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Background: The knowledge base on physical activity and sedentary behaviour in adults with Down syndrome (DS) may advance by accelerometer calibration studies. This study aimed to develop cut‐points for sedentary behaviour and moderate‐to‐vigorous physical activity (MVPA) for adults with DS based on output from accelerometers worn on the dominant and non‐dominant hips. Methods: Sixteen adults with DS (10 men; age 31 ± 15 years) performed 12 tasks including sedentary behaviours and physical activities. We obtained metabolic equivalents (METs) with indirect calorimetry and vector magnitude (VM) output from triaxial accelerometers (wGT3X‐BT, ActiGraph) worn on the dominant and non‐dominant hips. Receiver operating characteristic curves were used to identify optimal VM cut‐points that maximised sensitivity and specificity. Results: Overall classification accuracy was very high (area under the ROC curve: 0.95 and 0.92 for sedentary and MVPA models, respectively). For the non‐dominant hip, the optimal VM cut‐points were (1) sedentary behaviour ≤236 counts·min−1 and (2) MVPA ≥2167 counts·min−1. For the dominant hip, optimal cut‐points were (1) sedentary behaviour ≤243 counts·min−1 and (2) MVPA ≥2092 counts·min−1. Conclusions: The presented VM cut‐points for sedentary behaviour and MVPA for adults with DS had high classification accuracy. There were small differences in accelerometer cut‐points between the dominant and non‐dominant hip. [ABSTRACT FROM AUTHOR]

Background: Adults with intellectual disability (ID) have a higher rate of fall events than the general population. Consequently, interventions for reducing fall events and improving health are highly required for individuals with ID. One essential step towards effectively delivering fall prevention interventions among adults with ID involves evaluating their feasibility. This study examined the feasibility of a home‐based exercise intervention, supplemented with behavioural change strategies, among individuals with ID living in residential settings. Method: This study provided an 8‐week intervention, consisting of a workshop for support workers and sessions for participants with ID, focusing on behavioural reward/s, education regarding fall prevention/exercise and exercise training. One week prior to and 1 week following such an intervention, such participants underwent measurements for (1) physical performance, (2) fall efficacy, (3) self‐efficacy for activity and (4) social support. Results: Participants having ID (n = 33), support workers (n = 11) and one administrator participated in this study. There were no adverse events during the intervention, and the mean adherence rate was 70.8 ± 19.5%. Two participants with ID dropped out of the programme due to a lack of interest. The participants with ID significantly improved individual physical performance, self‐efficacy for activity, fall efficacy and support from friends and support workers. Conclusions: Fall prevention interventions for adults with ID living in group‐homes were highly promising for eventual large‐scale implementation within such communities. [ABSTRACT FROM AUTHOR]

Background: Triaxial accelerometer output [vector magnitude (VM) counts] may better estimate physical activity intensity as reflected in the rate of oxygen uptake (V̇O2) than the traditional vertical axis (VA) counts in adults with Down syndrome (DS). This study examined the accuracy of VM vs. VA counts in estimating V̇O2 in adults with and without DS across different physical activities and sedentary behaviours. Methods: Sixteen adults with DS (10 men and 6 women; 31 ± 15 years) and 19 adults without DS (10 men and 9 women; 24 ± 5 years) performed 12 tasks. V̇O2 was measured by portable spirometer (K4b2, Cosmed) and VM and VA with an accelerometer (wGT3X‐BT, Actigraph). Results: Vector magnitude and VA were significant predictors of V̇O2 in adults with DS (P < 0.001; R2 = 0.74 and 0.65, respectively) and adults without DS (P < 0.001; P < 0.001; R2 = 0.75 and 0.61, respectively). Absolute error of prediction was significantly smaller for VM than VA for sitting, playing app, drawing, sweeping, standing and basketball (P ≤ 0.005), but smaller for VA than VM for walking at 0.8 m·s−1 (P = 0.005). Bland–Altman plots for adults with and without DS indicated narrower limits of agreement for VM than VA (−5.57 to 5.57 and −6.44 to 6.44 mL·kg−1·min−1; −6.21 to 6.17 and −7.75 to 7.74 mL·kg−1·min−1, respectively). Conclusions: Vector magnitude and VA are significant predictors of V̇O2 in adults with and without DS, yet VM more accurately estimated V̇O2 than VA for most tasks. Development of accelerometer‐based prediction of physical activity levels in adults with and without DS may improve by utilising VM counts. [ABSTRACT FROM AUTHOR]

Background and purpose: Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the central nervous system (CNS) that can be tracked through biomarkers of disease status. We investigated the effects of exercise on MS biomarkers associated with CNS status including imaging, blood–brain barrier (BBB) function and neurotrophic factors. Methods: We conducted open‐dated searches of Scopus, Medline, EMBASE and the Cochrane Library. We included studies written in English describing interventions of exercise that measured one or more of the biomarkers associated with MS published up to October 2018. Results: We located a total of 3012 citations through searches in electronic databases. Of these, 16 studies were eligible for review; six studies focused on magnetic resonance imaging (MRI) markers, nine studies focused on neurotrophic factors and three studies focused on BBB function markers. It is of note that two studies included both neurotrophic factor and BBB function markers and are therefore included across categories of biomarkers in this review. The existing evidence from MRI studies confirmed that exercise training can improve CNS integrity and function. There is evidence of a positive effect of exercise training on modulation of BBB permeability markers and brain‐derived neurotrophic factor. Conclusions: Exercise successfully improves MRI outcomes and peripheral biomarkers (i.e. brain‐derived neurotrophic factor) in people with MS. This suggests that exercise can be recommended as an adjuvant therapy for MS treatment. This conclusion is tempered by some methodological limitations including small sample sizes and high drop‐out rates in the reviewed studies. [ABSTRACT FROM AUTHOR]

Objective: This study examined body fatness and its association with cardiorespiratory fitness (CRF) in persons with multiple sclerosis (pwMS) accounting for disability status. Materials and Methods: This study involved a secondary data analysis from a previous study of 62 pwMS. Body fatness was indirect measured as body mass index (BMI), and CRF was measured as peak oxygen consumption from an incremental exercise test with spirometry. Participants were allocated into 3 different groups based on established BMI categories (ie, normal, overweight, and obese), and data were analyzed using SPSS. Results: The average BMI was 27.0 (6.7) kg/m2, and CRF was 19.5 (7.2) mL/kg/min. There was an inverse correlation (pr = ‐.38 [−.57; −.14]; P = .003) between BMI and CRF controlling for age, sex, disease duration, and disability level. ANCOVA with linear contrast analysis revealed a statistical significant reduction in CRF between groups of different BMI categories; normal weight 20.8 (0.85); overweight 19.8 (1.13); and obese 16.9 (1.73) mL/kg/min; F (2, 55) = 3.33, P = .043; η2 = .11. Conclusions: The findings suggest that BMI has a negative impact on CRF in pwMS, with a marked reduction in CRF for those classified as obese compared to those in the normal and overweight category. [ABSTRACT FROM AUTHOR]

This study compared physical fitness components between fatigued and non-fatigued persons with MS and examined those components as correlates of fatigue. Sixty-two ambulatory persons with MS completed the Modified Fatigue Impact Scale ( MFIS) and underwent assessments of cardiorespiratory capacity, lower extremity muscle strength (i.e., peak torque and asymmetry), body composition, and static balance over two different sessions 7 days apart. Participants were allocated into fatigue groups based on MFIS scores (non-fatigued group (i.e., MFIS ≤38), n = 26; and fatigued group ( MFIS >38), n = 36). The fatigued group had significantly ( P < 0.05) lower cardiorespiratory capacity ( VO2peak) and muscular strength (i.e., knee flexion peak torque) than the non-fatigued group. VO2peak and knee extension peak torque were the two physical fitness components significantly correlated with fatigue scores in the fatigued group ( P < 0.05), and follow-up stepwise linear regression revealed that VO2peak was a significant predictor of fatigue scores ( R2 = 0.13). Discriminant function analysis further identified VO2peak as a significant ( P < 0.05) correlate of fatigue status. This model explained 21% of variance in group status (i.e., fatigued vs non-fatigued) and correctly classified approximately 76% of cases into fatigue status groups. The improvement of cardiorespiratory capacity should be considered in rehabilitation programs for persons with MS, especially those presenting with elevated fatigue. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to investigate whether neurological disability status, heart rate variability ( HRV), cardiorespiratory fitness ( CRF) explained the variance in depressive symptoms in multiple sclerosis ( MS). Methods Associations between CRF (via maximal oxygen uptake; VO2peak), HRV indices of normalized ultra-low ( nULF) and very low frequency domains ( nVLF), neurological disability status and depressive symptoms (using the Depression subscale of the Hospital Anxiety Depression Scale; HADS-D) were assessed in 53 participants with MS and 17 matched controls. Hierarchical linear regression analysis was conducted within the MS subsample to examine the variance explained by neurological disability alone and CRF. Results The groups were similar in mean age ( MS=52.0 years, Control=51.1 years) and sex ( MS=72% female, Control=77% female). Among individuals with MS, HADS-D scores significantly correlated with disability status (sample mean score=4) and VO2peak ( r=−.62, P<.001), whereas VO2peak only correlated with nVLF ( r=0.29, P<.05), but not nULF ( r=0.26, P=.06). The hierarchical linear regression indicated that VO2peak ( P<.05) attenuated the effect of disability status on HADS-D scores such that disability was no longer a predictor of depressive symptomology at step 2 ( P>.05). Conclusion Heart rate variability does not seem to significantly differ between individuals with MS and healthy controls. When accounting for CRF, disability status no longer explains significant variance in depressive symptoms in MS. Accordingly, targeting CRF might be an effective approach for effectively managing depressive symptoms in individuals with MS. [ABSTRACT FROM AUTHOR]

