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Fridolfsson J, Raustorp A, Börjesson M, Ekblom‐Bak E, Ekblom Ö, Arvidsson D. Simple step counting captures comparable health information to complex accelerometer measurements. J Intern Med 2025; 297:492-504. [PMID: 40165032 PMCID: PMC12032995 DOI: 10.1111/joim.20081] [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] [Indexed: 04/02/2025]
Abstract
BACKGROUND Physical activity guidelines recommend accumulating moderate-to-vigorous physical activity but interpreting and monitoring these recommendations remains challenging. Although step-based metrics from wearable devices offer a simpler approach, their relationship with health outcomes requires validation against established accelerometer measurements. OBJECTIVES To evaluate how effectively step-based metrics capture health-related information from accelerometer data and determine optimal step cadence and intensity thresholds associated with cardiometabolic health in middle-aged adults. METHODS Cross-sectional data from 4172 participants (aged 50-64 years) in the Swedish CArdioPulmonary bioImage Study (SCAPIS) were analyzed. Physical activity was measured using ActiGraph accelerometers, collecting both step metrics (daily steps and cadence) and full accelerometer data. Both cardiorespiratory fitness, estimated using a submaximal cycle ergometer test, and cardiometabolic health, assessed using a composite score of waist circumference, blood pressure, lipids, and glycated hemoglobin (HbA1c), were considered outcomes. Associations between physical activity and outcomes were examined using linear regression and partial least squares analysis. RESULTS Step counting metrics retained 88% of the health-related information from full accelerometer data. The optimal accelerometer intensity associated with cardiometabolic health was around four metabolic equivalents of tasks (METs). A step cadence of 80 steps/min, rather than the commonly used 100 steps/min, appeared more relevant for capturing moderate-intensity activity. Combining step and accelerometer data provided additional explanatory power for cardiometabolic health. CONCLUSION Step data capture most of the health-related information from accelerometer-measured physical activity in middle-aged adults. These findings support the use of step-based metrics for assessing and promoting physical activity while suggesting a need for recalibration of intensity thresholds in free-living conditions.
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Affiliation(s)
- Jonatan Fridolfsson
- Center for Lifestyle InterventionDepartment of Molecular and Clinical MedicineSahlgrenska AcademyUniversity of Gothenburg, Gothenburg, Sweden/Sahlgrenska University Hospital, Region Västra GötalandGothenburgSweden
| | - Anders Raustorp
- Center for Health and PerformanceDepartment of Food and Nutrition, and Sport ScienceFaculty of EducationUniversity of GothenburgGothenburgSweden
| | - Mats Börjesson
- Center for Lifestyle InterventionDepartment of Molecular and Clinical MedicineSahlgrenska AcademyUniversity of Gothenburg, Gothenburg, Sweden/Sahlgrenska University Hospital, Region Västra GötalandGothenburgSweden
| | - Elin Ekblom‐Bak
- Section for Health SciencesDepartment of Physical Activity and Healththe Swedish School of Sport and Health SciencesStockholmSweden
| | - Örjan Ekblom
- Section for Health SciencesDepartment of Physical Activity and Healththe Swedish School of Sport and Health SciencesStockholmSweden
- Division of NursingDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Daniel Arvidsson
- Center for Health and PerformanceDepartment of Food and Nutrition, and Sport ScienceFaculty of EducationUniversity of GothenburgGothenburgSweden
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Paz A, Lavikainen J, Turunen MJ, García JJ, Korhonen RK, Mononen ME. Knee-Loading Predictions with Neural Networks Improve Finite Element Modeling Classifications of Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Ann Biomed Eng 2024; 52:2569-2583. [PMID: 38842728 PMCID: PMC11329407 DOI: 10.1007/s10439-024-03549-2] [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: 10/04/2023] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
Physics-based modeling methods have the potential to investigate the mechanical factors associated with knee osteoarthritis (OA) and predict the future radiographic condition of the joint. However, it remains unclear what level of detail is optimal in these methods to achieve accurate prediction results in cohort studies. In this work, we extended a template-based finite element (FE) method to include the lateral and medial compartments of the tibiofemoral joint and simulated the mechanical responses of 97 knees under three conditions of gait loading. Furthermore, the effects of variations in cartilage thickness and failure equation on predicted cartilage degeneration were investigated. Our results showed that using neural network-based estimations of peak knee loading provided classification performances of 0.70 (AUC, p < 0.05) in distinguishing between knees that developed severe OA or mild OA and knees that did not develop OA eight years after a healthy radiographic baseline. However, FE models incorporating subject-specific femoral and tibial cartilage thickness did not improve this classification performance, suggesting there exists an optimal point between personalized loading and geometry for discrimination purposes. In summary, we proposed a modeling framework that streamlines the rapid generation of individualized knee models achieving promising classification performance while avoiding motion capture and cartilage image segmentation.
