Gender and Age Differences in Levels, Types and Locations of Physical Activity among Older Adults Living in Car-Dependent Neighborhoods

Predictors of physical activity and public safety perception regarding technology adoption for promoting physical activity in Jeddah, Saudi Arabia

Background

This study aims to identify the predictors of levels of physical activity among the residents of Jeddah, Saudi Arabia. Additionally, it seeks to understand the public's safety perception regarding the adoption of technology for promoting physical activity.

Method

This is an analytical cross-sectional study using self-administered web-based survey. A stratified sampling technique was used to select participants from adult population in Jeddah and data collection took place from May 2023 to December 2023. Multivariable logistic regression models were applied to identify predictors of low-intensity (walking steps) and high-intensity physical activities.

Result

A total of 462 participated in the study. Gender significantly influenced walking habits, with males more likely to walk than females (AOR = 2.37; 95 % CI: 1.55-3.62; P < 0.001). Smoking status was also a predictor, with smokers more inclined to walk compared to non-smokers (AOR = 2.15; 95 % CI: 1.20-3.82; P = 0.010). High-intensity physical activity strongly correlated with increased walking, especially among those active 3-7 days per week (AOR = 3.03; 95 % CI: 1.91-4.78; P < 0.001). Chronic diseases negatively impacted walking frequency (AOR = 0.57; 95 % CI: 0.34-0.95; P = 0.031). Furthermore, males were likelier to engage in high-intensity activities compared to females (AOR = 1.61; 95 % CI: 1.04-2.50; P = 0.033). Those walking ≥ 10,000 steps weekly were more likely to participate in high-intensity activities (AOR = 3.07; 95 % CI: 1.95-4.82; P < 0.001). Excellent self-rated health was associated with higher participation in such activities (AOR = 2.00; 95 % CI: 1.30-3.06; P = 0.002). Most respondents (84.9 %) felt safe on public walkways, and 78.1 % indicated safety perceptions influenced their walkway use. Technology use was divided, with about half (49.1 %) using apps for tracking physical activity. The majority (90.9 %) supported adding motivational features to the 'Sehhaty' app, and 73.6 % favored financial rewards for walking. However, only 45.5 % believed that public walkways are designed to encourage walking.

Conclusion

The study highlights significant predictors of physical activity among general population in Jeddah. The study also revealed the impact of safety perceptions and technology use on physical activity, with strong support for motivational features in health apps. However, there is a need for improved design of public walkways to encourage walking.

Social risk and patient-reported outcomes after total knee replacement: Implications for Medicare policy

OBJECTIVE

To determine whether county-level or patient-level social risk factors are associated with patient-reported outcomes after total knee replacement when added to the comprehensive joint replacement risk-adjustment model.

DATA SOURCES AND STUDY SETTING

Patient and outcomes data from the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement cohort were merged with the Social Vulnerability Index from the Centers for Disease Control and Prevention.

STUDY DESIGN

This prospective longitudinal cohort measured the change in patient-reported pain and physical function from baseline to 12 months after surgery. The cohort included a nationally diverse sample of adult patients who received elective unilateral knee replacement between 2012 and 2015.

DATA COLLECTION/EXTRACTION METHODS

Using a national network of over 230 surgeons in 28 states, the cohort study enrolled patients from diverse settings and collected one-year outcomes after the surgery. Patients <65 years of age or who did not report outcomes were excluded.

PRINCIPAL FINDINGS

After adjusting for clinical and demographic factors, we found patient-reported race, education, and income were associated with patient-reported pain or functional scores. Pain improvement was negatively associated with Black race (CI = -8.71, -3.02) and positively associated with higher annual incomes (≥$45,00) (CI = 0.07, 2.33). Functional improvement was also negatively associated with Black race (CI = -5.81, -0.35). Patients with higher educational attainment (CI = -2.35, -0.06) reported significantly less functional improvement while patients in households with three adults reported greater improvement (CI = 0.11, 4.57). We did not observe any associations between county-level social vulnerability and change in pain or function.

CONCLUSIONS

We found patient-level social factors were associated with patient-reported outcomes after total knee replacement, but county-level social vulnerability was not. Our findings suggest patient-level social factors warrant further investigation to promote health equity in patient-reported outcomes after total knee replacement.

Physical activity following pulmonary embolism and clinical correlates in selected patients: a cross-sectional study

Background

There is limited knowledge regarding physical activity and clinical correlates among people who have suffered a pulmonary embolism (PE).

Objectives

To assess physical activity levels after PE and potential clinical correlates.

Methods

One hundred forty-five individuals free of major comorbidities were recruited at a mean of 23 months (range, 6-72) after PE diagnosis. Physical activity was assessed by steps/day on the Sensewear monitor for 7 consecutive days, exercise capacity with the incremental shuttle walk test, and cardiac function with left ventricular ejection fraction (LVEF). The association between physical activity and other variables was analyzed by a mixed-effects model.

Results

Participants achieved a mean of 6494 (SD, 3294; range, 1147-18.486) steps/day. The mixed-effects model showed that physical activity was significantly associated with exercise capacity (β-coefficient, 0.04; 95% CI, 0.03-0.05) and LVEF (β-coefficient, -0.81; 95% CI, -1.42 to -0.21). The analysis further showed that men became less physically active with increasing age (β-coefficient, -0.14; 95% CI, -0.24 to -0.04), whereas no change with age could be detected for women.

Conclusion

In selected post-PE patients, physical activity seems to be associated with exercise capacity and LVEF but not with quality of life, dyspnea, or characteristics of the initial PE. Men appear to become less physically active with increasing age.

