Data-driven MRI analysis reveals fitness-related functional change in default mode network and cognition following an exercise intervention.

Previous research has indicated that cardiorespiratory fitness (CRF) is structurally and functionally neuroprotective in older adults. However, questions remain regarding the mechanistic role of CRF on cognitive and brain health. The purposes of this study were to investigate if higher pre-intervention CRF was associated with greater change in functional brain connectivity during an exercise intervention and to determine if the magnitude of change in connectivity was related to better post-intervention cognitive performance. The sample included low-active older adults (n = 139) who completed a 6-month exercise intervention and underwent neuropsychological testing, functional neuroimaging, and CRF testing before and after the intervention. A data-driven multi-voxel pattern analysis was performed on resting-state MRI scans to determine changes in whole-brain patterns of connectivity from pre- to post-intervention as a function of pre-intervention CRF. Results revealed a positive correlation between pre-intervention CRF and changes in functional connectivity in the precentral gyrus. Using the precentral gyrus as a seed, analyses indicated that CRF-related connectivity changes within the precentral gyrus were derived from increased correlation strength within clusters located in the Dorsal Attention Network (DAN) and increased anti-correlation strength within clusters located in the Default Mode Network (DMN). Exploratory analysis demonstrated that connectivity change between the precentral gyrus seed and DMN clusters were associated with improved post-intervention performance on perceptual speed tasks. These findings suggest that in a sample of low-active and mostly lower-fit older adults, even subtle individual differences in CRF may influence the relationship between functional connectivity and aspects of cognition following a 6-month exercise intervention.

BAILA: A Randomized Controlled Trial of Latin Dancing to Increase Physical Activity in Spanish-Speaking Older Latinos.

BACKGROUND: Latinos are the fastest growing minority group of the older adult population. Although physical activity (PA) has documented health benefits, older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance, popular among Latinos, holds promise as a culturally relevant form of PA. PURPOSE: To describe self-reported and device-assessed changes in PA as a result of a randomized controlled trial of BAILAMOS, a 4-month Latin dance program with a 4-month maintenance program, versus a health education control group. METHODS: Adults, aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels at baseline, and risk for disability were randomized to the dance program (n = 167) or health education condition (n = 166). Data were analyzed using multilevel modeling with full information maximum likelihood. RESULTS: A series of multilevel models revealed significant time × group interaction effects for moderate-to-vigorous physical activity (MVPA), dance PA, leisure PA, and total PA. Exploring the interaction revealed the dance group to significantly increase their MVPA, dance PA, leisure PA, and total PA at months 4 and 8. Household PA and activity counts from accelerometry data did not demonstrate significant interaction effects. CONCLUSIONS: The study supports organized Latin dance programs to be efficacious in promoting self-reported PA among older Latinos. Efforts are needed to make dancing programs available and accessible, and to find ways for older Latinos to add more PA to their daily lives. CLINICAL TRIAL INFORMATION: NCT01988233.

Moderators of physical activity and quality of life response to a physical activity intervention for breast cancer survivors.

PURPOSE: Moderate-to-vigorous physical activity (MVPA) can improve the quality of life (QoL) for breast cancer survivors (BCS), yet, most do not achieve 150 + weekly minutes of MVPA. This study investigated moderators of response to a physical activity (PA) behavior change intervention for BCS. METHODS: BCS (N = 222) were randomized to the 3-month intervention (BEAT Cancer) or usual care. Measurements occurred at baseline, post-intervention, and 3 months post-intervention. Measures included accelerometry, self-reported MVPA, and Functional Assessment of Cancer Therapy (FACT-General, FACT-Breast, physical well-being (PWB), social well-being (SWB), emotional well-being (EWB), functional well-being (FWB), additional concerns (AC), and Trial Outcome Index (TOI)). RESULTS: Adjusted linear mixed-model analyses indicated individuals ≤ 24 months post-diagnosis and who were single reported smaller increases in weekly self-reported MVPA than those > 24 months (44.07 vs 111.93) and partnered (- 16.24 vs. 49.16 min), all p < 0.05. As for QoL, participants < 12 months post-diagnosis who received chemotherapy experienced smaller improvements than those ≥ 12 months in FACT-General, FACT-Breast, PWB, and SWB scores. Survivors with a history of chemotherapy had smaller improvements in FACT-General, FACT-Breast, PWB, SWB, TOI, and AC scores, all p < 0.05. CONCLUSION: These findings indicate that being < 2 years post-diagnosis, single, and prior chemotherapy may limit MVPA and QOL responses to a PA intervention. Further studies are needed to determine if and/or what additional PA supports and resources these subgroups of BCS might find beneficial and effective. TRIAL REGISTRATION: ClinicalTrials.gov number: NCT00929617.

