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OBJECTIVES: Patients with asthma may feel limited in physical activity (PA). Reduced PA has been demonstrated in asthmatics versus healthy controls, and increasing PA associated with improved asthma outcomes. Obesity is commonly found with difficult-to-control asthma and worsens outcomes. We compared PA levels in participants with difficult-to-control asthma and elevated body mass index (BMI) (DOW group) and two mild-moderate asthma groups: one with BMI <25 kg/m2 (MHW) and one with BMI ≥25 (MOW). METHODS: This cross-sectional study used 7-day recordings from wrist-worn accelerometers to compare PA between groups. Inactive time, light (LPA), moderate-vigorous PA (MVPA) were measured, along with two novel metrics: intensity gradient (IG) reflecting PA intensity, and average acceleration (AA) reflecting PA volume. PA parameters were compared using ANOVA or Kruskall-Wallis testing. Correlation and linear regression analyses explored associations between PA parameters and asthma outcomes. As AA was the PA parameter correlated most closely with asthma-related outcomes, an exploratory analysis compared outcomes in highest and lowest AA quartiles. RESULTS: 75 participants were recruited; 57 accelerometer readings were valid and included in analysis. Inactive time was significantly higher (p < 0.001), and LPA (p < 0.007), MVPA (p < 0.001), IG (p < 0.001) and AA (p < 0.001) all significantly lower in DOW versus MHW and MOW groups, even after adjusting for age and BMI. Quartiles based on AA had significantly different asthma profiles. CONCLUSIONS: Overweight/obese participants with difficult-to-control asthma performed less PA, and activity of reduced intensity and volume. Increased AA is associated with improvement in several asthma-related outcomes. Increased PA should be recommended to relevant patients.
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Asma , Benchmarking , Humanos , Índice de Masa Corporal , Estudios Transversales , Ejercicio Físico , Obesidad , Gravedad del Paciente , AcelerometríaRESUMEN
This study compared physical activity metrics from the activPAL (AP) worn on the thigh with the ActiGraph worn on the non-dominant wrist using open-source methods. Measures included average acceleration, intensity gradient (IG) and the minimum acceleration value of the most active X mins (MX). Fifty-two children (26 boys; age: 10.4 ± 0.6 years) provided≥1 day (24 h) of concurrent wear time from the activPAL and ActiGraph. Measures tended to be lower from the activPAL versus the ActiGraph. Poor agreement was evident for average acceleration but good for the IG. For the IG, the absolute and relative zones needed to reach equivalence was 4% and 0.4 SDs, respectively and for average acceleration were 10% and 1.2 SDs, respectively. Good agreement was evident for M60, M30, M20, M15 and M10 between devices. Regardless of the reference device used, equivalent estimates for the intensity gradient, M60, M30, M20, M15 and M10 were observed with relative and absolute equivalence zones being≤4% and≤0.5 SDs, respectively. The IG, M60, M30, M20, M15 and M10 appear good candidates for comparing activity data collected from the activPAL and ActiGraph. Future research can use the AP to report on sedentary behaviours as well as PA outcomes.
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Muslo , Muñeca , Masculino , Humanos , Niño , Ejercicio Físico , Articulación de la Muñeca , AcelerometríaRESUMEN
We aimed to explore the feasibility, acceptability, and potential efficacy of Happy Homework (HH); an 8-week home-focussed intervention, with the purpose of encouraging children's positive dietary behaviours and engagement in positive physical activity (PA) and sleep behaviours. We randomised four Scottish schools (n = 71 participants; 5 classrooms) to either the HH intervention (n = 2) or usual curriculum control group (n = 2). HH consisted of movement and dietary-focused parent and child tasks. Primary outcome measures were intervention feasibility, acceptability, and potential efficacy. Secondary outcomes were objectively measured PA via ActiGraph GT3X+, sedentary behaviours (SBs) and sleep duration via activPAL4™ accelerometers and dietary behaviours, fruit and vegetable consumption and screen-time via questionnaires. After controlling for pre-test levels, post intervention stepping time and sleep duration were significantly greater for the HH group in comparison to the control group. The HH group reported eating more fruit and vegetables at post-test than the control group. Participants also reported the intervention to be enjoyable and motivating. These findings provide promising evidence that given a greater sample size, better retention and the prioritisation of health and wellbeing homework, HH could enhance children's health and wellbeing.
