Morning physical activity may be more beneficial for blood lipids than afternoon physical activity in older adults: a cross-sectional study.

BACKGROUND: The effect of differences in daily physical activity patterns on blood lipids has not been determined. This study examines the effects of the differences in free-living daily physical activity patterns (amount and intensity) on blood lipid levels in older adults. METHODS: This cross-sectional study included 51 older participants (71.8 ± 0.6 years, men = 8, women = 43). A triaxial accelerometer was used to assess physical activity patterns. The time from awakening to bedtime for each participant was used for group classification based on the amount (number of steps) and intensity (moderate-to-vigorous physical activity, MVPA) of physical activity. The morning step group (M Step) was defined as those who took more steps in the morning, and the afternoon step group (A Step) was defined as those who took more steps in the afternoon. The same method was used for MVPA (morning MVPA: M MVPA; afternoon MVPA: A MVPA). Blood samples were collected at the start of the study to determine blood lipid levels. RESULTS: Number of steps taken showed a trend toward lower low-density lipoprotein cholesterol (LDL-C) levels in the M Step group compared with the A Step group. The LDL/high-density lipoprotein (HDL) ratio was significantly lower in the M Step group than the A Step group (p < 0.05). The M MVPA group also had higher HDL-C levels and significantly lower LDL/HDL ratios than the A MVPA group (p < 0.05). CONCLUSIONS: These results suggest that compared with afternoon physical activity, daily morning physical activity (amount and intensity) is more effective in improving blood lipid levels.

Are individual and social factors specific to the home associated with children's behaviour and physical environment at home.

This study used linear regression analyses to investigate the influence of parent-reported home-specific social and individual factors on: (i) 235 children's home-based objectively measured overall sitting time, breaks in sitting, and PA, and; (ii) the home physical environment via an audit. Parental importance assigned to active play for children was positively associated with PA equipment (accessibility and availability), as well as light physical activity (LPA) and sitting breaks on both weekdays and weekend days. Parental preference for being active at home and limits on screen-time were associated with less household media equipment and portable media equipment, respectively. Greater parental importance placed on playing electronic games/using computers for fun was associated with less LPA and more sitting on weekdays. Further, children who preferred being sedentary sat more and engaged in less moderate-vigorous physical activity (MVPA) on weekdays. Parental and child preferences and priorities, as well as parental rules for activity at home, were associated with children's home-based sitting and PA, especially on weekdays. Such factors were also associated with the physical environment in the expected directions. The findings suggest interventions need to target social and individual factors, alongside adapting the physical environment to create homes more promotive of physical activity.

Sedentary behavior, physical activity, and mental health in older adults: An isotemporal substitution model.

INTRODUCTION: Regular moderate-to-vigorous physical activity (MVPA) is associated with improved mental health, but the evidence for the effect of reducing sedentary behavior (SB) or increasing light PA (LPA) in older adults is lacking. Using isotemporal substitution (IS) models, the aim of this paper was to investigate the effect of substituting SB with LPA or MVPA on associations with mental health in older adults. METHODS: Data from 1360 older adults (mean age 75.18 years) in four countries were utilized. PA and SB was measured using ActiGraph wGT3X-BT + accelerometers worn for 7 days. Self-rated mental health was measured using the Hospital and Anxiety Depression Scale (HADS). IS models estimated cross-sectional associations when 30 minutes of one behavior was substituted with another. Models were adjusted for age, sex, marital status, and educational attainment. RESULTS: Substituting 30 minutes of SB with LPA (ß -.37; 95% CI -0.42, -0.32) or MVPA (ß -.14; 95% CI -0.21, -0.07) and substituting LPA with MVPA (ß -.11; 95% CI -0.18, -0.04) were associated with improvements in anxiety. However, substituting 30 minutes of SB with LPA (ß .55; 95% CI 0.49, 0.62) was associated with increased depression. CONCLUSION: Replacing 30 minutes of SB with LPA or MVPA was associated with improved anxiety symptoms in older adults. Greater benefits were observed when shifting SB and LPA to MVPA.

