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This paper examines the within-day, bidirectional associations between physical activity and self-reported pain among older adults. Older adults (N = 104; range: 60–98 years) participated in a 10-day Ecological Momentary Assessment (EMA) study. Participants received six EMA prompts/day with a single item assessing pain. Participants wore an activPAL monitor measuring step counts. At the within-person level, on occasions when participants took more steps than usual in the 30 min before the EMA prompt, they were more likely to experience pain at the prompt ( β ^ 02 = 0.0003 , p <.03). At the between-person level, greater step counts in the 30 min before the EMA prompt, on average, were associated with less pain on occasions when pain was experienced ( β ^ 01 = − 0.0005 , p <.04). Pain was not related to subsequent stepping. Bidirectional associations between physical activity and pain were not documented, but physical activity did appear to be related to subsequent pain. [ABSTRACT FROM AUTHOR]

Purpose: This work aims to assess the association of sleep duration with cardiometabolic risk (adiposity, blood pressure, lipids, albuminuria and A1C) and to investigate lifestyle factors (physical activity, light exposure, caffeine consumption and sugar consumption) associated with sleep duration in children. Methods: A nationally representative sample of 3907 children ages 6–17 years enrolled in NHANES from 2011 to 2014 was included in this cross‐sectional study. Sleep duration was defined as the daily average time spent sleeping over 7 days as measured by a physical activity monitor (PAM). Participants without valid sleep data for ≥95% of the study were excluded. Regression models were adjusted for age, sex, race, body mass index (BMI) Z score, physical activity and light exposure. Results: In adjusted regression models, longer sleep duration was associated with lower systolic blood pressure index (β = −3.63 * 10−5, 95% CI −6.99 * 10−5, −2.78 * 10−6, p = 0.035) and BMI Z score (β = −0.001, 95% CI −0.001, 0.000, p = 0.002). In logistic regression models, longer sleep duration was associated with lower odds of obesity (OR = 0.998, 95% CI 0.997, 0.999, p < 0.001) and overweight status (OR = 0.998, 95% CI 0.997, 0.999, p = 0.004). Greater light exposure (β = 6.64 * 10−5, 95% CI 3.50 * 10−5, 9.69 * 10−5, p < 0.001) and physical activity (β = 0.005, 95% CI 0.004, 0.006, p < 0.001) were associated with longer sleep. Conclusion: Longer sleep duration was associated with lower blood pressure and adiposity measures in children. Improving sleep quality by increasing physical activity and light exposure in childhood may decrease the lifetime risk of cardiometabolic disease. [ABSTRACT FROM AUTHOR]

Background: Suboptimal rest-activity patterns in adolescence are associated with worse health outcomes in adulthood. Understanding sociodemographic factors associated with rest-activity rhythms may help identify subgroups who may benefit from interventions. This study aimed to investigate the association of rest-activity rhythm with demographic and socioeconomic characteristics in adolescents. Methods: Using cross-sectional data from the nationally representative National Health and Nutrition Examination Survey (NHANES) 2011–2014 adolescents (N = 1814), this study derived rest-activity profiles from 7-day 24-hour accelerometer data using functional principal component analysis. Multiple linear regression was used to assess the association between participant characteristics and rest-activity profiles. Weekday and weekend specific analyses were performed in addition to the overall analysis. Results: Four rest-activity rhythm profiles were identified, which explained a total of 82.7% of variance in the study sample, including (1) High amplitude profile; (2) Early activity window profile; (3) Early activity peak profile; and (4) Prolonged activity/reduced rest window profile. The rest-activity profiles were associated with subgroups of age, sex, race/ethnicity, and household income. On average, older age was associated with a lower value for the high amplitude and early activity window profiles, but a higher value for the early activity peak and prolonged activity/reduced rest window profiles. Compared to boys, girls had a higher value for the prolonged activity/reduced rest window profiles. When compared to Non-Hispanic White adolescents, Asian showed a lower value for the high amplitude profile, Mexican American group showed a higher value for the early activity window profile, and the Non-Hispanic Black group showed a higher value for the prolonged activity/reduced rest window profiles. Adolescents reported the lowest household income had the lowest average value for the early activity window profile. Conclusions: This study characterized main rest-activity profiles among the US adolescents, and demonstrated that demographic and socioeconomic status factors may shape rest-activity behaviors in this population. [ABSTRACT FROM AUTHOR]

Purpose: In a cross-sectional sample of US Hispanic/Latino adults, we aimed to describe step-based metric distributions, estimate their associations with activity counts and self-report, and calibrate step-based translations of current (2018) US physical activity (PA) guidelines, that is, ≥150 min·wk-1 moderate-to-vigorous PA (MVPA) from accelerometer counts and self-report. Methods: The Hispanic Community Health Study/Study of Latinos enrolled 16,415 Hispanic/Latino adults 18-74 yr from four US cities (2008-2011). Participants completed the Global PA Questionnaire and 1 wk of Actical accelerometer wear (n = 12,528). Weighted medians were used to describe step-based metrics, and Spearman correlations estimated their relationships with count-based and self-reported PA indicators. Receiver operator characteristic curve analyses were used to examine the ability of each step-basedmetric to classify participantsmeeting PAguidelines. Results: Overall, US Hispanic/Latino adults accumulated medians of 6770 steps per day and 6, 18, 236, and 630 min·d-1 at ≥100, ≥70, 1-69, and 0 steps perminute, respectively. Count-based time inMVPA, light PA, and sedentary behavior weremost strongly correlated (rs = 0.79-0.85) with times ≥70, 1-69, and 0 steps perminute, respectively,whereas self-reported MVPA had similar correlations with steps per day and times ≥40 and ≥70 steps per minute (rs = 0.28-0.29). Time ≥70 steps per minute had the greatest capacity to classify participants meeting PA guidelines with both measures of MVPA. Conclusions: This study provides the first normative values (based on percentiles) of step-based metrics for US Hispanic/Latino adults, which can facilitate surveillance, program planning, research, and data interpretation. Our finding that PA guidelines corresponded to 6000-7000 steps per day or ~20 min·d-1 at ≥70 steps per minute with an Actical accelerometer can be considered alongside dose-response relationships with health outcomes to develop step-based recommendations that are consistent with and better communicate PA guidelines. [ABSTRACT FROM AUTHOR]

Aim: This study compared indirect measurement of physical activity (PA) using the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and direct using accelerometers in African American adults. Subject and methods: African Americans in a southeastern US metropolitan city were recruited to participate in a lifestyle intervention. Participants were predominantly female (79%) and spanned a 40-year age range (min = 25, max = 65). Participants completed the IPAQ-SF and wore an Actigraph GT1M accelerometer on the right hip for a minimum of 7 days, including 1 weekend day. IPAQ-SF data were reduced using IPAQ scoring protocol; accelerometer data were reduced using Freedson cutpoints. We calculated minutes/day of moderate, vigorous, and moderate to vigorous PA, and sedentary time. Descriptive statistics summarized minutes/day. Paired-sample t-tests and Bland–Altman plots compared differences between methods. Pearson correlations assessed associations between the methods. Results: In total, 158 participants completed the IPAQ-SF and 141 participants had usable accelerometer data. Participants reported significantly more vigorous and moderate to vigorous PA (12.6 ± 29.4 and 10.7 ± 39.1 min/day, respectively) and reported significantly less sedentary time (−189.6 ± 207.0 min/day) on the IPAQ-SF compared to the accelerometer. Correlations of interest ranged from 0.24 to 0.31. Bland–Altman analyses demonstrated measurement error of higher reporting of PA and lower reporting of sedentary time. Conclusions: Measurement differences were in expected directions. Both measures correlated similarly in our sample compared to other populations. Future studies may compare other indirect measures of PA with direct. Measurement method may influence relationships of physical activity or sedentary time on other outcomes in clinical and practice settings. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity is important for children's health and well-being. Supportiveness for physical activity of home and neighborhood environments may affect children's PA, but most studies are cross-sectional. We examined environmental predictors of change in children's physical activity over two years. Methods: Data were from the longitudinal, observational cohort study, 'Neighborhood Impact on Kids'. Participants were children (initially aged 6–12 years) and their parent/caregiver (n = 727 dyads) living in neighborhoods throughout San Diego County, California and King County (Seattle area), Washington, USA. Children's moderate-to-vigorous physical activity (MVPA) was measured using accelerometers at T1 (Time 1 or baseline, 2007–2009) and T2, the two-year follow-up. At T1, parents survey-reported on physical activity (PA) equipment at home and demographics. Neighborhood environment was measured using spatial data in Geographic Information Systems (intersection density; park availability) and in-person audits (informal play space near home; park-based PA facilities; land use; support for walking/cycling). Generalized additive mixed models estimated total effects, then direct effects, of environmental attributes on MVPA at T1. Two-way moderating effects of child's sex and age were examined at T1. To examine associations of environmental exposures with changes in MVPA, we estimated interaction effects of environmental attributes on the association between time and MVPA. Results: On average, children accumulated 146 min/day (standard deviation or SD = 53) of MVPA at T1, and 113 (SD = 58) min/day at T2. There were no significant total or direct effects of environmental attributes on MVPA at T1, and no significant two-way interaction effects of child's age and sex for T1 MVPA. Having informal play spaces proximal to home with more amenities was associated with less MVPA decline from T1 to T2. Higher residential density, higher land use mix, and higher number of PA facilities in nearby parks were unexpectedly associated with greater MVPA decline. Conclusion: Higher quality informal play spaces close to home may help offset declines in MVPA during middle childhood, as they may promote unstructured active play with opportunities for parental or neighbor surveillance. Unexpectedly, environmental factors consistent with higher walkability were associated with greater declines in children's MVPA. As physical activity differs across the lifespan, so may environmental factors that facilitate it. [ABSTRACT FROM AUTHOR]