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Dieta , Ejercicio Físico , Niño , Humanos , Proyectos Piloto , Estudios de Factibilidad , Ingestión de Alimentos , Verduras , Instituciones AcadémicasRESUMEN
BACKGROUND: Difficult-to-control asthma associated with elevated body mass index (BMI) is challenging with limited treatment options. The effects of pulmonary rehabilitation (PR) in this population are uncertain. METHODS: This is a randomised controlled trial of an eight-week asthma-tailored PR programme versus usual care (UC) in participants with difficult-to-control asthma and BMI ≥ 25 kg/m2. PR comprised two hours of education and supervised exercise per week, with encouragement for two individual exercise sessions. Primary outcome was difference in change in Asthma Quality of Life Questionnaire (AQLQ) in PR versus UC groups between visits. Secondary outcomes included difference in change in Asthma Control Questionnaire-6 (ACQ6), and a responder analysis comparing proportion reaching minimum clinically important difference for AQLQ and ACQ6. RESULTS: 95 participants were randomised 1:1 to PR or UC. Median age was 54 years, 60% were female and median BMI was 33.8 kg/m2. Mean (SD) AQLQ was 3.9 (+/-1.2) and median (IQR) ACQ6 2.8(1.8-3.6). 77 participants attended a second visit and had results analysed. Median (IQR) change in AQLQ was not significantly different: 0.3 (- 0.2 to 0.6) in PR and - 0.1 (- 0.5 to 0.4) in UC, p = 0.139. Mean change in ACQ6 was significantly different: - 0.4 (95% CI - 0.6 to - 0.2) in PR and 0 (- 0.3 to + 0.3) in UC, p = 0.015, but below minimum clinically important difference. In ACQ6 responder analysis, minimum clinically important difference was reached by 18 PR participants (54.5%) versus 10 UC (22.7%), p = 0.009. Dropout rate was 31% between visits in PR group, and time to completion was significantly prolonged in PR group at 94 (70-107) days versus 63 (56-73) in UC, p < 0.001. CONCLUSIONS: PR improved asthma control and reduced perceived breathlessness in participants with difficult-to-control asthma and elevated BMI. However, this format appears to be suboptimal for this population with high drop-out rates and prolonged time to completion. Trial registration Clinicaltrials.gov. ID NCT03630432. Retrospectively registered, submitted May 26th 2017, posted August 14th 2018.
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Asma , Calidad de Vida , Asma/rehabilitación , Índice de Masa Corporal , Disnea/rehabilitación , Terapia por Ejercicio/métodos , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
This study evaluated the equivalence of activity outcomes from three accelerometer brands worn on both wrists during free living. Forty-four adults wore a GENEActiv, ActiGraph and Axivity accelerometer for 7 days. Outcomes were assessed between and within accelerometer brand and wrist location with average acceleration and the intensity gradient (IG) being of particular interest. Pairwise 95% equivalence tests and intra-class correlation coefficients (ICC) evaluated agreement. Average acceleration and the IG were largely equivalent between combinations of accelerometer device and wrists when applying a 10% equivalence zone. There was largely a lack of equivalence between pairings for time spent in acceleration values ≥100 mg. However, equivalence was largely achieved when applying an equivalence zone that encompassed values ranging from 0.3 to 0.45 SDs for IG and time spent above 100 mg and 150 mg. Agreement between pairings tended to be stronger between different brands on the non-dominant (ICCs ≥ 0.73-0.97) versus the dominant wrist (ICCs ≥ 0.57-0.97) and between wrists for the same accelerometer (ICCs ≥ 0.59-0.97) for average acceleration and the IG. These are important findings since device placement is not consistent in studies. Further work that applies an equivalence zone reflecting the variability of the outcome measure is encouraged.
