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Reliability and Validity of the International Physical Activity Questionnaire Adapted to Include Adults With Physical Disability

Julianne G. Clina, R. Drew Sayer, James E. Friedman, Tsz Kiu Chui, Tapan Mehta, James H. Rimmer, and James O. Hill

Background: People with physical disabilities (PWD) participate in less physical activity than people without physical disabilities (PWoD), which increases the risk for several negative health consequences. Comparing physical activity between PWD and PWoD remains a challenge since no reliable and valid survey exists to measure physical activity in both populations. The International Physical Activity Questionnaire (IPAQ) was adapted to be inclusive of PWD using a recently developed survey adaption framework; however, the adapted IPAQ has not been assessed for reliability and validity. The objective of this study was to assess the reliability and validity of the adapted IPAQ. Methods: To assess test–retest reliability, the adapted IPAQ was completed twice within a 72-hour period by 172 individuals (PWD: n = 102, PWoD: n = 70) and compared using intraclass correlation coefficients. Using Spearman rho, convergent validity and construct validity were assessed in 62 individuals by comparing the adapted IPAQ against the original instrument and activity monitor measured step count, respectively. Results: The adapted IPAQ demonstrated moderate test–retest reliability, with intraclass correlation coefficients of total scores for the total sample of .690 (95% confidence interval [CI] .581–.770) and among subgroup analysis (PWD, .640, 95% CI, .457–.761; PWoD, .758, 95% CI, .610–.850). Correlation coefficients were also good for the assessment of convergent validity of total score (.727; 95% CI, .579–.829; P < .001). Construct validity assessment yielded moderate coefficient (.406; 95% CI, .166–.596; P = .001). Conclusions: The adapted IPAQ demonstrated acceptable reliability and validity and is appropriate for use in PWD and PWoD.

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Volume 20 (2023): Issue 12 (Dec 2023)

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Effect of a Customized Physical Activity Promotion Program on Visceral Fat and Glycemic Parameters in Individuals With Prediabetes: A Randomized Controlled Trial

Radhika A. Jadhav, G. Arun Maiya, Shashikiran Umakanth, and K.N. Shivashankara

Background: Physical activity of any amount results in substantial health benefits. However, public awareness of physical activity benefits in chronic diseases is inadequate in India. Prediabetes is a significant health issue on a global scale. Visceral fat (VF) is considered as an early predictor of prediabetes. Ethnicity and race have a substantial impact on VF. Hence, this study intended to evaluate the effect of a customized physical activity promotion program on VF and glycemic parameters in individuals with prediabetes. Methods: In the current, parallel group randomized controlled trial, a total of 158 participants were recruited: 79 in intervention and 79 in control group. The study included the prediabetes individuals based on American Diabetes Association criteria. Participants from the intervention group received the customized physical activity promotion program for 24 weeks. The primary outcome measures of the study were VF level and glycemic parameters that included fasting blood sugar and glycosylated hemoglobin. Two-way mixed analysis of variance was used to study the mean difference of an outcome between 2 groups over time. Results: The study found a statistically significant interaction between the intervention and times on VF level, F 1,136 = 23.564, fasting blood sugar levels, F 1,136 = 8.762, and glycosylated hemoglobin levels, F 1,136 = 64.582 at the end of 24 weeks (P < .05). Conclusions: This study concluded that a customized physical activity promotion program was effective in reducing VF in individuals with prediabetes as compared with controls. It improved glycemic control by reducing fasting blood sugar and glycosylated hemoglobin levels.

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Effects of Breaking Up Sedentary Behavior With Short Bouts of Yoga and Tai-Chi on Glycemia, Concentration, and Well-Being

Alexander Colvin, Lynne Murray, Jillian Noble, and Sebastien Chastin

Background: Investigating the effects of breaking up sedentary behavior with short bouts of Yoga and Tai-Chi on glycemic control, concentration, and well-being in healthy individuals. Methods: In this randomized balanced incomplete block study, 15 adults (age = 26 [2.50] y, 8 females) completed 2 of 3 protocols: uninterrupted sitting (Control), sitting interrupted with 3 minutes of Yoga every 30 minutes, or with 3 minutes of Tai-Chi every 30 minutes. Protocols lasted 7.5 hours and included a standardized diet. Glucose was measured every 30 minutes with a glucometer (Abbott FreeStyle Libre). Concentration and well-being were recorded with self-reported ecological momentary assessment. Area under the curve was calculated for glucose data. Statistical analyses were performed as a hierarchical repeated-measures model. Results: Glucose area under the curve for the Yoga intervention (34.55 [3.12] mmol/L) was significantly lower than the Control (38.14 [3.18] mmol/L; P < .05). There was a trend toward lower glucose in the Tai-Chi group compared with the Control, but no significant differences were found (AUCTai-Chi = 36.64 [3.11] mmol/L; P = .57). Mean concentration in all groups decreased throughout the day, with the largest decrease in the Control. Well-being for the Yoga and Control groups decreased but increased with Tai-Chi. Concentration and well-being responses were not statistically significant between intervention groups. Conclusions: Breaking up sedentary behavior using 3-minute bouts of Yoga significantly lowers blood glucose in healthy individuals without compromising concentration or well-being. Tai-Chi did not provide the same significant effect on glucose levels but allowed better maintenance of concentration and well-being. These interventions provide effective ways to combat the deleterious effects of prolonged sedentary time while maintaining concentration and well-being.

