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Lönn A, Ekblom Ö, Kallings LV, Börjesson M, Ekström M. Decrease in accelerometer assessed physical activity during the first-year post-myocardial infarction: a prospective cohort study. SCAND CARDIOVASC J 2024; 58:2397442. [PMID: 39193855 DOI: 10.1080/14017431.2024.2397442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/18/2024] [Accepted: 07/29/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVES To elucidate physical activity in the first year after myocardial infarction (MI), and to explore differences in various subgroups, delineated by age, participation in exercise-based cardiac rehabilitation (exCR), or restrictions due to the covid-19 pandemic. Secondly, to explore associations between changes in physical activity variables with blood pressure and lipid levels. METHODS A longitudinal study in 2017-2023. Physical activity variables were assessed via accelerometers at two- and twelve months post-MI. The intensity was divided into, sedentary, light, moderate, and vigorous-intensity physical activity, according to established cut-offs. Blood pressure and lipids were measured by standardized procedures at the same time points. RESULTS There were 178 patients included at baseline, 81% male, mean age of 64 (9 SD) years. Patients spent 72% of their time sedentary, followed by light (19%), moderate (8%), and vigorous physical activity (1%). Patients included during covid-19 restrictions and younger patients had a higher level of moderate-intensity physical activity compared to patients included during non-pandemic restrictions and older patients. At 12-month follow-up, patients overall increased time (1%) in sedentary behavior (p = 0.03) and decreased time (0.6%) in moderate-intensity physical activity (p = 0.04), regardless of participation in exCR or age. There was a positive association between the change in mean physical activity intensity and HDL-cholesterol (p = 0.047). CONCLUSIONS Participants had a low fraction of time in moderate-to-vigorous-intensity physical activity two months post-MI, which deteriorated during the first year. This emphasizes the need for improved implementation of evidence-based interventions to support and motivate patients to perform regular physical activity.
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Affiliation(s)
- Amanda Lönn
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Women´s Health and Allied Health Professionals Theme Medical Unit Occupational therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Örjan Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Solna, Sweden
| | - Lena Viktoria Kallings
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Unit of Family Medicine, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mats Börjesson
- Center for lifestyle intervention, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of MGAÖ, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mattias Ekström
- Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm, Sweden
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Ding D, Ekelund U. From London buses to activity trackers: A reflection of 70 years of physical activity research. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:736-738. [PMID: 38851584 PMCID: PMC11336341 DOI: 10.1016/j.jshs.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 05/31/2024] [Indexed: 06/10/2024]
Affiliation(s)
- Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo 0806, Norway; Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo 0213, Norway
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Son JY, Woo S, Struble LM, Marriott DJ, Chen W, Larson JL. Objectively Measured Physical Activity and Sedentary Behaviors Among Older Adults in Assisted Living Facilities: A Scoping Review. J Appl Gerontol 2024; 43:1544-1559. [PMID: 38662904 DOI: 10.1177/07334648241248332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2024] Open
Abstract
Older adults in assisted living facilities (ALF) are at risk for low physical activity (PA) and high sedentary behavior (SB), both of which place them at risk for negative health outcomes. The purpose of this scoping review was to synthesize evidence describing the volume of device-measured PA/SB, factors associated with PA/SB, and interventions designed to change PA/SB in older adults living in ALF. Twenty articles representing 15 unique studies were identified from eight electronic databases and grey literature. Residents in ALF spent 96-201 min/day in light PA (n = 2 studies), 1-9.74 min/day in moderate to vigorous PA (n = 2 studies), and 8.5-11.01 hr/day of SB during waking hours (n = 3 studies). Factors associated with PA included 16 personal factors (n = 6 articles), one social factor (n = 2 articles), and two environmental factors (n = 2 articles). Factors associated with SB included 14 personal factors (n = 4 articles) and one social factor (n = 1 article). No intervention successfully changed PA/SB.
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Affiliation(s)
| | - Seoyoon Woo
- University of North Carolina Wilmington, Wilmington, NC, USA
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Happe L, Sgraja M, Quinten V, Förster M, Diekmann R. Requirement Analysis of Different Variants of a Measurement and Training Station for Older Adults at Risk of Malnutrition and Reduced Mobility: Focus Group Study. JMIR Aging 2024; 7:e58714. [PMID: 39288403 DOI: 10.2196/58714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/26/2024] [Accepted: 08/05/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Demographic change is leading to an increasing proportion of older people in the German population and requires new approaches for prevention and rehabilitation to promote the independence and health of older people. Technical assistance systems can offer a promising solution for the early detection of nutritional and physical deficits and the initiation of appropriate interventions. Such a system should combine different components, such as devices for assessing physical and nutritional status, educational elements on these topics, and training and feedback options. The concept is that the whole system can be used independently by older adults (aged ≥70 years) for monitoring and early detection of problems in nutrition or physical function, as well as providing opportunities for intervention. OBJECTIVE This study aims to develop technical and digital elements for a measurement and training station (MuTs) with an associated app. Through focus group discussions, target group requirements, barriers, and favorable components for such a system were identified. METHODS Older adults (aged ≥70 years) were recruited from a community-based setting as well as from a geriatric rehabilitation center. Focus group interviews were conducted between August and November 2022. Following a semistructured interview guideline, attitudes, requirements, preferences, and barriers for the MuTs were discussed. Discussions were stimulated by videos, demonstrations of measuring devices, and participants' ratings of the content presented using rankings. After conducting 1 focus group in the rehabilitation center and 2 in the community, the interview guide was refined, making a more detailed discussion of identified elements and aspects possible. The interviews were recorded, transcribed verbatim, and analyzed using content analysis. RESULTS A total of 21 older adults (female participants: n=11, 52%; mean age 78.5, SD 4.6 years) participated in 5 focus group discussions. There was a strong interest in the independent measurement of health parameters, such as pulse and hand grip strength, especially among people with health problems who would welcome feedback on their health development. Participants emphasized the importance of personal guidance and interaction before using the device, as well as the need for feedback mechanisms and personalized training for everyday use. Balance and coordination were mentioned as preferred training areas in a MuTs. New training options that motivate and invite people to participate could increase willingness to use the MuTs. CONCLUSIONS The target group is generally open and interested in tracking and optimizing diet and physical activity. A general willingness to use a MuTs independently was identified, as well as a compelling need for guidance and feedback on measurement and training to be part of the station.
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Affiliation(s)
- Lisa Happe
- Junior Research Group "Nutrition and Physical Function in Older Adults", Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Marie Sgraja
- Junior Research Group "Nutrition and Physical Function in Older Adults", Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Vincent Quinten
- Junior Research Group "Nutrition and Physical Function in Older Adults", Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Mareike Förster
- Junior Research Group "Nutrition and Physical Function in Older Adults", Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Rebecca Diekmann
- Junior Research Group "Nutrition and Physical Function in Older Adults", Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
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Mahe J, Xu A, Liu L, Hua L, Tu H, Huo Y, Huang W, Liu X, Wang J, Tang J, Zhao Y, Liu Z, Hong Q, Ye R, Hu P, Jia P, Huang J, Kong X, Ge Z, Xu A, Wu L, Du C, Shi F, Cui H, Wang S, Li Z, Wang L, Zhang L, Zhang L. Association between weekend warrior physical activity pattern and all-cause mortality among adults living with type 2 diabetes: a prospective cohort study from NHANES 2007 to 2018. Diabetol Metab Syndr 2024; 16:226. [PMID: 39267148 PMCID: PMC11391736 DOI: 10.1186/s13098-024-01455-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/22/2024] [Indexed: 09/14/2024] Open
Abstract
BACKGROUND It is uncertain whether the weekend warrior pattern is associated with all-cause mortality among adults living with type 2 diabetes. This study explored how the 'weekend warrior' physical activity (PA) pattern was associated with all-cause mortality among adults living with type 2 diabetes. METHODS This prospective cohort study investigated US adults living with type 2 diabetes in the National Health and Nutrition Examination Survey (NHANES). Mortality data was linked to the National Death Index. Based on self-reported leisure-time and occupational moderate-to-vigorous PA (MVPA), participants were categorized into 3 groups: physically inactive (< 150 min/week of MVPA), weekend warrior (≥ 150 min/week of MVPA in 1 or 2 sessions), and physically active (≥ 150 min/week of MVPA in 3 or more sessions). RESULTS A total of 6067 participants living with type 2 diabetes [mean (SD) age, 61.4 (13.5) years; 48.0% females] were followed for a median of 6.1 years, during which 1206 deaths were recorded. Of leisure-time and occupational activity, compared with inactive individuals, hazard ratios (HRs) for all-cause mortality were 0.49 (95% CI 0.26-0.91) and 0.57 (95% CI 0.38-0.85) for weekend warrior individuals, and 0.55 (95% CI 0.45-0.67) and 0.64 (95% CI 0.53-0.76) for regularly active individuals, respectively. However, when compared leisure-time and occupational weekend warrior with regularly active participants, the HRs were 0.82 (95% CI 0.42-1.61) and 1.00 (95% CI 0.64-1.56) for all-cause mortality, respectively. CONCLUSIONS Weekend warrior PA pattern may have similar effects on lowering all-cause mortality as regularly active pattern among adults living with type 2 diabetes, regardless of leisure-time or occupational activity. Therefore, weekend warrior PA pattern may be sufficient to reduce all-cause mortality for adults living with type 2 diabetes.
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Affiliation(s)
- Jinli Mahe
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China
| | - Ao Xu
- Monash University-Southeast University Joint Research Institute (Suzhou), Southeast University, Suzhou, China
| | - Li Liu
- Data Centre, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Lei Hua
- Data Centre, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Huiming Tu
- Department of Gastroenterology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Yujia Huo
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China
- Monash University-Southeast University Joint Research Institute (Suzhou), Southeast University, Suzhou, China
| | - Weiyuan Huang
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China
| | - Xinru Liu
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China
| | - Jian Wang
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China
| | - Jinhao Tang
- International College, Krirk University, Bangkok, Thailand
| | - Yang Zhao
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- The George Institute for Global Health, Beijing, China
| | - Zhining Liu
- Anhui Medical University Affiliated Hospital, Hefei, China
| | - Qiaojun Hong
- Anhui No.2 Provincial People's Hospital, Hefei, China
| | - Rong Ye
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Canter of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Panpan Hu
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Canter of Neuropsychiatric Disorders and Mental Health, Hefei, China
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- Hubei Luojia Laboratory, Wuhan, China
- School of Public Health, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Junjie Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hongkong, China
| | - Xiangyi Kong
- Department of Breast Surgical Oncology, National Cancer Centre/National Clinical Research Centre for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zongyuan Ge
- Faculty of Engineering, Monash University, Melbourne, Australia
| | - Aimin Xu
- College of Big Data and Software Engineering, Zhejiang Wanli University, Ningbo, China
| | - Longfei Wu
- Centre for Genetic Epidemiology and Genomics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Chaopin Du
- Department of Neurology, Nantong Third Hospital Affiliated to Nantong University, Nantong, China
| | - Feng Shi
- Department of Surgery, Civil Aviation General Hospital, Shanghai, China
| | - Hanbin Cui
- Department of Cardiovascular Medicine, First Affiliated Hospital, Ningbo University, Ningbo, China
| | - Shengfeng Wang
- School of Public Health, Peking University, Beijing, China
| | - Zhihui Li
- Tsinghua Vanke School of Public Health, Beijing, China
| | - Liang Wang
- Department of Public Health, Marshall University, Huntington, WV, USA
| | - Lei Zhang
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
- Clinical Medical Research Centre, Children's Hospital of Nanjing Medical University, Nanjing, China.
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.
| | - Lin Zhang
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China.
- Monash University-Southeast University Joint Research Institute (Suzhou), Southeast University, Suzhou, China.
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6
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Chang Q, Zhu Y, Liu Z, Cheng J, Liang H, Lin F, Li D, Peng J, Pan P, Zhang Y. Replacement of sedentary behavior with various physical activities and the risk of all-cause and cause-specific mortality. BMC Med 2024; 22:385. [PMID: 39267013 PMCID: PMC11395964 DOI: 10.1186/s12916-024-03599-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 08/29/2024] [Indexed: 09/14/2024] Open
Abstract
BACKGROUND Sedentary behavior (SB) has emerged as a significant health concern that deserves attention. This study aimed to examine the associations between prolonged sedentary behavior and the risk of all-cause and cause-specific mortality as well as to explore desirable alternatives to sitting in terms of physical activity (PA). METHODS Two prospective cohort investigations were conducted using the UK Biobank and NHANES datasets, with a total of 490,659 and 33,534 participants, respectively. Cox proportional hazards regression models were used to estimate the associations between SB and the risk of all-cause and cause-specific mortality due to cancer, cardiovascular disease (CVD), respiratory diseases, and digestive diseases. In addition, we employed isotemporal substitution models to examine the protective effect of replacing sitting with various forms of PA. RESULTS During the average follow-up times of 13.5 and 6.7 years, 36,109 and 3057 deaths were documented in the UK Biobank and NHANES, respectively. Both cohorts demonstrated that, compared with individuals sitting less than 5 h per day, individuals with longer periods of sitting had higher risks of all-cause and cause-specific mortality due to cancer, CVD, and respiratory diseases but not digestive diseases. Moreover, replacing SB per day with PA, even substituting 30 min of walking for pleasure, reduced the risk of all-cause mortality by 3.5% (hazard ratio [HR] 0.965, 95% confidence interval [CI] 0.954-0.977), whereas cause-specific mortality from cancer, CVD, and respiratory diseases was reduced by 1.6% (HR 0.984, 95% CI 0.968-1.000), 4.4% (HR 0.956, 95% CI 0.930-0.982), and 15.5% (HR 0.845, 95% CI 0.795-0.899), respectively. Furthermore, the protective effects of substitution became more pronounced as the intensity of exercise increased or the alternative duration was extended to 1 h. CONCLUSIONS SB was significantly correlated with substantially increased risks of all-cause mortality and cause-specific mortality from cancer, CVD, and respiratory diseases. However, substituting sitting with various forms of PA, even for short periods involving relatively light and relaxing physical activity, effectively reduced the risk of both overall and cause-specific mortality.
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Affiliation(s)
- Qinyu Chang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, 410008, China
| | - Yiqun Zhu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, 410008, China
| | - Zhichen Liu
- Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China
| | - Jun Cheng
- Department of Spine Surgery, Central South University, The Third Xiangya Hospital, Changsha, Hunan, China
| | - Huaying Liang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, 410008, China
| | - Fengyu Lin
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, 410008, China
| | - Dianwu Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, 410008, China
| | - Juan Peng
- Department of Nephrology, Central South University, The Third Xiangya Hospital, Changsha, Hunan, China
| | - Pinhua Pan
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China.
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, 410008, China.
| | - Yan Zhang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China.
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, 410008, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, 410008, China.