Is Sedentary Behavior or Physical Activity Associated With Loneliness in Older Adults? Results of the European-Wide SITLESS Study.

Research has found that social relationships are central to the health and well-being of an aging population. Evidence exploring the association between physical activity (PA) and sedentary behavior (SB) with social isolation and loneliness is limited. This study uses objectively measured PA and SB (ActiGraph®) and self-reported measures of loneliness (the De Jong Gierveld Loneliness Scale) and social engagement (the Lubben Social Network Scale) from the SITLESS study, a European-wide study of community-dwelling older adults. Social isolation was associated with SB where higher levels of SB were associated with an increase in the level of social isolation, controlling for age, sex, living arrangements, employment status, body mass index, educational background, marital status, and self-reported general health. In contrast, PA was not associated with social isolation, and neither SB nor PA was a statistically significant predictor of loneliness. SB may be linked to social isolation in older adults, but PA and SB are not necessarily linked to loneliness in older community-dwelling adults.

Cardiorespiratory fitness and adiposity in breast cancer survivors: is meeting current physical activity recommendations really enough?

PURPOSE: Breast cancer (BC) survivors are becoming increasingly predisposed to cardiovascular disease (CVD) mortality. Low cardiorespiratory fitness and physical activity (PA) levels, as well as high values of adiposity indices, contribute to CVD risk. We evaluated adiposity, cardiorespiratory profile, and PA levels in two independent cohorts of BC survivors. METHODS: Data were collected from two groups (99% women) from different areas of Madrid (Spain): group 1, n = 110, age 51.4 ± 9.7 years, median time from diagnosis 365 days (95% confidence interval [CI], 354-401), and group 2, n = 93, age 54.7 ± 8.9 years, 1714 days (95% CI, 1502-1938). We estimated peak oxygen uptake (VO2peak) and measured body mass index (BMI), waist circumference (WC), waist-to-hip index, and accelerometry-determined PA. RESULTS: Both groups had values of BMI in the overweight range (25.3 ± 4.3 and 27.1 ± 5.1 kg/m2, p = 0.003). Estimated VO2peak levels were lower in group 2 than in group 1 (28.1 ± 9.1 and 23.7 ± 8.8 ml/kg/min, p < 0.001), although levels in both groups were low. Yet, the majority of participants in both groups (81 and 88%, p = 0.234) met international PA recommendations (235 ± 196 and 351 ± 173 min/week of moderate-vigorous PA, p < 0.001). Both groups had very low levels of vigorous PA. These results were essentially independent of type of treatment (anthracycline/radiotherapy). CONCLUSIONS: We found a poor cardiorespiratory profile in two independent BC cohorts that differed in median time from diagnosis (as well in socioeconomic status), supporting the notion that implementation of PA (possibly focusing on vigorous PA) and dietary intervention is urgently needed in this patient population.

Association of objectively measured physical activity and physical fitness with menopause symptoms. The Flamenco Project.

