The effects of acute exercise on stress reactivity assessed via a multidimensional approach: a systematic review.

Psychological stress is associated with numerous deleterious health effects. Accumulating evidence suggests acute exercise reduces stress reactivity. As stressors activate a wide array of psychological and physiological systems it is imperative stress responses are examined through a multidimensional lens. Moreover, it seems prudent to consider whether stress responses are influenced by exercise intervention characteristics such as modality, duration, intensity, timing, as well as participant fitness/physical activity levels. The current review therefore examined the role of acute exercise on stress reactivity through a multidimensional approach, as well as whether exercise intervention characteristics and participant fitness/physical activity levels may moderate these effects. Stress reactivity was assessed via heart rate, blood pressure, cortisol, catecholamines, and self-report. A systematic search following PRISMA guidelines of five databases was updated in November 2022. Reviewed studies met the following criteria: English language, participants aged ≥ 18, use of acute exercise, use of a validated stress-inducing task, and assessment(s) of stress reactivity. Thirty-one studies (1386 participants) were included. Acute exercise resulted in reliable reductions to blood pressure and cortisol. Acute exercise yielded mostly negligible effects on heart rate reactivity and negligible effects on self-report measures. As for exercise intervention characteristics, intensity-dependent effects were present, such that higher intensities yielded larger reductions to reactivity measures, while limited evidence was present for duration, modality, and timing-dependent effects. Regarding participant fitness/physical activity levels, the effects on stress reactivity were mixed. Future work should standardize the definitions and assessment time points of stress reactivity, as well as investigate the interaction between physiological and psychological stress responses in real-world contexts.

A single bout of passive exercise mitigates a mental fatigue-induced inhibitory control deficit.

Sustained cognitive effort associated with the psychomotor vigilance task (PVT) increases objective and subjective measures of mental fatigue and elicits a post-PVT inhibitory control deficit. In contrast, passive exercise wherein an individual's limbs are moved via an external force (i.e., mechanically driven cycle ergometer flywheel) provides a postexercise inhibitory control benefit linked to an exercise-based increase in cerebral blood flow. Here, we examined whether passive exercise performed concurrently with the PVT 'blunts' an inhibitory control deficit. On separate days, participants (N = 27) completed a 20 min PVT protocol (control condition) and same duration PVT protocol paired with passive cycle ergometry (passive exercise condition). Prior to (i.e., baseline), immediately after and 30 min after each condition inhibitory control was assessed via the antisaccade task. Antisaccades require a goal-directed eye movement (i.e., saccade) mirror-symmetrical to a target and provide an ideal tool for evaluating task-based changes in inhibitory control. PVT results showed that vigilance (as assessed via reaction time: RT) during control and passive exercise conditions decreased from the first to last 5 min of the protocol and increased subjective ratings of mental fatigue. As well, in the control condition, immediate (but not 30-min) post-intervention antisaccade RTs were longer than their baseline counterparts-a result evincing a transient mental fatigue-based inhibitory control deficit. For the passive exercise condition, immediate and 30-min post-intervention antisaccade RTs were shorter than their baseline counterparts and this result was linked to decreased subjective ratings of mental fatigue. Thus, passive exercise ameliorated the selective inhibitory control deficit associated with PVT-induced mental fatigue and thus provides a potential framework to reduce executive dysfunction in vigilance-demanding occupations.

Physical activity and prenatal depression: going beyond statistical significance by assessing the impact of reliable and clinical significant change.

BACKGROUND: Previous literature supports exercise as a preventative agent for prenatal depression; however, treatment effects for women at risk for prenatal depression remain unexplored. The purpose of the study was to examine whether exercise can lower depressive symptoms among women who began pregnancy at risk for depression using both a statistical significance and reliable and clinically significant change criteria. METHODS: This study is a secondary analysis of two randomized controlled trials that followed the same exercise protocol. Pregnant women were allocated to an exercise intervention group (IG) or control group (CG). All participants completed the Center for Epidemiological Depression (CES-D) scale at gestational week 9-16 and 36-38. Women with a baseline score ⩾16 were included. A clinically reliable cut-off was calculated as a 7-point change in scores from pre- to post-intervention. RESULTS: Thirty-six women in the IG and 25 women in the CG scored ⩾16 on the CES-D at baseline. At week 36-38 the IG had a statistically significant lower CES-D score (14.4 ± 8.6) than the CG (19.4 ± 11.1; p < 0.05). Twenty-two women in the IG (61%) had a clinically reliable decrease in their post-intervention score compared to eight women in the CG (32%; p < 0.05). Among the women who met the reliable change criteria, 18 (81%) in the IG and 7 (88%) in the CG had a score <16 post-intervention, with no difference between groups (p > 0.05). CONCLUSIONS: A structured exercise program might be a useful treatment option for women at risk for prenatal depression.