Background Persons with multiple sclerosis ( MS) engage in substantially less overall physical activity than healthy controls, but there is little information on public health rates of physical activity necessary for health benefits. Purpose This study examined the rates of insufficient, moderate, and sufficient physical activity in persons with MS compared with healthy controls. Method Secondary analysis of data from participants with MS ( n = 1521) and healthy controls ( n = 162) who completed the Godin Leisure-Time Exercise Questionnaire ( GLTEQ) as part of a questionnaire battery in 14 previous investigations. Results There were statistically significant differences in overall GLTEQ scores ( F1,1666 = 96.8, P < 0.001, d = 0.83) and rates of physical activity ( χ2 (2, N = 1683) = 94.2, P < 0.001) between MS and control groups. The rates of insufficient, moderate, and sufficient physical activity in the MS group were 58.0%, 15.2%, and 26.8%, respectively. Those with MS were 2.5 times more likely to report insufficient physical activity and 2.3 times less likely to report sufficient physical activity than controls. Conclusion The majority of persons with MS were insufficiently physically active, and this segment represents the largest opportunity for successful behavior change and accumulation of associated health benefits. [ABSTRACT FROM AUTHOR]

Objective Accelerometry has been identified as a possible ecologically valid and objective approach for measuring community ambulation in multiple sclerosis ( MS). This study provides a validation of accelerometer output based on associations with Expanded Disability Status Scale ( EDSS), Patient Determined Disease Steps ( PDDS) Scale, and Multiple Sclerosis Walking Scale-12 ( MSWS-12) scores, timed 25-foot walk (T25 FW) and 6-min walk (6 MW) performance, oxygen cost ( O2 cost) of walking, and spatial and temporal parameters of gait. Materials and Methods 256 persons with MS completed the PDDS and MSWS-12, underwent an examination for the generation of an EDSS score, undertook two T25 FW tests and a 6 MW while wearing a portable metabolic unit for measuring the O2 cost of walking, completed two trials of comfortable walking on a GAITRite electronic walkway for measuring spatial and temporal parameters of gait, and then wore an Actigraph accelerometer during the waking hours of a 7-day period. Results The accelerometer output was significantly correlated with EDSS (ρ = −0.522), PDDS (ρ = −0.551), and MSWS-12 (ρ = −0.617) scores, T25 FW (ρ = −0.595) and 6 MW (ρ = 0.630) performance, and O2 cost of walking (ρ = −0.457). Regarding gait parameters, the accelerometer output was significantly correlated with velocity (ρ = 0.420), cadence (ρ = 0.349), step time (ρ = −0.353), step length (ρ = 0.395), double support (ρ = −0.424), and single support (ρ = 0.400). Conclusion We provide comprehensive evidence from a large sample of persons with MS that further supports accelerometry as a measure of walking behavior. [ABSTRACT FROM AUTHOR]

Objectives There is increasing recognition that physical activity has beneficial consequences among persons with multiple sclerosis ( MS), but there is concern regarding the current degree of physical inactivity in this population because of limitations with previous research and increased recognition of health behaviors in MS. This study compared physical activity levels between large samples of persons with mild MS and matched controls using validated measures of physical activity. Materials and methods The sample included 77 cases of MS and 77 controls matched on age, height, weight, and gender. Physical activity was assessed using five measures, namely the Godin Leisure-Time Exercise Questionnaire ( GLTEQ), International Physical Activity Questionnaire ( IPAQ), and activity counts per day, step counts per day, and time spent in moderate-to-vigorous physical activity ( MVPA) per day by accelerometry. Results There were statistically significant differences between groups in accelerometer activity counts ( t = −3.87, P = 0.0001), accelerometer step counts ( t = −4.29, P = 0.0001), time spent in MVPA ( t = −2.39, P = 0.01), GLTEQ scores ( t = −3.83, P = 0.0001), and IPAQ scores ( t = −3.42, P = 0.0001). The average effect size across all five measures was d = −0.59 and indicated that persons with MS overall were moderately less physically active than the matched controls. Conclusions The primary finding was a moderate reduction in physical activity among those with MS, but the magnitude was substantially smaller than reported in a published meta-analysis. Importantly, the degree of physical inactivity can likely be overcome through the delivery of behavioral interventions for increasing physical activity and this should translate into meaningful consequences for persons with MS. [ABSTRACT FROM AUTHOR]

Motl RW, Goldman M. Physical inactivity, neurological disability, and cardiorespiratory fitness in multiple sclerosis. Acta Neurol Scand: 2011: 123: 98-104. © 2010 John Wiley & Sons A/S. We examined the associations among physical activity, neurological disability, and cardiorespiratory fitness in two studies of individuals with multiple sclerosis (MS). Study 1 included 25 women with relapsing-remitting MS (RRMS) who undertook an incremental exercise test for measuring peak oxygen (V̄O) consumption, wore an accelerometer during a 7-day period, and completed the Godin Leisure-Time Exercise Questionnaire (GLTEQ). Study 2 was a follow-up of Study 1 and included 24 women with RRMS who completed the self-reported Expanded Disability Status Scale (EDSS), undertook an incremental exercise test, wore an accelerometer during a 7-day period, and completed the GLTEQ. Study 1 indicated that V̄O was significantly correlated with accelerometer counts (pr = 0.69) and GLTEQ scores (pr = 0.63) even after controlling for age and MS duration. Study 2 indicated that V̄O was significantly correlated with accelerometer counts (pr = 0.50), GLTEQ scores (pr = 0.59), and EDSS scores (pr = −0.43) even after controlling for age and MS duration; there was a moderate partial correlation between accelerometer counts and EDSS scores (pr = −0.43). Multiple linear regression analysis indicated that both accelerometer counts (β = 0.32) and EDSS scores (β = −0.40) had statistically significant associations with V̄O. The findings indicate that physical inactivity and neurological disability might represent independent risk factors for reduced levels of cardiorespiratory fitness in this population. [ABSTRACT FROM AUTHOR]

