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Smith R, Gould R, Kenworthy Y, Astbury N, Smith I, Birks J, Bateman P, Hirst JE, Jebb S, Michalopoulou M, Pulsford R, Roman C, Santos M, Wango N, Wire A, Mackillop L. A feasibility study using motivational interviewing and a smartphone application to promote physical activity (+Stay-Active) for women with gestational diabetes. BMC Pregnancy Childbirth 2024; 24:360. [PMID: 38745288 PMCID: PMC11094872 DOI: 10.1186/s12884-024-06508-w] [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: 09/17/2023] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Physical activity (PA) interventions have an encouraging role in gestational diabetes mellitus (GDM) management. Digital technologies can potentially be used at scale to support PA. The aim of this study was to assess the feasibility and acceptability of + Stay-Active: a complex intervention which combines motivational interviewing with a smartphone application to promote PA levels in women with GDM. METHODS This non-randomised feasibility study used a mixed methods approach. Participants were recruited from the GDM antenatal clinic at Oxford University Hospitals. Following baseline assessments (visit 1) including self-reported and device determined PA measurements (wrist worn accelerometer), women participated in an online motivational interview, and then downloaded (visit 2) and used the Stay-Active app (Android or iOS). Women had access to Stay-Active until 36 weeks' gestation, when acceptability and PA levels were reassessed (visit 3). The primary outcome measures were recruitment and retention rates, participant engagement, and acceptability and fidelity of the intervention. Secondary outcome measures included PA levels, app usage, blood glucose and perinatal outcomes. Descriptive statistics were performed for assessments at study visits. Statistics software package Stata 14 and R were used. RESULTS Over the recruitment period (46 weeks), 114 of 285 women met inclusion criteria and 67 (58%) enrolled in the study. Mean recruitment rate of 1.5 participants/clinic with 2.5 women/clinic meeting inclusion criteria. Fifty-six (83%) received the intervention at visit 2 and 53 (79%) completed the study. Compliance to accelerometer measurement protocols were sufficient in 78% of participants (52/67); wearing the device for more than 10 h on 5 or more days at baseline and 61% (41/67) at 36 weeks. There was high engagement with Stay-Active; 82% (55/67) of participants set goals on Stay-Active. Sustained engagement was evident, participants regularly accessed and logged multiples activities on Stay-Active. The intervention was deemed acceptable; 85% of women rated their care was satisfactory or above, supported by written feedback. CONCLUSIONS This combined intervention was feasible and accepted. Recruitment rates were lower than expected. However, retention rates remained satisfactory and participant compliance with PA measurements and engagement was a high. Future work will explore the intervention's efficacy to increase PA and impact on clinical outcomes. TRIAL REGISTRATION The study has received a favourable opinion from South Central-Hampshire B Research Ethics Committee; REC reference: 20/SC/0342. ISRCTN11366562.
