A systematic literature review of reviews on techniques for physical activity measurement in adults: a DEDIPAC study

The links between increased participation in Physical Activity (PA) and improvements in health are well established. As this body of evidence has grown, so too has the search for measures of PA with high levels of methodological effectiveness (i.e. validity, reliability and responsiveness to change). The aim of this “review of reviews” was to provide a comprehensive overview of the methodological effectiveness of currently employed measures of PA, to aid researchers in their selection of an appropriate tool. A total of 63 review articles were included in this review, and the original articles cited by these reviews were included in order to extract detailed information on methodological effectiveness.

Self-report measures of PA have been most frequently examined for methodological effectiveness, with highly variable findings identified across a broad range of behaviours. The evidence-base for the methodological effectiveness of objective monitors, particularly accelerometers/activity monitors, is increasing, with lower levels of variability observed for validity and reliability when compared to subjective measures. Unfortunately, responsiveness to change across all measures and behaviours remains under-researched, with limited information available.

Other criteria beyond methodological effectiveness often influence tool selection, including cost and feasibility. However, researchers must be aware of the methodological effectiveness of any measure selected for use when examining PA. Although no “perfect” tool for the examination of PA in adults exists, it is suggested that researchers aim to incorporate appropriate objective measures, specific to the behaviours of interests, when examining PA in free-living environments.

Inventory of surveillance systems assessing dietary, physical activity and sedentary behaviours in Europe: a DEDIPAC study

Background

There is a need for harmonized public health surveillance systems to monitor regional variations and temporal trends of health behaviours and health outcomes and to align policies, action plans and recommendations in terms of healthy diet and physical (in)activity within Europe. We provide an inventory of currently existing surveillance systems assessing diet, physical activity, and sedentary behaviours in Europe as a tool to assist in the identification of gaps and needs and to contribute to the roadmap for an integrated pan-European surveillance system.

Methods

An inventory questionnaire was completed by representatives of eleven European countries. Eligible surveillance systems were required to meet specific inclusion criteria. First, pre-screening of available surveillance systems in each country was conducted. Second, an in-depth appraisal of the retained surveillance systems complying with the pre-defined requirements was performed.

Results

Fifty surveillance systems met the inclusion criteria: six multinational European surveys and forty-four national surveys. Dietary intake and physical activity are the domains predominantly assessed and adults are the most frequently studied age group.

Conclusions

Many on-going activities were identified at the national level focussing on adults, but fewer surveillance systems involving vulnerable groups such as infants and pre-school children. Assessment of sedentary and dietary behaviours should be more frequently considered. There is a need for harmonization of surveillance methodologies, indicators and target populations for between-country and over time comparisons. This inventory will serve to feed future discussions within the DEDIPAC-JPI major framework on how to optimize design and identify priorities within surveillance.

Postural Control in Young People with Visual Impairments and Various Risks of Falls

Introduction

Early diagnosis of postural control deficiencies facilitates implementation of an individual rehabilitation plan to prevent falls. The aim of the study was to assess the risk of falling in individuals with visual impairments, and to compare performance-based and theoretical limits of stability in subjects with various risks of falling.

Methods

The study was comprised of 23 participants with severe visual impairments. The risk of fall was assessed with the Step Test. Performance-based limits of stability were measured with the Advanced Mechanical Technology, Inc. (AMTI) platform, and theoretical limits of stability were calculated based on the height of the center of mass (COM) and maximum body sway leaning angles.

Results

COM displacement values, corresponding to performance-based limits of stability, in individuals with visual impairments whose risk of falling was classified as high were significantly lower than the theoretical values (p ≤ .05). Similar differences were not observed in participants with visual impairments whose risk of falling was assessed as low. Individuals from the low-risk group showed significantly higher values of performance-based limits of stability than the participants from the high-risk group (p ≤ .01 for medio-lateral direction and p ≤ .05 for forward-backward direction).

Discussion

Nearly half of young people with visual impairments are at increased risk of falling. Such persons showed lower performance-based limits of stability than participants with visual impairments with a low risk of falling. Performance-based limits of stability in individuals with visual impairments with a high risk of falling are lower than their theoretical limits of stability.

