Comparing national device-based physical activity surveillance systems: a systematic review.

BACKGROUND: Physical activity surveillance systems are important for public health monitoring but rely mostly on self-report measurement of physical activity. Integration of device-based measurements in such systems can improve population estimates, however this is still relatively uncommon in existing surveillance systems. This systematic review aims to create an overview of the methodology used in existing device-based national PA surveillance systems. METHODS: Four literature databases (PubMed, Embase.com, SPORTDiscus and Web of Science) were searched, supplemented with backward tracking. Articles were included if they reported on population-based (inter)national surveillance systems measuring PA, sedentary time and/or adherence to PA guidelines. When available and in English, the methodological reports of the identified surveillance studies were also included for data extraction. RESULTS: This systematic literature search followed the PRISMA guidelines and yielded 34 articles and an additional 18 methodological reports, reporting on 28 studies, which in turn reported on one or multiple waves of 15 different national and 1 international surveillance system. The included studies showed substantial variation between (waves of) systems in number of participants, response rates, population representativeness and recruitment. In contrast, the methods were similar on data reduction definitions (e.g. minimal number of valid days, non-wear time and necessary wear time for a valid day). CONCLUSIONS: The results of this review indicate that few countries use device-based PA measurement in their surveillance system. The employed methodology is diverse, which hampers comparability between countries and calls for more standardized methods as well as standardized reporting on these methods. The results from this review can help inform the integration of device-based PA measurement in (inter)national surveillance systems.

Effectiveness of pedometer-based walking programmes in improving some modifiable risk factors of stroke among community-dwelling older adults: a systematic review, theoretical synthesis and meta-analysis.

BACKGROUND: Pedometer-based walking programs hold promise as a health promotion strategy for stroke prevention in community-dwelling older adults, particularly when targeted at physical activity-related modifiable risk factors. The question arises: What is the effectiveness of pedometer-based walking program interventions in improving modifiable stroke risk factors among community-dwelling older adults? METHOD: Eight databases were searched up to December 2nd, 2023, following the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. Inclusion criteria focused on randomized controlled trials (RCTS) involving community-dwelling older adults and reported in English. Two independent reviewers utilized Physiotherapy Evidence Database (PEDro) tool to extract data, assess eligibility, evaluate study quality, and identify potential bias. Standardized mean difference (SMD) was employed as summary statistics for primary -physical activity level -and secondary outcomes related to cardiovascular function (blood pressure) and metabolic syndrome, including obesity (measured by body mass index and waist circumference), fasting blood sugar, glycated hemoglobin, high-density lipoprotein cholesterol (HDL-C), and triglycerides. A random-effects model was used to generate summary estimates of effects. RESULTS: The review analyzed eight studies involving 1546 participants aged 60-85 years, with 1348 successfully completing the studies. Across these studies, pedometer-based walking programs were implemented 2-3 times per week, with sessions lasting 40-60 minutes, over a duration of 4-26 weeks. The risk of bias varied from high to moderate. Our narrative synthesis revealed positive trends in HDL-C levels, fasting blood sugar, and glycated hemoglobin, suggesting improved glycemic control and long-term blood sugar management. However, the impact on triglycerides was only marginal. Primary meta-analysis demonstrated significantly improved physical activity behavior (SMD=0.44,95%CI:0.26, 0.61,p=<0.00001;I2=0%;4 studies; 532 participants) and systolic blood pressure (SMD=-0.34,95%CI:-0.59,-0.09;p=<0.008;I2=65%,2 studies;249 participants), unlike diastolic blood pressure (SMD=0.13,95%CI:-0.13,-0.38,p=0.33; I2=91%; 2 studies; 237 participants). Interventions based on social cognitive, self-efficacy, and self-efficiency theory(ies), and social cognitive theory applied in an ecological framework, were linked to successful physical activity behavior outcomes. CONCLUSION: Pedometer-based walking programs, utilizing interpersonal health behavior theory/ecological framework, enhance physical activity behavior and have antihypertensive effects in community-dwelling older adults. While they do not significantly affect diastolic blood pressure, these programs potentially serve as a primary stroke prevention strategy aligning with global health goals. TRIAL REGISTRATION: Registration Number: INPLASY202230118.