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Ejercicio Físico , Muñeca , Aceleración , Acelerometría , Adulto , Humanos , Articulación de la MuñecaRESUMEN
BACKGROUND: This study examined the impact of a 4-week school-based sprint interval training program on cardiorespiratory fitness (CRF), daily physical activity (PA) behavior, and cardiometabolic risk (CMR) outcomes in adolescents. METHODS: A total of 56 adolescents (22 females) were allocated to either an intervention (n = 22; 17.0 [0.3] y) or control group (n = 30; 16.8 [0.5] y). Intervention group performed 5 to 6, 30 second "all out" running sprints, interspersed with 30-second rest intervals, 3 times per week, for 4 consecutive weeks, whereas control group performed their normal physical education lessons. CRF was estimated from the 20-m multistage fitness test and PA behavior was determined using accelerometry. Fasting blood samples were obtained to measure biochemical markers of CMR. RESULTS: Significant group × time interactions were observed for CRF (5.03 [1.66 to 8.40]; P < .001; d = 0.95), sedentary time (136.15 [91.91 to 180.39]; P = .004; d = 1.8), moderate PA (57.20 [32.17 to 82.23]; P < .001; d = 1.5), vigorous PA (5.40 [4.22 to 6.57]; P < .001; d = 1.2), fasting insulin (0.37 [-0.48 to 1.21]; P = .01; d = 1.0), homeostasis model of assessment-insulin resistance (0.26 [0.15 to 0.42]; P < .001; d = 0.9), and clustered CMR score (0.22 [-0.05 to 0.68]; P < .001; d = 10.63). CONCLUSION: Findings of this study indicate that 4 weeks of school-based sprint interval training improves CRF, improves PA profiles, and maintains CMR in adolescents during the school term.
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Capacidad Cardiovascular , Enfermedades Cardiovasculares/epidemiología , Curriculum , Entrenamiento de Intervalos de Alta Intensidad , Educación y Entrenamiento Físico , Adolescente , Presión Sanguínea , Femenino , Frecuencia Cardíaca , Humanos , Resistencia a la Insulina , Masculino , Factores de Riesgo , Conducta SedentariaRESUMEN
This study examined differences in physical activity (PA) estimates provided from raw and counts processing methods. One hundred and sixty-five children (87 girls) wore a hip-mounted ActiGraph GT3X+ accelerometer for 7 days. Data were available for 129 participants. Time in moderate PA (MPA), vigorous PA (VPA) and moderate-vigorous PA (MVPA) were calculated using R-package GGIR and ActiLife. Participants meeting the wear time criteria for both processing methods were included in the analysis. Time spent in MPA (-21.4 min.d-1, 95%CI -21 to -20) and VPA (-36 min.d-1, 95%CI -40 to -33) from count data were higher (P < 0.001) than raw data. Time spent in MVPA between the two processing methods revealed significant differences (All P < 0.001). Bland-Altman plots suggest that the mean bias for time spent in MPA, VPA and MVPA were large when comparing raw and count methods. Equivalence tests showed that estimates from raw and count processing methods across all activity intensities lacked equivalence. Lack of equivalence and poor agreement between raw and count processing methods suggest the two approaches to estimate PA are not comparable. Further work to facilitate the comparison of findings between studies that process and report raw and count physical activity data may be necessary.
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Actigrafía/métodos , Ejercicio Físico , Monitores de Ejercicio , Actigrafía/instrumentación , Niño , Femenino , Cadera , Humanos , Masculino , Conducta Sedentaria , Factores de TiempoRESUMEN
This study used the intensity gradient (IG) and average acceleration metrics to describe children's activity profiles and explore associations with body mass index (BMI) z-score. Two hundred and forty-six children (n = 138 girls) aged 9.6 ± 1.4 years wore a wrist-mounted ActiGraph wGT3X-BT accelerometer for 7 days on their non-dominant wrist. Physical activity (PA) metrics captured included: the IG which describes the intensity distribution of accelerations across the 24 h monitoring period; average acceleration which provides a measure of the volume of activity; total moderate-to-vigorous PA (MVPA) and inactive time. Acceleration was averaged over 5s epochs. Finally, BMI z-score was calculated for each participant. Average acceleration was negatively associated with BMI z-score (p < 0.05) independent of age and gender but not IG. The IG was negatively associated with BMI z-score independent of potential correlates and average acceleration. Total MVPA was not associated with BMI-z score. The IG and average acceleration metrics may be used to explore the independent or cumulative effects of the volume and intensity distribution of activity upon measures of health and well-being in children to inform specific activity recommendations.
