An mHealth Workplace-Based "Sit Less, Move More" Program: Impact on Employees' Sedentary and Physical Activity Patterns at Work and Away from Work.

BACKGROUND: Most workplace interventions that aim to reduce sedentary behaviour have 38 focused on employees' sedentary patterns at-work but less have focused on understanding the 39 impact beyond working time. The aim of this study was to evaluate the impact of a 13-week m-40 health workplace-based 'sit less, move more' intervention (Walk@WorkApp; W@W-App) on 41 physical activity (PA) and sitting in desk-based employees at-work and away from work. METHODS: Participants (n = 141) were assigned by hospital to an intervention group (IG; used the W@W-App; n = 90) or an active comparison group (A-CG; monitored occupational activity; n = 51). The W@W-App, installed on the participants´ own smartphones, provided real-time feedback for occupational sitting, standing, and stepping, and gave access to automated strategies to sit less and move more at work. Changes between groups were assessed for total sitting time, sedentary bouts and breaks, and light and moderate-to-vigorous PA (activPAL3TM; min/day) between the baseline and after program completion. RESULTS: Compared to the A-CG, employees that used the W@W-App program increased their number of daily breaks and the time spent on short sedentary bouts (<20 min, p = 0.047) during weekends. Changes in shortest sedentary bouts (5-10 min) during weekends were also statistically significant (p < 0.05). No changes in workday PA or sitting were observed. CONCLUSION: Desk-based employees seemed to transfer the W@W-App program knowledge outside of work. Evaluating the impact of workplace (mHealth-based or not) interventions at work but also away from work would provide a better understating of the impact of such interventions.

Nordic walking for people with relapsing-remittent multiple sclerosis: A case series study.

BACKGROUND: Patients with multiple sclerosis (MS) show fatigue, impaired gait and decreased functional mobility, which lead to a low quality of life (QoL). Low-cost and easy to perform exercise modalities having a positive impact on the aforementioned symptoms are needed. The performance of Nordic Walking (NW) could be a useful rehabilitation strategy but, to our knowledge, no study has been published in this regard as yet. This case series study aims at providing information regarding the usefulness and impact of a three-month NW program on self-perceived fatigue, functional mobility, physical fitness and QoL on a group of people with mild relapsing-remitting MS. METHODS: A case series study with multiple assessments was performed. Three data collection points at 1-week intervals for three weeks were done at baseline. The intervention consisted of a 12-weeks NW program with a total of four measurement occasions, one every three weeks. The Fatigue Severity Scale (FSS), the Timed up and Go test (TUG), the 6-Minute Walk test (6MWT) and the Multiple Sclerosis Impact Scale (MSIS-29), were used to assess the outcomes of the program on the participants' self-perceived fatigue, functional mobility, physical fitness and QoL, respectively. RESULTS: Of the 14 participants who volunteered for the study, five completed at least 80% of the planned sessions and were included in the final analysis. The intervention did not have a clinical significant impact on the participants' fatigue while its impact on their QoL showed mixed results. Positive trends were found for all the participants in their functional mobility and physical fitness. Regarding functional mobility, clinically important changes were observed in three participants. None of the observed changes in physical fitness achieved clinical significance. CONCLUSION: A 12-week Nordic walking program did not appear to be particularly feasible and had little impact on the functional levels on a group of people with mild relapsing-remitting MS. Given that beneficial effects were seen in some participants, and taken into account the low adherence rate observed, future studies should explore the feasibility of NW programs performed under different environmental conditions (i.e. outdoors) and including motivational strategies aimed at increasing participation.

Nordic walking for women with breast cancer: A systematic review.

Nordic walking (NW) seems to be an interesting rehabilitation strategy for women with breast cancer (BC). No review article that has synthesised and summarised the existing scientific evidence about the effect of NW on BC survivors has been published so far. A systematic review was conducted aimed at identifying the characteristics and methodological quality of the studies that have analysed the effects of NW on women with BC. The critical appraisal of the randomised controlled trials (RCTs) was retrieved from the Physiotherapy Evidence Database (PEDro). The methodological quality of the uncontrolled studies was evaluated by means of the Quality Assessment Tool for Before-After Studies with No Control Group. Nine investigations (four RCTs and five quasi-experimental studies) were included in the final analysis. The RCTs showed a fair methodological quality, while the quasi-experimental studies obtained a score ranging from "fair" to "poor". Judging from the findings of the analysed studies, NW had a significant and positive impact on a number of BC symptoms, including lymphedema, physical fitness, disability and morbid perceptions. No adverse effects were reported. However, due to the methodological limitations observed, further research is needed to confirm such findings.