The association of skeletal muscle energetics with recurrent falls in older adults within the Study of Muscle, Mobility and Aging (SOMMA)

Background

Falls in the older population are a major public health concern. While many physiological and environmental factors have been associated with fall risk, muscle mitochondrial energetics has not yet been investigated.

Methods

In this analysis, 835 Study of Muscle, Mobility and Aging (SOMMA) participants aged 70-94 were surveyed for recurrent falls (2+) after one year. Skeletal muscle energetics were assessed at baseline in vivo using 31 P Magnetic Resonance Spectroscopy (MRS) (ATPmax) and ex vivo by High Resolution Respirometry (HRR) of permeabilized muscle fibers from the vastus lateralis (MaxOXPHOS).

Results

SOMMA participants who reported recurrent falls (12%) had a slower 400m walk gait speed compared to those with 0-1 falls (1.0 +/-0.2 vs. 1.1 +/-0.2, p<.001) and took a greater number of medication in the 30 days before their baseline visit (5.6 +/-4.4 vs. 4.2 +/-3.4, p<0.05). MaxOXPHOS was significantly lower in those who reported recurrent falls (p=0.008) compared to those with one or fewer falls, but there was no significant difference in ATPmax (p=0.369). Neither muscle energetics measure was significantly associated with total number of falls or injurious falls, but recurrent falls were significantly higher with lower MaxOXPHOS (RR=1.33, 95% CI= 1.02-1.73, p=0.033). However, covariates accounted for the increased risk.

Conclusions

Ex vivo maximal muscle mitochondrial energetics were lower in older adults who experienced recurrent falls, but covariates accounted for its association with recurrent fall risk, suggesting this "hallmark of aging" may not be directly implicated in the complex etiology of falls.

Gender of Study Partners and Research Participants Associated With Differences in Study Partner Ratings of Cognition and Activity Level

OBJECTIVES

Studies of Alzheimer's disease typically include "study partners" (SPs) who report on participants' cognition and function. Prior studies show SP reports differ depending on the relationship between the SP and participant, that is, spouse or adult child. Adult children SPs are typically female. Could differing reports be due to gender? Knowing this may help explain variability in measurement.

METHODS

The Aging, Demographics, and Memory Study enrolled a subset of participants from the Health and Retirement Study. Each participant had an SP. Bivariate and multivariable regression models compared 718 SP-participant dyads.

RESULTS

In analyses of 4 groups defined by SP and participant gender, dyads composed of 2 women were less likely to identify as White (75.8%, 95% confidence interval [CI], 70.4-80.5) than dyads composed of 2 men (93.3%, 95% CI, 81.2-97.8). In analyses adjusted for the severity of cognitive and functional impairment, women SPs rated women participants as more active than they rated men, mean 2.15 (95% CI, 2.07-2.22) versus mean 2.30 (95% CI, 2.24-2.37), respectively, on a 4-point scale. Similarly, men SPs rated women participants as more active than they rated men, mean 2.1 (95% CI, 2.0-2.2) and mean 2.4 (95% CI, 2.3-2.5), respectively. In an analysis of cognitively unimpaired participants, women SPs rated participants' memory worse than men SPs did (p < .05).

DISCUSSION

SP and participant gender influence SPs' reports of another person's cognition and activity level. Our findings expand what is understood about how nondisease factors influence measures of disease severity.

Physical Activity Level and Specific Type of Exercises Among US Middle-Aged and Older Adults: Findings From the Behavioral Risk Factor Surveillance Survey

BACKGROUND

This study aimed to assess physical activity level and identify specific types of exercises by sex, race/ethnicity, and age for adults 50 years and older.

METHODS

Behavioral Risk Factor Surveillance System 2013, 2015, and 2017 data were used to study US adults 50 years and older on their specific types of exercises, stratified by sex, race/ethnicity, and age. Weighted logistic regression was used to model physical exercise level and specific types of exercises.

RESULTS

The sample included 460,780 respondents. Non-Hispanic Black and Hispanic were less likely than non-Hispanic White to meet the recommended physical activity level (Odds ratio [OR] = 0.73, P < .0001 and OR = 0.96, P = .04, respectively). Walking was the most participated type of exercise, followed by gardening, for both men and women, all racial/ethnic groups, and all age groups. Non-Hispanic Blacks were more likely to participate in walking (OR = 1.19, P = .02) and less likely to participate in gardening (OR = 0.65, P < .0001) than non-Hispanic Whites. Men were more likely to engage in strenuous exercises than women. The average number of minutes on walking was the longest among all types of specific exercises.

CONCLUSIONS

The types of exercises were mostly walking and gardening for adults aged 50 and older. Non-Hispanic Black adults had less physical activity than non-Hispanic White and were less likely to engage in gardening.

Analysis of the motivational processes involved in university physical activity

Introduction

Physical activity plays an important role in all stages of development, especially in adolescence, as it is a period in which different lifestyles are shaped. Therefore, regular practice of physical activity contributes to an improvement in quality of life. This study analyzed university students' motivational processes and intention to be physically active when engaging in physical activity (PA) according to gender and fields of study.

Methods

A total of 1.524 subjects participated in the study, 61.9% (n = 944) of whom were female and 38.1% (n = 580) were male, with an average age of 19.61 years. The fields of study consisted of Arts and Humanities (n = 118), Science (n = 132), Health Sciences (n = 351), Engineering and Architecture (n = 196) and Social and Legal Sciences (n = 727). The instruments used were the Behavioral Regulation in Exercise Questionnaire (BREQ-3) and the Intention to be Physically Active in the University Context (MIFAU) measurement scale.

