Patterns and Predictors of Change in Moderate-to-Vigorous Physical Activity Over Time in Multiple Sclerosis

2017 ◽  
Vol 14 (3) ◽  
pp. 183-188 ◽  
Author(s):  
Rachel E. Klaren ◽  
Jeffer E. Sasaki ◽  
Edward McAuley ◽  
Robert W. Motl
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Latent Class ◽  
Vigorous Physical Activity ◽  
Clinical Predictors ◽  
Physical Activity Interventions ◽  
Time Period ◽  
Class 1 ◽  
Time Class ◽  
Over Time

Background:Physical inactivity is common in persons with multiple sclerosis (MS), but there is very little known about the pattern and predictors of changes in physical activity over time.Purpose:This study examined changes in moderate-to-vigorous physical activity (MVPA) over a 30-month time period and the demographic and clinical predictors of such changes in relapsing-remitting MS (RRMS).Methods:269 persons with MS wore an accelerometer for a 7-day period and completed a demographic/clinical scale every 6 months over a 30-month period. Data were analyzed using latent class growth modeling (LCGM).Results:LCGM identified a two-class model for changes in levels of MVPA over time. Class 1 involved higher initial levels of MVPA and linear decreases in MVPA over time, whereas Class 2 involved lower initial levels of MVPA and linear increases in MVPA over time. LCGM further indicated that males were more likely (OR = 5.8, P < .05) and those with higher disability status were less likely (OR = 0.51, P < .05) to belong to Class 1 than Class 2.Conclusion:Levels of MVPA change over time in persons with RRMS and the pattern of change suggests that behavioral physical activity interventions for persons with MS might target men and those with lower disability.

Patterns and predictors of naturally occurring change in depressive symptoms over a 30-month period in multiple sclerosis

2013 ◽  
Vol 20 (5) ◽  
pp. 602-609 ◽  
Author(s):  
Ipek Ensari ◽  
Robert W Motl ◽  
Edward McAuley ◽  
Sean P Mullen ◽  
Anthony Feinstein
Keyword(s):  
Multiple Sclerosis ◽  
Depressive Symptoms ◽  
Latent Class ◽  
Depression Scale ◽  
Physically Active ◽  
Modifiable Factors ◽  
Relapsing Remitting ◽  
Class 1 ◽  
Time Class ◽  
Over Time

Background: Depressive symptoms are common in multiple sclerosis (MS), yet there is little information about the pattern and predictors of changes in depressive symptoms over time. Objective: We examined changes in depressive symptoms over a 30-month period and the demographic, clinical and behavioral predictors of such changes in relapsing–remitting MS (RRMS). Methods: 269 persons with RRMS completed the Hospital Anxiety and Depression Scale (HADS) and a demographic/clinical scale, Godin Leisure-Time Exercise Questionnaire (GLTEQ) and Patient Determined Disease Steps (PDDS) scale every 6 months over a 30-month period. Data were analyzed using latent class growth modeling (LCGM). Results: LCGM identified a two-class model for changes in HADS depression scores over time. Class 1 involved lower initial status (i.e. fewer depressive symptoms) and linear decreases in depressive symptoms over time (i.e. improving HADS scores), whereas Class 2 involved higher initial status (i.e. more depressive symptoms) and linear increases in depressive symptoms over time (i.e. worsening HADS scores). LCGM further indicated that being older (OR = 2.46; p < .05), married (OR = 2.62; p < .05), employed (OR = 4.29; p < .005) and physically active (OR = 2.71; p < .05) predicted a greater likelihood of belonging to C1 than C2. Conclusions: Depressive symptoms change over time in persons with RRMS, and the pattern of change can be predicted by modifiable and non-modifiable factors.

scholarly journals Customary physical activity and odds of depression: a systematic review and meta-analysis of 111 prospective cohort studies

2021 ◽  
pp. bjsports-2020-103140
Author(s):  
Rodney K Dishman ◽  
Cillian P McDowell ◽  
Matthew Payton Herring
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Depressive Symptoms ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Observational Studies ◽  
Meta Analysis ◽  
Vigorous Physical Activity ◽  
Prospective Cohort Studies ◽  
Over Time