[Physical activity questionnaires: a systematic review and analysis of their psychometric properties in Spanish population over 60 years old]. / Cuestionarios de estimación de actividad física: revisión sistemática y análisis de sus propiedades psicométricas en población española mayor de 60 años.

BACKGROUND: Questionnaires for estimating physical activity are measurement tools widely used by health professionals. Therefore, it is important to know their characteristics and quality. This systematic review aimed at identifying and analyzing de psychometric properties of the existing physical activity questionnaires validated in Spanish people older than 60 years of age, as well as to inform about the methodological quality of the studies performed concerning their validity and/or reliability. METHODS: A systematic review of the available scientific literature regarding studies focused on the validity and/or reliability of questionnaires used for estimating the prevalence of physical activity among Spanish populations over 60 years old. The Qualitative Attributes and Measurement Properties of Physical Activity Questionnaires checklist (QAPAQ), was used to evaluate the sample characteristics, the psychometric properties, the validity, the test-retest reliability and the methodological quality of each study identified. RESULTS: A total of 8 questionnaires were found and analyzed, highlighting in means of validity the short Spanish version (VREM) of the Minnesota Leisure Time Physical Activity Questionnaire (construct validity 95.5% with Kappa = 0.93) as well as in reliability (ICC=0.96), along with the Modified Baecke (ICC = 0,92-0,96). Four questionnaires met more than 80% of the criteria proposed by the QAPAQ. The YPAS was the questionnaire which reached the higher score. CONCLUSIONS: When estimating the amount of physical activity performed by Spanish people older than 60 years of age by means of questionnaires, it is advisable to use (in this order) the YPAS, VREM and Modified Baecke.

OBJETIVO: Los cuestionarios de estimación de actividad física son herramientas ampliamente empleadas por los profesionales de la salud. Resulta esencial conocer la calidad y características de los mismos. Esta revisión sistemática tuvo como objetivo identificar y analizar las características psicométricas de los cuestionarios de realización de actividad física validados en población española mayor de 60 años, así como la calidad metodológica de los estudios de su validez y/o fiabilidad. METODOS: Revisión sistemática de estudios donde se informe de la validez y/o fiabilidad de cuestionarios adaptados al castellano para estimar la actividad física realizada por población mayor de 60 años. Se estudiaron las características de la muestra, las propiedades psicométricas validez y fiabilidad test-retest, así como la calidad metodológica de los estudios, que se evaluó mediante la lista de comprobación Qualitative Atributes and Measurement Properties of Physical Activity Questionnaires (QAPAQ). RESULTADOS: Fueron encontrados y analizados un total de 8 cuestionarios, destacando en validez la Versión Reducida en Español del cuestionario de actividad física en el tiempo libre de Minnesota (VREM) (validez de constructo 95,5% con Kappa = 0,93) así como en fiabilidad (ICC=0,96), junto con el Modified Baecke (ICC = 0,92-0,96). Los criterios propuestos por el QAPAQ fueron superados en un 80% por 4 cuestionarios, siendo el Yale Physical Activity Survey (YPAS), el cuestionario que mayor puntuación obtuvo. CONCLUSIONES: Al objeto de estimar la cantidad de AF realizada por personas mayores de 60 años de nacionalidad española mediante cuestionarios, se aconseja el empleo, por este orden, de los instrumentos YPAS, VREM y Modified Baecke.

Can a workplace 'sit less, move more' programme help Spanish office employees achieve physical activity targets?

We evaluated the impact of a workplace 'sit less, move more' programme (Walk@WorkSpain, W@WS, 19-week) on self-reported activity-related energy expenditure (AREE) in Spanish office employees (n = 264; 42 ± 10 years; 171 female) randomly assigned to Intervention (IG; used W@WS; n = 129) or comparison groups (CGs; n = 135). A linear mixed model assessed changes in METs-min/wk of total, vigorous, moderate and light physical activity (IPAQ short form) between baseline and 2 months follow-up. Over the CG, IG significantly increased light intensity AREE (P = 0.027). W@WS secured sustained increases on AREE-but not on achieving PA recommendations-providing translational evidence that active living in office employees can be increased.

Impact of a workplace 'sit less, move more' program on efficiency-related outcomes of office employees.