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Meredith SJ, Shepherd AI, Saynor ZL, Scott A, Gorczynski P, Perissiou M, Horne M, McNarry MA, Mackintosh KA, Witcher CSG. Device-based 24-hour movement behaviours in adult phase III cardiac rehabilitation service-users during the COVID-19 pandemic: a mixed-methods prospective observational study. Disabil Rehabil 2024:1-12. [PMID: 39257350 DOI: 10.1080/09638288.2024.2397086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/21/2024] [Accepted: 08/22/2024] [Indexed: 09/12/2024]
Abstract
PURPOSE To examine changes in device-based 24-hour movement behaviours (MB), and facilitators and barriers to physical activity (PA) and exercise, during remotely-delivered cardiac rehabilitation (RDCR). MATERIALS AND METHODS This prospective observational study used wrist-worn GENEActiv accelerometers to assess MB of 10 service-users (63 ± 10 years) at the start, middle, and end of three-months of RDCR. Barriers and facilitators to PA and exercise were explored through self-report diaries and analysed using content analysis. RESULTS At start, service-users were sedentary for 12.6 ± 0.7 h · day-1 and accumulated most PA at a light-intensity (133.52 ± 28.57 min · day-1) - neither changed significantly during RDCR. Sleep efficiency significantly reduced from start (88.80 ± 4.2%) to the end (86.1 ± 4.76%) of CR, with values meeting health-based recommendations (≥85%). Barriers to RDCR exercise included exertional discomfort and cardiac symptoms, and reduced confidence when exercising alone. Setting meaningful PA goals, self-monitoring health targets, and having social support, facilitated PA and exercise during RDCR. CONCLUSIONS Our RDCR programme failed to elicit significant changes in MB or sleep. To increase the likelihood of successful RDCR, it is important to promote a variety of exercise and PA options, target sedentary time, and apply theory to RDCR design, delivery, and support strategies.
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Affiliation(s)
- S J Meredith
- Academic Geriatric Medicine and National Institute of Health Research Collaboration for Leadership in Health Research and Care Wessex, University of Southampton, Southampton, UK
| | - A I Shepherd
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Z L Saynor
- School of Health Sciences, University of Southampton, Southampton, UK
| | - A Scott
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - P Gorczynski
- School of Human Sciences, University of Greenwich, London, UK
| | - M Perissiou
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - M Horne
- School of Healthcare, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - M A McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Department of Sport and Exercise Sciences, Swansea University, Swansea, UK
| | - K A Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Department of Sport and Exercise Sciences, Swansea University, Swansea, UK
| | - C S G Witcher
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
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8
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Coenen P, Huysmans MA, Holtermann A, Troiano RP, Mork PJ, Krokstad S, Clays E, Cillekens B, De Bacquer D, Aadahl M, Kårhus LL, Sjøl A, Andersen LB, Kauhanen J, Voutilainen A, Pulsford RM, Stamatakis E, Goldbourt U, Peters A, Thorand B, Rosengren A, Björck L, Sprow K, Franzon K, Rodriguez-Barranco M, Luján-Barroso L, Knutsson A, Alfredsson L, Bahls M, Ittermann T, Kluttig A, Hassan L, Wanner M, Bopp M, Marott JL, Schnohr P, Nordestgaard BG, Dalene KE, Ekelund U, Clausen J, Jensen MT, Petersen CB, Krause N, Twisk J, Mechelen WV, van der Beek AJ. Associations of occupational and leisure-time physical activity with all-cause mortality: an individual participant data meta-analysis. Br J Sports Med 2024:bjsports-2024-108117. [PMID: 39255999 DOI: 10.1136/bjsports-2024-108117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2024] [Indexed: 09/12/2024]
Abstract
OBJECTIVE Health effects of different physical activity domains (ie, during leisure time, work and transport) are generally considered positive. Using Active Worker consortium data, we assessed independent associations of occupational and leisure-time physical activity (OPA and LTPA) with all-cause mortality. DESIGN Two-stage individual participant data meta-analysis. DATA SOURCE Published and unpublished cohort study data. ELIGIBILITY CRITERIA Working participants aged 18-65 years. METHODS After data harmonisation, we assessed associations of OPA and LTPA with all-cause mortality. In stage 1, we analysed data from each study separately using Cox survival regression, and in stage 2, we pooled individual study findings with random-effects modelling. RESULTS In 22 studies with up to 590 497 participants from 11 countries, during a mean follow-up of 23.1 (SD: 6.8) years, 99 743 (16%) participants died. Adjusted for LTPA, body mass index, age, smoking and education level, summary (ie, stage 2) hazard ration (HRs) and 95% confidence interval (95% CI) for low, moderate and high OPA among men (n=2 96 134) were 1.01 (0.99 to 1.03), 1.05 (1.01 to 1.10) and 1.12 (1.03 to 1.23), respectively. For women (n=2 94 364), HRs (95% CI) were 0.98 (0.92 to 1.04), 0.96 (0.92 to 1.00) and 0.97 (0.86 to 1.10), respectively. In contrast, higher levels of LTPA were inversely associated with mortality for both genders. For example, for women HR for low, moderate and high compared with sedentary LTPA were 0.85 (0.81 to 0.89), 0.78 (0.74 to 0.81) and 0.75 (0.65 to 0.88), respectively. Effects were attenuated when adjusting for income (although data on income were available from only 9 and 6 studies, for men and women, respectively). CONCLUSION Our findings indicate that OPA may not result in the same beneficial health effects as LTPA.
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Affiliation(s)
- Pieter Coenen
- Public and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Public and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Steinar Krokstad
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Bart Cillekens
- Public and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Mette Aadahl
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Line Lund Kårhus
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Anette Sjøl
- The Capital Region of Denmark, Copenhagen, Denmark
| | - Lars Bo Andersen
- Faculty of Education, Arts and Sports, Western Norwegian University of Applied Sciences, Sogndal, Norway
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | - Emmanuel Stamatakis
- Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Uri Goldbourt
- Sackler Medical faculty, Tel Aviv University, Tel Aviv, Israel
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Centre for Cardiovascular Research (DZHK e.V.), partner site Munich Heart Alliance, Munich, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Pettenkofer School of Public Health, Faculty of Medicine, Ludwig-Maximilians-Universität, Munich, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Pettenkofer School of Public Health, Faculty of Medicine, Ludwig-Maximilians-Universität, Munich, Germany
| | - Annika Rosengren
- Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medicine Geriatrics and Emergency Medicine/Östra, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lena Björck
- Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medicine Geriatrics and Emergency Medicine/Östra, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kyle Sprow
- Administration for Strategic Preparedness and Response, Washington DC, Columbia, USA
| | - Kristin Franzon
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Miguel Rodriguez-Barranco
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Leila Luján-Barroso
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, L'Hospitalet de Llobregat, Spain
- Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Anders Knutsson
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Lars Alfredsson
- Centre for Occupational and Environmental Medicine, Stockholm, Region Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Martin Bahls
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Till Ittermann
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Alexander Kluttig
- Institute for Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Lamiaa Hassan
- Institute for Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Miriam Wanner
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - Matthias Bopp
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Jacob Louis Marott
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Peter Schnohr
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Børge Grønne Nordestgaard
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Knut Eirik Dalene
- Department of Sport Sciences, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Ulf Ekelund
- Department of Sport Sciences, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Johan Clausen
- Epidemiological Research Unit, Departments of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Magnus Thorsten Jensen
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, Denmark
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christina Bjørk Petersen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Niklas Krause
- Fielding School of Public Health, Departments of Epidemiology and Environmental Health Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Jos Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Public and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Public and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
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Ainsworth BE, Tian H. Commentary on "Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study". JOURNAL OF SPORT AND HEALTH SCIENCE 2024:100984. [PMID: 39255853 DOI: 10.1016/j.jshs.2024.100984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Accepted: 08/25/2024] [Indexed: 09/12/2024]
Affiliation(s)
- Barbara E Ainsworth
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China.
| | - Haili Tian
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
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Soldato D, Michiels S, Havas J, Di Meglio A, Pagliuca M, Franzoi MA, Pistilli B, Iyengar NM, Cottu P, Lerebours F, Coutant C, Bertaut A, Tredan O, Vanlemmens L, Jouannaud C, Hrab I, Everhard S, Martin AL, André F, Vaz-Luis I, Jones LW. Dose/Exposure Relationship of Exercise and Distant Recurrence in Primary Breast Cancer. J Clin Oncol 2024; 42:3022-3032. [PMID: 38838281 PMCID: PMC11361355 DOI: 10.1200/jco.23.01959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/15/2024] [Accepted: 04/02/2024] [Indexed: 06/07/2024] Open
Abstract
PURPOSE Postdiagnosis exercise is associated with lower breast cancer (BC) mortality but its link with risk of recurrence is less clear. We investigated the impact and dose-response relationship of exercise and recurrence in patients with primary BC. METHODS Multicenter prospective cohort analysis among 10,359 patients with primary BC from 26 centers in France between 2012 and 2018 enrolled in the CANcer TOxicities study, with follow-up through October 2021. Exercise exposure was assessed using the Global Physical Activity Questionnaire-16, quantified in standardized metabolic equivalent of task-hours per week (MET-h/wk). We examined the dose/exposure response of pretreatment exercise on distant recurrence-free interval (DRFI) for all patients and stratified by clinical subtype and menopausal status using inverse probability treatment weighted multivariable Cox models to estimate hazard ratios (HRs). RESULTS For the overall cohort, the relationship between exercise and DRFI was nonlinear: increasing exercise ≥ 5 MET-h/wk was associated with an inverse linear reduction in DRFI events up to approximately 25 MET-h/wk; increasing exercise over this threshold did not provide any additional DRFI benefit. Compared with <5 MET-h/wk, the adjusted HR for DRFI was 0.82 (95% CI, 0.61 to 1.00) for ≥ 5 MET-h/wk. Stratification by subtype revealed the hormone receptor-/human epidermal growth factor receptor 2- (HR-/HER2-; HR, 0.59 [95% CI, 0.38 to 0.92]) and HR-/HER2+ (HR, 0.37 [95% CI, 0.14 to 0.96]) subtypes were preferentially responsive to exercise. The benefit of exercise was observed especially in the premenopausal population. CONCLUSION Postdiagnosis/pretreatment exercise is associated with lower risk of DRFI events in a nonlinear fashion in primary BC; exercise has different impact on DRFI as a function of subtype and menopausal status.
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Affiliation(s)
- Davide Soldato
- INSERM U981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy, Villejuif, France
| | - Stefan Michiels
- INSERM U1018 CESP, Service de Biostatistique et d’Epidemiologie, Institut Gustave Roussy, Villejuif, France
| | - Julie Havas
- INSERM U981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy, Villejuif, France
| | - Antonio Di Meglio
- INSERM U981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy, Villejuif, France
| | - Martina Pagliuca
- INSERM U981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy, Villejuif, France
- Division of Breast Medical Oncology, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, Naples, Italy
| | - Maria Alice Franzoi
- INSERM U981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy, Villejuif, France
| | | | - Neil M. Iyengar
- Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | | | | | | | | | | | | | | | - Iona Hrab
- Centre François Baclesse, Caen, France
| | | | | | - Fabrice André
- INSERM U981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy, Villejuif, France
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Ines Vaz-Luis
- INSERM U981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy, Villejuif, France
- Medical Oncology Department, Gustave Roussy, Villejuif, France
- Supportive Care and Pathways Department (DIOPP), Gustave Roussy, Villejuif, France
| | - Lee W. Jones
- Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
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11
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McLellan HL, Dawson EA, Eijsvogels TM, Thijssen DH, Bakker EA. Impact of Hypertension on the Dose-Response Association Between Physical Activity and Stroke: A Cohort Study. Stroke 2024; 55:2231-2239. [PMID: 39114902 PMCID: PMC11346707 DOI: 10.1161/strokeaha.123.045870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Regular physical activity is associated with a reduced stroke risk. However, this relationship might be attenuated in the presence of hypertension and antihypertensive medication use. We examined the dose-response relationship between physical activity and stroke in normotensive and hypertensive individuals. METHODS A Dutch population-based cohort including 139 930 individuals (41% men; mean age, 44±13) was performed (median follow-up, 6.75 years). Participants were stratified at baseline as hypertensive (44%) or normotensive (56%) and categorized into quartiles of the lowest (Q1) to the highest (Q4) moderate-to-vigorous, self-reported physical activity. The primary outcome was incident stroke (fatal and nonfatal). Cox regression estimated hazard ratios and 95% CIs. The main analyses were stratified on baseline blood pressure and adjusted for confounders. Hypertensives were stratified into medicated (21%) or non-medicated (79%). RESULTS Compared with Q1, adjusted hazard ratios were 0.87 (0.69-1.10; P=0.23), 0.75 (0.59-0.95; P=0.02), and 0.94 (0.74-1.20; P=0.64) for Q2 to Q4, respectively in the total population. Hazard ratios for normotensives were 0.79 (0.50-1.25; P=0.32), 0.75 (0.48-1.18; P=0.22), 0.97 (0.62-1.51; P=0.90) for Q2 to Q4, respectively. In hypertensives, hazard ratios were 0.89 (0.68-1.17; P=0.41), 0.74 (0.56-0.98; P=0.03), 0.92 (0.69-1.23; P=0.56) for Q2 to Q4, respectively. There was no significant interaction between hypertension status for the relation between physical activity and stroke risk. The stratified analysis revealed a smaller benefit of moderate-to-vigorous physical activity in medicated hypertensives compared with nonmedicated hypertensives, but no significant interaction effect was found. CONCLUSIONS Regular moderate-to-vigorous physical activity is beneficial for stroke risk reduction (Q3 compared with Q1), which is not affected by hypertension. Antihypertensive medication may be associated with a smaller benefit of moderate-to-vigorous physical activity on the risk of stroke, but further research is warranted.
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Affiliation(s)
- Hannah L. McLellan
- Liverpool Centre for Cardiovascular Science, Research Institute for Sport and Exercise Science, Liverpool John Moore’s University, United Kingdom (H.L.M.L., E.A.D., D.H.J.T.)
| | - Ellen A. Dawson
- Liverpool Centre for Cardiovascular Science, Research Institute for Sport and Exercise Science, Liverpool John Moore’s University, United Kingdom (H.L.M.L., E.A.D., D.H.J.T.)
| | - Thijs M.H. Eijsvogels
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands (T.M.H.E., D.H.J.T., E.A.B.)
| | - Dick H.J. Thijssen
- Liverpool Centre for Cardiovascular Science, Research Institute for Sport and Exercise Science, Liverpool John Moore’s University, United Kingdom (H.L.M.L., E.A.D., D.H.J.T.)
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands (T.M.H.E., D.H.J.T., E.A.B.)
| | - Esmée A. Bakker
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands (T.M.H.E., D.H.J.T., E.A.B.)
- Department of Physical Education and Sports, Sport and Health University Research Institute (iMUDS), University of Granada, Spain (E.A.B.)
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12
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Ross R, Janssen I, Tremblay MS. Public health importance of light intensity physical activity. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:674-675. [PMID: 38307207 PMCID: PMC11282331 DOI: 10.1016/j.jshs.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/20/2024] [Indexed: 02/04/2024]
Abstract
•Light intensity physical activity is associated with a marked reduction in chronic disease and mortality risk. •That activities of daily living are associated with health benefits supports public health initiatives that advocate for replacing sitting time with standing and engaging in routine activities such as casual walking, leisurely sports and light housework. •The shift in focus from movement behaviors in isolation to the integration of all movement behaviors over the whole day will provide movement options for adults, treatment options for practitioners, and greater opportunities for public health promotion.
