Lessons learned from a pilot implementation of physical activity recommendations in axial spondyloarthritis exercise group therapy

Background The Ankylosing Spondylitis Association of Switzerland (SVMB) aimed to implement physical activity recommendations (PAR) within their exercise groups (EGs). The PAR promote exercise in all fitness dimensions at the correct dose. To implement the PAR within EGs, they were translated into a new EG concept with five key activities: (a) training for supervising physiotherapists (PTs), (b) correctly dosed exercises in all fitness dimensions, (c) exercise counselling, (d) bi-annual fitness assessments, and (e) individual exercise training, in addition to EG. All these activities were realized in close coordination with SVMB management. Objectives To analyse the implementation success by evaluating adherence/fidelity, feasibility, and satisfaction at the patient, PTs, and organisational level. Methods The five key activities of the new EG concept were developed, executed, and assessed after 6 months. The primary outcomes for implementation success were adherence of patients to the recommended exercise behaviour, self-reported by electronic diary; fidelity of PTs to the new concept, self-reported by diary; SVMB organisational changes. Secondary outcomes were feasibility and satisfaction with the new EG concept at all three levels. The tertiary outcome, to evaluate the effectiveness of PAR, was patient fitness, assessed through fitness assessments. Results 30 patients with axSpA (ten women, mean age 58 ± 9 years) and four PTs (three women, mean age 46 ± 9 years) participated. The patients' self-reporting of adherence to the PAR was insufficient (43%), possibly due to technical problems with the electronic dairy. The PTs' fidelity to the new EG concept was satisfactory. On all levels, the new concept was generally perceived as feasible and useful for supporting personalised exercise.The frequency of exercise counselling and the fitness assessments was found by patients and PTs to be too high and rigid. Patients' cardiorespiratory fitness [ES 1.21 (95%CI 0.59, 1.89)] and core strength [ES 0.61 (95%CI 0.18, 1.06)] improved over the 6 months. Conclusions The pilot implementation of PAR showed acceptance and satisfaction to be sufficient, thus confirming the need for evidence-based EGs, provided by a patient organisation in order to support active PA behaviour. However, adaptations are necessary to increase its feasibility for nationwide implementation. Trial Registration: SNCTP, SNCTP000002880. Registered 31 May 2018, https://www.kofam.ch/en/snctp-portal/search/0/study/42491.

Role of Spanish Toddlers’ Education and Care Institutions in Achieving Physical Activity Recommendations in the COVID-19 Era: A Cross-Sectional Study

To our knowledge, there are no published studies that describe the physical activity (PA) levels and objectively measure them through accelerometry in toddlers (2–3 years old) attending early childhood education and care (ECEC) institutions during the COVID-19 pandemic. The aims of this study were two-fold: (a) to analyse toddlers’ PA levels and sedentary behaviour (SB) during school hours in ECEC institutions, as well as the rate of adherence to specific recommendations on total PA (TPA) and moderate–vigorous PA (MVPA); and (b) to evaluate the characteristics correlates (age, gender, and body mass index –BMI) of young children and the school environment on toddlers’ TPA, light PA (LPA), MVPA, and SB during school hours in ECEC institutions. PA was evaluated with ActiGraph accelerometers. The main findings were that: (a) toddlers engaged in very high amounts of TPA and MVPA during ECEC hours; (b) girls and boys displayed similar levels of LPA, TPA, and SB, while girls had lower levels of MVPA, compared to boys, and younger toddlers were less active than older ones; (c) BMI was not associated with PA of any intensity or SB; (d) playground and classroom density were not associated with higher levels of PA of any intensity, though classroom density was associated with SB. These ECEC institutions provide and challenge the new COVID-19 scenario, as well as supportive environments for toddlers’ PA.

NAct: The Nutrition & Activity Ontology for Healthy Living

This paper presents the NAct (Nutrition & Activity) Ontology, designed to drive personalised nutritional and physical activity recommendations and effectively support healthy living, through a reasoning-based AI decision support system. NAct coalesces nutritional, medical, behavioural and lifestyle indicators with potential dietary and physical activity directives. The paper presents the first version of the ontology, including its co-design and engineering methodology, along with usage examples in supporting healthy nutritional and physical activity choices. Lastly, the plan for future improvements and extensions is discussed.

Leisure-time physical activity among older adults in Brazil: results from the Brazilian National Health Survey – 2013

Introduction: Health behaviors are fundamental for healthy aging. In this sense, the practice of physical activity is one of the most beneficial factors for the health of individuals. Objective: To describe the prevalence of leisure-time physical activity among the older adults and analyze in terms of sociodemographic characteristics, national regions, Federative Units of Brazil, and types of physical activity practiced. Methods: Study utilizing data from the Brazilian National Health Survey - 2013. Leisure-time physical activity was analyzed with two distinct cutoff points: 1) Some physical activity - 10 or more minutes/week; 2) Meeting recommended 150 minutes/week of physical activity. Results: Nearly 21% of the older adults completed some physical activity, and 13.2% reached the physical activity recommendations. There was no difference in the prevalence of physical activity between men and women. Individuals aged 60-69 years and those with higher income were more active than their peers. As for the national regions, the North had the lowest prevalence of physically active older adults. Among all regions, walking was the most frequent form of physical activity practiced. Conclusion: The prevalence of older adults who practiced some physical activity and reached the physical activity recommendations was low, with walking being the most common form of physical activity. Older adults with higher age, low socioeconomic status and from the Northern Brazilian regions were the least active.