Use of activity trackers to improve blood pressure in young people at risk for cardiovascular disease: a pilot randomized controlled trial.

BACKGROUND: Promoting physical activity among young individuals with cardiovascular disease (CVD) risk factors such as hypertension, diabetes, or chronic kidney disease can lower systolic blood pressure (BP). We sought to determine whether a 6-month intervention using a physical activity tracker was feasible and effective, compared with usual care. METHODS: Participants were recruited at a single academic medical center. Those aged 8-30 years were randomized in a 2:1 ratio to either the intervention (use of a Fitbit physical activity tracker coupled with feedback regarding the participant's step count) or usual care. The primary feasibility outcomes were screening-to-enrollment ratio and 6-month retention rates; the primary clinical outcome was a change in systolic BP from 0-6 months. RESULTS: Sixty-three participants were enrolled (57% male; mean age: 18 ± 4 years). The screening-to-enrollment ratio was 1.8:1. Six-month retention was 62% in the intervention group and 86% in the control group (p = 0.08). Mean change in systolic BP in the intervention group was not significantly different from the control group at 6 months (- 2.3 mmHg; 95% CI - 6.5, 1.8 vs. 3.0 mmHg; 95% CI - 2.5, 8.4, respectively, p = 0.12). CONCLUSIONS: Among children and young adults at elevated CVD risk, the use of a physical activity tracker coupled with tailored feedback regarding their step count progress was feasible but not sustained over time. Physical activity tracker use did not have a statistically significant effect on BP after 6 months. Augmented strategies to mitigate risk in young patients at high risk for early-onset CVD should be explored. This trial is registered at ClinicalTrials.gov (NCT03325426).

Social effects on behaviorally-scored and pedometer-detected estrus in beef cattle.

The number of cows in estrus often influences estrus behavior; however, the effects of social order are not well documented. This study examined the effects of social order on the expression of behaviorally-scored and pedometer-detected estrus, combined with the effects of the number of cows in estrus. In a herd comprising 13 or 15 beef cattle, cows with orders 1st-7th were defined as dominant and the remaining cows as subordinate. Sole or simultaneous estrus was induced by prostaglandin F2α analog injection and/or intravaginal progesterone treatment. Ovulation timing was determined using ultrasonography at 6-hour intervals. Estrous signs and steps of the cows were recorded 49 h before ovulation using video monitoring and a pedometer, respectively. Among the 59 treated cows, 56 behaviorally-scored estruses (27 sole and 29 simultaneous) were detected. In the sole estrus, 61.5% of the dominant-rank cows had no zero-point period; however, 35.7% of the subordinate-rank cows had that period. The dominant-rank cows in estrus alone had a significantly shorter duration of scored estrus than those in simultaneous estrus (P < 0.05). Among the 50 pedometer-detected estruses (24 sole and 26 simultaneous), the subordinate-rank cows in sole estrus had a shorter interval from estrus onset to ovulation than the dominant-rank cows in simultaneous estrus (P < 0.05). The effects of social order varied in response to the number of cows in estrus, which might have influenced determining the optimal time for artificial insemination.

The effects of the first wave of COVID-19 restrictions on physical activity: a longitudinal study from "step into health" program in Qatar.

Introduction: The COVID-19 pandemic led to restrictions that prevented physical activity in public places. This study sought to conduct a comprehensive longitudinal analysis of how lockdown policies in an Arabian Gulf country influenced the patterns of physical activity during first wave. Methods: In a longitudinal study design, members of the ongoing "Step into health" community-based health promotion program who provided valid pedometer data from January to August 2020, covering pre, during and post-covid first wave period met the inclusion criteria. Results: 420 (76.7% men, 13.8% ≤40 years) were included in the study. Overall, significant decline in daily step counts was recorded (-1,130 ± SE302) after the implementation of lockdown policies (p < 0.001). When the restrictions were removed, the steps per day were still lower compared to pre-covid for men (-910 ± SE610, p = 0.017) and among individuals with normal BMI (-1,304 ± SE409, p = 0.004). The lockdown in Qatar did not significantly affect women and individuals with obesity who already had lower daily steps pre-covid. Discussion: The present study confirms immediate decline in daily steps imposed indirectly through the COVID-19 lockdown measures. Participants with higher physical activity levels pre-covid experienced significant decline in step count during and even after restrictions were uplifted.

