Changes in physical activity across a 6-month weight loss intervention in adolescents with intellectual and developmental disabilities.

BACKGROUND: Adolescents and young adults with intellectual and developmental disabilities (IDD) have high rates of obesity and low levels of physical activity. This analysis examined changes in light, moderate-to-vigorous physical activity (MVPA) and sedentary time, and the association between changes in MVPA and weight loss in adolescents and young adults with IDD and overweight and obesity participating in a 6-month multi-component weight loss intervention. METHODS: Adolescents and young adults with IDD and overweight or obesity (body mass index ≥ 85 percentile, n = 110, age ~16 years, 52.7% female) and a parent were randomised to one of three intervention groups: face-to-face delivery/conventional reduced energy diet (n = 36), remote delivery (RD)/conventional reduced energy diet (n = 39), or RD/reduced energy enhanced stop light diet (eSLD) (n = 35.) Participants were asked to engage in 60 min/day of MVPA on 5 or more days/wk. Participants and a parent attended twice monthly education/behavioural counselling sessions with a health educator to assist participants in complying with dietary and MVPA recommendations. Education/counselling in the RD arms was delivered remotely using video conferencing, and self-monitoring of MVPA and daily steps was completed using a wireless activity tracker. Education/counselling in the face-to-face arm was delivered during home-visits and self-monitoring of MVPA and daily steps was completed by self-report using paper tracking forms designed for individuals with IDD. MVPA, light activity, and sedentary time were assessed over 7 days at baseline and 6 months using a portable accelerometer (ActiGraph wGT3x-BT). RESULTS: Mixed modelling analysis completed using participants with valid accelerometer data (i.e. ≥4-10 h days) at baseline (n = 68) and 6 months (n = 30) revealed no significant changes in light, moderate- MVPA, or sedentary time across the 6-month intervention (all P > 0.05). Participants obtained 15.2 ± 21.5 min/day of MVPA at baseline and 19.7 ± 19.7 min/day at 6 months (P = 0.119). Mixed modelling indicated no significant effects of group (P = 0.79), time (P = 0.10), or group-by-time interaction (P = 0.21) on changes in MVPA from baseline to 6 months. Correlational analysis conducted on participants with valid accelerometer data at both baseline and 6 months (n = 24) revealed no significant associations between baseline sedentary time (r = 0.10, P = 0.40) and baseline MVPA (r = -0.22, P = 0.30) and change in MVPA across the 6-month intervention. Additionally, attendance at education/counselling sessions (r = 0.26, P = 0.22) and frequency of self-monitoring of MVPA were not significantly associated with change in MVPA from baseline to 6 months (r = 0.26, P = 0.44). Baseline MVPA (r = 0.02, P = 0.92) and change in MVPA from baseline to 6 months (r = 0.13, P = 0.30) were not associated with changes in body weight across the 6-month intervention. CONCLUSION: We observed a non-significant increase in MVPA (30%), which was not associated with the magnitude of weight loss in a sample of adolescents and young adults with IDD who participated in a 6-month multi-component weight loss intervention. Additional strategies to increase MVPA in adolescents and young adults with IDD participating in weight loss interventions need to be developed and evaluated.

Intrapersonal, interpersonal and environmental correlates of moderate to vigorous physical activity and sedentary time in adolescents with intellectual and developmental disabilities.