Results

The results showed statistically significant differences in favour of men (p <0.01) in terms of intrinsic, integrated, identified, and introjected regulation of PA. Similarly, men were more likely to be physically active in the future than women (p <0.001). In terms of the study variables relating to the fields of study, statistically significant differences were obtained in the case of both more self-determined behavior (intrinsic, integrated and identified regulation) and amotivation (p <0.001).

Conclusion

It was concluded that there is a need for the promotion of intervention strategies to encourage young adults to take up sporting activities as a means of preventing noncommunicable diseases, thereby avoiding the negative consequences of a sedentary lifestyle, physical inactivity, or abandonment of such activities.

Health effects and cost-effectiveness of a multilevel physical activity intervention in low-income older adults; results from the PEP4PA cluster randomized controlled trial

Background

Older adults are the least active population in the U.S. Low-income communities have fewer physical activity (PA) resources, contributing to less PA and increased chronic disease risk. This study assessed the effect of the multilevel, peer-led, Peer Empowerment Program 4 Physical Activity (PEP4PA) on moderate-to-vigorous PA (MVPA) and health outcomes, over 2 years of follow up.

Methods

In a cluster-randomized controlled trial, 12 senior or community centers serving low-income older adults were assigned to a PA intervention (n = 6) or usual programming (n = 6) condition. PEP4PA included self-monitoring, health coaching, group walks, social support, and community advocacy to improve walking conditions. The primary outcome was daily minutes of MVPA (7-day accelerometer). Secondary outcomes included Perceived Quality of Life (PQoL), 6-Minute Walk Test (6-MWT), blood pressure (BP), and depressive symptoms at baseline, 6, 12, 18 and 24 months. Mixed effects regression models estimated the effects on outcomes between groups over time and included random effects for repeated measures and center clustering. Effect modification by sex and income status was assessed. We calculated the incremental cost per daily minute of MVPA gained in the intervention group relative to the control group to assess cost effectiveness.

Results

We enrolled 476 older adults (50 + years). Participants were on average 71 years old, 76% female, 60% low income, and 38% identified as racial or ethnic minorities. Compared to the control group, intervention participants sustained roughly a 10 min/day increase in MVPA from baseline at all time points and increased mean PQoL scores from unsatisfied at baseline to satisfied at 12, 18 and 24 months. Males and higher-income groups had greater improvements in MVPA. No significant effects were observed for 6-MWT or depressive symptoms, and BP results were mixed. The incremental cost per minute MVPA gained per person was $0.25, $0.09, $0.06, and $0.05 at 6, 12, 18 and 24 months, respectively.

Conclusions

PEP4PA achieved increases in MVPA and PQoL in low-income older adults, over 2 years of follow up. The peer-led, community-based intervention provides a sustainable and cost-effective model to improve health behaviors in underserved, aging populations.

Trial registration

ClinicalTrials.gov (NCT02405325) March 20, 2015.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01309-w.

Levels of Physical Activity and Psychological Well-Being in Non-Athletes and Martial Art Athletes during the COVID-19 Pandemic

Background: The objectives of this study were to identify which of the sociodemographic variables affected psychological well-being in two populations that differed in their sports practice at the end of the COVID-19 lockdown in Colombia. Methods: The study was conducted through an online survey using the IPAQ-S and PGWBI-S questionnaires six months after the first SARS-CoV-2 lockdown, between 8 and 22 September 2020 in Colombia. The total number of study participants was 582, subdivided into two groups: (i) non-athlete university population (NA) without constant practice in physical activity or sports training (n = 470); and (ii) martial arts athletes (n = 122) with a sports career (A), 7.4 ± 3.4 years of experience, at different levels (advanced belts and black belts). Results: Sports practice, normal BMI levels and high levels of physical activity translated into absence of distress (ND) in the psychological well-being of populations. The variance between the factors could be explained by the general health dimension (2.4% population; 4.2% sex; 12% physical activity; 2.6% age). A moderate correlation between vitality and MET was found (r = 0.33; p < 0.001). Conclusions: The practice of a sport such as martial arts, normal body mass index and high levels of physical activity were factors that positively reduced levels of distress, translated into better psychological well-being in populations, and the general health dimension presented important contributions to psychological well-being. Intervention plans must be carried out, especially in populations that do not practice physical activity—mainly female and those under 40 years of age.

Pre-stroke Physical Inactivity and Stroke Severity in Male and Female Patients

Introduction

Females experience more severe ischemic strokes than do males. A higher pre-stroke physical activity level is associated with less severe stroke. The primary aim of this study was to explore the association between pre-stroke physical inactivity and stroke severity in male and female patients.

Methods

This was a retrospective, registry-based study. The data were retrieved from two stroke registries from 2014 to 2019. The primary explanatory variable was physical activity level before the stroke, assessed using the Saltin-Grimby Physical Activity Level Scale. The outcome was moderate to severe stroke at hospital admission, assessed using the National Institutes of Health Stroke Scale (NIHSS). A moderate to severe stroke was defined as a NIHSS score of ≥6. Binary logistic regression analysis was performed to explore if physical inactivity before the stroke could explain stroke severity in male and female patients.

Results

In total, we included 4,535 patients with ischemic stroke. Female patients (n = 2,145) had a mean age of 76 years, 35% had a moderate to severe stroke, and 64% were physically inactive pre-stroke. Male patients (n = 2,390) had a mean age of 72 years, 25% had a moderate to severe stroke, and 49% were physically inactive pre-stroke. Physical inactivity was associated with higher odds for moderate to severe stroke in both sexes (females' odds ratio [OR], 2.7, 95% confidence interval [CI]: 2.2–3.3, p < 0.001 and males' OR, 2.06, 95% CI: 1.7–2.5, p < 0.001). The association remained significant in the adjusted models.

