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Xiaolin Yang, Irinja Lounassalo, Anna Kankaanpää, Mirja Hirvensalo, Suvi P. Rovio, Asko Tolvanen, Stuart J.H. Biddle, Harri Helajärvi, Sanna H. Palomäki, Kasper Salin, Nina Hutri-Kähönen, Olli T. Raitakari and Tuija H. Tammelin

Background: The purpose of this study was to examine trajectories of leisure-time physical activity (LTPA) and television-viewing (TV) time and their associations in adults over 10 years. Methods: The sample comprised 2934 participants (men, 46.0%) aged 24–39 years in 2001 and they were followed up for 10 years. LTPA and TV time were assessed using self-report questionnaires in 2001, 2007, and 2011. Longitudinal LTPA and TV-time trajectories and their interactions were analyzed with mixture modeling. Results: Three LTPA (persistently highly active, 15.8%; persistently moderately active, 60.8%; and persistently low active, 23.5%) and 4 TV time (consistently low, 38.6%; consistently moderate, 48.2%; consistently high, 11.7%; and consistently very high, 1.5%) trajectory classes were identified. Persistently highly active women had a lower probability of consistently high TV time than persistently low-active women (P = .02), whereas men who were persistently highly active had a higher probability of consistently moderate TV time and a lower probability of consistently low TV time than their persistently low-active counterparts (P = .03 and P = .01, respectively). Conclusions: Maintaining high LTPA levels were accompanied by less TV over time in women, but not in men. The associations were partially explained by education, body mass index, and smoking.

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Baruch Vainshelboim, Zhongming Chen, Ricardo M. Lima and Jonathan Myers

Background: To assess the joint and stratified associations between cardiorespiratory fitness (CRF), incidence, and mortality from cancer in never, former, and current male smokers. Methods: CRF (treadmill exercise test) was assessed in 4694 men (never smokers [n = 1715]; former smokers [n = 1602], 32.4 [30.5] pack-years; and current smokers [n = 1377], 40.3 [26] pack-years) aged 58.1 (17.3) years, and prospectively followed for 12.7 (7.5) years. Multivariable Cox hazard models were analyzed. Results: In joint analyses, where high CRF in never smokers was used as a reference, hazard ratios and 95% (confidence intervals) for cancer incidence and cancer mortality were as follows: moderate CRF 1.41 (1.0–1.9) and 3.0 (1.7–5.5) in never smokers, 1.65 (1.3–2.2) and 3.7 (2.1–6.6) in former smokers, and 1.3 (0.9–1.7) and 3.4 (1.9–6.1) in current smokers, respectively. The corresponding values for low CRF were 1.53 (1.1–2.2) and 5.1 (2.7–9.5), 1.84 (1.3–2.5) and 6.6 (3.7–11.8), and 1.5 (1.1–2.2) and 5 (2.7–9.3), respectively. In stratified analyses by smoking status, compared with low CRF, moderate and high CRF were associated with a 32% to 78% reduction in cancer mortality risk (P trend for all <.001). Conclusion: Higher CRF is associated with lower risk of incidence and mortality from cancer regardless of smoking status, supporting the potential preventive benefits for public health.

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Mohammad Sahebkar, Hamid Heidarian Miri, Pardis Noormohammadpour, Amir Tiyuri, Reza Pakzad, Nasrin Mansournia, Zahra Heidari, Mohammad Ali Mansournia and Emmanuel Stamatakis

Background: To investigate the geographical distribution of physical activity (PA) prevalence among adults aged 15–64 years old across Iran provinces using geographic maps. Methods: Data from 4 consecutive national surveys conducted between 2007 and 2010 were pooled to determine the geographical distribution. Prevalence of low PA with 95% confidence interval was estimated by sociodemographic subpopulations over provinces using complex survey design. Results: In total, 119,560 participants (49.9% females) were included in the analyses. The mean (SD) age of participants was 39.5 (14.3) years. The prevalence of the low PA in the pooled 2007–2010 was 35.8% (95% confidence interval, 34.1–37.6). The 3 provinces with the highest prevalence of low PA were Sistan and Baluchestan, Yazd, and Hormozgan. The results of hot spot analysis showed that the Kerman province was a hot spot, and Ilam, Kermanshah, Hamedan, and Markazi were cold spots for low PA. Ilam, Kohgiluyeh and Boyer-Ahmad, and Mazandaran had the highest total PA volume (metabolic equivalent minutes per week). Hot spot analysis showed that Ilam and Khuzestan provinces were hot spots for the total PA volume. Conclusions: The regions with low and high PA are predominately situated in the near center/southeast and west, respectively.

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Robert J. Brychta, Vaka Rögnvaldsdóttir, Sigríður L. Guðmundsdóttir, Rúna Stefánsdóttir, Soffia M. Hrafnkelsdóttir, Sunna Gestsdóttir, Sigurbjörn A. Arngrímsson, Kong Y. Chen and Erlingur Jóhannsson

Introduction: Sleep is often quantified using self-report or actigraphy. Self-report is practical and less technically challenging, but prone to bias. We sought to determine whether these methods have comparable sensitivity to measure longitudinal changes in adolescent bedtimes. Methods: We measured one week of free-living sleep with wrist actigraphy and usual bedtime on school nights and non-school nights with self-report questionnaire in 144 students at 15 y and 17 y. Results: Self-reported and actigraphy-measured bedtimes were correlated with one another at 15 y and 17 y (p < .001), but reported bedtime was consistently earlier (>30 minutes, p < .001) and with wide inter-method confidence intervals (> ±106 minutes). Mean inter-method discrepancy did not differ on school nights at 15 y and 17 y but was greater at 17 y on non-school nights (p = .002). Inter-method discrepancy at 15 y was not correlated to that at 17 y. Mean change in self-reported school night bedtime from 15 y to 17 y did not differ from that by actigraphy, but self-reported bedtime changed less on non-school nights (p = .002). Two-year changes in self-reported bedtime did not correlate with changes measured by actigraphy. Conclusions: Although methods were correlated, consistently earlier self-reported bedtime suggests report-bias. More varied non-school night bedtimes challenge the accuracy of self-report and actigraphy, reducing sensitivity to change. On school nights, the methods did not differ in group-level sensitivity to changes in bedtime. However, lack of correlation between bedtime changes by each method suggests sensitivity to individual-level change was different. Methodological differences in sensitivity to individual- and group-level change should be considered in longitudinal studies of adolescent sleep patterns.