Implications for practitioners

The fact that nearly half of young people with visual impairments are at an increased risk of falling necessitates implementation of preventive measures in this group, as well as among individuals who are blind.

Habitual physical activity as a determinant of the effect of moderate physical exercise on postural control in older men

The aim of the study was to compare the effect of exercise on postural control (PC) among the elderly with lower or higher level of habitual physical activity (HPA). The study involved 17 elderly men (mean age 72.9 ± 4.79 years). Mean velocity of the center of pressure (COP) displacements was measured using a force plate both before and after cycle ergometer exercise. A significantly higher increase in mean velocity of COP displacements and its component in the sagittal plane were observed in the group with lower level of HPA in comparison with the group with higher HPA level. Simultaneously, a relatively similar reaction to the exercise in the frontal plane was observed in both groups, possibly connected to the specific type of used exercise, which mainly activated the sagittal muscles.

Effect of Tai Chi on body balance: randomized controlled trial in men with osteopenia or osteoporosis

The purpose of this study was to assess the effect of 18-week Tai Chi training on body balance in dynamic trial among elderly men. The study covered 49 subjects from age 60 to 82.1 years, who had osteopenia or osteoporosis. The subjects were recruited from the community by direct mailings and community efforts to participate in studies. The participants were randomly assigned to either the exercise intervention (n = 25) or control groups (n = 24). The Tai Chi group participated in an 18-week exercise class held for 45 min, twice a week. Body balance was assessed using a Computer Posturographic System PE 90 produced by the Military Institute of Aviation Medicine in Warsaw with modified software made in Pro-Med. During the measurement of body balance, the capacity to perform specific tasks was analyzed (deflections in the set scope and direction). In the Tai Chi group, an increase (p < or = 0.01) in effectiveness of balance task performance was noted from 80.95% to 84.45% after the training. In the control group, no statistically significant improvement in the level of body balance was found in the same period. Thus, an 18-week period of Tai Chi exercises twice a week for 45 min is beneficial for dynamic balance. It can be important for reducing fall risk factors.

Biochemical markers of bone metabolism in healthy elderly men. The relationship to physical activity

The purpose of the present study was to examine the serum levels of bone turnover markers and interleukin 1beta in healthy elderly men with different levels of habitual physical activity. The study was conducted on 40 healthy men aged between 65 and 85 years (mean 74.0 +/- 7.55 years). The study population was divided into two groups with respect to the level of physical activity: 22 less active subjects (energy expenditure related to physical activity below 1600 kcal per week) and 18 more active subjects (above 1600 kcal per week). To estimate the physical activity of the study population, weekly energy expenditure was measured in each subject with use of Caltrac accelerometer. In the blood serum levels of bone formation marker--osteocalcin and resorption marker--the C-terminal telopeptide of collagen I (ICTP), and interleukin-1beta were determined. Concentrations of osteocalcin and ICTP in less active subjects were significantly higher (by 3.62 ng/ml and by 1.21 mug/l respectively, p < 0.05), reflecting the higher bone turnover in comparison to values determined in more active subjects. Positive correlations between ICTP and osteocalcin levels (r = 0.5814 and r = 0.6526; p < 0.05), and between ICTP and IL-1beta (r = 0.5823 and r = 0.6040; p < 0.05) in less and more active men were found. On the ground of the presented study it can be concluded that the decreased bone turnover occurred in men with higher level of habitual physical activity. This study showed the relationship between serum level of IL-1beta and bone resorption but the habitual physical activity has no effect on this cytokine activity.