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Índice de Masa Corporal , Ejercicio Físico/fisiología , Aceleración , Actigrafía/instrumentación , Niño , Estudios Transversales , Femenino , Monitores de Ejercicio , Humanos , Masculino , Análisis de Regresión , Carrera/fisiología , Conducta Sedentaria , Velocidad al Caminar/fisiologíaRESUMEN
The purpose of this study was to examine the ability of international normative centiles for the 20 m shuttle run test (20mSRT) to identify youth at increased cardiometabolic risk. This was a cross-sectional study involving 961 children aged 10-17 years (53% girls) from the United Kingdom. Receiver operating characteristic (ROC) curves determined the discriminatory ability of cardiorespiratory fitness percentiles for predicting increased cardiometabolic risk. ROC analysis demonstrated a significant but poor discriminatory accuracy of cardiorespiratory fitness in identifying low/high cardiometabolic risk in girls (AUC = 0.58, 95% CI: 0.54-0.63; p = 0.04), and in boys (AUC = 0.59, 95% CI: 0.54-0.63; p = 0.03). The cardiorespiratory fitness cut-off associated with high cardiometabolic risk was the 55th percentile (sensitivity = 33.3%; specificity = 84.5%) in girls and the 60th percentile (sensitivity = 42.9%; specificity = 73.6%) in boys. These 20mSRT percentile thresholds can be used to identify children and adolescents who may benefit from lifestyle intervention. Nonetheless, further work involving different populations and cardiometabolic risk scores comprising of different variables are needed to confirm our initial findings.
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Capacidad Cardiovascular , Prueba de Esfuerzo/métodos , Carrera/fisiología , Adolescente , Factores de Edad , Enfermedades Cardiovasculares , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Consumo de Oxígeno , Curva ROC , Valores de Referencia , Medición de Riesgo/métodos , Factores de Riesgo , Factores Sexuales , Reino UnidoRESUMEN
The GT3X+ worn at the wrist promotes greater compliance than at the hip. Minutes in SB and PA calculated from raw accelerations at the hip and wrist provide contrasting estimates and cannot be directly compared. Wear-time for the wrist (15.6 to 17.4 h.d-1) was greater than the hip (15.2 to 16.8 h.d-1) across several wear-time criteria (all P < 0.05). Moderate-strong associations were found between time spent in SB (r = 0.39), LPA (r = 0.33), MPA (r = 0.99), VPA (r = 0.82) and MVPA (r = 0.81) between the two device placements (All P < 0.001). The wrist device detected more minutes in LPA, MPA, VPA and MVPA whereas the hip detected more SB (all P = 0.001). Estimates of time in SB and all activity outcomes from the wrist and hip lacked equivalence. One hundred and eighty-eight 9-12-year-old children wore a wrist- and hip-mounted accelerometer for 7 days. Data were available for 160 (hip) and 161 (wrist) participants. Time spent in SB and PA was calculated using GGIR. This study examined the compliance of children wearing wrist- and hip-mounted ActiGraph GT3X+ accelerometers and compared estimates of sedentary behaviour (SB) and physical activity (PA) between devices.