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Affiliation(s)
- Alexander Paz
- Department of Technical Physics, University of Eastern Finland, Yliopistonranta 1, 70211, Kuopio, Finland.
- Escuela de Ingeniería Civil y Geomática, Universidad del Valle, Cali, Colombia.
| | - Jere Lavikainen
- Department of Technical Physics, University of Eastern Finland, Yliopistonranta 1, 70211, Kuopio, Finland
- Diagnostic Imaging Center, Wellbeing Services County of North Savo, Kuopio, Finland
| | - Mikael J Turunen
- Department of Technical Physics, University of Eastern Finland, Yliopistonranta 1, 70211, Kuopio, Finland
- Science Service Center, Kuopio University Hospital, Wellbeing Services County of North Savo, Kuopio, Finland
| | - José J García
- Escuela de Ingeniería Civil y Geomática, Universidad del Valle, Cali, Colombia
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Yliopistonranta 1, 70211, Kuopio, Finland
| | - Mika E Mononen
- Department of Technical Physics, University of Eastern Finland, Yliopistonranta 1, 70211, Kuopio, Finland
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Olsson KSE, Ceci R, Wahlgren L, Rosdahl H, Schantz P. Perceived exertion can be lower when exercising in field versus indoors. PLoS One 2024; 19:e0300776. [PMID: 38809815 PMCID: PMC11135770 DOI: 10.1371/journal.pone.0300776] [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: 05/07/2023] [Accepted: 03/05/2024] [Indexed: 05/31/2024] Open
Abstract
PURPOSE Studies indicate that the rated perceived exertion (RPE) during physical exercise can be lower in field environments than indoors. The environmental conditions of those studies are explored. Furthermore, we study if the same phenomenon is valid when cycling indoors versus in cycle commuting environments with high levels of stimuli from both traffic and suburban-urban elements. METHODS Twenty commuter cyclists underwent measurements of heart rate (HR) and oxygen uptake ([Formula: see text]O2) and RPE assessments for breathing and legs, respectively, while cycling in both laboratory and field conditions. A validated mobile metabolic system was used in the field to measure [Formula: see text]O2. Three submaximal cycle ergometer workloads in the laboratory were used to establish linear regression equations between RPE and % of HR reserve (%HRR) and %[Formula: see text]O2max, separately. Based on these equations, RPE from the laboratory was predicted and compared with RPE levels at the participants' individual cycle commutes at equal intensities. The same approach was used to predict field intensities and for comparisons with corresponding measured intensities at equal RPE levels. RESULTS The predicted RPE levels based on the laboratory cycling were significantly higher than the RPE levels in cycle commuting at equal intensities (67% of HRR; 65% of [Formula: see text]O2max). For breathing, the mean RPE levels were; 14.0-14.2 in the laboratory and 12.6 in the field. The corresponding levels for legs were; 14.0-14.2 and 11.5. The range of predicted field intensities in terms of %HRR and %[Formula: see text]O2max was 46-56%, which corresponded to median differences of 19-30% compared to the measured intensities in field at equal RPE. CONCLUSION The cycle commuters perceived a lower exertion during their cycle commutes compared to ergometer cycling in a laboratory at equal exercise intensities. This may be due to a higher degree of external stimuli in field, although influences from other possible causes cannot be ruled out.
