Physical Activity and Health-Related Quality of Life of Patients on Hemodialysis with Comorbidities: A Cross-Sectional Study

Patients on hemodialysis with multiple comorbidities have limited physical activity, resulting in poor health, low activity participation, and low quality of life. Accordingly, the nursing care provided to such patients should include regular physical activity training programs. Therefore, this cross-sectional descriptive study investigated whether patients on hemodialysis with and without comorbidities have different levels of physical activity and health-related quality of life (HRQoL); the correlations among the comorbidities, physical activity, and HRQoL of the two cohorts were also assessed. The 36-Item Short-Form Health Survey version 2 and International Physical Activity Questionnaire were employed to collect data from 120 patients on hemodialysis. An independent samples t-test and univariate and multivariate linear regression analyses were conducted. The overall HRQoL of patients with comorbidities was lower than that of patients without comorbidities (p = 0.008). Compared with patients who participated in low-intensity physical activity, the overall HRQoL of patients who participated in moderate-intensity physical activity was higher (p < 0.001). The overall HRQoL of patients with comorbidities who participated in low-intensity physical activity was lower than that of those who participated in moderate-intensity physical activity (p < 0.001). Moderate-intensity physical activity was correlated with higher HRQoL for patients with comorbidities. This finding supports the implementation of effective physical activity intervention measures. Furthermore, it supports the promotion of patient self-management and the implementation of regular exercise programs and lifestyle changes, and patients on hemodialysis can benefit from the future management of physical activities.

Acceptability and feasibility of an online physical activity program for women over 50: a pilot trial

Regular physical activity benefits health across the lifespan. Women in middle-age often juggle carer and work responsibilities, are often inactive, and may benefit from tailored support to increase physical activity. Establish the acceptability, feasibility, and impact on physical activity of a scalable program for women 50+ years. This pilot trial randomized participants to immediate program access, or to a wait-list control. [Active Women over 50 Online] program included: (1) study-specific website, (2) 8 emails or 24 SMS motivation-based messages, (3) one telephone health-coaching session. Outcomes, at 3 months, were acceptability (recommend study participation, intervention uptake), feasibility (recruitment, reach, completion), intervention impact (physical activity), intervention impressions. At baseline, 62 participants of mean (SD) age 59 (±7) years took 7459 (±2424) steps/day and most (92%) reported ≥2 medical conditions. At 3 months, acceptability and impact data were available for 52 (84%) and 57 (92%) participants, respectively. Study participation was recommended by 83% of participants. Participants mostly agreed to receive health coaching (81%) and messages (87%: email = 56%, SMS = 44%), opened 82% of emails and accessed the website 4.8 times on average. Respondents reported the intervention supported their physical activity. Intervention participants were more likely to increase steps from baseline by 2000+/day (OR: 6.31, 95% CI: 1.22 to 32.70, p = .028) than controls, and trended toward more light-intensity (p = .075) and moderate-vigorous intensity physical activity (p = .11). The [Active Women over 50 Online] program demonstrated acceptability and feasibility among the target population, and effectiveness in some domains in the short term. Results warrant further testing in a full-scale RCT.

Do School-Level Factors Affect the Health Behaviors of High School Students in Korea?

We conducted a multilevel analysis to identify the individual- and school-level factors that affect Korean high school students’ tooth brushing, soda intake, smoking, and high-intensity physical activity. We sampled 27,919 high school students from the 15th Korea Youth Risk Behavior Web-Based Survey. The individual-level variables included demographic, socioeconomic, and health-related factors. The school-level variables included school system and school type. Regarding the individual-level factors, economic level and academic performance had a significant effect on health behavior when the demographic variables were adjusted. In the final model, the school-level factors had a significant effect on health behavior. The odds ratio (OR) of brushing less than twice a day in vocational schools compared to general schools was 1.63 (p < 0.001), and the OR of soda intake more than three times a week in vocational schools was 1.33 (p < 0.001). In addition, the OR of smoking in vocational schools was 2.89 (p < 0.001), and the OR of high-intensity physical activity in vocational schools was 0.80 (p < 0.001). Therefore, both individual- and school-level factors affect Korean students’ health behaviors. A school-based comprehensive health promotion strategy should be developed that considers schools’ characteristics to equip all students with health awareness, regardless of socioeconomic status.