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Actigrafía/instrumentación , Ejercicio Físico/fisiología , Conductas Relacionadas con la Salud , Conducta Sedentaria , Niño , Femenino , Cadera , Humanos , Masculino , Factores de Tiempo , MuñecaRESUMEN
OBJECTIVES: To evaluate the ability of BMI, WC, and WHtR to identify increased cardiometabolic risk in pre-adolescents. METHODS: This is a cross-sectional study involving 192 children (10.92 ± 0.58 years, 56% female) from the United Kingdom between 2010 and 2013. Receiver operating characteristic curves determined the discriminatory ability of BMI, WC and WHtR to identify individuals with increased cardiometabolic risk (increased clustered triglycerides, HDL-cholesterol, systolic blood pressure, cardiorespiratory fitness, and glucose). RESULTS: A WHtR ≥ 0.5 increased the odds by 5.2 (95% confidence interval 2.6 - 10.3) of having increased cardiometabolic risk. Similar associations were observed for BMI and WC. Both BMI-z and WHtR were fair predictors of increased cardiometabolic risk, although BMI-z demonstrated the best trade-off between sensitivity and specificity, 76.1% and 63.6%, compared with 68.1% and 65.5% for WHtR. Cross-validation analysis revealed that BMI-z and WHtR correctly classified 84% of individuals (kappa score = 0.671, 95% CI 0.55, 0.79). The sensitivity of the cut-points suggests that 89.3% of individuals were correctly classified as being at risk with only 10.7% misdiagnosed whereas the specificity of the cut-points indicated that 77.8% of individuals were correctly identified as being healthy with 22.2% of individuals incorrectly diagnosed as being at risk. CONCLUSIONS: Findings suggest that WHtR provides similar cardiometabolic risk estimates to age and sex adjusted BMI.
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Antropometría/métodos , Síndrome Metabólico/epidemiología , Glucemia/análisis , Presión Sanguínea , Índice de Masa Corporal , Capacidad Cardiovascular , Niño , HDL-Colesterol/sangre , Estudios Transversales , Inglaterra/epidemiología , Femenino , Humanos , Masculino , Síndrome Metabólico/etiología , Irlanda del Norte/epidemiología , Factores de Riesgo , Triglicéridos/sangre , Circunferencia de la Cintura , Relación Cintura-EstaturaRESUMEN
BACKGROUND: Limited studies have examined the diagnostic performance of body mass index (BMI), waist circumference (WC) or waist-to-height ratio (WHtR) for identifying cardiometabolic risk (increased clustered glucose, triglycerides, mean arterial pressure and inv-HDL-cholesterol) in pre-adolescent youth. AIM: To compare the utility of BMI, WC and WHtR as predictors of cardiometabolic risk (CMR) in Scottish pre-adolescent children. SUBJECTS AND METHODS: A cross-sectional analysis of 223 Scottish children (55.2% boys, mean age =8.4 years) was undertaken. BMI, WC and WHtR were used as exposure variables within multivariate logistic regression analysis and ROC analysis to examine the utility of these anthropometrical indices in identifying those at cardiometabolic risk. RESULTS: Individuals with an elevated WHtR, WC and BMI were 3.51 (95% CI = 1.71-7.23; p < .001); 2.34 (95% CI = 1.35-4.06; p = .002) and 2.59 (95% CI = 1.42-4.73; p = .002) times more likely to be at cardiometabolic risk, respectively. The areas under the curves [AUC] to identify children with cardiometabolic risk were significant and similar among anthropometric indices (AUC's = 0.60-0.65). When stratified by BMI, both WC and WHtR demonstrated a fair-to-good ability for identifying those at cardiometabolic risk (AUC = 0.75-0.81). CONCLUSIONS: Findings suggest that the combination of BMI with either WC or WHtR may provide an added benefit in the assessment of cardiometabolic risk amongst pre-adolescents.
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Índice de Masa Corporal , Síndrome Metabólico/diagnóstico , Medición de Riesgo/métodos , Circunferencia de la Cintura , Relación Cintura-Estatura , Presión Arterial , Glucemia/metabolismo , Niño , Preescolar , HDL-Colesterol/metabolismo , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Curva ROC , Escocia , Triglicéridos/metabolismoRESUMEN
Body Mass Index (BMI), as an adiposity indicator, assumes that for any given height a change in weight is attributed to a change in fat. This seems problematic in growing youth as great divergence is evident in bone, muscle, and adipose tissue development. Secondly, use of reference populations in categorizing children based on BMI, frequently use arbitrary percentile cut-offs for obesity and do not meet all of the assumptions that cut-offs imply. Lastly, BMI does not control for maturation status. Criterion-referenced assessments of child obesity that account for abdominal adiposity and permit international comparisons, such as waist-to-height ratio (WtHR), must be considered. Better predictive utility has been demonstrated when using WtHR for abdominal adiposity and cardiovascular risk factors in youth compared with BMI. Although multiple methods for assessing waist circumference may be problematic for comparison purposes, its simplicity and international comparability aspects make it a promising alternative to BMI.