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Affiliation(s)
- Karin Sofia Elisabeth Olsson
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Ruggero Ceci
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
- The Unit for Road Safety, Planning Department, Swedish Transport Administration, Solna, Sweden
| | - Lina Wahlgren
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Hans Rosdahl
- The Research Unit for Movement, Health and Environment, Department of Physiology, Nutrition and Biomechanics, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Peter Schantz
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
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Li C, Powell L, Stamatakis E, McGreevy P, Podberscek A, Bauman A, Edwards K. Is dog walking suitable for physical activity promotion? Investigating the exercise intensity of on-leash dog walking. Prev Med Rep 2024; 41:102715. [PMID: 38595731 PMCID: PMC11002884 DOI: 10.1016/j.pmedr.2024.102715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/26/2024] [Accepted: 03/31/2024] [Indexed: 04/11/2024] Open
Abstract
Background Approximately a quarter of the global population is physically inactive, increasing the prevalence of chronic health conditions such as cardiovascular disease. Clearly, a population shift is needed to increase physical activity participation. Given almost half of American and Australian households have at least one dog, dog walking has the potential to increase physical activity. The objective of this study was to characterize the exercise intensity of dog walking using physiological measures to determine whether it achieved a threshold for health-enhancement. Method From February 2020 to September 2022, dog owners (aged > 18 years, without impediment to walking) who resided in metropolitan Sydney participated in an on-leash dog walk for a minimum of 20 minutes, while wearing a heart rate monitor and carrying a phone to track cadence, route and duration. Results Forty-three participants were recruited (aged 34.26 ± 16 years). Data from measures of %heart rate reserve (38 ± 10.8 %HRR), %heart rate max (61 ± 7.2 %HRmax) and average cadence (45 ± 8.4steps/min) classified dog-walking as light intensity. However, when using average walking speed (4.29 ± 0.8 km/hr) and metabolic equivalents (3.53 ± 0.6METs), the walk was classified as moderate intensity. Conclusion Overall, depending on the intensity measure used, dog walking was positioned in the upper range of light intensity and the lower range of moderate intensity. Although dog walking at a certain intensity may be difficult to prescribe as strategy for meeting current moderate-to-vigorous focused physical activity recommendations, it should be recognised as a beneficial activity that may reach moderate intensity on some occasions.
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Affiliation(s)
- Crystal Li
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Lauren Powell
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Paul McGreevy
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Anthony Podberscek
- Charles Perkins Centre, Sydney School of Veterinary Science, University of Sydney, NSW, Australia
| | - Adrian Bauman
- Charles Perkins Centre, Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Kate Edwards
- Charles Perkins Centre, Faculty of Medicine and Health, Sydney School of Health Sciences, University of Sydney, Sydney, NSW, Australia
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Bae WR, Seo Y, Yun S, Lee DT. Determination of moderate walking intensity using step rate and VO 2 reserve in healthy men. BMC Public Health 2024; 24:403. [PMID: 38326857 PMCID: PMC10851523 DOI: 10.1186/s12889-024-17843-0] [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: 09/21/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVE This study investigated step rates (SR) during overground walking to estimate the relative aerobic capacity that corresponds to a moderate intensity. METHODS The present study utilized a repeated measure, within-subjects design incorporating a counterbalanced order. A total of twenty-three healthy men walked on a 119-meter oval track with artificial turf at self-selected pace (FP), 100, 120, and 140 steps/min for 6 min each while oxygen uptake (VO2), speed (in km/h), distance (in m), and steps (in steps/min) were measured. RESULTS During FP, participants walked an average cadence of 117 ± 9.3 steps/minclose to 120 steps/min, which corresponds to 4.7 metabolic equivalents (METs). The estimated VO2 reserve was 30.5% of VO2 reserve at the FP and was close to the 120 steps/min of 33.3%. At the 100 and 140 steps/min, the VO2 reserve were 24.1% and 45.2%, respectively. The regression analysis revealed that an SR of 88.2 elicited 3METs and 17.1% of VO2reserve. Additionally, an SR of 129 elicited 5.9METs and 40% of VO2 reserve. CONCLUSIONS This study demonstrated that a moderate walking intensity for young, healthy men corresponded to 128.9 steps per minute. A range of 120 ~ 140 steps/min for walking could be recommended as a general guideline for moderate-intensity exercise. However, concerning providing public guidelines, caution should be taken regarding determining the moderate walking intensity due to the individual's fitness level.