BACKGROUND: Although correlates of physical activity (PA) have been extensively examined in both children and adolescents who are typically developing, little is known about correlates of moderate to vigorous physical activity (MVPA) and sedentary time in adolescents with intellectual and developmental disabilities (IDD). Therefore, we examined intrapersonal, interpersonal and environmental factors and their association with device-based MVPA and sedentary time in adolescents with IDD. METHODS: MVPA and sedentary time was assessed using a hip-worn ActiGraph model wGT3x-BT tri-axial accelerometer across a 7-day period in adolescents with IDD and one of their parents. Pearson and point-biserial correlations were calculated to inspect the associations of PA (MVPA, sedentary time) with intrapersonal factors (demographic characteristic, BMI, waist circumference, motor ability, muscle strength, grip strength, cardiovascular fitness and self-efficacy for PA), interpersonal factors (parent demographics, parent BMI, parent MVPA and sedentary time, family social support for PA, parent barriers and support for PA, parent's beliefs/attitudes towards PA and number of siblings), and environmental factors (meteorologic season and COVID-19). Ordinary least squares regression was used to estimate the unique contributions of key factors to PA after controlling for participants' age, sex, race, waist circumference and total wear time. RESULTS: Ninety-two adolescents (15.5 ± 3.0 years old, 21.7% non-White, 6.5% Hispanic, 56.5% female) provided valid accelerometer data. Average sedentary time was 494.6 ± 136.4 min/day and average MVPA was 19.8 ± 24.2 min/day. Age (r = 0.27, P = 0.01), diagnosis of congenital heart disease (r = -0.26, P = 0.01) and parent sedentary time (r = 0.30, P = 0.01) were correlated with sedentary time. BMI (r = -0.24, P = 0.03), waist circumference (r = -0.28, P = 0.01), identifying as White (r = -0.23, P = 0.03) and parent MVPA (r = 0.56, P < 0.001) were correlated with MVPA. After adjusting for the adolescent's age, sex, race, waist circumference, and total wear time, the association between parent and adolescent MVPA remained significant (b = 0.55, P < 0.01, partial η2  = 0.11). CONCLUSION: The results of this study provide evidence that race, waist circumference and parental MVPA may influence the amount of MVPA in adolescents with IDD. The limited available information and the potential health benefits of increased MVPA highlight the need to evaluate the effectiveness of multi-component interventions targeting both intrapersonal and interpersonal levels to promote increased PA in adolescents with IDD.

The feasibility of using pedometers for self-report of steps and accelerometers for measuring physical activity in adults with intellectual and developmental disabilities across an 18-month intervention.

BACKGROUND: Improving physical activity in adults with intellectual and developmental disabilities (IDDs) is recommended to improve weight loss and general health. However, in order to determine the success of physical activity interventions, identification of feasible methods for assessment of physical activities is necessary. The purpose of this study is to assess the feasibility of adults with IDD to track daily steps and wear an accelerometer. METHODS: Overweight/obese adults with mild to moderate IDD followed a diet and physical activity program for 18 months. All participants were asked to wear a pedometer and track steps daily by using a pedometer and to provide accelerometer data for 7 days at baseline, 6, 12 and 18 months. Adherence to the pedometer protocol and plausibility of the number of recorded steps were assessed, and these measures along with average wear time of the accelerometer were recorded. RESULTS: Data were collected from 149 participants (36.5 ± 12.2 years of age, 57% female). Participants recorded a step value on 81.5% of days across the 18-month study, with 40.9% of written days classified as plausible. When wearing the accelerometer, 26.8% of participants met the recommended 4-day/10-h wear time criterion at baseline, and 22.6, 24.8 and 18.8% met the criterion at 6, 12 and 18 months, respectively. CONCLUSIONS: Adults with IDD will adhere reasonably well to wearing a pedometer long term, but may be unable to record the step data accurately. Furthermore, adults with IDD have poor compliance with accelerometer protocols, and future studies should determine if a shorter wear time protocol would produce valid data in this population.

Remote delivery of a weight management intervention for adults with intellectual disabilities: Results from a randomized non-inferiority trial.

BACKGROUND: Remote delivery of multi-component weight management interventions results in clinically meaningful weight loss in adults without intellectual disabilities (ID), but the effectiveness of remotely delivered weight management interventions in adults with ID has not previously been evaluated. OBJECTIVE: To determine if a weight management intervention delivered remotely could achieve weight loss (kg) at 6 months that is non-inferior to in-person visits in adults with ID and overweight or obesity (BMI ≥25 kg/m2). METHODS: Participants were randomized to a 24-mo. trial (6 mos weight loss,12 mos weight maintenance, 6 mos. no-contact follow up) to compare weight loss achieved with the same multicomponent intervention delivered to individual participants in their home either remotely (RD) or during face-to-face home visits (FTF). RESULTS: One hundred twenty adults with ID (∼32 years of age, 53 % females) were randomized to the RD (n = 60) or the FTF arm (n = 60). Six-month weight loss in the RD arm (-4.9 ± 7.8 kg) was superior to 6-month weight loss achieved in the FTF arm (-2.1 ± 6.7 kg, p = 0.047). However, this may be partially attributed to the COVID-19 pandemic, since weight loss in the FTF arm was greater in participants who completed the intervention entirely pre-COVID (n = 33,-3.2 %) compared to post-COVID (n = 22, -0.61 %). Weight loss across did not differ significantly between intervention arms at 18 (p = 0.33) or 24 months (p = 0.34). CONCLUSION: Our results suggest that remote delivery is a viable option for achieving clinically relevant weight loss and maintenance in adults with ID. NCT REGISTRATION: NCT03291509.