ObjectiveTo explore whether physical activity is inversely associated with the onset of depression, we quantified the cumulative association of customary physical activity with incident depression and with an increase in subclinical depressive symptoms over time as reported from prospective observational studies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, PsycINFO, PsycARTICLES and CINAHL Complete databases, supplemented by Google Scholar.Eligibility criteriaProspective cohort studies in adults, published prior to January 2020, reporting associations between physical activity and depression.Study appraisal and synthesisMultilevel random-effects meta-analysis was performed adjusting for study and cohort or region. Mixed-model meta-regression of putative modifiers.ResultsSearches yielded 111 reports including over 3 million adults sampled from 11 nations in five continents. Odds of incident cases of depression or an increase in subclinical depressive symptoms were reduced after exposure to physical activity (OR, 95% CI) in crude (0.69, 0.63 to 0.75; I2=93.7) and adjusted (0.79, 0.75 to 0.82; I2=87.6) analyses. Results were materially the same for incident depression and subclinical symptoms. Odds were lower after moderate or vigorous physical activity that met public health guidelines than after light physical activity. These odds were also lower when exposure to physical activity increased over time during a study period compared with the odds when physical activity was captured as a single baseline measure of exposure.ConclusionCustomary and increasing levels of moderate-to-vigorous physical activity in observational studies are inversely associated with incident depression and the onset of subclinical depressive symptoms among adults regardless of global region, gender, age or follow-up period.

scholarly journals Impact of Baseline BMI upon the Success of Latina Participants Enrolled in a 6-Month Physical Activity Intervention

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Sheri J. Hartman ◽  
Shira I. Dunsiger ◽  
Dori W. Pekmezi ◽  
Brooke Barbera ◽  
Charles J. Neighbors ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Processes ◽  
Physical Activity Intervention ◽  
The Body ◽  
Physical Activity Interventions ◽  
Family Social Support ◽  
Longitudinal Regression ◽  
Baseline Bmi ◽  
The Relationship ◽  
Over Time

High rates of obesity in Latinas highlight the need to determine if physical activity interventions are equally effective across the body mass index (BMI) range. Thus, this study assessed how BMI impacts success of Spanish-speaking Latinas in a culturally and linguistically adapted theory-based physical activity intervention (). Longitudinal regression models tested the relationship between baseline BMI and outcomes. Overall, a trend for a negative association was found between baseline BMI and self-reported physical activity and theoretical constructs targeted by the intervention over time. For example, someone with a 25 kg/m2BMI would report, on average, 27.5 more minutes/week of activity compared to someone with a 30 kg/m2BMI at followup. Furthermore, higher baseline BMI was significantly associated with lower self-efficacy, behavioral and cognitive processes of change, and family social support over time. These findings suggest that participants with higher BMI may need additional intervention to promote physical activity.

scholarly journals Stability of ARDS subphenotypes over time in two randomised controlled trials

Thorax ◽  
2018 ◽  
Vol 73 (5) ◽  
pp. 439-445 ◽  
Author(s):  
Kevin Delucchi ◽  
Katie R Famous ◽  
Lorraine B Ware ◽  
Polly E Parsons ◽  
B Taylor Thompson ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Outcomes ◽  
Randomised Controlled Trials ◽  
Latent Class ◽  
Lung Protective Ventilation ◽  
Controlled Trials ◽  
Transition Analysis ◽  
Class 1 ◽  
Randomised Controlled ◽  
Over Time

RationaleTwo distinct acute respiratory distress syndrome (ARDS) subphenotypes have been identified using data obtained at time of enrolment in clinical trials; it remains unknown if these subphenotypes are durable over time.ObjectiveTo determine the stability of ARDS subphenotypes over time.MethodsSecondary analysis of data from two randomised controlled trials in ARDS, the ARMA trial of lung protective ventilation (n=473; patients randomised to low tidal volumes only) and the ALVEOLI trial of low versus high positive end-expiratory pressure (n=549). Latent class analysis (LCA) and latent transition analysis (LTA) were applied to data from day 0 and day 3, independent of clinical outcomes.Measurements and main resultsIn ALVEOLI, LCA indicated strong evidence of two ARDS latent classes at days 0 and 3; in ARMA, evidence of two classes was stronger at day 0 than at day 3. The clinical and biological features of these two classes were similar to those in our prior work and were largely stable over time, though class 2 demonstrated evidence of progressive organ failures by day 3, compared with class 1. In both LCA and LTA models, the majority of patients (>94%) stayed in the same class from day 0 to day 3. Clinical outcomes were statistically significantly worse in class 2 than class 1 and were more strongly associated with day 3 class assignment.ConclusionsARDS subphenotypes are largely stable over the first 3 days of enrolment in two ARDS Network trials, suggesting that subphenotype identification may be feasible in the context of clinical trials.