OBJECTIVE: The primary aim was to analyze the association of moderate-to-vigorous physical activity (MVPA) with menopause symptomatology and its overall impact. A secondary/exploratory aim was to assess the association of different components of physical fitness with menopause symptomatology. METHODS: This cross-sectional study comprised 191 perimenopausal women from Southern Spain (age range 45-60 years, mean age 52.6 ± 4.5 years). The Blatt-Kupperman Menopausal Index was used to evaluate menopause symptomatology. Objectively measured MVPA was registered with accelerometry. Physical fitness was assessed with the Senior Fitness Test battery plus handgrip strength and sit-and-reach tests. RESULTS: After adjustment for multiple confounders, MVPA was only inversely associated with vertigo (r = -0.185, p < 0.05) and palpitations (r = -0.148, p < 0.05). Upper-body flexibility was inversely associated with the Blatt-Kupperman Menopausal Index global score (r = -0.147, p < 0.05). This test was also inversely associated with vertigo (r = -0.230, p < 0.01) and arthralgia (r = -0.168, p < 0.05). Lower-body muscle strength was associated with lower nervousness (r = -0.171, p < 0.05). Cardiorespiratory fitness was inversely associated with paresthesia (r = -0.158, p < 0.05), vertigo (r = -0.219, p < 0.01), fatigue (r = -0.159, p < 0.05) and arthralgia (r = -0.180, p < 0.05). CONCLUSION: The main findings of the present study indicate a weak association of objectively measured MVPA with menopause symptomatology. Exploratory analyses suggest that upper-body flexibility was associated with slightly lower overall menopause impact whereas neither MVPA nor any physical fitness components studied were associated with vasomotor symptoms.

Patterns of physical activity of people with COPD during participation in a pulmonary rehabilitation program.

INTRODUCTION: Very few studies have examined patterns of physical activity (PA) during a pulmonary rehabilitation (PR) program in people with COPD. AIMS: To compare the patterns of PA in: 1) the week before commencing PR (pre-PR) with a week during PR (PR week); 2) PR days and non-PR days during a PR week; 3) pre-PR and the week following PR completion (post-PR). METHODS: This was a multicenter, prospective cohort study. Participants attended twice weekly supervised PR for 8-12 weeks. Daily step count (primary outcome), time in light activities, time in moderate to vigorous PA (MVPA), total sedentary time and sit-to-stand (STS) transitions were measured using a thigh worn accelerometer for seven days, at each assessment time point: pre-PR, PR week and post-PR. RESULTS: 29 participants, mean age (SD) 69years(7), FEV1 53%pred(16). The PR week compared to pre-PR, showed higher daily: step count (mean difference (95%CI)), 941steps(388-1494); and MVPA, 11mins(6-15), with no difference in: time in light activities, -1min(-6-5); total sedentary time, 7mins(-21-36); or STS transitions, 0(-5-6). PR days compared to non-PR days showed higher: step count, 2810steps(1706-3913); time in light activities 11mins(1-20); time in MVPA, 27mins(17-35) and STS transitions, 8(4-12), with no difference in total sedentary time: -33mins(-80-15). There were no differences in any PA measures post-PR compared to pre-PR (p < 0.05). CONCLUSION: Daily step count and time spent in MVPA increased significantly during the PR week, solely due to increased PA on days participants attended PR.

Lower cardiac rehabilitation enrolment occurs in acute coronary syndrome patients who report low levels of physical activity at four weeks post-event: A prospective observational study using physical activity tracker data.

BACKGROUND: Physical activity (PA) and cardiac rehabilitation (CR) attendance are important for recovery and prognosis following acute coronary syndrome (ACS). However, PA patterns early post-ACS are not well known. OBJECTIVES: Investigate the level of PA at 4-weeks post-ACS and any potential associations with CR enrolment. METHODS: We recruited patients admitted for ACS from cardiac wards and clinics at two hospital sites in Sydney, Australia. PA data were collected using wearable activity trackers worn at 4-weeks post-ACS, and CR enrolment was self-reported. RESULTS: Participants (n = 61) were aged 66.7 ± 10.3 years, 74 % male, 61 % were married or partnered, and 33 % were diagnosed with ST-elevation myocardial infarction. Patients engaged in 7514±3355 steps per day and 44.6 ± 37.5 min of moderate-to-vigorous physical activity (MVPA). Patients who enrolled in CR exhibited higher daily step counts (p = 0.044), MVPA minutes (p = 0.001), and were more likely to meet PA guidelines. ACS patients who engaged in higher levels of MVPA were more likely to enrol in CR (odds ratio [OR] 1.46; 95 % confidence interval [CI] 1.08, 1.98). CR enrolment was also positively associated with being married or in an intimate partnership (OR 9.93; 95 % CI 1.83, 53.85) and absence of depressive symptoms (OR 11.86; 95 % CI 1.91, 73.74). CONCLUSION: Lower CR enrolment rates were observed among less physically active patients at 4-weeks post-ACS. However, each 10 min increment in MVPA increased the odds of CR enrolment by 46 %. Future research should explore strategies to target this inactive and high-risk group, given the potential for a large prognostic gain with CR participation.