Background and purpose: Individuals with multiple sclerosis (MS) want health advice regarding participation in their choice of exercise. To address this need, a flexible exercise participation programme (FEPP) was developed, underpinned by the MS aerobic exercise guidelines and supported by a physiotherapist using behaviour change techniques. The aim of this study was to investigate the feasibility of the FEPP for individuals with minimal disability from MS. Methods: A feasibility study utilising a single group pre/post‐intervention design was conducted. The 12‐week FEPP was completed by 10 individuals with MS (EDSS 0–3.5). Exercise progression in duration, intensity or frequency of exercise (in line with MS exercise guidelines) was guided by a self‐perceived weekly energy level score, and weekly telephone coaching sessions using behavioural change techniques. Trial feasibility was assessed via measures of process (recruitment and retention), resources/management (communication time; data entry) and scientific feasibility (safety; compliance). Secondary FEPP feasibility outcomes included the Goal Attainment Scale (GAS) T‐score, exercise participation (weekly exercise diary), high‐level mobility (HiMAT), vitality (Subjective Vitality Scale), biomarkers for inflammation (cytokines levels [IL2, IL4, IL6, IL10, TNF and IFNγ]), and acceptability (participant survey). Results: Process: In total, 11 (85%) of 13 eligible participants enroled at baseline with 10 (91%) completing the study. Resources/management: Coaching sessions included a baseline interview—mean 39 min (SD: 6.6) and telephone coaching—mean 10 min (SD: 3.8) per week. Outcome measure data collection time—mean 44 min (SD: 2.1). Scientific feasibility: Two participants experienced a fall during their exercise participation. Self‐reported compliance was high (99%). GAS T‐scores increased significantly, indicating achievement of exercise participation goals. Secondary outcomes showed trends towards improvement. Discussion: The FEPP was feasible, safe and highly acceptable for use with individuals with MS and warrants a larger trial to explore effectiveness. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is a chronic neurological condition resulting in decreased aerobic capacity (peak VO2). The hemodynamic responses to peak exercise in MS are unknown. Further, it is unknown if the hemodynamic responses are due to disease or fitness. Therefore, the purpose was to compare hemodynamic response to peak exercise between individuals with and without MS, with similar peak VO2. Individuals with MS (n = 21) and CON (n = 21) underwent maximal incremental cycle exercise test to assess peak aerobic capacity (peak VO2). Heart rate, stroke volume, cardiac output, and blood pressure were obtained every other minute of the exercise test. There were no significant group differences in peak VO2. All hemodynamic variables increased similarly from baseline to peak exercise in both MS and CON. There was a significant group by time interaction for HR in individuals with MS (p < 0.01), accounted for by age, but no group by time interactions in MAP (p = 0.78), SV (p = 0.11), or Q (p = 0.86). Our findings suggest that individuals with and without MS, with similar peak VO2, have similar hemodynamic responses to peak exercise. Our data suggest that fitness is a key underlying determinants of hemodynamics responses in individuals with MS. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is the most common neurological disorder in young adults. The prevalence of walking impairment in people with MS (pwMS) is estimated between 41% and 75%. To evaluate the walking capacity in pwMS, the patient reported outcomes (PROs) and performance-based tests (i.e., the 2-minute walk test, the 6-minute walk test, the Timed 25-Foot Walk Test, the Timed Up and Go Test, and the Six Spot Step Test) could be used. However, some studies point out that the results of both performance-based tests and objective measures (i.e., by accelerometer) could not reflect patient reports of walking performance and impact of MS on daily life. This review analyses different motion sensors embedded in smartphones and motion wearable device (MWD) that can be useful to measure free-living walking behavior, to evaluate falls, fatigue, sedentary lifestyle, exercise, and quality of sleep in everyday life of pwMS. Caveats and limitations of MWD such as variable accuracy, user adherence, power consumption and recharging, noise susceptibility, and data management are discussed as well. [ABSTRACT FROM AUTHOR]

Background: Dysfunctions of the hypothalamic‐pituitary‐adrenal (HPA) axis can trigger multiple sclerosis (MS) symptoms. Mood disorders comorbid with MS are implicated in the HPA axis activation in most people with MS (pwMS). This study purposed to examine salivary cortisol (SC) levels and their association with mood disorders in pwMS. Methods: Forty‐three men as pwMS and sixteen men as healthy controls (HC) were included in this study. pwMS and HC completed the Beck Depression Inventory (BDI), 36‐Item Short Form Survey (SF‐36), Fatigue Severity Scale (FSS), Depression Anxiety and Stress Scale, and Hospital Anxiety and Depression Scale questionnaires. SC levels were also measured in pwMS and HC. A linear regression model was used to analyze the relationship between the Expanded Disability Status Scale (EDSS) and mood disorders and SC levels. Pearson's or Spearman's tests examined the correlation between SC levels and mood disorders. Results: The SC level, anxiety, depression, fatigue, and stress were significantly higher in pwMS than in HC (p < 0.05). pwMS also showed significant correlations between SC levels and role physical (r = 0.3, p < 0.05) and emotional (r = 0.34, p < 0.05) in SF‐36. Among SF‐36 domains, only general health (β = −0.72, p < 0.05) and physical functioning (β = −1.61, p < 0.05) were negatively associated with disease duration. No correlation was found between SC levels and anxiety, depression, and fatigue (p > 0.05). Conclusions: The pwMS showed mild to moderate depression, anxiety, and fatigue. Only general health and physical functioning as aspects of quality of life were related to disease duration, while SC levels, mood disorders, and other quality‐of‐life domains were not associated with clinical characteristics. Also, this study failed to find a significant role for SC as a valuable marker in approaching mood disorders in pwMS. [ABSTRACT FROM AUTHOR]

Background and Purpose: The flexible exercise participation program (FEPP) is a novel intervention developed to enable individuals with multiple sclerosis (MS) participate and progress in an exercise or sport of their choice. The FEPP is underpinned by guidelines on aerobic exercise for individuals with MS and is supported by a physiotherapist using behaviour change techniques. As part of a FEPP feasibility trial, the aim of this nested study was to explore the experience of participation in the FEPP from the perspective of individuals with MS. The objectives were to (i) determine the acceptability of the FEPP and (ii) identify recommendations for improvement. Methods: A mixed methods study using a sequential explanatory design was conducted. Part I consisted of a quantitative participant survey. Survey data were analysed descriptively using SPSS and informed the protocol for part II – qualitative interviews. Interview data were analysed thematically using NVivo. Part III consisted of integration of quantitative and qualitative data to allow greater explanation of survey responses. Individuals with MS who had participated in the FEPP feasibility trial were invited to take part in the study. Results: The FEPP was highly acceptability to the 10 participants. Five themes emerged to describe the experience of participating in the FEPP: (i) exploring exercise boundaries, (ii) measuring energy, (iii) acknowledging accountability, (iv) adjusting to exercising in a pandemic and (v) sustaining participation. Recommendations for improving the FEPP included changes to energy level monitoring and incorporation of peer support mechanisms. Discussion: Participants found the FEPP highly acceptable and valued the flexibility to choose their own activity and the health professional support. Based on participant recommendations, future versions of the FEPP will include daily rather than weekly monitoring of exercise and peer support to further enable individuals with MS to find the right balance with exercise and sport. [ABSTRACT FROM AUTHOR]

Background: Impairments in speech and social cognition have been reported in people with multiple sclerosis (pwMS), although their relationships with neuropsychological outcomes and their clinical utility in MS are unclear., Objectives: To evaluate word finding, prosody and social cognition in pwMS relative to healthy controls (HC)., Methods: We recruited people with relapsing MS (RMS, n = 21), progressive MS (PMS, n = 24) and HC (n = 25) from an outpatient MS clinic. Participants completed a battery of word-finding, social cognitive, neuropsychological and clinical assessments and performed a speech task for prosodic analysis., Results: Of 45 pwMS, mean (SD) age was 49.4 (9.4) years, and median (range) Expanded Disability Severity Scale score was 3.5 (1.0-6.5). Compared with HC, pwMS were older and had slower information processing speed (measured with the Symbol Digit Modalities Test, SDMT) and higher depression scores. Most speech and social cognitive measures were associated with information processing speed but not with depression. Unlike speech, social cognition consistently correlated with intelligence and memory. Visual naming test mean response time (VNT-MRT) demonstrated worse outcomes in MS versus HC (p = .034, Nagelkerke's R 2  = 65.0%), and in PMS versus RMS (p = .009, Nagelkerke's R 2  = 50.2%). Rapid automatised object naming demonstrated worse outcomes in MS versus HC (p = .014, Nagelkerke's R 2  = 49.1%). These word-finding measures showed larger effect sizes than that of the SDMT (MS vs. HC, p = .010, Nagelkerke's R 2  = 40.6%; PMS vs. RMS, p = .023, Nagelkerke's R 2  = 43.5%). Prosody and social cognition did not differ between MS and HC., Conclusions: Word finding, prosody and social cognition in MS are associated with information processing speed and largely independent of mood. Impairment in visual object meaning perception is potentially a unique MS disease-related deficit that could be further explored and cautiously considered as an adjunct disability metric for MS., (© 2022 The British Psychological Society.)