Abstract P231: Physical Activity and Sedentary Behavior Trajectories During Pregnancy and Postpartum Blood Pressure

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Abbi Lane-Cordova ◽  
Melissa Jones ◽  
Janet M Catov ◽  
Bethany Barone Gibbs
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Sedentary Behavior ◽  
Latent Class ◽  
Vigorous Physical Activity ◽  
Clinic Visit ◽  
Singleton Pregnancy ◽  
Group Assignment ◽  
Pregnancy And Postpartum ◽  
Adjusted Model

Background: Pregnancy influences longer-term vascular health for women. Moderate-vigorous physical activity (MVPA) and sedentary behavior (SED) have been associated with blood pressure (BP) in non-pregnant adults. Self-reported pregnancy MVPA has been associated with less risk of hypertension during pregnancy, but associations of MVPA and SED patterns during pregnancy and postpartum BP have not been investigated. Methods: MVPA and SED were measured objectively in women in each trimester of a singleton pregnancy using triaxial and positional accelerometers and defined using established cut points. Systolic and diastolic BP obtained at the 6-week postpartum clinic visit were abstracted from medical charts. Latent class trajectory modeling was used to assign women to one of three MVPA and SED trajectory groups: low, medium, and high. Kruskal-Wallis tests were used to evaluate differences in systolic and diastolic BP between trajectory groups and linear regression was used to test for associations of MVPA and SED trajectory group assignment with BP. Adjustment variables included age, race, and postpartum BMI. Results: Of the 101 women in the study, 23 were African American, mean age = 31±0.5 years and mean postpartum BMI = 27.6±0.7 kg/m 2 . Mean postpartum systolic and diastolic BP were 114±1 and 71±1 mmHg. Systolic BP was similar among MVPA and SED trajectory groups. Diastolic BP differed between MVPA (low: 76±2, medium: 70±1, high: 70±2 mmHg, p<0.05) and SED (low: 71±3, medium: 69±1, high: 74±1, p<0.05) trajectory groups. In adjusted analyses, SED, but not MVPA, trajectory assignment was significantly associated with postpartum diastolic BP, b=3.1, 95% CI: 0.6, 5.6, p<0.02. Compared to the low SED trajectory, assignment to the high SED trajectory was associated with 4.9 (95% CI: -0.2, 10.0) mmHg higher diastolic BP in the adjusted model. Conclusions: SED trajectory across three trimesters of pregnancy was associated with postpartum diastolic BP, even after accounting for biologic covariates and MVPA. Results suggest avoiding high SED during pregnancy might help improve diastolic BP after delivery.

scholarly journals Is Symptomatic Fatigue Associated With Physical Activity and Sedentary Behaviors Among Persons With Multiple Sclerosis?

2020 ◽  
Vol 34 (6) ◽  
pp. 505-511 ◽  
Author(s):  
Whitney N. Neal ◽  
Katie L. Cederberg ◽  
Brenda Jeng ◽  
Jeffer E. Sasaki ◽  
Robert W. Motl
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Sedentary Behavior ◽  
Behavioral Interventions ◽  
Vigorous Physical Activity ◽  
Lower Percentage ◽  
Sedentary Behaviors ◽  
Reduced Physical Activity ◽  
Fatigue Severity ◽  
The Difference