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Índice de Masa Corporal , Obesidad Infantil/diagnóstico , Relación Cintura-Estatura , Adiposidad , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Circunferencia de la CinturaRESUMEN
This study examined the independent relationships between cardiorespiratory and muscular fitness with cardiometabolic risk in adolescents. Subjects were 192 adolescents (118 boys), aged 15-17.5 years. The 2 m multi-stage fitness test assessed cardiorespiratory fitness and the counter movement jump assessed muscular fitness. Additional measures included interleukin-6, C-reactive protein, adiponectin, fibrinogen and plasminogen activator inhibitor-1. Regression analysis revealed that cardiorespiratory fitness was negatively related to cardiometabolic risk (ß = -0.014, p < 0.001). With additional adjustment for muscular fitness the relationship remained significant (ß = -0.015, p < 0.001). Muscular fitness was negatively related to cardiometabolic risk (ß = -0.021, p < 0.001) and remained significant after adjustment for cardiorespiratory fitness. Participants in the least-fit quartile for both cardiorespiratory and muscular fitness had significantly poorer cardiometabolic risk scores than those in the other quartiles. Findings revealed that muscular and cardiorespiratory fitness are significantly associated with cardiometabolic risk independently of one another.
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Fenómenos Fisiológicos Cardiovasculares , Músculo Esquelético/fisiología , Aptitud Física/fisiología , Adiponectina/sangre , Adolescente , Proteína C-Reactiva/metabolismo , Prueba de Esfuerzo , Femenino , Fibrinógeno/metabolismo , Humanos , Interleucina-6/sangre , Masculino , Análisis Multivariante , Inhibidor 1 de Activador Plasminogénico/sangre , Análisis de Regresión , Medición de Riesgo , Factores de RiesgoRESUMEN
OBJECTIVES: The purpose of this study was to examine the independent associations between measures of adiposity and cardiorespiratory fitness (CRF) with clustered cardiometabolic risk in adolescents. METHODS: 209 adolescents (139 boys), aged 15-17.5 years participated. Participants completed anthropometric measurements [height, weight, waist circumference (WC)] whilst the 20 m fitness test was used to assess CRF. Additional measures included systolic blood pressure, triglycerides, ratio total cholesterol/high-density lipoprotein cholesterol, insulin resistance (HOMA), interleukin-6, C-reactive protein (CRP), and adiponectin. RESULTS: Partial correlations revealed weak to moderate negative associations for body mass index (BMI) and WC with CRF (r = -0.295 and -0.292, P < 0.001) and adiponectin (r = -0.227 and -0.262, P < 0.05). Weak to moderate positive associations were evident for BMI with CRP, and cardiometabolic risk (r = 0.274, and 0.283, P < 0.05, respectively). Weak to moderate positive associations were apparent for WC with CRP and triglycerides (r = 0.240 and 0.254, P < 0.05), whilst moderate to large associations were evident for WC with clustered cardiometabolic risk (r = 0.317, P < 0.05). Regression analyses revealed that BMI was positively associated with cardiometabolic risk (ß = 0.243, P < 0.001). Further analysis whilst additionally controlling for WC and CRF strengthened this association (ß = 0.352, P < 0.001). Finally, participants in the least-fit quartile for CRF had significantly poorer cardiometabolic risk scores than those in the other quartiles. CONCLUSION: BMI and not CRF was independently associated with cardiometabolic risk. Reducing BMI appears essential to minimize cardiometabolic risk during adolescence.
