Home-based Circuit Training and Community Walking for Intermittent Claudication.

BACKGROUND: Supervised exercise training is recommended for people with peripheral artery disease (PAD), yet it remains underutilized. Home-based exercise programs (HBEPs) are a potential alternative. The aim of this study was to assess the feasibility of conducting a full scale trial of a 12-week HBEP for people living with symptomatic PAD. METHODS: In a randomized feasibility trial, patients with intermittent claudication were allocated to either an HBEP or a nonexercise control. The HBEP group was given a Fitbit to use during a 12-week exercise program comprising of personalized step goals and a resistance-based circuit to be undertaken at home twice weekly. The primary outcome was feasibility, assessed via eligibility, recruitment, attrition, tolerability, and adherence. Acceptability was assessed via semistructured interviews. Secondary analysis was undertaken to determine the feasibility of collecting clinical outcome data. RESULTS: 188 people were screened, 133 were eligible (70.7%), 30 were recruited (22.6%) and one withdrew (3.33%). Mean adherence to the daily step goal was 53.5% (range = 29.8-90.5%), and 58.6% of prescribed circuits were completed of which 56.4% were at the desired intensity. Six adverse events were recorded, 3 of which were related to study involvement. No significant differences were observed in exploratory outcomes. Small clinically important differences were seen in walking speed and pain-free treadmill walking distance which should be confirmed or refuted in a larger trial. CONCLUSIONS: The HBEP was feasible and well tolerated, with successful recruitment and minimal attrition. The intervention was acceptable, with walking seen as more enjoyable than circuit exercise. The WALKSTRONG program may be suitable for those who will not, or cannot, take part in supervised exercise outside of the home.

Influence of water-based exercise on energy intake, appetite, and appetite-related hormones in adults: A systematic review and meta-analysis.

Single bouts of land-based exercise suppress appetite and do not typically alter energy intake in the short-term, whereas it has been suggested that water-based exercise may evoke orexigenic effects. The primary aim was to systematically review the available literature investigating the influence of water-based exercise on energy intake in adults (PROSPERO ID number CRD42022314349). PubMed, Medline, Sport-Discus, Academic Search Complete, CINAHL and Public Health Database were searched for peer-reviewed articles published in English from 1900 to May 2022. Included studies implemented a water-based exercise intervention versus a control or comparator. Risk of bias was assessed using the revised Cochrane 'Risk of bias tool for randomised trials' (RoB 2.0). We identified eight acute (same day) exercise studies which met the inclusion criteria. Meta-analysis was performed using a fixed effects generic inverse variance method on energy intake (8 studies (water versus control), 5 studies (water versus land) and 2 studies (water at two different temperatures)). Appetite and appetite-related hormones are also examined but high heterogeneity did not allow a meta-analysis of these outcome measures. We identified one chronic exercise training study which met the inclusion criteria with findings discussed narratively. Meta-analysis revealed that a single bout of exercise in water increased ad-libitum energy intake compared to a non-exercise control (mean difference [95% CI]: 330 [118, 542] kJ, P = 0.002). No difference in ad libitum energy intake was identified between water and land-based exercise (78 [-176, 334] kJ, P = 0.55). Exercising in cold water (18-20 °C) increased energy intake to a greater extent than neutral water (27-33 °C) temperature (719 [222, 1215] kJ; P < 0.005). The one eligible 12-week study did not assess whether water-based exercise influenced energy intake but did find that cycling and swimming did not alter fasting plasma concentrations of total ghrelin, insulin, leptin or total PYY but contributed to body mass loss 87.3 (5.2) to 85.9 (5.0) kg and 88.9 (4.9) to 86.4 (4.5) kg (P < 0.05) respectively. To conclude, if body mass management is a person's primary focus, they should be mindful of the tendency to eat more in the hours after a water-based exercise session, particularly when the water temperature is cold (18-20 °C).

Safety of home-based exercise for people with intermittent claudication: A systematic review.