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Affiliation(s)
- Robert Ross
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada; School of Medicine, Division of Endocrinology and Metabolism, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; Department of Pediatrics, University of Ottawa, Ottawa, ON K1H 8L1, Canada
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13
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Feter N, Ligeza TS, Bashir N, Shanmugam RJ, Montero Herrera B, Aldabbagh T, Usman AF, Yonezawa A, McCarthy S, Herrera D, Vargas D, Mir EM, Syed T, Desai S, Shi H, Kim W, Puhar N, Gowda K, Nowak O, Kuang J, Quiroz F, Caputo EL, Yu Q, Pionke JJ, Zou L, Raine LB, Gratton G, Fabiani M, Lubans DR, Hallal PC, Pindus DM. Effects of reducing sedentary behaviour by increasing physical activity, on cognitive function, brain function and structure across the lifespan: a systematic review and meta-analysis. Br J Sports Med 2024:bjsports-2024-108444. [PMID: 39197948 DOI: 10.1136/bjsports-2024-108444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVE To examine the acute and chronic effects of reducing prolonged sedentary time (ST) with physical activity (PA) on cognitive and brain health. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Scopus, CINAHL, PsycINFO, SPORTDiscus, Web of Science, and ProQuest Dissertation and Theses. ELIGIBILITY CRITERIA Randomised controlled trials (RCTs) published from inception to 17 June 2024, with healthy participants without cognitive impairment or neurological conditions that affect cognitive functioning, aged ≥4 years, testing acute and chronic effects of reducing ST and/or prolonged ST by reallocating ST to PA on cognitive function, brain function, and structure. RESULTS We included 25 RCTs (n=1289) investigating acute (21 studies) and chronic (4 studies) effects on cognitive function (acute: n=20, chronic: n=4) and brain function (acute: n=7, chronic: n=1); there were no studies on brain structure. Acutely interrupting continuous ST with either multiple or a single PA bout improved cognitive function measured from 3 hours to three consecutive days based on 91 effect sizes (g=0.17, 95% CI: 0.05 to 0.29, p=0.005, I 2=45.5%). When comparing single versus multiple PA bouts, only multiple PA bouts yielded a positive effect on cognitive function based on 72 effect sizes (g=0.20, 95% CI: 0.06 to 0.35, p=0.006; I 2=48.8%). Chronic studies reported null findings on cognitive function (n=4), with some evidence of improved neural efficiency of the hippocampus (n=1). CONCLUSION Interrupting ST with PA acutely improves cognitive function. The evidence from chronic studies remains inconclusive. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020200998.
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Affiliation(s)
- Natan Feter
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tomasz S Ligeza
- Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Neha Bashir
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Ramiya J Shanmugam
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Bryan Montero Herrera
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Tamara Aldabbagh
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- School of Integrative Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Anne-Farah Usman
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Ayumi Yonezawa
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Shane McCarthy
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Physiology and Biophysics, University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Danielle Herrera
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Surgery, Ann and Robert Lurie Children's Hospital, Chicago, Illinois, USA
| | - Denise Vargas
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Emaad M Mir
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Talha Syed
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Sanam Desai
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Hector Shi
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - William Kim
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Economics, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Natalie Puhar
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Kushi Gowda
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- College of Medicine Peoria, University of Illinois, Peoria, Illinois, USA
| | - Olivia Nowak
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Research & Development Solutions, IQVIA, Overland Park, Kansas, USA
| | - Jin Kuang
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- School of Psychology, Shenzhen University, Shenzhen, People's Republic of China
| | - Flor Quiroz
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Eduardo L Caputo
- School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Qian Yu
- School of Psychology, Shenzhen University, Shenzhen, People's Republic of China
| | - J J Pionke
- iSchool, Syracuse University, Syracuse, New York, USA
| | - Liye Zou
- School of Psychology, Shenzhen University, Shenzhen, People's Republic of China
| | - Lauren B Raine
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
- Department of Medical Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Gabriele Gratton
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Monica Fabiani
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - David R Lubans
- College of Human and Social Futures, University of Newcastle Australia, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pedro C Hallal
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Dominika M Pindus
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
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14
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Vrints C, Andreotti F, Koskinas KC, Rossello X, Adamo M, Ainslie J, Banning AP, Budaj A, Buechel RR, Chiariello GA, Chieffo A, Christodorescu RM, Deaton C, Doenst T, Jones HW, Kunadian V, Mehilli J, Milojevic M, Piek JJ, Pugliese F, Rubboli A, Semb AG, Senior R, Ten Berg JM, Van Belle E, Van Craenenbroeck EM, Vidal-Perez R, Winther S. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J 2024:ehae177. [PMID: 39210710 DOI: 10.1093/eurheartj/ehae177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
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15
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Fuchs Andersen C, Omar M, Larsen JH, Kistorp C, Tuxen C, Gustafsson F, Køber L, Poulsen MK, Brønd JC, Møller JE, Schou M, Jensen J. Accelerometer-measured physical activity in patients with heart failure and reduced ejection fraction: Determinants and relationship with patient-reported health status. Am Heart J 2024; 278:14-23. [PMID: 39209211 DOI: 10.1016/j.ahj.2024.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 08/22/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Accelerometer-measured physical activity is an increasingly used endpoint in heart failure (HF) trials. We investigated the determinants of accelerometer-measured physical activity and the relationship with patient-reported health status. METHODS Post-hoc analysis of the Empire HF trial, including outpatients with HF with reduced ejection fraction (HFrEF). Physical activity was quantified as average accelerometer counts per minute (CPM) with higher values representing higher activity. We investigated associations between activity level and clinical variables, including age, sex, and body mass index, as well as patient-reported health status assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ). RESULTS Complete data were available in 180 (95%) patients (86% male, mean age 65 year). Baseline median physical activity level was 1,318 CPM (Q1-Q3 1,111-1,585). Age and anemia were independently associated with activity level (β-coefficients: -10 CPM per year age increase [95% CI -16 to -5.1], P = .00015, and -126 CPM for anemia [95% CI -9.1 to -244], P = .035). Significant independent associations were observed between activity level and all KCCQ summary scores (β-coefficient point estimates of 3.7, 4.6, and 4.9 CPM, all P < .02). For 12-week changes in KCCQ-summary scores, only the KCCQ-CSS was associated with activity level; mean increase of 17.5 CPM [95% CI 1.5 to 34.0], P = 0.032, per 5-point increase in KCCQ-CSS. Associations were not modified by treatment allocation (interaction P-values > .05). CONCLUSIONS In patients with HFrEF, older age and anemia were independently associated with lower activity. Moreover, physical activity only weakly increased with better health status, suggesting that changes in physical activity reflect improvements in patients' health status to a limited degree. This highlights the need to better understand the endpoint with regards to all other health parameters to ease interpretation in future HF trials.
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Affiliation(s)
- Camilla Fuchs Andersen
- Department of Cardiology, Herlev-Gentofte Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
| | - Massar Omar
- Department of Cardiology, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Julie Hempel Larsen
- Department of Cardiology, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Caroline Kistorp
- Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark; Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
| | - Christian Tuxen
- Department of Cardiology, Frederiksberg-Bispebjerg Hospital, Copenhagen, Denmark
| | - Finn Gustafsson
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark
| | | | - Jan Christian Brønd
- Department of Sports Science and Clinical Biomechanics, Center for Research in Childhood Health/Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Jacob Eifer Møller
- Department of Cardiology, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark
| | - Morten Schou
- Department of Cardiology, Herlev-Gentofte Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Jesper Jensen
- Department of Cardiology, Herlev-Gentofte Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
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16
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Liang YY, He Y, Huang P, Feng H, Li H, Ai S, Du J, Xue H, Liu Y, Zhang J, Qi L, Zhang J. Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes. JOURNAL OF SPORT AND HEALTH SCIENCE 2024:100973. [PMID: 39214513 DOI: 10.1016/j.jshs.2024.100973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/22/2024] [Accepted: 02/28/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Physical activity (PA) is considered beneficial for lowering cardiovascular risks following type 2 diabetes mellitus (T2DM) and prediabetes, but existing evidence relies mainly on self-reported measurements. We aimed to describe the intensity-specific dose-response associations of PA and sedentary behavior (SB) with macrovascular and microvascular events among individuals with T2DM and prediabetes. METHODS This study included 11,474 individuals with T2DM and prediabetes from the UK Biobank. PA, including total PA, moderate-to-vigorous intensity PA (MVPA), light intensity PA (LPA), and SB, were measured by accelerometers over 7 days. MVPA was categorized according to the American Diabetes Association guideline-recommended level (at least 150 min/week), and total PA, LPA, and SB were grouped by tertiles. The outcomes were incidences of macrovascular events, microvascular events, heart failure (HF), and their combination (composite events). The events were ascertained using the ICD-10 codes on the hospital or death records. RESULTS During a median follow-up of 6.8 years, 1680 cases were documented, including 969 macrovascular events, 839 microvascular events, and 284 incidents of HF. Accelerometer-measured PA, irrespective of intensity, was inversely associated with the risk of composite events and each outcome in the dose-response patterns. Regarding categorized PA, engagement in total PA (high vs. low) was associated with decreased risk of macrovascular events (hazard ratio (HR) = 0.80; 95% confidence interval (95%CI): 0.67-0.95), microvascular events (HR = 0.76; 95%CI: 0.63-0.93), and HF (HR = 0.46; 95%CI: 0.32-0.66). Adherence to MVPA, but not LPA, above the guideline-recommended level (at least 150 min/week) was associated with reduced risk of macrovascular events (HR = 0.80; 95%CI: 0.68-0.95), microvascular events (HR = 0.76; 95%CI: 0.63-0.92), and HF (HR = 0.65; 95%CI: 0.46-0.92). The minimum dose of MVPA for lowering the risk of composite events was approximately 59.0 min/week. More time spent in SB was associated with an increased risk of composite events (high vs. low, HR = 1.17; 95%CI: 1.02-1.35) and HF (high vs. low, HR = 1.54; 95%CI: 1.09-2.20). Replacement of 30 min of SB (HR = 0.73; 95%CI: 0.65-0.81) and LPA (HR = 0.74; 95%CI: 0.66-0.83) with MVPA dramatically reduced the risk of composite events. CONCLUSION Adherence to a higher amount of accelerometer-measured PA, especially MVPA at least 59 min/week, is associated with reduced risks of macrovascular and microvascular events among individuals with T2DM and prediabetes. Replacement of SB and LPA with MVPA helped lower the risk of diabetic vascular events.
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Affiliation(s)
- Yannis Yan Liang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, China; Institute of Psycho-neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Yu He
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Division of Nephrology, Department of Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Piao Huang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Southern Medical University, Guangzhou 510080, China
| | - Hongliang Feng
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, China
| | - Haiteng Li
- Division of Nephrology, Department of Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Sizhi Ai
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, China
| | - Jing Du
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, China
| | - Huachen Xue
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, China
| | - Yaping Liu
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, China
| | - Jun Zhang
- Division of Nephrology, Department of Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Lu Qi
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, China.
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17
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Berglund A, Orädd H. Exploring the Psychological Effects and Physical Exertion of Using Different Movement Interactions in Casual Exergames That Promote Active Microbreaks: Quasi-Experimental Study. JMIR Serious Games 2024; 12:e55905. [PMID: 39186776 PMCID: PMC11384167 DOI: 10.2196/55905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 06/19/2024] [Accepted: 07/15/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Prolonged sedentary behavior, such as sitting or reclining, has consistently been identified as a stand-alone risk factor for heightened cardiometabolic risk and overall mortality. Conversely, interrupting sedentary periods by incorporating short, active microbreaks has been shown to mitigate the negative effects of sedentary behavior. Casual exergames, which mix elements of casual gaming with physical activity, are one prospective intervention to reduce sedentary behavior because they require physical exertion. Casual exergames have shown promise in fostering emotional and physical advantages when played in specific circumstances. However, little research exists on how different types of movement interactions impact the psychological effects as well as the physical exertion of playing casual exergames. OBJECTIVE The primary aim of this work was to explore the psychological effects and physical exertion of playing casual exergames lasting 2 minutes. More precisely, the investigation focused on comparing upper body and full body movement interactions. In addition, the work examined variations in body positions, considering both standing and seated positions during upper body movement interactions. METHODS Two casual exergames were developed and investigated through 2 quasi-experimental studies. In study 1, we investigated how players' perceptions of control, exertion, and immersion were affected by using upper body as opposed to full body exergame controllers when playing casual exergames. In study 2, we investigated differences in positive affect, performance, enjoyment, and exertion when playing casual exergames with upper body movement interactions in seated and standing positions. RESULTS Study 1 showed that perceived control was significantly higher for upper body movement interactions than for full body movement interactions (P=.04), but there were no significant differences regarding perceived exertion (P=.15) or immersion (P=.66). Study 2 showed that positive affect increased significantly for both standing (P=.003) and seated (P=.001) gameplay. The participants in the standing gameplay group showed slightly higher actual exertion; however, there were no differences between the groups in terms of positive affect, perceived exertion, enjoyment, or performance. CONCLUSIONS Casual exergames controlled by upper body movement interactions in seated gameplay can produce similar psychological effects and physical exertion as upper body movement interactions in standing gameplay and full body movement interactions. Therefore, upper body and seated casual exergames should not be overlooked as a suitable microbreak activity.
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Affiliation(s)
- Aseel Berglund
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Helena Orädd
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
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18
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Zaccardi F, Rowlands AV, Dempsey PC, Razieh C, Henson J, Goldney J, Maylor BD, Bhattacharjee A, Chudasama Y, Edwardson C, Laukkanen JA, Ekelund U, Davies MJ, Khunti K, Yates T. Interplay between physical activity volume and intensity with modeled life expectancy in women and men: A prospective cohort analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2024:100970. [PMID: 39181446 DOI: 10.1016/j.jshs.2024.100970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 04/29/2024] [Accepted: 06/07/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND There is a lack of research examining the interplay between objectively measured physical activity volume and intensity with life expectancy. METHODS Individuals from UK Biobank with wrist-worn accelerometer data were included. The average acceleration and intensity gradient were extracted to describe the physical activity volume and intensity profile. Mortality data were obtained from national registries. Adjusted life expectancies were estimated using parametric flexible survival models. RESULTS 40,953 (57.1%) women (median age = 61.9 years) and 30,820 (42.9%) men (63.1 years) were included. Over a median follow-up of 6.9 years, there were 1719 (2.4%) deaths (733 in women; 986 in men). At 60 years, life expectancy was progressively longer for higher physical activity volume and intensity profiles, reaching 95.6 years in women and 94.5 years in men at the 90th centile for both volume and intensity, corresponding to 3.4 (95% confidence interval (95%CI): 2.4-4.4) additional years in women and 4.6 (95%CI: 3.6-5.6) additional years in men compared to those at the 10th centiles. An additional 10-min or 30-min daily brisk walk was associated with 0.9 (95%CI: 0.5-1.3) and 1.4 (95%CI: 0.9-1.9) years longer life expectancy, respectively, in inactive women; and 1.4 (95%CI: 1.0-1.8) and 2.5 (95%CI: 1.9-3.1) years in inactive men. CONCLUSION Higher physical activity volumes were associated with longer life expectancy, with a higher physical activity intensity profile further adding to a longer life. Adding as little as a 10-min brisk walk to daily activity patterns may result in a meaningful benefit to life expectancy.
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Affiliation(s)
- Francesco Zaccardi
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - Paddy C Dempsey
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Cameron Razieh
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Joe Henson
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - Jonathan Goldney
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Benjamin D Maylor
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Atanu Bhattacharjee
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Yogini Chudasama
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Charlotte Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - Jari A Laukkanen
- Department of Medicine, Central Finland Health Care Hospital District, 40620 Jyväskylä, Finland; Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, 70210 Kuopio, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210 Kuopio, Finland
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, 0863 Oslo, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, 0473 Oslo, Norway
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Applied Research Collaborations East Midlands, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK.
