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Kurusart Konharn, Wichai Eungpinichpong, Kluaymai Promdee, Paramaporn Sangpara, Settapong Nongharnpitak, Waradanai Malila and Jirachai Karawa

Background:

The suitability of smartphone applications (apps) currently used to track walking/running may differ depending on a person’s weight condition. This study aimed to examine the validity and reliability of apps for both normal-weight and overweight/obese young adults.

Methods:

Thirty normal-weight (aged 21.7 ± 1.0 years, BMI 21.3 ± 1.9 kg/m2) and 30 overweight/ obese young adults (aged 21.0 ± 1.4 years, BMI 28.6 ± 3.7 kg/m2) wore a smartphone and pedometer on their right hip while walking/running at 3 different intensities on treadmills. Apps was randomly assigned to each individual for measuring average velocity, step count, distance, and energy expenditure (EE), and these measurements were then analyzed.

Results:

The apps were not accurate in counting most of the measured variables and data fell significantly lower in the parameters than those measured with standard-reference instruments in both light and moderate intensity activity among the normal-weight group. Among the overweight and obese group, the apps were not accurate in detecting velocity, distance, or EE during either light or vigorous intensities. The percentages of mean difference were 30.1% to 48.9%.

Conclusion:

Apps may not have sufficient accuracy to monitor important physical parameters of human body movement. Apps need to be developed that can, in particular, respond differently based on a person’s weight status.

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Clara Suemi da Costa Rosa, Danilo Yuzo Nishimoto, Ismael Forte Freitas Júnior, Emmanuel Gomes Ciolac and Henrique Luiz Monteiro

Background:

Patients on hemodialysis (HD) report lower physical activity (PA) levels. We analyzed factors associated with low levels of PA in patients with chronic kidney disease (CKD) and compared PA on HD day and non-HD.

Methods:

79 patients wore an accelerometer and were classified according to time spent on moderate-to-vigorous PA (MVPA). Demographic data, BMI, comorbidities, clinical status, and health-related quality of life (HRQoL) were checked for association with PA. In addition, PA level was compared between days of HD and non-HD.

Results:

Accelerometer compliance was 78.5% [33 men and 29 women (53.96 ± 15.71 yrs) were included in analysis]. 35.5% of sample achieved ≥150min/week on MVPA. Lower MVPA was associated with older age (OR = 5.80, 95% CI = 1.11 to 30.19, P = .04), and lower score of physical function HRQoL (OR = 4.33, 95% CI = 1.23 to 15.23, P = .02). In addition, patients spent 9.73% more time on sedentary behavior, 38.9% less on light PA and 74.9% less on MVPA on HD day versus non-HD day.

Conclusion:

Age and physical function HRQoL were the main factors associated to lower PA levels. In addition, lower time spent on PA during HD day suggest that strategies for increasing physical activity levels during HD day such exercising during HD session could help CKD patients to reach current PA recommendations.

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Sharon A. Plowman, Charles L. Sterling, Charles B. Corbin, Marilu D. Meredith, Gregory J. Welk and James R. Morrow Jr.

Initially designed by Charles L. Sterling as a physical fitness “report card” FITNESSGRAM ® / ACTIVITYGRAM ® is now an educational assessment and reporting software program. Based on physiological/epidemiological, behavioral, and pedagogical research, FITNESSGRAM is committed to health-related physical fitness, criterion-referenced standards, an emphasis on physical activity including behavioral based recognitions, and the latest in technology. The evolution of these major concepts is described in this history of FITNESSGRAM.

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Kathleen Y. Wolin, Daniel P. Heil, Sandy Askew, Charles E. Matthews and Gary G. Bennett

Background:

The International Physical Activity Questionnaire-Short Form (IPAQ-S) has been evaluated against accelerometer-determined physical activity measures in small homogenous samples of adults in the United States. There is limited information about the validity of the IPAQ-S in diverse US samples.

Methods:

142 Blacks residing in low-income housing completed the IPAQ-S and wore an accelerometer for up to 6 days. Both 1- and 10-minute accelerometer bouts were used to define time spent in light, moderate, and vigorous physical activity.