One set resistance training: effect on body composition in overweight young adults.

AIM: This study evaluate the impact of a 6-month, 1-set RT protocol on changes in weight and body composition in overweight young adults. METHODS: Sixty-three overweight young adults were randomized to RT or control; 55 participants (RT: N.=32; C: N.=23; BMI=27.3+2.9; age=20.7+2.7 yrs) competed the 6 month training protocol and all assessments. RT consisted of 1-set, 9 exercises, 3 times/wk., with a resistance of 3-6 repetition maximum (RM). Body composition was assessed using dual energy X-ray absorptiometry, and strength using 1RM. Participants were instructed to maintain their normal ad libitum diet and normal activities of daily living. RESULTS: Body weight and BMI increased significantly (P<0.05) in RT and C, however; the between group difference was not significant. RT induced a mean increase in fat-free mass of 1.5 kg in both males and females with significant between groups differences for change in fat-free mass noted in the total sample, and in both males and females. Between group differences for change in fat mass were not statistically significant in the total sample, or in either gender. Significant between group differences for change in % fat were noted in the total sample (RT=-0.3%, C=+5.8%, P<0.05) and in females (RT=-3.7%, C=+3.0%, P<0.01), but not in males (RT=3.4%, C=9.8%). Significant between group differences (P<0.001) were observed for change in chest (RT=45 %, C=3%) and leg press (RT=57 %, C=9%) maximal strength. CONCLUSION: A 6 month, 1-set RT program in overweight young adults increased fat-free mass and prevented increases in fat mass and % fat.

Individual and family-based approaches to increase physical activity in adolescents with intellectual and developmental disabilities: Rationale and design for an 18 month randomized trial.

Adolescents with intellectual and developmental disabilities (IDD) are less physically active and have lower cardiovascular fitness compared with their typically developing peers. This population faces additional barriers to participation in moderate-to-vigorous physical activity (MVPA) such as reliance on parents, lack of peer-support, and lack of inclusive physical activity opportunities. Previous interventions to increase MVPA in adolescents with IDD have met with limited success, at least in part due to requiring parents to transport their adolescent to an exercise facility. We recently developed a remote system to deliver MVPA to groups of adolescents with IDD in their homes via video conferencing on a tablet computer. This approach eliminates the need for transportation and provides social interaction and support from both a health coach and other participants. We will conduct a 18-mo. trial (6 mos. active, 6 mos. maintenance, 6 mos. no-contact follow-up) to compare changes in objectively assessed MVPA in 114 adolescents with IDD randomized to a single level intervention delivered only to the adolescent (AO) or a multi-level intervention delivered to both the adolescent and a parent (A + P). Our primary aim is to compare increases in MVPA (min/d) between the AO and A + P groups from 0 to 6 mos. Secondarily we will compare changes in MVPA, sedentary time, cardiovascular fitness, muscular strength, motor ability, quality of life, and the percentage of adolescents achieving the US recommendation of 60 min. MVPA/d across 18 mos. We will also explore the influence of process variables/participant characteristics on changes in MVPA across 18 mos. NCT registration: NCT03684512.

Caregivers' effect on weight management in adults with intellectual and developmental disabilities.