Background. Fatigue is a debilitating symptom in multiple sclerosis (MS) that may be associated with reduced physical activity and increased sedentary behavior. Objective. This study examined the associations among fatigue and device-measured physical activity and sedentary behavior in people with MS. Methods. The participants (n = 252) completed the Patient Determined Disease Steps (PDDS) and Fatigue Severity Scale (FSS) and wore a waist-mounted accelerometer for 7 days. Participants were divided into 2 groups based on fatigue severity as measured by the FSS scale. We compared percentage of wear time spent in sedentary, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) between the 2 groups. Results. Persons in the fatigued group (FSS score ≥ 4) spent a greater percentage of time in sedentary behavior ( P = .004) and a lower percentage of time in LPA ( P = .035). Persons in the fatigued group further spent a lower percentage of time in nontransformed MVPA ( P < .001) and square-root-transformed MVPA ( P < .001) than persons in the nonfatigued group. When controlling for PDDS scores and years of education, there were no longer significant differences between groups in sedentary behavior, LPA, or transformed MVPA values; the difference in nontransformed MVPA was still statistically significant but likely the result of nonnormally distributed data. Conclusion. The present study suggests that factors other than fatigue might be associated with physical activity and sedentary behavior in MS, and this group might benefit from focal behavioral interventions that take into account mobility status in persons with MS who have fatigue.

scholarly journals Where are Children Active and Does it Matter for Physical Activity? A Latent Transition Analysis

2016 ◽  
Vol 13 (12) ◽  
pp. 1294-1300 ◽  
Author(s):  
Natalie Colabianchi ◽  
Jamie L. Griffin ◽  
Kerry L. McIver ◽  
Marsha Dowda ◽  
Russell R. Pate
Keyword(s):  
Physical Activity ◽  
Latent Class ◽  
Latent Transition Analysis ◽  
Latent Classes ◽  
Activity Levels ◽  
Transition Analysis ◽  
Physical Activity Levels ◽  
Latent Transition ◽  
Over Time

Background:Numerous studies have focused on the role of environments in promoting physical activity, but few studies have examined the specific locations where children are active and whether being active in these locations is associated with physical activity levels over time.Methods:Self-reported locations of where physical activity occurred and physical activity measured via accelerometry were obtained for a cohort of 520 children in 5th and 6th grades. Latent class analysis was used to generate classes of children defined by the variety of locations where they were active (ie, home, school grounds, gyms, recreational centers, parks or playgrounds, neighborhood, and church). Latent transition analyses were used to characterize how these latent classes change over time and to determine whether the latent transitions were associated with changes in physical activity levels.Results:Two latent classes were identified at baseline with the majority of children in the class labeled as ‘limited variety.’ Most children maintained their latent status over time. Physical activity levels declined for all groups, but significantly less so for children who maintained their membership in the ‘greater variety’ latent status.Conclusions:Supporting and encouraging physical activity in a variety of locations may improve physical activity levels in children.

Internet intervention for increasing physical activity in persons with multiple sclerosis

2010 ◽  
Vol 17 (1) ◽  
pp. 116-128 ◽  
Author(s):  
Robert W Motl ◽  
Deirdre Dlugonski ◽  
Thomas R Wójcicki ◽  
Edward McAuley ◽  
David C Mohr
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Goal Setting ◽  
Cognitive Theory ◽  
Intervention Group ◽  
Internet Intervention ◽  
The Internet ◽  
Control Group ◽  
Significant Change ◽  
Over Time

Background:Physical activity has been associated with improvements in walking mobility and quality of life in persons with multiple sclerosis (MS), and yet this population is largely sedentary and inactive compared with the general population. Objectives:We conducted a pilot, randomized controlled trial (RCT) for examining the effect of an Internet intervention based on social cognitive theory (SCT) for favorably increasing physical activity among persons with MS. We further examined variables from SCT as possible mediators of the Internet intervention. Methods:We randomly allocated 54 persons with MS into either an Internet intervention condition or a waitlist control condition. The participants completed measures of physical activity, self-efficacy, outcome expectations, functional limitations, and goal setting before and after the 12-week period. Results:The intervention group reported a statistically significant ( p = 0.01) and large increase in physical activity over time ( d = 0.72), whereas the control group had a small ( d = 0.04) and non-significant change in physical activity ( p = 0.71). The intervention group further reported a statistically significant ( p = 0.001) and large increase in goal setting over time ( d = 0.97), whereas the control group had a small ( d = −0.13) and non-significant change ( p = 0.17). The change in goal setting over time mediated the effect of the Internet intervention on physical activity behavior. Conclusions:This pilot study sets the stage for a subsequent RCT that includes a larger sample of persons with MS, longer intervention period along with a follow-up, objective measure of physical activity, and secondary outcomes of walking mobility and QOL.

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