White matter plasticity in healthy older adults: The effects of aerobic exercise.

White matter deterioration is associated with cognitive impairment in healthy aging and Alzheimer's disease. It is critical to identify interventions that can slow down white matter deterioration. So far, clinical trials have failed to demonstrate the benefits of aerobic exercise on the adult white matter using diffusion Magnetic Resonance Imaging. Here, we report the effects of a 6-month aerobic walking and dance interventions (clinical trial NCT01472744) on white matter integrity in healthy older adults (n = 180, 60-79 years) measured by changes in the ratio of calibrated T1- to T2-weighted images (T1w/T2w). Specifically, the aerobic walking and social dance interventions resulted in positive changes in the T1w/T2w signal in late-myelinating regions, as compared to widespread decreases in the T1w/T2w signal in the active control. Notably, in the aerobic walking group, positive change in the T1w/T2w signal correlated with improved episodic memory performance. Lastly, intervention-induced increases in cardiorespiratory fitness did not correlate with change in the T1w/T2w signal. Together, our findings suggest that white matter regions that are vulnerable to aging retain some degree of plasticity that can be induced by aerobic exercise training. In addition, we provided evidence that the T1w/T2w signal may be a useful and broadly accessible measure for studying short-term within-person plasticity and deterioration in the adult human white matter.

Effects of a DVD-delivered randomized controlled physical activity intervention on functional health in cancer survivors.

BACKGROUND: Supervised physical activity interventions improve functional health during cancer survivorship, but remain costly and inaccessible for many. We previously reported on the benefits of a DVD-delivered physical activity program (FlexToBa™) in older adults. This is a secondary analysis of the intervention effects among cancer survivors in the original sample. METHODS: Low active, older adults who self-reported a history of cancer (N = 46; M time since diagnosis = 10.7 ± 9.4 years) participated in a 6-month, home-based physical activity intervention. Participants were randomized to either the DVD-delivered physical activity program focused on flexibility, toning, and balance (FlexToBa™; n = 22) or an attentional control condition (n = 24). Physical function was assessed by the Short Physical Performance Battery (SPPB) at baseline, end of intervention, and at 12 and 24 months after baseline. RESULTS: Repeated measures linear mixed models indicated a significant group*time interaction for the SPPB total score (ß = - 1.14, p = 0.048), driven by improved function from baseline to six months in the FlexToBa™ group. The intervention group also had improved balance (ß = - 0.56, p = 0.041) compared with controls. Similar trends emerged for the SPPB total score during follow-up; the group*time interaction from 0 to 12 months approached significance (ß = - 0.97, p = 0.089) and was significant from 0 to 24 months (ß = - 1.84, p = 0.012). No significant interactions emerged for other outcomes (ps > 0.11). CONCLUSIONS: A DVD-delivered physical activity intervention designed for cancer-free older adults was capable of eliciting and maintaining clinically meaningful functional improvements in a subgroup of cancer survivors, with similar effects to the original full sample. These findings inform the dissemination of evidence-based physical activity programs during survivorship. TRIAL REGISTRATION: ClinicalTrials.gov NCT01030419 . Registered 11 December 2009.

A comparison of total and domain-specific sedentary time in breast cancer survivors and age-matched healthy controls.