INTRODUCTION: Caregivers of adults with IDD often play a large role in the ability of adults with IDD to lose weight. OBJECTIVE: The purpose of this study was to determine to examine the effects of the caregivers' perceived burdens and self-efficacy and their relationship to an individual (family member or paid staff) on weight changes across a weight management intervention for adults with IDD. METHODS: Overweight/obese adults with mild to moderate IDD, along with assigned caregivers who served as their study partner, were randomized to an 18-month weight management intervention. The living environment and caregiver relationship were assessed at baseline. Caregivers completed questionnaires regarding perceived hassles, uplifts, and self-efficacy in helping the participant follow a weight management intervention. RESULTS: 147 adults with IDD (∼57% women and ∼16% minorities) were included in data analysis. After 18 months, there were no differences in weight loss between participants who had a family member as their study partner and those who had a paid assistant as their study partner (-5.5 ± 5.2% vs. -5.6± 5.3% p = 0.16). However, paid assistants reported more hassles with following the diet intervention at 6 months (p < 0.05). Participants who had a paid assistant as their study partner were more likely to have multiple study partners during the study, which was correlated with smaller weight loss. CONCLUSION: While caregivers are important for weight management of adults with IDD, the caregiver's relationship to the participant does not affect weight change in an intervention.

A virtual reality intervention (Second Life) to improve weight maintenance: Rationale and design for an 18-month randomized trial.

Despite the plethora of weight loss programs available in the US, the prevalence of overweight and obesity (BMI≥25kg/m(2)) among US adults continues to rise at least, in part, due to the high probability of weight regain following weight loss. Thus, the development and evaluation of novel interventions designed to improve weight maintenance are clearly needed. Virtual reality environments offer a promising platform for delivering weight maintenance interventions as they provide rapid feedback, learner experimentation, real-time personalized task selection and exploration. Utilizing virtual reality during weight maintenance allows individuals to engage in repeated experiential learning, practice skills, and participate in real-life scenarios without real-life repercussions, which may diminish weight regain. We will conduct an 18-month effectiveness trial (6 months weight loss, 12 months weight maintenance) in 202 overweight/obese adults (BMI 25-44.9kg/m(2)). Participants who achieve ≥5% weight loss following a 6month weight loss intervention delivered by phone conference call will be randomized to weight maintenance interventions delivered by conference call or conducted in a virtual environment (Second Life®). The primary aim of the study is to compare weight change during maintenance between the phone conference call and virtual groups. Secondarily, potential mediators of weight change including energy and macronutrient intake, physical activity, consumption of fruits and vegetables, self-efficacy for both physical activity and diet, and attendance and completion of experiential learning assignments will also be assessed.

Weight management for adolescents with intellectual and developmental disabilities: Rationale and design for an 18month randomized trial.

Adolescents with intellectual and developmental disabilities (IDD) are an underserved group in need of weight management. However, information regarding effective weight management for this group is limited, and is based primarily on results from small, non-powered, non-randomized trials that were not conducted in accordance with current weight management guidelines. Additionally, the comparative effectiveness of emerging dietary approaches, such as portion-controlled meals (PCMs) or program delivery strategies such as video chat using tablet computers have not been evaluated. Therefore, we will conduct an 18month trial to compare weight loss (6months) and maintenance (7-18months) in 123 overweight/obese adolescents with mild to moderate IDD, and a parent, randomized to a weight management intervention delivered remotely using FaceTime™ on an iPad using either a conventional meal plan diet (RD/CD) or a Stop Light diet enhanced with PCMs (RD/eSLD), or conventional diet delivered during face-to-face home visits (FTF/CD). This design will provide an adequately powered comparison of both diet (CD vs. eSLD) and delivery strategy (FTF vs. RD). Exploratory analyses will examine the influence of behavioral session attendance, compliance with recommendations for diet (energy intake), physical activity (min/day), self-monitoring of diet and physical activity, medications, and parental variables including diet quality, physical activity, baseline weight, weight change, and beliefs and attitudes regarding diet and physical activity on both weight loss and maintenance. We will also complete a cost and contingent valuation analysis to compare costs between RD and FTF delivery.

Echocardiographic left ventricular mass and physical activity: quantification of the relation in spinal cord injured and apparently healthy active men.

