Journal of physical activity & health最新文献

Aims: Supervised exercise provides numerous health benefits for people with type 2 diabetes mellitus (T2D); however, long-term adherence is poor. We aimed to identify (1) factors associated with total physical activity (PA) participation 10 months following supervised exercise and (2) barriers to and enablers of self-directed exercise.

Methods: Fifty-seven adults with type 2 diabetes mellitus (age: 60.4 [8.6] y, 23% women, glycated hemoglobin [HbA1c]: 8.7% [1.9%], PA: 68.1 [142.3] min·wk-1) were allocated to low-volume combined aerobic and resistance high-intensity interval training (78 min·wk-1) or combined moderate intensity continuous training (210 min·wk-1). Participants completed 8 weeks of supervised training, then 10 months of self-directed exercise (12 mo total). Sociodemographic, medical, psychological, and health determinants of total PA at 12 months were identified using correlation and multiple regression analyses. Barriers and enablers were derived from individual participant interviews.

Results: At 12 months, average weighted total PA was 209.4 (174.3) minutes per week. Only allocation to combined aerobic and resistance high-intensity interval training was an independent predictor of total PA at 12 months (β = 0.477, P = .027). Enablers of self-directed exercise included flexible exercise schedule and social support. Barriers were limited access to specialized equipment and competing time demands.

Conclusions: This study highlights factors to consider when designing long-term exercise support for people with type 2 diabetes mellitus.

Background: Physical activity benefits both individuals and societies. This article evaluates progress in physical activity surveillance, research, policy, and authorship gender equity in Brazil (1950-2019).

Methods: We used data from a systematic review and the country cards produced by the Global Observatory for Physical Activity. Brazilian articles identified in the review were classified according to research theme and gender distribution in authorship. We also assessed the changes in physical activity policy and surveillance in Brazil.

Results: Of the 23,860 articles identified in the global review, 1200 (5.0%) were from Brazil. There was a sharp increase in publications from the 2000s, but a slight decline has been observed since 2015. Most studies were on physical activity surveillance (37%). The proportion of females as first authors was 51.2% in the last decade analyzed (2010-2019)-however, the proportion of female senior authors was below 40%. Brazil has a comprehensive surveillance system that includes all ages in periodic physical activity monitoring. Brazil has a physical activity policy embedded in noncommunicable diseases and health promotion policies, has recently launched guidelines for the population, and has a wide range of policies embedded in the national public health system.

Conclusion: Brazil is a leading middle-income country regarding physical activity research, policy, and surveillance. The results revealed some gender disparity in leadership roles in publications. The next challenge is translating this progress into increased physical activity levels among the Brazilian population.

Background: We aimed to develop and validate a multivariable model for predicting dropout from a community-based going-out program for older adults.

Methods: The National Center for Geriatric and Gerontology's Study of Geriatric Syndromes, with a prospective cohort of general older adults, was employed. A total of 5905 older adults who were independent in their activities of daily living were recruited and randomly allocated into training, validation, and testing data sets in a 6:2:2 ratio. An outcome was defined as dropping out of a community-based going-out program within 180 days. An extreme gradient boosting algorithm was used to develop the predictive model using training and validation data sets and to identify feature importance. The model's discrimination and calibration were evaluated in the test data set.

Results: The area under the curve for the receiver operating characteristic ( 95% CI) was 0.701 (0.670-0.732). Sensitivity, specificity, positive predictive value, and negative predictive value and their 95% CIs were 0.253 (0.226-0.277), 0.915 (0.899-0.931), 0.588 (0.560-0.612), and 0.718 (0.692-0.743), respectively, and the slope of the calibration plot was 1.046 (0.909-1.182). Cognitive and physical functions and willingness to engage in exercise/sport activities were selected as the most important features.

Conclusions: The predictive model reliably indicates whether a participant will drop out when classified as negative but not when classified as positive. Physical and cognitive functions and willingness to engage in physical activity may be primary predictors.

