Perspectives of people with myasthenia gravis on physical activity and experience of physical activity advice from health professionals in the Australian context: a qualitative study.

PURPOSE: Physical activity is an important modifiable determinant of health. There has been a historical aversion to movement in people with myasthenia gravis (MG) due to the pathophysiology of the disease, however, research suggests engagement in physical activity is safe and does not exacerbate symptoms. There are currently no studies investigating the qualitative perspectives of people with MG on physical activity. The aim of this study was to explore perceptions of physical activity, barriers, enablers, and participants' experiences of physical activity advice from health professionals. MATERIALS AND METHODS: Semi-structured interviews were used, with verbatim transcripts analysed using content analysis. RESULTS: Ten adults (median age 64.5 years) living in Australia with generalised MG were interviewed. Key findings were identified: (1) Physical activity is perceived to be important for general health and for MG; (2) Medical management and social support are key enablers; (3) Fatigue and pain are potential barriers; and (4) Experiences with healthcare professionals were considered insufficient and failed to provide disease specific advice regarding MG and physical activity. CONCLUSION: People with MG have unique barriers and enablers to physical activity engagement that clinicians should consider when providing physical activity behaviour change support to this population.

Physical activity is perceived positively by people with myasthenia gravis, both due to the general benefits and disease-specific impacts, however unique barriers such as fatigue and pain can make physical activity engagement challenging.Tailored physical activity behaviour change support is recommended to consider these barriers on an individual level.Effective interprofessional collaboration is important in ensuring medical management is optimised to enable greater physical activity participation, and behaviour change techniques involving social supports may warrant consideration.Health professionals should seek to improve their understanding of myasthenia gravis to deliver evidence-based, person-centred approaches to physical activity promotion in this population.

Data from four consecutive cohorts of students in Australia (2019-2022) show the impact of the COVID-19 pandemic on domestic and international university students' mental health.

INTRODUCTION: COVID-19 and related travel and social restrictions caused significant stress for university students in Australia and globally. Learning quickly moved online and many students (particularly international students) were separated from social and economic support. This study examined the impact of the pandemic from pre-pandemic (2019) to the COVID-19 Omicron wave (2022) on domestic and international students' mental health. METHODS: Participants were 1540 students (72% females, 28% international) in four first-year cohorts (2019, 2020, 2021, 2022). We screened for mental health concerns (% positive) and symptom scores for depression, anxiety and somatic distress using the PsyCheck, and general wellbeing using the Warwick-Edinburgh Mental Well-being scale. RESULTS: From pre-COVID (2019) to the first wave of COVID-19 (2020), the proportion of students screening positive for mental health problems rose in both domestic students (66-76%) and international students (46-67%). Depression symptoms and wellbeing were worse in 2020 than in 2019, 2021 and 2022. Anxiety symptoms increased from 2019 to 2020 and continued to rise in 2021 and 2022. Somatic symptoms did not show an effect of cohort. Contrary to expectations, domestic students reported higher distress and lower wellbeing than international students across cohorts. CONCLUSION: The pandemic was associated with a marked increase in psychological distress in first-year university students, not all of which settled with the easing of restrictions. Post-pandemic recovery in the Australian university sector must include university-wide access to mental health information and support for incoming students.

To sleep or not to sleep? No effect of sleep on contextual word learning in younger adults.

This study investigated the effect of sleep on novel word learning through reading context. Seventy-four healthy young adults attended two testing sessions, with either overnight sleep (sleep group) or daytime wakefulness (wake group) occurring between the sessions. At the initial learning session, participants identified the hidden meanings of novel words embedded within sentence contexts and were subsequently tested on their recognition of the novel word meanings. A recognition test was also conducted at the delayed session. The analyses revealed comparable recognition of novel word meanings for the sleep and wake group at both the initial and the delayed session, indicating that there was no benefit of sleep compared with wakefulness for novel word learning through context. Overall, this study highlights the critical influence of encoding method on sleep-dependent learning, where not all forms of word learning appear to benefit from sleep for consolidation.

Physical activity behaviour change in people living with and beyond cancer following an exercise intervention: a systematic review.