To assess the relation of echocardiographic left ventricular (LV) mass to reported physical activity, 2 groups of subjects with widely different physical activity levels were evaluated: 50 men with spinal cord injuries and 166 apparently healthy, active men. Multivariate analysis revealed that reported physical activity was a significant independent predictor of LV mass index (LV mass/body surface area) in both injured patients and healthy, active subjects after controlling for age and blood pressure. The relation between LV mass index and physical activity (linear regression) was similar for both groups; LV mass index = 0.00321 (physical activity) + 82.8 and LV mass index = 0.00335 (physical activity) +88.4 for patients and healthy active subjects, respectively. These results suggest that physical activity as assessed by self-report is associated with echocardiographically detectable differences in LV mass in groups with widely divergent physical activity levels. In addition, for each of these groups 1,000 kcal/week of physical activity apparently results in a change of approximately 3 g/m2 in LV mass index. This information may have practical use for correction of LV mass for the effects of physical activity.

Reliability and physiologic correlates of the Harvard Alumni Activity Survey in a general population.

The reliability of the Harvard Alumni Activity Survey (HAAS) and its association with physiologic measures was assessed in a large sample of men and women aged 25-65 years residing in the Boston metropolitan area in 1987. Reliability was estimated by comparing HAAS energy expenditure reports (kcal/week) from two separate interviews conducted 7-12 weeks apart. The test-retest reliability coefficient was 0.58 for the entire sample, but was considerably higher (r = 0.69) for those whose activity patterns had not changed from one interview to the next. HAAS self-reports were compared to two physiologic measures known to be affected by physical activity: high density lipoprotein cholesterol (HDLC) and body mass index (BMI). The natural logarithm of weekly HAAS expenditures was positively correlated with HDLC (r = 0.14, p less than 0.01) and negatively correlated with BMI (r = 0.13, p less than 0.01) for all respondents. These statistically significant associations persisted when adjusted for other covariates influencing physiologic status. The reliability coefficients and physiologic correlations for the HAAS in this sample are comparable to those reported for physical activity instruments requiring more intensive data collection and scoring procedures.

The Physical Activity Scale for the Elderly (PASE): development and evaluation.

A Physical Activity Scale for the Elderly (PASE) was evaluated in a sample of community-dwelling, older adults. Respondents were randomly assigned to complete the PASE by mail or telephone before or after a home visit assessment. Item weights for the PASE were derived by regressing a physical activity principal component score on responses to the PASE. The component score was based on 3-day motion sensor counts, a 3-day physical activity dairy and a global activity self-assessment. Test-retest reliability, assessed over a 3-7 week interval, was 0.75 (95% CI = 0.69-0.80). Reliability for mail administration (r = 0.84) was higher than for telephone administration (r = 0.68). Construct validity was established by correlating PASE scores with health status and physiologic measures. As hypothesized, PASE scores were positively associated with grip strength (r = 0.37), static balance (r = +0.33), leg strength (r = 0.25) and negatively correlated with resting heart rate (r = -0.13), age (r = -0.34) and perceived health status (r = -0.34); and overall Sickness Impact Profile score (r = -0.42). The PASE is a brief, easily scored, reliable and valid instrument for the assessment of physical activity in epidemiologic studies of older people.

The physical activity scale for the elderly (PASE): evidence for validity.

We assessed the validity of the Physical Activity Scale for the Elderly (PASE) in a sample of sedentary adults (56 men, 134 women, mean age +/- [SD] 66.5+/-5.3 years) who volunteered to participate in a randomized controlled trial on the effect of aerobic conditioning on psychological function. Construct validity was established by correlating PASE scores with physiologic and performance characteristics: peak oxygen uptake, resting heart rate and blood pressure, percent body fat, and balance. The mean PASE scores were higher in men than in women (men = 145.8+/-78.0; women = 123.9+/-66.3, P<0.05), and in those age 55-64 years compared with those age 65 years and over (55-64 = 144.2+/-75.8; 65 and over = 118.9+/-63.9, P<0.05). PASE scores were also significantly higher in those who did not report a chronic health condition (cardiovascular disease, hypertension, cancer, or recent surgery). PASE scores were significantly associated (P<0.05) with peak oxygen uptake (r = 0.20), systolic blood pressure (r = -0.18) and balance score (r = 0.20). No significant associations of PASE score and diastolic blood pressure, resting heart rate, or percent body fat were noted. These results provide additional evidence for the validity of the PASE as a measure of physical activity suitable for use in epidemiology studies on the association of physical activity, health, and physical function in older individuals.