REducing SEDENTary Behavior Among Mild to Moderate Cognitively Impaired Assisted Living Residents: A Pilot Randomized Controlled Trial (RESEDENT Study).

Older adults in assisted living spend most of their day in sedentary behaviors, which may be detrimental to cognitive function. The primary purpose of this pilot study was to assess the feasibility of using a prompting device to reduce sitting time with light walking among older adults with mild to moderate cognitive impairment residing in an assisted living setting. A secondary purpose was to examine the effectiveness of the intervention on the residents' cognitive function, physical function, and quality of life. The participants (n = 25, mean age = 86.7 [5.3] years) were assigned in clusters into a two-arm 10-week single-site pilot randomized controlled trial. The intervention group was prompted with a watch to interrupt sedentary behaviors and partake in 10 min of light physical activity (i.e., walking) three times a day after a meal. The assessments included hip-worn accelerometers (Actical) and diaries, the Alzheimer's disease assessment scale-cognitive, Timed Up and Go, and the short-form 36 health survey. Adherence was high, as there were no dropouts, and over 70% of the participants completed over 80% of the prescribed physical activity bouts. Significant effects favoring the intervention were shown for all outcomes.

Adding team-based financial incentives to the Carrot Rewards physical activity app increases daily step count on a population scale: a 24-week matched case control study.

BACKGROUND: Mobile health applications (mHealth apps) targeting physical inactivity have increased in popularity yet are usually limited by low engagement. This study examined the impact of adding team-based incentives (Step Together Challenges, STCs) to an existing mHealth app (Carrot Rewards) that rewarded individual physical activity achievements. METHODS: A 24-week quasi-experimental study (retrospective matched pairs design) was conducted in three Canadian provinces (pre-intervention: weeks 1-12; intervention: weeks 13-24). Participants who used Carrot Rewards and STCs (experimental group) were matched with those who used Carrot Rewards only (controls) on age, gender, province and baseline mean daily step count (±500 steps/d). Carrot Rewards users earned individual-level incentives (worth $0.04 CAD) each day they reached a personalized daily step goal. With a single partner, STC users could earn team incentives ($0.40 CAD) for collaboratively reaching individual daily step goals 10 times in seven days (e.g., Partner A completes four goals and Partner B completes six goals in a week). RESULTS: The main analysis included 61,170 users (mean age = 32 yrs.; % female = 64). Controlling for pre-intervention mean daily step count, a significant difference in intervention mean daily step count favoured the experimental group (p < 0.0001; ηp2 = 0.024). The estimated marginal mean group difference was 537 steps per day, or 3759 steps per week (about 40 walking min/wk). Linear regression suggested a dose-response relationship between the number of STCs completed (app engagement) and intervention mean daily step count (adjusted R2 = 0.699) with each new STC corresponding to approximately 200 more steps per day. CONCLUSION: Despite an explosion of physical activity app interest, low engagement leading to small or no effects remains an industry hallmark. In this paper, we found that adding modest team-based incentives to the Carrot Rewards app increased mean daily step count, and importantly, app engagement moderated this effect. Others should consider novel small-teams based approaches to boost engagement and effects.

Are pre-pregnancy weight fluctuations and adherence to prenatal nutrition and exercise recommendations related to excessive gestational weight gain?