PURPOSE: Exercise interventions can increase physical activity and wellbeing of people living with/beyond cancer. However, little is known about maintenance of physical activity in this population ≥ 6 months post-exercise intervention, when theoretical evidence suggests behaviour maintenance occurs. Study aims are to (i) systematically review maintenance of physical activity ≥ 6-month post-exercise intervention, and (ii) investigate the influence of behaviour change techniques (BCTs) on physical activity maintenance in people living with/beyond cancer. METHODS: CINAHL, CENTRAL, EMBASE and PubMed databases were searched for randomised controlled trials up to August 2021. Trials including adults diagnosed with cancer that assessed physical activity ≥ 6 months post-exercise intervention were included. RESULTS: Of 142 articles assessed, 21 reporting on 18 trials involving 3538 participants were eligible. Five (21%) reported significantly higher physical activity ≥ 6 months post-exercise intervention versus a control/comparison group. Total number of BCTs (M = 8, range 2-13) did not influence intervention effectiveness. The BCTs Social support, Goal setting (behaviour), and Action planning, alongside supervised exercise, were important, but not sufficient, components for long-term physical activity maintenance. CONCLUSIONS: Evidence for long-term physical activity maintenance post-exercise intervention for people living with/beyond cancer is limited and inconclusive. Further research is required to ensure the physical activity and health benefits of exercise interventions do not quickly become obsolete. IMPLICATIONS FOR CANCER SURVIVORS: Implementation of the BCTs Social support, Goal setting (behaviour), and Action planning, alongside supervised exercise, may enhance physical activity maintenance and subsequent health outcomes in people living with/beyond cancer.

The effect of sleep and semantic information on associative novel word learning.

This study investigated the effect of overnight sleep on associative novel word learning and examined whether the effects of sleep on word learning are modulated by the provision of semantic information. Seventy-five healthy young adults attended an initial word-learning session followed by a delayed testing session. An interval of overnight sleep (sleep group) or daytime wakefulness (wake group) separated the two sessions. At the initial learning session, participants learned three-word names of 20 novel objects, where half the names comprised a novel word and two semantic attributes (semantic condition), and half comprised a novel word and two meaningless proper names (name condition). Novel word cued-recall was measured at both the initial and the delayed session. Although both groups demonstrated similar cued-recall accuracy at the first session, by the delayed session the sleep group demonstrated superior cued-recall accuracy compared to the wake group. There was no influence of semantics on the sleep-dependent consolidation of the novel words. Overall, these findings suggest that novel words encoded with or without the provision of semantic information can benefit from an overnight sleep period for consolidation.

The efficacy of morning versus evening exercise for weight loss: A randomized controlled trial.

OBJECTIVE: The aim of this study was to investigate the influence of morning versus evening exercise on weight loss, cardiometabolic health, and components of energy balance. METHODS: A total of 100 inactive adults with overweight or obesity were randomized to morning exercise (AMEx; 06:00-09:00), evening exercise (PMEx; 16:00-19:00), or wait-list control (CON). AMEx and PMEx were prescribed 250 min·wk-1 of self-paced aerobic exercise for 12 weeks. Anthropometry and body composition, physical activity, and dietary intake were assessed at baseline, 6 weeks, and 12 weeks. Cardiorespiratory fitness (V̇O2 peak), resting metabolic rate, and blood markers were assessed at baseline and 12 weeks. Body composition and V̇O2 peak were also measured at 3- and 6-month follow-up. RESULTS: AMEx and PMEx lost weight during the intervention (mean [SD], AMEx, -2.7 [2.5] kg, p < 0.001; PMEx, -3.1 [3.4] kg, p < 0.001). V̇O2 peak significantly increased in both intervention groups, and these changes were different from CON (AMEx, +4.7 mL·kg-1 ·min-1 , p = 0.034; PMEx, +4.2 mL·kg-1 ·min-1 , p = 0.045). There were no between-group differences for resting metabolic rate or physical activity. At 12 weeks, total energy intake was significantly reduced in both AMEx and PMEx versus CON (AMEx, -3974 kJ, p < 0.001; PMEx, -3165 kJ, p = 0.001). CONCLUSIONS: Adults with overweight and obesity experience modest weight loss in response to an exercise program, but there does not appear to be an optimal time to exercise.

Results from the Australian 2022 Report Card on physical activity for children and young people.