Breast cancer survivors (BCS) engage in more sedentary behavior (SED) than those without cancer. However, the context in which SED is accrued is unknown. The purpose of this study is to examine differences in total and domain-specific SED of BCS and healthy controls. 20 BCS and 20 age-matched, healthy controls wore ActiGraph GT3X + accelerometers to measure SED and activity. Participants self-reported SED for transportation, occupational, screen time and leisure purposes. Multiple linear regressions were used to estimate differences in SED between BCS and controls. BCS spent significantly more time watching TV (152.4 vs. 60.3; p < 0.01) and less time in total SED (490.8 vs. 587.4; p = 0.046) and other leisure activities (57.6 vs. 106.9; p < 0.01) than healthy controls. BCS engage in more TV watching and less time in other leisure activities than controls, thus interventions should focus on reducing TV time. Understanding facilitators of TV viewing is needed to determine specific intervention targets.

A pilot feasibility randomized controlled trial adding behavioral counseling to supervised physical activity in prostate cancer survivors: behavior change in prostate cancer survivors trial (BOOST).

The purpose of this study was to evaluate the feasibility of delivering a supervised physical activity program plus standard exercise counseling (PA + EC) versus a supervised physical activity plus motivationally-enhanced behavioral counseling (PA + BC) in prostate cancer survivors. Secondary outcomes included objectively assessed PA, quality of life, body composition, cardiorespiratory fitness, cognitive functioning, and physical function. Twenty-six prostate cancer survivors were randomized to a 12-week supervised PA program plus standard exercise counseling or a 12-week supervised PA plus behavioral counseling based on the Multi-Process Action Control framework. Feasibility was determined through enrolment rate, measurement completion rate, loss-to-follow-up, adherence to the intervention, adverse events, and program evaluation items assessing burden and satisfaction. Of the 26 prostate cancer survivors enrolled (Mage = 65.6 ± 6.8), 96% completed the intervention. Measurement completion rates for the study measures were 88.5%. Adherence to the supervised PA sessions was 92% (completed 11/12 supervised PA sessions) and 100% (completed 12/12 supervised PA sessions) in the PA + EC and PA + BC group, respectively. Adherence to the home-based PA sessions was 70% (completed 7/10 home-based sessions) and 90% (completed 9/10 home-based sessions) in the PA + EC and PA + BC group, respectively. Overall, prostate cancer survivors were highly satisfied with the intervention components and found it rewarding, useful for research helping others, and useful for them personally. The patterns in the secondary outcomes were consistent with a positive impact of the intervention, favoring the PA + BC group. Preliminary evidence suggests that adding behavioral counseling to supervised PA in prostate cancer survivors may be feasible and result in better adherence to PA compared to exercise counseling alone, although additional refinement is needed. A combination of supervised and home-based PA may be feasible for behavior change in the self-management of prostate cancer. The study is registered with http://ClinicalTrials.gov (ID NCT03191968).

Demographic, medical, social-cognitive, and environmental correlates of meeting independent and combined physical activity guidelines in kidney cancer survivors.

PURPOSE: Guidelines for cancer survivors recommend both aerobic physical activity (PA) and strength training (ST). Few kidney cancer survivors (KCS) are meeting single-activity or combined guidelines; therefore, examining factors influencing PA participation is warranted. The purpose of this study is to examine demographic, medical, social-cognitive, and environmental correlates of meeting independent (i.e., aerobic-only, strength training (ST)-only) and combined guidelines (i.e., aerobic and ST) in KCS. METHODS: KCS (N = 651) completed self-reported measures of PA and demographic, medical, social-cognitive, and perceived environmental factors. Built environment was assessed using the geographic information systems (GIS). Multinomial logistic regressions were conducted to determine the correlates of meeting the combined versus independent guidelines. RESULTS: Compared with meeting neither guideline, meeting aerobic-only guidelines was associated with higher intentions (p < .01) and planning (p < .01); meeting ST-only guidelines was associated with higher intentions (p = .02) and planning (p < .01), lower perceived behavioral control (PBC) (p = .03), healthy weight (p = .01), and older age (p < .01); and meeting the combined guidelines were associated with higher intentions (p < .01), planning (p = .02), higher instrumental attitudes (p < .01), higher education (p = .04), better health (p < .01), and localized cancer (p = .05). Additionally, compared with neither guideline, meeting aerobic-only (p < .01) and combined (p < .01) guidelines was significantly associated with access to workout attire. Compared with neither guideline, meeting aerobic-only guidelines was associated with proximity to retail (p = .02). CONCLUSION: PA participation correlates may vary based on the modality of interest. Interventions may differ depending on the modality promoted and whether KCS are already meeting single-modality guidelines.