Results:

We found fair agreement between the IPAQ-S and accelerometer-determined physical activity (r = .26 for 10-minute bout, r = .36 for 1-minute bout). Correlations were higher among men than women. When we classified participants as meeting physical activity recommendations, agreement was low (kappa = .04, 10-minute; kappa = .21, 1-minute); only 25% of individuals were classified the same by both instruments (10-minute bout).

Conclusions:

In one of the few studies to assess the validity of a self-reported physical activity measure among Blacks, we found moderate correlations with accelerometer data, though correlations were weaker for women. Correlations were smaller when IPAQ-S data were compared using a 10- versus a 1-minute bout definition. There was limited evidence for agreement between the instruments when classifying participants as meeting physical activity recommendations.

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Stamatis Agiovlasitis, Robert W. Motl, John T. Foley and Bo Fernhall

This study examined the relationship between energy expenditure and wrist accelerometer output during walking in persons with and without Down syndrome (DS). Energy expenditure in metabolic equivalent units (METs) and activity-count rate were respectively measured with portable spirometry and a uniaxial wrist accelerometer in 17 persons with DS (age: 24.7 ± 6.9 years; 9 women) and 21 persons without DS (age: 26.3 ± 5.2 years; 12 women) during six over-ground walking trials. Combined groups regression showed that the relationship between METs and activity-count rate differed between groups (p < .001). Separate models for each group included activity-count rate and squared activity-count rate as significant predictors of METs (p ≤ .005). Prediction of METs appeared accurate based on Bland-Altman plots and the lack of between-group difference in mean absolute prediction error (DS: 17.07%; Non-DS: 18.74%). Although persons with DS show altered METs to activity-count rate relationship during walking, prediction of their energy expenditure from wrist accelerometry appears feasible.

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Melissa Raymond, Adele Winter and Anne E. Holland

Background:

Older adults undergoing rehabilitation may have limited mobility, slow gait speeds and low levels of physical activity. Devices used to quantify activity levels in older adults must be able to detect these characteristics.

Objective:

To investigate the validity of the Positional Activity Logger (PAL2) for monitoring position and measuring physical activity in older inpatients (slow stream rehabilitation).

Methods:

Twelve older inpatients (≥65 years) underwent a 1-hour protocol (set times in supine, sitting, standing; stationary and moving). Participants were video-recorded while wearing the PAL2. Time spent in positions and walking (comfortable and fast speeds) were ascertained through video-recording analysis and compared with PAL2 data.

Results:

There was no difference between the PAL2 and video recording for time spent in any position (P-values 0.055 to 0.646). Walking speed and PAL2 count were strongly correlated (Pearson’s r = .913, P < .01). The PAL2 was responsive to within-person changes in gait speed: activity count increased by an average of 52.47 units (95% CI 3.31, 101.63). There was 100% agreement for transitions between lying to sitting and < 1 transition difference between siting to standing.

Conclusion:

The PAL2 is a valid tool for quantifying activity levels, position transitions, and within-person changes in gait speed in older inpatients.

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Leon Straker, Amity Campbell, Svend Erik Mathiassen, Rebecca Anne Abbott, Sharon Parry and Paul Davey

Background:

Capturing the complex time pattern of physical activity (PA) and sedentary behavior (SB) using accelerometry remains a challenge. Research from occupational health suggests exposure variation analysis (EVA) could provide a meaningful tool. This paper (1) explains the application of EVA to accelerometer data, (2) demonstrates how EVA thresholds and derivatives could be chosen and used to examine adherence to PA and SB guidelines, and (3) explores the validity of EVA outputs.

Methods:

EVA outputs are compared with accelerometer data from 4 individuals (Study 1a and1b) and 3 occupational groups (Study 2): seated workstation office workers (n = 8), standing workstation office workers (n = 8), and teachers (n = 8).

Results:

Line graphs and related EVA graphs highlight the use of EVA derivatives for examining compliance with guidelines. EVA derivatives of occupational groups confirm no difference in bouts of activity but clear differences as expected in extended bouts of SB and brief bursts of activity, thus providing evidence of construct validity.

Conclusions:

EVA offers a unique and comprehensive generic method that is able, for the first time, to capture the time pattern (both frequency and intensity) of PA and SB, which can be tailored for both occupational and public health research.