Conclusions

Physically inactive females and males had higher odds of experiencing a moderate to severe stroke. However, the OR of female patients was somewhat higher than that of male patients.

Capacity building in participatory stakeholder groups: results from a German research consortium on active lifestyles

To implement sustainable health-promoting structures in a setting, various agents must work together. In the Capital4Health research network, participatory stakeholder groups consisting of key persons, stakeholders, representatives of the target group, and facilitating experts are assembled in five settings (child care center, school, company, rural community, nursing home). In a Cooperative Planning process, the various groups meet regularly to plan and implement strategies to promote physical activity across different settings. This study evaluates whether participatory stakeholder groups have been established and also examines the capacity-building processes that took place in these stakeholder groups. For process evaluation, 78 group meetings were documented in 16 different stakeholder groups using a semi-structured protocol based on established capacity-building domains. For outcome evaluation, six semi-structured interviews (1-2 per setting) with facilitating experts were conducted. Data were analyzed by content analysis. Across all settings, capacity-building processes were successful to a certain degree (e.g. problem assessment, resource mobilization). However, in most groups it was difficult to broadly assess problems, to establish sustainable networks, or to find persons with leadership characteristics. Also, irregular participation, lack of motivation to take over responsibility, and minimal institutional readiness for structural and personal changes often hindered the progress of the projects. Stakeholder groups can actively involve setting members in the development of physical activity promotion programs. It seems challenging, however, to sustainably establish such groups that continue working independently without assistance from a facilitating expert.

Physical exercise and goal attainment after shunt surgery in idiopathic normal pressure hydrocephalus: a randomised clinical trial

Background

Rehabilitation in iNPH is suggested to be an important factor to improve patients’ functions but there are lack of clinical trials evaluating the effect of rehabilitation interventions after shunt surgery in iNPH. The objective of this study was to evaluate the effect of a physical exercise programme and goal attainment for patients with idiopathic normal pressure hydrocephalus (iNPH) after surgery compared to a control group.

Methods

This was a dual centre randomised controlled trial with assessor blinding, intention-to-treat (ITT) and per protocol (PP) analysis. Individuals diagnosed with iNPH scheduled to undergo shunt surgery at the Linköping University Hospital in Linköping and Sahlgrenska University Hospital in Gothenburg, Sweden were consecutively eligible for inclusion. Inclusion was conducted between January 2016 and June 2018. The patients were randomised 1:1 using sequentially numbered sealed envelopes to receive either written exercise information (control group) or written information and an additional supervised high-intensity, functional exercise programme (HIFE) executed twice weekly over 12 weeks (exercise group). Preoperatively, the patients set individual goals. The primary outcome was change from baseline in the total iNPH scale score at the post-intervention follow-up. Secondary outcomes were goal attainment, and change in the separate scores of gait, balance, neuropsychology and continence and in the total score after 6 months.

Results

In total, 127 participants were randomised to the exercise group (n = 62) and to the control group (n = 65). In the ITT population (exercise group, n = 50; control group, n = 59), there were no between-group differences in the primary outcome, but the attrition rate in the exercise group was high. The exercise group improved more than the control group in the balance domain scores after 6 months. Post-intervention, the PP exercise population achieved their set goals to a greater extent than the controls.

Conclusions

An additional effect of the 12-week HIFE-programme on the overall improvement according to the iNPH-scale after shunt surgery in iNPH was not shown. This could be due to high attrition rate. However, the long-term effect on balance and higher goal achievement indicate beneficial influences of supervised physical exercise.

Trial registration clinicaltrials.gov, NCT02659111. Registered 20 January 2016, https://clinicaltrials.gov/ct2/show/NCT02659111

Supplementary Information

The online version contains supplementary material available at 10.1186/s12987-021-00287-8.

Perioperative Exercise Intention and Influencing Factors: A Multi-Centered Cross-Sectional Study

Objectives: This study aimed to evaluate the level and factors affecting the perioperative exercise intention in China.

Design: This study was a cross-sectional survey in Southwest China.

Methods: Four hundred and ninety nine participants were randomly sampled in eight medical centers from November 23, 2020 to November 27, 2020. The survey included sociodemographic information and a 24-item modified questionnaire, which aimed to evaluate the attitude toward daily exercise, perception of perioperative exercise, social support and the perioperative exercise intention. A multivariable linear regression model was used to evaluate the effect of different items on the patients' intention for perioperative exercise.

Results: A total of 523 responses (95.09%) were collected and 499 (95.41%) were analyzed. The level of exercise intention of the patients during the perioperative period was: 14.83% planned to exercise every day in the hospital, 21.04% planned to exercise every other day, and 35.87% planned to exercise every week. Intensity of daily exercise (P = 0.016), positive attitude of daily exercise (P < 0.001), positive attitude of perioperative exercise (P < 0.001) and social support (P < 0.001) were positively associated with the intention for perioperative exercise. Female (P = 0.012), non-tertiary center (P = 0.011), and preoperative anxiety (P = 0.023) was negatively associated with it.

Conclusions: The intention for perioperative exercise was low in Southwest China. The authors aimed to relieve preoperative anxiety, promote the education of perioperative exercise, design perioperative exercise programs, and provide more social support from medical staff and family for inpatients undergoing elective surgery.