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Affiliation(s)
- Woo Ram Bae
- Exercise Physiology Laboratory, Kookmin University, Seoul, Republic of Korea
| | - Yongsuk Seo
- Exercise Physiology Laboratory, Kookmin University, Seoul, Republic of Korea
| | - Somi Yun
- Exercise Physiology Laboratory, Kookmin University, Seoul, Republic of Korea.
| | - Dae Taek Lee
- Exercise Physiology Laboratory, Kookmin University, Seoul, Republic of Korea.
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Schantz P, Olsson KSE, Salier Eriksson J, Rosdahl H. Perspectives on exercise intensity, volume, step characteristics and health outcomes in walking for transport. Front Public Health 2022; 10:911863. [PMID: 36339183 PMCID: PMC9635924 DOI: 10.3389/fpubh.2022.911863] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/21/2022] [Indexed: 01/22/2023] Open
Abstract
Background Quantification of movement intensity and energy utilization, together with frequency of trips, duration, distance, step counts and cadence, is essential for interpreting the character of habitual walking for transport, and its potential support of health. The purpose of the study is to illuminate this with valid methods and novel perspectives, and to thereby provide a new basis for characterizing and interpreting walking in relation to health outcomes. Methods Habitual middle-aged commuting pedestrians (males = 10, females = 10) were investigated in the laboratory at rest and with maximal treadmill and cycle ergometer tests. Thereafter, levels of oxygen uptake, energy expenditure, ventilation, heart rate, blood lactate, rated perceived exertion, cadence, number of steps, duration, distance, and speed were recorded during the normal walking commute of each participant in Greater Stockholm, Sweden. The number of commutes per week over the year was self-reported. Results Walking in the field demanded about 30% more energy per km compared to level treadmill walking. For both sexes, the walking intensity in field was about 46% of maximal oxygen uptake, and energy expenditure amounted to 0.96 kcal · kg- 1 · km- 1. The MET values (males: 6.2; females: 6.5) mirrored similar levels of walking speed (males: 5.7; females: 5.9 km · h- 1) and levels of oxygen uptake (males: 18.6; females: 19.5 mL · kg- 1 · min- 1). The average number of MET-hours per week in a typical month was 22 for males and 20 for females. This resulted in a total weekly energy expenditure of ~1,570 and 1,040 kcal for males and females, respectively. Over the year, the number of walking commutes and their accumulated distance was ~385 trips and 800 km for both sexes. Conclusion Walking in naturalistic field settings demands its own studies. When males and females walk to work, their relative aerobic intensities and absolute energy demands for a given distance are similar. It is equivalent to the lower part of the moderate relative intensity domain. The combination of oxygen uptake, trip duration and frequency leads to high and sustained levels of MET-hours as well as energy expenditure per week over the year, with a clear health enhancing potential. Based on this study we recommend 6000 transport steps per day, or equivalent, during five weekdays, over the year, in order to reach optimal health gains.
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Affiliation(s)
- Peter Schantz
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Karin Sofia Elisabeth Olsson
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Jane Salier Eriksson
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Hans Rosdahl
- The Research Unit for Movement, Health and Environment, Department of Physiology, Nutrition and Biomechanics, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
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