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Predictive Validity of Health-Related Fitness Tests on Back Pain and Related Disability: A 6-Year Follow-Up Study Among High-Functioning Older Adults

Pauliina Husu and Jaana Suni

Background:

Back pain and related disability seem to be increasing among older adults. Health-related fitness tests have been developed to identify individuals at risk for mobility difficulties. However, poor fitness as a risk factor for back problems has seldom been studied. The purpose of the current study was to investigate whether performance in fitness tests predicts back pain and related disability during 6 years of follow-up.

Methods:

Study population consisted of community-dwelling men and women, born 1927 to 1941, who participated in assessment of health-related fitness and reported no long-term back pain or related disability at baseline (n = 517). The assessment included measurements of body mass index (BMI), one-leg stand, backward tandem walk, trunk side-bending, dynamic back extension, forward squat, 6.1-m walking speed and 1-km walk time.

Results:

Prospective analyses indicated that poor fitness (poorest-third) in one-leg stand and trunk side-bending tests were the most powerful predictors of back pain. Regarding disability, poor fitness in dynamic back extension and overweight in terms of BMI ≥ 27 increased the risk.

Conclusions:

Tests of balance, trunk flexibility and trunk muscle endurance, as well as BMI can be implemented as screening tools for identifying persons with increased risk of back pain and related disability.

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Does Physical Activity Affect the Predictive Value of Health-Related Fitness Tests on Walking Difficulty?

Pauliina Husu, Jaana Suni, Matti Pasanen, and Seppo Miilunpalo

Background:

Low levels of physical activity (PA) and poor fitness tend to predict a decline in mobility. The current study investigated whether PA modifies the predictive value of health-related fitness (HRF) tests on difficulty in walking 2 km (WD).

Methods:

PA was assessed by self-reported questionnaires in 1990 and 1996. Subjects age 55 to 69 years and free of self-reported WD participated in assessment of HRF in 1996. Occurrence of WD was assessed by questionnaire in 2002 (n = 537).

Results:

There were no statistically significant interactions between PA and HRF tests; thus, PA and HRF were both independent predictors of WD. Regardless of the PA level, the subjects in the poorest performing third in each HRF test had higher risk of WD than the subjects in the best performing third.

Conclusions:

PA and HRF seemed to be independent predictors of WD, although the association of PA with WD was weaker than the association of HRF. Thus, PA did not modify the predictive value of HRF on WD.

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Depressive Symptoms Are Associated With Accelerometer-Measured Physical Activity and Time in Bed Among Working-Aged Men and Women

Pauliina Husu, Kari Tokola, Henri Vähä-Ypyä, Harri Sievänen, and Tommi Vasankari

Background: Depression is a significant health problem, whereas higher physical activity (PA) associates with fewer depressive symptoms. We examined how self-reported depressive symptoms are associated with accelerometer-measured PA, standing, sedentary behavior, and time in bed (TIB) among 20- to 69-year-old men and women. Methods: The study is a part of the cross-sectional, population-based FinFit2017 study, in which depressive symptoms were assessed by modified nine-item Finnish version of the Patient Health Questionnaire, and physical behavior in terms of PA, sedentary behavior, standing, and TIB was assessed 24/7 by a triaxial accelerometer. During waking hours, the accelerometer was hip worn. Intensity of PA was analyzed by mean amplitude deviation and body posture by angle for posture estimation algorithms. During TIB, the device was wrist worn, and the analysis was based on the wrist movements. A total of 1,823 participants answered the nine-item Finnish version of the Patient Health Questionnaire and used the accelerometer 24 hr at least 4 days per week. Results: Men without depressive symptoms had on average more standing, light, and moderate to vigorous PA and steps, and less low and high movement TIB than the men with at least moderate symptoms, when age group, education, work status, marital status, and fitness were adjusted for. The asymptomatic women had more moderate to vigorous PA and steps and less high movement TIB than the women with at least moderate symptoms. Conclusions: Depressive symptoms were associated with lower levels of PA and longer TIB. It is important to identify these symptoms as early as possible to be able to initiate and target preventive actions, including PA promotion, to these symptomatic persons on time.