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Affiliation(s)
- Ralph Smith
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - Rebecca Gould
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Yvonne Kenworthy
- Cardiovascular Clinical Research Facility, University of Oxford, Oxford, UK
| | - Nerys Astbury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Jacqueline Birks
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Paul Bateman
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jane E Hirst
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
- The George Institute for Global Health, Imperial College London UK, London, UK
| | - Susan Jebb
- 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
| | - Richard Pulsford
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Cristian Roman
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Mauro Santos
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Nicola Wango
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Amy Wire
- Independent Researcher, Patient Representative, Oxford, UK
| | - Lucy Mackillop
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
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Howie EK, Nelson A, McVeigh JA, Andres A. Physical Activity, Sedentary and Sleep Phenotypes in Women During the First Trimester of Pregnancy. Matern Child Health J 2023; 27:1834-1845. [PMID: 37436642 DOI: 10.1007/s10995-023-03745-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVES Patterns of physical behaviors including physical activity, sedentary time, and sleep are unknown during pregnancy, but are likely to influence health outcomes. The purpose was to first identify "physical behavior phenotypes" from accelerometer-measured physical behaviors in pregnant women during the first trimester and secondly, to explore the associations between the identified phenotypes with demographic variables and body-mass-index (BMI). METHODS Data were from the Glowing Study (gov ID: NCT01131117), collected between 2011 and 2017 with accelerometer-measured physical behaviors of women in their 12th week of pregnancy. Latent class analysis was used to identify patterns of total physical activity, sleep time, sedentary time, and variation in physical activity. Maternal Body-Mass-Index (BMI). BMI and sociodemographic characteristics were compared between physical behavior phenotypes. RESULTS A total of 212 pregnant women were included in the study (mean age 30.2 years (range 22.1 to 42.4), mean days wear 4.3 (SD 0.7)). Three physical behavior phenotypes were identified from the four physical behavior constructs: low sedentary and stable activity (n = 136, 64%), variable activity (n = 39, 18%), high sedentary and low sleep (n = 37, 17%). BMI, race, and education were significantly different between the three phenotypes, with the low sedentary and stable activity phenotype having the lowest BMI and a higher percentage of white and college educated women. CONCLUSIONS FOR PRACTICE Total physical activity and physical behavior phenotypes during the first trimester were associated with early-pregnancy BMI, race, and education. Future research should examine whether these physical behavior phenotypes are associated with maternal and child health outcomes.
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Affiliation(s)
- Erin K Howie
- Department of Health, Human Performance and Recreation, University of Arkansas, HPER 308I, Fayetteville, AR, 72701, USA.
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
| | - Alexander Nelson
- Department of Computer Science and Computer Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Joanne A McVeigh
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Aline Andres
- Arkansas Children's Nutrition Center & Arkansas Children's Research Institute, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Smith R, Kenworthy Y, Astbury NM, Birks J, Bateman P, Dyson P, Hirst JE, Jebb SA, Michalopoulou M, Pulsford R, Roman C, Santos M, Tarassenko L, Wango N, Wire A, MacKillop LH. Study protocol: use of a smartphone application to support the implementation of a complex physical activity intervention (+ Stay Active) in women with gestational diabetes mellitus-protocol for a non-randomised feasibility study. BMJ Open 2022; 12:e062525. [PMID: 36171028 PMCID: PMC9528591 DOI: 10.1136/bmjopen-2022-062525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Physical activity (PA) interventions have a promising role in the management of gestational diabetes mellitus (GDM). Digital technologies can support PA at scale and remotely. The protocol describes a study designed to determine the feasibility and acceptability of a complex intervention; known as +Stay Active. +Stay Active combines motivational interviewing with a bespoke behaviour change informed smartphone application (Stay-Active) to augment PA levels in women with GDM. METHODS AND ANALYSIS This is a non-randomised feasibility study using a mixed methods approach. Participants will be recruited from the GDM antenatal clinic at the Women Centre, John Radcliffe Hospital, Oxford. Following baseline assessments (visit 1) including self-reported and device determined PA assessment (wearing a wrist accelerometer), women will be invited to participate in an online motivational interview, then download and use the Stay-Active app (Android or iOS) (visit 2). Women will have access to Stay-Active until 36 weeks gestation, when engagement and PA levels will be reassessed (visit 3). The target sample size is 60 women. Primary outcomes are recruitment and retention rates, compliance and assessment of participant engagement and acceptability with the intervention. Secondary outcomes are assessment of blood glucose control, self-reported and device determined assessment of PA, usage and structured feedback of participant's attitudes to +Stay Active, assessment of health costs and description of maternal and neonatal outcomes. This study will provide key insights into this complex intervention regarding engagement in smartphone technology and the wearing of accelerometers. These data will inform the development of a randomised controlled trial with refinements to intervention implementation. ETHICS AND DISSEMINATION The study has received a favourable opinion from South Central-Hampshire B Research Ethics Committee; REC reference: 20/SC/0342. Written informed consent will be obtained from all participants. Findings will be disseminated through peer-reviewed journals, conferences and seminar presentations. TRIAL REGISTRATION NUMBER ISRCTN11366562.