Pedometer- and accelerometer- based physical activity interventions in Type 2 diabetes: A systematic review and meta-analysis.

AIMS: Although accelerometer- and pedometer-based physical activity (PA) interventions can increase PA, there is no solid evidence for their benefits in patients with type 2 diabetes (T2DM). The aim of this systematic review and meta-analysis of randomized controlled clinical trials (RCTs) was to determine the effects of accelerometer- and pedometer-based PA interventions on hemoglobin A1c (HbA1c), fasting glucose, weight, BMI, blood pressure, lipids, and PA in adults with T2DM. DATA SYNTHESIS: Records from MEDLINE/PubMed, EMBASE, LILACS, and Scopus were searched from inception through March 28th, 2022. RCTs of at least two weeks of duration evaluated the effectiveness of pedometers or accelerometers as motivating tools for increasing PA in T2DM patients. This study was registered with PROSPERO and followed the PRISMA reporting guide. Of the 7131 non-duplicated articles retrieved, 24 RCTs (1969 patients) were included. The mean baseline HbA1c of the experimental group of included studies varied from 6.3 ± 0.9 % to 9.0 ± 0.01 %. The accelerometer- and pedometer-based PA interventions resulted in a greater improvement in HbA1c (-0.22 %; 95%CI, -0.4 % to -0.05 %; I2 = 77 %) and triglycerides (-13.11 mg/dL; 95%CI, -25.21 to -1.02; I2 = 22 %) versus control participants. Pedometer ambulatory use as a motivating tool significantly increased PA by 2,131 steps/day (95 % CI, 1,348 to 2,914; I2 = 74 %) in T2DM patients. CONCLUSIONS: Pedometers and accelerometers are associated with reductions in HbA1c and triglycerides when used as motivating tools. Larger and higher-quality studies are required to determine the full effects of PA as motivated by trackers in T2DM population.

Objectively measured daily steps as an outcome in a clinical trial of chronic kidney disease: a systematic review.

BACKGROUND: Physical inactivity is prevalent among individuals with chronic kidney disease (CKD) and is linked to unfavorable outcomes. In recent years, daily steps have emerged as a prominent target for interventions in clinical trials. The present study endeavors to scrutinize the effectiveness and/or efficacy of various interventions on daily steps in patients with full-spectrum CKD. METHODS: In December 2022, a systematic search was conducted across three databases, namely PubMed, Embase, and Web of Science, and subsequently updated in June 2023. The inclusion criteria included randomized controlled studies, quasi-experimental studies, and single-arm trials that assessed an intervention's impact on objectively measured daily steps in patients with chronic kidney disease. The Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool was used to assess the risk of bias in non-randomized controlled trials (RCT), while the Cochrane revised tool (ROB-2) was utilized for RCTs. RESULTS: Seventeen studies were deemed eligible for inclusion in this review, with a focus on examining the efficacy and/or effectiveness of exercise training-based interventions (n = 10), daily step goal-oriented interventions (n = 4), mobile health (mHealth) interventions (n = 1), different dialysis modalities (n = 1), and a "Sit Less, Interact, Move More" intervention (n = 1). The studies exhibit variability in their characteristics and assessment tools, reflecting the findings' heterogeneity. The results indicate that increasing physical activity levels remain challenging, as only a limited number of studies demonstrated significant improvements in participants' daily step counts from baseline to endpoint. CONCLUSION: Clinical trials with daily steps as an outcome are still lacking in the CKD population. Well-designed clinical trials that objectively assess the physical activity of CKD patients are needed.

Effect of Step Count Measurement on Glycemic Control: Secondary Analysis of a Randomized Controlled Trial.

Although walking has proven efficacy for glycemic control, patients struggle to meet daily step goals. This secondary analysis investigated the effect of step count measurement rate on glycemic control. Patients with type 2 diabetes from eight hospitals in Japan participated in a 12-month randomized controlled trial. The intervention group received DialBetesPlus, a self-management support system that allowed patients to monitor step count using a pedometer. We divided the intervention group into two groups based on whether daily step count measurement rate (the percentage of days with pedometer use) increased or decreased during the last three months of the intervention (month 10-12), relative to the first three months of the intervention (month 1-3). Patients with a reduced measurement rate experienced a worsening in glycemic control, with between-group difference of 0.516% in the amount of change in HbA1c (p=0.012). We conclude that step count measurement may lead to a better glycemic profile.