BACKGROUND: Few studies have examined the impact of 'sit less, move more' interventions on workplace performance. This study assessed the short and mid-term impacts of and patterns of change within, a 19-week workplace web-based intervention (Walk@WorkSpain; W@WS; 2010-11) on employees´ presenteeism, mental well-being and lost work performance. METHODS: A site randomised control trial recruited employees at six Spanish university campuses (n = 264; 42 ± 10 years; 171 female), assigned by worksite and campus to an Intervention (IG; used W@WS; n = 129; 87 female) or an active Comparison group (A-CG; pedometer, paper diary and self-reported sitting time; n = 135; 84 female). A linear mixed model assessed changes between the baseline, ramping (8 weeks), maintenance (11 weeks) and follow-up (two months) phases for the IG versus A-CG on (i) % of lost work productivity (Work Limitations Questionnaire; WLQ); (ii) three scales for presenteeism (WLQ) assessing difficulty meeting scheduling demands (Time), performing cognitive and inter-personal tasks (Mental-Interpersonal) and decrements in meeting the quantity, quality and timeliness of completed work (Output); and (iii) mental well-being (Warwick-Edinburgh Mental Well-being Scale). T-tests assessed differences between groups for changes on the main outcomes. In the IG, a multivariate logistic regression model identified patterns of response according to baseline socio-demographic variables, physical activity and sitting time. RESULTS: There was a significant 2 (group) × 2 (program time points) interaction for the Time (F [3]=8.69, p = 0.005), Mental-Interpersonal (F [3]=10.01, p = 0.0185), Output scales for presenteeism (F [3]=8.56, p = 0.0357), and for % of lost work performance (F [3]=10.31, p = 0.0161). Presenteeism and lost performance rose significantly in both groups across all study time points; after baseline performance was consistently better in the IG than in the A-CG. Better performance was linked to employees being more active (Time, p = 0.041) and younger (Mental-interpersonal, p = 0.057; Output, p = 0.017). Higher total sitting time during nonworking days (Mental-interpersonal, p = 0.019) and lower sitting time during workdays (WLQ Index, p = 0.013) also improved performance. CONCLUSION: Versus an active comparison condition, a 'sit less, move more` workplace intervention effectively reduced an array of markers of lost workday productivity. TRIAL REGISTRATION: NCT02960750 ; Date of registration: 07/11/2016.

Reliability of Sargent Jump Test in 4- to 5-Year-Old Children.

We assessed the test-retest reliability of the Sargent jump (VJ) for vertical jumping performed by 4 and 5 years old pre-schoolers. The VJ was administered three times (familiarization, test, and retest) to 163 children (mean age: 4.48 ± 0.5 years; 55.8% girls). The results were compared with those obtained in the standing long jump (SLJ) and in the 25 -m dash test to identify how its performance correlated with other measures of leg power. Systematic change in the mean and retest correlations with these other measures were used to help analyze VJ test-retest reliability. Additionally, Pearson correlation coefficients were used to examine the degree of association between the test and retest trials of the VJ. The VJ showed a higher correlation and agreement in the 4-year-old, compared with the 5-year old, group (rc = 0.956 vs. 0.796; α = 0.95 vs. 0.84; ICC: 0.828; 95% CI: 0.730-0.891 vs 0.739; 95% CI: 0.589-0.834). Effect sizes were small ( d ≤ 0.285) for all the VJ tests performed. Fair to poor significant relationships were established between the VJ (test), VJ (retest), and the SLJ. No significant association was observed between the VJ and the 25 -m dash tests. Our findings suggest that the Sargent jump test is reliable when executed by 4- and 5-year-olds. The lack of a strong association with other measures of leg power should be taken into account at the time of selecting the most appropriate test to assess this strength dimension.

Patterns of impact resulting from a 'sit less, move more' web-based program in sedentary office employees.

PURPOSE: Encouraging office workers to 'sit less and move more' encompasses two public health priorities. However, there is little evidence on the effectiveness of workplace interventions for reducing sitting, even less about the longer term effects of such interventions and still less on dual-focused interventions. This study assessed the short and mid-term impacts of a workplace web-based intervention (Walk@WorkSpain, W@WS; 2010-11) on self-reported sitting time, step counts and physical risk factors (waist circumference, BMI, blood pressure) for chronic disease. METHODS: Employees at six Spanish university campuses (n=264; 42±10 years; 171 female) were randomly assigned by worksite and campus to an Intervention (used W@WS; n=129; 87 female) or a Comparison group (maintained normal behavior; n=135; 84 female). This phased, 19-week program aimed to decrease occupational sitting time through increased incidental movement and short walks. A linear mixed model assessed changes in outcome measures between the baseline, ramping (8 weeks), maintenance (11 weeks) and follow-up (two months) phases for Intervention versus Comparison groups. RESULTS: A significant 2 (group) × 2 (program phases) interaction was found for self-reported occupational sitting (F[3]=7.97, p=0.046), daily step counts (F[3]=15.68, p=0.0013) and waist circumference (F[3]=11.67, p=0.0086). The Intervention group decreased minutes of daily occupational sitting while also increasing step counts from baseline (446±126; 8,862±2,475) through ramping (+425±120; 9,345±2,435), maintenance (+422±123; 9,638±3,131) and follow-up (+414±129; 9,786±3,205). In the Comparison group, compared to baseline (404±106), sitting time remained unchanged through ramping and maintenance, but decreased at follow-up (-388±120), while step counts diminished across all phases. The Intervention group significantly reduced waist circumference by 2.1cms from baseline to follow-up while the Comparison group reduced waist circumference by 1.3cms over the same period. CONCLUSIONS: W@WS is a feasible and effective evidence-based intervention that can be successfully deployed with sedentary employees to elicit sustained changes on "sitting less and moving more".

