Yale Physical Activity Survey Research Articles

Physical activity has a stronger correlation with arterial stiffness than strength, balance, or BMI in an older population.

Background: Arterial stiffness is associated with an array of debilitating health conditions. While exercise typically has beneficial effects on both arterial stiffness and overall health, more research is needed to understand the associations of different types of fitness indices with arterial stiffness. Aim: To investigate the relationship between balance, strength, cardiovascular fitness and physical activity with arterial stiffness (as measured by pulse wave velocity (PWV)) in older adults. Method: Eighty retirement-village residents (24 males, 56 females, age: 78.2 ± 6.4years, weight: 69.4 ± 12.5kg, height: 162.9 ± 8.5cm) completed the Yale Physical Activity Survey, PWV measurement, 30-s sit-to-stand leg strength test, hand grip strength assessment, 4-stage balance test, and a 6-min walk fitness test. The number of exiting risk factors (smoking, previous heart incidents, previous stroke(s), having hypertension, or taking anti-hypertension medication) were tallied. Pearson's correlations were used to assess the relationship between PWV and health and fitness parameters. Results were interpreted using qualitative inference. Results: The number of risk factors (r = 0.57, p < 0.001), age (r = 0.51, p < 0.001) and systolic blood pressure (r = 0.50, p = 0.001) had strong, harmful associations with PWV. Total physical activity minutes/week (r = -0.31 p = 0.01), total energy expenditure Kcal/week (r = -0.30, p = 0.01), and the 6-min walk test (r = -0.29, p = 0.01) had a moderate, beneficial association with PWV, while sit-to-stand (r = -0.27, p = 0.02) and balance (r = -0.27, p = 0.01) had a weak, beneficial association with PWV. Hand grip strength (r = 0.02, p = 0.94) and body mass index (r = -0.04, p = 0.75) had no significant associations with PWV. Discussion: All measured fitness indices had beneficial associations with PWV. However, having more risk factors, increased age, and higher systolic blood pressure had significant (harmful) associations with PWV in our older population. Conclusion: Controlling cardiovascular risk factors, especially high systolic blood pressure, is likely to have the largest beneficial effect on PWV. Improving general physical activity, including walking capacity, may prove beneficial in improving PWV in an older population.

Physical activity and sedentary behaviour in patients admitted with COPD: Associated factors

AimTo establish amongst a cohort of patients admitted with Chronic Obstructive Pulmonary Disease which factors were associated with their level of Physical Activity and Sedentary Behavior prior to the admission event. MethodsProspective observational cohort study. Nine Spanish hospitals participated. Patients were recruited consecutively. Variables relating to the patients' clinical baseline status were recorded, including the COPD Assessment test, the HADS anxiety-depression test, comorbidities and the Yale Physical Activity Survey. Data relating to admission and up to two months after discharge were also recorded. Results1638 COPD patients were studied, with a mean age of 72.39 (SD 10.33), 76.56 % male, FEV1 49.41 % (SD19.19), Charlson index 2. The level of PA at baseline was 30.79 points (SD 22.43). Multivariable linear regression analysis identified the following as being associated with low PA: older age, obesity, higher level of hemoglobin, lower score of Barthel index, which means disability, health related quality of life (EuroQoL-5d and CAT) and dyspnea. Variables associated with sedentary behavior were: older age, presence of obstructive apnea syndrome, higher disability, presence of depressive symptoms and dyspnea. ConclusionsIn a cohort of hospitalized COPD patients, we have found several variables, some of them modifiable, associated with physical activity/inactivity and sedentary behavior.

Translation and Validation of the Yale Physical Activity Survey (YPAS) Questionnaire for the Elderly in Croatia

This research aimed to validate the Yale Physical Activity Survey (YPAS) questionnaire in the context of population of the Republic of Croatia. The research was conducted on 135 participants who are users of four homes for the elderly and infirm in the City of Zagreb. The participants are people over 65 years old, they are Croatian speakers, and they do not have any neurological diagnosis (dementia, Parkinson’s disease and they did not survive a cerebrovascular insult). People who are recovering from a cold or flu or who are unable to move independently are not included in the research. The research used the original YPAS questionnaire, i.e., a list of activities in one part and categories of activities in the other. Physical activity is shown in the average hours reported per week. Calories are calculated for each activity separately, depending on how many kcal/min each activity brings. In this research, the original YPAS questionnaire was used, to examine the levels of physical activity, and the calories for each activity were calculated using a formula. Through the research, the YPAS questionnaire was validated for the Croatian context, and the results showed that participants spend most of their time shopping, washing dishes, and walking. A certain percentage of participants do not engage in any physical activity, which confirmed the theoretical assumptions about the sedentary behaviour of elderly people.