Open access

Physical Activity, Sedentary Behavior, and Time in Bed Among Finnish Adults Measured 24/7 by Triaxial Accelerometry

Pauliina Husu, Kari Tokola, Henri Vähä-Ypyä, Harri Sievänen, Jaana Suni, Olli J. Heinonen, Jarmo Heiskanen, Kaisu M. Kaikkonen, Kai Savonen, Sami Kokko, and Tommi Vasankari

Background: Studies measuring physical activity (PA) and sedentary behavior on a 24/7 basis are scarce. The present study assessed the feasibility of using an accelerometer at the hip while awake and at the wrist while sleeping to describe 24/7 patterns of physical behavior in working-aged adults by age, sex, and fitness. Methods: The study was based on the FinFit 2017 study where the physical behavior of 20- to 69-year-old Finns was assessed 24/7 by triaxial accelerometer (UKKRM42; UKK Terveyspalvelut Oy, Tampere, Finland). During waking hours, the accelerometer was kept at the right hip and, during time in bed, at the nondominant wrist. PA variables were based on 1-min exponential moving average of mean amplitude deviation of the resultant acceleration signal analyzed in 6-s epochs. The angle for the posture estimation algorithm was used to identify sedentary behavior and standing. Evaluation of time in bed was based on the wrist movement. Fitness was estimated by the 6-min walk test. Results: A total of 2,256 eligible participants (mean age 49.5 years, SD = 13.5, 59% women) wore the accelerometer at the hip 15.7 hr/day (SD = 1.4) and at the wrist 8.3 hr/day (SD = 1.4). Sedentary behavior covered 9 hr 18 min/day (SD = 1.8 hr/day), standing nearly 2 hr/day (SD = 0.9), light PA 3.7 hr/day (SD = 1.3), and moderate to vigorous PA 46 min/day (SD = 26). Participants took 7,451 steps per day (SD = 2,962) on average. Men were most active around noon, while women had activity peaks at noon and at early evening. The low-fit tertile took 1,186 and 1,747 fewer steps per day than the mid- and high-fit tertiles (both p < .001). Conclusions: One triaxial accelerometer with a two wear-site approach provides a feasible method to characterize hour-by-hour patterns of physical behavior among working-aged adults.

Open access

Results from Finland’s 2018 Report Card on Physical Activity for Children and Youth

Katariina Kämppi, Annaleena Aira, Nina Halme, Pauliina Husu, Virpi Inkinen, Laura Joensuu, Sami Kokko, Kaarlo Laine, Kaisu Mononen, Sanna Palomäki, Timo Ståhl, Arja Sääkslahti, and Tuija Tammelin

Open access

Results From Finland’s 2016 Report Card on Physical Activity for Children and Youth

Tuija H. Tammelin, Annaleena Aira, Matti Hakamäki, Pauliina Husu, Jouni Kallio, Sami Kokko, Kaarlo Laine, Kati Lehtonen, Kaisu Mononen, Sanna Palomäki, Timo Ståhl, Arja Sääkslahti, Jorma Tynjälä, and Katariina Kämppi

Background:

Finland’s 2016 Report Card on Physical Activity for Children and Youth gathers and translates research results and assesses the status and promotion of physical activity (PA) among Finnish children and youth less than 18 years of age. This article summarizes the results and provides grades for 9 indicators.

Methods:

The working group evaluated the evidence and assigned grades of A (highest, 81% to 100%), B, C, D, or F (lowest, 0% to 20%) for 9 PA indicators using the Active Healthy Kids Canada Report Card development process.

Results:

The grades varied in Finland as follows: 1) Overall PA/fulfillment of recommendations = D, 2) Organized Sport Participation = C, 3) Active Play = C, 4) Active Transportation = B, 5) Sedentary Behaviors = D, 6) Family and Peers = C, 7) School = B, 8) Community and the Built Environment = B, 9) Government = B.

Conclusions:

Despite good policies and programs to promote PA in Finland, children and youth overall PA levels are low, whereas their time spent sedentary is high. More effective interventions, operation models, concrete tools as well as environmental solutions are needed to support the work toward more physically active childhood and youth.