Physical Activity, Sleep and Quality of Life in Older Adults: Influence of Physical, Mental and Social Well-being.

Introduction: Physical activity and sleep quality have been consistently associated with quality of life (QOL) in a number of clinical and non-clinical populations. However, mechanisms underlying this relationship are not well understood. The purpose of this study was to longitudinally test a model examining how changes in physical activity and sleep quality, predict physical, mental and social well-being and global QoL across a 6-month exercise trial in a sample of healthy older adults. Methods: Participants (N = 247, mean age 65.4 ± 4.6) wore an accelerometer to assess objective levels of physical activity and completed measures of sleep, physical and mental well-being, social well-being and QOL at baseline and following a 6-month physical activity intervention. Relationships among model constructs were examined over time using panel analysis within a covariance-modeling framework. Results: The hypothesized model provided a good model-data fit (χ2 = 58.77, df = 41, p = .036); CFI = 0.98; SRMR = 0.05; RMSEA = 0.04). At both time-points, physical activity and sleep quality were significantly correlated. Sleep quality indirectly influenced QOL via physical, mental and social well-being (QOL R2 = .47, p < .001). These relationships were also supported across time at month 6 (QOL R2 = .50, p < .001). Neither physical activity nor sleep quality directly influenced QOL. Conclusion: Our results support a novel sleep and QOL model that may inform the design of health interventions to promote sleep quality, and thereby influencing QOL by targeting physical activity and modifiable mediators of physical, mental and social health. Our findings may have significant implications for older adults as well as clinical populations that report compromised sleep, impaired health related and global QOL.

Results from the randomized controlled IHOPE trial suggest no effects of oral protein supplementation and exercise training on physical function in hemodialysis patients.

Few long-term studies have assessed whether changes in both diet and exercise can improve the health and quality of life (QOL) of hemodialysis (HD) patients. Here we examined whether 12 months of intradialytic protein supplementation and endurance exercise improves physical function, risk of cardiovascular disease (CVD), and QOL in HD patients in a randomized controlled trial (RCT). A total of 138 HD patients (average age 58 years) were assigned for 12 months to control, intradialytic protein, or protein plus exercise groups. The protein and protein plus exercise groups consumed an oral protein supplement (30 grams of whey) three days/week during dialysis. The protein plus exercise group cycled for 30-45 minutes during dialysis treatment. The primary outcome was change in physical function at 12 months, assessed by a shuttle walk test. Secondary outcomes included arterial stiffness, blood pressure, body composition, muscle strength, markers of nutritional status, and QOL. Assessments were conducted at baseline, 6 and 12 months. In total, 101 patients completed the intervention. There were no significant differences between groups in shuttle walk test performance from baseline to 12 months. There were trends for improvements in some secondary measures of physical function and strength in the protein and protein plus exercise groups at six or 12 months, but these did not reach statistical significance. Thus, our trial did not demonstrate significant improvements in markers of physical function, risk of CVD or QOL after one year of intradialytic oral OPS and aerobic exercise training. More comprehensive lifestyle management may be needed to uncover robust improvements in the health and QOL of HD patients.

Acute aerobic exercise effects on cognitive function in breast cancer survivors: a randomized crossover trial.

