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Body: There is a need to design interventions that increase physical activity (PA) in COPD patients at the long term. Aim: To assess the effectiveness of the Urban Training intervention on PA after 12 months in COPD patients. Methods: We recruited 410 COPD patients from 33 primary care centers and 5 hospitals from Catalonia in 2013-2015 and allocated them randomly 1:1 to Urban Training or Usual Care. The Urban Training intervention combined behavioral strategies (motivational interviewing, pedometers, calendars, text messages, and walking groups) and unsupervised walking in trails from outdoor public spaces specifically designed for COPD (PLoSOne 14;11(1):e0146705). Primary outcome: steps/day by accelerometer; secondary: hospital admissions, exercise capacity, body composition, health-related quality of life, anxiety and depression. Modified intention to treat (MITT) and per protocol (PP) populations were analyzed, the latter including patients adherent to their corresponding intervention. Results: Patients were 85% male, had age 69 (8.5) years, and FEV1 56 (16) % pred. 284 patients completed the follow-up. In MITT there was no difference in the number of steps, but a large difference was observed in PP approach (Table 1). There were no differences in secondary outcomes. Conclusions: The Urban Training intervention increased PA after 12 months of follow-up in adherent patients.

Objective To evaluate the role of extracurricular physical activity and sedentary behavior at preschool and primary school age on working memory at primary school age and adolescence, respectively. Study design This prospective study was based on a birth cohort across 4 Spanish regions. In the 3 younger subcohorts (n = 1093), parents reported lifestyle habits of child at age 4 years of age on a questionnaire, and children performed a computerized working memory task at 7 years of age. In the older subcohort (n = 307), the questionnaire was completed at 6 years of age and working memory was tested at 14 years of age. Adjusted regression models were developed to investigate the associations between lifestyle habits and working memory. Results Low extracurricular physical activity levels at 4 years of age were associated with a nonsignificant 0.95% (95% CI −2.81 to 0.92) reduction of correct responses in the working memory task at age 7 years of age. Low extracurricular physical activity levels at 6 years of age were associated with a 4.22% (95% CI −8.05 to −0.39) reduction of correct responses at age 14 years. Television watching was not associated with working memory. Other sedentary behaviors at 6 year of age were associated with a 5.07% (95% CI −9.68 to −0.46) reduction of correct responses in boys at 14 years of age. Conclusion Low extracurricular physical activity levels at preschool and primary school ages were associated with poorer working memory performance at primary school age and adolescence, respectively. High sedentary behavior levels at primary school age were related negatively to working memory in adolescent boys.

There is a need to increase and maintain physical activity in patients with chronic obstructive pulmonary disease (COPD). We assessed 12-month efficacy and effectiveness of the Urban Training intervention on physical activity in COPD patients. This randomised controlled trial (NCT01897298) allocated 407 COPD patients from primary and hospital settings 1:1 to usual care (n=205) or Urban Training (n=202). Urban Training consisted of a baseline motivational interview, advice to walk on urban trails designed for COPD patients in outdoor public spaces and other optional components for feedback, motivation, information and support (pedometer, calendar, physical activity brochure, website, phone text messages, walking groups and a phone number). The primary outcome was 12-month change in steps·day−1 measured by accelerometer. Efficacy analysis (with per-protocol analysis set, n=233 classified as adherent to the assigned intervention) showed adjusted (95% CI) 12-month difference +957 (184–1731) steps·day−1 between Urban Training and usual care. Effectiveness analysis (with intention-to-treat analysis set, n=280 patients completing the study at 12 months including unwilling and self-reported non-adherent patients) showed no differences between groups. Leg muscle pain during walks was more frequently reported in Urban Training than usual care, without differences in any of the other adverse events. Urban Training, combining behavioural strategies with unsupervised outdoor walking, was efficacious in increasing physical activity after 12 months in COPD patients, with few safety concerns. However, it was ineffective in the full population including unwilling and self-reported non-adherent patients., Urban Training in COPD increased physical activity after 12 months but not in self-reported non-adherent patients http://ow.ly/dc2C30lnAEs