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Physical Activity: A Strategy to Improve Antibody Response to a SARS-CoV-2 Vaccine Booster Dose in Patients With Autoimmune Rheumatic Diseases

Bruno Gualano, Sofia M. Sieczkowska, Ítalo Ribeiro Lemes, Rafael Pires da Silva, Ana J. Pinto, Bruna C. Mazzolani, Fabiana I. Smaira, Nadia E. Aikawa, Leonard V.K. Kupa, Sandra G. Pasoto, Ana C. Medeiros-Ribeiro, Carla G.S. Saad, Emily F.N. Yuk, Clovis A. Silva, Paul Swinton, Pedro C. Hallal, Hamilton Roschel, and Eloisa Bonfa

Background: Physical activity associates with improved immunogenicity following a 2-dose schedule of CoronaVac (Sinovac’s inactivated SARS-CoV-2 vaccine) in patients with autoimmune rheumatic diseases (ARD). This study evaluates whether physical activity impacts vaccine-induced antibody responses to a booster dose in this population. Methods: This was a phase-4 trial conducted in São Paulo, Brazil. Patients with ARD underwent a 3-dose schedule of CoronaVac. One month after the booster, we assessed seroconversion rates of anti-SARS-CoV-2 S1/S2 IgG, geometric mean titers of anti-S1/S2 IgG, frequency of positive neutralizing antibodies, and neutralizing activity. Physical activity was assessed through questionnaire. Results: Physically active (n = 362) and inactive (n = 278) patients were comparable for most characteristics; however, physically active patients were younger (P < .01) and had a lower frequency of chronic inflammatory arthritis (P < .01). Adjusted models showed that physically active patients had ∼2 times odds of seroconversion rates (OR: 2.09; 95% confidence interval, 1.22 to 3.61), ∼22% greater geometric mean titers of anti-S1/S2 IgG (22.09%; 95% confidence interval, 3.91 to 65.60), and ∼7% greater neutralizing activity (6.76%; 95% confidence interval, 2.80 to 10.72) than inactive patients. Conclusions: Patients with ARD who are physically active have greater odds of experiencing better immunogenicity to a booster dose of CoronaVac. These results support the recommendation of physical activity to improve vaccination responses, particularly for immunocompromised individuals.

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Journal of Physical Activity and Health’s 2022 in Review

Pedro C. Hallal

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A Review of Sedentary Behavior Assessment in National Surveillance Systems

Danielle L. Harvey, Karen Milton, Andy P. Jones, and Andrew J. Atkin

Background: Temporal changes in sedentary behavior patterns reflect the evolving nature of our built and social environments, particularly the expanding availability of electronic media. It is important to understand what types of sedentary behavior are assessed in national surveillance to determine whether, and to what extent, they reflect contemporary patterns. The aims of this review were to describe the characteristics of questionnaires used for national surveillance of sedentary behavior and to identify the types of sedentary behaviors being measured. Method: We reviewed questionnaires from national surveillance systems listed on the Global Observatory for Physical Activity (GoPA!) country cards to locate items on sedentary behavior. Questionnaire characteristics were categorized using the Taxonomy of Self-reported Sedentary Behavior Tools (TASST). The purpose and type of sedentary behaviors captured were classified using the Sedentary Behavior International Taxonomy (SIT). Results: Overall, 346 surveillance systems were screened for eligibility, of which 93 were included in this review. Most questionnaires used a single-item direct measure of sitting time (n = 78, 84%). Work and domestic were the most frequently captured purposes of sedentary behavior, while television viewing and computer use were the most frequently captured types of behaviors. Conclusion: National surveillance systems should be periodically reviewed in response to evidence on contemporary behavior patterns in the population and the release of updated public health guidelines.

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Volume 20 (2023): Issue 3 (Mar 2023)

Open access

A Case for Unifying Accelerometry-Derived Movement Behaviors and Tests of Exercise Capacity for the Assessment of Relative Physical Activity Intensity

Mark W. Orme, Phoebe H.I. Lloyd-Evans, Akila R. Jayamaha, Winceslaus Katagira, Bruce Kirenga, Ilaria Pina, Andrew P. Kingsnorth, Ben Maylor, Sally J. Singh, and Alex V. Rowlands

Albert Einstein taught us that “everything is relative.” People’s experience of physical activity (PA) is no different, with “relativism” particularly pertinent to the perception of intensity. Markers of absolute and relative intensities of PA have different but complimentary utilities, with absolute intensity considered best for PA guideline adherence and relative intensity for personalized exercise prescription. Under the paradigm of exercise and PA as medicine, our Technical Note proposes a method of synchronizing accelerometry with the incremental shuttle walking test to facilitate description of the intensity of the free-living PA profile in absolute and relative terms. Our approach is able to generate and distinguish “can do” or “cannot do” (based on exercise capacity) and “does do” or “does not do” (based on relative intensity PA) classifications in a chronic respiratory disease population, facilitating the selection of potential appropriate individually tailored interventions. By synchronizing direct assessments of exercise capacity and PA, clearer insights into the intensity of PA performed during everyday life can be gleaned. We believe the next steps are as follows: (1) to determine the feasibility and effectiveness of using relative and absolute intensities in combination to personalize the approach, (2) to determine its sensitivity to change following interventions (eg, exercise-based rehabilitation), and (3) to explore the use of this approach in healthier populations and in other long-term conditions.