Intermittent claudication (IC) is a classic symptom of peripheral artery disease, with first line treatment being supervised exercise therapy (SET). Despite this, SET is frequently underutilised, and adherence is often poor. An alternative option are home-based exercise programmes (HBEP). Although HBEPs are well tolerated, to the authors' knowledge, no research has assessed their safety. The aim of this review was to assess the safety of HBEPs in people living with IC. We performed an electronic search of the MEDLINE, CINAHL, and Cochrane Library databases. The main parameter of interest was complication rate, calculated as the number of related adverse events per patient-hours. Subanalysis was undertaken to determine differences in safety for studies that did and did not include pre-exercise cardiac screening, and for studies with exercise at low, moderate, and high levels of claudication pain. Our search strategy identified 8693 results, of which 27 studies were included for full review. Studies included 1642 participants completing 147,810 patient-hours of home-based exercise. Four related adverse events were reported, three of which were cardiac in origin, giving an all-cause complication rate of one event per 36,953 patient-hours. Three of these events occurred following exercise to high levels of claudication pain, and one occurred with pain-free exercise. One event occured in a study without cardiac screening. Based on the low number of related adverse events, HBEPs appear to be a safe method of exercise prescription for people with IC. Our results strengthen the rationale for providing alternative exercise options for this population. PROSPERO Registration No.: CRD42021254581.

An acute bout of swimming increases post-exercise energy intake in young healthy men and women.

Single bouts of land-based exercise (for example, walking, running, cycling) do not typically alter post-exercise energy intake on the day of exercise. However, anecdotal and preliminary empirical evidence suggests that swimming may increase appetite and energy intake. This study compared the acute effects of swimming on appetite, energy intake, and food preference and reward, versus exertion-matched cycling and a resting control. Thirty-two men (n = 17; mean ± SD age 24 ± 2 years, body mass index [BMI] 25.0 ± 2.6 kg/m2) and women (n = 15; age 22 ± 3 years, BMI 22.8 ± 2.3 kg/m2) completed three experimental trials (swimming, cycling, control) in a randomised, crossover design. The exercise trials involved 60-min of 'hard' exercise (self-selected rating of perceived exertion: 15) performed 90-min after a standardised breakfast. Food preference and reward were assessed via the Leeds Food Preference Questionnaire 15-min after exercise, whilst ad libitum energy intake was determined 30-min after exercise. The control trial involved identical procedures except no exercise was performed. Compared with control (3259 ± 1265 kJ), swimming increased ad libitum energy intake (3857 ± 1611 kJ; ES = 0.47, 95% CI of the mean difference between trials 185, 1010 kJ, P = 0.005); the magnitude of increase was smaller after cycling (3652 ± 1619 kJ; ES = 0.31, 95% CI -21, 805 kJ, P = 0.062). Ad libitum energy intake was similar between swimming and cycling (ES = 0.16, 95% CI -207, 618 kJ, P = 0.324). This effect was consistent across sexes and unrelated to food preference and reward which were similar after swimming and cycling compared with control. This study has identified an orexigenic effect of swimming. Further research is needed to identify the responsible mechanism(s), including the relevance of water immersion and water temperature per se.

Eating with a smaller spoon decreases bite size, eating rate and ad libitum food intake in healthy young males.

There is a paucity of data examining the effect of cutlery size on the microstructure of within-meal eating behaviour or food intake. Therefore, the present studies examined how manipulation of spoon size influenced these eating behaviour measures in lean young men. In study one, subjects ate a semi-solid porridge breakfast ad libitum, until satiation. In study two, subjects ate a standardised amount of porridge, with mean bite size and mean eating rate covertly measured by observation through a one-way mirror. Both studies involved subjects completing a familiarisation visit and two experimental visits, where they ate with a teaspoon (SMALL) or dessert spoon (LARGE), in randomised order. Subjective appetite measures (hunger, fullness, desire to eat and satisfaction) were made before and after meals. In study one, subjects ate 8 % less food when they ate with the SMALL spoon (SMALL 532 (SD 189) g; LARGE 575 (SD 227) g; P=0·006). In study two, mean bite size (SMALL 10·5 (SD 1·3) g; LARGE 13·7 (SD 2·6) g; P<0·001) and eating rate (SMALL 92 (SD 25) g/min; LARGE 108 (SD 29) g/min; P<0·001) were reduced in the SMALL condition. There were no condition or interaction effects for subjective appetite measures. These results suggest that eating with a small spoon decreases ad libitum food intake, possibly via a cascade of effects on within-meal eating microstructure. A small spoon might be a practical strategy for decreasing bite size and eating rate, likely increasing oral processing, and subsequently decreasing food intake, at least in lean young men.