Women who have an overweight or obese pre-pregnancy body mass index (BMI) may be recommended to lose weight before pregnancy, however the association of preconception weight fluctuations and prenatal adherence to nutrition and exercise recommendations with gestational weight gain (GWG) have not been assessed. One hundred women with a pre-pregnancy BMI ≥ 25.0 kg/m2 who participated in the Nutrition and Exercise Lifestyle Intervention Program (NELIP) were included and stratified as gained weight excessively (n = 47) or not (n = 53) using the 2009 Institute of Medicine GWG guidelines. Participants completed a Weight Health History Questionnaire providing information about weight loss prior to the index pregnancy. Adherence was scored based on meeting six nutrition and exercise goals for the NELIP (/6). More women who gained excessively reported that they had actively tried to lose weight a year before the current pregnancy (61%) than women who did not gain excessively (39%; p = 0.02). Of the women attempting preconception weight loss, those who gained excessively lost more weight (6.7 ± 10.2 kg) than women who did not (2.1 ± 3.8 kg; p = 0.003). Adherence to the NELIP was lower among women who gained excessively (3.3 ± 0.8; 55%) than those who did not (4.4 ± 0.9;73%; p < 0.001). Program adherence (p < 0.001) was related to excessive GWG.

Sequential Introduction of Exercise First Followed by Nutrition Improves Program Adherence During Pregnancy: a Randomized Controlled Trial.

BACKGROUND: Adhering to nutrition and exercise recommendations simultaneously during pregnancy may be challenging. The purpose was to examine adherence to the sequential introduction of nutrition and exercise behaviors during pregnancy in comparison with a simultaneous approach. METHOD: A randomized controlled trial including nutrition and exercise was executed. Using a stratified body mass index (BMI) randomization, participants (n = 88) were allocated to one of three groups at 12-18 weeks gestation. Group A received nutrition and exercise simultaneously. Group B received nutrition first and Group C received exercise first, and the second behavior was added at 25 weeks gestation for both groups. The program included weekly weighing, supervised walking sessions, and/or nutrition counseling. Adherence (primary outcome) was measured by scoring women on meeting the intervention goals (3 nutrition and 3 exercise goals) and converted to a percentage. Secondary health outcomes were gestational weight gain (GWG) and excessive GWG on the program, birthweight, macrosomia (birthweight > 4000 g), and low birthweight (birthweight < 2500 g). RESULTS: Group C (n = 23) had the highest adherence to the program (80.2 ± 14.7%) compared with Groups A (n = 17; 60.9 ± 17.9%) and B (n = 20; 66.8 ± 16.7%; p < 0.05, ηp2 = 0.26). There was a significant effect for gestational weight gain (p < 0.05; ηp2 = 0.10) as Group C gained less weight (7.7 ± 2.2 kg) over Group B (9.8 ± 2.8 kg; p = 0.04), however, not Group A (9.1 ± 3.5, p = 0.35). Non-significant small effects favored Group C for the prevention of EGWG (Cramer's V = 0.13). CONCLUSION: Introducing exercise first followed by nutrition at 25 weeks gestation can improve adherence to multiple behavior change programs and thus have a positive effect on health outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02804061.

Implementation of clinical research trials using web-based and mobile devices: challenges and solutions.

BACKGROUND: With the increasing implementation of web-based, mobile health interventions in clinical trials, it is crucial for researchers to address the security and privacy concerns of patient information according to high ethical standards. The full process of meeting these standards is often made more complicated due to the use of internet-based technology and smartphones for treatment, telecommunication, and data collection; however, this process is not well-documented in the literature. RESULTS: The Smart Heart Trial is a single-arm feasibility study that is currently assessing the effects of a web-based, mobile lifestyle intervention for overweight and obese children and youth with congenital heart disease in Southwestern Ontario. Participants receive telephone counseling regarding nutrition and fitness; and complete goal-setting activities on a web-based application. This paper provides a detailed overview of the challenges the study faced in meeting the high standards of our Research Ethics Board, specifically regarding patient privacy. CONCLUSION: We outline our solutions, successes, limitations, and lessons learned to inform future similar studies; and model much needed transparency in ensuring high quality security and protection of patient privacy when using web-based and mobile devices for telecommunication and data collection in clinical research.

Exercise to Enhance Smoking Cessation: the Getting Physical on Cigarette Randomized Control Trial.

