Background: This study investigates the association between self-rated health and the time spent in sedentary behavior (SB), low light-intensity physical activity (LLPA), high light-intensity physical activity (HLPA), and moderate to vigorous physical activity (MVPA), by controlling for demographics, socioeconomic status, and chronic diseases. Methods: A total of 1665 participants (55% women) completed a questionnaire about demographics, chronic diseases, and anthropometric characteristics and provided objective physical activity data on time in SB, LLPA, HLPA, and MVPA, using an ActiGraph 7164 accelerometer. Association between self-rated health and activity data was explored in a compositional data analysis. Results: The multinomial logistic regression analysis showed a significantly lower time spent in MVPA in proportion to time in other movement behaviors (SB, LLPA, and HLPA) for participants who rated their health as alright or poor compared with excellent (P < .001). Participants with poor, compared with excellent health, spent about a third of the time in MVPA (17 vs 50 min), marginally higher time in HLPA (134 vs 125 min), more time in LLPA (324 vs 300 min), and similar time in SB (383 vs 383 min), accounting for confounders and time in other movement behaviors. Conclusions: Promoting MVPA, as opposed to time in other movement behaviors, is suggested to be beneficial for excellent self-rated health.
Philip von Rosen and Maria Hagströmer
Lydia Kwak, Maria Hagströmer, and Michael Sjostrom
To be able to draw any conclusions regarding the health effects of occupational physical activity (OPA), more information is needed regarding valid measures to assess OPA. Aims were to compare OPA as assessed with the International Physical Activity Questionnaire long version (IPAQ-L) with OPA assessed with an accelerometer and to assess the contribution of OPA to total PA.
Working adults (n = 441; mean age = 49.4 yrs; 44% males) wore an accelerometer for 7 days in free-living situations and completed the IPAQ-L. Comparisons were made between IPAQ-L-work and accelerometer data limited to working time (Moderate and Vigorous PA (accelerometer-MVPA-work) and average intensity). Subgroup analyses were performed.
Spearman correlation was r = .46 (P < .01) between IPAQ-L-work and accelerometer-MVPA-work. Correlations ranged from r = .27 to r = .55 in respectively obese and overweight subjects. The contribution of IPAQ-L-work to IPAQ-total was 24.7%.
The IPAQ-L work domain is a moderately good measure of time spent on MVPA at work and can be used to assess the contribution of OPA to total PA. This study provides valuable information regarding the use of the IPAQ-L in assessing work domain specific PA, and underscores the importance of assessing OPA, as it can contribute for a substantial part to total PA.
Ing-Mari Dohrn, Maria Hagströmer, Mai-Lis Hellénius, and Agneta Ståhle
To describe objectively-measured physical activity levels and patterns among community-dwelling older adults with osteoporosis, impaired balance, and fear of falling, and to explore the associations with gait, balance performance, falls self-efficacy, and health-related quality of life (HRQoL).
Ninety-four individuals (75.6 ± 5.4 years) were included. Physical activity was assessed with pedometers and accelerometers. Mean steps/day, dichotomized into < 5,000 or = 5,000 steps/day, and time spent in different physical activity intensities were analyzed. Gait was assessed with a GAITRite walkway, balance performance was assessed with the modified figure-eight test and oneleg stance, falls self-efficacy was assessed with the Falls Efficacy Scale International, and HRQoL was assessed with Short Form-36.
Mean steps/day were 6,201 (991–17,156) and 40% reported < 5,000 steps/day. Participants with < 5,000 steps/day spent more time sedentary, had slower gait speed, poorer balance performance, and lower HRQoL than participants with ≥ 5,000 steps/day. No participants with < 5,000 met the recommended level of physical activity.
Maria Hagströmer, Barbara E. Ainsworth, Lydia Kwak, and Heather R. Bowles
The quality of methodological papers assessing physical activity instruments depends upon the rigor of a study’s design.
We present a checklist to assess key criteria for instrument validation studies.
A Medline/PubMed search was performed to identify guidelines for evaluating the methodological quality of instrument validation studies. Based upon the literature, a pilot version of a checklist was developed consisting of 21 items with 3 subscales: 1) quality of the reported data (9 items: assess whether the reported information is sufficient to make an unbiased assessment of the findings); 2) external validity of the results (3 items: assess the extent to which the findings are generalizable); 3) internal validity of the study (9 items: assess the rigor of the study design). The checklist was tested for interrater reliability and feasibility with 6 raters.
Raters viewed the checklist as helpful for reviewing studies. They suggested minor wording changes for 8 items to clarify intent. One item was divided into 2 items for a total of 22 items.
Checklists may be useful to assess the quality of studies designed to validate physical activity instruments. Future research should test checklist internal consistency, test-retest reliability, and criterion validity.
Maria Hagstromer, Barbara E. Ainsworth, Pekka Oja, and Michael Sjostrom
The aim of this study was to compare physical activity components in the long, self-administrated version of IPAQ with an accelerometer in a population sample.
In total 980 subjects (18-65 years) wore an accelerometer (Actigraph) for 7 consecutive days and thereafter filled in the IPAQ. Measures of total physical activity, time spent in moderate and in vigorous activity as well as time spent sitting as assessed by the IPAQ and the Actigraph were compared.
The results showed significant low to moderate correlations (Rs = 0.07−0.36) between the 2 instruments and significantly (P < .001) higher values for sitting and vigorous intensity physical activity from the IPAQ compared with the Actigraph. The higher the values reported by the IPAQ the bigger differences were seen between the instruments. Comparison between the tertiles of total physical activity by the 2 instruments showed significant overall association with consistent agreement in the low and the high tertiles.