Psychometric Properties of the Turkish Adaptation of the Yale Physical Activity Survey.

This study aimed to examine the convergent validity and test-retest reliability of the Turkish version of the Yale Physical Activity Survey (YPAS-TR). Eighty-one volunteer older adults were included in the study. Test-retest reliability was evaluated using the intraclass correlation coefficient. Correlation coefficients between YPAS-TR and Physical Activity Scale for the Elderly (PASE), Short Form-36, and Short Physical Performance Battery were examined for convergent validity. Acceptable intraclass correlation coefficient values were reached for YPAS-TR energy expenditure, total physical activity time and summary, vigorous, leisurely walking, moving, standing, and sitting indices (intraclass correlation coefficient = .96-.99). There was a moderate correlation between energy expenditure and total physical activity time with PASE (leisure time activities), PASE (household activities), and PASE (total) (r = .478, r = .468, r = .570, r = .406, r = .490, r = .550, respectively, p < .001). Also, a weak correlation was found between summary and leisurely walking index with PASE (household activities), standing index with PASE (leisure time activities), and PASE (total) (r = .285, p = .010; r = .257, p = .021; r = .238, p = .033; r = .283, p = .010; respectively). The results of the study suggest that the YPAS-TR is a valid and reliable measurement tool that can be used to assess the physical activity patterns of Turkish older adults.

Change in physical activity related to admission for exacerbation in COPD patients

IntroductionThe aim of this study was to determine the impact of hospitalizations on levels of physical activity (PA) and whether other factors were associated with subsequent changes in PA. MethodsProspective observational cohort study with a nested case-control study, with follow-up 60 days from the index hospital admission. Nine hospitals participated in the study. Patients were recruited consecutively. Several variables and questionnaires of the clinical baseline status of the patients were recorded including: the COPD Assessment Test (CAT), the Hospital Anxiety-Depression scale (HADS), comorbidities and the Yale Physical Activity Survey. Patients’ data related to admission and up to two months after discharge were also recorded. Results883 patients were studied: 79.7% male; FEV1 48%; Charlson index 2; 28.7% active smokers. The baseline PA level for the total sample was 23 points. A statistically significant difference in PA was found between patients readmitted up to 2 months after the index admission and those not readmitted (17vs. 27, p < 0.0001). Multivariable linear regression analysis identified the following as predictors of the decrease of PA from baseline (index admission) up to 2 months follow-up: admission for COPD exacerbation in the two months prior to the index admission; readmission up to 2 months after the index admission; baseline HAD depressive symptoms, worse CAT score, and patient-reported “need for help”. ConclusionsIn a cohort of admitted COPD patients, we identified a strong relationship between hospitalization for exacerbation and PA. In addition, some other potentially modifiable factors were found associated with the change in PA level after an admission.

Dissociation between physical capacity and daily physical activity in COPD patients. A population-based approach

BadkgroundPhysical capacity (PC) and daily physical activity (PA) are two crucial factors in the clinical course of COPD, although they do not always maintain a close relationship. The objectives were to evaluate the frequency of PC-PA dissociation in patients with COPD and subjects without airflow limitation (AL) and to identify its risk factors. MethodsA sample of 319 COPD patients and 399 subjects without AL was consecutively obtained from a population-based sample of 9092 subjects evaluated in the EPISCAN II study. Baseline evaluation included clinical questionnaires, lung function testing, blood analysis and low-dose computed tomography (CT) scan with evaluation of lung density and airway wall thickness. A distance walked in 6 min > 70% predicted was considered an indicator of normal PC, while a Yale Physical Activity Survey summary index score <51 was used to identify with sedentary lifestyle. Results166 COPD patients (52.0%) reported a sedentary lifestyle with evidence of preserved PC, while this phenomenon was present in 188 (47.1%) subjects without AL. In the COPD group, symptoms of chronic bronchitis, depression and elevated hematocrit and blood eosinophil count were identified as independent risk factors for PC-PA dissociation. In turn, in the subjects without AL, the risk factors for PC-PA dissociation were low fat-free mass, obesity and anxiety, as well as reduced levels of HDL-cholesterol and the absence of osteoporosis. ConclusionsAlmost half of COPD patients and subjects without airflow limitation with preserved PC maintain a sedentary lifestyle, with different risk factors for sedentarism between both groups.