BACKGROUND: Exercise has been proposed as a useful smoking cessation aid. PURPOSE: The purpose of the present study is to determine the effect of an exercise-aided smoking cessation intervention program, with built-in maintenance components, on post-intervention 14-, 26- and 56-week cessation rates. METHOD: Female cigarette smokers (n = 413) participating in a supervised exercise and nicotine replacement therapy (NRT) smoking cessation program were randomized to one of four conditions: exercise + smoking cessation maintenance, exercise maintenance + contact control, smoking cessation maintenance + contact control or contact control. The primary outcome was continuous smoking abstinence. RESULTS: Abstinence differences were found between the exercise and equal contact non-exercise maintenance groups at weeks 14 (57 vs 43 %), 26 (27 vs 21 %) and 56 (26 vs 23.5 %), respectively. Only the week 14 difference approached significance, p = 0.08. CONCLUSIONS: An exercise-aided NRT smoking cessation program with built-in maintenance components enhances post-intervention cessation rates at week 14 but not at weeks 26 and 56.

A Domain-Specific Approach for Assessing Physical Activity Efficacy in Adolescents: From Scale Conception to Predictive Validity.

OBJECTIVE: To develop and test the utility of a domain-specific physical activity efficacy scale in adolescents for predicting physical activity behaviour. DESIGN: Two independent studies were conducted. Study 1 examined the psychometric properties of a newly constructed Domain-Specific Physical Activity Efficacy Questionnaire (DSPAEQ) and study 2 tested the utility of the scale for predicting leisure- and school-time physical activity. METHODS: In study 1, descriptive physical activity data were used to generate scale items. The scales factor structure and internal consistency were tested in a sample of 272 adolescents. A subsequent sample of Canadian (N = 104) and New Zealand (N = 29) adolescents, was recruited in study 2 to explore the scale's predictive validity using a subjective measure of leisure- and school-time physical activity. RESULTS: A principle axis factor analysis in study 1 revealed a 26-item, five-factor coherent and interpretable solution; representative of leisure and recreation, household, ambulatory, transportation, and school physical activity efficacy constructs, respectively. The five-factor solution explained 81% of the response variance. In study 2 the domain-specific efficacy model explained 16% and 1% of leisure- and school-time physical activity response variance, respectively, with leisure time physical activity efficacy identified as a unique and significant contributor of leisure-time physical activity. CONCLUSION: Study 1 provides evidence for the tenability of a five factor DSPEAQ, while study 2 shows that the DSPEAQ has utility in predicting domain-specific physical activity. This latter finding underscores the importance of scale correspondence between the behavioral elements (leisure-time physical activity) and cognitive assessment of those elements (leisure-time physical activity efficacy).

The ACT-i-Pass study protocol: How does free access to recreation opportunities impact children's physical activity levels?

BACKGROUND: Physical activity during childhood is associated with a multitude of physical, behavioural, and psychological health benefits. Identification of effective population level strategies for increasing children's physical activity levels is critical for improving the overall health of Canadians. The overall objective of this study is to assess how a naturally-occurring, community-level intervention which offers Grade 5 children in London, Canada a free access pass to physical activity opportunities (facilities and programs) for an entire school year can lead to increased physical activity among recipients. METHODS/DESIGN: This study adopts a longitudinal cohort study design to assess the effectiveness of improving children's access to physical activity opportunities for increasing their physical activity levels. To meet our overall objective we have three aims: (1) to assess whether the provision of free access increases children's physical activity levels during and after the intervention compared to a control group; (2) to assess how and why child-specific trajectories of physical activity (between-children differences in level of physical activity measured across time) in the intervention group differ according to children's individual and household characteristics; and (3) to explore additional factors that are unaccounted for in the theoretical model to gain a further understanding of why the free access intervention had varying effects on changing physical activity levels. We will be addressing these aims using a mixed methods approach, including: a series of youth surveys conducted before, during, immediately after, and 4-months after the intervention; parent surveys before, during, and post-intervention; real-time tracking of the access pass use during the intervention; and focus groups at the conclusion of the intervention. Data compiled from the youth surveys will provide a subjective measure of physical activity to be used as our outcome measure to address our primary aims. DISCUSSION: The results of this study can inform policy- and decision-makers about the sub-groups of the population that benefitted the most (or least) from the intervention to provide more specific information on how to develop and target future interventions to have a greater impact on the physical activity levels and overall health of children.