Self-reported sitting time and physical activity: interactive associations with mental well-being and productivity in office employees.

BACKGROUND: Little is known about how sitting time, alone or in combination with markers of physical activity (PA), influences mental well-being and work productivity. Given the need to develop workplace PA interventions that target employees' health related efficiency outcomes; this study examined the associations between self-reported sitting time, PA, mental well-being and work productivity in office employees. METHODS: Descriptive cross-sectional study. Spanish university office employees (n = 557) completed a survey measuring socio-demographics, total and domain specific (work and travel) self-reported sitting time, PA (International Physical Activity Questionnaire short version), mental well-being (Warwick-Edinburg Mental Well-Being Scale) and work productivity (Work Limitations Questionnaire). Multivariate linear regression analyses determined associations between the main variables adjusted for gender, age, body mass index and occupation. PA levels (low, moderate and high) were introduced into the model to examine interactive associations. RESULTS: Higher volumes of PA were related to higher mental well-being, work productivity and spending less time sitting at work, throughout the working day and travelling during the week, including the weekends (p < 0.05). Greater levels of sitting during weekends was associated with lower mental well-being (p < 0.05). Similarly, more sitting while travelling at weekends was linked to lower work productivity (p < 0.05). In highly active employees, higher sitting times on work days and occupational sitting were associated with decreased mental well-being (p < 0.05). Higher sitting times while travelling on weekend days was also linked to lower work productivity in the highly active (p < 0.05). No significant associations were observed in low active employees. CONCLUSIONS: Employees' PA levels exerts different influences on the associations between sitting time, mental well-being and work productivity. The specific associations and the broad sweep of evidence in the current study suggest that workplace PA strategies to improve the mental well-being and productivity of all employees should focus on reducing sitting time alongside efforts to increase PA.

Uptake and factors that influence the use of 'sit less, move more' occupational intervention strategies in Spanish office employees.

BACKGROUND: Little is known about the types of 'sit less, move more' strategies that appeal to office employees, or what factors influence their use. This study assessed the uptake of strategies in Spanish university office employees engaged in an intervention, and those factors that enabled or limited strategy uptake. METHODS: The study used a mixed method design. Semi-structured interviews were conducted with academics and administrators (n = 12; 44 ± 12 mean SD age; 6 women) at three points across the five-month intervention, and data used to identify factors that influenced the uptake of strategies. Employees who finished the intervention then completed a survey rating (n = 88; 42 ± 8 mean SD age; 51 women) the extent to which strategies were used [never (1) to usually (4)]; additional survey items (generated from interviewee data) rated the impact of factors that enabled or limited strategy uptake [no influence (1) to very strong influence (4)]. Survey score distributions and averages were calculated and findings triangulated with interview data. RESULTS: Relative to baseline, 67% of the sample increased step counts post intervention (n = 59); 60% decreased occupational sitting (n = 53). 'Active work tasks' and 'increases in walking intensity' were the strategies most frequently used by employees (89% and 94% sometimes or usually utilised these strategies); 'walk-talk meetings' and 'lunchtime walking groups' were the least used (80% and 96% hardly ever or never utilised these strategies). 'Sitting time and step count logging' was the most important enabler of behaviour change (mean survey score of 3.1 ± 0.8); interviewees highlighted the motivational value of being able to view logged data through visual graphics in a dedicated website, and gain feedback on progress against set goals. 'Screen based work' (mean survey score of 3.2 ± 0.8) was the most significant barrier limiting the uptake of strategies. Inherent time pressures and cultural norms that dictated sedentary work practices limited the adoption of 'walk-talk meetings' and 'lunch time walking groups'. CONCLUSIONS: The findings provide practical insights into which strategies and influences practitioners need to target to maximise the impact of 'sit less, move more' occupational intervention strategies.