Purpose: Sedentary behavior is associated with poor physical function in older adults, which can lead to accelerated skeletal muscle aging (sarcopenia) and premature mortality. We examined the independent and joint effects of sedentary behavior and moderate to vigorous intensity physical activity (MVPA) with measures of physical functioning. Methods: We studied 5408 participants in the REasons for Geographic and Racial Differences in Stroke study who wore a hip-mounted accelerometer over seven consecutive days (2009–2013) and had self-reported and directly observed physical function (time walk, chair stand test) measured during an in-home visit conducted from 2013 to 2016. Results: Greater sedentary time was significantly associated with poorer chair stand and timed walk scores. Substituting 30 min of sedentary time with 30 min of MVPA was associated with significant improvements in chair stands (β −0.57; P = 0.007) and timed walk (β −0.36; P = 0.01). Similar, but less robust, findings were observed for reallocations of sedentary time to light-intensity physical activity. In joint association analyses, high sedentary time in combination with low MVPA (but not in combination with high MVPA) was associated with poorer physical function compared with the referent group (low sedentary time/high MVPA; P < 0.001 for all). Conclusions: Greater time spent being sedentary was associated with worse physical functioning outcomes. However, reallocations of sedentary time to light-intensity physical activity, and especially MVPA, were associated with more favorable physical functioning. Interventions aimed to increase MVPA and reduce sedentary behavior should be a priority, especially among populations at greatest risk for sarcopenia and physical function decline. [ABSTRACT FROM AUTHOR]

Background: Spinal cord stimulation (SCS) is an important option for patients with chronic neuropathic pain. In the United States, a successful SCS trial determines eligibility for SCS implant. Metrics to determine success are often self-reported and subjective, which may limit achievement of patient goals. This study aimed to assess whether patients undergoing SCS implant after successful trial felt that use of external accelerometry prior to implant was a useful educational tool to objectively appraise function and achievement of treatment goals. Methods: This was a single center, prospective, pilot study. Sixteen subjects with persistent spinal pain syndrome type 2 underwent a percutaneous SCS trial. Five subjects did not have a successful trial, one expired after the SCS trial, before implant, and one dropped out prior to completion of post-implant follow-up visits. Nine subjects underwent SCS implant and completed the required follow-up visits. All subjects were provided an Actigraph GT3X external accelerometer, worn 7 days prior to the trial to determine baseline physical activity and during the 7-day trial to assess for change in activity from baseline. Results were shared with subjects to individualize goals for therapy. Goal attainment was assessed at 1, 3, and 6 months after implant. Subjects wore the accelerometer again 24 hours before visits to update progress in meeting treatment goals. The primary outcome was satisfaction with using accelerometry as an educational tool to appraise function and guide treatment goals for SCS therapy. Secondary outcomes included physical activity, as captured via accelerometry, as well as validated patient-reported measures of pain severity, physical functioning, and quality-of-life. Results: Eight of nine subjects were satisfied with accelerometry as an educational tool. Secondary outcomes were not reliably assessed due to poor stewardship and study execution. Conclusion: External accelerometry may assist patients in developing individualized functional treatment goals for SCS therapy. [ABSTRACT FROM AUTHOR]

Treating opioid use disorder (OUD) is a significant healthcare challenge in the United States. Remaining abstinent from opioids is challenging for individuals with OUD due to withdrawal symptoms that include restlessness. However, to our knowledge, studies of acute withdrawal have not quantified restlessness using involuntary movements. We hypothesized that wearable accelerometry placed mid-sternum could be used to detect withdrawal-related restlessness in patients with OUD. To study this, 23 patients with OUD undergoing active withdrawal participated in a protocol involving wearable accelerometry, opioid cues to elicit craving, and non-invasive Vagal Nerve Stimulation (nVNS) to dampen withdrawal symptoms. Using accelerometry signals, we analyzed how movements correlated with changes in acute withdrawal severity, measured by the Clinical Opioid Withdrawal Scale (COWS). Our results revealed that patients demonstrating sinusoidal–i.e., predominantly single-frequency oscillation patterns in their motion almost exclusively demonstrated an increase in the COWS, and a strong relationship between the maximum power spectral density and increased withdrawal over time, measured by the COWS (R = 0.92, p = 0.029). Accelerometry may be used in an ambulatory setting to indicate the increased intensity of a patient's withdrawal symptoms, providing an objective, readily-measurable marker that may be captured ubiquitously. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) may be an important fall prevention strategy. Current PA guidelines emphasize total PA dose, but daily patterning of PA is underappreciated. With aging, PA bouts become less frequent and shorter in duration (ie, more fragmented). PA fragmentation may be an indicator of fall risk, but the relationship is not well understood. This study examined daily PA accumulation and patterns with fall risk in older adults., Methods: Participants (n = 685, 54.3% women, 61.5% aged 70-79 years) from the National Health and Aging Trends Study with wrist-worn accelerometry PA data from Round 11 (baseline) and sample person interviews with fall data from Round 12 (follow-up) were included. PA variables were categorized into tertiles and incident falls were defined as ≥1 self-reported fall in the year following the PA assessment between baseline and follow-up. A modified Poisson approach was used to estimate the relative risk of both PA accumulation and fragmentation with falls., Results: Overall, 40.0% reported an incident fall. After adjustment for sociodemographic and health characteristics, those in the highest tertile of total PA accumulation had lower fall risk (aRR = 0.74, 95% CI: 0.57, 0.95) and those in the highest tertile of PA fragmentation had increased fall risk (aRR = 1.33, 95% CI: 1.03, 1.73). Models were attenuated after adjustment for physical functioning., Conclusions: PA fragmentation may identify fall risk in older adults. Longitudinal studies are needed to disentangle the temporal sequencing of the complex relationship between PA and physical functioning across the life course., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Older adults are the least active population in the U.S. Low-income communities have fewer physical activity (PA) resources, contributing to less PA and increased chronic disease risk. This study assessed the effect of the multilevel, peer-led, Peer Empowerment Program 4 Physical Activity (PEP4PA) on moderate-to-vigorous PA (MVPA) and health outcomes, over 2 years of follow up. Methods: In a cluster-randomized controlled trial, 12 senior or community centers serving low-income older adults were assigned to a PA intervention (n = 6) or usual programming (n = 6) condition. PEP4PA included self-monitoring, health coaching, group walks, social support, and community advocacy to improve walking conditions. The primary outcome was daily minutes of MVPA (7-day accelerometer). Secondary outcomes included Perceived Quality of Life (PQoL), 6-Minute Walk Test (6-MWT), blood pressure (BP), and depressive symptoms at baseline, 6, 12, 18 and 24 months. Mixed effects regression models estimated the effects on outcomes between groups over time and included random effects for repeated measures and center clustering. Effect modification by sex and income status was assessed. We calculated the incremental cost per daily minute of MVPA gained in the intervention group relative to the control group to assess cost effectiveness. Results: We enrolled 476 older adults (50 + years). Participants were on average 71 years old, 76% female, 60% low income, and 38% identified as racial or ethnic minorities. Compared to the control group, intervention participants sustained roughly a 10 min/day increase in MVPA from baseline at all time points and increased mean PQoL scores from unsatisfied at baseline to satisfied at 12, 18 and 24 months. Males and higher-income groups had greater improvements in MVPA. No significant effects were observed for 6-MWT or depressive symptoms, and BP results were mixed. The incremental cost per minute MVPA gained per person was $0.25, $0.09, $0.06, and $0.05 at 6, 12, 18 and 24 months, respectively. Conclusions: PEP4PA achieved increases in MVPA and PQoL in low-income older adults, over 2 years of follow up. The peer-led, community-based intervention provides a sustainable and cost-effective model to improve health behaviors in underserved, aging populations. Trial registration: ClinicalTrials.gov (NCT02405325) March 20, 2015. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the shape of the relationship between physical activity (PA) and total energy expenditure (TEE) and to explore the role of energy balance status (negative, stable, positive) in influencing this association. Methods : Cross-sectional. Participants were 584 older adults (50-74 yr) participating in the Interactive Diet and Activity Tracking in AARP study. TEE was assessed by doubly labeled water and PA by accelerometer. The relationship between PA and TEE was assessed visually and using nonlinear methods (restricted cubic splines). Percent weight change (>3%) over a 6-month period was used as a proxy measurement of energy balance status. Results : TEE generally increased with increasing deciles of PA averaging 2354 (SD, 351) kcal[middle dot]d-1 in the bottom decile to 2693 (SD, 480) kcal[middle dot]d-1 in the top decile. Cubic spline models showed an approximate linear association between PA and TEE (linear relation, P < 0.0001; curvature, P = 0.920). Results were similar in subgroup analyses for individuals classified as stable or positive energy balance. For those in negative energy balance, TEE was generally flat with increasing deciles of PA averaging 2428 (SD, 285) kcal[middle dot]d-1 in the bottom decile to 2372 (SD, 560) kcal[middle dot]d-1 in the top decile. Conclusions: Energy balance status seems to play an important role in the relationship between PA and TEE. When in a positive energy balance, the relationship between TEE and PA was consistent with an additive model; however, when energy balance was negative, TEE seems to be consistent with a constrained model. These findings support PA for weight gain prevention by increasing TEE; however, the effect of PA on TEE during periods of weight loss may be limited. An adequately powered, prospective study is warranted to confirm these exploratory findings. [ABSTRACT FROM AUTHOR]