Understanding of Physical Activity in Social Ecological Perspective: Application of Multilevel Model

In the social ecological model, personal characteristics are important determinants of health behaviors, however, multi-dimensional approaches that consider social and physical environments must be utilized to gain a broader picture. Accordingly, this study examines the effects of personal, social, and physical environment variables as factors affecting levels of physical activity (METs). Our findings are based on 72,916 responses from the 2015 Community Health Survey in South Korea. Individual characteristics considered included sex, education level, marital status, age, and income. The social environment variables considered were trust between neighbors and the social network with neighbors. The physical environment variables were satisfaction with living environment and satisfaction with public transportation. The analysis was conducted using a multilevel model in order to accurately consider the characteristic differences of the variables. Regarding personal characteristics, sex, education level, and age have a significant effect on physical activity. Of the social and physical environment variables, social network with neighbors and satisfaction with public transportation have a significant effect on physical activity. This study confirms that a macroscopic understanding is needed to explain individual levels of physical activity; the results of this study will be helpful for public health interventions concerning physical activity.

The Effect of COVID-19 Lockdown Measures on Physical Activity Levels and Sedentary Behaviour in a Relatively Young Population Living in Kosovo

To abate the spread of the COVID-19 virus, different restriction measures were imperative, limiting the possibility to be engaged in physical activity. Therefore, this study aimed to evaluate the effect of COVID-19 lockdown on physical activity (PA) levels expressed as energy expenditure (MET-min/week) and sedentary behaviour in Kosovo. The possible association between PA levels and other factors was analyzed. 1633 participants (age range: 13 to 63 years; mean: 24.70 ± 9.33 years; body height: 172 ± 10.57 cm; body mass: 69.10 ± 13.80 kg; BMI: 23.09 ± 3.63 kg/m2) participated in the study, categorized by age, gender, BMI, and living area. An online survey, including an adapted version of the IPAQ-SF, was administered once during lockdown to assess PA levels and sedentary behaviour both before and during COVID-19 lockdown. The Wilcoxon signed-rank, Mann-Whitney U and Kruskal-Wallis rank of sum tests were used for statistical analysis. COVID-19 restrictions had a negative impact on the types of and overall PA levels MET-min/week (p < 0.001). Sedentary behaviour significantly increased during COVID-19 restrictions (p < 0.001). Higher decreases in MET-min/week during lockdown were observed among males, young and young adults, overweight, and urban-living participants. Finally, COVID-19 restrictions decreased the PA levels and MET-min/week, and increased sedentary behaviour also in a relatively young cohort. Such differences were dependent on several factors.

Association between Physical Activity and Mood States of Children and Adolescents in Social Isolation during the COVID-19 Epidemic

The COVID-19 epidemic adversely affects the lifestyle of people. This study aimed to examine the impacts of social isolation on physical activity (PA) levels and mood states of children and adolescents and to explore the correlation between them during the COVID-19 epidemic. A total of 9979 children and adolescents (11.63 ± 1.23 years old) from Yan’an, China volunteered to participate in this study and completed online questionnaires. PA and mood states were measured by International Physical Activity Questionnaire Short Form (IPAQ-SF) and Profile of Mood States (POMS), respectively. The results showed that the mean of students’ moderate-to-vigorous PA (MVPA) was 23.19 min per day. The total mood disturbance in the moderate and high-level PA groups were significantly lower than those in the low-level PA group (p < 0.05). Additionally, boys and girls had significant differences in PA levels (p < 0.01), and the PA levels of students in different grades were also significantly different (p < 0.01). Meanwhile, boys’ mood states were worse than girls’. The Grade 4 in primary schools had the worst mood states while Grade 5 had the best mood states. The results suggested that the MVPA of students has dropped badly, compared with the results of previous studies investigated in normal times. In addition, the PA level had a significantly positive impact on the mood states of children and adolescents during the COVID-19 epidemic. Sex and grades were factors which affected the PA levels and mood states. This study can help policymakers and healthcare professionals understand PA and mood states of Chinese children and adolescents during the epidemic. We should pay attention to the changes in PA levels and mood states of children and adolescents.

Physical performance and activity among older adults visiting primary healthcare centres in Riyadh

Objective

To assess physical performance (PP) and physical activity (PA) among older adults visiting primary healthcare centres (PHCCs) in Riyadh.

Methods

In this cross-sectional study, men and women (n = 74) aged ≥60 years were recruited from five PHCCs across Riyadh, Saudi Arabia, between 19 February and 6 August 2017. The Timed Up & Go test was used to assess PP. Self-reported PA was assessed using the Physical Activity Scale for the Elderly. Means and standard deviations were used to describe PP and PA scores across genders. A two-tailed independent samples t-test was used to estimate mean differences (MD) and 95% confidence intervals (CI) between genders.

Results

Men scored significantly lower than women on PP (MD: 2.11, 95% CI: 0.59 to 3.64) and PA (MD: −46.1, 95% CI: −80.96 to −11.25). Significant gender differences were observed for leisure time activities (MD: 17.35, 95% CI: 3.29 to 31.40), light household activities (MD: –10.86, 95% CI: –16.19 to –5.53) and heavy household activities (MD: –6.48, 95% CI: –11.73 to –1.23).

Conclusions

Men show significantly lower PP and PA than women. There are gender differences in leisure time activities and in light and heavy household activities.