BACKGROUND: Many breast cancer survivors (BCS) report deficits in cognitive function. Physical activity (PA) has been associated with better processing speed and memory in healthy adults and thus may be a useful method for improving cognition in BCS. The purpose of this study was to examine the effects of an acute bout of PA on processing speed and spatial working memory in a sample of BCS. METHODS: Using a repeated measures, crossover design, BCS [N = 27; Mage (SD) = 49.11(8.05)] completed two sessions in counterbalanced order: 30 min of moderate-intensity treadmill walking and 30 min of seated rest. Women completed cognitive tasks immediately before and after each session. RESULTS: Within-subjects repeated measures analyses of variance revealed a significant time by session effect for processing speed reaction time [F (1,25) = 5.02, p = .03, η2 = 0.17]. This interaction was driven by significantly reduced reaction time (e.g., faster response) post-exercise and no change post-rest. Further between-subjects analyses indicated a significant time by session by moderate to vigorous physical activity (MVPA) split [F (1,25) = 5.23, p = .03, η2 = 0.17], such that women who engaged in ≥45 min of average daily MVPA reduced their reaction time post-exercise (p = .01) and increased RT post-rest (p = .06). Time by session effects for spatial working memory 3-item accuracy and 4-item reaction time trended towards significance, p = 0.08 and p = 0.10, respectively, again driven by better performance post-exercise. CONCLUSIONS: The moderate effect of acute exercise on domains of memory and processing speed in BCS is encouraging. Cancer-related cognitive impairment remains largely misunderstood; however, the results from the present study offer preliminary evidence for the positive relationship between acute exercise and cognition in BCS. TRIAL REGISTRATION: ClinicalTrials.gov NCT02592070 . Registered 30 October 2015. Retroactively registered.

Effects of reallocating sedentary time with physical activity on quality of life indicators in breast cancer survivors.

OBJECTIVES: Physical activity is associated with better quality of life (QOL) among breast cancer survivors. However, it is unknown the extent to which time spent sedentary or replacing this time with active behaviors may affect QOL. Our aim was to determine the effect of substituting time between sedentary and active behaviors on QOL indicators in breast cancer survivors. METHODS: An isotemporal substitution approach was used to examine the associations of reallocating time to sedentary and active behaviors measured by accelerometry with Functional Assessment of Cancer Treatment-Breast (FACT-B; total, physical, social, emotional, functional well-being, and breast cancer-specific concerns) and the Hospital Anxiety and Depression Scale (HADS) scores in a pooled analysis of breast cancer survivors (n = 753; Mage  = 56.9 ± 9.5 y) from two observational studies. RESULTS: Reallocating 30 minutes of sedentary time to 30 minutes of moderate-to-vigorous intensity physical activity (MVPA) was associated with improved FACT-B total (B = 3.0; 95% CI, 0.6-4.5), physical well-being (B = 0.8; 95% CI, 0.33-1.2), and functional well-being (B = 0.6; 95% CI, 0.03-1.2) scores. Reallocating 30 minutes of light activity to 30 minutes of MVPA was associated with improved FACT-B total (B = 2.4; 95% CI, 0.3-6.0) and physical well-being (B = 0.72; 95% CI, 0.27-1.2) scores. There was no significant substitution of time effects on HADS scores. CONCLUSIONS: Substituting sedentary time with MVPA showed the greatest range of effects across QOL indicators. These results can inform intervention development interventions and more comprehensive activity recommendations for breast cancer survivors.

Estimation of physical activity intensity cut-points using accelerometry in breast cancer survivors and age-matched controls.

OBJECTIVE: To examine the association between accelerometer activity counts and energy expenditure during walking in breast cancer survivors (BCS) compared with age-matched healthy controls, and differences in moderate-to-vigorous physical activity (MVPA) cut-points. METHODS: Using a case-control design, 19 BCS and 19 age-matched women completed 6 min of resting energy expenditure and 6-min periods of treadmill walking in Midwestern United States. Accelerometers and an open-circuit spirometry system were used to measure activity counts and energy expenditure (VO2 ). A mixed-factor analysis of variance was conducted on activity counts and VO2 . Independent samples t tests compared the magnitude of associations between groups. RESULTS: There were group by speed interactions on energy expenditure (p < 0.001) and counts (p < 0.001). The linear association did not differ between BCS and controls for the R2 (p = 0.62) nor the slope (p = 0.43), but there was a difference in the intercept (p = 0.01). This resulted in different MVPA cut-points between groups: 1,439 ± 761 counts·min-1 in BCS and 1,937 ± 639 counts·min-1 in controls. CONCLUSION: The findings support the use of different cut-points to quantify time spent in MVPA for BCS. Application of these cut-points is warranted to accurately assess physical activity (PA) patterns for better prescription and health outcomes in PA programmes for BCS.