Validation of the Spanish Activity Questionnaire in COPD (SAQ-COPD) in Patients with Chronic Obstructive Pulmonary Disease.

The Spanish Activity Questionnaire in COPD (SAQ-COPD) is a short, simple physical activity (PA) measurement instrument for patients with chronic obstructive pulmonary disease (COPD). In this study, we analyzed its validity and sensitivity to change. Prospective scale validation study. An accelerometer (DynaPort MoveMonitor®) and the Yale Physical Activity Survey (YPAS) were used as reference standards. The analyses examined the criterion validity (Spearman correlations), internal consistency (Cronbach's alpha), factorial structure, test-retest reliability (intraclass correlation coefficient, ICC), sensitivity to change and receiver operating characteristic (ROC) curve to classify patients with low PA. A total of 300 patients diagnosed with COPD were analyzed (73% males, mean age 66 ± 8 years, 40.3% with severe airflow limitation). Cronbach's alpha was 0.60 and Spearman's correlations with accelerometer measurements of PA [number of steps, metabolic equivalents (MET), physical activity level (PAL)] and YPAS ranged from 0.37 to 0.53 (all p < 0.001). ICC was 0.69 (95% CI 0.61-0.74) and the area under the ROC curve to identify low PA was 0.65 (95% confidence interval: 0.58-0.73). Significant variations in SAQ-COPD scores were found between groups defined by YPAS for change. The SAQ-COPD questionnaire is a valid instrument for classifying PA in patients with COPD. Correlations with other instruments provide criterion validity and also demonstrate good sensitivity to change.

Feasibility and Impact of Physical Activity on Compassion Fatigue and Burnout Among Ambulatory Care Oncology Nurses.

Compassion fatigue (CF) and burnout are well described phenomena among oncology nurses. Physical activity (PA) has been shown to reduce CF and burnout. The purpose of this pilot study was to determine the feasibility of promoting PA and assessing its impact on CF and burnout among RNs across three ambulatory care cancer clinics. A convenience sample of nurses with varying roles were invited to participate. Feasibility was assessed by participant accrual and retention rates. CF and burnout were assessed at weeks 0, 6, and 12. The Yale Physical Activity Survey was used to obtain self-reported PA, and daily steps were tracked using participants' personal devices. Stress scores decreased. Burnout scores demonstrated levels of low emotional exhaustion, moderate depersonalization, and moderate to high personal achievement. Leisurely walking increased significantly, and average daily step counts increased by 37% for weekdays, 10% for weekend days, and 29% for the total week.

Simplified Chinese adaptation of the Yale Physical Activity Survey: reliability and validity measurement in mainland China elderly women

ObjectiveTo verify the reliability and validity of the simplified Chinese version of the Yale Physical Activity Survey (YPAS) scale in the measurement of physical activity of elderly women in mainland China to provide a new standardized scale for evaluating the level of physical activity.MethodsTwenty-one healthy elderly women completed all the research procedures. The participants completed the questions on the YPAS and wore an Omegawave Sport Technology®System diagnostic system that recorded maximum oxygen uptake and the adaptation index of the energy metabolism system. The reliability of the YPAS was evaluated based on the consistency of the two measurements (pre-test and post-test), and its validity was verified based on the relevant indicators in the Omegawave diagnostic system. Descriptive statistics, intraclass correlation coefficient and Pearson correlation analysis were used. The significance level was set at p < 0.05.ResultsIn terms of reliability, the Pearson correlation coefficient and ICC of the total physical activity time of YPAS (r = 0.917, ICC = 0.897) was high. In terms of total calories, the Pearson correlation coefficient and ICC of the two test results was high (r = 0.958, ICC = 0.934). On the YPAS total index, the Pearson correlation coefficient and ICC of the two test was high (r = 0.930, ICC = 0.920). In terms of validity, there was a moderate correlation between the energy metabolism system adaptation index and the YPAS-total time (r = 0.472) and a moderate correlation with total calories (r = 0.472). There was a high correlation between the YPAS-total index and the maximum oxygen uptake (r = 0.782).ConclusionThe simplified Chinese version of the YPAS can measure the level of physical activity and energy metabolism of elderly women in mainland China. It is a reliable tool for measuring the physical activity of the elderly.