The Impact of Covid-19 and the Effect of Psychological Factors on Training Conditions of Handball Players

The spread of COVID-19 has altered sport in Spain, forcing athletes to train at home. The objectives of the study were: (i) to compare training and recovery conditions before and during the isolation period in handball players according to gender and competitive level, and (ii) to analyse the impact of psychological factors during the isolation period. A total of 187 participants (66 women and 121 men) answered a Google Forms questionnaire about demographics, training, moods, emotional intelligence, and resilience sent using the snowball sampling technique. T-test and analysis of variance (ANOVA) were used to compare sport level and gender differences. Linear regressions were used to analyse the psychological influence on training. Handball players reduced training intensity (in the whole sample; p = 0.44), training volume (especially in professional female handball players; p < 0.001), and sleep quality (especially in professional male handball players; p = 0.21) and increased sleep hours (especially in non-professional female players; p = 0.006) during the isolation period. Furthermore, psychological factors affected all evaluated training and recovery conditions during the quarantine, except for sleep quantity. Mood, emotional intelligence, and resilience have an influence on physical activity levels and recovery conditions. In addition, training components were modified under isolation conditions at p < 0.001. We conclude that the COVID-19 isolation period caused reductions in training volume and intensity and decreased sleep quality. Furthermore, psychological components have a significant impact on training and recovery conditions.

Environmental and behavioural interventions for reducing physical activity limitation and preventing falls in older people with visual impairment

BACKGROUND

Impairment of vision is associated with a decrease in activities of daily living. Avoidance of physical activity in older adults with visual impairment can lead to functional decline and is an important risk factor for falls. The rate of falls and fractures is higher in older people with visual impairment than in age-matched visually normal older people. Possible interventions to reduce activity restriction and prevent falls include environmental and behavioral interventions.

OBJECTIVES

We aimed to assess the effectiveness and safety of environmental and behavioral interventions in reducing physical activity limitation, preventing falls and improving quality of life amongst visually impaired older people.

SEARCH METHODS

We searched CENTRAL (including the Cochrane Eyes and Vision Trials Register) (Issue 2, 2020), Ovid MEDLINE, Embase and eight other databases to 4 February 2020, with no language restrictions.

SELECTION CRITERIA

Eligible studies were randomized controlled trials (RCTs) and quasi-randomized controlled trials (Q-RCTs) that compared environmental interventions, behavioral interventions or both, versus control (usual care or no intervention); or that compared different types of environmental or behavioral interventions. Eligible study populations were older people (aged 60 and over) with irreversible visual impairment, living in their own homes or in residential settings. To be eligible for inclusion, studies must have included a measure of physical activity or falls, the two primary outcomes of interest. Secondary outcomes included fear of falling, and quality of life.

DATA COLLECTION AND ANALYSIS

We used standard Cochrane methods. We assessed the certainty of the evidence using the GRADE approach.

MAIN RESULTS

We included six RCTs (686 participants) conducted in five countries (Australia, Hungary, New Zealand, UK, US) with follow-up periods ranging from two to 12 months. Participants in these trials included older adults (mean age 80 years) and were mostly female (69%), with visual impairments of varying severity and underlying causes. Participants mostly lived in their homes and were physically independent. We classified all trials as having high risk of bias for masking of participants, and three trials as having high or unclear risk of bias for all other domains. The included trials evaluated various intervention strategies (e.g. an exercise program versus home safety modifications). Heterogeneity of study characteristics, including interventions and outcomes, (e.g. different fall measures), precluded any meta-analysis. Two trials compared the home safety modification by occupational therapists versus social/home visits. One trial (28 participants) reported physical activity at six months and showed no evidence of a difference in mean estimates between groups (step counts: mean difference (MD) = 321, 95% confidence interval (CI) -1981 to 2623; average walking time (minutes): MD 1.70, 95% CI -24.03 to 27.43; telephone questionnaire for self-reported physical activity: MD -3.68 scores, 95% CI -20.6 to 13.24; low-certainty of evidence for each outcome). Two trials reported the proportion of participants who fell at six months (risk ratio (RR) 0.76, 95% CI 0.38 to 1.51; 28 participants) and 12 months (RR 0.59, 95% CI 0.43 to 0.80, 196 participants) with low-certainty of evidence for each outcome. One trial (28 participants) reported fear of falling at six months, using the Short Falls Efficacy Scale-International, and found no evidence of a difference in mean estimates between groups (MD 2.55 scores, 95% CI -0.51 to 5.61; low-certainty of evidence). This trial also reported quality of life at six months using 12-Item Short Form Health Survey, and showed no evidence of a difference in mean estimates between groups (MD -3.14 scores, 95% CI -10.86 to 4.58; low-certainty of evidence). Five trials compared a behavioral intervention (exercise) versus usual activity or social/home visits. One trial (59 participants) assessed self-reported physical activity at six months and showed no evidence of a difference between groups (MD 9.10 scores, 95% CI -13.85 to 32.5; low-certainty of evidence). Three trials investigated different fall measures at six or 12 months, and found no evidence of a difference in effect estimates (RRs for proportion of fallers ranged from 0.54 (95% CI 0.29 to 1.01; 41 participants); to 0.93 (95% CI 0.61 to 1.39; 120 participants); low-certainty of evidence for each outcome). Three trials assessed the fear of falling using Short Falls Efficacy Scale-International or the Illinois Fear of Falling Measure from two to 12 months, and found no evidence of a difference in mean estimates between groups (the estimates ranged from -0.88 score (95% CI -2.72 to 0.96, 114 participants) to 1.00 score (95% CI -0.13 to 2.13; 59 participants); low-certainty of evidence). One trial (59 participants) assessed the European Quality of Life scale at six months (MD -0.15 score, 95% CI -0.29 to -0.01), and found no evidence of a clinical difference between groups (low-certainty of evidence).