Background: Interventions promoting increased physical activity (PA) and limited sedentary time in older adults are urgently required. This study examines how 5 years of supervised high-intensity interval training (HIIT), or moderate-intensity continuous training (MICT) affects PA and sedentary time measured objectively, during, and 5 years after the intervention, compared to an unsupervised control group.

Methods: In total, 1405 participants with a mean age of 72.8 years, consisting of 51% females, were randomized 1:1:2 to 5 years of 2 weekly sessions of HIIT (90% of peak heart rate), MICT (70% of peak heart rate), or as controls asked to follow national PA recommendations. Total PA, number of steps, sedentary time, light PA, moderate PA, and vigorous PA were measured with ActiGraph GT3X+ monitors at baseline, years 1, 3, 5, and 10.

Results: There were no significant between-group differences throughout the study. However, HIIT, MICT, and control demonstrated significant changes after 1 year, including decreased total PA (-10%, -9%, and -9%, respectively), increased sedentary time (164, 163, and 163 min/d, respectively), and increased moderate PA (21, 21, and 19 min/d, respectively). Furthermore, after 10 years, pooled moderate to vigorous PA was maintained or increased in all groups (5.7, 1.9, and 1.5 min/d in HIIT, MICT, and control, respectively).

Conclusion: HIIT, MICT, and control exhibited a similar long-term effect on objective PA and sedentary time in a general population of older adults. Notably, both supervised and unsupervised exercise combined with regular follow-up hindered the expected age-related decline in moderate to vigorous PA over 10 years.

Background: This study aimed to map and understand the organizational and contextual conditions and mechanisms that contribute to the long-term effect of the Vida Ativa Melhorando à Saúde (VAMOS) program.

Methods: A primary health care-based intervention implemented in 15 cities, with 16 groups. The sample included professionals and participants from the VAMOS program. The analysis adopted was multivalued qualitative comparative analysis. Representing the VAMOS program groups, 16 cases were considered. For this analysis, the outcome variable was the long-term effect observed after the intervention. The mechanisms were analyzed on the basis of identified and calibrated conditions.

Results: Seven conditions were identified. The lower impact of COVID-19 was necessary for long-term effect. Four mechanisms that led to the long-term effect of VAMOS were identified, where the one with greater consistency and coverage had less external incentive, impact of COVID-19, and content execution, accompanied by greater relative priority, primary health care professionals' self-efficacy, process execution, and maintenance intention. A tracing process identified the conditions that least varied for the long-term effect were relative priority and execution of the content.

Conclusions: Considering several organizational aspects, the greatest variation between the mechanisms for intervention long-term effect were linked to the program management and the implementation process.

Purpose: This study aims to establish the reliability of accelerometer-based measurements for physical activity, sedentary behavior, and step counts in preschoolers and determine the optimal monitoring duration necessary for reliable data.

Methods: The study analyzed data from 434 preschoolers (ages 3-5) who wore waist-worn ActiGraph wGT3X-BT accelerometers for 7 days as part of the Sunrise Study in Spain. Two-way mixed effects intraclass correlation coefficients were calculated for various combinations of daily wear time and number of valid days to assess reliability. The Spearman-Brown prophecy formula was applied to determine the required days to achieve reliability scores of 0.7, 0.8, and 0.9.

Results: The findings showed that reliability improved with increased wear time, although intraclass correlation coefficients values were weaker around 7 to 9 hours per day. To achieve a reliability score of 0.7, moderate to vigorous physical activity required 3 to 4 days, light physical activity required 4 to 7 days, and sedentary behavior required 8 to 13 days. Steps per day required 7 to 9 days for a reliability score of 0.7, while other step outcomes needed 10 to 13 days.

Conclusion: The study provides evidence-based recommendations on the monitoring duration required for reliable estimates of physical activity, sedentary behavior, step counts, and sleep duration in preschoolers using accelerometers. These findings are crucial for researchers and practitioners aiming to accurately assess and promote physical activity in early childhood.

Background: The prevalence of overweight, obesity, and low physical fitness is associated with minimal engagement in physical exercise (PEx) and has increasingly affected children and adolescents in rural areas. This study examines the effects of a 15-minute PEx intervention on the levels of physical fitness and anthropometric indicators of overweight and obesity among rural school students.