Clinical Utility of Wearable Sensors and Patient-Reported Surveys in Patients With Schizophrenia: Noninterventional, Observational Study.

BackgroundRelapse in schizophrenia may be preceded by early warning signs of biological, sensory, and clinical status. Early detection of warning signs may facilitate intervention and prevent relapses.ObjectiveThis study aims to investigate the feasibility of using wearable devices and self-reported technologies to identify symptom exacerbation correlates and relapse in patients with schizophrenia.MethodsIn this observational study, patients with schizophrenia were provided with remote sensing devices to continuously monitor activity (Garmin vivofit) and sleep (Philips Actiwatch), and smartphones were used to record patient-reported outcomes. Clinical assessments of symptoms (Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale) were performed biweekly, and other clinical scales on symptoms (Clinical Global Impression-Schizophrenia, Calgary Depression Scale), psychosocial functioning, physical activity (Yale Physical Activity Survey), and sleep (Pittsburgh Sleep Quality Index) were assessed every 4 weeks. Patients were observed for 4 months, and correlations between clinical assessments and aggregated device metrics data were assessed using a mixed-effect model. An elastic net model was used to predict the clinical symptoms based on the device features.ResultsOf the 40 patients enrolled, 1 patient relapsed after being stable with evaluable postbaseline data. Weekly patient-reported outcomes were moderately correlated with psychiatric symptoms (Brief Psychiatric Rating Scale total score, r=0.29; Calgary Depression Scale total score, r=0.37; and Positive and Negative Syndrome Scale total score, r=0.3). In the elastic net model, sleep and activity features derived from Philips Actigraph and Garmin vivofit were predictive of the sitting index of the Yale Physical Activity Survey and sleep duration component of the Pittsburgh Sleep Quality Index. On the basis of the combined patient data, a high percentage of data coverage and compliance (>80%) was observed for each device.ConclusionsThis study demonstrated that wearable devices and smartphones could be effectively deployed and potentially used to monitor patients with schizophrenia. Furthermore, metrics-based prediction models can assist in detecting earlier signs of symptom changes. The operational learnings from this study may provide insights to conduct future studies.Trial RegistrationClinicalTrials.gov NCT02224430; https://www.clinicaltrials.gov/ct2/show/NCT02224430

Perceived Health, Depression and Psychological Well-Being in Older Adults: Physical Activity and Osteoarticular Disease

Osteoarticular diseases are one of the effects of aging, and they are related to physical, psychological, and social functions. Physical activity seems to slow the start and progression of these kinds of illnesses and presents benefits for psychosocial health. The main aim of the study was to investigate the possible effect of physical activity level (Yale Physical Activity Survey) on quality of life (SF-36 Health Questionnaire), subjective psychological well-being (Psychological Well-being Scale), and depression levels (Geriatric Depression Scale), depending on osteoarticular illness. The sample consisted of 263 Spanish adults aged 65 to 98 years who had high or low physical activity (assessed by YPAS Questionnaire) and osteoarticular disease. Results show that physical activity influences the perceived quality of life, depression levels, and subjective well-being in older adults regardless of osteoarticular disease. The present study suggests the need for promoting physical exercise due to its proven positive impact on older adults’ mental health, entailing a significant reduction in the risks of suffering from a variety of frequent diseases and disorders.

Deteriorated regional calf microcirculation measured by contrast-free MRI in patients with diabetes mellitus and relation with physical activity.