AUTHORS' CONCLUSIONS

There is no evidence of effect for most of the environmental or behavioral interventions studied for reducing physical activity limitation and preventing falls in visually impaired older people. The certainty of evidence is generally low due to poor methodological quality and heterogeneous outcome measurements. Researchers should form a consensus to adopt standard ways of measuring physical activity and falls reliably in older people with visual impairments. Fall prevention trials should plan to use objectively measured or self-reported physical activity as outcome measures of reduced activity limitation. Future research should evaluate the acceptability and applicability of interventions, and use validated questionnaires to assess the adherence to rehabilitative strategies and performance during activities of daily living.

The impact of physical activity on psychological health during Covid-19 pandemic in Italy

The worldwide spread of COVID-19 has upset the normality of Italian daily life, forcing population to social distancing and self-isolation. Since the containment precautions also concern sport-related activities, home workout remained the only possibility to play sports and stay active during the pandemic. The present study aimed to examine changes in the physical activity levels during self-quarantine in Italy, and the impact of exercise on psychological health. A total of 2974 Italian subjects has completed an online survey, but only 2524 subjects resulted eligible for this study. The questionnaire measured the total weekly physical activity energy expenditure before and during quarantine (i.e. the sum of walking, moderate-intensity physical activities, and vigorous-intensity physical activities) in Metabolic Equivalent Task minutes per week (MET-min/wk) using an adapted version of International Physical Activity Questionnaire and their psychological well-being using the Psychological General Well Being Index. Of the 2524 Italian subjects included in the study, 1426 were females (56.4%) and 1098 males (43.6%). Total physical activity significantly decreased between before and during COVID-19 pandemic (Mean: 2429 vs. 1577 MET-min/wk, ∗∗∗∗p < 0.0001), in all age groups and especially in men (Female, mean: 1994 vs. 1443 MET-min/wk, ∗∗∗∗p < 0.0001; Male, mean: 2998 vs. 1754 MET-min/wk, ∗∗∗∗p < 0.0001). Furthermore, a significant positive correlation was found between the variation of physical activity and mental well-being (r = 0.07541, ∗∗∗p = 0.0002), suggesting that the reduction of total physical activity had a profoundly negative impact on psychological health and well-being of population. Based on this scientific evidence, maintaining a regular exercise routine is a key strategy for physical and mental health during a forced rest period like the current coronavirus emergency.

Physical Activity Levels and Related Energy Expenditure during COVID-19 Quarantine among the Sicilian Active Population: A Cross-Sectional Online Survey Study

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the Italian government has adopted containment measures to control the virus’s spread, including limitations to the practice of physical activity (PA). The aim of this study was to estimate the levels of PA, expressed as energy expenditure (MET–minute/week), among the physically active Sicilian population before and during the last seven days of the COVID-19 quarantine. Furthermore, the relation between this parameter and specific demographic and anthropometric variables was analyzed. Methods: 802 Sicilian physically active participants (mean age: 32.27 ± 12.81 years; BMI: 23.44 ± 3.33 kg/m2) were included in the study and grouped based on gender, age and BMI. An adapted version of the International Physical Activity Questionnaire—short form (IPAQ-SF) was administered to the participants through an online survey. The Wilcoxon signed-rank test and the Kruskal-Wallis rank-sum test were used for statistical analyses. Results: As expected, we observed a significant decrease of the total weekly energy expenditure during the COVID-19 quarantine (p < 0.001). A significant variation in the MET–min/wk in the before quarantine condition (p = 0.046) and in the difference between before and during quarantine (p = 0.009) was found for males and females. The male group decreased the PA level more than the female one. Moreover, a significant difference in the MET–min/wk was found among groups distributions of BMI (p < 0.001, during quarantine) and of age (p < 0.001, both before and during quarantine). In particular, the highest and the lowest levels of PA were reported by the young and the elderly, respectively, both before and during quarantine. Finally, the overweight group showed the lowest level of PA during quarantine. Conclusion: Based on our outcomes, we can determine that the current quarantine has negatively affected the practice of PA, with greater impacts among males and overweight subjects. In regards to different age groups, the young, young adults and adults were more affected than senior adults and the elderly.

Subjective reports of physical activity levels and sedentary time prior to hospital admission can predict utilization of hospital care and all-cause mortality among patients with cardiovascular disease

Background

In prevention, sedentary behaviour and physical activity have been associated with risk of cardiovascular disease and mortality. Less is known about associations with utilization of hospital care.

Aim

To investigate whether physical activity level and sedentary behaviour prior to cardiac ward admission can predict utilization of hospital care and mortality among patients with cardiovascular disease.

Methods

Longitudinal observational study including 1148 patients admitted and treated in cardiac wards in two hospitals. Subjective reports of physical activity levels and sedentary time prior to admission were collected during inpatient care and categorized as low, medium or high. The associations between physical activity level and sedentary time with hospital stay, readmission and mortality were analysed using linear, logistic and Cox regressions.

Results

Median hospital stay was 2.1 days. One higher step in the physical activity level, or lower sedentary time, was related to an approximately 0.9 days shorter hospital stay. Sixty per cent of patients were readmitted to hospital. The risk of being readmitted was lower for individuals reporting high physical activity and low sedentary time (odds ratios ranging between 0.44 and 0.91). A total of 200 deaths occurred during the study. Mortality was lower among those with high and medium physical activity levels and low sedentary time (hazard ratios ranging between 0.36 and 0.90).