Validity of the Marshall Sitting Questionnaire in people with multiple sclerosis.

This study examines the validity of the Marshall Sitting Questionnaire (MSQ) in people with multiple sclerosis (MS) and presents a prediction model to improve the accuracy of the MSQ estimates. Participants (n = 63 [15M and 48F], age: 56.6 ± 7.3 years) wore an accelerometer on the hip for a 7-day period and completed the MSQ. Sedentary behaviour (SB) estimates were computed as min/day for both the MSQ and accelerometer. Associations between the two methods were examined using the Pearson correlation and agreement was assessed using a Bland-Altman plot. A linear prediction model was developed to improve the accuracy of the MSQ estimates using a selection of predictor variables routinely collected in MS research. There was a moderate correlation between MSQ and accelerometer SB estimates (r = 0.34, p < 0.01). The Bland-Altman plot indicated that the MSQ overestimated SB (mean bias: 80.54 min/day, 95% limits of agreement: -410.5 to 571.5 min/day). The prediction model improved the MSQ estimates by 39% and virtually eliminated measurement bias (mean bias:-0.21 min/day; 95% limits of agreement:-109.8 to 109.4 min/day). The results indicate preliminary evidence for the validity of the MSQ in people with MS, and support the application of an alternative prediction model to improve the accuracy of the MSQ estimates. Abbreviations: SB = sedentary behaviour; MS = multiple sclerosis; MSQ = Marshall Sitting Questionnaire; PA = physical activity; EDSS = Expanded Disability Status Scale; LPA = light physical activity; MVPA = moderate-to-vigorous physical activity; GLTEQ = Godin Leisure Time Exercise Questionnaire; PDDS = Patient-Determined Disease Steps; RMSE = root mean square error.

Discovery and visualization of structural biomarkers from MRI using transport-based morphometry.

Disease in the brain is often associated with subtle, spatially diffuse, or complex tissue changes that may lie beneath the level of gross visual inspection, even on magnetic resonance imaging (MRI). Unfortunately, current computer-assisted approaches that examine pre-specified features, whether anatomically-defined (i.e. thalamic volume, cortical thickness) or based on pixelwise comparison (i.e. deformation-based methods), are prone to missing a vast array of physical changes that are not well-encapsulated by these metrics. In this paper, we have developed a technique for automated pattern analysis that can fully determine the relationship between brain structure and observable phenotype without requiring any a priori features. Our technique, called transport-based morphometry (TBM), is an image transformation that maps brain images losslessly to a domain where they become much more separable. The new approach is validated on structural brain images of healthy older adult subjects where even linear models for discrimination, regression, and blind source separation enable TBM to independently discover the characteristic changes of aging and highlight potential mechanisms by which aerobic fitness may mediate brain health later in life. TBM is a generative approach that can provide visualization of physically meaningful shifts in tissue distribution through inverse transformation. The proposed framework is a powerful technique that can potentially elucidate genotype-structural-behavioral associations in myriad diseases.

Role of Brain Structure in Predicting Adherence to a Physical Activity Regimen.

OBJECTIVE: Physical activity (PA) is important for maintaining health throughout the lifespan. However, adherence to PA regimens is poor with approximately 50% of older adults terminating activity intervention programs within 6 months. In this study, we tested whether gray matter volume and white matter microstructural integrity before the initiation of a PA intervention predicts PA adherence. METHODS: One hundred fifty-nine adults aged 60 to 80 years were randomly assigned to a moderate-intensity aerobic walking condition or a nonaerobic stretching and toning condition. Participants engaged in supervised exercise 3 times per week for 12 months. Data were collected for a period of 1 year. Voxel-based morphometry and tract-based spatial statistics protocols were used to process neuroimaging data, and ordinary least squares regression models with bootstrapping were used to analyze voxelwise neural predictors of PA adherence. RESULTS: Greater volume in several regions predicted greater PA adherence, including prefrontal, motor, somatosensory, temporal, and parietal regions (p < .01). We also found that higher fractional anisotropy in several white matter tracts predicted greater PA adherence (pFDR-corrected < .05), including the superior longitudinal fasciculus, anterior thalamic radiation, forceps minor, and body of the corpus callosum. CONCLUSIONS: These findings provide preliminary support for macro- and microstructural neural predictors of PA adherence and may translate to other health behaviors and behavioral goal pursuit more broadly.