An acute bout of cycling does not induce compensatory responses in pre-menopausal women not using hormonal contraceptives.

There is a clear need to improve understanding of the effects of physical activity and exercise on appetite control. Therefore, the acute and short-term effects (three days) of a single bout of cycling on energy intake and energy expenditure were examined in women not using hormonal contraceptives. Sixteen active (n = 8) and inactive (n = 8) healthy pre-menopausal women completed a randomised crossover design study with two conditions (exercise and control). The exercise day involved cycling for 1 h (50% of maximum oxygen uptake) and resting for 2 h, whilst the control day comprised 3 h of rest. On each experimental day participants arrived at the laboratory fasted, consumed a standardised breakfast and an ad libitum pasta lunch. Food diaries and combined heart rate-accelerometer monitors were used to assess free-living food intake and energy expenditure, respectively, over the subsequent three days. There were no main effects or condition (exercise vs control) by group (active vs inactive) interaction for absolute energy intake (P > 0.05) at the ad libitum laboratory lunch meal, but there was a condition effect for relative energy intake (P = 0.004, ηp2 = 0.46) that was lower in the exercise condition (1417 ±â€¯926 kJ vs. 2120 ±â€¯923 kJ). Furthermore, post-breakfast satiety was higher in the active than in the inactive group (P = 0.005, ηp2 = 0.44). There were no main effects or interactions (P > 0.05) for mean daily energy intake, but both active and inactive groups consumed less energy from protein (14 ±â€¯3% vs. 16 ±â€¯4%, P = 0.016, ηp2 = 0.37) and more from carbohydrate (53 ±â€¯5% vs. 49 ±â€¯7%, P = 0.031, ηp2 = 0.31) following the exercise condition. This study suggests that an acute bout of cycling does not induce compensatory responses in active and inactive women not using hormonal contraceptives, while the stronger satiety response to the standardised breakfast meal in active individuals adds to the growing literature that physical activity helps improve the sensitivity of short-term appetite control.

Establishment of clinical exercise physiology as a regulated healthcare profession in the UK: a progress report.

In 2021, a 'call to action' was published to highlight the need for professional regulation of clinical exercise physiologists to be established within UK healthcare systems to ensure patient safety and align training and regulation with other health professions. This manuscript provides a progress report on the actions that Clinical Exercise Physiology UK (CEP-UK) has undertaken over the past 4 years, during which time clinical exercise physiologists have implemented regulation and gained formal recognition as healthcare professionals in the UK. An overview of the consultation process involved in creating a regulated health profession, notably the development of policies and procedures for both individual registration and institutional master's degree (MSc) accreditation is outlined. Additionally, the process for developing an industry-recognised scope of practice, a university MSc-level curriculum framework, the Academy for Healthcare Science Practitioner standards of proficiency and Continuing Professional Development opportunities is included. We outline the significant activities and milestones undertaken by CEP-UK and provide insight and clarity for other health professionals to understand the training and registration process for a clinical exercise physiologist in the UK. Finally, we include short, medium and long-term objectives for the future advocacy development of this workforce in the UK.

Examining the New-Member Effect to an Established Community-Based Physical Activity Program for Older Adults in England.

Community-based group physical activity programs promote exercise opportunities for older people. The aim of this study was to examine the short-term, new participant effect after joining Vitality, a community-based group physical activity program available in the East of England for older adults. Two independent groups of participants were assessed before and after an 8 week period: a group recruited from the 'Vitality' program (VP) (n 15, age: Age = 69.4 ± 6.4 y), and; a non-intervention control (CON) group (n 14, age: 64.5 ± 5.8 y). Assessment outcomes included basic physical health measures, a fitness test battery, and three psychological scales. The VP group recorded statistically significant improvements on the following outcomes: body mass (VP: -1.39 kg/CON: -0.2 kg), body mass index (VP: -1.5 kg/CON: -0.2 kg), 6 min walk (VP: +42.81 m/CON: -0.45 m), 30 s sit-to-stand (VP: -1.7 s/CON: -0.7 s), the chair sit-and-reach (VP: +3.12 cm/CON: +1.90 cm), and the 30 s arm curl test (VP: + 2 reps/CON: +0.9 reps). No significant differences were found with the other outcomes assessed. New members to the Vitality program achieved several physical and functional benefits without regression on any aspects of physical or psychological health.