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Yuko Oguma, Yusuke Osawa, Michiyo Takayama, Yukiko Abe, Shigeho Tanaka, I-Min Lee and Yasumichi Arai

Background:

To date, there is no physical activity (PA) questionnaire with convergent and construct validity for the oldest-old. The aim of the current study was to investigate the validity of questionnaire-assessed PA in comparison with objective measures determined by uniaxial and triaxial accelerometers and physical performance measures in the oldest-old.

Methods:

Participants were 155 elderly (mean age 90 years) who were examined at the university and agreed to wear an accelerometer for 7 days in the 3-year-follow-up survey of the Tokyo Oldest-Old Survey of Total Health. Fifty-nine participants wore a uniaxial and triaxial accelerometer simultaneously. Self-rated walking, exercise, and household PA were measured using a modified Zutphen PA Questionnaire (PAQ). Several physical performance tests were done, and the associations among PAQ, accelerometer-assessed PA, and physical performances were compared by Spearman’s correlation coefficients.

Results:

Significant, low to moderate correlations between PA measures were seen on questionnaire and accelerometer assessments (ρ = 0.19 to 0.34). Questionnaireassessed PA measure were correlated with a range of lower extremity performance (ρ = 0.21 to 0.29).

Conclusions:

This PAQ demonstrated convergent and construct validity. Our findings suggest that the PAQ can reasonably be used in this oldest-old population to rank their PA level.

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John Cooper, Barbara Stetson, Jason Bonner, Sean Spille, Sathya Krishnasamy and Sri Prakash Mokshagundam

Background:

This study assessed physical activity (PA) in community dwelling adults with Type 2 diabetes, using multiple instruments reflecting internationally normed PA and diabetes-specific self-care behaviors.

Methods:

Two hundred and fifty-three Black (44.8%) and White (55.2%) Americans [mean age = 57.93; 39.5% male] recruited at low-income clinic and community health settings. Participants completed validated PA self-report measures developed for international comparisons (International Physical Activity Questionnaire Short Form), characterization of diabetes self-care (Summary of Diabetes Self-Care Activities Measure; SDSCA) and exercise-related domains including provider recommendations and PA behaviors and barriers (Personal Diabetes Questionnaire; PDQ).

Results:

Self-reported PA and PA correlates differed by instrument. BMI was negatively correlated with PA level assessed by the PDQ in both genders, and assessed with SDSCA activity items in females. PA levels were low, comparable to previous research with community and diabetes samples. Pain was the most frequently reported barrier; females reported more frequent PA barriers overall.

Conclusions:

When using self-report PA measures for PA evaluation of adults with diabetes in clinical settings, it is critical to consider population and setting in selecting appropriate tools. PA barriers may be an important consideration when interpreting PA levels and developing interventions. Recommendations for incorporating these measures in clinical and research settings are discussed.

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Andreas Wolff Hansen, Inger Dahl-Petersen, Jørn Wulff Helge, Søren Brage, Morten Grønbæk and Trine Flensborg-Madsen

Background:

The International Physical Activity Questionnaire (IPAQ) is commonly used in surveys, but reliability and validity has not been established in the Danish population.

Methods:

Among participants in the Danish Health Examination survey 2007–2008, 142 healthy participants (45% men) wore a unit that combined accelerometry and heart rate monitoring (Acc+HR) for 7 consecutive days and then completed the IPAQ. Background data were obtained from the survey. Physical activity energy expenditure (PAEE) and time in moderate, vigorous, and sedentary intensity levels were derived from the IPAQ and compared with estimates from Acc+HR using Spearman’s correlation coefficients and Bland-Altman plots. Repeatability of the IPAQ was also assessed.

Results:

PAEE from the 2 methods was significantly positively correlated (0.29 and 0.49; P = 0.02 and P < 0.001; for women and men, respectively). Men significantly overestimated PAEE by IPAQ (56.2 vs 45.3 kJ/kg/day, IPAQ: Acc+HR, P < .01), while the difference was nonsignificant for women (40.8 vs 44.4 kJ/kg/day). Bland-Altman plots showed that the IPAQ overestimated PAEE, moderate, and vigorous activity without systematic error. Reliability of the IPAQ was moderate to high for all domains and intensities (total PAEE intraclass correlation coefficient = 0.58).

Conclusions:

This Danish Internet-based version of the long IPAQ had modest validity and reliability when assessing PAEE at population level.