Chronic low level physical activity as a determinant of high density lipoprotein cholesterol and subfractions.

Physical activity has been associated with reduced risk of coronary heart disease. A mechanism for the reduced risk may be through increased high density lipoprotein cholesterol (HDL-C) and subfractions, in particular HDL2-C. Research associated with increased physical activity investigating HLD-C have assessed the effects of intense aerobic activity. The current research evaluated the relationship between low intensity, long duration activity to HDL-C and subfractions in 35 active postal carriers. Measurements of physical activity via the Large Scale Integrated monitor and reported miles walked, and lipoproteins were assessed at 3-month intervals over a 1-year period. Reported miles walked/day (5.3) was significantly correlated with HLD2-C (r = 0.50, P = 0.003) and approached significance for HDL-C (r = 0.29, P = 0.06). The Large Scale Integrated measures were correlated with HDL-C (r = 0.44, P = 0.008) and HDL2-C (r = 0.44, P = 0.007). Controlling for either age, alcohol consumption, body mass index, or leisure time activity did not reduce the relationship between reported miles walked or Large Scale Integrated readings and HDL2-C, suggesting that the increased HDL-C was the result of long duration, low intensity physical activity.

Cardiovascular response to static contraction in borderline hypertension.

Nine young males with borderline hypertension (BH) (mean age +/- SD, 25 +/- 5 yr) and 13 young male normotensive controls (NT) (24 +/- 3 yr) were studied to determine their cardiovascular responses to small and large muscle static contractions. The subjects performed one-arm handgrip and two-leg extension in a randomly assigned order for 3 min at 30% of maximal voluntary contraction. Mean intra-arterial blood pressure (MABP), heart rate (HR), and tension were measured throughout the contractions. Borderline hypertensive patients had a higher MABP at rest (p less than 0.005) and at the end of both types of static contractions (p less than 0.05). The average increases in MABP from rest to the end of exercise (delta MABP) were slightly greater for the BH patients (6 mmHg), but these differences were not significant (p greater than 0.1). However, a greater percentage of BH patients were hyperreactive to handgrip (delta BP greater than 35 mmHg) and leg extension (delta BP greater than 40 mmHg) when compared to controls. These data indicate that, in general, young men with borderline hypertension demonstrate normal cardiovascular regulation in response to static contraction, but that a portion of this population may be hyperreactive to this type of circulatory stress.

Physical activity, stress, and type A behavior in blacks.

We assessed the relationship between potential risk factors for coronary heart disease, including type A behavior, leisure time physical activity, and stress in a young black adult population. The study population consisted of 192 black college freshmen at the University of Pittsburgh. The mean age of male subjects was 18.4; the mean age of female subjects was 18.5 years. No significant sex differences were noted for body mass index, type A behavior, stress, or physical activity levels. For both men and women, type A (Framingham) was positively correlated with stress. Only among women was there a positive association between type A (Bortner) and physical activity.

Physical activity and high-density lipoprotein cholesterol and subfractions among young black adults.