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Adiposidad , Enfermedades Cardiovasculares/epidemiología , Aptitud Física , Adolescente , Análisis Químico de la Sangre , Índice de Masa Corporal , Enfermedades Cardiovasculares/etiología , Estudios Transversales , Femenino , Humanos , Masculino , Factores de Riesgo , Escocia/epidemiología , Circunferencia de la CinturaRESUMEN
INTRODUCTION: Poor sleep health is associated with increased asthma morbidity and mortality. Accelerometers have been validated to assess sleep parameters though studies using this method in patients with asthma are sparse and none have compared mild to difficult-to-treat asthma populations. METHODS: We performed a retrospective analysis from two recent in-house trials comparing sleep metrics between patients with mild and difficult-to-treat asthma. Participants wore accelerometers for 24-hours/day for seven days. RESULTS: Of 124 participants (44 mild, 80 difficult-to-treat), no between-group differences were observed in sleep-window, sleep-time, sleep efficiency or wake time. Sleep-onset time was ~ 40 min later in the difficult-to-treat group (p = 0.019). DISCUSSION: Broadly, we observed no difference in accelerometer-derived sleep-metrics between mild and difficult-to-treat asthma. This is the largest analysis of accelerometer-derived sleep parameters in asthma and the first comparing groups by asthma severity. Sleep-onset initiation may be delayed in difficult-to-treat asthma but a dedicated study is needed to confirm.
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BACKGROUND: Body composition, blood pressure, estimated maximal oxygen uptake (VO2max), lung function, physical activity, muscle architecture, and endothelial function had not previously been examined in people with young onset dementia. Therefore, the study measured these variables in a young onset dementia group, compared them to age-matched controls. METHODS: Estimated VO2max (via the Astrand-Rhyming test), body composition, blood pressure, lung function (via spirometry), muscle architecture (via ultrasonography) and endothelial function (via flow mediated dilation) were assessed. Physical activity was measured using ActiGraph accelerometers for 7 days. RESULTS: We recruited 33 participants (16 young onset dementia, 17 controls). The young onset dementia group had shorter fascicle lengths of the vastus lateralis, were sedentary for longer over a seven-day period, and completed less moderate-vigorous physical activity than controls (p=0.028, d=0.81; large effect, p=0.029, d=0.54; moderate effect, and p=0.014, d=0.97; large effect, respectively for pairwise comparisons). Pairwise comparisons suggest no differences at the p<0.05 level between young onset dementia and controls for estimated VO2max (despite a moderate effect size [d=0.66]), height, body mass, BMI, blood pressure, light physical activity, lung function, muscle thickness, pennation angle, or endothelial function. CONCLUSION: This study highlights differences between people with young onset dementia and controls, underscoring the need for multicomponent exercise interventions. Future interventions should target muscle architecture, increase moderate-vigorous physical activity, and reduce sedentariness, with the goal of improving quality of life and promoting functional independence.
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The aim of this study was to investigate levels of clustered cardiometabolic risk and the odds of being 'at risk' according to cardiorespiratory fitness status in children. Data from 88 10-11.9-year-old children (mean age 11.05 ± 0.51 years), who participated in either the REACH Year 6 or the Benefits of Fitness Circuits for Primary School Populations studies were combined. Waist circumference, systolic blood pressure, diastolic blood pressure, glucose, triglycerides, high-density lipoprotein cholesterol, adiponectin and C-reactive protein were assessed and used to estimate clustered cardiometabolic risk. Participants were classified as 'fit' or 'unfit' using recently published definitions (46.6 and 41.9 mL/kg/min for boys and girls, respectively), and continuous clustered risk scores between fitness groups were assessed. Participants were subsequently assigned to a 'normal' or 'high' clustered cardiometabolic risk group based on risk scores, and logistic regression analysis assessed the odds of belonging to the increased cardiometabolic risk group according to fitness. The unfit group exhibited significantly higher clustered cardiometabolic risk scores (p < 0.001) than the fit group. A clear association between fitness group and being at increased cardiometabolic risk (B = 2.509, p = 0.001) was also identified, and participants classed as being unfit were found to have odds of being classified as 'at risk' of 12.30 (95 % CI = 2.64-57.33). Conclusion Assessing cardiorespiratory fitness is a valid method of identifying children most at risk of cardiometabolic pathologies. The ROC thresholds could be used to identify populations of children most at risk and may therefore be used to effectively target a cardiometabolic risk-reducing public health intervention.