Does moderate to vigorous physical activity mediate the association between depression and physical function in midlife: Evidence from two British birth cohort studies.

BACKGROUND: Mental health and physical health are intrinsically linked, yet the mechanisms are not well understood. We investigated whether moderate-vigorous physical activity (MVPA) mediated the association between depression and physical function (PF) in midlife. METHODS: Individuals from two UK birth cohorts born within one week in 1958 (n = 7278) and 1970 (n = 6097) with data on depression (ages 33/34; Malaise Inventory), MVPA (age 42; self-reported) and PF (ages 50/56; Short Form-36 subscale). Covariates included sex, childhood and adulthood social class, maternal mental health, childhood mood, alcohol consumption, smoking habits, sleep, marital status, BMI and long-standing illness/disability. Linear or multinomial logistic regression models examined associations between depression, MVPA and PF. We used a parametric g-computation mediation analysis approach to estimate percent differences in PF. RESULTS: Depression was associated with less frequent MVPA and poorer PF. Lower MVPA was associated with worse PF. The direct effect - randomised analogue not operating via MVPA - of depression on PF was -18.8 % (95%CI:--25.8,-11.8) and -15.8 % (20.6,-11.0) in the 1958 and 1970 cohorts, respectively. The indirect effect - operating via MVPA - was -0.5 % (-1.0,-0.03) and -0.2 % (-0.6, 0.3), resulting in a total proportion mediated of 3.1 % (0.1, 6.0) and 0.9 % (-1.6, 3.4). LIMITATIONS: MVPA was self-reported. Intermediate confounders and mediators were measured at the same age, however associations did not change in sensitivity analysis considering age 46 MVPA (1958 cohort). CONCLUSIONS: Although higher MVPA was protective against poor PF, there was only minor evidence that it mediated the association between depression and PF. Further investigation into other potential mediators of pathways from mental to physical health is needed.

Association of the "Weekend Warrior" and Other Physical Activity Patterns with Metabolic Syndrome in the South Korean Population.

These days, it is not common for people to have time to do physical activities regularly because of their own work. So, they perform physical activities all at once, which is often called the "weekend warrior". Therefore, this study aimed to examine the association of the "weekend warrior" and other physical activity patterns with metabolic syndrome. Data from the Korea National Health and Nutrition Examination Survey were used, and 27,788 participants were included. The participants were divided into inactive, weekend warriors, and regularly active based on physical activity patterns. The risk of metabolic syndrome in each group was analyzed using multiple logistic regression. The inactive and weekend warrior groups showed a higher likelihood of developing metabolic syndrome than the regularly active groups (weekend warrior: odds ratio (OR) 1.29, confidence interval (CI) 1.02-1.65; inactive: OR 1.38, CI 1.25-1.53). According to the physical activity patterns, the weekend warrior group showed a dose-response relationship compared to the regularly active group (only moderate: OR 1.85, CI 1.25-2.72; only vigorous: OR 1.41, CI 0.93-2.14; both: OR 0.84, CI 0.56-1.27). This study found increasing the amount of physical activity and performing vigorous-intensity physical activity helped manage metabolic syndrome in the weekend warrior group.

Green Walkability and Physical Activity in UK Biobank: A Cross-Sectional Analysis of Adults in Greater London.