Relative Vigorous-Intensity Physical Activity Predicts Brain Microstructural Changes in Older Adults

Physical activity especially at moderate-to-vigorous intensity may preserve brain structure in old age. However, current findings are cross-sectional and rely on absolute intensity. This study aimed to examine whether relative or absolute vigorous-intensity physical activity (VPA) predicts brain microstructural changes. We analyzed 260 initially cognitively normal and well-functioning participants(age=70.5yrs) who had VPA data via ActiHeart and longitudinal brain microstructure by DTI(follow-up=3.7yrs). Associations of VPA with microstructural changes were examined using linear mixed-effects models, adjusted for demographics. Each SD higher relative VPA defined by heart rate reserve (i.e. 21 min/day) was significantly associated with less decline in memory-related microstructural integrity, including mean diffusivity of entorhinal cortex and parahippocampal gyrus and fractional anisotropy of uncinate fasciculus and cingulum-hippocampal part, and not executive/motor-related microstructure. Absolute VPA was not associated with microstructural markers. Among well-functioning older adults, participating in VPA defined by heart rate reserve may predict less brain microstructural decline in memory-related areas.

Association of dog ownership with accelerometer-measured physical activity and daily steps in 70-year-old individuals: a population-based cross-sectional study

Background Dog ownership (DO) has been associated with higher levels of self-reported walking and physical activity. However, compared to device-based measures, self-reported measures of physical activity may suffer from bias due to recall and social desirability. They are also incapable of quantifying light-intensity physical activity (LPA) and step volume, both of which may have important health benefits, especially for older adults. In this study, we investigated the association of DO with accelerometer-measured physical activity of different intensities and daily steps in 70-year-old individuals. Methods This was a population-based cross-sectional study including 1406 participants aged 70 years [54.1% female] who participated in a health survey in Umeå, Sweden between February 2017–November 2019. All participants self-reported DO [yes/no]. Daily averages of LPA, moderate-to-vigorous-intensity physical activity (MVPA), and steps per day [steps/d] were measured for 1 week using hip-mounted Actigraph GT3X+ accelerometers. Associations were investigated using linear- and logistic regression models, adjusted for sociodemographic and health-related factors, date of examination, and accelerometer wear time. Results The prevalence of DO was 14.1% [N = 199]. After adjustment for all covariates, DO was associated with 19.2 more minutes/d of LPA [95% CI, 8.8–29.6], 11.4 more minutes/d of MVPA [95% CI, 8.0–14.9] and 1738 more steps/d [95% CI, 1326–2149]. DO was also associated with twice the odds of meeting the physical activity recommendations [OR, 2.07, 95% CI, 1.48–2.90]. Exploratory interaction analyses showed that the association between DO and steps/d was stronger [Pinteraction = 0.030] in female [β = 2165, 95% CI, 1585–2744] than in male [β =1255, 95% CI, 664–1845], with a similar trend for MVPA [Pinteraction = 0.082]. Conclusions In this study of community-dwelling 70-year-old individuals, DO was associated with higher levels of daily LPA, MVPA, and steps. With the limitation of the observational design of the study, these findings add knowledge regarding the beneficial role that DO may play for promoting physical activity in the older population. In turn, these findings could support the development and evaluation of targeted interventions seeking to promote dog-friendly environments and facilitate dog walking in the community.