Objectives: The validity of the Global Physical Activity Questionnaire has not been thoroughly evaluated among Hispanics/Latinos. In this cross-sectional study, we assessed the concurrent validity and correlates of discordance of the Global Physical Activity Questionnaire by comparing it to accelerometry in estimating sedentary behavior, moderate-to-vigorous physical activity, and meeting United States physical activity guidelines by sociodemographic, behavioral, and health characteristics., Design: The Hispanic Community Health Study/Study of Latinos is a 4-site cohort study of United States adults aged 18-74 years enrolled from 2008 to 2011., Methods: Participants (n = 11,873) completed the Global Physical Activity Questionnaire and wore an accelerometer for 1 week. Lin's concordance and Pearson correlations assessed concurrent validity between self-reported and accelerometry-assessed measures of sedentary behavior and moderate-to-vigorous physical activity. Kappa coefficients assessed agreement of meeting physical activity guidelines. Linear and logistic regression models identified correlates of discordance., Results: The overall Lin's concordance and Pearson correlations between the Global Physical Activity Questionnaire and accelerometry estimates were 0.10 (95 % confidence interval 0.09, 0.12) and 0.24 (0.21, 0.27) for sedentary behavior, and 0.04 (0.03, 0.05) and 0.18 (0.15, 0.22) for moderate-to-vigorous physical activity, respectively. Agreement was poor for meeting the physical activity guideline classifications (Kappa coefficients: 0.12 to 0.26). Over a 16-hour day, sedentary behavior was under-reported by 3.8 h and moderate-to-vigorous physical activity was over-reported by 1.9 h., Conclusions: The concurrent validity of the Global Physical Activity Questionnaire in measuring moderate-to-vigorous physical activity and sedentary behavior when compared to accelerometry was poor among Hispanic/Latino adults., Competing Interests: Declaration of interest statement The accelerometer used in this study was an Actical device (version B-1, model 198-0200-03, 32 Hz) which is not considered a commercial product. This manuscript does not involve consultancies, stock ownership, or other equity interests or patent-licensing arrangements. The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: The harmful relationship of sedentary behavior to health may reflect an exchange of sedentary activity for moderate-to-vigorous physical activity (MVPA), or sedentary behavior may be a separate risk factor. We examined whether time spent in sedentary behavior is related to disability in activities of daily living (ADL), independent of time spent in MVPA in older adults. Methods: The nationally representative 2003-2006 National Health and Nutrition Examinations Surveys (NHANES) included 2286 adults aged 60 years and older in whom physical activity was assessed by accelerometer. The association between ADL task disability and the daily percentage of sedentary time was evaluated by multiple logistic regression. Results: These adults on average spent 9h/d being sedentary during waking hours and 4.5% reported ADL disability. The odds of ADL disability were 46% greater (odds ratio, 1.46; 95% confidence interval, 1.07-1.98) for each daily hour spent in sedentary behavior, adjusted for MVPA and socioeconomic and health factors. Conclusion: These US national data show a strong relationship between greater time spent in sedentary behavior and the presence of ADL disability, independent of time spent in moderate or vigorous activity. These findings support programs encouraging older adults to decrease sedentary behavior regardless of their engagement in moderate or vigorous activity. [ABSTRACT FROM AUTHOR]

Background: Analysis of the 2005-2006 National Health and Nutrition Examination Survey (NHANES) accelerometer data provides the descriptive epidemiology of peak 30-minute cadence (defined as the average steps/min recorded for the 30 highest, but not necessarily consecutive, minutes in a day) and peak 1-minute cadence (defined as the steps/min recorded for the highest single minute in a day) by sex, age, and body mass index (BMI). Methods: Minute-by-minute step data were rank ordered each day to identify the peak 30-minute and I -minute cadences for 3522 adults (20+ years of age) with complete sex, age, and BMI data and at least 1 valid day (ie, 10/24 hours of accelerometer wear) of accelerometer data. Peak values were averaged across days within participants by sex, age, and BMI-defined categories. Results: U.S. adults average a peak 30-minute cadence of 71.1 (men: 73.7, women: 69.6, P< .0001) steps/min and a peak 1-minute cadence of 100.7 (men: 100.9, women: 100.5, P = .54) steps/min. Both peak cadence indicators displayed significant and consistent declines with age and increasing levels of obesity. Conclusions: Peak cadence indicators capture the highest intensity execution of naturally occurring ambulatory activity. Future examination of their relationship with health parameters using cross-sectional, longitudinal, and intervention designs is warranted. [ABSTRACT FROM AUTHOR]

Nursing influences growth rate and overall health of mammals; however, the behavior is difficult to study in wild cetaceans because it occurs below the surface and can thus be misidentified from surface observations. Nursing has been observed in humpback whales on the breeding and calving grounds, but the behavior remains unstudied on the feeding grounds. We instrumented three dependent calves (four total deployments) with combined video and 3D-accelerometer data loggers (CATS) on two United States feeding grounds to document nursing events. Two associated mothers were also tagged to determine if behavior diagnostic of nursing was evident in the mother's movement. Animal-borne video was manually analyzed and the average duration of successful nursing events was 23 s (±7 sd, n D 11). Nursing occurred at depths between 4.1- 64.4 m (along the seafloor) and in close temporal proximity to foraging events by the mothers, but could not be predicted solely by relative positions of mother and calf. When combining all calf deployments, successful nursing was documented eleven times; totaling only 0.3% of 21.0 hours of video. During nursing events, calves had higher overall dynamic body acceleration (ODBA) and increased fluke-stroke rate (FSR) compared to non-nursing segments (Mixed effect models, ODBA: F1,107 D 13.57756, pD0:0004, FSR: F1,107D32.31018, p<0:0001). In contrast, mothers had lowerODBA and reduced FSR during nursing events compared to non-nursing segments. These data provide the first characterization of accelerometer data of humpback whale nursing confirmed by animal-borne video tags and the first analysis of nursing events on feeding grounds. This is an important step in understanding the energetic consequences of lactation while foraging. [ABSTRACT FROM AUTHOR]