"It is Easy to do Nothing and Easy to Sit Down": Perceptions of Physical Activity and Sedentary Behaviors During Pre-retirement.

This study explored the insights of old age pre-retirement employees towards physical activity and sedentary behavior. A quota sampling of 20 participants from within the Civil Service in Malta were invited to an interview. Participants who were included met the statutory requirement for retirement within the subsequent 6 months to 1 year. Semi-structured interviews were conducted using a narrative approach. Structural narrative analysis and reflective thematic analysis were used. The story structure highlighted the significance of the individual experiences on the perceptions towards future physical activity during retirement. Two themes were identified using the thematic analysis, influencers, and perceptions. Triangulation identified that sedentary behavior was not part of the narration. The transition from work to retirement is a unique and personal experience and therefore when promoting an active lifestyle, the individual experience and past behaviors must be actively considered.

Physical Activity and Sedentary Behaviour with Retirement in Maltese Civil Servants: A Dialectical Mixed-Method Study.

(1) Background: Retirement is a life event that can influence physical activity (PA) and sedentary behaviour (SB) and can be used as an opportunity to promote positive lifestyle choices. The aims of this study were to (a) to identify changes in PA and SB resulting from retirement and (b) to explore predictors of any changes in PA and SB following retirement in Maltese civil servants. (2) Methods: a hybrid mixed-method (MM) study, using first quantitative followed by qualitative methods, of civil servants aged ≥60 years, who were followed during their retirement transition for two years. A proportion of the research participants in the MM study retired while the others remained employed. Questionnaires and semi-structured interviews were used to collect data. (3) Results: there were no changes in total PA and sitting behaviour with retirement in Maltese civil servants. People who retired carried out more domestic PA compared to when they were in employment, which resulted in more moderate-intensity PA behaviour. People perceived that their sitting time increased with retirement in the qualitative interviews, but this was not observed in the quantitative data. Past PA behaviour was an important predictor of future PA behaviour, but not for SB. (4) Conclusions: A change in PA occurs with the retirement transition. However, the uptake of exercise is a personal choice that is dependent on previous experience. Increasing SB is perceived as part of the retirement plan but is not necessarily seen in the measured quantitative data.

Time to Load Up-Resistance Training Can Improve the Health of Women with Polycystic Ovary Syndrome (PCOS): A Scoping Review.

BACKGROUND: Guidelines for the management of polycystic ovary syndrome (PCOS) focus on lifestyle changes, incorporating exercise. Whilst evidence suggests that aerobic exercise may be beneficial, less is known about the effectiveness of resistance training (RT), which may be more feasible for those that have low fitness levels and/or are unable to tolerate/participate in aerobic exercise. OBJECTIVES: To identify the available evidence on RT in women with PCOS and to summarise findings in the context of a scoping review. ELIGIBILITY CRITERIA: Studies utilising pre-post designs to assess the effectiveness of RT in PCOS; all outcomes were included. SOURCES OF EVIDENCE: Four databases (PubMed, CENTRAL, CINAHL and SportDiscus) were searched and supplemented by hand searching of relevant papers/reference lists. CHARTING METHODS: Extracted data were presented in tables and qualitatively synthesised. RESULTS: Searches returned 42 papers; of those, 12 papers were included, relating to six studies/trials. Statistical changes were reported for multiple pertinent outcomes relating to metabolic (i.e., glycaemia and fat-free mass) and hormonal (i.e., testosterone and sex hormone-binding globulin) profiles. CONCLUSIONS: There is a striking lack of studies in this field and, despite the reported statistical significance for many outcomes, the documented magnitude of changes are small and the quality of the evidence questionable. This highlights an unmet need for rigorously designed/reported and sufficiently powered trials.

Changes in Physical Activity and Sedentary Behaviour Due to Enforced COVID-19-Related Lockdown and Movement Restrictions: A Protocol for a Systematic Review and Meta-Analysis.