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Affiliation(s)
- Ralph Smith
- Sport and Exercise Medicine, Rheumatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Yvonne Kenworthy
- Oxford Cardiovascular Clinical Research Facility, University of Oxford, Oxford, Oxfordshire, UK
| | - Nerys M Astbury
- Nuffield Department of Primary Care Health Sciences, Univeristy of Oxford, Oxford, UK
| | - Jacqueline Birks
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Paul Bateman
- Nuffield Department of Primary Care Health Sciences, Univeristy of Oxford, Oxford, UK
| | - Pamela Dyson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Jane E Hirst
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
- Women Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, Univeristy of Oxford, Oxford, UK
| | - Moscho Michalopoulou
- Nuffield Department of Primary Care Health Sciences, Univeristy of Oxford, Oxford, UK
| | - Richard Pulsford
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Cristian Roman
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, Oxfordshire, UK
| | - Mauro Santos
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, Oxfordshire, UK
| | - Lionel Tarassenko
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, Oxfordshire, UK
| | - Nicola Wango
- Women Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Amy Wire
- Patient representative, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Lucy H MacKillop
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
- Women Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
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Physical Activity during Pregnancy and Newborn Body Composition: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127127. [PMID: 35742376 PMCID: PMC9222359 DOI: 10.3390/ijerph19127127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022]
Abstract
The current literature demonstrates that not only is exercise during pregnancy safe, but it has substantial maternal and infant benefits and appears to influence infant growth/size throughout pregnancy and at birth. However, many existing studies have investigated only the effects of prenatal exercise on birth weight. The purpose of this review was to determine the impact or association of maternal physical activity during pregnancy on neonatal body composition assessed between birth and two weeks of age. Electronic database searches were conducted on 29 July 2019 for randomized control trials and cohort studies, with an updated search completed on 8 January 2021. A total of 32 articles that met eligibility criteria were selected for review. Overall, prenatal exercise was not associated with infant body composition at birth. Yet, five of the studies identified suggest that infant body composition could be influenced by higher volumes of mid-to-late term prenatal physical activity. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO (Registration No. CRD42020160138).
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Does Prenatal Physical Activity Affect the Occurrence of Postnatal Anxiety and Depression? Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042284. [PMID: 35206473 PMCID: PMC8872187 DOI: 10.3390/ijerph19042284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 02/04/2023]
Abstract
The aim of the foregoing study was to assess whether physical activity during pregnancy affects the occurrence of anxiety and depression during pregnancy, postpartum and 6 months following childbirth. This study tried to answer the following questions: How was the incidence of depression and anxiety different in the pre- and postpartum periods? What intensity level of physical activity protects against the symptoms of anxiety and depression? Does the time spent engaged in sedentary activities and MVPA affect the occurrence of depression and anxiety before and after childbirth? The study group under analysis consisted of 187 women aged 19–41 years. The research was conducted between April 2016 and November 2020. The study was divided into four stages: T0—qualification to participate in the study; T1—medical history acquisition, consisting of a short questionnaire and two long questionnaires (the Edinburgh Postnatal Depression Scale (EPDS) and General Anxiety Disorder-7 (GAD-7)), as well as an assessment of 7-day physical activity using Actigraph accelerometers during the pregnancy; T2—the completion of the EPDS and GAD-7 questionnaires after the birth; T3—the completion of the EPDS and GAD-7 questionnaire 6 months after giving birth. The obtained results were statistically processed in the Statistica 13.3 software package. A significance level of p < 0.05 was assumed. The highest percentage of depression occurred immediately after the delivery, followed by 6 months after delivery, and the smallest number of women suffered from depression before the birth (p < 0.001). The analysis of correlations of physical activity with anxiety symptoms did not show significant correlations. However, the situation is different in the case of depression symptoms. Women taking fewer steps before delivery showed a greater tendency to develop depressive symptoms before, immediately after and 6 months after the delivery (p < 0.001). Women who were less active (took fewer steps per day, spent less time in moderate-to-vigorous physical (MVPA) activities or spent more time being sedentary) showed symptoms of depression on the EPDS scale. It appeared that those with severe anxiety symptoms had the highest sedentary time scores before the delivery (p = 0.020). Reduced physical activity promotes the onset of postnatal depression, while being active reduces this risk. Interestingly, even light physical activity “protects” against the occurrence of depression and is better than sedentary activities. Such clear conclusions cannot be drawn in relation to anxiety symptoms. Sedentary behaviour may promote anxiety symptoms immediately after childbirth, but this study should be continued in order to confirm it during other time periods.