This study assessed muscle activity (root mean square, RMS, and median frequency, MDF) to evaluate the acute response to blood flow restriction (BFR) resistance exercise (RE) and conventional moderate intensity (MI) RE. We also performed exploratory analyses of differences based on sex and exercise‐induced hypoalgesia (EIH). Fourteen asymptomatic individuals performed four sets of unilateral leg press with their dominant leg to volitional fatigue under two exercise conditions: BFR RE and MI RE. Dominant side rectus femoris (RF) and vastus lateralis (VL) muscle activity were measured using surface electromyography (sEMG) through exercise. RMS and MDF were calculated and compared between conditions and timepoints using a linear mixed model. Pressure pain thresholds (PPT) were tested before and immediately after exercise and used to quantify EIH. Participants were then divided into EIH responders and nonresponders, and the differences on RMS and MDF were compared between the two groups using Hedges' g. RMS significantly increased over time (RF: p = 0.0039; VL: p = 0.001) but not between conditions (RF: p = 0.4; VL: p = 0.67). MDF decreased over time (RF: p = 0.042; VL: p < 0.001) but not between conditions (RF: p = 0.74; VL: p = 0.77). Consistently lower muscle activation was found in females compared with males (BRF, RF: g = 0.63; VL, g = 0.5. MI, RF: g = 0.72; VL: g = 1.56), with more heterogeneous findings in MDF changes. For BFR, EIH responders showed greater RMS changes (Δ RMS) (RF: g = 0.90; VL: g = 1.21) but similar MDF changes (Δ MDF) (RF: g = 0.45; VL: g = 0.28) compared to nonresponders. For MI, EIH responders demonstrated greater increase on Δ RMS (g = 0.61) and decrease on Δ MDF (g = 0.68) in RF but similar changes in VL (Δ RMS: g = 0.40; Δ MDF: g = 0.39). These results indicate that when exercising to fatigue, no statistically significant difference was observed between BFR RE and conventional MI RE in Δ RMS and Δ MDF. Lower muscle activity was noticed in females. While exercising to volitional fatigue, muscle activity may contribute to EIH. [ABSTRACT FROM AUTHOR]

Background and Purpose. The number of older adults and the occurrence of concomitant health issues continue to grow. One of the most prevalent mental health issues in this population is depression. Physical exercise (PE) is widely acknowledged as a method to alleviate the associated health burdens of aging, including depression; however, there is no collated evidence regarding the effectiveness of specific types of exercise on a range of health outcomes. To address this, we conducted a systematic review to evaluate exercise benefits for this specific subgroup. Methods. An electronic search of five databases was used to retrieve controlled studies investigating health‐related outcomes associated with any type of PE, in adults over 65 years with depression. Where possible, data were analyzed in meta‐analyses or else reported narratively. Results and Discussion. Fifteen studies were included in the review. All 15 studies had data available for meta‐analysis, yet heterogeneity in exercise types and outcome measures limited synthesis. When data for all types of exercise were pooled together, significant improvements were found in depression (SMD = 0.52; CI = 0.07, 0.97; p = 0.02), physical health and function (SMD = 0.44, CI = 0.14, 0.74; p = 0.004), anxiety (SMD = 0.23; CI = 0.04, 0.42; p = 0.02), and self‐efficacy (SMD = 0.97; CI = 0.32, 1.61; p = 0.003). When data were pooled according to exercise type, positive effects were demonstrated for aerobic exercise on depression (SMD = 0.49; CI = −0.16, 0.8; p = 0.003), tai chi/qigong on depression (SMD = 0.89; CI = −0.14, 1.63; p = 0.02), and self‐efficacy (SMD = 6.70; CI = −0.90, 12.50; p = 0.02) and multicomponent exercise demonstrated positive effects on physical function (SMD = 0.49; CI = 0.12, 0.87; p = 0.009) and the physical health component of quality of life (SMD = 0.88; CI = 0.10, 1.65; p = 0.03). No health‐related benefits were revealed from the combined findings of the two studies investigating strengthening exercises. Conclusion. Lack of consistency regarding exercise types, dosage, and outcomes presents challenges in the evidence. In general, exercise is beneficial across a range of health‐related variables. Multicomponent, aerobic, and tai chi forms of exercise appear most likely to reap benefits in depressed older adults; however, the type of benefit is determined by the type of exercise and should be considered when recommending a regime. This trial is registered with CRD42020173465. [ABSTRACT FROM AUTHOR]

Older people who are wanting to support their own ability to age well may benefit from attending community-based group programs. However, many of these programs are designed and implemented by health professionals without direct input from older people, which may limit the opportunity to ensure such programs are authentically meeting the needs of this population group. A qualitative approach, using an interpretative phenomenological analysis (IPA), was undertaken with seven (six female and one male) participants, aged between 62 and 80 years to explore the experiences of participating in a pilot Ageing Well Program. Interviews were transcribed and analysed according to IPA principles. Three themes emerged from the analysis of the interview data: (1) The value of focusing on different aspects of ageing; (2) Learning new knowledge; and (3) Transferring skills to everyday life. Participants in the pilot of the Ageing Well Program highlighted that those aspects of the Program, such as the focus on adding value through targeting multiple aspects of ageing, as well as developing strategies to successfully learn, apply, and translate new knowledge into their everyday lives, were beneficial and supported engagement. However, future programs would benefit from the inclusion of clear and coherent written material to provide an aide in remembering the strategies and new information learnt during the Program. Findings support the importance and value of engaging with older people to assist with the development of community-based programs that are authentically designed to align with the expectations of older people, through a process of quality improvement. [ABSTRACT FROM AUTHOR]

Purpose. The link between moderate‐ to vigorous‐intensity physical activity (MVPA) and cardiorespiratory fitness in individuals with multiple sclerosis (MS) remains unclear. This study examined the relationship between self‐reported MVPA and objectively assessed cardiorespiratory fitness, emphasizing sex differences. Methods. 107 adults with MS (77 females), aged (mean ± standard deviation) 47.2 ± 10.2 years, were recruited from a local MS clinic. Fitness was measured as maximal oxygen uptake (V̇O2max) during a graded maximal exercise test using a recumbent stepper. MVPA (24‐hour recall) was estimated as the duration of activities ≥ 3 MET (metabolic equivalent of task). MET‐minutes were calculated by multiplying MET by duration. We explored sex differences in self‐reported MVPA, cardiorespiratory fitness, and disability; examined sex differences in associations between these variables; and investigated whether MET‐minutes of MVPA predicted V̇O2max in females and males. Results. Mean V̇O2max was 24.79 mL·kg-1·min-1, indicating poor cardiorespiratory fitness levels, despite high levels of self‐reported MVPA (mean = 412.5 MET‐minutes). Fifty‐three percent of males and 40% of females had V̇O2max levels below the 20th age‐ and sex‐standardized population percentile, indicating poor cardiorespiratory fitness. There were statistically significant associations between MVPA and V̇O2max (Rho = 0.27, p =.01), as well as disability and V̇O2max (Rho = −0.35, p =.02), in females but not males. A regression model using sex, age, body mass, disability, and MVPA to estimate V̇O2max was valid in predicting V̇O2max values that were statistically equivalent to those measured in the laboratory in females but not males. However, the inclusion of MVPA did not add to the predictive value of this equation. Conclusions. Despite reporting high levels of MVPA, people with MS had poor cardiorespiratory fitness. MVPA, fitness, and disability were associated in females only, indicating that sex differences should be considered in fitness appraisal. Self‐reported MVPA did not predict fitness, suggesting 24‐hour recall may not be representative of true activity or fitness levels in persons with MS. Future work should examine sex differences in associations between MVPA and fitness using objective measures such as accelerometry. [ABSTRACT FROM AUTHOR]

Background. Up to 80% of people with MS experience worsening of their condition upon an increase in body temperature. Therefore, various options of cooling are being evaluated to help improve physical performance in people with MS. Most previous studies used active cooling methods. Our aim was to study the effect of simple device providing passive cooling. Methods. A randomized crossover study was conducted in 21 thermosensitive people with mild to moderate disability. Subjects were tested immediately before and after intervention (experimental or sham cooling). The assessment included timed 25-foot walk test, the 2- and 6-minute walk test, nine-hole peg test, and symbol digit modalities test. Results. A significant improvement was found in the experimental group in timed 25-foot walk test (p = 0.011) and in nine-hole peg test for dominant hand (p = 0.033). No significant improvement was found in the control group (sham cooling). Conclusions. Wearing cooling cap can improve short-term functional performance (walking and fine motor skills) in thermosensitive people with MS. This passive cooling method can be considered as a symptomatic treatment for some people with MS. This trial is registered with ISRCTN56350227. [ABSTRACT FROM AUTHOR]