Little is known concerning the type of activity that should be substituted for sedentary time and its potentially most hazardous form (prolonged sedentary bouts) to impart health benefit. We used isotemporal substitution techniques to examine whether 1) replacing total sedentary time with light-intensity or moderate to vigorous physical activity (LIPA or MVPA) or 2) replacing prolonged sedentary bouts with shorter sedentary bouts is associated with reductions in all-cause mortality risk. Participants (n = 7,999) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national cohort of US adults aged ≥45 years, were studied. Sedentary time was measured by accelerometry between 2009 and 2013. There was a beneficial association with mortality risk for replacing total sedentary time with both LIPA (per 30 minutes, hazard ratio (HR) = 0.83; 95% confidence interval (CI): 0.80, 0.87) and MVPA (per 30 minutes, HR = 0.65; 95% CI: 0.50, 0.85). Similarly, there was a beneficial association for replacing prolonged sedentary-bout time with LIPA and MVPA but not for replacement with shorter sedentary bouts (per 30 minutes, HR = 1.00; 95% CI: 0.96, 1.03). These findings suggest short sedentary bouts still carry mortality risk and are not a healthful alternative to prolonged sedentary bouts. Instead, physical activity of any intensity is needed to mitigate the mortality risks incurred by sedentary time. [ABSTRACT FROM AUTHOR]

OBJECTIVES To evaluate the effect of hospitalizations on patterns of sedentary and physical activity time in mobility‐limited older adults randomized to structured physical activity or health education. DESIGN Secondary analysis of investigator‐blinded, parallel‐group, randomized trial conducted at 8 U.S. centers between February 2010 and December 2013. PARTICIPANTS Sedentary men and women aged 70 to 89 at baseline who wore a hip‐fitted accelerometer 7 consecutive days at baseline and 6, 12, and 24 months after randomization (N=1,341). MEASUREMENTS Participants were randomized to a physical activity (PA; n = 669) intervention that included aerobic, resistance, and flexibility training or to a health education (HE; n = 672) intervention that consisted of workshops on older adult health and light upper‐extremity stretching. Accelerometer patterns were characterized as bouts of sedentary (<100 counts/min; ≥1, ≥10, ≥30, ≥60 minute lengths) and activity (≥100 counts/min; ≥1, ≥2, ≥5, ≥10 minute lengths) time. Each participant was categorized as having 0, 1 to 3, or 4 or more cumulative hospital days before each accelerometer assessment. RESULTS: Hospitalization increased sedentary time similarly in both intervention groups (8 min/d for 1–3 cumulative hospital days and 16 min/d for ≥4 cumulative hospital days). Hospitalization was also associated with less physical activity time across all bouts of less than 10 minutes (≥1: −7 min/d for 1–3 cumulative hospital days, –16 min/d for ≥4 cumulative hospital days; ≥2: −5 min/d for 1–3 cumulative hospital days, −11 min/d for ≥4 cumulative hospital days; ≥5: −3 min/d for 1–3 cumulative hospital days, −4 min/d for ≥4 cumulative hospital days). There was no evidence of recovery to prehospitalization levels (time effect p >.41). PA participants had less sedentary time in bouts of less than 30 minutes than HE participants (−8 to −10 min/d) and more total activity (+3 to +6 min/d), although hospital‐related changes were similar between the intervention groups (interaction effect p >.26). CONCLUSION: Participating in a PA intervention before hospitalization had expected benefits, but participants remained susceptible to hospitalization's detrimental effects on their daily activity levels. There was no evidence of better activity recovery after hospitalization. J Am Geriatr Soc 67:261–268, 2019. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine how accelerometer-assessed physical activity accumulation patterns (e.g., is activity performed daily or only 1 or 2 d·wk−1 or is activity accrued in bouts) may affect the association with mortality. Methods: Adults (N = 3438), age 40 yr and older, who wore an accelerometer (ActiGraph 7164), were drawn from the longitudinal follow-up of the National Health and Nutritional Examination Survey (2003–2006), a population-based survey of the United States. Accelerometer-assessed moderate-to-vigorous physical activity (MVPA) was described by activity patterns. Participants engaging in the majority of their activity on only 1 or 2 d·wk−1· were classified as "weekend warriors." Activity bouts were defined as a period of at least moderate intensity lasting at least 10 min. Bout characteristics included bout frequency and length. Mortality was assessed through National Death Index matching through 2013. Mortality rates were compared among groups with different activity patterns. Results: Over an average follow-up of 77.4 months, 394 deaths occurred. Compared to participants with <37.5 min of MVPA per week, those with greater amounts of activity had a 60% to 69% mortality rate reduction after adjusting for relevant covariables. Similar risk reductions were found when contrasting weekend warriors with those who were more frequently active. An increase of one MVPA bout per week was associated with a 13% increased mortality rate. Bout duration was not associated with mortality. Conclusion: Physical activity is associated with decreased mortality rate, even among those who are active 1 or 2 d·wk−1. [ABSTRACT FROM AUTHOR]

Background. Accurate time-energy budgets summarise an animal's energy expenditure in a given environment, and are potentially a sensitive indicator of how an animal responds to changing resources. Deriving accurate time-energy budgets requires an estimate of time spent in different activities and of the energetic cost of that activity. Bio-loggers (e.g., accelerometers) may provide a solution for monitoring animals such as fur seals that make long-duration foraging trips. Using low resolution to record behaviour may aid in the transmission of data, negating the need to recover the device. Methods. This study used controlled captive experiments and previous energetic research to derive time-energy budgets of juvenile Australian fur seals (Arctocephalus pusillus) equipped with tri-axial accelerometers. First, captive fur seals and sea lions were equipped with accelerometers recording at high (20 Hz) and low (1 Hz) resolutions, and their behaviour recorded. Using this data, machine learning models were trained to recognise four states--foraging, grooming, travelling and resting. Next, the energetic cost of each behaviour, as a function of location (land or water), season and digestive state (pre- or post-prandial) was estimated. Then, diving and movement data were collected from nine wild juvenile fur seals wearing accelerometers recording at high- and low- resolutions. Models developed from captive seals were applied to accelerometry data from wild juvenile Australian fur seals and, finally, their time-energy budgets were reconstructed. Results. Behaviour classification models built with low resolution (1 Hz) data correctly classified captive seal behaviours with very high accuracy (up to 90%) and recorded without interruption. Therefore, time-energy budgets of wild fur seals were constructed with these data. The reconstructed time-energy budgets revealed that juvenile fur seals expended the same amount of energy as adults of similar species. No significant differences in daily energy expenditure (DEE) were found across sex or season (winter or summer), but fur seals rested more when their energy expenditure was expected to be higher. Juvenile fur seals used behavioural compensatory techniques to conserve energy during activities that were expected to have high energetic outputs (such as diving). Discussion. As low resolution accelerometry (1 Hz) was able to classify behaviour with very high accuracy, future studies may be able to transmit more data at a lower rate, reducing the need for tag recovery. Reconstructed time-energy budgets demonstrated that juvenile fur seals appear to expend the same amount of energy as their adult counterparts. Through pairing estimates of energy expenditure with behaviour this study demonstrates the potential to understand how fur seals expend energy, and where and how behavioural compensations are made to retain constant energy expenditure over a short (dive) and long (season) period. [ABSTRACT FROM AUTHOR]