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Liu F, Wanigatunga AA, Schrack JA. Assessment of Physical Activity in Adults using Wrist Accelerometers. Epidemiol Rev 2021; 43:65-93. [PMID: 34215874 DOI: 10.1093/epirev/mxab004] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 11/12/2022] Open
Abstract
The health benefits of physical activity have been widely recognized, yet traditional measures of physical activity including questionnaires and category-based assessments of volume and intensity provide only broad estimates of daily activities. Accelerometers have advanced epidemiologic research on physical activity by providing objective and continuous measurement of physical activity in free-living conditions. Wrist-worn accelerometers have become especially popular due to low participant burden. However, the validity and reliability of wrist-worn devices for adults have yet to be summarized. Moreover, accelerometer data provide rich information on how physical activity is accumulated throughout the day, but only a small portion of these rich data have been utilized by researchers. Lastly, new methodological developments that aim to overcome some of the limitations of accelerometers are emerging. The purpose of this review is to provide an overview of accelerometry research, with a special focus on wrist-worn accelerometers. We describe briefly how accelerometers work, summarize the validity and reliability of wrist-worn accelerometers, discuss the benefits of accelerometers including measuring light-intensity physical activity, and discuss pattern metrics of daily physical activity recently introduced in the literature. A summary of large-scale cohort studies and randomized trials that implemented wrist-worn accelerometry is provided. We conclude the review by discussing new developments and future directions of research using accelerometers, with a focus on wrist-worn accelerometers.
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Affiliation(s)
- Fangyu Liu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, United States
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Jones D, De Lucia Rolfe E, Rennie KL, Griep LMO, Kusinski LC, Hughes DJ, Brage S, Ong KK, Beardsall K, Meek CL. Antenatal Determinants of Childhood Obesity in High-Risk Offspring: Protocol for the DiGest Follow-Up Study. Nutrients 2021; 13:1156. [PMID: 33807319 PMCID: PMC8067255 DOI: 10.3390/nu13041156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 12/11/2022] Open
Abstract
Childhood obesity is an area of intense concern internationally and is influenced by events during antenatal and postnatal life. Although pregnancy complications, such as gestational diabetes and large-for-gestational-age birthweight have been associated with increased obesity risk in offspring, very few successful interventions in pregnancy have been identified. We describe a study protocol to identify if a reduced calorie diet in pregnancy can reduce adiposity in children to 3 years of age. The dietary intervention in gestational diabetes (DiGest) study is a randomised, controlled trial of a reduced calorie diet provided by a whole-diet replacement in pregnant women with gestational diabetes. Women receive a weekly dietbox intervention from enrolment until delivery and are blinded to calorie allocation. This follow-up study will assess associations between a reduced calorie diet in pregnancy with offspring adiposity and maternal weight and glycaemia. Anthropometry will be performed in infants and mothers at 3 months, 1, 2 and 3 years post-birth. Glycaemia will be assessed using bloodspot C-peptide in infants and continuous glucose monitoring with HbA1c in mothers. Data regarding maternal glycaemia in pregnancy, maternal nutrition, infant birthweight, offspring feeding behaviour and milk composition will also be collected. The DiGest follow-up study is expected to take 5 years, with recruitment finishing in 2026.