Objective:To evaluate regional calf muscle microcirculation in people with diabetes mellitus (DM) with and without foot ulcers, compared to healthy control people without DM, using contrast-free magnetic resonance imaging methods.Methods:Three groups of subjects were recruited: non-DM controls, DM, and DM with foot ulcers (DM + ulcer), all with ankle brachial index (ABI) > 0.9. Skeletal muscle blood flow (SMBF) and oxygen extraction fraction (SMOEF) in calf muscle were measured at rest and during a 5-min isometric ankle plantarflexion exercise. Subjects completed the Yale physical activity survey.Results:The exercise SMBF (ml/min/100 g) of the medial gastrocnemius muscle were progressively impaired: 63.7 ± 18.9 for controls, 42.9 ± 6.7 for DM, and 36.2 ± 6.2 for DM + ulcer, p < 0.001. Corresponding exercise SMOEF was the lowest in DM + ulcers (0.48 ± 0.09). Exercise SMBF in the soleus muscle was correlated moderately with the Yale physical activity survey (r = 0.39, p < 0.01).Conclusions:Contrast-free MR imaging identified progressively impaired regional microcirculation in medial gastrocnemius muscles of people with DM with and without foot ulcers. Exercise SMBF in the medial gastrocnemius muscle was the most sensitive index and was associated with HbA1c. Lower exercise SMBF in the soleus muscle was associated with lower Yale score.

Wheat Germ Supplementation Improves Glucose Homeostasis Markers of Overweight Adults Independent of Gut Microbial Modulation

Abstract Objectives This study investigated the effects of wheat germ (WG) supplementation on inflammation, metabolic, and gut health markers in overweight adults. Methods Forty overweight (BMI = 25.0–30 kg/m2) adults between 18–45 y old were recruited to this single-blinded randomized placebo-controlled study. Qualified participants were asked to maintain their normal diet and physical activity and consume energy balls containing 30 g of either WG or cornmeal (control) daily for 4 wks. Anthropometric and metabolic parameters, as well as dietary (3-d food record), medical history, physical activity (Yale Physical Activity Survey), stool measures (Bristol Stool Chart and the Cleveland Clinic Constipation Scoring System), gut integrity markers, and fecal bacterial population were assessed at baseline and at the end of the supplementation period. Results Thirty-nine participants completed the 4-week study (n = 20 and 19 for the WG and control group, respectively). There were no differences in the lipid profile, but glycated hemoglobin (P = 0.04), insulin (P = 0.03), and homeostatic model assessment of insulin resistance (HOMA-IR; P = 0.04) were significantly decreased in the WG but not the control group. Similarly, the adipokine resistin was also significantly reduced (P = 0.03) by WG but not the control. There were no changes in stool characteristics between the two groups before and after supplementation. Similarly, there were no changes in gut bacterial population due to WG supplementation but the phyla Bacteroidetes (P = 0.03) and Proteobacteria (P = 0.048) and the genus Bacteroides (P = 0.03) were significantly decreased in the control group. No significant changes were observed in plasma inflammatory markers, fecal short-chain fatty acid (SCFA) concentrations, and markers of gut integrity in both groups. Conclusions Four weeks of WG supplementation improved markers of glucose homeostasis, which can partly be attributed to the reduction of the pro-inflammatory adipokine resistin and not due to changes within the gut (i.e., bacterial population, gut integrity markers, and SCFA production). Our findings indicate that WG may be a safe, effective, and economical approach to improve glucose homeostasis. Funding Sources USDA Award #2019–67,018-29,260 and the Jim and Lynn Williams Professorship.

Association between Self-Reported and Accelerometer-Based Estimates of Physical Activity in Portuguese Older Adults.

Accurate assessment of physical activity (PA) is crucial in interventions promoting it and in studies exploring its association with health status. Currently, there is a wide range of assessment tools available, including subjective and objective measures. This study compared accelerometer-based estimates of PA with self-report PA data in older adults. Additionally, the associations between PA and health outcomes and PA profiles were analyzed. Participants (n = 110) wore a Xiaomi Mi Band 2® for fifteen consecutive days. Self-reported PA was assessed using the International Physical Activity Questionnaire (IPAQ) and the Yale Physical Activity Survey (YPAS). The Spearman correlation coefficient was used to compare self-reported and accelerometer-measured PA and associations between PA and health. Bland–Altman plots were performed to assess the agreement between methods. Results highlight a large variation between self-reported and Xiaomi Mi Band 2® estimates, with poor general agreement. The highest difference was found for sedentary time. Low positive correlations were observed for IPAQ estimates (sedentary, vigorous, and total PA) and moderate for YPAS vigorous estimates. Finally, self-reported and objectively measured PA associated differently with health outcomes. Summarily, although accelerometry has the advantage of being an accurate method, self-report questionnaires could provide valuable information about the context of the activity.