Replacing sedentary time with physical activity or sleep: effects on cancer-related cognitive impairment in breast cancer survivors.

BACKGROUND: Evidence suggests reallocating daily sedentary time to physical activity or sleep confers important health benefits in cancer survivors. Despite emerging research suggesting physical activity as a treatment for cancer-related cognitive impairment (CRCI), little is known about the interactive effects of behaviors across the 24-h period. The present purpose was to examine the cognitive effects of reallocating sedentary time to light-intensity physical activity, moderate-to-vigorous physical activity (MVPA), or sleep in breast cancer survivors. METHODS: Breast cancer survivors (N = 271, Mage = 57.81 ± 9.50 years) completed iPad-based questionnaires and cognitive tasks assessing demographics, health history, executive function, and processing speed (Task-Switch, Trail Making). Participants wore an accelerometer for seven consecutive days to measure their sedentary, physical activity, and sleep behaviors. Single effects (each behavior individually) and partition (controlling for other behaviors) models were used to examine associations among behaviors and cognitive performance. Isotemporal substitution models were used to test the cognitive effects of substituting 30 min of sedentary time with 30 min of light-intensity activity, MVPA, and sleep. RESULTS: MVPA was associated with faster Task-switch reaction time in the partition models (stay: B = - 35.31, p = 0.02; switch: B = - 48.24, p = 0.004). Replacing 30 min of sedentary time with 30 min of MVPA yielded faster reaction times on Task-Switch stay (B = - 29.37, p = 0.04) and switch (B = - 39.49, p = 0.02) trials. In Trails A single effects models, sedentary behavior was associated with faster completion (B = - 0.97, p = 0.03) and light-intensity activity with slower completion (B = 1.25, p = 0.006). No single effects were observed relative to Trails B completion (all p > 0.05). Only the effect of MVPA was significant in the partition models (Trails A: B = - 3.55, p = 0.03; Trails B: B = - 4.46, p = 0.049). Replacing sedentary time with light-intensity activity was associated with slower Trails A (B = 1.55 p = 0.002) and Trails B (B = 1.69, p = 0.02) completion. Replacing light activity with MVPA yielded faster Trails A (B = - 4.35, p = 0.02) and Trails B (B = - 5.23, p = 0.03) completion. CONCLUSIONS: Findings support previous research suggesting MVPA may be needed to improve cognitive function in breast cancer survivors. Trails findings underscore the need to dissect sedentary contexts to better understand the impact of daily behavioral patterns on CRCI. Additional research investigating the cognitive impacts of behaviors across the 24-h period is warranted. TRIAL REGISTRATION: This study is registered with United States ClinicalTrials.gov ( NCT02523677 ; 8/14/2015).

Effects of physical activity on psychological well-being outcomes in breast cancer survivors from prediagnosis to posttreatment survivorship.

OBJECTIVE: The purpose of this study was to examine the effects of physical activity from prediagnosis to posttreatment survivorship on the psychological well-being (PWB) outcomes of fatigue, depression, anxiety, and quality of life (QoL) in breast cancer survivors (BCS). METHODS: Participants (N = 387) completed a questionnaire battery by using an iPad-based platform. Measures included self-reported PA (before diagnosis and currently) and perceptions of fatigue, depression, anxiety, and QoL. Multivariate analysis of covariance was used to examine differences in PWB among BCS categorized into 1 of 4 physical activity levels: (a) low-active prediagnosis, low-active currently (low-active maintainers; n = 128); (b) low-active prediagnosis, active currently (increasers; n = 74); (c) active prediagnosis, low-active currently (decreasers; n = 52); and (d) active prediagnosis, active currently (high-active maintainers; n = 136). Participants were classified as active (≥24 units) or low-active (<24 units) by using Godin Leisure-Time Exercise Questionnaire cut-points for health benefits. RESULTS: Fatigue and depression were lowest, and QoL was highest among women in the high-active maintainers category, followed by the increasers, low-active maintainers, and decreasers. No differences in anxiety were observed across categories. Women in the high-active maintainers category differed significantly in fatigue, depression, and QoL from both low-active categories (low-active maintainers and decreasers), P ≤ .001. Women in the increasers category also differed significantly in fatigue, depression, and QoL from the decreasers, P ≤ .01. CONCLUSION: Low physical activity during survivorship was associated with greater fatigue and depression and lower QoL. IMPLICATIONS FOR CANCER SURVIVORS: Efforts to help increase or maintain high levels of physical activity may be critical to helping BCS maintain their PWB.