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19
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Kroesen SH, van Bakel BMA, de Bruin M, Günal A, Scheepmaker A, Aengevaeren WRM, Willems FF, Wondergem R, Pisters MF, Ortega FB, Hopman MTE, Thijssen DHJ, Bakker EA, Eijsvogels TMH. A cardiac-rehab behaviour intervention to reduce sedentary time in coronary artery disease patients: the SIT LESS randomized controlled trial. Int J Behav Nutr Phys Act 2024; 21:90. [PMID: 39160570 PMCID: PMC11331608 DOI: 10.1186/s12966-024-01642-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 08/12/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND High sedentary times (ST) is highly prevalent in patients with coronary artery disease (CAD), highlighting the need for behavioural change interventions that effectively reduce ST. We examined the immediate and medium-term effect of the SIT LESS intervention on changes in ST among CAD patients enrolled in cardiac rehabilitation (CR). METHODS CAD patients participating in CR at 2 regional hospitals were included in this randomized controlled trial (1:1, stratified for gender and hospital). The control group received CR, whereas SIT LESS participants additionally received a 12-week hybrid behaviour change intervention. The primary outcome was the change in accelerometer-derived ST from pre-CR to post-CR and 3 months post-CR. Secondary outcomes included changes in ST and physical activity characteristics, subjective outcomes, and cardiovascular risk factors. A baseline constrained linear mixed-model was used. RESULTS Participants (23% female; SIT LESS: n = 108, control: n = 104) were 63 ± 10 years. Greater ST reductions were found for SIT LESS compared to control post-CR (-1.7 (95% confidence interval (CI): -2.0; -1.4) versus - 1.1 (95% CI: -1.4; -0.8) h/day, pinteraction=0.009), but not at 3 months post-CR (pinteraction=0.61). Besides, larger light-intensity physical activity (LIPA) increases were found for SIT LESS compared to control post-CR (+ 1.4 (95% CI: +1.2; +1.6) versus + 1.0 (95% CI: +0.8; +1.3) h/day, pinteraction=0.020). Changes in other secondary outcomes did not differ among groups. CONCLUSION SIT LESS transiently reduced ST and increased LIPA, but group differences were no longer significant 3 months post-CR. These findings highlight the challenge to induce sustainable behaviour changes in CAD patients without any continued support. TRIAL REGISTRATION Netherlands Trial Register: NL9263. Registration Date: 24 February 2021.
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Affiliation(s)
- Sophie H Kroesen
- Department of Medical BioSciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
| | - Bram M A van Bakel
- Department of Medical BioSciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
| | - Marijn de Bruin
- Department of IQ healthcare, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, 6525 GA, The Netherlands
| | - Arzu Günal
- Department of Cardiology, Bernhoven Hospital, Nistelrodeseweg 10, Uden, 5406 PT, The Netherlands
| | - Arko Scheepmaker
- Department of Cardiology, Bernhoven Hospital, Nistelrodeseweg 10, Uden, 5406 PT, The Netherlands
| | - Wim R M Aengevaeren
- Department of Cardiology, Rijnstate Hospital, Wagnerlaan 55, Arnhem, 6815 AD, The Netherlands
| | - Frank F Willems
- Department of Cardiology, Rijnstate Hospital, Wagnerlaan 55, Arnhem, 6815 AD, The Netherlands
| | - Roderick Wondergem
- Department of Rehabilitation, Physical Therapy Science and Sport, University Medical Centre Utrecht Brain Centre, Utrecht University, Universiteitsweg 100, Utrecht, 3584 CG, The Netherlands
- Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Rachelsmolen 1, Eindhoven, 5612 MA, The Netherlands
- Centre for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centres, Universiteitsweg 100, Utrecht, 3584 CG, the Netherlands
| | - Martijn F Pisters
- Department of Rehabilitation, Physical Therapy Science and Sport, University Medical Centre Utrecht Brain Centre, Utrecht University, Universiteitsweg 100, Utrecht, 3584 CG, The Netherlands
- Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Rachelsmolen 1, Eindhoven, 5612 MA, The Netherlands
- Centre for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centres, Universiteitsweg 100, Utrecht, 3584 CG, the Netherlands
| | - Francisco B Ortega
- Department of Physical Education and Sports, Sport and Health University Research Institute (iMUDS), University of Granada, Parque Tecnologico de la Salud, Av. del Conocimiento, s/n, Granada, 18007, Spain
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, Madrid, 28029, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Keskussairaalantie 4, Jyväskylä, 40600, Finland
| | - Maria T E Hopman
- Department of Medical BioSciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
| | - Dick H J Thijssen
- Department of Medical BioSciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
- Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK
| | - Esmée A Bakker
- Department of Medical BioSciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
- Department of Physical Education and Sports, Sport and Health University Research Institute (iMUDS), University of Granada, Parque Tecnologico de la Salud, Av. del Conocimiento, s/n, Granada, 18007, Spain
- Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, 6525 GA, The Netherlands
| | - Thijs M H Eijsvogels
- Department of Medical BioSciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands.
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20
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Lucena Alves CPD, Leão OADA, Delpino FM, Mielke GI, Ekelund U, Costa EC, Crochemore-Silva I. Independent, Stratified, and Joint Associations of Sedentary Time and Physical Activity With Cardiovascular Disease: A Systematic Review. J Phys Act Health 2024:1-10. [PMID: 39151901 DOI: 10.1123/jpah.2024-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/21/2024] [Accepted: 06/20/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Recent statistics highlight cardiovascular diseases (CVD) as a major global cause of death. This review examines the methodological approaches and the main results of independent, stratified, and joint association of sedentary time (ST) and physical activity (PA) on CVD outcomes. METHODS We searched PubMed, Embase, Web of Science, and Scopus for prospective cohorts that examined the independent, stratified, or joint associations of ST and PA with CVD outcomes. Independent associations were defined as analyses mutually adjusted for PA and ST. Stratified associations were considered when there was a reference group in each stratum of PA or ST, and joint associations were defined by a single reference group for all other combined categories of ST and PA levels. RESULTS Of 45 articles, 69% explored independent association of ST or PA on CVD outcomes, while 31% using a stratified/joint approach. Most studies used self-reports for ST and PA and focused on CVD mortality. Mutually adjusted analyses identified ST positively and PA inversely associated to CVD outcomes. Stratified studies showed higher ST's pronounced impact on CVD for lower PA levels. High PA mitigated but did not eliminate ST's negative impact. Joint analyses revealed highest CVD risk in those with both high ST and low PA, and elevated risk in various intermediate combinations. CONCLUSIONS Employing independent, stratified, and joint association approaches can yield distinct and complementary public health messages aimed at promoting cardiovascular health. Recommendations should aim to not only to encourage boosting PA levels, but also, concurrently decrease ST.
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Affiliation(s)
| | - Otávio Amaral de Andrade Leão
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Felipe Mendes Delpino
- Postgraduate Program in Nursing, Federal University of Pelotas, Rio Grande do Sul, RS, Brazil
| | - Gregore Iven Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Eduardo Caldas Costa
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Inácio Crochemore-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
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21
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Oliveira GMMD, Almeida MCCD, Arcelus CMA, Neto Espíndola L, Rivera MAM, Silva-Filho ALD, Marques-Santos C, Fernandes CE, Albuquerque CJDM, Freire CMV, Izar MCDO, Costa MENC, Castro MLD, Lemke VDMG, Lucena AJGD, Brandão AA, Macedo AVS, Polanczyk CA, Lantieri CJB, Nahas EP, Alexandre ERG, Campana EMG, Bragança ÉOV, Colombo FMC, Barbosa ICDQ, Rivera IR, Kulak J, Moura LAZ, Pompei LDM, Baccaro LFC, Barbosa MM, Rodrigues MAH, Albernaz MA, Decoud MSPD, Paiva MSMDO, Sanchez-Zambrano MB, Campos MDSB, Acevedo M, Ramirez MS, Souza OFD, Medeiros OOD, Carvalho RCMD, Machado RB, Silva SCTFD, Rodrigues TDCV, Avila WS, Costa-Paiva LHSD, Wender MCO. Brazilian Guideline on Menopausal Cardiovascular Health - 2024. Arq Bras Cardiol 2024; 121:e20240478. [PMID: 39166619 PMCID: PMC11341215 DOI: 10.36660/abc.20240478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024] Open
Affiliation(s)
| | | | | | - Larissa Neto Espíndola
- Hospital Santa Izabel, Salvador, BA - Brasil
- Hospital Municipal de Salvador, Salvador, BA - Brasil
| | | | | | - Celi Marques-Santos
- Universidade Tiradentes (UNIT), Aracaju, SE - Brasil
- Hospital São Lucas Rede D'Or São Luis, Aracaju, SE - Brasil
| | | | - Carlos Japhet da Matta Albuquerque
- Hospital Santa Joana Recife, Recife PE - Brasil
- EMCOR - Diagnósticos do Coração LTDA, Recife PE - Brasil
- Hospital Barão de Lucena, Recife PE - Brasil
| | | | | | | | | | | | | | | | | | - Carisi Anne Polanczyk
- Hospital de Clínicas da Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre RS - Brasil
| | | | | | | | | | | | | | | | | | - Jaime Kulak
- Maceió AL - BrasilUniversidade Federal do Paraná (UFPR), Curitiba, PR - Brasil
| | | | | | | | | | | | | | | | | | | | | | - Monica Acevedo
- Pontificia Universidad Católica de Chile, Santiago - Chile
| | - Monica Susana Ramirez
- Hospital Privado Rosario, Rosario - Argentina
- Instituto Universitario Rosario (IUNIR), Santa Fe - Argentina
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22
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Liu L, Wang H, Xing Y, Zhang Z, Zhang Q, Dong M, Ma Z, Cai L, Wang X, Tang Y. Dose-response relationship between computerized cognitive training and cognitive improvement. NPJ Digit Med 2024; 7:214. [PMID: 39147783 PMCID: PMC11327304 DOI: 10.1038/s41746-024-01210-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 08/01/2024] [Indexed: 08/17/2024] Open
Abstract
Although computerized cognitive training (CCT) is an effective digital intervention for cognitive impairment, its dose-response relationship is understudied. This retrospective cohort study explores the association between training dose and cognitive improvement to find the optimal CCT dose. From 2017 to 2022, 8,709 participants with subjective cognitive decline, mild cognitive impairment, and mild dementia were analyzed. CCT exposure varied in daily dose and frequency, with cognitive improvement measured weekly using Cognitive Index. A mixed-effects model revealed significant Cognitive Index increases across most dose groups before reaching the optimal dose. For participants under 60 years, the optimal dose was 25 to <30 min per day for 6 days a week. For those 60 years or older, it was 50 to <55 min per day for 6 days a week. These findings highlight a dose-dependent effect in CCT, suggesting age-specific optimal dosing for cognitive improvement.
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Affiliation(s)
- Liyang Liu
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
- Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Haibo Wang
- Clinical Research Institute, Institute of Advanced Clinical Medicine, Peking University, 100191, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, 38 Xueyuan St, Haidian district, 100191, Beijing, China
| | - Yi Xing
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
- Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Ziheng Zhang
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Qingge Zhang
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Ming Dong
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Zhujiang Ma
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Longjun Cai
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Xiaoyi Wang
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Yi Tang
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China.
- Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China.
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23
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Giacona JM. Exploring Dynamics of Blood Pressure Variability: Sitting Still, Rising Pressure? Am J Hypertens 2024; 37:659-660. [PMID: 38776104 DOI: 10.1093/ajh/hpae070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 05/17/2024] [Indexed: 08/15/2024] Open
Affiliation(s)
- John M Giacona
- Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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24
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Altulea A, Rutten MGS, Verdijk LB, Demaria M. Sport and longevity: an observational study of international athletes. GeroScience 2024:10.1007/s11357-024-01307-9. [PMID: 39129051 DOI: 10.1007/s11357-024-01307-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 07/29/2024] [Indexed: 08/13/2024] Open
Abstract
The human lifespan is influenced by various factors, with physical activity being a significant contributor. Despite the clear benefit of exercise on health and longevity, the association between different types of sports and lifespan is yet to be considered. Accordingly, we aimed to study this association in a large international cohort of former athletes using a robust linear regression model. We collected data on athletes from public sources, accumulating a total of 95,210 observations, 95.5% of which were accounted for by males. The dataset represented athletes born between 1862 and 2002 from 183 countries across 44 sports disciplines. We calculated the change in lifespan by measuring the difference in age between athletes and the corresponding reference populations, while accounting for variations caused by sex, year of death, and country. The results revealed that various sports impacted lifespan differently, with male athletes being more likely to experience benefits from sports than female athletes. Among male athletes, pole vaulting and gymnastics were linked to the highest extension in lifespan (8.4 years, 95% CI [6.8, 9.9] and 8.2 years, 95% CI [7.4, 9], respectively), while volleyball and sumo wrestling were the most negatively associated with lifespan (- 5.4 years, 95% CI [- 7, - 3.8]; - 9.8 years, 95% CI [- 11, - 8.6], respectively). The association between lifespan and popular team sports in males was positive for cricket, rowing, baseball, water polo, Australian rules, hurling, lacrosse, field hockey, minimal for rugby, canoeing and kayaking, basketball, gridiron football, and football (soccer), and negative for handball and volleyball. Racquet sports (i.e., tennis and badminton) exhibited a consistent and positive association in both male and female athletes, as shown by an extended lifespan of up to 5.7 years in males (95% CI [5, 6.5]) and 2.8 years in females (95% CI [1.8, 3.9]). Although lacking conclusive evidence, we theorize that the observed results may be attributed to the aerobic and anaerobic characteristics of each sport, with mixed sports yielding the maximum benefits for the lifespan. While results from female athletes should be cautiously interpreted, our study highlights the complex interplay between sports and lifespan and contributes to the growing body of knowledge on the multifaceted relationship between physical activity and human longevity.
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Affiliation(s)
- Abdullah Altulea
- European Research Institute for the Biology of Ageing (ERIBA), University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
| | - Martijn G S Rutten
- European Research Institute for the Biology of Ageing (ERIBA), University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
| | - Lex B Verdijk
- Department of Human Biology, NUTRIM Institute for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Marco Demaria
- European Research Institute for the Biology of Ageing (ERIBA), University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands.
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25
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Berglund A, Jaarsma T, Orädd H, Fallström J, Strömberg A, Klompstra L, Berglund E. The Application of a Serious Game Framework to Design and Develop an Exergame for Patients With Heart Failure. JMIR Form Res 2024; 8:e50063. [PMID: 39110976 PMCID: PMC11339584 DOI: 10.2196/50063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 12/29/2023] [Accepted: 06/26/2024] [Indexed: 08/25/2024] Open
Abstract
Reducing inactivity in patients with chronic disease is vital since it can decrease the risk of disease progression and mortality. Exergames are an innovative approach to becoming more physically active and positively affecting physical health outcomes. Serious games are designed for purposes beyond entertainment and exergames are serious games for physical activity. However, current commercial exergames might not optimally meet the needs of patients with special needs. Developing tailored exergames is challenging and requires an appropriate process. The primary goal of this viewpoint is to describe significant lessons learned from designing and developing an exergame for patients with chronic heart failure using the player-centered, iterative, interdisciplinary, and integrated (P-III) framework for serious games. Four of the framework's pillars were used in the design and development of a mobile exergame: player-centered design, iterative development of the game, interdisciplinary teamwork, and integration of play and serious content. The mobile exergame was developed iteratively in 7 iterations by an interdisciplinary team involving users and stakeholders in all iterations. Stakeholders played various roles during the development process, making the team stay focused on the needs of the patients and creating an exergame that catered to these needs. Evaluations were conducted during each iteration by both the team and users or patients according to the player-centered design pillar. Since the exergame was created for a smartphone, the assessments were conducted both on the development computer and on the intended platforms. This required continuous deployment of the exergame to the platforms and smartphones that support augmented reality. Our findings show that the serious game P-III framework needs to be modified in order to be used for the design and development of exergames. In this viewpoint, we propose an updated version of the P-III framework for exergame development including (1) a separate and thorough design of the physical activity and physical interaction, and (2) early and continuous deployment of the exergame on the intended platform to enable evaluations and everyday life testing.