Background: Past Physical Activity Report Cards have indicated a minority of Australian children and young people are sufficiently active. The purpose of this paper is to summarise grades across 10 indicators of the 2022 Australian Physical Activity Report Card, to assess physical activity behaviours and supports. Methods: A development team consisting of research experts synthesised and evaluated national and state level data to inform grades for each indicator. Data were drawn from nationally and state/territory representative datasets spanning 2016-2021. Results: Overall Physical Activity Levels and Screen Time were both assigned grades of D-, remaining the worst performing indicators. Australia's best performing indicator was Community and the Built Environment (A-), followed by Organised Sport and Physical Activity (B-). Remaining indicators were Family and Peers (C+), School (C+), Strategies and Investments (C-), Active Transport (D-) and Physical Fitness (D-). Active Play was unable to be graded, due to lack of consensus on a primary metric for this indicator and a lack of representative data. Conclusion: Evidence suggests that physical activity levels of Australian children remain consistently low, despite access to and availability of facilities and open spaces. There is a strong need for a National Physical Activity Plan to address this. The theme for the 2022 Australian Physical Activity Report Card, REBOOT! Reimagining physically active lives encourages us all to think more imaginatively about how we might engage all children and young people through diverse physical activity opportunities to be more active.

How do previously inactive individuals restructure their time to 'fit in' morning or evening exercise: a randomized controlled trial.

The objective of this study was to investigate changes in sedentary and active behaviors when previously inactive adults start exercising in the morning or evening. One-hundred adults with overweight or obesity (BMI ≥ 25 kg/m2) were recruited for a 12-week intervention and randomized to one of three groups: (i) morning exercise (AMEx; 0600-0900); (ii) evening exercise (PMEx; 1600-1900); or (iii) waitlist control. AMEx and PMEx were prescribed self-paced aerobic exercise to achieve a weekly total of 250 min via a combination of supervised and unsupervised training. Sedentary and active behavior times were measured at baseline, mid- and post-intervention using the multimedia activity recall for children and adults. Time spent engaging in physical activity was significantly increased from baseline at both mid- (+ 14-22 min·day-1) and post-intervention (+ 12-19 min·day-1), for AMEx and PMEx. At 12-weeks, participants in both morning and evening exercise groups reported increased time spent Sleeping (+ 36 and + 20 min·day-1, respecitively), and reduced time spent watching TV/playing videogames (- 32 and - 25 min·day-1, respectively). In response to an exercise stimulus, previously inactive adults make encouraging modifications in how they use their time, and the patterns of change are similar with morning and evening exercise.

Behaviour Change Techniques in Computerized Cognitive Training for Cognitively Healthy Older Adults: A Systematic Review.

We aimed to describe behaviour change techniques (BCT) used in trials evaluating computerised cognitive training (CCT) in cognitively healthy older adults, and explore whether BCTs are associated with improved adherence and efficacy. The 90 papers included in a recent meta-analysis were reviewed for information about adherence and use of BCTs in accordance with the Behaviour Change Taxonomy. Studies using a specific BCT were compared with studies not using that BCT on efficacy (difference in Hedges' g [Δg]) using three level meta-regression models and on median adherence using the Wilcoxon test. The median number of BCTs per study was 3 (interquartile range [IQR] = 2-5). 'Feedback on behaviour' (if provided by a person; Δg = -0.19, 95% confidence interval [CI] = -0.31;-0.07) and 'non-specific reward' (Δg = -0.19, CI = -0.34;-0.05) were associated with lower efficacy. Certain BCTs that involve personal contact may be beneficial, although none were statistically significantly associated with greater efficacy. The median percentage of adherence was 90% (IQR = 81-95). Adherence was higher in studies using the BCT 'self-monitoring of behaviour' and lower in studies using the BCT 'graded tasks' than studies not using these BCTs (p < 0.001). These findings provide first evidence that BCTs can influence both adherence to and efficacy of CCT programs in cognitively healthy older adults.

Barriers to and Facilitators of Adherence to Prescribed Home Exercise in Older Adults at Risk of Falling in Singapore: A Qualitative Study.

Adherence to prescribed exercise poses significant challenges for older adults despite proven benefits. The aim of this exploratory descriptive qualitative study was to explore the perceived barriers to and facilitators of prescribed home exercise adherence in community-dwelling adults 65 years and older. Three focus groups with 17 older adults (Mage ± SD = 77 ± 5.12) living in Singapore were conducted. Inductive thematic analysis revealed that "the level of motivation" of individuals constantly influenced their exercise adherence (core theme). The level of motivation appeared to be a fluid concept and changed due to interactions with two subthemes: (a) individual factors (exercise needs to be tailored to the individual) and (b) environmental factors (i.e., support is essential). Hence, these factors must be considered when designing strategies to enhance exercise adherence in this vulnerable population. Strategies must be informed by the culturally unique context, in this case, a developed country with a multiethnic urban Asian population.

Predictors of real-world adherence to prescribed home exercise in older patients with a risk of falling: A prospective observational study.