Prolonged lockdown/restriction measures due to the COVID-19 pandemic have reportedly impacted opportunities to be physically active for a large proportion of the population in affected countries globally. The exact changes to physical activity and sedentary behaviours due to these measures have not been fully studied. Accordingly, the objective of this PROSPERO-registered systematic review is to evaluate the available evidence on physical activity and sedentary behaviours in the general population during COVID-19-related lockdown/restriction measures, compared to prior to restrictions being in place. Defined searches to identify eligible studies published in English, from November 2019 up to the date of submission, will be conducted using the following databases: CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus, PSYCinfo, Coronavirus Research Database, Public Health Database, Publicly Available Content Database, SCOPUS, and Google Scholar. The applied inclusion criteria were selected to identify observational studies with no restrictions placed on participants, with outcomes regarding physical activity and/or sedentary behaviour during lockdown/restriction measures, and with comparisons for these outcomes to a time when no such measures were in place. Where appropriate, results from included studies will be pooled and effect estimates will be presented in random effects meta-analyses. To the best of our knowledge, this will be the first systematic review to evaluate one complete year of published data on the impact of COVID-19-related lockdown/restriction measures on physical activity and sedentary behaviour. Thus, this systematic review and meta-analysis will constitute the most up-to-date synthesis of published evidence on any such documented changes, and so will comprehensively inform clinical practitioners, public health agencies, researchers, policymakers and the general public regarding the effects of lockdown/restriction measures on both physical activity and sedentary behaviour.

Influence of Short-Term Hyperenergetic, High-Fat Feeding on Appetite, Appetite-Related Hormones, and Food Reward in Healthy Men.

Short-term overfeeding may provoke compensatory appetite responses to correct the energy surplus. However, the initial time-course of appetite, appetite-related hormone, and reward-related responses to hyperenergetic, high-fat diets (HE-HFD) are poorly characterised. Twelve young healthy men consumed a HE-HFD (+50% energy, 65% fat) or control diet (36% fat) for seven days in a randomised crossover design. Mean appetite perceptions were determined during an oral glucose tolerance test (OGTT) before and after each diet. Fasted appetite perceptions, appetite-related hormones, and reward parameters were measured pre-diet and after 1-, 3- and 7-days of each diet. The HE-HFD induced a pre-to-post diet suppression in mean appetite during the OGTT (all ratings p ≤ 0.058, effect size (d) ≥ 0.31), and reduced the preference for high-fat vs. low-fat foods (main effect diet p = 0.036, d = 0.32). Fasted leptin was higher in the HE-HFD than control diet (main effect diet p < 0.001, d = 0.30), whilst a diet-by-time interaction (p = 0.036) revealed fasted acylated ghrelin was reduced after 1-, 3- and 7-days of the HE-HFD (all p ≤ 0.040, d ≥ 0.50 vs. pre-diet). Appetite perceptions and total peptide YY in the fasted state exhibited similar temporal patterns between the diets (diet-by-time interaction p ≥ 0.077). Seven days of high-fat overfeeding provokes modest compensatory changes in subjective, hormonal, and reward-related appetite parameters.

Eating Behaviours and Food Cravings; Influence of Age, Sex, BMI and FTO Genotype.

Previous studies indicate that eating behaviours and food cravings are associated with increased BMI and obesity. However, the interaction between these behaviours and other variables such as age, sex, BMI and genetics is complex. This study aimed to investigate the relationships between eating behaviours and food cravings, and to examine the influence of age, sex, body mass index (BMI) and fat mass and obesity-associated (FTO) genotype on these relationships. A total of 475 participants (252 female, 223 male, BMI: 25.82 ± 6.14 kg/m², age: 30.65 ± 14.20 years) completed the revised 18-question version of the Three Factor Eating Questionnaire (TFEQ-R18) to assess cognitive restraint, uncontrolled eating and emotional eating, and the Food Cravings Inventory (FCI) to assess cravings for fatty food, sweet food, carbohydrates and fast food. DNA samples were genotyped for the rs9939609 polymorphism in the obesity-linked gene FTO. Questionnaire data was analysed for associations between the TFEQ-R18 and FCI subscales for the whole study group, and the group divided by sex, genotype and age (≤25 years versus >25 years). Finally, mediation analysis was used to explore the relationships between BMI, cognitive restraint and food cravings. FTO AA + AT genotype was associated with increased BMI, but not with differences in eating behavior scores or food craving scores; age was associated with increased BMI and decreases in food craving scores in which this effect was stronger in women compared to men. Increased cognitive restraint was associated with decreased food craving scores in the ≤25 years group. Mediation analysis demonstrated that in this group the association between BMI and reduced food cravings was mediated by cognitive restraint indicating that in this age group individuals use cognitive restraint to control their food cravings. The positive correlation between age and BMI confirms previous results but the findings of this study show that age, sex, FTO genotype and BMI have an influence on the relationships between eating behaviours and food cravings and that these variables interact.

Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis.

BACKGROUND: Typically, management of PCOS focuses on lifestyle changes (exercise and diet), aiming to alleviate symptoms, and lower the associated risk of type 2 diabetes and cardiovascular disease. Our objective was to analyse evidence on the effectiveness of exercise in the management of PCOS, when compared to (i) usual care, (ii) diet alone, and (iii) exercise combined with diet, and also exercise combined with diet, compared to (i) control or usual care and (ii) diet alone. METHODS: Relevant databases were searched (June 2017) with no time limit for trial inclusion. Eligible trials employed a randomised or quasi-randomised design to measure the chronic effects of exercise, or exercise and diet in women with PCOS. RESULTS: Searches returned 2390 articles; of those, 27 papers from 18 trials were included. Results are presented as mean difference (MD) and 95% confidence intervals (95% CI). Compared with control, exercise had a statistical effect on change from baseline fasting insulin (MD - 2.44 µIU/mL, 95% CIs - 4.24 to - 0.64; very low-quality evidence), HOMA-IR (- 0.57, - 0.99 to - 0.14; very low-quality evidence), total cholesterol (- 5.88 mg/dL, - 9.92 to - 1.83; low-quality evidence), LDL cholesterol (- 7.39 mg/dL, - 9.83 to - 4.95; low-quality evidence), and triglycerides (- 4.78 mg/dL, - 7.52 to - 2.05; low-quality evidence). Exercise also improved VO2 max (3.84 ml/kg/min, 2.87 to 4.81), waist circumference (- 2.62 cm, - 4.13 to - 1.11), and body fat percentage (- 1.39%, - 2.61 to - 0.18) when compared with usual care. No effect was found for change value systolic/diastolic blood pressure, fasting glucose, HDL cholesterol (all low-quality evidence), or waist-to-hip ratio. Many favourable change score findings were supported by post-intervention value analyses: fasting insulin (- 2.11 µIU/mL, - 3.49 to - 0.73), total cholesterol (- 6.66 mg/dL, - 11.14 to - 2.17), LDL cholesterol (- 6.91 mg/dL, - 12.02 to - 1.80), and VO2 max (5.01 ml/kg/min, 3.48 to 6.54). Statistically lower BMI (- 1.02 kg/m2, - 1.81 to - 0.23) and resting heart rate (- 3.26 beats/min - 4.93 to - 1.59) were also revealed in post-intervention analysis. Subgroup analyses revealed the greatest improvements in overweight/obese participants, and more outcomes improved when interventions were supervised, aerobic in nature, or of a shorter duration. Based on limited data, we found no differences for any outcome between the effects of exercise and diet combined, and diet alone. It was not possible to compare exercise vs diet or exercise and diet combined vs diet. CONCLUSION: Statistically beneficial effects of exercise were found for a range of metabolic, anthropometric, and cardiorespiratory fitness-related outcomes. However, caution should be adopted when interpreting these findings since many outcomes present modest effects and wide CIs, and statistical effects in many analyses are sensitive to the addition/removal of individual trials. Future work should focus on rigorously designed, well-reported trials that make comparisons involving both exercise and diet. SYSTEMATIC REVIEW REGISTRATION: This systematic review was prospectively registered on the Prospero International Prospective Register of Systematic Reviews ( CRD42017062576 ).

Smart technology for healthcare: Exploring the antecedents of adoption intention of healthcare wearable technology.