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More Than Ever, It Is Time to Ensure Regular Opportunities for Physical Activity Among Children and Adolescents: The Potential of Structured Settings

Rafael Tassitano

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Opportunities for Physical Activity Research in Africa: Desert or Oasis?

Adewale L. Oyeyemi

Open access

Changes in Pediatric Movement Behaviors During the COVID-19 Pandemic by Stages of Lockdown in Ontario, Canada: A Longitudinal Cohort Study

Priya Patel, Xuedi Li, Charles D.G. Keown-Stoneman, Leigh M. Vanderloo, Laura M. Kinlin, Jonathon L. Maguire, and Catherine S. Birken

Background: Children’s movement behaviors have been affected by the COVID-19 pandemic; however, little is known regarding movement behavior patterns over time by government-issued lockdowns. Our primary objective was to evaluate how children’s movement behaviors changed by stages of lockdown/reopening in Ontario, Canada, from 2020 to 2021. Methods: A longitudinal cohort study with repeated measures of exposure and outcomes was conducted. The exposure variables were dates from before and during COVID-19 when child movement behavior questionnaires were completed. Lockdown/reopening dates were included as knot locations in the spline model. The outcomes were daily screen, physical activity, outdoor, and sleep time. Results: A total of 589 children with 4805 observations were included (53.1% boys, 5.9 [2.6] y). On average, screen time increased during the first and second lockdowns and decreased during the second reopening. Physical activity and outdoor time increased during the first lockdown, decreased during the first reopening, and increased during the second reopening. Younger children (<5 y) had greater increases in screen time and lower increases in physical activity and outdoor time than older children (≥5 y). Conclusions: Policy makers should consider the impact of lockdowns on child movement behaviors, especially in younger children.

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Pedometer Efficacy for Clinical Care in Pediatric Cardiology

Angelica Blais, Patricia E. Longmuir, and Jane Lougheed

Background: Physical activity is essential to the long-term health of children living with cardiac disease. The simplicity and cost of pedometers make them an attractive alternative to accelerometers for monitoring the physical activity behaviors of these children. This study compared measures obtained from commercial-grade pedometers and accelerometers. Methods: Pediatric cardiology outpatients (n = 41, mean age = 8.4 [3.7] y, 61% female) wore a pedometer and accelerometer daily for 1 week. Step counts and minutes of moderate to vigorous physical activity were compared between devices, accounting for age group, sex, and diagnostic severity, using univariate analysis of variance. Results: While pedometer data were significantly correlated with accelerometers (r > .74, P < .001), measurements obtained were significantly different between devices. Overall, pedometers overestimated physical activity data. The overestimation of moderate to vigorous physical activity was significantly less among adolescents than younger age groups (P < .01, η p 2 = .38 ). For step counts, there was a significant age by sex interaction observed where preschool and adolescent males tended to have greater differences between accelerometer and step count data than females (P < .01, η p 2 = .33 ). Differences between devices were not associated with severity of diagnosis. Conclusions: The distribution of pedometers in a pediatric outpatient clinic was feasible, yet the data collected significantly overestimated physical activity, especially among younger children. Practitioners who want to introduce objective measurements as part of their physical activity counseling practice should use pedometers to monitor individual changes in physical activity and consider patient age before administering these devices for clinical care.

Open access

Factors Associated With Changes in Objectively Measured Moderate to Vigorous Physical Activity in Patients After Percutaneous Coronary Intervention: A Prospective Cohort Study

Kuya Funaki, Takuji Adachi, Masataka Kameshima, Hiroaki Fujiyama, Naoki Iritani, Chikako Tanaka, Daisuke Sakui, Yasutaka Hara, Hideshi Sugiura, and Sumio Yamada

Background: This study aimed to clarify factors affecting changes in moderate to vigorous physical activity (MVPA) in patients 1 to 3 months after undergoing percutaneous coronary intervention (PCI). Methods: In this prospective cohort study, we enrolled patients aged <75 years who underwent PCI. MVPA was objectively measured using an accelerometer at 1 and 3 months after hospital discharge. Factors associated with increased MVPA (≥150 min/wk at 3 mo) were analyzed in participants with MVPA < 150 minutes per week at 1 month. Univariate and multivariate logistic regression analyses were performed to explore variables potentially associated with increasing MVPA, using MVPA ≥ 150 minutes per week at 3 months as the dependent variable. Factors associated with decreased MVPA (<150 min/wk at 3 mo) were also analyzed in participants with MVPA ≥ 150 minutes per week at 1 month. Logistic regression analysis was performed to explore factors of declining MVPA, using MVPA < 150 minutes per week at 3 months as the dependent variable. Results: We analyzed 577 patients (median age 64 y, 13.5% female, and 20.6% acute coronary syndrome). Increased MVPA was significantly associated with participation in outpatient cardiac rehabilitation (odds ratio 3.67; 95% confidence interval, 1.22–11.0), left main trunk stenosis (13.0; 2.49–68.2), diabetes mellitus (0.42; 0.22–0.81), and hemoglobin (1.47, per 1 SD; 1.09–1.97). Decreased MVPA was significantly associated with depression (0.31; 0.14–0.74) and Self-Efficacy for Walking (0.92, per 1 point; 0.86–0.98). Conclusions: Identifying patient factors associated with changes in MVPA may provide insight into behavioral changes and help with individualized PA promotion.