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.
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
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.
The present article aimed to systematically summarize primary school-based intervention programs and their effects evaluated through randomized-controlled trial design. A systematic review of relevant articles was carried out using 4 electronic databases. From a total of 193 studies initially found, 30 were included in the qualitative synthesis. Main results: (1) Intensive interval training or jump/strength exercises may positively influence physical fitness, promoting challenging task, psychological needs, and guided styles to a greater extent; (2) Games that demand more cognitive function seem more beneficial than those based on repetitive aerobic exertion to improve fundamental motor skills; (3) The jumping/strength exercises may cause benefits in bone area and bone mineral density, while flexibility and balance may reduce the risk of muscle injury; and (4) Programming a greater dose of moderate-to-vigorous physical activity seems to be related to positive effects in core executive function and academic performance. Additionally, providing information and involving the social environment may enhance the positive effects.
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.
Pedro C. Hallal
Adewale L. Oyeyemi
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.
Maryam Selk-Ghaffari, Amin Nakhostin-Ansari, Iman Menbari Oskouie, Yasamin Maleki Gilvaei, Behnaz Mahdaviani, Maedeh Gholami-Mehrabadi, and Ramin Kordi
Background: This study aimed to translate and cross-culturally adapt the Lifetime Total Physical Activity Questionnaire (LTPAQ) for use in Persian-speaking countries as well as evaluate its validity and reliability. Methods: There were 3 stages to this study. First, a forward–backward translation method was used to develop a Persian version of the LTPAQ. In the second stage, the Persian version of the LTPAQ was evaluated for its face validity and content validity. Finally, test–retest reliability and known-group validity were assessed. The LTPAQ has occupational and volunteer activities, including travel to work, exercise and sports, and household activities. Frequency, duration, and estimated metabolic costs of activities with light, moderate, and heavy intensities were used to calculate the metabolic equivalent of each domain during life (in metabolic equivalent-hour/week). Metabolic equivalents of each domain and in total were used to evaluate the reliability and validity of the questionnaire. Results: In total, 60 people (41.7% females) with a mean age of 33.9 (SD = 11.5) years participated in this study. All domains showed excellent test–retest reliability (intraclass correlation coefficient > .9). All items had content validity indexes higher than 0.85. In addition, males had significantly higher physical activity levels than females (P = .022), indicating the known-group validity of the questionnaire. Conclusions: The LTPAQ was translated into Persian and trans-culturally adapted. This study indicates that the Persian version of the LTPAQ has adequate reliability and validity and can be utilized in future studies to assess physical activity in the Persian population.
Michael Pratt, Andrea Ramirez Varela, and Adrian Bauman
Chelsea L. Kracht, Sai S. Pochana, and Amanda E. Staiano
Background: More moderate to vigorous physical activity (MVPA) and less time in sedentary behavior (SB) may protect against poor mental health in adolescence. Depressive symptomatology may also influence adolescents’ own MVPA and SB. The aim of this study was to examine the bidirectional relationship between adolescent MVPA, SB, and depressive symptomatology using a longitudinal approach. Methods: Adolescents (10–16 y) were recruited for a prospective observational cohort. Depressive symptomatology was measured using the Short Mood and Feelings Questionnaire. Accelerometry was used to measure MVPA and SB. Adolescents were classified by meeting the MVPA guideline (≥60 min/d) and quartiles of SB time, with the lowest amount of time in SB compared to others. Bidirectional associations between MVPA, SB, and depressive symptomatology were assessed using mixed-effects regression models. Results: At baseline, adolescents (n = 205) were 12.5 (2.0) years, 54.6% women, 59.1% White, and 34.6% African American. In unadjusted models, adolescents with less baseline time in SB had lower follow-up Short Mood and Feelings Questionnaire scores, and fewer were classified as depressed at follow-up compared to others. After adjustment, adolescents with less baseline time in SB had lower depressive symptomatology at follow-up. Conclusions: Limiting time spent in SB in adolescence may improve future mental health.