Exercise counseling to enhance smoking cessation outcomes: the Fit2Quit randomized controlled trial.

BACKGROUND: Regular exercise has been proposed as a potential smoking cessation aid. PURPOSE: This study aimed to determine the effects of an exercise counseling program on cigarette smoking abstinence at 24 weeks. METHODS: A parallel, two-arm, randomized controlled trial was conducted. Adult cigarette smokers (n = 906) who were insufficiently active and interested in quitting were randomized to receive the Fit2Quit intervention (10 exercise telephone counseling sessions over 6 months) plus usual care (behavioral counseling and nicotine replacement therapy) or usual care alone. RESULTS: There were no significant group differences in 7-day point-prevalence and continuous abstinence at 6 months. The more intervention calls successfully delivered, the lower the probability of smoking (OR, 0.88; 95 % CI 0.81-0.97, p = 0.01) in the intervention group. A significant difference was observed for leisure time physical activity (difference = 219.11 MET-minutes/week; 95 % CI 52.65-385.58; p = 0.01). CONCLUSIONS: Telephone-delivered exercise counseling may not be sufficient to improve smoking abstinence rates over and above existing smoking cessation services. (Australasian Clinical Trials Registry Number: ACTRN12609000637246.).

The effect of active video games by ethnicity, sex and fitness: subgroup analysis from a randomised controlled trial.

BACKGROUND: The prevention and treatment of childhood obesity is a key public health challenge. However, certain groups within populations have markedly different risk profiles for obesity and related health behaviours. Well-designed subgroup analysis can identify potential differential effects of obesity interventions, which may be important for reducing health inequalities. The study aim was to evaluate the consistency of the effects of active video games across important subgroups in a randomised controlled trial (RCT). FINDINGS: A two-arm, parallel RCT was conducted in overweight or obese children (n=322; aged 10-14 years) to determine the effect of active video games on body composition. Statistically significant overall treatment effects favouring the intervention group were found for body mass index, body mass index z-score and percentage body fat at 24 weeks. For these outcomes, pre-specified subgroup analyses were conducted among important baseline demographic (ethnicity, sex) and prognostic (cardiovascular fitness) groups. No statistically significant interaction effects were found between the treatment and subgroup terms in the main regression model (p=0.36 to 0.93), indicating a consistent treatment effect across these groups. CONCLUSIONS: Preliminary evidence suggests an active video games intervention had a consistent positive effect on body composition among important subgroups. This may support the use of these games as a pragmatic public health intervention to displace sedentary behaviour with physical activity in young people.

Using a combined protection motivation theory and health action process approach intervention to promote exercise during pregnancy.

Despite the benefits of exercise during pregnancy, many expectant mothers are inactive. This study examined whether augmenting a protection motivation theory (PMT) intervention with a Health Action Process Approach can enhance exercise behavior change among pregnant women. Sixty inactive pregnant women were randomly assigned to one of three treatment groups: PMT-only, PMT + action-planning, and PMT + action-and-coping-planning. Week-long objective (accelerometer) and subjective (self-report) exercise measures were collected at baseline, and at 1- and 4-weeks post-intervention. Repeated-measures ANOVAs demonstrated that while all participants reported increased exercise from baseline to 1-week post-intervention, participants in both planning groups were significantly more active (p < .001) than those in the PMT-only group by 4-weeks post-intervention (η (2) = .13 and .15 for accelerometer and self-report data, respectively). In conclusion, augmenting a PMT intervention with action or action-and-coping-planning can enhance exercise behavior change in pregnant women.

Effect of Lifestyle on Reducing Risk Factors for Type 2 Diabetes among Arab Canadian Muslim Women: A Randomized Control Trial.