[Melatonin concentrations and other parameters of blood antioxidant defense system in elderly men with various levels of physical activity]

It is well documented that regular physical activity and increased levels of melatonin may enhance the blood antioxidant system. The aim of the present study was to evaluate the antioxidant defense mechanisms, in particular, the antioxidant potential of melatonin in groups of elderly men (mean age 70 years), marked of on the basis of habitual physical activity level. To estimate the physical activity of the study population, weekly energy expenditure was measured in each subject with a Caltrac accelerometer. The study population was divided into two groups (31 subjects in each group) according to the criteria proposed by Bauman: less active (energy expenditure below 1600 kcal per week) and more active (energy expenditure 1600 kcal per week). Venous blood samples were taken from each subject for assessment of plasma total antioxidant status (TAS), thiobarbituric acid reactive substances (TBARS) concentrations and melatonin (MLT) levels. The reduced glutathione (GSH) content and glutathione peroxidase (GPx) activity in hemolyzed red blood cells were also measured. A significant (p < 0.05), inverse Spearman correlation between MLT concentrations in plasma and physical activity levels was observed in the group of less active men. In more active subjects, a positive correlation between GSH and TAS levels (p < 0.05) and inverse correlations between GSH and TBARS concentrations (p < 0.05), TAS and TBARS levels (p < 0.01) and between TAS and MLT levels (p < 0.001) were noted. The results of the present study support the view that melatonin plays an important role in the blood antioxidant defense system in elderly men and indicate that habitual physical activity may have an influence on the plasma levels of melatonin.

Oxidative stress and antioxidant defense system in healthy, elderly men: relationship to physical activity

The aim of the present study was to compare selected markers of oxidative stress and the antioxidant system between groups of men aged 65 or more, differentiated by their level of physical activity. Thirty-one community-dwelling healthy, elderly men (mean age 73.4 +/- 6.1 years) with a good nutritional status participated in the study. The Caltrac accelerometer was used to estimate energy expenditure related to physical activity. Subjects were divided into two groups according to the criteria proposed by Bauman: less active (< 1600 kcal/week) and more active (> 1600 kcal/week). In all the men, plasma total antioxidant status (TAS), thiobarbituric acid reactive substances (TBARS) concentrations and hydrogen peroxide (H2O2) levels were determined. The reduced glutathione (GSH) content and glutathione peroxidase (GPx) activity in hemolyzed red blood cells were also measured. There were no significant differences in TAS, H2O2 concentrations and the activity of GPx between less and more active men. In the group of more active subjects, plasma levels of GSH were higher, while TBARS concentrations were lower compared with the group of less active men (p < 0.05). Negative correlation between GSH and TBARS levels was observed (r = -0.71; p < 0.01), and GSH concentrations positively correlated with level of physical activity (r = 0.63; p < 0.05). The results indicate that habitual physical activity can favorably affect antioxidant potential and prevent lipid peroxidation in healthy, elderly men.

[Glucosamine concentration in serum of old persons with hyperinsulinemia and normal insulin levels]

Increased glucose metabolism through the hexosamine biosynthesis pathway has been shown to mediate many of adverse effects i.e. desensitisation of glucose transport in tissues, an inhibition of glycolysis and glycogen synthesis in skeletal muscles, an impairment of insulin secretion in pancreatic islet cells, arteriosclerosis and nephropathy by stimulation of growth factor TGF-alpha and TGF-beta 1 promoters expression. The aim of the presented study was to compare of glucosamine concentrations in the blood serum between elderly human subjects (women and men) with hyperinsulinaemia and normoinsulinaemia. Subjects were divided into two groups: a group of 16 subjects with hyperinsulinaemia (concentration of fasting insulin is higher than 15 mU/l) and a group of 19 subjects with normoinsulinaemia (concentration of insulin was less or equal 15 mU/l). In the venous blood serum concentrations of insulin, C-peptide, glucose and glucosamine were determined. The Caltrac accelerometer was used to estimate energy expenditure in subgroup of 20 subjects: 10 subjects with hyperinsulinaemia and 10 with normoinsulinaemia. Significant differences were found between glucosamine and insulin concentrations (p < 0.01) and between C-peptide concentrations (p < 0.05) in both groups investigated. The mean value of the glucosamine concentration in the group with hyperinsulinaemia was higher by 22.6 mg/dl in comparison to mean value established in the group with normoinsulinaemia. Mean values of total and related to physical activity energy expenditure per day per 1 kg of body mass in the group with hyperinsulinaemia were less (p < 0.05) compared to the group with normoinsulinaemia. The presented results show that hyperinsulinaemia may contribute to the hyperactivity of hexosamine biosynthesis pathway.