Objectives: Using a multi-ethnic Asian population, this study assessed adherence to prescribed home exercise programs, explored factors predicting adherence, and evaluated whether home exercise adherence was associated with physical activity. Methods: A prospective cohort study was conducted in 68 older adults (aged ≥65 years) from two geriatric outpatient clinics in Singapore, who were receiving tailored home exercises while undergoing 6 weeks of outpatient physical therapy for falls prevention. Adherence was measured as the percentage of prescribed sessions completed. Predictor variables included sociodemographic factors, clinical characteristics, intervention-specific factors, and physical and psychosocial measures. Multivariable linear regressions were performed to develop a model that best predicted adherence to prescribed exercise. Physical activity levels, measured by accelerometry, were analyzed by cross-sectional univariate analysis at 6 weeks. Results: The mean adherence rate was 65% (SD 34.3%). In the regression model, the number of medications [B = 0.360, 95% CI (0.098-0.630)], social support for exercising [B = 0.080, 95% CI (0.015-0.145)], and self-efficacy for exercising [B = -0.034, 95% CI (-0.068-0.000)] significantly explained 31% (R 2 = 0.312) of the variance in exercise adherence. Older adults with better adherence took more steps/day at 6 weeks [B = 0.001, 95% CI (0.000-0.001)]. Conclusions: Low adherence to home exercise programs among older adults in Singapore, emphasizing the need for improvement. Counterintuitively, older adults with more medications, lower exercise self-efficacy, but with greater social support demonstrated higher adherence. Addressing unmet social support needs is crucial for enhancing adherence rates and reducing fall risks.

Effects of a therapeutic exercise program in children with non-cystic fibrosis bronchiectasis: A pilot randomized controlled trial.

Background: In the absence of randomized controlled trials (RCTs) on the benefits of therapeutic exercise programs involving children with bronchiectasis, we undertook a pilot RCT to evaluate the effects of a play-based therapeutic exercise program on fundamental movement skill (FMS) proficiency. The effects of the program on cardiorespiratory fitness, perceived competence, and health-related quality of life (HR-QoL) were examined as secondary outcomes. Methods: Children [median (IQR) age: 6.8 (5.3-8.8) years] with bronchiectasis unrelated to cystic fibrosis were randomized to a 7-week therapeutic exercise program (n = 11) or wait-list control (n = 10). The exercise program comprised 7 × 60-min weekly sessions and was supplemented by a home-based program 2-days/week. Participants were assessed on: FMS (locomotor and object control skills) using the Test of Gross Motor Development 2nd Edition (TGMD-2); cardiovascular fitness by calculating the percent change in heart rate (%ΔHR) from rest to completion of the first stage of a submaximal treadmill test; perceived competence using Harter's athletic competence subscale; and QoL with the PedsQL. Results: Significant group by time interactions were observed for locomotor and object control skills. Children completing the therapeutic exercise program exhibited significant improvements in both locomotor (pre 29.0 ± 2.0, post 35.2 ± 2.2, p = 0.01) and object control (pre 27.0 ± 2.0, post 35.5 ± 2.2, p = 0.01) skills, with no significant change in controls (pre 31.6 ± 2.1, post 31.8 ± 2.3 and pre 31.0 ± 2.1, post 32.3 ± 2.3, respectively). Among children completing the program, %ΔHR declined by 6% points, while %ΔHR declined only marginally among controls (0.9% points), but the group by time interaction was not statistically significant. The program had a small positive impact on competence perceptions (Cohen's d = 0.2) and HR-QoL (Cohen's d = 0.3). Conclusion: This pilot RCT provides preliminary evidence for the efficacy of a play-based therapeutic exercise program to improve proficiency in FMS and fitness in children with bronchiectasis. The results are sufficiently positive to warrant conducting a larger RCT testing the efficacy of the exercise program in children with bronchiectasis and/or other chronic respiratory conditions.

Dietary intake and educational outcomes among Australian university students: cross-sectional and longitudinal associations.