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Amanda L. Penko, Jacob E. Barkley, Anson B. Rosenfeldt and Jay L. Alberts

Background: Parkinson’s disease (PD) results in a global decrease in information processing, ultimately resulting in dysfunction executing motor-cognitive tasks. Motor-cognitive impairments contribute to postural instability, often leading to falls and decreased physical activity. The aim of this study was to determine the effects of a multimodal training (MMT) versus single-modal (SMT) training on motor symptoms, fall frequency, and physical activity in patients with PD classified as fallers. Methods: Individuals with PD were randomized into SMT (n = 11) or MMT (n = 10) and completed training 3 times per week for 8 weeks. The SMT completed gait and cognitive training separately, whereas MMT completed gait and cognitive training simultaneously during each 45-minute session. Physical activity, 30-day fall frequency, and PD motor symptoms were assessed at baseline, posttreatment, and during a 4-week follow-up. Results: Both groups exhibited significant (P < .05) improvements in clinical ratings of motor function, as symptoms improved by 8% and 15% for SMT and MMT, respectively. Physical activity significantly increased (P < .05) for both groups from baseline (mean steps 4942 [4415]) to posttreatment (mean steps 5914 [5425]). The MMT resulted in a significant 60% reduction in falls. Conclusions: Although SMT and MMT approaches are both effective in improving physical activity and motor symptoms of PD, only MMT reduced fall frequency after the intervention.

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Madhura Phansikar and Sean P. Mullen

Leisure-time physical activity (LTPA) is known to benefit cognition among older adults, but the impact of active travel is unclear. To explore this relationship, data from the 2011–2014 National Health and Nutritional Examination Survey (N = 2,702; mean age = 70) were retrieved on the self-reported frequency and duration of active travel (walking/cycling for transport, >20 min), LTPA engagement (e.g., sport), and three cognitive outcomes. Four groups were created according to physical activity guidelines (600 metabolic equivalent of task/week): inactive (n = 1,790), active travelers (n = 210), engaging in LTPA (n = 579), and engaging in both (n = 123). Analysis of covariance (and follow-up comparisons) revealed a significant main effect for each cognition variable, after adjusting for the covariates, indicating that those engaging in LTPA performed the best. Although correlational, these findings suggest that LTPA engagement may be important for cognition among older adults, but active travel did not provide added benefit.

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Juliessa M. Pavon, Richard J. Sloane, Carl F. Pieper, Cathleen S. Colón-Emeric, David Gallagher, Harvey J. Cohen, Katherine S. Hall, Miriam C. Morey, Midori McCarty, Thomas L. Ortel and Susan N. Hastings

This study describes the availability of physical activity information in the electronic health record, explores how electronic health record documentation correlates with accelerometer-derived physical activity data, and examines whether measured physical activity relates to venous thromboembolism (VTE) prophylaxis use. Prospective observational data comes from community-dwelling older adults admitted to general medicine (n = 65). Spearman correlations were used to examine association of accelerometer-based daily step count with documented walking distance and with duration of VTE prophylaxis. Only 52% of patients had documented walking in nursing and/or physical therapy/occupational therapy notes during the first three hospital days. Median daily steps recorded via accelerometer was 1,370 (interquartile range = 854, 2,387) and correlated poorly with walking distance recorded in physical therapy/occupational therapy notes (median 33 feet/day [interquartile range = 12, 100]; r = .24; p = .27). Activity measures were not associated with use or duration of VTE prophylaxis. VTE prophylaxis use does not appear to be directed by patient activity, for which there is limited documentation.

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Ian M. Greenlund, Piersan E. Suriano, Steven J. Elmer, Jason R. Carter and John J. Durocher

Background: Sedentary activity and sitting for at least 10 hours per day can increase the risk for cardiovascular disease by more than 60%. Use of standing desks may decrease sedentary time and improve cardiovascular health. Acute standing lowers pulse wave velocity (PWV), but chronic effects remain unknown. The purpose of this study was to determine the effect of chronic standing desk use on arterial stiffness versus seated controls. Methods: A total of 48 adults participated in this study. Twenty-four participants qualified as seated desk users (age 41 [10] y, body mass index 25 [4] kg/m2) and 24 as standing desk users (age 45 [12] y, body mass index 25 [5] kg/m2). Arterial stiffness was assessed as PWV within the aorta, arm, and leg. Results: Carotid–femoral PWV (cfPWV) was not different between seated (6.6 [1.3] m/s) and standing (6.9 [1.3] m/s) groups (P = .47). Similarly, there were no differences in arm or leg PWV between groups (P = .13 and P = .66, respectively). A secondary analysis of traditional factors of age and aerobic fitness revealed significant differences in cfPWV in seated and standing desk participants. Age also significantly influenced cfPWV across conditions. Conclusions: Standing for >50% of a workday did not affect PWV. Consistent with previous research, fitness and age are important modulators of arterial stiffness.

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Kelly Cornett, Katherine Bray-Simons, Heather M. Devlin, Sunil Iyengar, Patricia Moore Shaffer and Janet E. Fulton