Background. Sleep disturbances are commonly reported, although underestimated complaints from people with multiple sclerosis (MS). The aim of the study was to analyze the frequency and type of sleep disturbances in MS patients and to evaluate their relationships with demographics and clinical data. Methods. The study group consisted of 178 patients with relapsing-remitting MS: 130 females and 48 males. Clinical measures (disease duration, disability level in Expanded Disability Status Scale (EDSS), and treatment) were acquired from medical records. The questionnaire was applied, containing questions about sleep disturbances, somatic complaints, perception of fatigue, depression, anxiety, and problems at work and in social/family life. Athens Insomnia Scale (AIS) and Karolinska Sleepiness Scale (KSS) were performed to quantify sleep problems and Hamilton Depression Rating Scale (HDRS) and Addenbrooke's Cognitive Examination (Mini-ACE) to assess level of depression and cognitive performance. Electroencephalography was recorded to identify electrophysiological indices of sleep. Results. 109 patients (61%) reported sleep disturbances, most frequently insomnia, snoring, and parasomnias. This subgroup had significantly higher scores in AIS (p < 0.0001) and KSS (p = 0.010) and slightly higher EDSS score (p = 0.048) and more often complained of fatigue (71% vs. 53%, p = 0.0148), involuntary limb movement (42% vs. 25, p = 0.0170), and breathing disturbances (10% vs. 0%). There was a significant correlation between the results of AIS and HDRS (Rs = 0.715 , p < 0.05). Conclusion. Sleep disturbances, predominantly insomnia, are reported by more than a half of the patients with relapsing-remitting MS. Significant associations were found between sleep problems and MS-related clinical symptoms and psychosocial issues. [ABSTRACT FROM AUTHOR]

Background and Aims: Scientific research continues to advance and improve the medical management of type 2 diabetes. However, the importance of lifestyle management remains invaluable in treatment and tertiary prevention of this disease. Day‐to‐day sedentariness is the fourth most important risk factor for mortality in France. Numerous studies have demonstrated that physical activity is beneficial to people with type 2 diabetes and various recommendations have been made to encourage it. However, it is universally agreed that interventions that promote physical activity, while they may enhance its practice in the short term, do not impact on it over longer periods. It therefore seems essential to focus interventions on an individual's capacity to persist with physical activity in the long term. By looking at the literature, the aim of this review is to synthesize group and supervised physical activity interventions for people with type 2 diabetes using variables based on the following levers: motivation and self‐efficacy. Methods: The PRISMA (Preferred Reporting Items for Systematic reviews and Meta‐Analyses) methodology examined studies in English or French that are registered in the PubMed, PsycINFO, and SportDiscus databases and were published between 2005 and 2023, according to the following keywords: Motivation OR self‐efficacy AND physical activity AND type 2 diabetes AND intervention. Results and Conclusion: Seven studies out of 1207 were included. Despite the pertinence of the concepts of motivation and self‐efficacy and their complementarity in physical activity management programs, few studies have yet proposed a combined intervention for people with type 2 diabetes. [ABSTRACT FROM AUTHOR]

African Americans (AA) have a higher risk for cardiovascular disease (CVD) as compared to their White (W) counterparts. CVD is characterized by increased blood pressure (BP), arterial stiffness and systemic inflammation. An acute inflammatory stimulus may explain physiological manifestations responsible for amplified CVD in AA that are not apparent at rest. The purpose of this study was to evaluate central and peripheral BP, central and local arterial stiffness, and indices of pulse wave morphology in young healthy AA and W participants in response to acute inflammation. Concentrations of the inflammatory cytokine interleukin‐6 (IL‐6) and measures of central and peripheral BP, central arterial stiffness (carotid–femoral pulse wave velocity (cfPWV)), local carotid arterial stiffness (β‐stiffness, elastic modulus (Ep)), and indices of pulse wave morphology were assessed in 28 participants (21 ± 2 years, AA: n = 11) at baseline (BL), 24 h and 48 h post‐inflammation. Changes in IL‐6 concentrations (ΔIL‐6) were significantly greater at 24 h as compared to 48 h post‐inflammation (0.652 ± 0.644 vs. −0.146 ± 0.532 pg/μl, P ≤ 0.0001). Among AA participants, central and peripheral diastolic BP were significantly decreased at 24 h post‐inflammation as compared to BL (aortic diastolic BP: −4 ± 4 mmHg, P = 0.016; brachial diastolic BP: −4 ± 4 mmHg, P = 0.014). AA participants also experienced a significant decrease in central and peripheral mean arterial BP at 48 h post‐inflammation as compared to BL (aortic mean arterial pressure: −4 ± 4 mmHg, P = 0.009; brachial mean arterial pressure: −4 ± 4 mmHg, P = 0.012). Despite haemodynamic changes, there were no differences in central or local carotid arterial stiffness or indices of pulse wave morphology. What is the central question of this study?Are there differences in interleukin‐6 concentrations, blood pressure, arterial stiffness and indices of pulse wave morphology between young healthy African American (AA) and White (W) individuals in response to an acute inflammatory stimulus?What is the main finding and its importance?While young healthy AA and W adults have similar interleukin‐6 concentrations, arterial stiffness and indices of pulse wave morphology in response to an acute inflammatory stimulus, only AA experience decreases in blood pressure within 48 h post‐stimulus. The findings could elucidate physiological manifestations responsible for amplified CVD in AA. [ABSTRACT FROM AUTHOR]

Summary: Restless legs syndrome is a prevalent, sensorimotor sleep disorder temporarily relieved by movement, with evidence of symptomatic improvement with regular exercise. The present study describes perceptions of the effects of exercise on symptoms of restless legs syndrome. Participants (N = 528) completed a mixed‐methods (i.e. numerical and narrative), nationwide survey including items assessing personal experiences with exercise and restless legs syndrome (both positive and negative), as well as restless legs syndrome diagnosis, restless legs syndrome severity, and demographic and clinical characteristics. Responses varied widely on specific experiences with exercise, but a higher percentage of participants indicated positive experiences with exercise than those who reported negative experiences (72%–40%, respectively) with exercise. Further, 54% of respondents reported that exercise only improves restless legs syndrome, while 24% reported exercise only worsens symptoms. Participants described that any abrupt change in exercise routine would almost always elicit restless legs syndrome symptoms (e.g. hiking for a long time, stopping an exercise routine), and that a consistent pattern of exercise improved restless legs syndrome symptoms with an overall beneficial effect on the frequency of symptomatic bouts. Participants further described time of day as impactful for their exercise experience, with > 50% indicating morning exercise improves symptoms and evening exercise worsens symptoms. Participants described several questions that they wanted answered regarding the evidence for exercise in restless legs syndrome and specific exercise prescription recommendations. The present study describes information crucial to the creation of stakeholder‐informed health promotion programs for individuals with restless legs syndrome to optimize personalized treatment plans that could prevent and manage symptoms. [ABSTRACT FROM AUTHOR]

Objective: Non‐suicidal self‐injury (NSSI) is a significant mental health concern with the highest prevalence among adolescents. NSSI has been conceptualized as one of the maladaptive strategies to cope with challenging affect or a form of self‐punishment. Although characterizing moment‐to‐moment associations between shame and NSSI in individuals' real‐world environment and partitioning between‐ and within‐person effects is critical for mobile and timely interventions, most studies examined habitual experiences of negative affective states and focused on adults. Method: In this study, we focused on in vivo anger at self and others and shame and NSSI among 158 adolescents 3 weeks following their psychiatric hospitalizations using ecological momentary assessment (EMA) technology. Results: We found that greater between‐person levels of anger at self and others were linked to a higher number of subsequent NSSI occurrences within a day. These findings remained primarily unchanged when we statistically adjusted for participants' age, sex assigned at birth, the number of current psychiatric diagnoses, EMA response rates, and youth lifetime history of SI. Within‐person increases in NSSI were linked to increased anger at self over and beyond between‐person average levels of NSSI. Conclusions: These findings highlight the potential regulatory role of NSSI to decrease negative affective states and point to the clinical utility of assessing and early mobile interventions targeting challenging affect in youth. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the psychosocial markers associated with pre‐hospital delay among patients with diabetic foot (DF). Design: This study has a cross‐sectional design. Methods: The participants completed a questionnaire including pre‐hospital time, demographic characteristics, Social Support Rate Scale, Brief Illness Perception Questionnaire and Type D Personality Scale‐14. Bivariate and multivariate analyses were conducted to explore independent associations with pre‐hospital delay. Results: Only 1.8% (3/164) of participants arrived at the hospital for medical care in 24 h of symptom onset. Patients with low utilization of social support (p = 0.029), low negative illness perceptions (p = 0.014) and high levels of negative affectivity (p = 0.009) are likely to arrive late at the clinic. Medical staff should pay attention to identifying diabetic patients' Type D personalities and take actions to improve their social support as well as illness perception, so as to reduce the occurrence of hospital delay. Implications for the Profession and/or Patient Care: Psychosocial factors play a vital role in the delay in seeking medical treatment for patients with DF. Medical staff need to improve patients' illness perception as well as self‐management ability through health education. Importantly, key family members provide an emotional and psychological support system for diabetic patients. Therefore, nurses need to work with family members together to give information and psychological support during family visits. Additionally, building and maintaining trust with patients is crucial to encouraging individuals to express their concerns and worries. In this case, nurses may identify patients' negative emotions and conduct timely intervention, so as to achieve favourable outcomes. Patient or Public Contribution: This study used a convenience sample of 164 participants with DF recruited from the wound clinic of Northern Jiangsu People's Hospital and Yangzhou Hospital of TCM in China. [ABSTRACT FROM AUTHOR]