Urban greenspace provides opportunities for outdoor exercise and may increase physical activity, with accompanying health benefits. Areas suitable for walking (walkability) are also associated with increased physical activity, but interactions with greenspace are poorly understood. We investigated associations of walkability and green walkability with physical activity in an urban adult cohort. We used cross-sectional data from Greater London UK Biobank participants (n = 57,726) and assessed walkability along roads and footpaths within 1000 m of their residential addresses. Additionally, we assessed green walkability by integrating trees and low-lying vegetation into the walkability index. Physical activity outcomes included self-reported and accelerometer-measured physical activity and active transport. We assessed associations using log-linear, logistic and linear regression models, adjusted for individual- and area-level confounders. Higher green walkability was associated with favourable International Physical Activity Questionnaire responses and achievement of weekly UK government physical activity guideline recommendations. Participants living in the highest versus lowest quintile of green walkability participated in 2.41 min (95% confidence intervals: 0.22, 4.60) additional minutes of moderate-and-vigorous physical activity per day. Higher walkability and green walkability scores were also associated with choosing active transport modes such as walking and cycling. Our green walkability approach demonstrates the utility in accounting for walkability and greenspace simultaneously to understand the role of the built environment on physical activity.

Physical Activity, Energy Expenditure, Screen Time and Social Support in Spanish Adolescents-Towards an Explanatory Model about Health Risk Factors.

Youth obesity has been a pandemic for decades. One of its causes is a low level of physical activity. It is necessary to know the specific situation of adolescents and the factors that influence it in order to be able to act accordingly. The first aim of the current study is to create an explanatory model to establish the relationships between light physical activity time, light physical activity energy expenditure, screen time and social support. The second aim is to propose a theoretical model specifying the relationships between moderate-vigorous physical activity time, moderate-vigorous physical activity energy expenditure, screen time and social support. The study design was non-experimental (ex post facto), descriptive-correlational and cross-sectional. A total of 694 adolescents from the region of Soria (12-17 years) participated in the study. The instruments administered were the Four by One-Day Physical Activity Questionnaire, Parent Support Scale and Peer Support Scale. Two structural equation models were developed to analyse the relationships between the variables that comprised the explanatory models. The results show that social support had a negative influence on screen time in the proposed model in relation to light physical activity (r = -0.210; p ≤ 0.001) and in the proposed one regarding moderate-vigorous physical activity (r = -0.173; p ≤ 0.05). Social support was negatively related to light physical activity time (r = -0.167; p ≤ 0.05). Family support had a greater influence than did peer support. In conclusion, the models for light and moderate-vigorous physical activity are useful to describe the relationships between time, energy expenditure, screen time and social support.

A Mixed Methods Study to Examine the Influence of CLIL on Physical Education Lessons: Analysis of Social Interactions and Physical Activity Levels.

Physical Education is often selected for applying multilingual initiatives through the use of a content and language integrated learning (CLIL) approach. However, it is still unclear whether the introduction of such an approach might entail losing the essence of physical education and distorting its basic purposes. The aim of this study is to analyze the impact of CLIL on physical education lessons. Given the purpose of this study, a mixed methodological approach based on a sequential exploratory design divided into two different phases is used. We begin with initial qualitative data collection (phase I), consisting of the analysis of interviews with 12 participants (8 teachers and 4 students). Based on its analysis, two foci are identified: social relationships and physical activity. Then, informed by the results obtained, a quantitative approach is used (phase II), differentiating these two sets of data to make a more in-depth analysis of them. On the one hand, a sociometric questionnaire was applied to analyze the social relationships between CLIL students. On the other hand, a quasi-experimental design (n = 49) was implemented using accelerometry to measure moderate to vigorous physical activity (MVPA) in the physical education sessions. Regarding physical activity, the results show that levels of MVPA are higher in the experimental group (CLIL) than in the control group, a result which clarifies the divergent viewpoints of the interviewees. However, focusing on social relationships, the sociometric questionnaire results show that there were no statistically significative changes, although some signs of a slight effect on students' relationships arise depending on their gender. Therefore, more research would be necessary to further study the effect of CLIL in this regard.