Background: Limited evidence exists to inform physical activity (PA) and sedentary behavior guidelines for older people, especially women. Rigorous evidence on the amounts, intensities, and movement patterns associated with better health in later life is needed.Methods/design: The Objective PA and Cardiovascular Health (OPACH) Study is an ancillary study to the Women's Health Initiative (WHI) Program that examines associations of accelerometer-assessed PA and sedentary behavior with cardiovascular and fall events. Between 2012 and 2014, 7048 women aged 63-99 were provided with an ActiGraph GT3X+ (Pensacola, Florida) triaxial accelerometer, a sleep log, and an OPACH PA Questionnaire; 6489 have accelerometer data. Most women were in their 70s (40%) or 80s (46%), while approximately 10% were in their 60s and 4% were age 90 years or older. Non-Hispanic Black or Hispanic/Latina women comprise half of the cohort. Follow-up includes 1-year of falls surveillance with monthly calendars and telephone interviews of fallers, and annual follow-up for outcomes with adjudication of incident cardiovascular disease (CVD) events through 2020. Over 63,600 months of calendar pages were returned by 5,776 women, who reported 5,980 falls. Telephone interviews were completed for 1,492 women to ascertain the circumstances, injuries and medical care associated with falling. The dataset contains extensive information on phenotypes related to healthy aging, including inflammatory and CVD biomarkers, breast and colon cancer, hip and other fractures, diabetes, and physical disability.Discussion: This paper describes the study design, methods, and baseline data for a diverse cohort of postmenopausal women who wore accelerometers under free-living conditions as part of the OPACH Study. By using accelerometers to collect more precise and complete data on PA and sedentary behavior in a large cohort of older women, this study will contribute crucial new evidence about how much, how vigorous, and what patterns of PA are necessary to maintain optimal cardiovascular health and to avoid falls in later life.Clinical Trials Registration: ClinicalTrials.gov identifier NCT00000611 . Registered 27 October 1999. [ABSTRACT FROM AUTHOR]

Background: Moderate-to-vigorous-intensity physical activity is recommended to maintain and improve health, but the mortality benefits of light activity and risk for sedentary time remain uncertain. Objectives: Using accelerometer-based measures, we 1) described the mortality dose-response for sedentary time and light- and moderateto- vigorous-intensity activity using restricted cubic splines, and 2) estimated the mortality benefits associated with replacing sedentary time with physical activity, accounting for total activity. Design: US adults (n = 4840) from NHANES (2003-2006) wore an accelerometer for ≤ 7 d and were followed prospectively for mortality. Proportional hazards models were used to estimate adjusted HRs and 95% CIs for mortality associations with time spent sedentary and in light- and moderate-to-vigorous-intensity physical activity. Splines were used to graphically present behavior-mortality relation. Isotemporal models estimated replacement associations for sedentary time, and separate models were fit for low- (<5.8 h total activity/d) and high-active participants to account for nonlinear associations. Results: Over a mean of 6.6 y, 700 deaths occurred. Compared with less-sedentary adults (6 sedentary h/d), those who spent 10 sedentary h/d had 29% greater risk (HR: 1.29; 95% CI: 1.1, 1.5). Compared with those who did less light activity (3 h/d), those who did 5 h of light activity/d had 23% lower risk (HR: 0.77; 95% CI: 0.6, 1.0). There was no association with mortality for sedentary time or light or moderate-to-vigorous activity in highly active adults. In less-active adults, replacing 1 h of sedentary time with either lightor moderate-to-vigorous-intensity activity was associated with 18% and 42% lower mortality, respectively. Conclusions: Health promotion efforts for physical activity have mostly focused on moderate-to-vigorous activity. However, our findings derived from accelerometer-based measurements suggest that increasing light-intensity activity and reducing sedentary time are also important, particularly for inactive adults. [ABSTRACT FROM AUTHOR]

Purpose: We examined total activity, light activity, and moderate-to-vigorous physical activity (MVPA) as predictors of mortality in a nationally representative sample of older adults. Then we explored the theoretical consequences of replacing sedentary time with the same duration of light activity or MVPA. Methods: Using accelerometer-measured activity, the associations between total activity, light activity (100-2019 counts per minute), and MVPA (92019 counts per minute) counts and mortality were examined in adults age 50 to 79 yr in the National Health and Nutrition Examination Survey, 2003-2006 (n = 3029), with mortality follow-up through December 2011. Cox proportional hazard models were fitted to estimate mortality risks. An isotemporal substitution model was used to examine the theoretical consequences of replacing sedentary time with light activity or MVPA on mortality. Results: After adjusting for potential confounders, including age, sex, race/ethnicity, education, BMI, and the presence of comorbid conditions, those in the highest tertile of total activity counts had one fifth the risk of death of those in the lowest tertile (hazard ratio [HR] = 0.21, 95% confidence interval [CI] = 0.12-0.38), and those in the middle tertile had one third the risk of death (HR = 0.36, 95% CI = 0.30-0.44). In addition, replacing 30 min of sedentary time with light activity was associated with significant reduction in mortality risk (after 5 yr of follow-up: HR = 0.80, 95% CI = 0.75-0.85). Replacing 30 min of sedentary time with MVPA was also associated with reduction in mortality risk (HR = 0.49, 95% CI = 0.25-0.97). Conclusions: Greater total activity is associated with lower all-cause mortality risk. Replacing sedentary time with light activity or MVPA may reduce mortality risk for older adults. [ABSTRACT FROM AUTHOR]

PURPOSE: The purposes of this study were to examine patterns of objectively measured sedentary behavior in a national cohort of US middle-age and older adults and to determine factors that influence prolonged sedentary behavior. METHODS: We studied 8096 participants from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a population-based study of black and white adults 45 yr or older. Seven-day accelerometry was conducted. Prolonged sedentary behavior was defined as accumulating 50% or more of total sedentary time in bouts of 30 min or greater. RESULTS: The number of sedentary bouts greater than or equal to 20, 30, 60, and 90 min were 8.8 ± 2.3, 5.5 ± 1.9, 1.9 ± 1.1, and 0.8 ± 0.7 bouts per day, respectively. Sedentary bouts greater than or equal to 20, 30, 60, and 90 min accounted for 60.0% ± 13.9%, 48.0% ± 15.5%, 26.0% ± 15.4%, and 14.2% ± 12.9% of total sedentary time, respectively. Several factors were associated with prolonged sedentary behavior in multivariate-adjusted models (odds ratio [95% confidence interval]): older age (65-74 yr: 1.99 [1.55-2.57]; 75 yr or older: 4.68 [3.61-6.07] vs 45-54 yr), male sex (1.41 [1.28-1.56] vs female), residence in nonstroke belt/buckle region of the United States (stroke belt: 0.87 [0.77-0.98]; stroke buckle: 0.86 [0.77-0.95] vs non-belt/buckle), body mass index (BMI) (overweight: 1.33 [1.18-1.51]; obese: 2.15 [1.89-2.44] vs normal weight), winter (1.18 [1.03-1.35] vs summer), and low amounts of moderate-to-vigorous physical activity (MVPA) [0 min·wk: 2.00 [1.66-2.40] vs ≥150 min·wk). CONCLUSIONS: In this sample of US middle-age and older adults, a large proportion of total sedentary time was accumulated in prolonged, uninterrupted bouts of sedentary behavior as almost one-half was accumulated in sedentary bouts greater than or equal to 30 min. Several sociodemographic (age, sex, and BMI), behavioral (MVPA), environmental (region), and seasonal factors are associated with patterns of prolonged sedentary behavior. [ABSTRACT FROM AUTHOR]

Poor health outcomes from insufficient physical activity (PA) are a persistent public health issue. Public transit is often promoted for positive influence on PA. Although there is cross-sectional evidence that transit users have higher PA levels, this may be coincidental or shifted from activities such as recreational walking. We use a quasi-experimental design to test if light rail transit (LRT) generated new PA in a neighborhood of Salt Lake City, Utah, USA. Participants (n=536) wore Global Positioning System (GPS) receivers and accelerometers before (2012) and after (2013) LRT construction. We test within-person differences in individuals' PA time based on changes in transit usage pre- versus post-intervention. We map transit-related PA to detect spatial clustering of PA around the new transit stops. We analyze within-person differences in PA time based on daily transit use and estimate the effect of daily transit use on PA time controlling for socio-demographic variables. Results suggest that transit use directly generates new PA that is not shifted from other PA. This supports the public health benefits from new high quality public transit such as LRT. [ABSTRACT FROM AUTHOR]