OBJECTIVE: This study aimed to examine cross-sectional and longitudinal associations between dietary intake and educational outcomes (EO) in Australian first-year university students. DESIGN: This cross-sectional and longitudinal study measured outcomes of interest at three points over 1 year. Measures included self-reported dietary patterns and dietary intake via a three-day estimated food record. Objective EO (corresponding semester grade point average (GPA), overall GPA and graduation status) variables were extracted from academic records. Cross-sectional and longitudinal associations were examined using regression models and generalised estimating equations, respectively. SETTING: A large university in Queensland, Australia. PARTICIPANTS: Participants (n 80) were first-year students who had completed high school in the previous year. RESULTS: Some significant associations were found with semester GPA, including: (a) moderate positive associations between serves of vegetables and semester GPA at time point 2 and over time; and (b) a weak negative association between Na intake and semester GPA at time point 2. Although insignificant, meaningful negative associations were found between alcohol consumption and semester GPA at time point 1 and over time. Some significant associations were also found with graduation status, including: (a) a positive association between meeting Australian carbohydrate recommendations and graduation status; and (b) a negative association between Fe intake and graduation status, both at time point 1. CONCLUSIONS: Both cross-sectional and longitudinal findings highlight positive associations between vegetable intake and EO and negative associations between alcohol consumption and EO. Further relevant work is needed with larger, more variable samples in demographic, dietary and EO characteristics.

Effects of fitness and fatness on age-related arterial stiffening in people with type 2 diabetes.

People with type 2 diabetes (T2D) are at a greater risk of cardiovascular disease than the general population. Both non-modifiable (age) and modifiable (low aerobic fitness, high body fatness) factors are separately predictive of cardiovascular risk, although they often occur concomitantly. This study aimed to examine the (1) association between age and arterial stiffness, a subclinical marker of cardiovascular risk; and (2) effects of body fatness and aerobic fitness on age-related increases in arterial stiffness in people with T2D. Data from 64 individuals with T2D (age 59.8 ± 8.7 years, 40% female, HbA1c 8.4 ± 1.6%) were included in this cross-sectional analysis. Carotid-femoral pulse wave velocity (cfPWV) was used to quantify arterial stiffness. Aerobic fitness (relative V̇O2peak ) was determined via indirect calorimetry during maximal exercise testing. Central body fatness was determined using waist circumference. Data were analysed using hierarchical multiple regressions. After adjustment for sex and duration of T2D, each one standard deviation (SD) increase in age (8.68 years) was associated with a 0.63 m·s-1 increase in cfPWV (ß = 0.416, p = 0.001). Following adjustment for aerobic fitness and body fatness, the standardized ß was unchanged (0.417). A one SD increase in waist circumference (13.9 cm) and relative V̇O2peak (5.3 ml·kg-1 ·min-1 ) were associated with a similar magnitude of difference in cfPWV (0.47 m·s-1 and -0.44 m·s-1 , respectively). Therefore, age is a significant correlate of increased arterial stiffness in T2D, with higher aerobic fitness attenuating, and higher body fatness exacerbating, this increase. Interventions aimed at improving cardiovascular outcomes in people with T2D should target both increased aerobic fitness and reduced body fatness.

Physical Activity, Sedentary Behavior, and Educational Outcomes Among Australian University Students: Cross-Sectional and Longitudinal Associations.

BACKGROUND: This study aimed to examine cross-sectional and longitudinal associations between physical activity (PA), sedentary behavior (SB), and educational outcomes (EO) in first-year university students in Australia. METHOD: Participants (N = 80) engaged in 3 data collection points (semesters 1, 2, and 3) that included self-reported and device-based PA and SB, and objective EO measures. Cross-sectional associations were examined using linear and binary logistic regressions, and longitudinal associations were examined using generalized estimating equations. RESULT: Overall, results indicated some positive but weak cross-sectional associations between some device-based and self-reported measures of PA and EO outcomes when controlling for confounders. Self-reported SB was negatively associated with semester GPA at time point 3 after adjusting for confounders (ß = -0.224; 95% confidence interval, -0.446 to -0.001; P < .05). No other significant cross-sectional or longitudinal associations were identified. CONCLUSION: Our findings suggest that SB may be a more important target healthy behavior than PA when aiming to influence EO, and that related interventions may be more appropriate in second rather than first-year university students. Further research is needed to better understand this relationship that uses larger sample sizes, follows students beyond first year, and includes measures that distinguish between leisure and educational screen time.

Physiotherapy student clinical placements in Australian private practice: Patient-reported outcomes with supervised student care.