Background: Sedentary behaviour (SB) among adults with Down syndrome (DS) may differ based on personal or environmental factors. Objective: Investigate differences in SB levels and patterns of adults with DS based on sex, age, and residence‐type across weekdays and weekends. Methods: Thirty‐four adults with DS (15 men; 37 ± 12 years) underwent accelerometry‐based measurements of sedentary time, bouts, and breaks for 7 days. We evaluated differences with 2 × 2 mixed‐model (group‐by‐day) ANOVA. Results: Younger (19–36 years) individuals had less sedentary time (p =.042), and shorter (p =.048) and fewer (p =.012) bouts than older (37–60 years) individuals. Group home residents had more bouts on weekends than adults living with parent/guardians (p =.015). Conclusions: Adults with DS spent half their waking hours in SB of short bouts. Age and residence may influence SB. [ABSTRACT FROM AUTHOR]

Background and Purpose: Fatigue following neurological conditions negatively impacts daily activities, reducing overall quality of life. Transcranial direct current stimulation (tDCS) for fatigue management is still underexplored. This scoping review explores its use in managing fatigue among various neurological conditions. Methods: A thorough literature search was carried out using PubMed, Scopus, CINAHL, Web of Science, Embase, ProQuest, and the Cochrane Library. Google Scholar and clinicaltrials.gov were manually searched for gray literature and ongoing trials, respectively. Regardless of the study design, all studies utilizing tDCS for the management of fatigue in various neurological conditions were considered. Two reviewers independently screened all the studies, following which the data were retrieved. Results: Studies employing tDCS for fatigue management across neurological conditions is as follows: Multiple sclerosis (MS) (n = 28, 66%), stroke (n = 5, 12%), Parkinson's disease (PD) (n = 4, 10%), post‐polio syndrome (PPS) (n = 2, 5%), traumatic brain injury (TBI) (n = 2, 5%), and amyotrophic lateral sclerosis (n = 1, 2%). All the studies used anodal stimulation, with the common stimulation site being the left dorsolateral prefrontal cortex for MS, stroke, and PD. A stimulation intensity of 1.0–4.0 mA with a duration ranging from 15 to 30 min in 1 to 24 sessions were commonly reported. The Fatigue Severity Scale (n = 21) and Modified Fatigue Impact Scale (n = 17) were frequently implemented outcome measures. Regardless of the study design, 36/42 (85.7%) studies reported an improvement in fatigue scores in the tDCS group. The common adverse events noted were tingling (n = 8, 35%), headache (n = 6, 26%), and itching (n = 6, 26%). Discussion: Application of tDCS for fatigue was explored in individuals with stroke, PD, PPS, and TBI after MS. Even though a wide range of treatment parameters and outcome measures were adopted to assess and target fatigue, tDCS proves to have a promising role in alleviating this symptom. [ABSTRACT FROM AUTHOR]

Preventive healthcare behavior (PHB) refers to actions taken by consumers to avert possible incidences of lifestyle diseases. Over the years, diverse approaches have been used to comprehend the complex nature of PHB. This paper follows a three‐step process to examine work done in the PHB domain. At the outset, past literature was examined. This review included PHB models and frameworks, followed by a root‐cause analysis to identify factors that impacted PHB adoption. A systematic literature review (SLR) using a domain‐based hybrid review approach was the study's third and most crucial part. The SPAR‐4‐SLR (scientific procedures and rationales for systematic literature reviews) protocol was used to conduct the hybrid review, involving two separate review studies. In the first study, a bibliometric analysis was carried out, wherein a trend analysis was conducted on an initial pool of 1011 primary peer‐reviewed publications (1998–2023). The trend analysis was followed by a co‐citation network analysis of 39,608 secondary articles, which validated the importance of primary articles as indicated by the co‐citations in these secondary articles. Further, a purification process based on reliability, validity, and replicability criteria resulted in a final pool of 190 relevant articles. These articles were subjected to a thematic analysis. Next, a framework‐based review based on the theories, contexts, characteristics, and methods (TCCM) framework was conducted on the 190 articles. This step validated the primary study findings. Additionally, it examined and reported the underlying theories, context (country level), characteristics, and methods adopted by previous PHB studies. This analysis helps in indicating the future research agenda regarding PHB. Furthermore, the inferences drawn from the two studies were used to propose a conceptual framework for understanding consumers' PHB decisions based on the antecedents, decisions, and outcomes (ADO) framework. The framework posits that specific personal, demographic, cultural, social and socioeconomic factors are precursors to PHB adoption. This PHB adoption, in turn, has positive outcomes such as enhanced quality of life, consumer wellbeing, health promotion, health behavior change, and planning. The comprehensive review and proposed framework will significantly help advance knowledge about PHB. Apart from contributing to the academic literature, learnings from this study hold value for practitioners at the global level for designing actionable strategies for preventive healthcare products and services. [ABSTRACT FROM AUTHOR]

Introduction. Cognitive impairment is an important contributor to disability in multiple sclerosis (MS). Disconnection of neuronal circuits due to axonal injury is probably an important underlying mechanism for this disability. Neurofilament light chain (NfL) is a neuron-specific constituent of axons and has gained increasing attention as a biomarker of axonal injury. Objective. To assess the association between NfL in serum (sNfL) and cerebrospinal fluid (cNfL) and cognitive function over 10 years and compare these associations with volumetric brain magnetic resonance imaging (MRI) measurements. Methods. Newly diagnosed MS patients were followed prospectively with baseline NfL and MRI as well as with clinical and cognitive assessments for up to 10 years. Results. Forty-one patients were included. Baseline sNfL correlated negatively with symbol digit modalities test (SDMT) at baseline (r = − 0.45 , p = 0.005), year 5 (r = − 0.41 , p = 0.017), and at year 10 (r = − 0.52 , p = 0.008). Baseline cNfL correlated with baseline SDMT (r = − 0.34 , p = 0.030) and SDMT at year 10 (r = − 0.44 , p = 0.037). Baseline volumes of whole brain (r = 0.476 , p = 0.002), gray matter (r = 0.467 , p = 0.002), T1 (r = − 0.627 , p < 0.001), and T2 lesion volumes (r = − 0.475 , p = 0.002) correlated significantly with baseline SDMT. Longitudinal analyses showed that both MRI volumes and EDSS were associated with the rate of SDMT decline, whereas sNfL and cNfL were not. Conclusion. NfL levels measured in serum and cerebrospinal fluid were both associated with cognitive functioning in MS patients over a 10-year period from diagnosis. However, MRI volumes correlated strongly in addition to the rate of cognitive decline. [ABSTRACT FROM AUTHOR]

This is the protocol for an evidence and gap map. The objectives are as follows: To map available randomized control trials, economic evaluations, and systematic reviews that assess the effectiveness and cost‐effectiveness of non‐pharmacological interventions for older people with a diagnosis of depression and identify any existing gaps in the evidence that can inform future research. [ABSTRACT FROM AUTHOR]

Regular physical activity is an important health promoting behavior. Yet, many adults live sedentary lifestyles, especially during their workday. The current study applies an extended theory of planned behavior model, incorporating affective attitudes and instrumental attitudes, along with habit, to predict limiting sedentary behavior and physical activity within an office environment. Theory of planned behavior constructs and habit were assessed with an online survey on a sample of 180 full‐time office workers, with self‐reported behavior assessed 1 week later (Mage = 25.97, SDage = 10.24; 44 males, 134 females, and 2 nonbinary). Model fit was indicated by BRMSEA (M = 0.057, SD = 0.023), B γ^ (M = 0.984, SD = 0.010) and BCFI (M = 0.959, SD = 0.026), accounting for 46.1% of variance in intention, 21.6% of variance in sedentary behavior, and 17.4% of variance in physical activity behavior. A Bayesian structural equation model revealed direct effects of instrumental attitudes and perceived behavioral control on intention to limit sedentary behavior, direct effects of intention and perceived behavioral control on limiting sedentary behavior, and direct effects of perceived behavioral control and habit on engaging in physical activity. The current study indicates intentions to be active in the office are primarily driven by beliefs about the benefits of activity and individuals' perceived level of control, rather than normative or affective beliefs. As behavior was predicted by both intention and habit, findings also indicate office‐based activity is likely not always a consciously driven decision. These findings may have implications for improving activity levels in this highly sedentary population. [ABSTRACT FROM AUTHOR]