Conclusion

Both physical activity level and sedentary time during the period preceding hospitalization for cardiac events were predictors of hospital utilization and mortality. This highlights the prognostic value of assessing patients’ physical activity and sedentary behaviour.

Capacity Building in Community Stakeholder Groups for Increasing Physical Activity: Results of a Qualitative Study in Two German Communities

Community capacity building is an essential approach for health promotion, combining a participatory approach with the view to community ownership. Little research focuses on practical capacity building strategies and monitoring. Our paper looks into involving stakeholders in facilitated group discussions as a specific strategy for fostering capacity building processes. These processes focused on physical activity (PA) promotion in two German communities (ACTION4men). Along the dimensions of capacity building suggested in literature (e.g., problem solving, resource mobilization, leadership), we implemented two participatory stakeholder groups (1/community). These groups were motivated to develop and implement PA interventions for men >50 years. For measuring capacity building processes, a semi-standardized monitoring instrument was used to document all group meetings. Additionally, we conducted semi-standardized interviews with group participants and drop-outs to capture their perspectives on capacity building. All documents were analyzed using thematic analysis. We successfully established stakeholder groups that planned and implemented a range of local measures meant to increase PA among older men. In one community, the process was sustainable, whereby the group continued to meet regularly over years. Capacity building was successful to a certain degree (e.g., regarding participation, problem assessment, and resource mobilization), but stalled after first meetings. Capacity building processes differed between the two communities in terms of leadership and sustainability. The developed interventions mainly addressed the access to organized sport courses, rather than tackling walkability or active transport. The theoretical capacity building approach was successful to develop and implement programs aimed at promoting PA. The actual capacity building processes depend upon the composition of stakeholder groups and inherent power relations.

Do Older Adults with Multimorbidity Meet the Recommended Levels of Physical Activity? An Analysis of Scottish Health Survey

There is a positive association between physical activity (PA) and improved health in older adults. The objective of this study was to assess the prevalence and determinants of meeting recommended levels of PA among older adults with multimorbidity. Data has been derived from the nationally representative Scottish Health Surveys (2014–2017). A sub-sample of 2230 older adults (aged 65+) with multimorbidity were the study participants. Physical activity was evaluated using current recommended guidelines. Overall, 32.3% of the participants met the recommended levels of PA. Independent predictors of meeting the recommended levels of PA include male gender [odds ratio (OR) 2.00 (95% confidence interval (CI) 1.58–2.54)], living in the least deprived areas [OR 1.79 (95% CI 1.20–2.69)]; being a non-smoker [OR 2.22 (95% CI 1.48–3. 34)]. Also, meeting recommended PA decreased with age [OR 0.92 (95% CI 0.90–0.94)] and body mass index [OR 0.93 (95% CI 0.91–0.95]; but increased per additional portion of fruit and vegetables taken [OR 1.19 (95% CI 1.12–1.25)] and with increase in well-being scale score [OR 1.05 (95% CI 1.03 to 1.06)]. Adherence to PA guidelines seems to be more related to age, BMI, gender (i.e. higher PA adherence in men vs. women), social support (i.e. social deprivation), dietary habits (i.e. fruit and vegetable intake) and social isolation among the elderly. In the one-third of older population, adherence to PA was associated to better mental health. Therefore, adaptation of PA guideline to suit theses determinants factors would reduce the gap difference among older adults with multimorbidity and enhance their mental well-being.

The Role of Built Environment on Health of Older Adults in Korea: Obesity and Gender Differences

This study examines the effect of the built environment on obesity in older adults, taking into consideration gender difference. In this regard, we ask two questions: (1) How does the built environment affect obesity in older adults? (2) Is there a gender difference in the effect of the built environment? To examine the research questions, this study uses the 2015 Korean National Health and Nutrition Survey and geographically weighted regression (GWR) analysis. The empirical analyses show that environmental factors have stronger effects on local obesity rates for older men than for older women, which indicates a gender difference in obesity. Based on these findings, we suggest that public health policies for obesity should consider the built environment as well as gender difference.

Cognitive function and the agreement between self-reported and accelerometer-accessed physical activity

Background

Numerous studies have reported weak or moderate correlations between self-reported and accelerometer-assessed physical activity. One explanation is that self-reported physical activity might be biased by demographic, cognitive or other factors. Cognitive function is one factor that could be associated with either overreporting or underreporting of daily physical activity. Difficulties in remembering past physical activities might result in recall bias. Thus, the current study examines whether the cognitive function is associated with differences between self-reported and accelerometer-assessed physical activity.

Methods

Cross-sectional data from the population-based Activity and Function in the Elderly in Ulm study (ActiFE) were used. A total of 1172 community-dwelling older adults (aged 65–90 years) wore a uniaxial accelerometer (activPAL unit) for a week. Additionally, self-reported physical activity was assessed using the LASA Physical Activity Questionnaire (LAPAQ). Cognitive function was measured with four items (immediate memory, delayed memory, recognition memory, and semantic fluency) from the Consortium to Establish a Registry for Alzheimer’s Disease Total Score (CERAD-TS).

Results

Mean differences of self-reported and accelerometer-assessed physical activity (MPA) were associated with cognitive function in men (r_s = −.12, p = .002) but not in women. Sex-stratified multiple linear regression analyses showed that MPA declined with high cognitive function in men (β = −.13; p = .015).

Conclusion

Results suggest that self-reported physical activity should be interpreted with caution in older populations, as cognitive function was one factor that explained the differences between objective and subjective physical activity measurements.

Electronic supplementary material

The online version of this article (10.1186/s12877-018-0747-x) contains supplementary material, which is available to authorized users.