Purpose: Light-intensity physical activity (LIPA) accounts for much of adults' waking hours (≈40%) and substantially contributes to overall daily energy expenditure. Encompassing activity behaviors of low intensity (standing with little movement) to those of higher intensity (slow walking), LIPA is ubiquitous, yet little is known about how associations with health may vary depending on its intensity. We examined the associations of objectively assessed LIPA (categorized as either low LIPA [LLPA] or high LIPA [HLPA]) and moderate- to vigorous-intensity activity with cardiometabolic risk biomarkers. Methods: Cardiometabolic biomarkers were measured in 4614 US adults (47 ± 17 yr) who participated in the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey cycles. Multiple linear regression analyses examined the associations of three accelerometer-derived physical activity (SD increment per day) intensity categories (LLPA, 100-761 counts per minute; HLPA, 762-1951 counts per minute; moderate-intensity physical activity [MPA], 1952-5724 counts per minute; vigorous-intensity physical activity [VPA], ≥5725 counts per minute) with cardiometabolic biomarkers, adjusting for potential sociodemographic, behavioral, and medical confounders. Results: All intensities of physical activity were beneficially associated with waist circumference, C-reactive protein, triglycerides, fasting insulin, A-cell function, and insulin sensitivity (P < 0.05); only some activity intensities showed significant associations with systolic blood pressure (LLPA), body mass index, HDL cholesterol, fasting glucose, and 2-h plasma glucose (HLPA, MPA, and VPA). Generally, effect size increased with intensity of physical activity. Overall, further adjustment for waist circumference attenuated associations with MPA and VPA to a greater extent than associations with LLPA and HLPA. Conclusions: The crosssectional findings provide novel evidence for the potential benefits of increasing both LLPA and HLPA. They further reinforce the established importance of moderate- to vigorous-intensity activity, the mainstay of public health recommendations. [ABSTRACT FROM AUTHOR]

Commonly reported relationships of the broad personality traits of extraversion and neuroticism with self-reports of physical activity (PA) have not been elaborated within motivational theory that posits how functioning of the behavioral inhibition (BIS) and activation (BAS) systems can explain or modify the influence of personality on PA. Whether personality predicts physical activity when it is measured objectively has not been established. Purpose: The study was aimed to test direct, indirect, and interactive relations between extraversion, neuroticism, BIS and BAS, and PA measured by validated self-report and accelerometry. Methods: Two samples of female undergraduates completed personality questionnaires. Sample 2 also completed three PA self-reports and wore an accelerometer for 7 d. Factor structure and measurement equivalence of personality measures, structural equivalence of relationships between personality factors, and multivariate prediction of self-reported and objectively measured PA by personality were tested using structural equation modeling. Results: Equivalence between samples for personality models was confirmed. Behavioral activation system predicted self-reported PA. Neuroticism and BIS predicted objectively measured PA. Conclusions: The relationship between personality and PA may differ according to method used to measure PA. Behavioral inhibition system seems to protect against inactivity among young women high in neuroticism. [ABSTRACT FROM AUTHOR]

One strategy for increasing physical activity is to create and enhance access to park space. We assessed the literature on the relationship of parks and objectively measured physical activity in population-based studies in the United States (US) and identified limitations in current built environment and physical activity measurement and reporting. Five English-language scholarly databases were queried using standardized search terms. Abstracts were screened for the following inclusion criteria: 1) published between January 1990 and June 2013; 2) US-based with a sample size greater than 100 individuals; 3) included built environment measures related to parks or trails; and 4) included objectively measured physical activity as an outcome. Following initial screening for inclusion by two independent raters, articles were abstracted into a database. Of 10,949 abstracts screened, 20 articles met the inclusion criteria. Five articles reported a significant positive association between parks and physical activity. Nine studies found no association, and six studies had mixed findings. Our review found that even among studies with objectively measured physical activity, the association between access to parks and physical activity varied between studies, possibly due to heterogeneity of exposure measurement. Self-reported (vs. independently-measured) neighborhood park environment characteristics and smaller (vs. larger) buffer sizes were more predictive of physical activity. We recommend strategies for further research, employing standardized reporting and innovative study designs to better understand the relationship of parks and physical activity. [ABSTRACT FROM AUTHOR]

Nowhere is improving understanding and accurate assessment of physical activity more important for disease prevention and health promotion than among health disparities populations such as those residing in rural and Appalachian regions. To enhance accurate assessment of physical activity and potentially improve intervention capacity, we conducted a mixed-methods study examining the acceptability and feasibility of self-report physical activity questionnaires, pedometers, and accelerometers among rural Appalachian children, adolescents, and adults. Most participants reported positive experiences with all three physical activity assessment tools. Several acceptability ratings differed by age group and by sex within each age group. With very few exceptions, no significant differences in acceptability were found by race, education, employment status, health status, BMI categories, income levels, or insurance status within age groups or overall. Several factors may impact the choice of the physical activity assessment method, including target population age, equipment cost, researcher burden, and potential influence on physical activity levels. Children and adolescents appear to have more constraints on when they can wear pedometers and accelerometers. While pedometers are inexpensive and convenient, they may influence physical activity levels, rather than simply measure them. Accelerometers, while less influential on behavior, consume extensive resources, including high purchase costs and researcher burden. [ABSTRACT FROM AUTHOR]

Objectives: This study examined environmental factors associated with children's moderate-to vigorous-intensity physical activity (MVPA) during indoor and outdoor PA sessions at childcare centers. Methods: We observed daily activity schedules, recreational spaces, and play equipment at 16 Chicago childcare centers in winter and spring, 2011. Preschoolers aged 3-5 years (113 children in winter and 102 children in spring) completed accelerometer assessments. Results: More indoor play equipment, structured PA sessions (versus free play sessions), and spring season were associated with more MVPA during indoor PA sessions. Presence of an outdoor playground and spring season were associated with more MVPA during outdoor PA sessions. Conclusions: This study suggests detailed policy strategies for environmental settings and scheduling to promote child PA at childcare. [ABSTRACT FROM AUTHOR]

PURPOSE: This study aimed to examine compensatory changes in nonexercise energy expenditure (NEEx) and nonexercise physical activity (NEPA) in response to an aerobic exercise training program. METHODS: Ninety-two overweight/obese (body mass index, 25-39.9 kg•m-2) sedentary young adults (18-30 yr) completed a 10-month randomized clinical efficacy trial of aerobic exercise 5 d•wk-1 at either 400 kcal per session (n = 37), 600 kcal per session (n = 37), or control (n = 18). Total daily energy expenditure (TDEE) and resting metabolic rate (RMR) were measured at months 0 and 10. NEPA was measured by an accelerometer at months 0, 3.5, 7, and 10. NEEx was calculated by the following formula: [(total daily energy expenditure × 0.9) - RMR] - net EEEx (EEEx-RMR). Mixed modeling was used to examine differences between groups (group effect), within groups (time effect), and group-time interaction for NEEx and NEPA. RESULTS: Within the exercise groups, there were no significant effects (all P > 0.05) of group, time, or group-time interaction for NEPA. In addition, there were no significant within- or between-group differences for change in NEEx. However, activity counts per minute were significantly higher (P < 0.001) in the 600-kcal-per-session group (346 ± 141 min•d-1) versus controls (290 ± 106 min•d-1) at month 7 and significantly higher (P < 0.001) in both the 600-kcal-per-session (345 ± 163 min•d-1) and 400-kcal-per-session groups (317 ± 146 min•d-1) versus controls (277 ± 116 min•d-1) at 10 months. CONCLUSIONS: A 10-month aerobic exercise training program in previously sedentary, overweight and obese young adults was not associated with compensatory decreases in NEEx or NEPA. Results suggest that overweight and obese individuals do not become less physically active or spend more time in sedentary pursuits in response to exercise. [ABSTRACT FROM AUTHOR]

Objectives To compare daily and hourly activity patterns according to sex and age. Design Cross-sectional, observational. Setting Nationally representative community sample: National Health and Nutrition Examination Survey ( NHANES) 2003-04 and 2005-06. Participants Individuals (n = 5,788) aged 20 and older with 4 or more valid days of monitor wear-time, no missing data on valid wear-time minutes, and covariates. Measurements Activity was examined as average counts per minute ( CPM) during wear-time; percentage of time spent in nonsedentary activity; and time (minutes) spent in sedentary (<100 counts), light (100-759), and moderate to vigorous physical activity ( MVPA (≥760)). Analyses accounted for survey design, adjusted for covariates, and were sex specific. Results In adjusted models, men spent slightly more time (~1-2%) in nonsedentary activity than women aged 20 to 34, with levels converging at age 35 to 59, although the difference was not significant. Women aged 60 and older spent significantly more time (~3-4%) in nonsedentary activity than men, despite similarly achieved average CPM. With increasing age, all nonsedentary activity decreased in men; light activity remained constant in women (~30%). Older men had fewer CPM at night (~20), more daytime sedentary minutes (~3), fewer daytime light physical activity minutes (~4), and more MVPA minutes (~1) until early evening than older women. Conclusion Although sex differences in average CPM declined with age, differences in nonsedentary activity time emerged as men increased sedentary behavior and reduced MVPA time. Maintained levels of light-intensity activity suggest that women continue engaging in common daily activities into older age more than men. Findings may help inform the development of behavioral interventions to increase intensity and overall activity levels, particularly in older adults. [ABSTRACT FROM AUTHOR]