Interventions Promoting Physical Activity Among Older Adults: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVES: Frequent participation in physical activity (PA) has benefits across the lifespan but is particularly important for older adults. PA levels are either measured by objective or self-reported survey methods. Objective PA measurement is used to increase accuracy. This systematic review investigated the effect of physical activity-based interventions on objectively measured PA levels among community-dwelling adults aged 60 years and older. RESEARCH DESIGN AND METHODS: Literature searches were conducted in five electronic databases and four clinical trial registries. Randomized controlled trials investigating the effect of physical activity-based interventions on objectively measured PA levels (e.g., accelerometers or pedometers) in community-dwelling adults aged 60 years and older compared with no/minimal intervention were considered eligible. Data were pooled using the most conservative estimates reported from each study using the standardized mean difference (SMD). Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the overall quality of the evidence. RESULTS: Fourteen published trials and 3 ongoing trials were identified. There were significant effects favoring physical activity-based interventions compared with minimal intervention at short-term (less than or equal to 3 months) (SMD: 0.30, 95% CI: 0.17 to 0.43) and intermediate-term (more than 3 months and less than 12 months; SMD: 0.27, 95% CI: 0.06 to 0.49) follow-ups. The quality of evidence was moderate according to GRADE (downgraded for risk of bias). DISCUSSION AND IMPLICATIONS: Our findings suggest that physical activity-based interventions may increase objectively measured PA levels in community-dwelling older adults. Further studies are still needed to identify the optimal dose, intensity, and mode of delivery of physical activity-based interventions.

Physical activity, stress, and cardiovascular disease risk: HCHS/SOL Sociocultural Ancillary Study.

We assess whether the cross-sectional associations between moderate-vigorous physical activity (MVPA) and CVD risk factors are modified by various stress types. Complete baseline data from 4,000 participants, ages 18-74 years, of the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (HCHS/SOL SCAS) were analyzed using complex survey design methods. Accelerometer-measured MVPA was assessed continuously (average minutes per day). CVD risk factors assessed were diabetes, hypercholesterolemia, hypertension, and obesity. Stress was assessed using the Chronic Burden Scale for chronic stress, Traumatic Stress Schedule for traumatic stress, and the Perceived Stress Scale for perceived stress. Poisson regression models estimated prevalence ratios of CVD risk factors. The interaction was evaluated by cross-product terms with p <0.10. There was a significant interaction between chronic stress and MVPA among those with prevalent diabetes (pinteraction = 0.09). Among those reporting low chronic stress, higher MVPA was associated with a low prevalence of diabetes, however among those reporting high chronic stress, the prevalence of diabetes remained high even with higher MVPA. We did not observe interactions between chronic stress and MVPA for the remaining CVD risk factors, or interactions between traumatic stress or perceived stress and MVPA. This study provides initial evidence on the role of chronic stress on the association between MVPA and diabetes for Hispanic/Latino adults. Mostly, however, chronic stress, traumatic stress, and perceived stress did not modify the associations between MVPA and CVD risk factors for Hispanic/Latino adults.

A comparison of physical activity from Actigraph GT3X+ accelerometers worn on the dominant and non-dominant wrist.