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Improved Physical Health in Middle-Older Aged Golf Caddies Following 24 Weeks of High-Volume Physical Activity

Graeme G. Sorbie, Ashley K. Williams, Sophie E. Carter, Amy K. Campbell, Jonathan Glen, David Lavallee, Nicholas Sculthorpe, Andrew Murray, and Alexander J. Beaumont

Background: The physical demands of golf caddying, including walking while carrying a golf bag, may potentially affect body composition, and markers of metabolic, cardiovascular, and musculoskeletal health. Therefore, this study examined the impact of 24 weeks of caddying on physical health in middle-older aged males. Methods: Eleven full-time experienced male caddies (age: 59 [8] y; caddying experience: 14 [12] y) were recruited from a local golf course. The following were assessed at preseason and after 24 weeks of caddying (March–September 2022): body composition, heart rate, blood pressure, blood lipids, and performance tests (static and dynamic balance, strength, and submaximal fitness). Physical activity (PA) levels were assessed at preseason and at the mid-point of the caddying season. Across the caddying season, participants completed a monthly average of 24.0 (3.8) rounds. Results: Following the caddying season, improvements in static balance (Δ = 13.5 s), dynamic balance (Δ = −1.8 s), and lower back absolute strength (Δ = 112.8 N), and muscle quality (Δ = 2.0 N·kg−1) were observed (all P < .05). Additionally, blood lipids, including total cholesterol (Δ = −0.6 mmol·L−1), high-density lipoprotein cholesterol (Δ = 0.1 mmol·L−1), low-density lipoprotein cholesterol (Δ = −0.6 mmol·L−1) (all P < .05), and body composition, including body mass (Δ = −2.7 kg), fat mass (Δ = −1.9 kg), fat percentage (Δ = −1.4%), fat-to-muscle ratio (Δ = −0.03), and body mass index (Δ = −0.9 kg·m−2) (all P < .05) improved. Caddying did not offer beneficial changes to cardiovascular variables or cardiorespiratory fitness (P > .05), while coronary heart disease risk score decreased (Δ = −3.3%) (P < .05). In relation to PA, light- (Δ = 145 min) and moderate-intensity (Δ = 71 min) PA, moderate to vigorous PA (Δ = 73 min), and total PA (Δ = 218 min) between preseason and the mid-point of the caddying season increased, while sedentary time (Δ = −172 min) decreased (all P < .05). Conclusion: Golf caddying can provide several physical health benefits such as improvements in various markers of cardiometabolic health, lower back absolute strength, and static and dynamic balance. The physical health improvements that caddying offers is likely contributed to by increased PA volume and intensity through walking on the golf course. Therefore, caddying may represent a feasible model for increasing PA volume and intensity and achieve physical health–related benefits.

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Inequalities in Leisure-Time Physical Activity and Television Viewing According to Age Among a Brazilian Adult Population

Andrea Wendt, Adriana K.F. Machado, Bruna G.C. da Silva, Caroline S. Costa, Luiza I.C. Ricardo, and Shana Ginar da Silva

Background: The present study aims to estimate leisure-time physical activity and television (TV) viewing curves according to age stratified by sex, area of residence, and socioeconomic position. Methods: Using data from the Brazilian National Health Survey, we estimated the prevalence of leisure-time physical activity and TV viewing according to continuous age. The estimates were calculated using fractional polynomials and stratified by sex, wealth, skin color, and area of residence. Results: The sample included 87,376 adults (aged 18 y or over). In general, leisure-time physical activity decreased according to age while TV viewing increased. Regarding behavior of curves according to stratifiers, for leisure-time physical activity the disadvantaged groups maintained a pattern of low physical activity across all age groups or presented the decrease earlier when compared to groups in social advantage. On the other hand, for TV viewing, women presented an increase in prevalence before men, and individuals living in the urban area and the wealthiest group were those with a higher increase according to age. Conclusions: Our findings may help researchers and policymakers further explore inequalities in physical activity across life in different settings, as well as develop sensitive cultural actions to support more vulnerable people to adopt public health recommendations.