Seven-day, free-living, objectively-measured ambulatory activity: a data set from the Dikgale Health and Demographic Surveillance System site, Limpopo Province, South Africa.

OBJECTIVES: To investigate first, the level, distribution, patterns and prevalence of seven-day, objectively-measured physical activity (ambulation) in a rural health and demographic surveillance system (HDSS) site in South Africa, across demographic, temporal and anthropometric measures, within a sample of adolescent and adult participants from a defined ethnic group. Second, to investigate the strength and direction of association between levels of adiposity and physical activity (ambulation). DATA DESCRIPTION: The data collected comprises anonymized, individual-level, seven-day pedometry data from a cross-sectional, conveniently sampled survey conducted in 2005-2007. The data includes daily steps and daily activity energy expenditure, basic demographic and temporal information (age, sex, village, day, season) and anthropometric measures (stature, body mass, waist and hip circumference, skinfold thickness) and resting heart rate and blood pressure. Given that this data set was of the first large-scale surveys of objectively-measured physical activity in a South African sample, it could be useful for inclusion in future ecological studies investigating the trend of physical activity over time in the South African population. In addition, this objectively-measured data could provide a useful triangulation point for the interpretation and validation of surveys conducted using self-report measures, especially within rural communities.

Comparing physical activity prescription with verbal advice for general practice patients with cardiovascular risk factors: results from the PEPPER randomised controlled trial.

BACKGROUND: Regular physical activity improves health and quality of life for people with cardiovascular risk factors. However, few studies have demonstrated the applicability of strategies in health care to promote physical activity. OBJECTIVE: To evaluate if a written physical activity prescription combined with pedometer increases physical activity over one year compared with verbal advice in patients with cardiovascular disease risk in primary care. METHODS: The randomised-controlled, interventional, 12-month PEPPER study recruited patients aged 35 to 74 years, having quarterly followed-ups for hypertension, dyslipidaemia, or diabetes, and judged insufficiently active. Seventeen practices randomised patients into either the experimental group, who received a written, personalised prescription for daily step numbers, pedometer and logbook, or control group, who received verbal advice to do at least 15 min of rapid walking or equivalent daily. The primary outcome was the change in total weekly energy expenditure measured using an accelerometer at 3 months. The secondary outcomes were changes in step count, physical activity levels, quality of life, perceived obstacles to physical activity, and biomedical indicators at 3 and 12 months. RESULTS: One hundred and twenty-one participants were randomised. Although, weekly energy expenditure did not differ between the prescription and verbal instruction group, the estimated time spent doing moderate-intensity activity was significantly higher in the prescription group than the verbal group by an average of four minutes/week (p = 0.018)(95% CI [0.7 - 7.4]) reaching 48 min after 12 months (95% CI: 8 - 89). Similarly, this was associated with a clinically, higher average step number of 5256 steps/week increase over a year (95% CI: 660 - 9852). Among the most sedentary subgroup, walking less than 5000 steps/day at baseline, an 8868 steps/week (95% CI [2988 - 14700]) increase was observed in the prescription group. CONCLUSION: Prescribing physical activity did not significantly modify total weekly energy expenditure, but slightly increased moderate-intensity activity duration and step counts, particularly among the most sedentary participants. Prescribing personalised physical activity goals encourages sedentary patients to engage in physical activity. TRIAL REGISTRATION: The PEPPER trial is registered in the US National Institutes of Health Clinical Trials Registry under number NCT02317003 (15/12/2014).

Effectiveness of pedometer- and accelerometer-based interventions in improving physical activity and health-related outcomes among college students: A systematic review and meta-analysis.