Correlation of endogenous pain modulation function with physical activity in elders having chronic pain

Context: Chronic pain is a major predicament of the elderly population and lacks appropriate treatment. In normal healthy individuals, physical activity (PA) shows an effect on endogenous pain modulation (EPM) function by producing central opioids and producing exercise-induced analgesia. Aims: This study aimed to determine a correlation between EPM function and PA of the elderly having chronic pain. Methodology: This was a cross-sectional study of 45 elderly individuals who were between 60 and 80 years of age, suffering from chronic pain. The EPM function was tested using conditioned pain modulation test and PA levels were obtained using Yale Physical Activity Survey (YPAS). In addition, we collected demographic details, duration of pain, and site of pain from the study population. Descriptive statistics was depicted in terms of frequency. Categorical variables were indicated as the mean and standard error of mean. The Spearman's rank correlation (r) test was used to find the correlation between conditioned pain modulation (CPM) and YPAS score. Results: A positive moderate correlation was found between EPM function and PA of elderly having chronic pain (r = 0.05; P = 0.0002). Analysis of EPM function based on the gender of the study population showed that both females (22.54 ± 23.92) and males (6.24 ± 29.19) had similar EPM function values. YPAS score was found as a significant predictor of CPM (P = 0.0003). Conclusion: There is a positive moderate correlation between EPM function and PA levels of elderly having chronic pain.

Assessment Of Cardiorespiratory Fitness In Older Adults With Cognitive Impairment

Interest in the potential benefits of physical activity (PA) and exercise on cognition in late life has grown exponentially in the past decade. Peak oxygen uptake (VO2) is one of the most widely used metrics of physical fitness. The most accurate measure of VO2 is cardiopulmonary testing (CPX); however, this method may not be easily accessible in many settings nor appropriate for all populations, including older adults. Self-report measures of PA are easily administered and readily available, yet these measures rely on an accurate recall of past activity. This may be difficult for older adults with even mild forms of cognitive impairment. Identifying alternative methods that accurately estimate a patient’s physical fitness are essential. PURPOSE: To evaluate the use of multiple measures of physical fitness in a sample of older adults with amnestic Mild Cognitive Impairment (aMCI). METHODS: The sample included 105 older adults who were diagnosed with aMCI (93.3% male, aged = 71.2 ± 9.2 years). Measures of physical fitness included CPX, 6-minute walk test (6MWT), and the Yale Physical Activity Survey (YPAS). Analysis included comparison of the sub-maximal measures of physical fitness (6MWT) and self-report measures (YPAS) with directly-measured cardiorespiratory fitness on key measures on physiologic measures of fitness (e.g., peak VO2, resting blood pressure (BP), BMI). RESULTS: The 6MWT demonstrated a stronger correlation with directly-measured peak VO2 (r = 0.62, p = 0.00) compared to YPAS. The YPAS activity dimensions summary index (composed of questions on vigorous activity, leisurely walking, moving, sitting, and standing) correlated marginally with VO2max (r = 0.28; P = 0.01). The YPAS index of vigorous activity was slightly correlated with VO2max (r = 0.21; P = 0.03). CPX was inversely correlated with BMI (r=-0.21; P=0.03) and non-significantly with resting BP. Resting BP and BMI was not significantly associated with 6MWT nor the YPAS indices. CONCLUSION: The present analysis suggests that even mild forms of cognitive impairment impact the validity of self-report measures of physical fitness. Sub-maximal tests of aerobic capacity, such as the 6MWT, provide more accurate estimates of cardiorespiratory fitness and are easily administered in a variety of settings in which older adults receive health care.