Methods: A total of 245 school students (135 boys and 110 girls), aged between 11 and 17 years, were randomly allocated into intervention and comparator groups. The intervention lasted for 12 weeks, comprising 24 PEx sessions. Physical fitness was measured through cardiorespiratory fitness, muscular strength/endurance, handgrip strength, lower limb power, flexibility, speed, and agility. The measured anthropometric indicators of overweight and obesity included body mass index, waist circumference, and the sum of subscapular and triceps skinfolds.

Results: Generalized estimating equations analysis, performed with an intention-to-treat approach, indicated significant group × time interaction (P < .05) for flexibility, muscular strength/endurance, handgrip strength, cardiorespiratory fitness (only for boys), and waist circumference. For these 5 variables, there were no differences between groups at the baseline (P > .05), and the intervention group showed significantly greater improvements compared with the comparator group at the postintervention time (P < .05).

Conclusion: An intervention program consisting of 15 minutes of PEx during PE classes, conducted twice a week for 12 weeks, improves cardiorespiratory fitness, flexibility (only for boys), muscular strength/endurance, handgrip strength, body mass index (only for girls), and waist circumference of rural adolescent school students.

Background: Physical activity benefits adolescent health and well-being, known holistically as social and emotional well-being (SEWB) to Aboriginal people. However, little is known about the associations between physical activity and SEWB among Aboriginal adolescents. The "Next Generation: Youth Well-Being (NextGen) Study" is a cohort study of Aboriginal people aged 10-24 years in Australia. We aimed to examine associations between physical activity and SEWB, and cultural engagement and community connection among NextGen participants.

Methods: Prior to recruiting participants, partnerships and relationships were developed with Aboriginal community organizations. Participant recruitment and self-reported data collection through questionnaires using established tools were led by Aboriginal youth peer researchers. Logistic regression estimated odds ratios for engaging in higher levels of physical activity (3-7 d vs 0-2 d) according to SEWB, culture, and community factors; models were adjusted for sex, age, and state/territory.

Results: Of 1154 adolescents, 517 (45%) engaged in 3 to 7 days of physical activity. Factors associated with higher odds of physical activity were having good to excellent self-rated health; higher resilience; a lower risk Strengths and Difficulties Questionnaire score; regular community group/club participation, team sport, individual sport, or church/religious activities in the past 12 months; and perception of activities for young people to do in their community.

Conclusion: Physical activity participation was favorably associated with a holistic range of measures of adolescent health and well-being. These findings provide valuable insights for Aboriginal adolescent program and policy design and delivery. The follow-up of participants in this cohort study will allow for examination of causal associations.

Survivors of lower-extremity sarcoma are at high risk of developing physical performance dysfunctions and impaired quality of life resulting from the sarcoma disease itself and the adverse side effects of the treatments. Therefore, the implementation of safe and effective exercise programs addressing survivors' functionality and life quality is an essential and complementary nonpharmacological intervention in the cancer continuum. The viability and success of physical activity and exercise in lower-extremity sarcoma survivors remains largely unknown, likely due to the heterogeneity of clinical presentation and development of this type of cancer regarding diagnosis, treatment, and prognosis. This study provides specific recommendations for designing an appropriate training program that will help maintain sarcoma survivors' physical activity and improve their quality of life. The main conclusions reported here result from scientific studies and analyses of clinical data both selected from a systematic search in PubMed database. Sarcoma survivors should be advised as soon as the disease is diagnosed to perform a simple program of low-intensity and short-duration exercise prior to surgery (prehabilitation). Later, during clinical treatments and taking into account their psychobiological status, an adapted exercise program may be developed within the hospital environment. Finally, building healthy habits is recommended so as to improve disease-free survival, including regular physical activity, always under the supervision of professionals in this field. Hopefully, these suggestions will contribute to a better professional performance by specialists in the implementation of safe, reliable, and exercise programs in lower-extremity sarcoma survivors.