White matter pathologies analysis is important for segmenting multiple sclerosis (MS) lesions in MRI slices. Myelin damage affects motor function, sensory conflicts, paralysis, and vision. Extracting an optimistic number of hidden characteristic features induces high feature maps and reduces redundancy and dimensionality. A framework based on Hybrid Deep Convolutional Neural Networks (HD‐CNN) is presented to classify MS based on the acquired optimistic feature characteristic. First, Chaotic Leader‐Selective Particle Swarm Optimization uses the pixel intensity ratio of the targeted region to extract the most hidden white matter features. Second, Refined Slime Mold categorizes hidden features and ensures that the necessary features are selected effectively for a better segmentation result. An effective inbuilt Maximum Bidirectional Gradient Classifier accurately classifies MS lesions by detecting white matter spots in the target region. Finally, we will evaluate the proposed HD‐CNN framework using the industry‐standard University Medical Centre Ljubljana (UMCL) and international symposium on biomedical imaging (ISBI) 2015 datasets as benchmarks. It reaches 98.56%, 93.15%, and 98.44% accuracy for FLAIR, T1W, and T2W, respectively. Our HD‐CNN improves MS classification over other state‐of‐the‐art techniques, compared with accuracy, F‐score, Recall, Precision, Dice, and Jaccard indexes values. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to validate the revised Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) to measure sedentary activity in post-liver-transplant patients. The proposed scale could be useful for transplantation nurses to assess and modify sedentary lifestyles and increase physical activity. Methods: The SQUASH was modified to include items on sitting time and light-intensity physical activity (LPA-SQUASH). A pilot study was conducted with 20 liver transplant patients, and an expert panel validated the scale contents. Then, post-liver-transplant outpatients at a Japanese university hospital participated in the main study (September--October 2020), in which questionnaires were mailed twice to assess test--retest reliability, and accelerometers used to establish criterion validity. Intra-class correlation coefficients (ICC) were calculated for test--retest reliability. Spearman correlations and Bland-- Altman plots were used to assess validity and measurement error. Results: In total, 173 participants returned the questionnaires, and 106 and 71 completed the reliability and validation studies, respectively. The range of LPA-SQUASH correlation coefficients for test--retest was .49--.58. ICCs ranged from .72 to .80 for items other than leisure. Accelerometer data and the LPA-SQUASH total physical activity amount and light-intensity physical activity correlated moderately. Conclusion: We modified the SQUASH, which was developed to measure physical activity in healthy adults, to assess light-intensity physical activity in post-liver-transplant patients. The LPA-SQUASH showed acceptable validity and reliability. The questionnaire may be used by transplantation nurses to examine light-intensity physical activity content/duration, deliver patient education considering patients' sedentary lifestyle, and facilitate goal setting for physical activity interventions to prevent metabolic syndrome. [ABSTRACT FROM AUTHOR]

Summary: The study aim was to determine the effect of sleep restriction (3 h) between consecutive days of exercise on sprint and endurance cycling performance, wellness, and mood. A total of 10 well‐trained males performed 2 consecutive‐day trials separated by a normal night sleep (control [CONT]; mean [SD] sleep duration 3.0 [0.2] h) or sleep restriction (RES; mean [SD] sleep duration 3.0 [0.2] h). Experimental trials included a 90‐min fixed‐paced cycling bout and the respective sleep conditions on Day 1, followed by two 6‐s peak power (6‐s PP) tests, a 4‐ and 20‐min time trial (TT) on Day 2. Profile of Mood States (POMS) and wellness questionnaires were recorded on Day 1 and Day 2. Blood lactate and glucose, heart rate (HR), and rating of perceived exertion were recorded throughout Day 2. Power output (PO) was significantly reduced for RES in the 6‐s PP trial (mean [SD] 1159 [127] W for RES versus 1250 [186] W for CONT; p = 0.04) and mean PO during the 20‐min TT (mean [SD] 237 [59] W for RES versus 255 [58] W for CONT; p = 0.03). There were no differences for HR, lactate and glucose, or POMS between CONT and RES in all experimental trials (p = 0.05–0.89). Participants reported a reduction in overall wellness prior to exercise on Day 2 following RES (mean [SD] 14.5 [1.6] au) compared to CONT (mean [SD] 16 [3.0] au; p = 0.034). Sleep restriction and the associated reductions in wellness, reduce cycling performance during consecutive days of exercise in a range of cycling tests that are relevant to both track and road cyclists. [ABSTRACT FROM AUTHOR]

Inhibitory control processes are an important aspect of executive functions and goal‐directed behavior. However, the mostly correlative nature of neurophysiological studies was not able to provide insights which aspects of neural dynamics can best predict whether an individual is confronted with a situation requiring the inhibition of a response. This is particularly the case when considering the complex spatio‐temporal nature of neural processes captured by EEG data. In the current study, we ask whether independent spatial activity profiles in the EEG data are useful to predict whether an individual is confronted with a situation requiring response inhibition. We combine independent component analysis (ICA) with explainable artificial intelligence approaches (EEG‐based deep learning) using data from a Go/Nogo task (N = 255 participants). We show that there are four dissociable spatial activity profiles important to classify Go and Nogo trials as revealed by deep learning. Of note, for all of these four independent activity profiles, neural activity in the time period between 300 and 550 ms after stimulus presentation was most informative. Source localization analyses further revealed regions in the pre‐central gyrus (BA6), the middle frontal gyrus (BA10), the inferior frontal gyrus (BA46), and the insular cortex (BA13) were associated with the isolated spatial activity profiles. The data suggest concomitant processes being reflected in the identified time window. This has implications for the ongoing debate on the functional significance of event‐related potential correlates of inhibitory control. Inhibitory control processes are an important aspect of executive functions. However, which aspects of neural dynamics can best predict whether an individual is confronted with a situation requiring the inhibition of a response is tentative. Using deep learning, we delineate four dissociable spatial activity profiles and functional neuroanatomical structures in the time period between 300 and 550 ms after stimulus presentation important to classify Go and Nogo trials. This is central for the debate on the functional significance of EEG‐correlates of inhibitory control. [ABSTRACT FROM AUTHOR]

Rapid automatized naming (RAN) has been proven to be important for students' academic performance, but it remains unclear whether and how dealing with stressors (e.g., active coping) is associated with children's development of RAN. To examine this question, this research views the growth of RAN as a cross‐stressor adaptation process and proposes that school‐aged children may build up adapted and modified stress response systems through active coping in dealing with stressors and cognitive tasks. Based on the broaden‐and‐build theory and the mind–body unity theory, we explored the impact of active coping on RAN and hypothesized that subjective vitality and aerobic fitness chain mediated the relationship between active coping and RAN. We used two Likert‐like scales to measure active coping and subjective vitality, used a number‐reading task to measure RAN, and used the progressive aerobic cardiovascular endurance run (PACER) test to measure aerobic fitness. We recruited 303 elementary students in grades 3–5 in China. Results showed that both subjective vitality and aerobic fitness mediated the impact of active coping on time for RAN. Further, the chain indirect effect of active coping→subjective vitality→aerobic fitness→time for RAN was significant, but the reversed chain mediation was not significant. General resources (e.g., subjective vitality) have been shown to be relatively more important than simple physical resources (e.g., aerobic fitness) for RAN. These preliminary findings may contribute to both the cross‐stressor‐adaptation and active coping literature and have potential implications for improving RAN in school‐aged children. [ABSTRACT FROM AUTHOR]

Objective. This cross-sectional study aimed at investigating the influence of sociodemographic factors on physical activity among Syrian and Iraqi refugees in Jordan. In addition, it sought to determine the predictive ability of self-efficacy and mood in relation to the level of physical activity in this population. Methods. A convenient sample of refugees residing in Jordanian cities was collected. Participants completed a self-administered questionnaire pack consisting of a demographic data sheet, a physical activity level questionnaire, the Brunel Mood Scale, and the General Self-Efficacy Scale. Descriptive analysis was used to analyze demographic details, while the chi-square test examined the association between physical activity and demographic factors. The independent t-test assessed differences in self-efficacy and mood subscales in relation to physical activity. Logistic regression analysis was employed to identify potential predictors of the two categories of physical activity. Results. Most participants reported low levels of physical activity. The frequency of moderate-to-high physical activity was higher in male participants, those with higher education, better health, and higher income. Compared to participants of low physical activity, those in the moderate-to-high physical activity category expressed significantly higher mean score of self-efficacy but lower mean scores of tension, depression, anger, vigor, fatigue, and confusion, indicating better mood. The logistic regression analysis for physical activity indicated that the model was significant for education, income, good health perception, self-efficacy, and one mood subscale (vigor), with these variables collectively accounting for 11–18% of the variance (P value <0.001). Conclusion. The higher physical activity level is significantly associated with being male, higher education, higher income, better health, higher self-efficacy, and increased vigor. These findings highlight the importance of considering sociodemographic factors and psychological aspects, such as self-efficacy and mood, when addressing physical activity among refugees in Jordan. [ABSTRACT FROM AUTHOR]