The Effects of Wheat Germ Supplementation on Anthropometric, Biochemical, and Stool Measures in Overweight Adults

Abstract Objectives This study investigated the effects of a 4-week wheat germ supplementation on anthropometric, biochemical, and stool measures in overweight adults. Methods Forty overweight (body mass index = 25.0–30 kg/m2) adults (18–45 years old) were recruited to participate in this randomized controlled study. After initial screening, participants were asked to consume energy balls containing either cornmeal (control) or 30 g of wheat germ (WG) daily for 4 weeks. The energy balls were isocaloric and provided an additional 225 kcal/day. Participants were asked to otherwise maintain their normal diet and physical activity. Anthropometric and metabolic parameters, as well as dietary (3-day food record), medical history, physical activity (Yale Physical Activity Survey) and stool measures (Bristol Stool Chart and the Cleveland Clinic Constipation Scoring System) were assessed at baseline and at the end of the 4-week supplementation period. Results Thirty-nine participants completed the 4-week supplementation (n = 20 and 19 for the WG and control group, respectively). There were no significant differences in anthropometrics, metabolic parameters (i.e., lipid panel, glucose, and HbA1c) or stool measures between the control and WG groups at baseline or at the end of supplementation. However, when comparing change from baseline, significant differences in % body fat, HbA1c, and constipation score were observed between the two groups. Individuals who received the WG supplement exhibited a greater increase in % body fat (0.68 ± 0.28% vs. 0.40 ± 0.36%, P = 0.02) and a greater decrease in HbA1c (−0.095 ± 0.05% vs. −0.039 ± 0.04%, P = 0.04). On the other hand, the control group (−1.00 ± 0.57) perceived a more significant improvement (P = 0.01) in their constipation score compared to WG (−0.85 ± 0.42). Conclusions Similar to our findings in animals, this study demonstrates that daily supplementation with 30 g of WG may be beneficial in glucose homeostasis as indicated by improvement in HbA1C, despite increasing % body fat. Whether the effects of WG on HbA1C will be observed at longer supplementation duration or in other populations such as obese individuals or pre-diabetics needs to be investigated in future studies. Funding Sources United States Department of Agriculture.

Physical activity and risk of cardiovascular events and all-cause mortality among kidney transplant recipients.

Insufficient physical activity (PA) may increase the risk of all-cause mortality and cardiovascular disease (CVD) morbidity and mortality among kidney transplant recipients (KTRs), but limited research is available. We examine the relationship between PA and the development of CVD events, CVD death and all-cause mortality among KTRs. A total of 3050 KTRs enrolled in an international homocysteine-lowering randomized controlled trial were examined (38% female; mean age 51.8 ± 9.4 years; 75% white; 20% with prevalent CVD). PA was measured at baseline using a modified Yale Physical Activity Survey, divided into tertiles (T1, T2 and T3) from lowest to highest PA. Kaplan-Meier survival curves were used to graph the risk of events; Cox proportional hazards regression models examined the association of baseline PA levels with CVD events (e.g. stroke, myocardial infarction), CVD mortality and all-cause mortality over time. Participants were followed up to 2500 days (mean 3.7 ± 1.6 years). The cohort experienced 426 CVD events and 357 deaths. Fully adjusted models revealed that, compared to the lowest tertile of PA, the highest tertile experienced a significantly lower risk of CVD events {hazard ratio [HR] 0.76 [95% confidence interval (CI) 0.59-0.98]}, CVD mortality [HR 0.58 (95% CI 0.35-0.96)] and all-cause mortality [HR 0.76 (95% CI 0.59-0.98)]. Results were similar in unadjusted models. PA was associated with a reduced risk of CVD events and all-cause mortality among KTRs. These observed associations in a large, international sample, even when controlling for traditional CVD risk factors, indicate the potential importance of PA in reducing CVD and death among KTRs.

The Physical Activity Questionnaire for the Elderly (PAQE): A Polish Adaptation.

The aim of the study is to assess the reliability and validity of the Polish adaptation of the Physical Activity Questionnaire for the Elderly (PAQE-PL). One hundred and four older adults (75 women and 29 men) aged 65 to 89 (mean 72.2 ± 5.7 years) participated in the study. The test–retest procedure was used to evaluate the reliability of the PAQE-PL. Validity was assessed by comparing the results of the PAQE-PL with the measurements from an accelerometer (ActiGraph wGT3X+) and two questionnaires: the Polish version of the Community Healthy Activities Model Program for Seniors (CHAMPS-PL) and the Polish version of the Yale Physical Activity Survey (YPAS-PL). All test–retest interclass correlation coefficients (ICCs) were significant (ranged from 0.64 to 0.92). The long-term stability showed significant ICCs (ranged from 0.38 to 0.87) for all participants. In regard to validity, the obtained correlation coefficients were relatively low but statistically significant for all participants between the PAQE-PL scores and energy expenditure (r ranging from 0.25 to 0.26) measured by the accelerometer. The PAQE-PL correlated with almost all CHAMPS-PL indices, YPAS-PL energy expenditure, and total physical activity time. The results suggest that the adaptation of the PAQE-PL is an acceptable tool to estimate the physical activity level among older adults in the Polish population. We recommend the cautious and well-thought-out use of the PAQE-PL with a population of older women.