Background: Although the pedometer- and accelerometer-based interventions (PABI) have demonstrated efficacy in improving physical activity (PA) and health-related outcomes, the dearth of empirical evidence in college students warrants further investigation. Objective: This systematic review and meta-analysis aim to examine the effects of PABI on improving PA and health-related outcomes among college students. Methods: PubMed, Web of Science, Embase, Cochrane Library, and PsycINFO were searched for relevant literature from inception to 20 February 2022. Randomized controlled trials (RCTs) conducted among college students with PABI to increase objectively measured PA as the primary outcome were included in this study. Results: A total of nine RCTs with 527 participants were included in this study. The combined results showed that PABI significantly improved PA (standardized mean difference = 0.41, 95% confidence interval (CI): 0.08, 0.74, P = 0.016) and significantly contributed to weight loss (mean differences (MD) = -1.56 kg, 95% CI: -2.40 kg, -0.73 kg, P < 0.01), and lower body mass index (MD = -0.33 kg/m2, 95% CI: -0.66 kg/m2, 0.00 kg/m2, P = 0.05) compared to the control group, but no significant effects were observed on improvements of body fat (%) and exercise self-efficacy. Interventions in the group of step, general students, pedometer-based intervention, theory, and developed region were significantly more effective in subgroup analyses. Conclusions: PABI was found to be effective in promoting PA and weight loss among college students. Future research is needed to further explore the long-term effects of PABI and the characteristics of multiple intervention models.

ATHLETIQUE: interest of an adapted physical activity program in patients with juvenile idiopathic arthritis: a feasibility and preliminary effectiveness study.

Background: Juvenile Idiopathic Arthritis (JIA) is associated with joint inflammation, pain and limited joint mobility, impacting the practice of physical activities. Adapted Physical Activities (APA) are an increasingly used method of rehabilitation, but additional studies are needed to define the nature of the most appropriate physical activity for patients with JIA. The "ATHLETIQUE" project aims to evaluate the impact of a program integrating APA sessions with use of a pedometer watch, on disease activity in patients with JIA. Methods: This study will be a randomized, multicenter, open-label, controlled clinical trial with 2 parallel arms. The patients included in this study will be children and adolescents with JIA, aged 6 to 17 years. The experimental group (30 patients) will participate in an APA program for 3 months and will use a pedometer watch for one year. We will evaluate and compare the change in disease activity measurements (primary objective), fatigue, pain, quality of life, level of physical activity, functional capacities, and muscle strength (secondary objectives) after 14, 26 and 50 weeks. The control group (10 patients) will undergo the same evaluations as the experimental group but will not participate in the APA program and will not wear the pedometer watch. Expected results: The APA program may help to promote an active lifestyle with regular physical activity, preventing comorbidities and motor disability. Promising results on disease activity, functional capacities and quality of life would enable us to envisage a larger research program with a view to optimizing and assessing APA for children with JIA. Discussion: This study will be conducted in the short and medium-term, with one-year follow-up, including 3 months of APA sessions for the experimental group. The sessions proposed during the APA program will mainly be aerobic and bodyweight exercises. Furthermore, in contrast to previous studies on this topic, our study will integrate a novel element, namely the use of a pedometer watch. This watch will help to implement strategies to address motivation. This study aims to improve physical and mental well-being, provide a basis for the design of a larger study, and propose recommendations adapted to children with JIA. Trial registration: Registered with ClinicalTrials.gov under the number NCT05572424.

Physical Activity, Body Image, and Emotional Intelligence Differences in Adults with Overweight and Obesity.

Physical activity (PA) and emotional intelligence (EI) are integral parts of human nature. Body image (BI) and body mass index (BMI) may be indications of the psycho-emotional and physical health of human beings. The purpose of this study was to investigate the relationship between PA and EI of Greek adults living with overweight and obesity, as well as to identify the BI and EI differences in this population. A cross-sectional study design was used, involving 216 participants (65% females) of whom 51.4% were young adults (20-40 years), 48.6% were middle-aged adults (41-60 years), while 51.4% of participants were living with overweight or obesity. According to the results, all indicators of PA had very low correlations with EI factors, while statistically significant correlations were observed only for PA at work and the total score of the International Physical Activity Questionnaire with the use of emotions (r = 0.16 and r = 0.17, respectively, p < 0.05). Women had significantly higher EI scores than men regarding the care and empathy factor, while the individuals with obesity had lower scores in the use of emotions factor. Regarding BI, young adults who were satisfied with their BI had better control of feelings than the middle-aged adult counterparts. In conclusion, BI satisfaction and EI may differ between individuals living with overweight and obesity in both genders. Younger individuals with obesity may compensate better for their BI and better control their emotions. On the other side, PA does not seem to have an important role in these associations.