Background and purpose: Valid measurements of cardiorespiratory fitness in persons with multiple sclerosis (pwMS) are essential during inpatient rehabilitation for a precise evaluation of the current health status, for defining appropriate exercise intensities, and for evaluation of exercise intervention studies. We aim (i) to examine the proportion of pwMS who attain the American College of Sports Medicine (ACSM) criteria for maximal effort during graded cardiopulmonary exercise testing (CPET) and (ii) to provide insight into participant characteristics that limit maximal exercise performance. Methods: This cross‐sectional study comprises a retrospective examination of ACSM criteria for maximal effort during graded CPET of n = 380 inpatient pwMS (mean age = 48 ± 11 years, 66% female). Chi‐squared or Fisher's exact tests were conducted to compare differences in the distribution of criteria achieved. Participants' characteristics were examined as potential predictors using binary logistic regression. Results: Only 60% of the overall sample attained a respiratory exchange ratio ≥ 1.10. With regard to the definition applied, only 24% or 40% of the participants achieved an oxygen consumption plateau, and 17% or 50% attained the heart rate criterion. Forty‐six percent met at least two of three criteria. Disability status, gender, disease course, and body mass index were associated with the attainment of maximal effort. Conclusions: Our findings suggest that a relevant proportion of inpatient pwMS do not attain common criteria utilized to verify maximal oxygen consumption. Identified predictors for criteria attainment can be used to create models to predict cardiorespiratory fitness and to optimize CPET protocols in restrictive groups of pwMS. [ABSTRACT FROM AUTHOR]

Music and language are two fundamental forms of human communication. Many studies examine the development of music‐ and language‐specific knowledge, but few studies compare how listeners know they are listening to music or language. Although we readily differentiate these domains, how we distinguish music and language—and especially speech and song— is not obvious. In two studies, we asked how listeners categorize speech and song. Study 1 used online survey data to illustrate that 4‐ to 17‐year‐olds and adults have verbalizable distinctions for speech and song. At all ages, listeners described speech and song differences based on acoustic features, but compared with older children, 4‐ to 7‐year‐olds more often used volume to describe differences, suggesting that they are still learning to identify the features most useful for differentiating speech from song. Study 2 used a perceptual categorization task to demonstrate that 4–8‐year‐olds and adults readily categorize speech and song, but this ability improves with age especially for identifying song. Despite generally rating song as more speech‐like, 4‐ and 6‐year‐olds rated ambiguous speech–song stimuli as more song‐like than 8‐year‐olds and adults. Four acoustic features predicted song ratings: F0 instability, utterance duration, harmonicity, and spectral flux. However, 4‐ and 6‐year‐olds' song ratings were better predicted by F0 instability than by harmonicity and utterance duration. These studies characterize how children develop conceptual and perceptual understandings of speech and song and suggest that children under age 8 are still learning what features are important for categorizing utterances as speech or song. Research Highlights: Children and adults conceptually and perceptually categorize speech and song from age 4.Listeners use F0 instability, harmonicity, spectral flux, and utterance duration to determine whether vocal stimuli sound like song.Acoustic cue weighting changes with age, becoming adult‐like at age 8 for perceptual categorization and at age 12 for conceptual differentiation.Young children are still learning to categorize speech and song, which leaves open the possibility that music‐ and language‐specific skills are not so domain‐specific. [ABSTRACT FROM AUTHOR]

Purpose. Individuals with multiple sclerosis (MS) are at an increased fall risk due to motor and cognitive dysfunction. Our past studies suggest that backward walking (BW) velocity predicts fall risk; however, specific cognitive domains associated with BW velocity remain understudied. The goal of this study was to determine the specific contributions of cognitive functioning to BW velocity in persons with MS. We hypothesized that better visuospatial memory, verbal immediate recall, and faster information processing speed would contribute to faster BW velocity, and deficits in these domains would partially account for disease severity-related impairment in BW velocity. Methods. Participants completed demographic questionnaires, walking tests, and cognitive assessments. Applied structural equation modeling was used to test our hypothesized model of competing cognitive mediators. Within the model, disease severity was a predictor of BW via three intercorrelated cognitive mediators. Results. Participants included 39 individuals with relapsing-remitting MS. Results indicated that 35.3% of the significant total effect of disease severity on BW was accounted for by specific cognitive deficits. Verbal immediate recall had the largest contribution, followed by visuospatial memory and information processing speed. Conclusions. When examining the unique effects of cognitive domains on disease severity-related deficits in BW, a meaningful source of impairment related to visuospatial memory and verbal immediate recall was demonstrated. Considering the utility of BW velocity as a predictor of falls, these results highlight the importance of assessing cognition when evaluating fall risk in MS. Cognitive-based intervention studies investigating fall prevention may find BW as a more specific and sensitive predictor of fall risk than forward walking. [ABSTRACT FROM AUTHOR]

Background and aims: Depression is a major public health concern that affects over 4% of the global population. Identification of new nonpharmacologic recommendations will help decrease the burden of disease. The overarching of this study was to examine the association between physical activity and depressive symptoms in a large sample of adults in the United States. Methods: Presently, researchers utilized data from the National Health and Nutrition Examination Surveys (NHANES 2017–2020), which is a retrospective, complex, multistage, representative, and modern cohort of the United States. Adult patients (> 18 years; N = 8091) with complete 9‐item Patient Health Questionnaire (PHQ‐9) information were included in the study. The PHQ‐9 is a well‐validated survey, per literature, scores ≥10 are considered to have clinically relevant depression. Univariable and multivariable logistic regression was fit for active and sedentary activities on clinical depression (PHQ‐9 ≥ 10). The acquisition and analysis of the data within this study were approved by the National Center for Health Statistics Ethics Review Board. Results: After adjusting for potential confounders like age, race, sex, and income, we found that increased vigorous exercise was associated with lower rates of depressive symptoms. Each extra day of vigorous exercise was associated with 11% decreased odds of depression (odd ratio [OR]: 0.89, confidence interval [CI]: 0.83–0.96, p < 0.01). Increased sedentary activity was associated with increased depression. Each extra hour per day of sedentary activity was associated with a 6% increase in odds of depression (OR: 1.06, (1.02–1.10, p < 0.01). Conclusion: To conclude, exercise appears to be protective against depressive symptoms; however, further prospective studies are required to ascertain whether exercise causes decreased depressive symptoms. [ABSTRACT FROM AUTHOR]

Numerous disorders are characterised by fatigue as a highly disabling symptom. Fatigue plays a particularly important clinical role in multiple sclerosis (MS) where it exerts a profound impact on quality of life. Recent concepts of fatigue grounded in computational theories of brain–body interactions emphasise the role of interoception and metacognition in the pathogenesis of fatigue. So far, however, for MS, empirical data on interoception and metacognition are scarce. This study examined interoception and (exteroceptive) metacognition in a sample of 71 persons with a diagnosis of MS. Interoception was assessed by prespecified subscales of a standard questionnaire (Multidimensional Assessment of Interoceptive Awareness [MAIA]), while metacognition was investigated with computational models of choice and confidence data from a visual discrimination paradigm. Additionally, autonomic function was examined by several physiological measurements. Several hypotheses were tested based on a preregistered analysis plan. In brief, we found the predicted association of interoceptive awareness with fatigue (but not with exteroceptive metacognition) and an association of autonomic function with exteroceptive metacognition (but not with fatigue). Furthermore, machine learning (elastic net regression) showed that individual fatigue scores could be predicted out‐of‐sample from our measurements, with questionnaire‐based measures of interoceptive awareness and sleep quality as key predictors. Our results support theoretical concepts of interoception as an important factor for fatigue and demonstrate the general feasibility of predicting individual levels of fatigue from simple questionnaire‐based measures of interoception and sleep. [ABSTRACT FROM AUTHOR]