Background: The risk of stroke is greatest among adults who have experienced a previous stroke, transient ischemic attack, or myocardial infarction. Physical activity may reduce the secondary risk of stroke through mediating effects on blood pressure, vasoconstriction, and circulating lipid concentrations; however, little is known about the prevalence of physical activity and sedentary behavior among stroke survivors in the United States. Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), we describe self-reported and objectively measured physical activity and sedentary behavior among adults with a self-reported history of stroke. We also contrast physical activity among stroke survivors with that of adults without stroke (unexposed) to illustrate expected behavior in the absence of disease. Results: Fewer participants with stroke met weekly physical activity guidelines as outlined in the 2008 Physical Activity Guidelines for Americans when compared with unexposed participants (17.9% vs 25.0%) according to self-reported data. In addition, participants with stroke reported less moderate (46.1% vs 54.7%) and vigorous (9.1% vs 19.6%) leisure activity compared with unexposed participants. As measured by accelerometer, time since diagnosis was inversely associated with physical activity engagement, and participants with stroke recorded more daily hours of sedentary behavior compared with unexposed participants (10.1 hours vs 8.9 hours). Conclusion: Findings from this study provide a basis for future work seeking to measure the impact of physical activity on the secondary prevention of stroke by characterizing the prevalence of physical activity and sedentary behavior among stroke survivors in the United States. [ABSTRACT FROM AUTHOR]

Introduction: Elevated C-reactive protein (CRP) is associated with adverse pregnancy outcomes. In nonpregnant populations, physical activity has been inversely associated with CRP, but this association has not been evaluated during pregnancy. The purpose of this study was to evaluate the association between objectively measured physical activity, sedentary behavior, and CRP by pregnancy trimester. Methods: We evaluated this association among 294 pregnant participants in the National Health and Nutrition Examination Survey (2003-2004 and 2005-2006). Physical activity (min&8226;d−1) was assessed via accelerometer using established cut points. CRP (mg•L−1) was measured using a high sensitivity assay. Multivariable linear regression was used to determine the relationship between physical activity, sedentary behavior, and CRP by trimester of pregnancy. Results: Among women in the second trimester, after adjusting for age, body mass index, smoking status, and history of adverse pregnancy outcomes, light-intensity physical activity was associated with lower CRP (ß = -0.002, P = 0.05). In unadjusted models, sedentary time and proportion of wear time spent sedentary were positively associated with CRP (ß = 0.048, P = 0.02 and ß = 2.36, P = 0.03, respectively); however, the relationship was no longer statistically significant in multivariable models (ß = 0.33, P = 0.2 and ß = 1.96, P = 0.08, respectively). Neither physical activity nor sedentary behavior was associated with CRP among women in the first or third trimester. Conclusions: Objectively measured light-intensity physical activity had a protective effect on CRP among women in the second trimester of pregnancy. Findings highlight the need for longitudinal studies of pregnancy physical activity and CRP with careful control for clinical characteristics of the current pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: Parks offer a free option for physical activity in many communities. How much time people spend using parks and the contribution that parks makes to their physical activity is not known. This study describes patterns of park use and physical activity among a diverse adult sample. Methods: From five US states, 248 adults enrolled in or near 31 study parks. Participants wore a global positioning system (GPS) monitor (Qstarz BT-Q1000X) and an ActiGraph accelerometer (GT1M) concurrently for 3 wk. Parks were mapped from local and national park shape files. Park visits and travel to and from the parks were derived from the objective data. Results: Participants visited parks a median of 2.3 times per week, and park visits lasted a median of 42.0 min. Overall, participants engaged in a median of 21.7 min•d-1 of moderate activity and 0.1 min•d-1 of vigorous activity, with an average of 8.2% of all moderate and 9.4% of all vigorous activity occurring within the parks. Among those with at least one park visit (n = 218), counts per minute, moderate, moderate-to-vigorous physical activity (MVPA), number and time in MVPA bouts per day, and sedentary behavior were all higher on days when a park was visited compared with days when a park was not visited. Considering several definitions of active travel, walking or bicycling to and from the park added an additional 3.7-6.6 mean minutes of MVPA per park visit. Conclusions: Parks contributed as a place and destination for physical activity but were underused. One of the next steps in this line of inquiry is to understand characteristics of parks used more often as a place and destination for physical activity. [ABSTRACT FROM AUTHOR]

The article discusses taumatic brain injuries (TBIs) and a study that compared the National Institutes of Health's Balance Accelerometer Measure (BAM) with the Balance Error Scoring System (BESS) to detect differences in postural sway between adolescents with sports concussions and age-matched controls. It concluded that BAM was not as effective as BESS in identifying abnormal postural control in adolescents with sports concussions.

The article focuses on research which was conducted to examine changes in physical activity among children and adolescents by race/ethnicity in the United States from 2003-2004 to 2005-2006. Researchers evaluated data from more than 3,000 children. They found that physical activity decreased with age, boys were more active than girls, and non-Hispanic black children were more active than non-Hispanic whites. They concluded that because a lack of improvement in physical activity and an emerging race-ethnic disparity were found, more research was needed on physical activity among U.S. children.

The article reports on research which was conducted in an effort to evaluate the effect an after school intervention physical activity program had on changes and individual behaviors among children. Researchers evaluated the program with 212 children between the ages of five and 11. They found that there were significant increases in daily physical activity among children who participated in the intervention program . They concluded that their research documents the effectiveness of an environmental change approach in an applied setting.

The article presents a study about the physical activities of obese people in the U.S. The study revealed that the Tongans were the primary subgroups that has a multitude of obesity-related health disparities in the country. It also notes that the negative health consequences of people such as obesity was caused by their physically inactive and sedentary lifestyles.

The article presents a study which examines the impact of body mass index (BMI) on students' physical activity in a middle school physical education class in the U.S. The study used a preliminary multivariate analysis of variance, calculated the standard deviations for BMI, and one-way MANOVA with curriculum activity to determine the differences of BMI and activity levels of students. The result of the study shows the differences of student's physical activity levels in different activities.

The article presents the study of the physical activity (PA) of the youth in the U.S. It states that the aim of the study is to describe the PA levels of the ethnicity, age, and gender of youth. The study were conducted on youth aged 6-19 years old with four days of PA that were measured by accelerometry. It notes that the study has suggested that youths between the age of 6-11 spend more time in moderate-to-vigorous PA (MVPA) compared to the 12-15 year olds, and 16-to-19 year olds. It also mentions that the group of females and older youth were the least active.

The article offers information on the study about physical activity assessment in persons with rheumatoid arthritis using accelerometry. It investigates whether the nonwear threshold and the valid day definition for accelerometer data from the general adult U.S. population is accurate for accelerometer data from persons with rhenmatoid arthritis (RA). It examines the effect of selected nonwear threshold regarding the mean daily activity counts, activity counts per wear hour, mean daily minutes of moderate to vigorous physical activity (MVPA), and MVPA bout minutes per wear hour. It suggests increasing the allowed nonwear threshold in the RA subpopulation from 60-90 minutes and to retain the 10-h day as the measure of the valid day.