The effects of pedometer-based exercise on central and peripheral vascular functions among young sedentary men with CVD risk factors.

Introduction: Cardiovascular diseases (CVDs) remain the main cause of morbidity and mortality in Malaysia and worldwide. This is mainly due to an increase in the prevalence of CVD risk factors such as hypertension, dyslipidemia, smoking, and obesity. Increased physical activity has been recommended as a modality to improve CVD risk. Pulse wave velocity (PWVCF), augmentation index (AI), and finger photoplethysmography fitness (PPGF) index have been introduced to assess the vascular functions related to CVD risk factors. The effects of long-term exercise on PPGF index are not established. Materials and Methods: A total of 70 young men who were sedentary with two or more cardiovascular risk factors were recruited. Subjects were randomly assigned to a control group (CG) (n = 34; no change in walking) and pedometer group (PG) (n = 36; minimum target: 8,000 steps/day). PWVCF and AI were measured via the Vicorder system. The PPGF index was obtained via the finger photoplethysmography method. All parameters were measured at baseline and after 6 and 12 weeks. Results: After intervention, the PG had significant increased step count from 4,996 ± 805 to 10,128 ± 511 steps/day (p < 0.001). The PG showed significant improvement in anthropometric variables, lipid, PWVCF, AI, and PPGF index (time and group effect p < 0.001). No changes were observed in CG. Conclusion: This signifies that pedometer-based walking program is beneficial in improving markers of vascular functions among young working sedentary men with CVD risk factors. Pedometer-based exercise should be encouraged to improve cardiovascular health.

Efficacy of an mHealth Behavior Change Intervention for Promoting Physical Activity in the Workplace: Randomized Controlled Trial.

BACKGROUND: Insufficient physical activity (PA) is a well-established risk factor for several noncommunicable diseases such as cardiovascular diseases, cancer, diabetes, depression, and dementia. The World Health Organization (WHO) advises that individuals engage in 150 minutes of moderate PA per week or 75 minutes of intense PA per week. According to the WHO's latest report, 23% of adults fail to meet the minimum recommended level of PA. The percentage was even higher in a recent global study that showed 27% of adults were insufficiently active and reported a 5% increase in the prevalence trend of insufficient PA between 2001 and 2016. The study also showed the rate of insufficient PA among countries varied significantly. For instance, it was estimated that 40% were insufficiently active in the United States, and the percentage was even higher in Saudi Arabia (more than 50%). Governments are actively developing policies and methods to successfully establish a PA-inducing environment that encourages a healthy lifestyle in order to address the global steady decline in PA. OBJECTIVE: The purpose of this study was to determine the effectiveness of mobile health (mHealth) interventions, particularly SMS text messaging interventions, to improve PA and decrease BMI in healthy adults in the workplace. METHODS: In this parallel, 2-arm randomized controlled trial, healthy adults (N=327) were randomized to receive an mHealth intervention (tailored text messages combined with self-monitoring (intervention; n=166) or no intervention (control; n=161). Adults who were fully employed in an academic institution and had limited PA during working hours were recruited for the study. Outcomes, such as PA and BMI, were assessed at baseline and 3 months later. RESULTS: Results showed significant improvement in PA levels (weekly step counts) in the intervention group (ß=1097, 95% CI 922-1272, P<.001). There was also a significant reduction in BMI (ß=0.60, 95% CI 0.50-0.69, P<.001). CONCLUSIONS: Combining tailored text messages and self-monitoring interventions to improve PA and lower BMI was significantly effective and has the potential to leverage current methods to improve wellness among the public.

Chronic Obstructive Pulmonary Disease Access and Adherence to Pulmonary Rehabilitation Intervention (CAPRI): Protocol for a randomized controlled trial and adaptations during the COVID-19 pandemic.