PURPOSE: This study aimed to investigate whether modifiable risk factors for type 2 diabetes (T2D) can be reduced by an intensive healthy lifestyle intervention designed for Arab Muslim women of Middle Eastern descent (AWMD) who are at high risk for this disease. We hypothesized that among Canadian AWMD, the intervention would (a) reduce the identified health risk factors for T2D (body mass index [BMI], ≥30 kg·m-2; fasting blood glucose [FBG], ≥5.6 mmol·L-1; and waist circumference [WC], ≥80 cm); (b) improve anthropometric measurements; (c) improve lifestyle factors (physical activity level [steps per day] and dietary habits); and (d) improve cardiovascular fitness and reduce blood pressure. METHODS: After informed consent, 60 participants were randomized to either an exercise and nutrition group (ENG; n = 30) or a control group (CON; n = 30). ENG attended a women-only supervised exercise program that presented Arabic music and traditional Lebanese Dabka three times a week in a Mosque gym for 12 wk. A nutritionist was available 1 h·wk-1 for nutrition education. The CON followed their typical day. RESULTS: ENG and CON had similar increased risk profiles for diabetes at baseline. Large significant pre/posttreatment interaction effects were found for BMI, FBG, and WC with a reduced diabetes risk for ENG compared with CON for BMI (1,58) = 1184.8, P < 0.001), FBG (1,58) = 187.7, P < 0.001), and WC (1,58) = 326.4, P < 0.001). The ENG had significantly more participants reach postintervention target values (BMI: χ2(1) = 16.48, P = 0.001; FBG: χ2(1) = 52.26, P < 0.001; WC: χ2(1) = 4.29, P = 0.038) compared with the CON. Adherence to the program was 100%. CONCLUSIONS: Modifiable risk factors for T2D were reduced by using a culturally sensitive intervention program with high adherence through weight loss, regular exercise, and nutrition education.

When it comes to sedentary behaviour modification, should people be told what to do? A randomized comparison trial among home-based office workers living in Ontario, Canada.

The effects of adding choice architecture to a theory-based (Health Action Process Approach; HAPA) sedentary intervention remain unknown. To investigate whether choice architecture enhances a theory-based sedentary behaviour reduction intervention in home-based office workers. A 4-week HAPA-based intervention was conducted in London, Canada. Choice architecture was tested as an enhancement via a two (group: 'Choice of Intervention' vs. 'No Choice Intervention') by two (time: Baseline vs. Week 4) factorial repeated measure randomized comparison design. Sedentary behaviour reduction strategies focussed on obtaining a sedentary break frequency (BF) of every 30-45 min with break durations (BD) of 2-3 min. BF, BD, sitting, standing, and moving time were objectively measured (activPAL4™) at both time points. Participants (n = 148) were 44.9 ± 11.4 years old and 72.3% female. BF and total sitting time showed a time effect (P < .001), where both groups improved over the 4 weeks; there were no significant differences between groups across time. BD, standing, and moving time had a significant group by time effect where the 'No Choice' group showed significant increases in BD (P < .001), standing (P = .006), and moving time (P < .001) over the 4 weeks. Augmenting a theory-based intervention with choice architecture resulted in change in some sedentary behaviours in at home office workers. Specifically, while BF increased for all participants, the 'No Choice' group exhibited greater changes for BD, standing, and moving time compared with the 'Choice' group. Overall, these changes exceeded the intervention BF and BD goals.

The use of behaviour change theories has proven to be successful in reducing the amount people sit. However, it is unknown whether getting people to choose how and when they get up from sitting is better than just telling them how and when. This study explored the difference in sitting patterns across two groups: those that got to choose how and when to break up their sitting and those that did not get to choose. The study measured how often participants took breaks from sitting, how long the breaks were, as well as total sitting, standing, and moving time in Canadian home-based office workers. These measures were taken at baseline and 4 weeks later. The study aimed to achieve sitting breaks every 30­45 min with those breaks being to 2­3 min. One hundred and forty-eight participants were enrolled (average age = 44.9; 72.3% female). All participants took breaks more frequently and decreased their total time spent sitting over the 4-week period regardless of group assignment. Though, participants in the 'No Choice' group increased the length of their breaks from sitting and the total time they stood and moved over the study period. Overall, sitting break changes exceeded the intervention break duration goals.

Interventions to reduce sedentary behaviour in adults with type 2 diabetes: A systematic review and meta-analysis.