The long form of IPAQ is a valid measure of physical activity in population research. However, the IPAQ likely overestimates actual physical activity as shown by its limited ability to classify adults into low and high categories of physical activity based on accelerometer data.
Martin Benka Wallén, Ing-Mari Dohrn, Agneta Ståhle, Erika Franzén, and Maria Hagströmer
To compare self-reported pedometer steps with accelerometer steps under free-living conditions in individuals with Parkinson’s disease (PD) or osteoporosis (OP).
Seventy-three individuals with PD and 71 individuals with OP wore a pedometer (Yamax LS2000) and an accelerometer (ActiGraph GT1M/GT3X+) simultaneously for one week.
Fifty-one individuals with PD (72.6 ± 5.3 years) and 61 with OP (75.6 ± 5.3 years) provided simultaneously recorded data for 3–7 consecutive days. Pedometer steps were significantly lower than accelerometer steps in the PD group (p = .002) but not in the OP group (p = .956). Bland-Altman plots demonstrated wide limits of agreement between the instruments in both PD (range = 6,911 steps) and OP (range = 6,794 steps).
These results suggest that the ActiGraph GT1M/GT3X+ should be preferred over the Yamax LS2000 for the assessment of steps in both research and clinical evaluations, particularly in individuals with PD or altered gait.
Marita Södergren, Kristina Sundquist, Sven-Erik Johansson, Jan Sundquist, and Maria Hagströmer
The purpose of this study was to examine the association between total self-reported health-enhancing physical activity and country of birth among women living in Sweden.
Women (age 18 to 65 years) born in Sweden, Finland, Chile, and Iraq were recruited for this cross-sectional study. Data were collected by means of a postal questionnaire including the International Physical Activity Questionnaire (IPAQ-long version). Self-reported physical activity data were converted to MET-minutes per week and analyzed as continuous or categorical scores. A total of 2649 women were included in the analyses. The association between physical activity and country of birth was explored using ordinal logistic regression assuming proportional odds.
The total physical activity differed significantly between the countries of birth (P < .001). Women from Finland had significant higher odds and women from Iraq had significantly lower odds for reporting higher levels of physical activity, compared with Swedish-born women.
The direction of the associations between self-reported total health-enhancing physical activity varied by country of birth, which underlines the need to examine physical activity in each minority group separately.
Roman P. Kuster, Daniel Baumgartner, Maria Hagströmer, and Wilhelmus J.A. Grooten
Background: Sedentary behavior (SB) is associated with several chronic diseases and office workers especially are at increased risk. SB is defined by a sitting or reclined body posture with an energy expenditure of ≤1.5 metabolic equivalents. However, current objective methods to measure SB are not consistent with its definition. There is no consensus on which sensor placement and type should be used. Aim: To compare the accuracy of newly developed artificial intelligence models for 15 sensor placements in combination with four signal types (accelerometer only/plus gyroscope and/or magnetometer) to detect posture and physical in-/activity during desk-based activities. Method: Signal features for the model development were extracted from sensor raw data of 30 office workers performing 10 desk-based tasks, each lasting 5 min. Direct observation (posture) and indirect calorimetry (in-/activity) served as the reference criteria. The best classification model for each sensor was identified and compared among the sensor placements, both using Friedman and post hoc Wilcoxon tests (p ≤ .05). Results: Posture was most accurately measured with a lower body sensor, while in-/activity was most accurately measured with an upper body or waist sensor. The inclusion of additional signal types improved the posture classification for some placements, while the acceleration signal already contained the relevant signal information for the in-/activity classification. Overall, the thigh accelerometer most accurately classified desk-based SB. Conclusion: This study favors, in line with previous work, the measurement of SB with a thigh-worn accelerometer and adds the information that this sensor is also accurate in measuring physical in-/activity while sitting and standing.
Adrian Bauman, Barbara E. Ainsworth, Fiona Bull, Cora L. Craig, Maria Hagströmer, James F. Sallis, Michael Pratt, and Michael Sjöström
Christine Delisle Nyström, Christel Larsson, Bettina Ehrenblad, Hanna Eneroth, Ulf Eriksson, Marita Friberg, Maria Hagströmer, Anna Karin Lindroos, John J. Reilly, and Marie Löf
The 2016 Swedish Report Card on Physical Activity (PA) for Children and Youth is a unique compilation of the existing physical and health related data in Sweden. The aim of this article is to summarize the procedure and results from the report card.
Nationally representative surveys and individual studies published between 2005–2015 were included. Eleven PA and health indicators were graded using the Active Healthy Kids Canada grading system. Grades were assigned based on the percentage of children/youth meeting a defined benchmark (A: 81% to 100%, B: 61% to 80%, C: 41% to 60%, D: 21% to 40%, F: 0% to 20%, or incomplete (INC).
The assigned grades were Overall Physical Activity, D; Organized Sport Participation, B+; Active Play, INC; Active Transportation, C+; Sedentary Behaviors, C; Family and Peers, INC; School, C+; Community and the Built Environment, B; Government Strategies and Investments, B; Diet, C-; and Obesity, D.
The included data provides some support that overall PA is too low and sedentary behavior is too high for almost all age groups in Sweden, even with the many national policies as well as an environment that is favorable to the promotion of PA.