Purpose. To determine whether certain patterns of objectively measured physical activity (PA) are associated with the risk factors for or the diagnosis of the metabolic syndrome (MS). Design. Latent class analysis, including assessment of the associations between latent PA classes and risk factors for the MS. Setting. Random sample from throughout the United States using data from the 2003-2004 National Health and Nutrition Examination Survey. Subjects. A total of 3458 civilian adult noninstitutionalized U.S. citizens. Measures. Daily minutes of moderate-to-vigorous PA across a 7-day week based on accelerometer measurements, as well as high blood pressure, blood glucose levels, triglyceride levels, and body mass index, along with low levels of high density lipoproteins, using clinical cut points. Results. Membership in the more active PA classes was consistently associated with lower odds of all risk factors for the MS. However, when participants were categorized into quartiles of the coefficients of variation of PA across 7 days, few differences were seen in any of the risk factors. Conclusions. Accumulating the total weekly recommended amount of PA is consistently associated with positive health profiles, and more PA than the recommended amounts may be even better. However, the manner in which this activity is accumulated, either spread over most days of the week or compressed into just a couple of days, may have similar associations with the risk factors for the MS. [ABSTRACT FROM AUTHOR]

The article presents a study on the dose-response relationship between objectively measured physical activity (PA) and blood pressure (BP) of children and adolescents. The methods of the study included the sample of 1170 youth aged 8-17 years obtained from the U.S. National Health and Nutrition Examination Survey in 2003 and 2004. Actigraph accelerometers, standard procedures, and thirty-six functional polynomial regression models were used to measure the PA and the systolic and diastolic BP values that were adjusted for age, height, and sex. Results showed that inverse dose-response occurred between total and moderate-to-vigorous PA with systolic and diastolic BP. Slopes of curves were modest which indicated a minimal influence of PA on mean values of BP.

The article presents the study which assessed the patterns of physical among adults using the accelerometer data from 2003-2004 National Health and Nutrition Examination Survey (NHANES) in the U.S. The NHANES included seven consecutive days of accelerometry measurements among all ambulatory participants six years old and older who agreed to wear the health monitor for a week. The study showed that a very large portion of the U.S. population may be classified into patterns of physical activity that represents low levels of moderate-to-vigorous physical activity (MVPA) throughout the week.

Purpose. To examine associations of neighborhood walkability and recreation environment variables with physical activity in adolescents. Methods. The cross-sectional study was conducted with 98 white or Mexican-American adolescents (mean age = 16.2 years). Physical activity was measured with 7 days of accelerometer monitoring. Height and weight were measured to compute body mass index (BMI). Environmental measures were created using geographic information systems. A neighborhood walkability index was based on land use mix, retail density, street connectivity, and residential density. Proximity to public and private recreation facilities was assessed. Results. In a linear regression, the walkability index within 0.5 mile of homes was related to minutes of moderate to vigorous physical activity, explaining approximately 4% of variance. Recreation variables were not related to physical activity, and BMI was not explained by environmental variables. Conclusion. Neighborhood walkability was related to adolescents' physical activity, similar to findings for adults. [ABSTRACT FROM AUTHOR]

Background: Total sedentary time and prolonged sedentary patterns can negatively impact health. This study investigated rates of various sedentary pattern variables in Hispanic/Latino youth., Methods: Participants were 956 youths (50.9% female) in the Hispanic Community Health Study/Study of Latinos Youth, a population-based cohort study of Hispanic/Latino 8- to 16-year-olds from 4 geographic regions in the United States (2012-2014). Total sedentary time and 10 sedentary pattern variables were measured through 1 week of accelerometer wear. Differences were examined by sociodemographic characteristics, geographic location, weekdays versus weekends, and season., Results: On average, youth were sedentary during 67.3% of their accelerometer wear time, spent 24.2% engaged in 10- to 29-minute sedentary bouts, and 7.2% in ≥60-minute bouts. 8- to 12-year-olds had more favorable sedentary patterns (less time in extended bouts and more breaks) than 13- to 16-year-olds across all sedentary variables. Sedentary patterns also differed by Hispanic/Latino background, with few differences across sex, household income, season, and place of birth, and none between weekdays versus weekends., Conclusions: Variables representing prolonged sedentary time were high among Hispanic/Latino youth. Adolescents in this group appear to be at especially high risk for unhealthy sedentary patterns. Population-based efforts are needed to prevent youth from engaging in increasingly prolonged sedentary patterns.

Background: Individuals with Down syndrome (DS) are less physically active than the general population, but limited data on objective physical activity patterns in adults with DS are available., Methods: Free-living physical activity was measured by waist-worn accelerometry in adults with DS from 2018 to 2020. Data were analysed using descriptive statistics, bivariate and regression analyses., Results: Fifty-two subjects provided valid accelerometer data, with 46% male and a majority (75%) overweight/obese. Median (± standard deviation) daily sedentary time was 393.5 ± 216.6 min, light activity was 150.7 ± 85.5 min, moderate activity was 6.3 ± 13.5 min, and vigorous activity was 0 ± 9.8 min. Subjects had 10.3 ± 4.8 sedentary bouts per day lasting on average 30.7 ± 62.0 min. Median daily step count was 3,050 ± 1,988. Adults living alone had more steps and light physical activity in adjusted analyses., Conclusion: Adults with DS engage in little health-enhancing physical activity and do not meet current physical activity recommendations in the United States., (© 2020 John Wiley & Sons Ltd.)

Objective: This study aimed to investigate the relationship between changes in clinical status on daily life physical activity (PA) in patients with idiopathic inflammatory myopathy (IIM)., Methods: Patients with dermatomyositis (DM), immune-mediated necrotizing myopathy (IMNM) or overlap myositis (OM) who presented either a new-onset or relapsing IIM, stable disease on maintenance therapy or were undergoing immunosuppressant tapering were included. Patients were evaluated at inclusion (V0), and at two follow-up visits (V1, 94±12 days from V0; V2, 96±17 days from V1). The American College of Rheumatology/European League against Rheumatism (ACR/EULAR) response criteria was recorded. PA assessed using 14-days raw accelerometry data gathered using a wrist-worn accelerometer after each visit (mean daily Euclidean norm minus 1 g (ENMO) was computed)., Results: Fifty-five patients (16 OM, 27 IMNM and 12 DM) were included. At baseline, 67% of patients had an ENMO Z-score less than 1. At inclusion, ENMO mainly correlated with health assessment questionnaire score (HAQ, ρ=-0.51, p<0.01), manual muscle testing 8 (MMT8, ρ=0.42, p<0.01), creatinine level (ρ=0.41, p<0.01), and SF-36 physical functioning score (ρ=0.38, p<0.002). At follow-up, ENMO changes mainly correlated with changes in MMT8, HAQ, SF-36 fatigue, and depression score (all ρ>0.43, all p<0.001). Level of agreement between ACR/EULAR response criteria and changes in PA was 15, 45, and 90% for minimal (n = 13), moderate (n = 20), and major (n = 10) improvements, respectively., Conclusion: Baseline PA levels and change in PA correlated with muscle strength and function, yet changes in PA were also influenced by psychological status. Only patients with major improvements on the ACR/EULAR criteria had significant increase in PA. Accelerometer may serve as an objective tool to define a clinically relevant real-life outcome., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: A majority of youth with Autism Spectrum Disorder (ASD) have disrupted sleep patterns, but there has been limited research examining factors associated with sleep in this population., Objective: The objective of this study was to compare demographic and lifestyle behaviors with sleep quality in youth with ASD., Methods: A total of 49 children (12.44 years; 78% male) with ASD wore the Actigraph GT9X accelerometer over seven days and nights to assess moderate to vigorous physical activity (MVPA), sedentary behavior (SB), total sleep duration, and sleep efficiency. Parents reported their child's weekly amount of screen time and demographic information. Participants were classified according to whether they met sleep criteria for duration and efficiency (8-9 h of sleep duration and ≥85% sleep efficiency). T-tests and ANOVA were used to compare demographic and lifestyle factors between the groups., Results: Participants who meet both sleep duration and efficiency criteria had greater minutes of MVPA per day (113.65 min/day) than participants who only met sleep efficiency criteria (40.27 min/day) and participants who did not meet either sleep criteria (67.5 min/day; p < 0.0001). Additionally, participants who met both sleep criteria had fewer minutes of SB compared to those who only met sleep efficiency criteria (384.79 vs 526.05 min/day; p = 0.02)., Conclusions: Youth who had indicators of good sleep quality had greater amounts of MVPA and lower amounts of SB. Studies should further examine the relationship between sleep and health behaviors in youth with ASD to determine causal mechanisms, leading to more effective sleep interventions., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2019 Elsevier Inc. All rights reserved.)