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Affiliation(s)
- Danielle Jones
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (D.J.); (S.B.); (K.K.O.)
- Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK; (L.C.K.); (D.J.H.)
| | - Emanuella De Lucia Rolfe
- NIHR Cambridge Biomedical Research Centre—Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (E.D.L.R.); (K.L.R.); (L.M.O.G.)
| | - Kirsten L. Rennie
- NIHR Cambridge Biomedical Research Centre—Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (E.D.L.R.); (K.L.R.); (L.M.O.G.)
| | - Linda M. Oude Griep
- NIHR Cambridge Biomedical Research Centre—Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (E.D.L.R.); (K.L.R.); (L.M.O.G.)
| | - Laura C. Kusinski
- Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK; (L.C.K.); (D.J.H.)
| | - Deborah J. Hughes
- Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK; (L.C.K.); (D.J.H.)
- Cambridge Universities NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (D.J.); (S.B.); (K.K.O.)
- NIHR Cambridge Biomedical Research Centre—Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (E.D.L.R.); (K.L.R.); (L.M.O.G.)
| | - Ken K. Ong
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; (D.J.); (S.B.); (K.K.O.)
| | - Kathryn Beardsall
- Department of Paediatric Medicine, University of Cambridge, Cambridge CB2 0QQ, UK;
- Cambridge Universities NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Claire L. Meek
- Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK; (L.C.K.); (D.J.H.)
- Cambridge Universities NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
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How Many Valid Days Are Necessary to Assess Physical Activity Data From Accelerometry During Pregnancy? J Phys Act Health 2021; 18:337-344. [PMID: 33592577 DOI: 10.1123/jpah.2020-0636] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/05/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The authors examined whether or not ≤3 days wearing Actical® accelerometers provided acceptable results in comparison with the recommendation of ≥4 days in women across gestation. METHODS A total of 26, 76, and 57 participants at early, mid, and late pregnancy, respectively, were assessed. Participants were instructed to wear the device for 7 days and women who wore it for ≥4 days were included. For each participant, 3, 2, and 1 day(s) were randomly selected. Paired comparisons, intraclass correlations coefficients, and kappa statistics were performed for ≥4 days (criterion) versus 3, 2, and 1 day(s). Averages (in minutes per day) of sedentary time, light, moderate, vigorous, moderate to vigorous physical activity (PA) and steps per day were examined. RESULTS When 3 valid days were compared with the criterion, no significant differences were found for any gestational period. The intraclass correlations coefficients were "high" for all PA-related variables. The k values varied from .819 to .838 across pregnancy ("strong"). Two and 1 valid day(s) versus the criterion showed significant differences in some PA intensities, reduced intraclass correlations coefficients, "moderate" k values for 2 valid days (.638-.788) and "minimal-to-moderate" k values for 1 valid day (.367-.755). CONCLUSION In pregnant women during early, mid, and late pregnancy, PA data obtained from 3 valid days of wear was equivalent and agreed with ≥4 valid days.