Treatment and management of Type 2 Diabetes (T2D) includes physical activity, nutrition, and pharmacological management. Recently, the importance of reducing and breaking up sedentary behaviour has become recognized. This review aimed to summarize and synthesize the effectiveness of interventions in reducing and/or breaking up sedentary behaviour and cardiometabolic biomarkers in adults with T2D. A study protocol was preregistered on PROSPERO (CRD42022357281) and a database search (PubMed, EMBASE, Scopus, Web of Science, PsycINFO, SPORTDiscus, CINAHL, and Cochrane Library) was conducted on 16/09/2022 and updated on 03/01/2024. This review followed PRISMA guidelines and study quality was assessed with the Cochrane risk of Bias Tools. Twenty-eight articles were included in the review. The meta-analysis of short-term (Range: 3 hours- 4 days) sedentary behaviour interventions found significant improvement in continuous interstitial glucose measured for 24 hours after the sedentary behaviour intervention compared to control (SMD:-0.819,95%CI:-1.255,-0.383,p<0.001). Similarly, there was a significant improvement in postprandial interstitial glucose after the sedentary behaviour intervention compared to control (SMD:-0.347,95%CI:-0.584,-0.110,p = 0.004). Ten out of eleven longer-term (Range: 5 weeks- 3 years) sedentary behaviour interventions improved at least one measure of sedentary behaviour compared to control. Eight out of eight longer-term sedentary behaviour interventions improved at least one cardiometabolic biomarker compared to control. Reducing sedentary behaviour, independent of physical activity, can improve glycemic control in adults with T2D. Further, sedentary behaviour may be a feasible/ sustainable behaviour change.

Acute stress negatively impacts on-task behavior and lecture comprehension.

Acute stress has been shown to disrupt cognitive and learning processes. The present study examined the effects of acute stress on mind wandering during a lecture and subsequent lecture comprehension in young adults. Forty participants were randomized to acute stress induction via the Trier Social Stress Test or rest prior to watching a twenty-minute video lecture with embedded mind wandering probes, followed by a lecture comprehension assessment. Stress responses were assessed via heart rate, blood pressure, salivary cortisol, and state anxiety. Individuals exposed to acute stress endorsed greater mind wandering at the first checkpoint and lower lecture comprehension scores. Moreover, state anxiety post stress was positively associated with mind wandering at the first and second checkpoint and negatively associated with lecture comprehension. Only mind wandering at the third checkpoint was negatively correlated with overall lecture comprehension. Taken together, these data suggest that acute stress, mind wandering, and lecture comprehension are inextricably linked.

Comparing the lower limb tasks questionnaire to the Western Ontario and McMaster Universities Osteoarthritis Index: agreement, responsiveness, and convergence with physical performance for knee osteoarthritis patients.

OBJECTIVE: To compare the Lower Limb Tasks Questionnaire (LLTQ) with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in terms of agreement, responsiveness, and convergence. DESIGN: Cross-sectional with an exploratory repeated-measures subsample analysis. SETTING: Community-based seniors' centers and arthritis clinics. PARTICIPANTS: Individuals with symptomatic knee osteoarthritis (N=76) participated, with a subsample of 18 participants contributing to the pre- and postarthroplasty subanalysis. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Bland and Altman plots of agreement with 95% limits of agreement, statistical responsiveness, and standardized response mean (SRM) were calculated for LLTQ and WOMAC subscales. Both t tests and Wilcoxon rank-sum tests were used to examine changes in pre- and postarthroplasty self-reported function, 50-ft walk speed, stair ascent/descent speed, and isometric quadriceps strength. RESULTS: The agreement (bias) of the LLTQ activities of daily living (ADL) subscale when compared with the WOMAC physical function (PF) subscale was 1%±10% (mean ± SD), and the 95% limits of agreement were -19% to +22%. The statistical responsiveness of the WOMAC-PF and LLTQ ADL was 1.17 and -.63, respectively. The SRMs for these scales were .90 and -.61, respectively. The WOMAC-PF scores showed a notable improvement over the first 6 weeks postarthroplasty, while LLTQ ADL scores were unchanged. The objective measures of function were all significantly worse at 6 weeks. CONCLUSIONS: The LLTQ demonstrated adequate agreement with the WOMAC and acceptable responsiveness for use in place of the WOMAC in nonspecialized clinics. The LLTQ may more accurately represent functional status after total knee arthroplasty, but further study in larger samples is recommended.