Limited information is available regarding the relationship between physical activity and blood lipids in black populations. To assess the association, the authors measured high-density lipoprotein cholesterol (HDL-C) and subfractions (HDL(2)-C, HDL(3)-C), physical activity (Harvard Alumni Survey), height, weight, cigarette, alcohol, and oral contraceptive use (questionnaire) in a sample of 173 black freshmen college students at the University of Pittsburgh (59 male, 55 female) and Paine and Augusta colleges in Georgia (14 male, 18 female).Results indicated HDL-C, HDL(2)-C, and HDL(3)-C were significantly higher among women compared with men after adjustment for age, body mass index, alcohol consumption, physical activity, and oral contraceptive use. No significant sex differences were noted for physical activity, however a significantly greater proportion of women reported low physical activity levels (<2000 kcal/wk, 54 percent female, 31 percent male, P < .05). Physical activity was univariately associated with HDL-C (r = .32, P < .01) and HDL(2)-C (r = .29, P < .05) among women. No significant correlations among physical activity and lipid variables were noted among men. The results from stepwise multiple linear regression models (variables included were age, body mass index, physical activity, and oral contraceptive use) revealed that among women physical activity was the only significant independent predictor of both HDL-C and HDL(2)-C explaining 11 and 9 percent of the variance in HDL-C and HDL(2)-C, respectively. Physical activity was not a significant predictor of any of the lipid variables among men.If confirmed, the study finding of a significant association between physical activity and HDL-C and HDL(2)-C among black women suggests that increased physical activity may be an important intervention for the reduction of cardiovascular risk in this high-risk group.

Physical Activity Scale for the Elderly (PASE): the relationship with activity measured by a portable accelerometer.

BACKGROUND: The purpose of this study was to examine the validity of the Physical Activity Scale for the Elderly (PASE) by comparing PASE scores with physical activity assessed by a portable accelerometer. EXPERIMENTAL DESIGN: Correlational-mean activity level over a 3-day period was correlated with PASE scores. SETTING: Physical activity of participants was monitored over 3 days during normal daily activity. PARTICIPANTS: Twenty healthy adult volunteers, 67-80 years of age, participated in this study. MEASURES: Physical activity from 09:00 to 21:00 hours was assessed over 3 consecutive weekdays (Wednesday-Friday) using a Computer Science and Applications, Inc. (CSA) portable accelerometer. Following completion of the 3-day monitoring period physical activity was assessed with the PASE. RESULTS: PASE scores were significantly correlated with average 3-day CSA readings (r = 0.49, p < 0.05) in the total sample and in those over age 70 years (r = 0.64, p < 0.5). CONCLUSIONS: These results add to the literature supporting the validity of the PASE as a measure of physical activity in older individuals.

The objective assessment of physical activity in an occupationally active group.

Thirty-five male United States postal carriers, mean age (+/-SD) 46.1 +/- 11.4 years, mean distance walked on the job 5.3 +/- 3.3 miles day-1, participated in this study to determine the efficacy of two movement sensors for the assessment of daily physical activity. Subjects wore both a Large Scale Integrated Activity Monitor (LSI) and a Caltrac portable accelerometer on a belt for 3 days (2 work days, 1 non-work day) for 2 separate trials separated by a 3 month interval. Both monitors indicated similar mean levels of physical activity over the 2 work days with a significant decrease on the non-work day. Test-retest reliability within one trial over the 2 work days (LSI, r = 0.64; Caltrac, r = 0.58) and and between 2 trials (LSI, r = 0.58, Caltrac, r = 0.57), were similar for both monitors. The mean values for the LSI and Caltrac over the 2 trials were highly related (r = 0.75). Analysis of variance indicated a high percentage of the total variance in physical activity was accounted for by interindividual differences for both monitors (LSI = 77.4%, Caltrac = 77.7%). These results suggest that both the LSI and the Caltrac provide a reliable index of physical activity and can detect inter-individual differences in activity level in occupationally active individuals.

Cardiovascular responses to moderate facial cooling in men and women.

Experiments were conducted on a group of 20 healthy men and women to determine the pattern of cardiovascular response to moderate facial cooling (4.0 degrees C at 5.0 m X s-1) for 10 min. Data were collected each minute during exposure. During the course of exposure, both heart rate and forearm blood flow decreased significantly, 4.9 beats X min-1 (-9.2%) and -1.1 ml X 100 ml-1 X min-1 (-28.9%), respectively, while mean arterial blood pressure increased significantly +3.7 mm Hg (+4.0%) from pre-exposure values (p less than 0.05). There were no significant differences found in cardiovascular responses between men and women. There was considerable within-group variation for each recorded cardiovascular variable, but their ranges of variability remained relatively constant throughout exposure. These results indicate that moderate facial cooling precipitates significant cardiovascular responses in healthy subjects and the range of response may depend, in part, on individual factors.