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Affiliation(s)
- Aseel Berglund
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Helena Orädd
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Johan Fallström
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Anna Strömberg
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
| | - Leonie Klompstra
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Erik Berglund
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
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26
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Roseen EJ, McNaughton DT, Harrison S, Downie AS, Øverås CK, Nim CG, Jenkins HJ, Young JJ, Hartvigsen J, Stone KL, Ensrud KE, Lee S, Cawthon PM, Fink HA. Association of back pain with all-cause and cause-specific mortality among older men: a cohort study. PAIN MEDICINE (MALDEN, MASS.) 2024; 25:505-513. [PMID: 38741219 PMCID: PMC11292054 DOI: 10.1093/pm/pnae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/27/2024] [Accepted: 04/18/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE We evaluated whether more severe back pain phenotypes-persistent, frequent, or disabling back pain-are associated with higher mortality rate among older men. METHODS In this secondary analysis of a prospective cohort, the Osteoporotic Fractures in Men (MrOS) study, we evaluated mortality rates by back pain phenotype among 5215 older community-dwelling men (mean age, 73 years, SD = 5.6) from 6 sites in the United States. The primary back pain measure used baseline and Year 5 back pain questionnaire data to characterize participants as having no back pain, nonpersistent back pain, infrequent persistent back pain, or frequent persistent back pain. Secondary measures of back pain from the Year 5 questionnaire included disabling back pain phenotypes. The main outcomes measured were all-cause and cause-specific death. RESULTS After the Year 5 exam, during up to 18 years of follow-up (mean follow-up = 10.3 years), there were 3513 deaths (1218 cardiovascular, 764 cancer, 1531 other). A higher proportion of men with frequent persistent back pain versus no back pain died (78% versus 69%; sociodemographic-adjusted HR = 1.27, 95% CI = 1.11-1.45). No association was evident after further adjustment for health-related factors, such as self-reported general health and comorbid chronic health conditions (fully adjusted HR = 1.00; 95% CI = 0.86-1.15). Results were similar for cardiovascular deaths and other deaths, but we observed no association of back pain with cancer deaths. Secondary back pain measures, including back-related disability, were associated with increased mortality risk that remained statistically significant in fully adjusted models. CONCLUSION Although frequent persistent back pain was not independently associated with risk of death in older men, additional secondary disabling back pain phenotypes were independently associated with increased mortality rate. Future investigations should evaluate whether improvements in disabling back pain affect general health and well-being or risk of death.
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Affiliation(s)
- Eric J Roseen
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedision School of Medicine and Boston Medical Center, Boston, MA 02131, United States
- Department of Physical Medicine & Rehabilitation and Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA 02130, United States
| | - David T McNaughton
- School of Psychological Sciences, Macquarie University, Sydney, 2109, Australia
| | - Stephanie Harrison
- Research Institute, California Pacific Medical Center, San Francisco, CA 94107, United States
| | - Aron S Downie
- Department of Chiropractic, Macquarie University, Sydney, 2109, Australia
| | - Cecilie K Øverås
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, 7034, Norway
| | - Casper G Nim
- Spine Centre of Southern Denmark, University Hospital of Southern Denmark, Middelfart, 5000, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, 5000, Denmark
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, 5000, Denmark
| | - Hazel J Jenkins
- Department of Chiropractic, Macquarie University, Sydney, 2109, Australia
| | - James J Young
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, 5000, Denmark
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, M5T 0S8, Canada
| | - Jan Hartvigsen
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, M5T 0S8, Canada
- The Chiropractic Knowledge Hub, University of Southern Denmark, Odense, 5000, Denmark
| | - Katie L Stone
- Research Institute, California Pacific Medical Center, San Francisco, CA 94107, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94158, United States
| | - Kristine E Ensrud
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55415, United States
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN 55417, United States
| | - Soomi Lee
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, United States
| | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, CA 94107, United States
| | - Howard A Fink
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55415, United States
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN 55417, United States
- Geriatric Research Education and Clinical Center, Veterans Affairs Health Care System, Minneapolis, MN 55417, United States
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27
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Schumacher BT, LaMonte MJ, Di C, Parada H, Hooker SP, Bellettiere J, Simonsick EM, Liles S, LaCroix AZ. Associations of Relative Intensity of Physical Activity With Incident Cardiovascular Events and All-Cause Mortality. J Gerontol A Biol Sci Med Sci 2024; 79:glae113. [PMID: 38699999 PMCID: PMC11212487 DOI: 10.1093/gerona/glae113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The relative intensity of physical activity (PA) can be estimated as the percent of one's maximal effort required. METHODS We compared associations of relative and absolute intensity PA with incident major cardiovascular disease (CVD) and all-cause mortality in 5 633 women from the Objective Physical Activity and Cardiovascular Health Study (mean age 78.5 ± 6.7). Absolute intensity was measured by accelerometry. Relative intensity was estimated by dividing accelerometer-estimated metabolic equivalents (METs) by maximal MET capacity. Both were aggregated into mean daily hours of light intensity PA (LPA) and moderate-to-vigorous PA (MVPA). Cox proportional hazard models estimated hazard ratios (HRs) for 1-hour higher amounts of PA on outcomes. RESULTS During follow-up (median = 7.4 years), there were 748 incident CVD events and 1 312 deaths. Greater LPA and MVPA, on either scale, were associated with reduced risk of both outcomes. HRs for a 1-hour increment of absolute LPA were 0.88 (95% CI: 0.83-0.93) and 0.88 (95% CI: 0.84-0.92) for incident CVD and mortality, respectively. HRs for a 1-hour increment of absolute MPVA were 0.73 (95% CI: 0.61-0.87) and 0.55 (95% CI: 0.48-0.64) for the same outcomes. HRs for a 1-hour increment of relative LPA were 0.70 (95% CI: 0.59-0.84) and 0.78 (95% CI: 0.68-0.89) for incident CVD and mortality, respectively. HRs for a 1-hour increment of relative MPVA were 0.89 (95% CI: 0.83-0.96) and 0.82 (95% CI: 0.77-0.87) for the same outcomes. On the relative scale, LPA was more strongly, and inversely associated with both outcomes than relative MVPA. Absolute MVPA was more strongly inversely associated with the outcomes than relative MVPA. CONCLUSIONS Findings support the continued shift in the PA intensity paradigm toward recommendation of more movement, regardless of intensity. Relative LPA--a modifiable, more easily achieved behavioral target, particularly among ambulatory older adults--was associated with reduced risk of incident major CVD and death.
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Affiliation(s)
- Benjamin T Schumacher
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo–SUNY, Buffalo, New York, USA
| | - Chongzhi Di
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA
- UCSD Moores Cancer Center, La Jolla, California, USA
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, California, USA
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Eleanor M Simonsick
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Sandy Liles
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
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28
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Tarp J, Dalene KE, Fagerland MW, Steene-Johannesen J, Hansen BH, Anderssen SA, Hagströmer M, Dohrn IM, Dempsey PC, Wijndaele K, Brage S, Nordström A, Nordström P, Diaz KM, Howard VJ, Hooker SP, Morseth B, Hopstock LA, Sagelv EH, Yates T, Edwardson CL, Lee IM, Ekelund U. Physical Activity Volume, Intensity, and Mortality: Harmonized Meta-Analysis of Prospective Cohort Studies. Am J Prev Med 2024:S0749-3797(24)00262-9. [PMID: 39089430 DOI: 10.1016/j.amepre.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION It is unclear whether moderate-to-vigorous physical activity (MVPA) is associated with a lower mortality risk, over and above its contribution to total physical activity volume. METHODS 46,682 adults (mean age: 64 years) were included in a meta-analysis of nine prospective cohort studies. Each cohort generated tertiles of accelerometry-measured physical activity volume and volume-adjusted MVPA. Hazard ratios (HR, with 95% confidence intervals) for mortality were estimated separately and in joint models combining volume and MVPA. Data was collected between 2001 and 2019 and analyzed in 2023. RESULTS During a mean follow-up of 9 years, 4,666 deaths were recorded. Higher physical activity volume, and a greater contribution from volume-adjusted MVPA, were each associated with lower mortality hazard in multivariable-adjusted models. Compared to the least active tertile, higher physical activity volume was associated with a lower mortality (HRs: 0.62; 0.58, 0.67 and 0.50; 0.42, 0.60 for ascending tertiles). Similarly, a greater contribution from MVPA was associated with a lower mortality (HRs: 0.94; 0.85, 1.04 and 0.88; 0.79, 0.98). In joint analysis, a lower mortality from higher volume-adjusted MVPA was only observed for the middle tertile of physical activity volume. CONCLUSIONS The total volume of physical activity was associated with a lower risk of mortality to a greater extent than the contribution of MVPA to physical activity volume. Integrating any intensity of physical activity into daily life may lower mortality risk in middle-aged and older adults, with a small added benefit if the same amount of activity is performed with a higher intensity.
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Affiliation(s)
- Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.
| | - Knut E Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Morten W Fagerland
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | | | - Bjørge H Hansen
- Department of Sports Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Sigmund A Anderssen
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
| | - Ing-Mari Dohrn
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia; MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Katrien Wijndaele
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Søren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Anna Nordström
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Medical Sciences, Rehabilitation Medicine, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Peter Nordström
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
| | - Keith M Diaz
- Department of Medicine, Columbia University Medical Center, New York, New York
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, California
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Edvard H Sagelv
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Thomas Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Charlotte L Edwardson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - I-Min Lee
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
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29
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Liu L, Wen W, Andersen SW, Shrubsole MJ, Steinwandel MD, Lipworth LE, Sudenga SL, Zheng W. Sitting Time, Physical Activity and Mortality: A Cohort Study In Low-Income Older Americans. Am J Prev Med 2024:S0749-3797(24)00260-5. [PMID: 39089431 DOI: 10.1016/j.amepre.2024.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/24/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Physical inactivity and sedentary behavior are recognized as independent risk factors for many diseases. However, studies investigating their associations with total and cause-specific mortality in low-income and Black populations are limited, particularly among older adults. METHODS A prospective cohort study was conducted among 8,337 predominantly low-income and Black Americans aged ≥65 years residing in the southern United States. Participants reported their daily sitting time and leisure-time physical activity (LTPA) at baseline (2002-2009), and mortality data were collected through 2019. Analysis was conducted from September 2022 to October 2023. RESULTS During a median follow-up of 12.25 years, nearly 50% (n=4,111) were deceased. A prolonged sitting time (>10 hours/day versus <4 hours/day) was associated with elevated all-cause mortality (hazard ratios [HR], 1.15; 95% confidence intervals [CI], 1.04-1.27) after adjusting for LTPA and other potential confounders. LTPA was associated with a reduced risk of all-cause mortality, with an adjusted HR of 0.75 (95% CI 0.64, 0.88) associated with 150-300 minutes per week of moderate-intensity physical activity. Individuals who were physically inactive and had a sitting time of >10 hours/day had the highest mortality risk (HR, 1.48; 95% CI, 1.23-1.78), compared with those who were physically active and had low sitting time. These associations were more pronounced for mortality due to cardiovascular diseases. CONCLUSIONS High sitting time is an independent risk factor for all-cause and cardiovascular disease mortality, and LTPA could partially attenuate the adverse association of prolonged sitting time with mortality.
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Affiliation(s)
- Lili Liu
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Wanqing Wen
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Shaneda W Andersen
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Martha J Shrubsole
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mark D Steinwandel
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Loren E Lipworth
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Staci L Sudenga
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Wei Zheng
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
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Hendrickx W, Wondergem R, Veenhof C, English C, Visser-Meily JMA, Pisters MF. Improving Movement Behavior in People after Stroke with the RISE Intervention: A Randomized Multiple Baseline Study. J Clin Med 2024; 13:4341. [PMID: 39124608 PMCID: PMC11313465 DOI: 10.3390/jcm13154341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Objective: High amounts of sedentary behavior increase the risk of cardiovascular disease. This study aimed to determine the preliminary effectiveness and feasibility of the RISE intervention to support community-dwelling people with stroke, who are highly sedentary, to reduce and interrupt sedentary time. Additionally, the added value of including participatory support was determined. Methods: A randomized, multiple-baseline study was conducted including 14 participants. All received the RISE intervention, a 15-week blended behavioral intervention in which a primary care physiotherapist provided personalized coaching in the home setting by using behavior-change techniques and the RISE eCoaching system, including an activity monitor and app to provide real time feedback. Half of the participants (randomly allocated) received participatory support from someone from their social network (e.g., partner or close friend) who joined them in the intervention. Preliminary effectiveness was determined with significant changes in total sedentary time and fragmentation (interruption) of sedentary time using a randomization test. Feasibility was assessed by adherence with the intervention protocol, safety, and satisfaction with the intervention. Results: Participants significantly reduced total sedentary time (p = 0.01) by 1.3 h on average and increased their fragmentation (p < 0.01). Subgroup analyses showed significant improvements in both outcomes only in the group with participatory support. Thirteen (92.9%) participants completed the intervention, no related adverse events occurred, and the reported participant satisfaction was sufficient. Conclusions: The RISE intervention appears promising to support people with stroke who are highly sedentary to reduce and interrupt their sedentary time. Participatory support appears to contribute to greater results. Trial registration: ISRCTN international trial registry, 10694741.