BACKGROUND: Pulmonary rehabilitation (PR) is the standard of care for chronic obstructive pulmonary disease (COPD) management. However, significant barriers limit access and adherence to PR and alternatives are needed. The purpose of this randomized controlled trial is to test the efficacy of a web-based, pedometer-mediated intervention to increase physical activity (PA) for persons with COPD who decline PR or meet U.S. guidelines for referral to PR but have not participated (CAPRI-1). In addition, we will test whether the intervention maintains PA following PR in an exploratory aim (CAPRI-2). METHODS: Participants with COPD (N = 120) will be recruited and randomized 1:1 to a 12-week web-based, pedometer-mediated intervention or usual care (UC) (CAPRI-1). The intervention provides: 1) objective monitoring of walking and iterative feedback, 2) individualized step-count goals, 3) motivational messages and educational content, and 4) an online community. The primary outcome is change in daily step count from baseline to 12 weeks. Secondary outcomes include: (a) exercise capacity; (b) self-reported PA; (c) PA intensity; (d) exercise self-regulatory efficacy, (e) health-related quality of life, (f) dyspnea, (g) depression symptoms, and (h) healthcare utilization. CAPRI-2 will test whether participants (N = 96) assigned to the intervention following PR completion show greater maintenance of daily step count compared to UC at 3, 6, 9, and 12 months. DISCUSSION: If the intervention is efficacious, it may be an alternative for those who cannot attend PR or a maintenance program following completion of conventional PR. We also present adaptations made to the protocol in response to the COVID-19 pandemic.

A high performance lead-free flexible piezoelectric nanogenerator based on AlFeO3nanorods interspersed in PDMS matrix for biomechanical energy scavenging to sustainably power electronics.

Since lead-based piezoelectric nanogenerators (PENGs) possess serious health risks, environmental problems, proper disposal issues, and biocompatibility concerns, this work presents the fabrication of a flexible piezoelectric nanogenerator utilizing lead-free orthorhombic AlFeO3nanorods for biomechanical energy scavenging to sustainably power electronics. Hydrothermal technique is used to synthesize the AlFeO3nanorods and the PENG was fabricated on Indium tin oxide (ITO) coated Polyethylene terephthalate (PET) flexible film with AlFeO3nanorods interspersed in polydimethylsiloxane (PDMS). transmission electron microscopy proved that the AlFeO3nanoparticles are of nanorods shape. Through x-ray Diffraction, it is validated that AlFeO3nanorods have orthorhombic phase and crystalline structure. A high piezoelectric charge coefficient (d33) of 400 pm V-1is obtained from the piezoelectric force microscopy of AlFeO3nanorods. With optimized concentration of AlFeO3in the polymer matrix, an open circuit voltage (VOC) of 30.5 V, current density (JC) of 0.7888±0.0001µA cm-2and an instantaneous power density of 240.6 mW m-2are obtained under the application of a force of 1.25 kgf. To investigate the nanogenerator's practical utility, the PENG is used for lighting multiple LEDs, charging of a capacitor and as a pedometer via biomechanical energy harvesting. Hence, it can be employed for developing various self-powered wearable electronics such as flexible skin, artificial cutaneous sensors, etc.

MyGood Trip, a Telemedicine Intervention for Physical Activity Recovery After Bariatric Surgery: Randomized Controlled Trial.

BACKGROUND: Despite bariatric surgery showing significant weight loss trajectories for many patients, a substantial proportion regain weight after the first year following surgery. The addition of telemedicine to standard care could support patients with engaging in a more active lifestyle and thus improve clinical outcomes. OBJECTIVE: Our aim was to evaluate a telemedicine intervention program dedicated to the promotion of physical activity including digital devices, teleconsultation, and telemonitoring the first 6 months following bariatric surgery. METHODS: This study employed a mixed methods design based on an open-label randomized controlled trial. Patients were included during the first week after bariatric surgery; then, they were randomized into 2 intervention groups: The TelePhys group received a monthly telemedicine consultation focusing on physical activity coaching, while the TeleDiet group received a monthly telemedicine consultation involving diet coaching. Data were collected using a watch pedometer and body weight scale, both of which were connected wirelessly. The primary outcome was the difference between the 2 groups in the mean numbers of steps at the first and sixth postoperative months. Weight change was also evaluated, and focus groups and interviews were conducted to enrich the results and capture perceptions of the telemedicine provided. RESULTS: Among the 90 patients (mean age 40.6, SD 10.4 years; 73/90, 81% women; 62/90, 69% gastric bypass), 70 completed the study until the sixth month (n=38 TelePhys; n=32 TeleDiet), and 18 participants agreed to be interviewed (n=8 Telephys; n=10 TeleDiet). An increase in the mean number of steps between the first and sixth months was found in both groups, but this change was significant only in the TeleDiet group (P=.01). No difference was found when comparing both intervention groups. Interviewed participants reported having appreciated the teleconsultations, as the individualized tailored counseling helped them to make better choices about behaviors that could increase their likelihood of a daily life in better health. Weight loss followed by social factors (such as social support) were identified as the main facilitators to physical activity. Family responsibilities, professional constraints as well as poor urban policies promoting physical activity, and lack of accessibility to sport infrastructure were their major barriers to postoperative lifestyle adherence. CONCLUSIONS: Our study did not show any difference in mobility recovery after bariatric surgery related to a telemedicine intervention dedicated to physical activity. The early postoperative timing for our intervention may explain the null findings. eHealth interventions aiming to change behaviors and carried out by clinicians require support from structured public health policies that tackle patients' obesogenic environment in order to be efficient in their struggle against sedentary lifestyle-related pathologies. Further research will need to focus on long-term interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT02716480, https://clinicaltrials.gov/ct2/show/NCT02716480.