The purpose of this study was to evaluate the agreement between several activity measures using raw acceleration data from accelerometers worn concurrently on the dominant and non-dominant wrist. Fifty-five adults (31·9 ± 9·7 years, 26 males) wore two ActiGraph GT3X+ monitors continuously for 1 day, one on their non-dominant wrist and the other on their dominant wrist. Paired t-tests were undertaken with sequential Holm-Bonferroni corrections to compare wear time, moderate-vigorous physical activity (MVPA), time spent in 10-min bouts of MVPA (MVPA10 min ) and the average magnitude of dynamic wrist acceleration (ENMO). Level of agreement between outcome variables from the wrists was examined using intraclass correlation coefficients (ICC, single measures, absolute agreement) with 95% confidence intervals and limits of agreement (LoA). Time spent across acceleration levels in 40 mg resolution were also examined. There were no significant differences between the non-dominant and dominant wrist for ENMO, wear time, MVPA or MVPA10 min . Agreement between wrists was strong for most outcomes (ICC ≥0·92) including wear time, ENMO, MVPA, MVPA10 min and the distribution of time across acceleration levels. Agreement was strong in the low acceleration bands (ICC = 0·970 and 0·922) with a mean bias of 3·08 min (LoA -55·18 to 61·34) and -5·43 (LoA -43·47 to 32·62). In summary, ENMO, MVPA, MVPA10 min , wear time and the distribution of time across acceleration levels compared well at the group level. The LOA from the two lowest acceleration levels suggest further work over a longer monitoring period is needed to determine whether outputs from each wrist are comparable.

Do Social Cognitive Theory constructs explain response heterogeneity with a physical activity behavioral intervention in multiple sclerosis?

BACKGROUND: Behavioral interventions based on Social Cognitive Theory (SCT) are efficacious for increasing both objectively-measured and self-reported physical activity in people with multiple sclerosis (MS). PURPOSE: This study involved a secondary analysis of data focused on SCT constructs as correlates of individual-level changes (i.e., response heterogeneity) following a behavioral intervention. METHOD: Twenty-two persons with MS who completed a 6-month SCT-based behavioral intervention for increasing physical activity were included in analyses. The intervention consisted of two primary components, namely a dedicated Internet website and one-on-one video chats with a behavioral coach. Outcomes included objectively-measured moderate-vigorous physical activity (MVPA) using Actigraph model GT3X+ accelerometers and self-reported physical activity using the Godin Leisure-Time Exercise Questionnaire (GLTEQ) as well as SCT variables of exercise self-efficacy, barriers self-efficacy, outcome expectations, goal setting and planning and facilitators/impediments. RESULTS: There was individual variability in physical activity change following the intervention. For example, 4/22 participants demonstrated a reduction in MVPA, 1/22 participants had no change, 9/22 participants had less than 0.5 standard deviation (SD) increase in MVPA, and 8/22 participants had an increase in MVPA of more than 0.5 SD. Baseline SCT variables, particularly outcome expectations, goal setting, planning, and barriers self-efficacy, correlated with increased physical activity. CONCLUSIONS: This study indicates that SCT variables correlate with the response heterogeneity associated with physical activity behavioral interventions, and this might inform the delivery of interventions consistent with Bandura's stepwise implementation model for optimizing the "fit" of an intervention based on SCT for maximizing treatment efficacy in MS.

The feasibility and acceptability of morning versus evening exercise for overweight and obese adults: A randomized controlled trial.

BACKGROUND: The time of day that people exercise could have an influence on the efficacy of exercise for weight loss, via differences in adherence and/or physiological adaptations. However, there is currently no evidence to support an optimal time of day for exercise to maximise efficacy. PURPOSE: To examine the feasibility and acceptability of prescribed morning and evening exercise. METHODS: Twenty inactive, overweight adults aged 18-60 years were recruited for a 12-week intervention and randomized to one of three groups using a 2:2:1 random allocation ratio: i) morning exercise (AM; n = 9); ii) evening exercise (PM; n = 7); or iii) waitlist control (CON; n = 4). Exercise groups were prescribed self-paced walking or running on a treadmill to achieve a weekly total of 250 min. Feasibility and acceptability data were collected, and physiological and behavioural outcomes associated with energy balance were measured at baseline, mid- and post-intervention. RESULTS: Attrition was low (n = 2 dropped out), with high measurement completion rates (>80%). The intervention groups had high adherence rates to exercise sessions (94% and 87% for the AM and PM groups, respectively). No adverse events resulting from the intervention were reported. Both intervention groups displayed improvements to their cardiometabolic risk profile; cardiorespiratory fitness improved by 5.2 ±â€¯4.7, and 4.6 ±â€¯4.5 mL kg-1.min-1 and body fat percentage reduced by 1.2 ±â€¯1.4, and -0.6 ±â€¯1.2% for AM and PM groups, respectively. CONCLUSION: This feasibility study provides evidence that morning and evening exercise interventions are feasible, and also provides justification for a large-scale randomized controlled trial. TRIAL REGISTRATION: This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000457448p, 7/4/2016).