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Modarress Julin M, Saukkonen J, Oura P, Niemelä M, Junno JA, Määttä J, Niinimäki J, Jämsä T, Korpelainen R, Karppinen J. Association between device-measured physical activity and lumbar Modic changes. BMC Musculoskelet Disord 2020; 21:630. [PMID: 32977783 PMCID: PMC7519485 DOI: 10.1186/s12891-020-03638-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/08/2020] [Indexed: 11/24/2022] Open
Abstract
Background Modic changes (MC) in the lumbar spine are considered one potential etiological factor behind low back pain (LBP). Multiple risk factors for MC have been suggested, including male gender, smoking and factors affecting hyperloading and mechanical stress such as high body mass index (BMI), strenuous physical work and high occupational and leisure-time physical activity (PA). So far, the effect of PA on the occurrence of MC has remained under debate due to contradictory findings. The purpose of this study was to investigate the possible association between device-measured moderate-to-vigorous PA (MVPA) (≥ 3.5 METs) and lumbar MC. Methods The study had 1374 participants from the Northern Finland Birth Cohort 1966. At the age of 46–48, PA was measured by a wrist-worn accelerometer, and lumbar magnetic resonance imaging (MRI) was carried out to determine MC. We analyzed the association between Type 1 (MC1) and Type 2 (MC2) MC and daily amount of MVPA (min/day) using sex-stratified logistic regression models before and after adjustment for BMI, socioeconomic status, smoking, and accelerometer wear time. Results Among men, increased amount of MVPA was positively associated with any MC (adjusted OR corresponding to every 60 min/day of MVPA 1.41; 95% confidence interval (CI) 1.01 to 1.95) and MC2 (OR 1.54; 95% CI 1.14 to 2.08), but not with MC1 (OR 1.06; 95% CI 0.80 to 1.39). Among women, we only found a positive association between MVPA and MC1 before adjustments (unadjusted OR 1.42; 95% CI 1.06 to 1.92). Conclusion Among men, increased amount of MVPA was associated with increased odds of any MC and particularly MC2. Among women, MVPA was not independently associated with MC.
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Affiliation(s)
- Marella Modarress Julin
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014, Oulu, Finland. .,Center for Life Course Health Research, PO Box 5000, FI-90014, Oulu, Finland. .,Clinic of Physiatry, Oulu University Hospital (OYS), PO Box 21, 90029, Oulu, Finland.
| | - Jesperi Saukkonen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.,Center for Life Course Health Research, PO Box 5000, FI-90014, Oulu, Finland
| | - Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.,Center for Life Course Health Research, PO Box 5000, FI-90014, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland
| | - Maisa Niemelä
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland
| | - Juho-Antti Junno
- Center for Life Course Health Research, PO Box 5000, FI-90014, Oulu, Finland.,Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.,Department of Archaeology, Faculty of Humanities, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland
| | - Juhani Määttä
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.,Center for Life Course Health Research, PO Box 5000, FI-90014, Oulu, Finland
| | - Jaakko Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland
| | - Timo Jämsä
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.,Diagnostic Radiology, Oulu University Hospital (OYS), P.O. Box 10, FI-90029, Oulu, Finland
| | - Raija Korpelainen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.,Center for Life Course Health Research, PO Box 5000, FI-90014, Oulu, Finland.,Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation, PO Box 365, FI-90100, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.,Center for Life Course Health Research, PO Box 5000, FI-90014, Oulu, Finland.,Finnish Institute of Occupational Health, Aapistie 1, FI-90220, Oulu, Finland
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Physical Activity During Pregnancy and Preterm Birth: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study. J Phys Act Health 2020; 17:1065-1074. [PMID: 32947261 DOI: 10.1123/jpah.2019-0604] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 06/08/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical activity (PA) during pregnancy is associated with several benefits in maternal and child outcomes, and its relationship with preterm birth is still conflicting. This study aims to examine the associations between PA during pregnancy and occurrence of preterm birth. METHODS PA was assessed by questionnaire (for each trimester) and accelerometry (second trimester) in women enrolled in a birth cohort study that started during pregnancy and included births that occurred between January 1 and December 31, 2015. Gestational age was based on the last menstrual period and ultrasonography. All deliveries before 37 weeks of gestation were considered preterm births. A Poisson regression model was used to measure associations controlling for potential confounders. RESULTS PA information was available for 4163 women and 13.8% of births were preterm. A total of 15.8% of women were engaged in PA during pregnancy. Multivariate analysis showed that only PA performed in the third trimester of pregnancy (prevalence ratio = 0.58; 95% confidence interval, 0.36-0.96) was associated with the outcome. CONCLUSIONS PA performed in the third trimester of pregnancy was associated with a protection to preterm birth. Pregnant women should be counseled to engage in PA to lower the risk of premature delivery.
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