BACKGROUND AND PURPOSE: The sustainability of physiotherapy clinical placements is an ongoing challenge, yet there is potential to increase placement capacity within the private practice sector. Barriers to hosting students, including perceived impacts on patient care, reportedly limit the uptake of hosting students within this setting. This study aimed to evaluate the effect of physiotherapy student involvement on patient-reported Global Rating of Change (GRoC) in Australian physiotherapy private practice care. METHODS: A cross-sectional, patient survey study was conducted in three private physiotherapy practices over two 5-week periods. At their completion of care, participants completed the survey seeking demographic information, GRoC and aspects of care including number of consultations involving students, proportion of physiotherapy time involving students and frequency of student involvement in treatment delivery. After accounting for clinic-level differences, ordinal logistic regression analyses were performed to explore the impact of supervised student care on GRoC. RESULTS: 119 participants across three practices completed the survey. There were no significant associations between patient-reported GRoC and: (1) student involvement in patient care; (2) number of consultations involving students; (3) proportion of physiotherapy time involving students; or (4) frequency of student involvement in treatment delivery (p > 0.05). CONCLUSIONS: Supervised student care in private physiotherapy practice does not appear to have a detrimental impact on patient-reported outcomes. These findings may address concerns relating to student involvement in patient care within this setting. Future research should address economic and service delivery impacts of supervised student care on private practices.

Fundamental movement skill proficiency and objectively measured physical activity in children with bronchiectasis: a cross-sectional study.

BACKGROUND: Bronchiectasis is a major contributor to respiratory morbidity and healthcare utilization in children. Children with bronchiectasis exhibit low levels of physical activity (PA) and poor fundamental movement skills (FMS) may be a contributing factor. However, there are no data on FMS's in this population. The current study assessed FMS proficiency in children with bronchiectasis and examined associations with objectively measured PA. METHODS: Forty-six children with bronchiectasis (mean age 7.5 ± 2.6 year, 63% Male) were recruited from the Queensland Children's Hospital, Brisbane. PA was measured using the ActiGraph GT3X + accelerometer. Raw accelerometer data were processed into daily time spent in sedentary activities, light-intensity activities and games, walking, running, and moderate-to-vigorous activities and games using a random forest (RF) PA classification algorithm specifically developed for children. Daily MVPA was calculated by summing time spent in walking, running, and moderate-to-vigorous activities and games. FMS were assessed using the Test of Gross Motor Development 2nd Edition (TGMD-2). RESULTS: Fewer than 5% of children demonstrated mastery in the run, gallop, hop, and leap; while fewer than 10% demonstrated mastery for the two-handed strike, overarm throw, and underarm throw. Only eight of the 46 children (17.4%) achieved their age equivalency for locomotor skills, while just four (8.7%) achieved their age equivalency for object control skills. One-way ANCOVA revealed that children achieving their age equivalency for FMS had significantly higher levels of MVPA than children not achieving their age equivalency (51.7 vs 36.7 min/day). When examined by the five activity classes predicted by the RF algorithm, children achieving their age equivalency exhibited significantly greater participation moderate-to-vigorous intensity activities and games (22.1 vs 10.7 min/day). No significant differences were observed for sedentary activities, light-intensity activities and games, walking, and running. CONCLUSION: Children with bronchiectasis exhibit significant delays in their FMS development. However, those who meet their age equivalency for FMS proficiency participate in significantly more daily MVPA than children who do not meet their age-equivalency. Therapeutic exercise programs designed to improve FMS proficiency are thus likely to be beneficial in this population.

Does the Time-of-Day of Exercise Influence the Total Volume of Exercise? A Cross-Sectional Analysis of Objectively Monitored Physical Activity Among Active Individuals.

BACKGROUND: To improve compliance and adherence to exercise, the concept of temporal consistency has been proposed. Before- and after-work are periods when most working adults may reasonably incorporate exercise into their schedule. However, it is unknown if there is an association between the time-of-day that exercise is performed and overall physical activity levels. METHODS: Activity was assessed over 1 week in a sample of 69 active adults (n = 41 females; mean age = 34.9 [12.3] y). At the end of the study, participants completed an interviewer-assisted questionnaire detailing their motivation to exercise and their exercise time-of-day preferences. RESULTS: Participants were classified as "temporally consistent" (n = 37) or "temporally inconsistent" (n = 32) exercisers based on their accelerometry data. The "temporally consistent" group was further analyzed to compare exercise volume between "morning-exercisers" (n = 16) and "evening-exercisers" (n = 21). "Morning-exercisers" performed a greater volume of exercise than "evening-exercisers" (419 [178] vs 330 [233] min by self-report; 368 [224] vs 325 [156] min actigraph-derived moderate to vigorous physical activity, respectively). CONCLUSIONS: Our findings suggest that active individuals use a mixture of temporal patterns to meet PA guidelines. Time-of-day of exercise should be reported in intervention studies so the relationship between exercise time-of-day, exercise behavior, and associated outcomes can be better understood.