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“Post or Perish”? An Early Career Researcher’s Guide to Using Social Media

Emma S. Cowley, Kelly McNulty, Ciaran M. Fairman, and Lee Stoner

Social media usage has soared in the last decade, with the majority of adults having an account on at least one platform. Sites such as LinkedIn, X, and TikTok allow users to share content using different forms, for example, written or video, long form or short form. Social media can be used by researchers to forge collaborations, rapidly disseminate new research, and demonstrate societal impact. This opinion piece aims to highlight the value of social media, in particular for early career researchers, and offer suggestions on how early career researchers can strategically use social media to build a network and an online presence. We reflect on our own experiences of social media and include some of the reasons we have been deterred from it in the past, such as fear of making a mistake, being misunderstood, or painted as being an overconfident “know it all.” As the demonstration of impact and engagement becomes ever more important in grant applications and job security, social media competency is a powerful professional skill that will be important for all scientists.

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Charting a Course: Navigating Rigor and Meaning in Global Health Research

Tiago Canelas, Motlatso Godongwana, Feyisayo A. Wayas, Estelle Victoria Lambert, Yves Wasnyo, and Louise Foley

In the rapidly evolving landscape of global health research, the tension between scientific rigor and contextual meaning presents a critical challenge. Drawing on our work with the Global Diet and Physical Activity Network, this commentary explores the complexities of conducting environmental audits for physical activity and diet in 4 rapidly urbanizing African cities: Yaoundé, Lagos, Cape Town, and Soweto. We illustrate the competing demands and tensions that researchers face in balancing rigor and meaning. We discuss the adaptation of internationally validated audit tools to local contexts and the importance of area-level deprivation in interpreting data. We also examine the feasibility of virtual assessment tools, emphasizing the value of local expertise. We argue for a balanced approach that marries research rigor with contextual meaning, advocating for transparency, humility, and meaningful community engagement.

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Participant Bias in Community-Based Physical Activity Research: A Consistent Limitation?

Iris A. Lesser, Amanda Wurz, Corliss Bean, Nicole Culos-Reed, Scott A. Lear, and Mary Jung

Physical activity is a beneficial, yet complex, health behavior. To ensure more people experience the benefits of physical activity, we develop and test interventions to promote physical activity and its associated benefits. Nevertheless, we continue to see certain groups of people who choose not to, or are unable to, take part in research, resulting in “recruitment bias.” In fact, we (and others) are seemingly missing large segments of people and are doing little to promote physical activity research to equity-deserving populations. So, how can we better address recruitment bias in the physical activity research we conduct? Based on our experience, we have identified 5 broad, interrelated, and applicable strategies to enhance recruitment and engagement within physical activity interventions: (1) gain trust, (2) increase community support and participation, (3) consider alternative approaches and designs, (4) rethink recruitment strategies, and (5) incentivize participants. While we recognize there is still a long way to go, and there are broader community and societal issues underlying recruitment to research, we hope this commentary prompts researchers to consider what they can do to try to address the ever-present limitation of “recruitment bias” and support greater participation among equity-deserving groups.

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Effect of Yoga or Physical Exercise on Muscle Function in Rural Indian Children: A Randomized Controlled Trial

Sonal Kasture, Anuradha Khadilkar, Raja Padidela, Ketan Gondhalekar, Radhika Patil, and Vaman Khadilkar

Background: Synergistic effects of yoga or physical exercise (PE) along with protein supplementation on children’s muscle function in rural India have not been studied. Hence, we aimed to study the effect of yoga and PE along with protein supplementation on muscle function in healthy 6- to 11-year-old rural Indian children post 6 months of intervention. Methods: A randomized controlled trial on 232 children, recruited into 3 groups, each receiving 1 protein-rich ladoo (148 kcal, 7 g protein/40 g ladoo–an Indian sweet snack) daily and performing (1) yoga (n = 78) for 30 minutes 5 times per week, (2) PE (n = 76) for 30 minutes 5 times per week, or (3) control group (n = 78) no additional exercise. Maximum power, maximum voluntary force (Fmax), and grip strength (GS) were measured. Data were analyzed using paired t tests and a 2-way mixed analysis of variance with post hoc Bonferroni adjustment. Results: GS, maximum power, and Fmax within yoga group increased significantly (P < .05) from baseline to endline. GS and Fmax increased significantly within PE group postintervention (P < .001). In controls, GS increased (P < .05) at endline. No significant effect of the intervention was observed on the change in maximum power (P > .05) postintervention. The 2 exercise groups showed significant increase in Fmax compared with the control group (P < .05). Similarly, increase in GS was significantly higher in both the exercise groups compared with the control group (P < .05). No significant difference was observed in change in muscle function between the 2 exercise groups (P > .05). Conclusions: Structured physical activity along with protein supplementation resulted in improved muscle function in children. Yoga and PE showed a comparable impact on muscle force.