Physical activity levels are low in patients with pulmonary hypertension.

BACKGROUND: Pulmonary hypertension (PH) leads to exercise capacity impairment, but limited data are available on the objective evaluation of physical activity (PA) levels in these patients. METHODS: We assessed PA levels using triaxial accelerometry in Spanish PH patients (n=75, 48±14 years, 65% female) and gender/age matched controls (n=107), and examined potential associations of meeting minimum international recommendations [moderate-vigorous PA (MVPA) ≥150 min/week] with survival predictors. RESULTS: With the exception of vigorous PA (with very low values in both groups), all accelerometry data showed significant differences between patients and controls, with lower PA levels and proportion of individuals meeting minimum PA guidelines, but higher inactivity time, in the former. Notably, the odds ratio (OR) of having a "low-risk" value of 6-minute walking distance (≥464 m) or ventilatory equivalent for carbon dioxide (≤39) was higher in patients following MVPA guidelines than in their less active peers [OR =4.3, 95% confidence interval (CI), 1.6-11.6, P=0.005, and OR =4.5, 95% CI, 0.9-21.1, P=0.054]. CONCLUSIONS: Daily PA is reduced in patients with PH, often to a level that may decrease their odds of survival. Efforts should be made to promote the implementation of healthy PA habits in this patient population.

App-Based Intervention Combining Evidence-Based Behavior Change Techniques With a Model-Based Reasoning System to Promote Physical Activity Among Young Adults (Active2Gether): Descriptive Study of the Development and Content.

BACKGROUND: The Active2Gether intervention is an app-based intervention designed to help and encourage young adults to become and remain physically active by means of personalized, real-time activity tracking and context-specific feedback. OBJECTIVE: The objective of our study was to describe the development and content of the Active2Gether intervention for physical activity promotion. METHODS: A systematic and stepwise approach was used to develop the Active2Gether intervention. This included formulating objectives and a theoretical framework, selecting behavior change techniques, specifying the tailoring, pilot testing, and describing an evaluation protocol. RESULTS: The development of the Active2Gether intervention comprised seven steps: analyzing the (health) problem, developing a program framework, writing (tailored) messages, developing tailoring assessments, developing the Active2Gether intervention, pilot testing, and testing and evaluating the intervention. The primary objective of the intervention was to increase the total time spent in moderate-vigorous physical activity for those who do not meet the Dutch guideline, maintain physical activity levels of those who meet the guideline, or further increase physical activity levels if they so indicated. The theoretical framework is informed by the social cognitive theory, and insights from other theories and evidence were added for specific topics. Development of the intervention content and communication channel resulted in the development of an app that provides highly tailored coaching messages that are framed in an autonomy-supportive style. These coaching messages include behavior change techniques aiming to address relevant behavioral determinants (eg, self-efficacy and outcome expectations) and are partly context specific. A model-based reasoning engine has been developed to tailor the intervention with respect to the type of support provided by the app, send relevant and context-specific messages to the user, and tailor the graphs displayed in the app. For the input of the tailoring, different instruments and sensors are used, such as an activity monitor (Fitbit One), Web-based and mobile questionnaires, and the location services on the user's mobile phone. CONCLUSIONS: The systematic and stepwise approach resulted in an intervention that is based on theory and input from end users. The use of a model-based reasoning system to provide context-specific coaching messages goes beyond many existing eHealth and mHealth interventions.