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Affiliation(s)
- Wendy Hendrickx
- Research Group Empowering Healthy Behavior, Department of Health Innovations and Technology, Fontys University of Applied Sciences, 5600 AH Eindhoven, The Netherlands;
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht University, 3584 CX Utrecht, The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, 3454 PV De Meern, The Netherlands
| | - Roderick Wondergem
- School of Sport Studies, Fontys University of Applied Sciences, 5644 HZ Eindhoven, The Netherlands
| | - Cindy Veenhof
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht University, 3584 CX Utrecht, The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, 3454 PV De Meern, The Netherlands
- Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, 3584 CS Utrecht, The Netherlands
| | - Coralie English
- School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
- Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
- Centre of Research Excellence to Accelerate Stroke Trial Innovation and Translation, University of Sydney, Sydney, NSW 2010, Australia
| | - Johanna M. A. Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center and De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands
| | - Martijn F. Pisters
- Research Group Empowering Healthy Behavior, Department of Health Innovations and Technology, Fontys University of Applied Sciences, 5600 AH Eindhoven, The Netherlands;
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht University, 3584 CX Utrecht, The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, 3454 PV De Meern, The Netherlands
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Capdevila L, Losilla JM, Alfonso C, Estrella T, Lalanza JF. Physical activity and planetary health: A scoping review. J Sci Med Sport 2024:S1440-2440(24)00253-6. [PMID: 39164187 DOI: 10.1016/j.jsams.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/06/2024] [Accepted: 07/22/2024] [Indexed: 08/22/2024]
Abstract
OBJECTIVES The behaviors and attitudes associated with event attendance and engagement in physical and sporting activities exert a significant impact on planetary health. This scoping review aims to scrutinize existing literature, elucidate concepts, investigate methodologies, and identify knowledge gaps pertaining to physical activity behavior within the context of planetary health. DESIGN & METHODS A systematic search across PsycINFO (Psychological Information), Web of Science, and Scopus, guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines for Scoping Reviews (PRISMA-ScR) guidelines, yielded 62 relevant studies. These studies substantiate the designation of this research domain as "Planetary Health Physical Activity" and/or "Planetary Health Sport". RESULTS Results delineate four primary investigation areas: i) individuals' attitudes toward the environment and nature, ii) promotion of active lifestyles, including active commuting, iii) event organization, and iv) direct consequences of physical activity and sports on the natural world. Findings indicate that adopting an active lifestyle contributes to reducing air pollution, but engaging in physical activity and sports in natural settings may have adverse effects on ecosystems. CONCLUSIONS Results underscore the urgency for more experimental designs to establish causal relationships between physical activity and its ecological consequences on planetary health. This research contributes valuable insights to the emerging field of "Planetary Health Physical Activity", shedding light on the intricate interplay between human activities and the health of the planet.
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Affiliation(s)
- Lluis Capdevila
- Sport Research Institute, Universitat Autònoma de Barcelona, Spain; Laboratory of Sport Psychology, Department of Basic Psychology, Universitat Autònoma de Barcelona, Spain.
| | - Josep-Maria Losilla
- Sport Research Institute, Universitat Autònoma de Barcelona, Spain; Department of Psychobiology and Methodology in Health Science, Universitat Autònoma de Barcelona, Spain
| | - Carla Alfonso
- Sport Research Institute, Universitat Autònoma de Barcelona, Spain; Laboratory of Sport Psychology, Department of Basic Psychology, Universitat Autònoma de Barcelona, Spain
| | - Tony Estrella
- Sport Research Institute, Universitat Autònoma de Barcelona, Spain; Laboratory of Sport Psychology, Department of Basic Psychology, Universitat Autònoma de Barcelona, Spain
| | - Jaume F Lalanza
- Laboratory of Sport Psychology, Department of Basic Psychology, Universitat Autònoma de Barcelona, Spain
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Spartano NL, Zhang Y, Liu C, Chernofsky A, Lin H, Trinquart L, Borrelli B, Pathiravasan CH, Kheterpal V, Nowak C, Vasan RS, Benjamin EJ, McManus DD, Murabito JM. Agreement Between Apple Watch and Actical Step Counts in a Community Setting: Cross-Sectional Investigation From the Framingham Heart Study. JMIR BIOMEDICAL ENGINEERING 2024; 9:e54631. [PMID: 39047284 PMCID: PMC11306942 DOI: 10.2196/54631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Step counting is comparable among many research-grade and consumer-grade accelerometers in laboratory settings. OBJECTIVE The purpose of this study was to compare the agreement between Actical and Apple Watch step-counting in a community setting. METHODS Among Third Generation Framingham Heart Study participants (N=3486), we examined the agreement of step-counting between those who wore a consumer-grade accelerometer (Apple Watch Series 0) and a research-grade accelerometer (Actical) on the same days. Secondarily, we examined the agreement during each hour when both devices were worn to account for differences in wear time between devices. RESULTS We studied 523 participants (n=3223 person-days, mean age 51.7, SD 8.9 years; women: n=298, 57.0%). Between devices, we observed modest correlation (intraclass correlation [ICC] 0.56, 95% CI 0.54-0.59), poor continuous agreement (29.7%, n=957 of days having steps counts with ≤15% difference), a mean difference of 499 steps per day higher count by Actical, and wide limits of agreement, roughly ±9000 steps per day. However, devices showed stronger agreement in identifying who meets various steps per day thresholds (eg, at 8000 steps per day, kappa coefficient=0.49), for which devices were concordant for 74.8% (n=391) of participants. In secondary analyses, in the hours during which both devices were worn (n=456 participants, n=18,760 person-hours), the correlation was much stronger (ICC 0.86, 95% CI 0.85-0.86), but continuous agreement remained poor (27.3%, n=5115 of hours having step counts with ≤15% difference) between devices and was slightly worse for those with mobility limitations or obesity. CONCLUSIONS Our investigation suggests poor overall agreement between steps counted by the Actical device and those counted by the Apple Watch device, with stronger agreement in discriminating who meets certain step thresholds. The impact of these challenges may be minimized if accelerometers are used by individuals to determine whether they are meeting physical activity guidelines or tracking step counts. It is also possible that some of the limitations of these older accelerometers may be improved in newer devices.
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Affiliation(s)
- Nicole L Spartano
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
| | - Yuankai Zhang
- Boston University School of Public Health, Boston, MA, United States
| | - Chunyu Liu
- Boston University School of Public Health, Boston, MA, United States
| | - Ariel Chernofsky
- Boston University School of Public Health, Boston, MA, United States
| | - Honghuang Lin
- University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Ludovic Trinquart
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, United States
- Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, United States
| | - Belinda Borrelli
- Boston University Henry M. Goldman School of Dental Medicine, Center for Behavioral Science Research, Boston, MA, United States
| | | | | | | | - Ramachandran S Vasan
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
- University of Texas School of Public Health and University of Texas Health Sciences Center, San Antonio, TX, United States
| | - Emelia J Benjamin
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of Cardiology, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - David D McManus
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Joanne M Murabito
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, United States
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Ma W, Liang X, Wang H, Wen Z, Liu L, Fan L, Zhang X. Association between fear of falling and mortality in middle-aged and older adults: A systematic review and meta-analysis. Geriatr Nurs 2024; 59:113-120. [PMID: 38996768 DOI: 10.1016/j.gerinurse.2024.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/17/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Fear of falling (FOF) has emerged as a significant public health issue, contributing to excess disability among middle-aged and older adults. The association between FOF and mortality remains unclear. METHODS Prominent electronic databases (PubMed, Web of Science, the Cochrane Library, Embase, CINHAL, PsycINFO, Scopus, China National Knowledge Infrastructure, China Biology Medicine disc, and Wanfang Database) were searched from inception until October 21, 2023 (data updated on June 9, 2024), for cohort or longitudinal studies investigating the association between FOF and mortality. The heterogeneity between studies was quantitatively assessed using I2. A fixed-effect model calculated the pooled effect size. RESULTS A total of seven cohort studies, including 27,714 participants, were analyzed in this systematic review and meta-analysis. The meta-analysis results demonstrated a positive association between FOF and mortality, with a significant increase in the risk of mortality for those with FOF (hazard ratio [HR]:1.29, 95 % confidence interval [CI]: 1.19-1.41, p < 0.05). Subgroup analysis indicated that age, male sex, clinical diagnosis of depression, number of chronic diseases, activity restriction due to FOF, and FOF levels were associated with mortality. CONCLUSIONS FOF and mortality have a positive association, which needs to be confirmed by further prospective studies with large samples and long-term follow-up to provide evidence for clinicians to intervene in FOF to reduce mortality in middle-aged and older adults.
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Affiliation(s)
- Wenlian Ma
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoli Liang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Hongyan Wang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Zhifei Wen
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Linfeng Liu
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Liangliang Fan
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiangeng Zhang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China.
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Zhu S, Sinha D, Kirk M, Michalopoulou M, Hajizadeh A, Wren G, Doody P, Mackillop L, Smith R, Jebb SA, Astbury NM. Effectiveness of behavioural interventions with motivational interviewing on physical activity outcomes in adults: systematic review and meta-analysis. BMJ 2024; 386:e078713. [PMID: 38986547 PMCID: PMC11234249 DOI: 10.1136/bmj-2023-078713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE To evaluate the effectiveness of behavioural interventions that include motivational interviewing on physical activity outcomes in adults. DESIGN Systematic review and meta-analysis. STUDY SELECTION A search of seven databases for randomised controlled trials published from inception to 1 March 2023 comparing a behavioural intervention including motivational interviewing with a comparator without motivational interviewing on physical activity outcomes in adults. Outcomes of interest were differences in change in quantitative measures of total physical activity, moderate to vigorous physical activity (MVPA), and sedentary time. DATA EXTRACTION AND SYNTHESIS Two reviewers extracted data and assessed risk of bias. Population characteristics, intervention components, comparison groups, and outcomes of studies were summarised. For overall main effects, random effects meta-analyses were used to report standardised mean differences (SMDs) and 95% confidence intervals (CIs). Differential effects based on duration of follow-up, comparator type, intervention duration, and disease or health condition of participants were also examined. RESULTS 129 papers reporting 97 randomised controlled trials totalling 27 811 participants and 105 comparisons were included. Interventions including motivational interviewing were superior to comparators for increases in total physical activity (SMD 0.45, 95% CI 0.33 to 0.65, equivalent to 1323 extra steps/day; low certainty evidence) and MVPA (0.45, 0.19 to 0.71, equivalent to 95 extra min/week; very low certainty evidence) and for reductions in sedentary time (-0.58, -1.03 to -0.14, equivalent to -51 min/day; very low certainty evidence). Evidence for a difference in any outcome compared with comparators of similar intensity was lacking. The magnitude of effect diminished over time, and evidence of an effect of motivational interviewing beyond one year was lacking. Most interventions involved patients with a specific health condition, and evidence of an effect of motivational interviewing to increase MVPA or decrease sedentary time was lacking in general population samples. CONCLUSIONS Certainty of the evidence using motivational interviewing as part of complex behavioural interventions for promoting total physical activity in adults was low, and for MVPA and sedentary time was very low. The totality of evidence suggests that although interventions with motivational interviewing increase physical activity and decrease sedentary behaviour, no difference was found in studies where the effect of motivational interviewing could be isolated. Effectiveness waned over time, with no evidence of a benefit of motivational interviewing to increase physical activity beyond one year. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020219881.
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Affiliation(s)
- SuFen Zhu
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Deepra Sinha
- St Hugh's College, University of Oxford, Oxford, UK
| | - Megan Kirk
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Moscho Michalopoulou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Anisa Hajizadeh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Gina Wren
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Paul Doody
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lucy Mackillop
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Ralph Smith
- Sport and Exercise Medicine Department, Nuffield Orthopaedic Centre Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Nerys M Astbury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Ejiri M, Kawai H, Imamura K, Fujiwara Y, Ihara K, Hirano H, Obuchi S. Regular exercise reduces the risk of all-cause mortality in socially isolated older adults: the Otassha Study. Front Public Health 2024; 12:1344952. [PMID: 39026593 PMCID: PMC11254655 DOI: 10.3389/fpubh.2024.1344952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 06/25/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Social isolation is associated with increased mortality risk. On the other hand, some older adults prefer to be alone. Additionally, predictors of isolation are mostly unchanged across interventions. Therefore, knowledge of how to prevent negative health outcomes in isolation would be beneficial. One of the factors that reduces the risk of mortality is regular exercise. However, to date, no studies to our knowledge have examined whether regular exercise reduces mortality among socially isolated individuals. This study aimed to determine the effects of the combination of social isolation and regular exercise on mortality among community-dwelling older adults. Methods This prospective cohort study was part of the larger Otassha Study of community-dwelling older adults living in Itabashi Ward, Tokyo, Japan. In October 2012, 835 individuals (males = 350, females = 485; mean age 73.1 years) completed a comprehensive baseline health survey. Individuals were considered socially isolated if their frequency of interactions with others averaged less than once per week. Regular exercise was defined as exercise performed at least twice a week. The participants were assigned to one of the following four groups: (1) not isolated with regular exercise, (2) not isolated without regular exercise, (3) isolated with regular exercise, and (4) isolated without regular exercise. All-cause mortality information was obtained from the ward office database. Follow-ups were conducted until 1 November 2020. A Cox proportional regression analysis was performed. Results A final analysis was performed on a complete dataset of 735 participants (males = 303, females = 432; mean age 72.9 years). A total of 132 (18.0%), 426 (58.0%), 27 (3.7%), and 150 (20.4%) participants were assigned to groups 1, 2, 3, and 4, respectively. The mortality rates in groups 1, 2, 3, and 4 were 6.1%, 9.2%, 7.4%, and 19.3%, respectively. Compared with group 1, isolated individuals who did not perform regular exercise had a significantly higher mortality rate [adjusted hazard ratio (aHR), 2.48; 95% confidence interval (CI), 1.12-5.52]. However, no significant association was noted in isolated individuals who performed regular exercise (aHR, 1.25; 95% CI, 0.26-5.91). Conclusion Regular exercise was associated with a decrease in mortality risk, regardless of social isolation status. Thus, our results indicate that encouraging isolated older adults to exercise regularly may reduce their negative health outcomes.
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Affiliation(s)
- Manami Ejiri
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keigo Imamura
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | | | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Wang B, Fan Y, Wang X, Zeng X, Zeng S, Jia H, Li Y, Dai C. Influence of lifestyle patterns on depression among adults with diabetes: a mediation effect of dietary inflammatory index. BMC Public Health 2024; 24:1779. [PMID: 38961392 PMCID: PMC11223315 DOI: 10.1186/s12889-024-19319-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 07/01/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Lifestyle has become a crucial modulator in the management of diabetes and is intimately linked with the development and exacerbation of comorbid depression. The study aimed to analyze lifestyle patterns and their impact on depression in individuals with diabetes and to explore the role of the Dietary Inflammatory Index (DII) in the relationship between lifestyle patterns and depression. METHODS Data was attained from the National Health and Nutrition Examination Survey (NHANES) between 2009 and 2020. A latent class analysis (LCA) was performed on 3,009 diabetic adults based on lifestyle behaviors. A generalised linear model (GLM) was employed to analyse the effects of different lifestyle patterns on depression. The mediation effect model was utilised to examine the relationship between lifestyle patterns, DII and Patient Health Questionnaire-9 (PHQ-9) scores. RESULTS The cohort was divided through LCA into unhealthy lifestyle (44.53%), unhealthy but non-alcohol use (48.06%) and healthy but smoking (7.41%) groups of lifestyle behaviors, the unhealthy but non-alcohol use group was identified as a risk factor for depression (OR = 1.379, 95%CI = 1.095 ~ 1.735, P = 0.006). The DII partially mediated the relationship between the unhealthy but non-alcohol use group and PHQ-9, and fully mediated the relationship between the healthy but smoking group and PHQ-9, with effect coefficients of - 0.018 (95%CI: -0.044 ~ - 0.001) and - 0.035 (95%CI: -0.083 ~ - 0.001). CONCLUSIONS Lifestyle patterns significantly influence the occurrence of depression among diabetes patients. The dietary inflammation plays a varying mediating role between different lifestyle patterns and depression. Restricting pro-inflammatory diets or encouraging anti-inflammatory diets, combined with the promotion of healthy lifestyle practices, may be an effective method for preventing and alleviating symptoms of depression among patients with diabetes.