Prospective changes in physical activity, sedentary time and sleep during the COVID-19 pandemic in a US-based cohort study

ObjectivesAssess differences in movement behaviours within the 24-hour cycle, including light intensity physical activity (LPA), moderate-to-vigorous physical activity (MVPA), sedentary time and sleep, before and during the COVID-19 pandemic and assess these differences stratified by several relevant factors in a subcohort of the Cancer Prevention Study-3.Design and settingUS-based longitudinal cohort study (2018–August 2020).ParticipantsN=1992 participants, of which 1304 (65.5%) are women, and 1512 (75.9%) are non-Latino white, with a mean age 57.0 (9.8) years.MeasuresAge, sex, race/ethnicity, education; self-reported LPA, MVPA, sedentary time and sleep duration collected before and during the pandemic; pandemic-related changes in work, childcare and living arrangement; COVID-19 health history.ResultsCompared to 2018, participants spent an additional 104 min/day sedentary, 61 fewer min/day in LPA and 43 fewer min/day in MVPA during the pandemic. Time spent sleeping was similar at the two time points. Differences in movement behaviours were more pronounced among men, those with a higher level of education, and those who were more active before the pandemic.ConclusionsFrom 2018 to Summer 2020, during the COVID-19 pandemic, US adults have made significant shifts in daily time spent in LPA, MVPA and sedentary. There is an urgent need to promote more physical activity and less sedentary time during this public health crisis to avoid sustaining these patterns long-term.

The Relationship of Physical Activity Level With Arterial Stiffness, Cerebral Blood Flow, and Cognitive Function in Young Adults

PURPOSE: This study aimed to investigate the relationship of physical activity level with arterial stiffness, cerebral blood flow, and cognitive function in young adults.METHODS: Forty-six young adults participated in this cross-sectional study. Physical activity levels were assessed for seven consecutive days using accelerometers. To assess arterial stiffness, the carotid–femoral artery pulse wave velocity (cfPWV) and augmentation index (AIx) were measured. Cognitive function was assessed using the Stroop Color-Word test, and cerebral blood flow was evaluated using near-infrared spectroscopy devices during the cognitive function test.RESULTS: AIx was inversely associated with axis-1 counts, vector magnitude counts, moderate-intensity physical activity (MPA) time, and moderate-to-vigorous intensity physical activity (MVPA) time (r≤-0.31, p≤.04). The AIx adjusted to the heart rate of 75 beats per minute was inversely correlated with axis-1 counts, vector magnitude counts, step counts, MPA time, and MVPA time (r≤-0.33, p≤.03). There was no relationship between cfPWV and physical activity level parameters (r≤0.10, p≥.51). The difference between oxygenated and deoxygenated hemoglobin levels was positively related to axis-1 counts, step counts, MPA time, and MVPA time (r≥0.31, p≤.04). Regarding cognitive function, the response time for the presented words was negatively associated with step counts (r=-0.42, p<.01) and MPA time (r=-0.29, p=.048), and response time on the presented words with matched color was negatively related to step counts (r=-0.31, p=.04).CONCLUSIONS: More physically active adults are more likely to have lower arterial stiffness, increased brain oxygenation, and better cognitive function, even if they are young and healthy.

Snacktivity™ to Promote Physical Activity: a Qualitative Study

Background Adults should achieve a minimum of 150 min of moderate-to-vigorous intensity physical activity per week, but many people do not achieve this. Changes to international guidance have removed the requirement to complete physical activity in bouts of at least 10 min. Snacktivity is a novel and complementary approach that could motivate people to be physically active. It focuses on promoting shorter (2–5 min) and more frequent bouts, or ‘snacks’ of physical activity throughout the day. It is not known whether promoting physical activity in shorter bouts is acceptable to the public, or whether it likely to translate into health behaviour change. Methods As part of a larger research programme, this study explored the merits of using small bouts of physical activity to help the public become physically active (the Snacktivity™ programme). Thirty-one inactive adults used the approach for five days then participated in semi- structured interviews about their experiences. The data were analysed using the Framework approach. Results Whilst participants highlighted some potential barriers to implementation, they expressed the ease with which Snacktivity could be achieved, which gave them a new awareness of opportunities to do more physical activity throughout the day. Participants raised the importance of habit formation to achieve regular small bouts of physical activity. Conclusions Findings demonstrated that participants liked the Snacktivity concept and viewed it as a motivating approach. Guidance about physical activity must lead to advice that has the best chance of preserving and promoting health and Snacktivity has potential to meet this ambition.