Physical Activity and Well-Being during the Second COVID19-Related Lockdown in Germany in 2021

In the second wave of the COVID-19 pandemic in Germany, lockdown measures were reinstalled and were in place between November 2020 and April 2021, including the closure of physical activity facilities. The aim of the current online survey was to assess the lockdown effects on physical activity and well-being in the general population. Pre-lockdown vs. lockdown differences were tested with the Χ2 test and the Student’s t-test for paired data. Predictor variables to explain compliance with physical activity recommendations were identified using a fixed-effects binary logistic regression analysis. Data of 993 respondents were analyzed. Transport-related and leisure-time physical activity decreased (p < 0.001, d = 0.25, and p < 0.001, d = 0.33, respectively). Compliance with physical activity recommendations decreased from 42.2% to 29.4% (chi2 (1, 1986) = 35.335, p < 0.001, V = 0.13). Well-being decreased significantly (t (990) = 23.405, p < 0.001) by 16.3 points (d = 0.74). Physical activity and well-being declined in German adults during the second COVID-19-related lockdown. Physical activity should be promoted also in light of the emerging evidence on its protective effects against COVID-19.

Physical activity is associated with low-level stress among a sample of seniors during COVID-19 outbreak?

This study aimed to verify the association of physical activity, behaviors, and health conditions with stress among a sample of older adults from Manaus, Brazil, during the COVID-19 outbreak. This is a cross-sectional analysis of 79 older adults (76% female; age: 68.24 ± 6.82 years) from Fundação Universidade Aberta da Terceira Idade (FUnATI). The perceived stress (PS) was assessed by the Perceived Stress Scale, while a questionnaire via telephone call. The variables also included physical activity, sleep quality, sociodemographic, and health condition variables. Linear Bayesian mixed-effects regression models were applied to verify the association between these correlates with PS. Older people who met the recommendations before the COVID-19 outbreak but did not meet the same recommendations during the COVID-19 outbreak have a higher PS score compared to those older people who did not meet the PA recommendations at either time. In contrast, those elderly people who met PA recommendations before and during the COVID-19 outbreak had a lower PS score compared to their peers who did not meet physical activity recommendations at either time. Those older people who did not meet the PA recommendations before the COVID-19 outbreak, but did meet the PA recommendations during the COVID-19 outbreak, did not have significant differences in the PS score compared to their peers who did not meet the PA recommendations in either moment. Sleep changes and high BMI were negatively associated with PS. The maintenance of physical activity during the pandemic was associated with lower levels of stress in older people.

Logical Representation of Sensor Data, Preferences, and Personalized Activity Recommendations in an eCoach System: An Ontology-based Proof-of-Concept Study (Preprint)

UNSTRUCTURED An automatic electronic coaching (eCoaching) can motivate individuals to lead a healthy lifestyle through early health risk prediction, customized recommendation generation, preference setting (such as, goal setting, response, and interaction), and goal evaluation. Such an eCoach system needs to collect heterogeneous health, wellness, and contextual data, and then convert them into meaningful information for health monitoring, health risk prediction, and the generation of personalized recommendations. However, data from various sources may cause a data compatibility dilemma. The proposed ontology can help in data integration, logical representation of sensory observations and customized suggestions, and discover implied knowledge. This "proof of concept (PoC)" research will help sensors, personal preferences, and recommendation data to be more organized. The research aims to design and develop an OWL-based ontology ("UiA Activity Recommendation Ontology/UiAARO") to annotate activity sensor data, contextual weather data, personal information, personal preferences, and personalized activity recommendations. The ontology was created using Protégé (V. 5.5.0) open-source software. We used the Java-based Jena Framework (V. 3.16) to build a semantic web application, which includes RDF API, OWL API, native tuple storage (TDB), and SPARQL query engine. The HermiT (V. 1.4.3.x) ontology reasoner available in Protégé 5.x has implemented the logical and structural consistency of the proposed ontology. The ontology can be visualized with OWLViz and OntoGraf, and the formal representation has been used to infer the health status of the eCoach participants with a reasoner. We have also developed an ontology verification module that behaves like a rule-based decision making (e.g., health state monitor and prediction), which can evaluate participant’s health state based on the evaluation of SPARQL query results, activity performed and predefined goal. Furthermore, the “UiAARO” has helped to represent the personalized recommendation messages beyond just “String” values, rather more meaningful with object-oriented representation. The scope of the proposed ontology is limited neither to specific sensor data nor only activity recommendations; instead, its scope can be further extended.

Active breaks during virtual classrooms in schoolchildren in times of COVID-19 pandemic: A strategy to increase physical activity levels

As a result of the closure of schools to control COVID-19 transmission, the lifestyle of schoolchildren changed, with an increase in excess malnutrition, sedentary behavior, decreased outdoor time and increased screen time. The modification in the execution of classes in their new modalities (on-site or virtual) does not modify the deleterious effects of the sedentary behavior of schoolchildren. Short cumulative active breaks can be an efficient strategy to meet the minimum physical activity recommendations suggested by the WHO for children and adolescents aged 5-17 years.