PHYSICAL ACTIVITY LEVEL IN STABLE COPD PATIENTS FROM CENTRAL EASTERN EUROPE: RESULTS FROM A LARGE OBSERVATIONAL STUDY

SESSION TITLE: Pulmonary Rehabilitation and Muscle Dysfunction SESSION TYPE: Original Investigations PRESENTED ON: 10/22/2019 10:45 AM - 11:45 AM PURPOSE: Physical activity (PA) is an important functional outcome in chronic obstructive pulmonary disease (COPD). Low levels of PA are associated with a higher risk of exacerbations, exacerbations-related hospitalizations and mortality in COPD patients. This study aimed to describe the PA level (PAL) in a large population of stable COPD patients in Europe. The results from 5 Central Eastern European (CEE) countries are presented. METHODS: This multinational, cross-sectional study (NCT03031769) was conducted in 11 countries. In total, 2162 COPD patients were enrolled; some 1422 patients were from CEE countries: Romania (RO) 406, Poland (PL) 356, Serbia (SB) 250, Bulgaria (BG) 210 and Slovakia (SK) 200. All patients had COPD with duration of ≥1 year and no exacerbation history or changes in maintenance treatment in the last 2 months before enrolment. At each study visit, dyspnea was assessed with modified Medical Research Council (mMRC) scale. PAL was assessed through patient self-reports during clinical interview and clinical judgment of physicians (no specific guidance provided). The EVS program (exercise vital sign) and Yale Physical Activity Survey (YAPS) were used for self-reports. Active/insufficiently active/inactive were defined as performing ≥150/149-1/0 minutes/week of moderate to vigorous exercise, respectively. RESULTS: The 5 cohorts of patients presented the following mean ages (years): BG 66.7, PL 67.0, RO 65.9, SK 66.6, SB 68.0. Most patients had moderate to severe airflow obstruction: BG 84.3%, PL 87.7%, RO 83.7%, SK 90.0%, SB 80.0%. In BG 72.8%, PL 64.0%, RO 72.4%, SK 67.5% and SB 51.6% patients had mMRC≥2. The percentages of self-reported vs. clinically judged active patients were: BG 33.8% vs 44.3%, PL 38.5% vs 32.9%, RO 23.9% vs 54.4%, SK 36.0% vs 59.0%, SB 31.2% vs 38.4%. The percentages of completely inactive patients as self-reported by subjects vs. clinically judged by physicians were: BG 27.1% vs 12.4%, PL 15.2% vs 13.2%, RO 37.2% vs 9.1%, SK 37.0% vs 7.0%, SB 30.8% vs 9.6%, respectively. By YPAS, the mean time spent in mostly light activities expressed in hours/day was BG 2.8, PL 2.4, RO 3.7, SK 2.9, SB 3.4. The summary index of YPAS indicated the following values in each country: BG 41.0, PL 37.8, RO 45.3, SK 45.0 and SB 43.9, where 51 is the cut-off score used to identify COPD patients at risk of sedentarism CONCLUSIONS: This study confirms low levels of physical activity among COPD patients in CEE countries. In the absence of standardized tools, physicians tend to overestimate the physical activity of their COPD patients. CLINICAL IMPLICATIONS: Physicians and patients have a different perception of physical activity. Generally, COPD patients are less active than their physicians perceive. Clinicians should be equipped with adequate tools to assess and promote physical activity in their respiratory patients. DISCLOSURES: Employee relationship with AstraZeneca Please note: $1001 - $5000 Added 03/10/2019 by Silviu Alecu, source=Web Response, value=Salary No relevant relationships by Adam Antczak, source=Web Response Employee relationship with AstraZeneca Please note: $1001 - $5000 Added 03/14/2019 by Yunqin Chen, source=Web Response, value=Salary No relevant relationships by Florin Mihaltan, source=Web Response No relevant relationships by Vesna Radulović, source=Web Response