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Affiliation(s)
- Baoping Wang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Yuxin Fan
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Xin Wang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Xiangru Zeng
- Department of Endocrinology, Tianjin Dongli Hospital, Tianjin, 300300, China
| | - Sha Zeng
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital Airport Hospital, Tianjin, 300000, China
| | - Hongwei Jia
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Yin Li
- Dept. Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Chenlin Dai
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
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Rezende LFM, Ahmadi M, Ferrari G, Del Pozo Cruz B, Lee IM, Ekelund U, Stamatakis E. Device-measured sedentary time and intensity-specific physical activity in relation to all-cause and cardiovascular disease mortality: the UK Biobank cohort study. Int J Behav Nutr Phys Act 2024; 21:68. [PMID: 38961452 PMCID: PMC11223286 DOI: 10.1186/s12966-024-01615-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 06/19/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND AND AIMS Understanding the amounts of intensity-specific movement needed to attenuate the association between sedentary time and mortality may help to inform personalized prescription and behavioral counselling. Herein, we examined the joint associations of sedentary time and intensity-specific physical activity with all-cause and cardiovascular disease (CVD) mortality. METHODS Prospective cohort study including 73,729 adults from the UK Biobank who wore an Axivity AX3 accelerometer on their dominant wrist for at least 3 days, being one a weekend day, between June 2013 and December 2015. We considered the median tertile values of sedentary time and physical activity in each intensity band to determine the amount of physical activity needed to attenuate the association between sedentary time and mortality. RESULTS During a median of 6.9 years of follow-up (628,807 person-years), we documented 1521 deaths, including 388 from CVD. Physical activity of any intensity attenuated the detrimental association of sedentary time with mortality. Overall, at least a median of 6 min/day of vigorous physical activity, 30 min/day of MVPA, 64 min/day of moderate physical activity, or 163 min/day of light physical activity (mutually-adjusted for other intensities) attenuated the association between sedentary time and mortality. High sedentary time was associated with higher risk of CVD mortality only among participants with low MVPA (HR 1.96; 95% CI 1.23 to 3.14). CONCLUSIONS Different amounts of each physical activity intensity may attenuate the association between high sedentary time and mortality.
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Affiliation(s)
- Leandro F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, 7500912, Chile
| | - Matthew Ahmadi
- Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Borja Del Pozo Cruz
- Department of Sport Sciences and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, Odense, 5230, Denmark
- Faculty of Education, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz, Cádiz, Spain
| | - I-Min Lee
- Division of Preventive Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Emmanuel Stamatakis
- Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, Australia.
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
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Germano-Soares AH, Farah BQ, Da Silva JF, Barros MVG, Tassitano RM. Clustering of 24H movement behaviors associated with clinic blood pressure in older adults: a cross-sectional study. J Hum Hypertens 2024; 38:575-579. [PMID: 38890411 DOI: 10.1038/s41371-024-00925-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
Physical activity (PA), sedentary behavior (SB), and sleep duration are known to have an individual effect on clinic blood pressure (BP) of older adults. However, whether different patterns of these so-called movement behaviors over the 24h-cycle on BP remains poorly investigated. The study aimed to identify movement behavior patterns associated with clinic BP among older adults with chronic diseases. Cross-sectional study with 238 older adults (80.3% female; mean age 68.8 ± 6.6) with at least one chronic disease. PA, SB, and sleep duration were measured by a triaxial accelerometer. Clinic systolic BP (SBP) and diastolic BP (DBP) were obtained through an automated method following standard procedures. Non-hierarchical K-means cluster and linear regression modeling were employed to identify the clusters of movement behaviors and to examine the associations. Two clusters were identified [active and non-sedentary, n = 103 (i.e., sufficient sleep duration, higher LPA and MVPA, and lower SB) and sedentary and inactive, n = 135 (i.e., sufficient sleep duration, lower LPA and MVPA, and higher SB). Active and non-sedentary older adults presented lower systolic BP compared to sedentary and inactive ones, even after adjustments for sociodemographic and clinical characteristics (β = 6.356; CI 95% from 0.932 to 11.779; P = 0.022). No associations were found for diastolic BP. In conclusion, higher PA and lower SB were associated with lower systolic BP in older adults with chronic diseases. However, sleep duration did not modify this association. Therefore, interventions focusing on concomitantly increasing PA levels and reducing SB should be the priority for controlling blood pressure.
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Affiliation(s)
- Antonio H Germano-Soares
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
- Department of Physical Education Faculdade Pernambucana de Saúde, Recife, Pernambuco, Brazil
| | - Breno Q Farah
- Department of Physical Education Federal Rural University of Pernambuco, Recife, Brazil
| | - José F Da Silva
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
| | - Mauro V G Barros
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
| | - Rafael M Tassitano
- Department of Health and Kinesiology University of Illinois at Urbana-Champaign, Champaign, IL, USA.
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Liu Y, Liu S, Sum R, Duncan M, Gu Y, Li M. Associations between levels of physical literacy and adherence to the 24-h movement guidelines among university students: A cross-sectional study. J Exerc Sci Fit 2024; 22:221-226. [PMID: 38559907 PMCID: PMC10979097 DOI: 10.1016/j.jesf.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/10/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024] Open
Abstract
Objectives Emerging evidence indicates that the composition of movement behaviours within a 24-h period is associated with multiple health benefits across the lifespan. A concept that emphasises an individual's active lifestyle is physical literacy (PL), yet empirical research exploring the potential associations between PL and 24-h movement guidelines remains scarce. This study aimed to evaluate the associations between levels of PL and adherence to the guidelines among Chinese university students. Study design A cross-sectional study. Methods Seven hundred and ninety-eight university students (390 male, 19.2 ± 1.2 years) completed all the measurements. Levels of PL and participants' adherence to guidelines including physical activity, sedentary behaviour and sleep were self-reported through Perceived Physical Literacy Instrument, International Physical Activity Questionnaire and Pittsburgh Sleep Quality Index, respectively. Two-way ANOVA was conducted to determine the associations between the number of guidelines met (0, 1, 2, or 3) and levels of PL. Results The results demonstrate that 36.5% (n = 291) of the participants met all the three guidelines, while 4.1% (n = 33) met none. Further analysis indicated that meeting physical activity or sedentary behaviour guidelines was associated with significantly higher total PL scores, and scores in the sub-domains of Confidence and Physical Competence and Motivation. Conclusions The findings provide evidence that young adults who obtained higher PL scores may meet more guidelines during a 24-h period. Future studies should incorporate accelerometer-based physical activity measurements and investigate the causal relationship between PL and adherence to the movement guidelines.
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Affiliation(s)
- Y. Liu
- Public Health and Sport Sciences, University of Exeter, Exeter, UK
| | - S.X. Liu
- School of Physical Education, Chongqing University, Chongqing, China
| | - R.K.W. Sum
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - M.J. Duncan
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
| | - Y.D. Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - M.H. Li
- Faculty of Sports Science, Ningbo University, Ningbo, China
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Brakenridge CJ, Koster A, de Galan BE, Carver A, Dumuid D, Dzakpasu FQS, Eussen SJPM, Savelberg HHCM, Bosma H, Owen N, Schaper NC, Healy GN, Dunstan DW. Associations of 24 h time-use compositions of sitting, standing, physical activity and sleeping with optimal cardiometabolic risk and glycaemic control: The Maastricht Study. Diabetologia 2024; 67:1356-1367. [PMID: 38656371 PMCID: PMC11153304 DOI: 10.1007/s00125-024-06145-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/28/2024] [Indexed: 04/26/2024]
Abstract
AIMS/HYPOTHESIS The associations of sitting, standing, physical activity and sleep with cardiometabolic health and glycaemic control markers are interrelated. We aimed to identify 24 h time-use compositions associated with optimal metabolic and glycaemic control and determine whether these varied by diabetes status. METHODS Thigh-worn activPAL data from 2388 participants aged 40-75 years (48.7% female; mean age 60.1 [SD = 8.1] years; n=684 with type 2 diabetes) in The Maastricht Study were examined. Compositional isometric log ratios were generated from mean 24 h time use (sitting, standing, light-intensity physical activity [LPA], moderate-to-vigorous physical activity [MVPA] and sleeping) and regressed with outcomes of waist circumference, fasting plasma glucose (FPG), 2 h plasma glucose, HbA1c, the Matsuda index expressed as z scores, and with a clustered cardiometabolic risk score. Overall analyses were adjusted for demographics, smoking, dietary intake and diabetes status, and interaction by diabetes status was examined separately. The estimated difference when substituting 30 min of one behaviour with another was determined with isotemporal substitution. To identify optimal time use, all combinations of 24 h compositions possible within the study footprint (1st-99th percentile of each behaviour) were investigated to determine those cross-sectionally associated with the most-optimal outcome (top 5%) for each outcome measure. RESULTS Compositions lower in sitting time and with greater standing time, physical activity and sleeping had the most beneficial associations with outcomes. Associations were stronger in participants with type 2 diabetes (p<0.05 for interactions), with larger estimated benefits for waist circumference, FPG and HbA1c when sitting was replaced by LPA or MVPA in those with type 2 diabetes vs the overall sample. The mean (range) optimal compositions of 24 h time use, considering all outcomes, were 6 h (range 5 h 40 min-7 h 10 min) for sitting, 5 h 10 min (4 h 10 min-6 h 10 min) for standing, 2 h 10 min (2 h-2 h 20 min) for LPA, 2 h 10 min (1 h 40 min-2 h 20 min) for MVPA and 8 h 20 min (7 h 30 min-9 h) for sleeping. CONCLUSIONS/INTERPRETATION Shorter sitting time and more time spent standing, undergoing physical activity and sleeping are associated with preferable cardiometabolic health. The substitutions of behavioural time use were significantly stronger in their associations with glycaemic control in those with type 2 diabetes compared with those with normoglycaemic metabolism, especially when sitting time was balanced with greater physical activity.
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Affiliation(s)
- Christian J Brakenridge
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland.
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia.
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Bastiaan E de Galan
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Alison Carver
- National Centre for Healthy Ageing, The School of Translational Medicine, Monash University, Melbourne, VIC, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, SA, Australia
| | - Francis Q S Dzakpasu
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Simone J P M Eussen
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Hans H C M Savelberg
- Department of Nutrition and Movement Science, Maastricht University, Maastricht, the Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Nicolaas C Schaper
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Genevieve N Healy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
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Raichlen DA, Ally M, Aslan DH, Sayre MK, Bharadwaj PK, Maltagliati S, Lai MHC, Wilcox RR, Habeck CG, Klimentidis YC, Alexander GE. Associations between accelerometer-derived sedentary behavior and physical activity with white matter hyperintensities in middle-aged to older adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e70001. [PMID: 39183745 PMCID: PMC11342350 DOI: 10.1002/dad2.70001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 07/30/2024] [Accepted: 08/02/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION We examined the relationship between sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA), and white matter hyperintensity (WMH) volumes, a common magnetic resonance imaging (MRI) marker associated with risk of neurodegenerative disease in middle-aged to older adults. METHODS We used data from the UK Biobank (n = 14,415; 45 to 81 years) that included accelerometer-derived measures of SB and MVPA, and WMH volumes from MRI. RESULTS Both MVPA and SB were associated with WMH volumes (βMVPA = -0.03 [-0.04, -0.01], p < 0.001; βSB = 0.02 [0.01, 0.03], p = 0.007). There was a significant interaction between SB and MVPA on WMH volumes (βSB×MVPA = -0.015 [-0.028, -0.001], p SB×MVPA = 0.03) where SB was positively associated with WMHs at low MVPA, and MVPA was negatively associated with WMHs at high SB. DISCUSSION While this study cannot establish causality, the results highlight the potential importance of considering both MVPA and SB in strategies aimed at reducing the accumulation of WMH volumes in middle-aged to older adults. Highlights SB is associated with greater WMH volumes and MVPA is associated with lower WMH volumes.Relationships between SB and WMH are strongest at low levels of MVPA.Associations between MVPA and WMH are strongest at high levels of SB.Considering both SB and MVPA may be effective strategies for reducing WMHs.
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Affiliation(s)
- David A. Raichlen
- Human and Evolutionary Biology SectionDepartment of Biological SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of AnthropologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Madeline Ally
- Department of PsychologyUniversity of ArizonaTucsonArizonaUSA
| | - Daniel H. Aslan
- Human and Evolutionary Biology SectionDepartment of Biological SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | | | | | - Silvio Maltagliati
- Human and Evolutionary Biology SectionDepartment of Biological SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Mark H. C. Lai
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Rand R. Wilcox
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Christian G. Habeck
- Cognitive Neuroscience DivisionDepartment of Neurology and Taub InstituteColumbia UniversityNew YorkNew YorkUSA
| | - Yann C. Klimentidis
- Department of Epidemiology and BiostatisticsMel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
- BIO5 InstituteUniversity of ArizonaTucsonArizonaUSA
| | - Gene E. Alexander
- Department of PsychologyUniversity of ArizonaTucsonArizonaUSA
- BIO5 InstituteUniversity of ArizonaTucsonArizonaUSA
- Evelyn F. McKnight Brain InstituteUniversity of ArizonaTucsonArizonaUSA
- Department of PsychiatryUniversity of ArizonaTucsonArizonaUSA
- Neuroscience Graduate Interdisciplinary ProgramUniversity of ArizonaTucsonArizonaUSA
- Physiological Sciences Graduate Interdisciplinary ProgramUniversity of ArizonaTucsonArizonaUSA
- Arizona Alzheimer's ConsortiumPhoenixArizonaUSA
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Hamaya R, Shiroma EJ, Moore CC, Buring JE, Evenson KR, Lee IM. Time- vs Step-Based Physical Activity Metrics for Health. JAMA Intern Med 2024; 184:718-725. [PMID: 38767892 PMCID: PMC11106710 DOI: 10.1001/jamainternmed.2024.0892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/08/2024] [Indexed: 05/22/2024]
Abstract
Importance Current US physical activity (PA) guidelines prescribe moderate to vigorous PA (MVPA) time of at least 150 minutes per week for health. An analogous step-based recommendation has not been issued due to insufficient evidence. Objective To examine the associations of MVPA time and step counts with all-cause mortality and cardiovascular disease (CVD). Design, Setting, and Participants This cohort study analyzed data from an ongoing follow-up study of surviving participants of the Women's Health Study, a randomized clinical trial conducted from 1992 to 2004 in the US to evaluate use of low-dose aspirin and vitamin E for preventing cancer and CVD. Participants were 62 years or older who were free from CVD and cancer, completed annual questionnaires, and agreed to measure their PA with an accelerometer as part of a 2011-2015 ancillary study. Participants were followed up through December 31, 2022. Exposures Time spent in MVPA and step counts, measured with an accelerometer for 7 consecutive days. Main Outcomes and Measures The associations of MVPA time and step counts with all-cause mortality and CVD (composite of myocardial infarction, stroke, and CVD mortality) adjusted for confounders. Cox proportional hazards regression models, restricted mean survival time differences, and area under the receiver operating characteristic curve (AUC) were used to evaluate the associations. Results A total of 14 399 women (mean [SD] age, 71.8 [5.6] years) were included. The median (IQR) MVPA time and step counts were 62 (20-149) minutes per week and 5183 (3691-7001) steps per day, respectively. During a median (IQR) follow-up of 9.0 (8.0-9.9) years, the hazard ratios (HR) per SD for all-cause mortality were 0.82 (95% CI, 0.75-0.90) for MVPA time and 0.74 (95% CI, 0.69-0.80) for step counts. Greater MVPA time and step counts (top 3 quartiles vs bottom quartile) were associated with a longer period free from death: 2.22 (95% CI, 1.58-2.85) months and 2.36 (95% CI, 1.73-2.99) months at 9 years follow-up, respectively. The AUCs for all-cause mortality from MVPA time and step counts were similar: 0.55 (95% CI, 0.52-0.57) for both metrics. Similar associations of these 2 metrics with CVD were observed. Conclusion and Relevance Results of this study suggest that among females 62 years or older, MVPA time and step counts were qualitatively similar in their associations with all-cause mortality and CVD. Step count-based goals should be considered for future guidelines along with time-based goals, allowing for the accommodation of personal preferences.
