and initiatives may provide these experiences and appropriate environments to enable individuals to maintain mobility and independent functioning in the long term.

Does walking protect against decline in cognitive functioning among breast cancer patients undergoing chemotherapy? Results from a small randomised controlled trial.

BackgroundCancer related cognitive impairments have been subjectively reported and objectively detected in breast cancer patients treated with chemotherapy and are known to have a profound negative impact on productivity, psychosocial well-being and overall quality of life. Moderate levels of walking are known to be of benefit to the psychosocial well-being of those affected by breast cancer and for managing cognitive impairment in healthy adults, children, and the elderly. The purpose of this study is to investigate the effects of a home-based, self-managed, moderate intensity walking intervention on subjective and objective cognitive functioning in breast cancer patients undergoing chemotherapy.MethodsA home-based, self-managed intervention that consisted of moderate levels of walking was compared to usual care among breast cancer patients treated with chemotherapy in a randomised controlled trial. Outcome measures included changes in subjective (CFQ) and objectively detected cognitive functioning (Stroop, SART and two subscales from the WAIS- Digit Span and Block Design). Fifty participants were randomised to either the intervention group (n = 25), who completed 12 weeks of moderate intensity walking, or to the control group (n = 25) mid-way through chemotherapy.ResultsCompared with the control group, the self-managed walking intervention had positive effects on perceived cognitive function but not on sustained attention, executive function, memory or visual spatial skills when assessed objectively using neuropsychological measures.ConclusionThis home-based, self-managed intervention is beneficial for protecting against perceived cognitive decline in breast cancer patients treated with chemotherapy. There is a need for further research to objectively assess cognitive decline within this population with larger sample sizes of patients.Trial registrationCurrent Controlled Trials ISRCTN50709297

Physical activity of university students with disabilities: accomplishment of recommendations and differences by age, sex, disability and weight status.

This article aims to study physical activity and the achievement of World Health Organization physical activity recommendations in university students with disabilities, and to examine differences by sex, age, disability characteristics and weight status. Cross-sectional data from a wider research project conducted at the Spanish universities from Autumn 2016 to Autumn 2017 were analysed. The International Physical Activity Questionnaire-Short Form was administered to 1103 Spanish university students with different disabilities. Nonparametric tests were performed to examine the differences in physical activity based on the interest variables. The mean metabolic equivalent (MET)-minutes/week was 1772.75 (±2161.00) for total physical activity, 642.93 (±1303.08) for vigorous physical activity, 344.31 (±699.53) for moderate physical activity and 785.50 (±1053.31) for walking intensity physical activity. Overall, 72.2% of the participants did not meet the recommendation of 75min/week of vigorous physical activity, 80.3% did not meet the recommendation of 150min/week of moderate physical activity and 63.1% did not meet any of these recommendations. Nonparametric tests revealed that students with multiple disabilities, chronic illnesses, acquired disabilities, older students, obese students and women were less active than their counterparts. A high number of participants did not meet the World Health Organization physical activity recommendations, and some subgroups were especially inactive. Public health policies should implement interventions to encourage people with disabilities to engage in physical activity, paying extra attention to the most inactive subgroups.