Participation in the Global Corporate Challenge®, a Four-Month Workplace Pedometer Program, Reduces Psychological Distress.

BACKGROUND: Psychological distress (stress) has been linked to an increased risk of chronic diseases and is exacerbated by a range of workplace factors. Physical activity has been shown to alleviate psychological distress. Previous pedometer-based intervention evaluations have tended to focus on physical health outcomes. This study aimed to investigate the immediate and long-term changes in psychological distress in employees based in Melbourne, Australia after their participation in a four-month pedometer-based program in sedentary workplaces. METHODS: At baseline, 716 adults (aged 40 ± 10 years, 40% male) employed in primarily sedentary occupations, voluntarily enrolled in the Global Corporate Challenge© (GCC©), recruited from 10 Australian workplaces to participate in the GCC® Evaluation Study, completed the Kessler 10 Psychological Distress Scale (K10). Of these, 422 completed the K10 at baseline, 4 months and 12 months. RESULTS: Psychological distress reduced after participation in a four-month workplace pedometer-based program, which was sustained eight months after the program ended. Participants achieving the program goal of 10,000 steps per day or with higher baseline psychological distress had the greatest immediate and sustained reductions in psychological distress. Demographic predictors of immediate reduced psychological distress (n = 489) was having an associate professional occupation, younger age, and being 'widowed, separated or divorced'. CONCLUSIONS: Participation in a workplace pedometer-based program is associated with a sustained reduction in psychological distress. Low-impact physical health programs conducted in groups or teams that integrate a social component may be an avenue to improve both physical and psychological health in the workplace.

Validation of the 2 × 24 h recall method and a 7-d web-based food diary against doubly labelled water in Danish adults.

The European Food Safety Authority has suggested that EU countries implement the 2 × 24 h diet recall (2 × 24 h DR) method and physical activity (PA) measurements for national dietary surveys. Since 2000, Denmark has used 7 d food diaries (7 d FD) with PA questionnaires and measurements. The accuracy of the reported energy intakes (EI) from the two diet methods, pedometer-determined step counts and self-reported time spent in moderate-to-vigorous PA (MVPA) were compared with total energy expenditure measured by the doubly labelled water (TEEDLW) technique and with PA energy expenditure (PAEE), respectively. The study involved fifty-two male and sixty-eight female volunteers aged 18-60 years who were randomly assigned to start with either the 24 h DR or the web-based 7 d FD, and wore a pedometer for the first 7 d and filled in a step diary. The mean TEEDLW (11·5 MJ/d) was greater than the mean reported EI for the 7 d FD (9·5 MJ/d (P < 0·01)) but the same as the 2 × 24 h DR (11·5 MJ/d). The proportion of under-reporters was 34 % (7 d FD) and 4 % (2 × 24 h DR). Most participants preferred the 7 d DR as it was more flexible, despite altering their eating habits. Pearson's correlation between steps corrected for cycling and PAEE was r = 0·44, P < 0·01. Spearman's correlation for self-reported hours spent in MVPA and PAEE was r = 0·58, P < 0·01. The 2 × 24 h DR performs better than the existing 7 d FD method. Pedometer-determined steps and self-reported MVPA are good predictors of PAEE in adult Danes.