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Affiliation(s)
- Rikuta Hamaya
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eric J. Shiroma
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Christopher C. Moore
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - Julie E. Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Yerramalla MS, Chen M, Dugravot A, van Hees VT, Sabia S. Association between profiles of accelerometer-measured daily movement behaviour and mortality risk: a prospective cohort study of British older adults. BMJ Open Sport Exerc Med 2024; 10:e001873. [PMID: 38952852 PMCID: PMC11216065 DOI: 10.1136/bmjsem-2023-001873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2024] [Indexed: 07/03/2024] Open
Abstract
Objectives We identified profiles of wake-time movement behaviours (sedentary behaviours, light intensity physical activity and moderate-to-vigorous physical activity) based on accelerometer-derived features among older adults and then examined their association with all-cause mortality. Methods Data were drawn from a prospective cohort of 3991 Whitehall II accelerometer substudy participants aged 60-83 years in 2012-2013. Daily movement behaviour profiles were identified using k-means cluster analysis based on 13 accelerometer-assessed features characterising total duration, frequency, bout duration, timing and activity intensity distribution of movement behaviour. Cox regression models were used to assess the association between derived profiles and mortality risk. Results Over a mean follow-up of 8.1 (SD 1.3) years, a total of 410 deaths were recorded. Five distinct profiles were identified and labelled as 'active' (healthiest), 'active sitters', 'light movers', 'prolonged sitters', and 'most sedentary' (most deleterious). In model adjusted for sociodemographic, lifestyle, and health-related factors, compared with the 'active' profile, 'active sitters' (HR 1.57, 95% CI 1.01 to 2.44), 'light movers' (HR 1.75, 95% CI 1.17 to 2.63), 'prolonged sitters' (HR 1.67, 95% CI 1.11 to 2.51), 'most sedentary' (HR 3.25, 95% CI 2.10 to 5.02) profiles were all associated with a higher risk of mortality. Conclusion Given the threefold higher mortality risk among those with a 'most sedentary' profile, public health interventions may target this group wherein any improvement in physical activity and sedentary behaviour might be beneficial.
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Affiliation(s)
- Manasa Shanta Yerramalla
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Mathilde Chen
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
- CIRAD, UMR PHIM, Montpellier, France
- UMR PHIM, Univ Montpellier, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
| | - Aline Dugravot
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | | | - Severine Sabia
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
- Faculty of Brain Sciences, UCL, London, UK
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Lebuf E, Van Dyck D, Van de Velde L, Beeckman M, Van Cauwenberg J, Compernolle S. Sedentary patterns and health outcomes in the oldest-old: a latent profile analysis. PeerJ 2024; 12:e17505. [PMID: 38938606 PMCID: PMC11210487 DOI: 10.7717/peerj.17505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/13/2024] [Indexed: 06/29/2024] Open
Abstract
Background Sedentary behavior is most prevalent among those aged 80 years and above, referred to as the oldest-old. Current literature emphasizes the significance of sedentary behavior patterns, but further evidence is required to understand how these patterns relate to specific health outcomes and to identify at-risk profiles for tailored interventions in the oldest-old. Therefore, the aim of this study was to identify profiles of adults aged 80+ years based on their sedentary patterns and health outcomes, and to examine associations between profiles and socio-demographics. Methods A cross-sectional study was conducted in Flanders (Belgium) from February 2021 to December 2022 recruiting 90 older adults (80+) through convenience sampling, employing word of mouth, social media and local service centers. Latent profile analysis identified device-based sedentary patterns and assessed their associations with physical and cognitive functioning, mental health-related quality of life (QoL), and social isolation. Associations of these profiles with socio-demographic factors were analyzed. Results Three distinct profiles were identified: (1) the 'cognitively and physically frail' profile, (2) the 'healthy' profile and (3) the 'lower mental health-related QoL' profile. Those in the 'cognitively and physically frail' profile exhibited the least favorable sedentary pattern, and had a higher likelihood of residing in a nursing home. No significant differences were found for the other socio-demographic variables, being age, sex, educational degree and family situation. Conclusions Three distinct profiles in the oldest-old population, based on cognitive and physical functioning, mental health-related QoL, and sedentary behavior patterns, were identified. Lower physical and cognitive functioning was associated with unhealthy sedentary patterns. Further research with larger samples is crucial to uncover potential links between socio-demographics and at-risk subgroups, enhancing our understanding of sedentary behavior and geriatric health outcomes in this population.
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Affiliation(s)
- Elien Lebuf
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Laura Van de Velde
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Melanie Beeckman
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
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Skarpsno ES. Causal overstatements in modern physical activity research. Br J Sports Med 2024; 58:697-699. [PMID: 38702184 DOI: 10.1136/bjsports-2023-108031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/06/2024]
Affiliation(s)
- Eivind Schjelderup Skarpsno
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olav's University Hospital, Trondheim, Norway
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Svalbjørg T, Askim T, Saltvedt I, Alme K, Lydersen S, Eldholm R. Changes in sedentary behavior in the chronic phase following stroke. J Stroke Cerebrovasc Dis 2024; 33:107827. [PMID: 38901471 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 05/29/2024] [Accepted: 06/18/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Sedentary behavior increases risk for cardiovascular diseases. Little is known about sedentary behavior through the chronic phase after stroke. We aimed to describe how long and short bouts of sedentary behavior changed over the first three years after stroke and if cognition at baseline was an independent risk factor for sedentary behavior. METHODS This is a sub-study of the Norwegian cognitive impairment after stroke (Nor-COAST) study, a multicenter study recruiting patients with acute stroke. Sedentary behavior was monitored with a thigh-worn sensor (ActivPal3®), at three-, 18- and 36-months post stroke. Stroke severity was assessed by National Institutes of Health Stroke Scale (NIHSS) and cognition by Montreal cognitive assessment (MoCA). Mixed model analysis with mean number of sedentary minutes accumulated daily as the dependent variable was repeated for all four zones (<30min, 30-60min, 60-90min, >90min) and for total sedentary time. RESULTS The number of included participants was 528 (mean age 71.4, NIHSS on day 1, 2.7). The total amount of sedentary time accumulated between 08.00-22.00 increased significantly from about 9.8 hours at three months to 10.1 hours at 36 months post stroke (p=0.002). Patient characteristics associated with prolonged duration of the sedentary bouts and sedentary time were age, high BMI, comorbidities, and impaired physical function. No significant associations between MoCA score and sedentary time were found. CONCLUSION The participants became increasingly sedentary and had fewer breaks in sedentary time from three to 36 months after stroke. Baseline cognition was not related to later sedentary behavior.
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Affiliation(s)
- Tone Svalbjørg
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim 7491, Norway
| | - Torunn Askim
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim 7491, Norway
| | - Ingvild Saltvedt
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim 7491, Norway; Department of Geriatrics, Clinic of internal medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Katinka Alme
- Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Tronheim, Norway
| | - Rannveig Eldholm
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim 7491, Norway; Department of Geriatrics, Clinic of internal medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
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Cao Z, Min J, Chen H, Hou Y, Yang H, Si K, Xu C. Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes. Nat Commun 2024; 15:5164. [PMID: 38886353 PMCID: PMC11183112 DOI: 10.1038/s41467-024-49542-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
Physical activity (PA) has been shown to reduce diabetes mortality, but largely based on imprecise self-reported data, which may hinder the development of related recommendations. Here, we perform a prospective cohort study of 19,624 individuals with type 2 diabetes (T2D) from the UK Biobank with a median follow-up of 6.9 years. Duration and intensity of PA are measured by wrist-worn accelerometers over a 7-day period. We observe L-shaped associations of longer duration of PA, regardless of PA intensity, with risks of all-cause and cancer mortality, as well as a negatively linear association with cardiovascular disease mortality. 12.7%, 15.8%, and 22.3% of deaths are attributable to the lowest level of light-intensity, moderate-intensity PA, and vigorous-intensity PA, respectively. Collectively, our findings provide insights for clinical guidelines that should highlight the potential value of adherence to greater intensity and duration of PA for patients with T2D.
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Affiliation(s)
- Zhi Cao
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiahao Min
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Han Chen
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Yabing Hou
- Yanjing Medical College, Capital Medical University, Beijing, China
| | - Hongxi Yang
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Keyi Si
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China.
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Terrón-Pérez M, Cortes-Amador S, Portolés-Simeó JB. Analysis of losses in physiotherapy students during the COVID-19 pandemic: a phenomenological approach. BMC Psychol 2024; 12:349. [PMID: 38877593 PMCID: PMC11179356 DOI: 10.1186/s40359-024-01848-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/10/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, young people have experienced numerous personal losses across various aspects, impacting their quality of life. This study aimed to explore and analyze the losses experienced by physiotherapy students during the first year of the COVID-19 pandemic. METHODS A qualitative phenomenological study was conducted using an open-format exercise carried out during the Clinical Specialties class from February to May 2021. Thirty-four (83% female) third-year physical therapy students participated. ATLAS.ti software was used for the analysis and coding by three researchers. RESULTS Analysis of the categories revealed various losses experienced by the participants, including losses in psychological well-being, physical health, the social sphere (friendships, relationships with partners and family members, and experiences of death), spiritual losses (loss of freedom and identity), leisure time (travel, recreational activities and physical exercise), and different losses related to university studies (motivation and enthusiasm and clinical practices). CONCLUSION The COVID-19 pandemic has led to significant losses among physiotherapy students, with losses in the social sphere being the most prevalent. This study can serve as a foundation for developing resources aimed at enhancing the well-being of physiotherapy students, promoting optimal academic performance, improving self-care, and reducing psychosocial problems.
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49
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Hosokawa Y, Ishii K, Shibata A, Yako-Suketomo H, Suko R, Oka K. Social role of the 'Bow-Wow Patrol' in urban areas of Japan: a qualitative study. Sci Rep 2024; 14:13119. [PMID: 38849426 PMCID: PMC11161583 DOI: 10.1038/s41598-024-64079-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 06/05/2024] [Indexed: 06/09/2024] Open
Abstract
The 'Bow-Wow Patrol (BWP)', established to avert local crime by encouraging dog walking, may help build social relationships among individuals through dog walking. However, details of its social influence remain unclear. Thus, this study aimed to elucidate the social roles of BWP in the urban areas of Japan. A total of 18 BWP organisation members from two Tokyo municipalities were recruited using snowball sampling between November 2021 and July 2022. In an interview, participants were asked about their perceptions of changes in their social relationships through the BWP. Qualitative content analysis was conducted after text mining using the KH Coder software. The mean age of the participants was 63.9 years, and 83.3% engaged in BWP 7 days a week. The content analysis revealed six social roles of the BWP: establishment of social networks with schools as the centre, establishment of loose networks inside and outside the BWP organization, enhancement of a sense of trust among neighbours, enhancement of a sense of trust in communities, norms of reciprocity among dog owners, and dog and owner characteristics. This study found that the BWP in urban Japan strengthens social cohesion and expands social networks among dog walkers, encouraging them to continue walking.
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Affiliation(s)
- Yoshino Hosokawa
- Faculty of Health and Sports Sciences, Toyo University, Tokyo, Japan.
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Hiroko Yako-Suketomo
- Faculty of Physical Education, Japan Women's College of Physical Education, Tokyo, Japan
| | - Riki Suko
- Faculty of Physical Education, Japan Women's College of Physical Education, Tokyo, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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50
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Zhang X, Yang D, Luo J, Meng M, Chen S, Li X, Yin Y, Hao Y, Sun C. Determinants of sedentary behavior in community-dwelling older adults with type 2 diabetes based on the behavioral change wheel: a path analysis. BMC Geriatr 2024; 24:502. [PMID: 38844849 PMCID: PMC11157943 DOI: 10.1186/s12877-024-05076-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 05/14/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Sedentary behavior (SB) is deeply ingrained in the daily lives of community-dwelling older adults with type 2 diabetes mellitus (T2DM). However, the specific underlying mechanisms of the determinants associated with SB remain elusive. We aimed to explore the determinants of SB based on the behavior change wheel framework as well as a literature review. METHODS This cross-sectional study recruited 489 community-dwelling older adults with T2DM in Jinan City, Shandong Province, China. Convenience sampling was used to select participants from relevant communities. This study used the Measure of Older Adults' Sedentary Time-T2DM, the Abbreviated-Neighborhood Environment Walkability Scale, the Social Support Rating Scale, the Lubben Social Network Scale 6, the Subjective Social Norms Questionnaire for Sedentary Behavior, the Functional Activities Questionnaire, the Numerical Rating Scale, the Short Physical Performance Battery, and the Montreal Cognitive Assessment Text to assess the levels of and the determinants of SB. Descriptive statistical analysis and path analysis were conducted to analyze and interpret the data. RESULTS Pain, cognitive function, social isolation, and social support had direct and indirect effects on SB in community-dwelling older adults with T2DM (total effects: β = 0.426, β = -0.171, β = -0.209, and β = -0.128, respectively), and physical function, walking environment, and social function had direct effects on patients' SB (total effects: β = -0.180, β = -0.163, and β = 0.127, respectively). All the above pathways were statistically significant (P < 0.05). The path analysis showed that the model had acceptable fit indices: RMSEA = 0.014, χ 2/df = 1.100, GFI = 0.999, AGFI = 0.980, NFI = 0.997, RFI = 0.954, IFI = 1.000, TLI = 0.996, CFI = 1.000. CONCLUSION Capability (physical function, pain, and cognitive function), opportunity (social isolation, walking environment, and social support), and motivation (social function) were effective predictors of SB in community-dwelling older adults with T2DM. Deeper knowledge regarding these associations may help healthcare providers design targeted intervention strategies to decrease levels of SB in this specific population.
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Affiliation(s)
- Xiaoyan Zhang
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Dan Yang
- School of Nursing, Beijing University of Chinese Medicine, No. 11, Beisanhuandonglu, Chaoyang District, Beijing, People's Republic of China
| | - Jiayin Luo
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Meiqi Meng
- School of Nursing, Beijing University of Chinese Medicine, No. 11, Beisanhuandonglu, Chaoyang District, Beijing, People's Republic of China
| | - Sihan Chen
- School of Nursing, Beijing University of Chinese Medicine, No. 11, Beisanhuandonglu, Chaoyang District, Beijing, People's Republic of China
| | - Xuejing Li
- School of Nursing, Beijing University of Chinese Medicine, No. 11, Beisanhuandonglu, Chaoyang District, Beijing, People's Republic of China
| | - Yiyi Yin
- School of Nursing, Beijing University of Chinese Medicine, No. 11, Beisanhuandonglu, Chaoyang District, Beijing, People's Republic of China
| | - Yufang Hao
- School of Nursing, Beijing University of Chinese Medicine, No. 11, Beisanhuandonglu, Chaoyang District, Beijing, People's Republic of China.
| | - Chao Sun
- Department of Nursing, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.
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