Technological advancement and personalized health information has led to an increase in people using and responding to wearable technology in the last decade. These changes are often perceived to be beneficial, providing greater information and insights about health for users, organizations and healthcare and government. However, to date, understanding the antecedents of its adoption is limited. Seeking to address this gap, this cross-sectional study examined what factors influence users' adoption intention of healthcare wearable technology. We used self-administrated online survey to explore adoption intentions of healthcare wearable devices in 171 adults residing in Hong Kong. We analyzed the data by Partial least squares - structural equation modelling (PLS-SEM). The results reveal that perceived convenience and perceived irreplaceability are key predictors of perceived usefulness, which in turn strengthens users' adoption intention. Additionally, the results also reveal that health belief is one of the key predictors of adoption intention. This paper contributes to the extant literature by providing understanding of how to strengthen users' intention to adopt healthcare wearable technology. This includes the strengthening of perceived convenience and perceived irreplaceability to enhance the perceived usefulness, incorporating the extensive communication in the area of healthcare messages, which is useful in strengthening consumers' adoption intention in healthcare wearable technology.

Examining Consumers' Adoption of Wearable Healthcare Technology: The Role of Health Attributes.

With the advancement of information technology, wearable healthcare technology has emerged as one of the promising technologies to improve the wellbeing of individuals. However, the adoption of wearable healthcare technology has lagged when compared to other well-established durable technology products, such as smartphones and tablets, because of the inadequate knowledge of the antecedents of adoption intention. The aim of this paper is to address an identified gap in the literature by empirically testing a theoretical model for examining the impact of consumers' health beliefs, health information accuracy, and the privacy protection of wearable healthcare technology on perceived usefulness. Importantly, this study also examines the influences of perceived usefulness, consumer innovativeness, and reference group influence on the adoption intention of wearable healthcare technology. The model seeks to enhance understanding of the influential factors in adopting wearable healthcare technology. Finally, suggestions for future research for the empirical investigation of the model are provided.

Gotta Catch 'Em All: Impact of Pokémon Go on Physical Activity, Sitting Time, and Perceptions of Physical Activity and Health at Baseline and Three-Month Follow-Up.

Objective: The objective was to examine differences in physical activity, sitting time and perceptions of physical activity and health between Pokémon Go users and nonusers at baseline (launch of the application in the United Kingdom) and 3-month follow-up. Materials and Methods: The self-administered, short version of the 7-day recall, International Physical Activity Questionnaire, was adapted to develop the "Physical Activity and Pokémon Go questionnaire," which was distributed using social media. Four weeks after the launch of the application, 461 participants (n = 193 male, n = 265 female, n = 3 transgender) had completed the questionnaire. At 3-month follow-up, 127 participants repeated the questionnaire. Results: At baseline, mixed models analysis of variance (ANOVA) revealed main effects for Pokémon Go users versus nonusers in the amount of days of vigorous physical activity, moderate physical activity, and walking (All P < 0.01). Users reported that they undertook less days of vigorous physical activity than nonusers, but more days of moderate physical activity and walking. There were no differences in body mass index, minutes of vigorous or moderate physical activity, and walking, or sitting on weekdays (All P > 0.05). Repeated measures ANOVA identified increased sitting on weekdays (P < 0.05), but maintained vigorous, moderate and walking physical activity behaviors in users who remained users. Conclusion: Pokémon Go use can increase the frequency of days of physical activity benefitting health. Users at both time points maintained their physical activity behaviour, but increased sitting time on weekdays, highlighting that another intervention to prevent sitting is needed.

3D surface-imaging for volumetric measurement in people with obesity.

BACKGROUND: Current methods for tracking the progress of people with obesity towards a weight loss goal appear simple and potentially misleading. A technique to quantify change in body shape whilst visualising areas of the body where weight loss occurs would be advantageous, and has the potential to be used as a motivational tool. Three-dimensional (3D) surface-imaging would serve as a good basis for such a technique, however current systems are prohibitively expensive. OBJECTIVE: Highlight the use of a cheaper alternative 3D surface-imaging system for volumetric measurement in people with obesity. METHODS: A recently developed low-cost 3D surface-imaging system was used, having previously being validated in a healthy population. A total of 61 people with obesity, enrolled on a weight-loss programme, were surface-imaged using the system. RESULTS: The findings suggest the low-cost system can obtain 3D surface-images of an obese human body, from which numerical parameters could be calculated and further analysis conducted. CONCLUSIONS: Further studies will focus on the validity and reliability of such analyses and the potential of the system to be considered as a long-term instalment in primary healthcare settings as a weight loss aid.