Physical activity programming and counseling preferences among cancer survivors: a systematic review.

BACKGROUND: Physical activity (PA) participation and adherence among cancer survivors is low, despite research indicating numerous physical, psychological and emotional health benefits of exercise. Tailoring exercise programs specific to the PA preferences in cancer survivors has merit for increasing PA participation and adherence to accrue these benefits. This systematic review identifies and differentiates PA programming and counseling preferences of adult cancer survivors across various cancer survivor groups. METHODS: PubMed, SPORTDiscus, Scopus, PsycINFO, EMBASE, Web of Science and CINAHL were electronically searched (inception to Oct 2017) and articles were identified using PRISMA guidelines. Two reviewers independently assessed identified articles to determine eligibility and then individually performed a quality assessment on all final studies. Extracted and analyzed data included participant characteristics, interest in exercise counseling and programming, as well as specific exercise and counseling preferences (e.g. location, timing, intensity). RESULTS: Forty-one articles were included in this systematic review. Most studies assessed mixed cancer survivor groups or breast cancer survivors. Most cancer survivors felt able and interested in participating in a PA program, though starting a PA program after or before treatment was preferred. Walking was the strongest PA modality preference, and most cancer survivors preferred moderate intensity PA. Cancer survivors also indicated preferences for home-based PA that could take place in the morning. Slight preferences were found towards physical activity counseling delivered by a fitness expert from a cancer center. Both quantitative and qualitative studies were found to be of moderate to high quality based on the Appraisal Tool for Cross-Sectional Studies (AXIS) and the Consolidated Criteria for Reporting Qualitative Research (COREQ), respectively. CONCLUSION: Cancer survivors have an interest in participating in PA programs with walking as the primary modality. Additionally, morning-based PA programs that can be tapered to home-based programs are desirable. However, there was wide variation in other PA preference variables, suggesting multiple program options would be beneficial. Many cancer survivors felt interested and able to participate in PA, and therefore designing PA programs that are tailored to cancer survivors is integral for optimizing recruitment and adherence, as well as enhancing health outcomes in cancer survivors.

Physical Activity, Sedentary Behavior, and Physical Function in Older Adults With Multiple Sclerosis.

Older adults with multiple sclerosis (MS) experience the combined effects of aging and a chronic, disabling neurological disease on physical activity, sedentary behavior, and physical function. This study examined associations among light and moderate-to-vigorous physical activity (LPA and MVPA), sedentary behavior, and physical function in older adults with MS. Forty older adults with MS (median age = 60 years) who had a median Expanded Disability Status Scale score of 4.5 wore an accelerometer for a 7-day period and completed the Short Physical Performance Battery (SBBP), 6-minute walk (6MW), and timed 25-foot walk (T25FW). LPA was associated with SPPB (rs = .551, p < 0.01), 6MW (rs = .660, p < 0.01), and T25FW (rs = .623, p < 0.01) scores; MVPA was associated with 6MW (rs = .529, p < 0.01) and T25FW (rs = .403, p < 0.01) scores. There were significant associations between LPA, but not MVPA, with SPPB (ß = .583, p < 0.01), 6MW (ß = .613, p < 0.01), and T25FW (ß = .627, p < 0.01) scores in linear regression analyses. Older adults with MS who engaged in more LPA demonstrated better physical function and therefore LPA might be a target of future behavioral interventions.