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Enfermedades Cardiovasculares/diagnóstico , Enfermedades Metabólicas/diagnóstico , Consumo de Oxígeno/fisiología , Aptitud Física/fisiología , Medición de Riesgo , Adiponectina/sangre , Glucemia/análisis , Presión Sanguínea , Índice de Masa Corporal , Proteína C-Reactiva/análisis , Niño , Análisis por Conglomerados , Femenino , Humanos , Lipoproteínas/sangre , Modelos Logísticos , Masculino , Curva ROC , Reino Unido , Circunferencia de la CinturaRESUMEN
BACKGROUND: With accumulating evidence suggesting that CVD has its origins in childhood, the purpose of this study was to examine whether a high intensity training (HIT) intervention could enhance the CVD risk profile of secondary school aged adolescents in a time efficient manner. METHODS: Participants in the study were adolescent school children (64 boys, 25 girls, 16.7 ± 0.6 years). The intervention group (30 boys, 12 girls) performed three weekly exercise sessions over 7 weeks with each session consisting of either four to six repeats of maximal sprint running within a 20 m area with 30 s recovery. The control group were instructed to continue their normal behaviour. All participants had indices of obesity, blood pressure and nine biochemical risk markers for cardiovascular disease recorded as well as four physical performance measures at baseline and post-intervention. Feedback was provided through informal discussion throughout the intervention period as well as post-intervention focus groups. Statistical differences between and within groups were determined by use of paired samples t-tests and ANCOVA. RESULTS: Significant enhancements (P ≤ 0.05) in vertical jump performance, 10 m sprint speed and cardiorespiratory fitness was evident in the intervention group whereas a significant decrease in both agility and vertical jump performance was evident in the control group. Participants in the intervention group also experienced a significant decrease in systolic blood pressure post-intervention. Limited changes occurred with respect to the biochemical markers although both groups did experience a significant increase in LDL post-intervention whilst the control group experienced a significant decrease in total cholesterol. No apparent differences were evident between groups post intervention for any of the biochemical markers. Feedback indicated that participants endorsed the use of the intervention as an effective means of exercise. CONCLUSIONS: Our results demonstrate that high intensity exercise interventions may be used in the school setting for adolescents as a means of improving measures of physical fitness. Further investigations involving a larger cohort of participants, taken from different schools, is recommended. TRIAL REGISTRATION: NCT01027156.
Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Aptitud Física/fisiología , Carrera/fisiología , Servicios de Salud Escolar , Adolescente , Presión Sanguínea/fisiología , Enfermedades Cardiovasculares/metabolismo , Enfermedades Cardiovasculares/fisiopatología , Colesterol/metabolismo , LDL-Colesterol/metabolismo , Femenino , Grupos Focales , Estudios de Seguimiento , Humanos , Masculino , Factores de RiesgoRESUMEN
The purpose of this study was to develop sedentary cut-points for the activPAL and evaluate their performance against a criterion measure (i.e., activPAL processed by PALbatch). Part 1: Thirty-five adults (23.4 ± 3.6 years) completed 12 laboratory activities (6 sedentary and 6 non-sedentary activities). Receiver operator characteristic (ROC) curves proposed optimal Euclidean Norm Minus One (ENMO) and Mean Amplitude Deviation (MAD) cut-points of 26.4 mg (ENMO) and 30.1 mg (MAD). Part 2: Thirty-eight adults (22.6 ± 4.1 years) wore an activPAL during free-living. Estimates from PALbatch and MAD revealed a mean percent error (MPE) of 2.2%, mean absolute percent error (MAPE) of 6.5%, limits of agreement (LoA) of 19% with absolute and relative equivalence zones of 5% and 0.3 SD. Estimates from PALbatch and ENMO revealed an MPE of -10.6%, MAPE of 14.4%, LoA of 31% and 16% and 1 SD equivalence zones. After standing was isolated from sedentary behaviours, ROC analysis proposed an optimal cut-off of 21.9 mg (herein ENMOs). Estimates from PALbatch and ENMOs revealed an MPE of 3.1%, MAPE of 7.5%, LoA of 25% and 9% and 0.5 SD equivalence zones. The MAD and ENMOs cut-points performed best in discriminating between sedentary and non-sedentary activity during free-living.