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Background: Digital technology is ubiquitous in the lives of many children and parents. To better understand any influence of technology use by infants, and mothers, on child development, technology use should be considered within the broader family system context in which children develop. This study aimed to investigate associations between infant and maternal technology use and infant 12-month development, taking into consideration other family factors., Methods: This cross-sectional study used data from ORIGINS participants, collected at 12-months of age: maternal and child technology use (TechU-Q), sociodemographic factors (e.g. child sex, household income), parental mental health (DASS-21), and child development (Ages and Stages Questionnaire). Linear regression was used for analyses., Results: When family factors were considered, higher infant mobile touchscreen device (MTSD) use was associated with poorer infant development for gross motor, problem-solving, and total ASQ-3 scores. In contrast there were no associations between infant television (TV) watching or maternal technology use and total ASQ-3 scores. Higher maternal technology use was associated with higher infant technology use. Poorer maternal and paternal mental health were associated with poorer infant development. Poorer maternal mental health was also associated with higher infant TV watching and higher maternal MTSD use., Conclusion: There is a complex relationship between technology use, parental mental health and other family factors that together influence infant development. To improve infant development outcomes, less focus should be on infant or maternal technology use, and more on supporting the family as a whole, and parental mental health in particular., (© 2024. The Author(s).)

Background: ActiMotus, a thigh-accelerometer-based software used for the classification of postures and movements (PaMs), has shown high accuracy among adults and school-aged children; however, its accuracy among younger children and potential differences between sexes are unknown. This study aimed to evaluate the accuracy of ActiMotus to measure PaMs among children between 3 and 14 years and to assess if this was influenced by the sex or age of children., Method: Forty-eight children attended a structured ~1-hour data collection session at a laboratory. Thigh acceleration was measured using a SENS accelerometer, which was classified into nine PaMs using the ActiMotus software. Human-coded video recordings of the session provided the ground truth., Results: Based on both F1 scores and balanced accuracy, the highest levels of accuracy were found for lying, sitting, and standing (63.2-88.2%). For walking and running, accuracy measures ranged from 48.0 to 85.8%. The lowest accuracy was observed for classifying stair climbing. We found a higher accuracy for stair climbing among girls compared to boys and for older compared to younger age groups for walking, running, and stair climbing., Conclusions: ActiMotus could accurately detect lying, sitting, and standing among children. The software could be improved for classifying walking, running, and stair climbing, particularly among younger children.

Background: Parents commonly seek information to support the health and well-being of their children. The increasing availability of health information online and social changes related to the COVID-19 pandemic may have changed what information is sought, from whom, where, and why. This qualitative study explored parents' practices and perspectives on seeking health and digital technology use information for their young children., Methods: Twenty parents, living in Australia (7 rural, 3 remote, and 10 metropolitan), with children aged 0-36 months completed a semi-structured interview., Results: Parents commonly turned to friends and family and online sources to access health information for their young children. For all types of health information, including digital technology use, themes were identified surrounding aspects of information sources participants valued and accessibility of health services. Perceived credibility and trustworthiness, relatability with other parents, ease of accessibility and convenience, and actionable, bite-sized information were valued. Reduced accessibility to health services due to COVID-19 and geographical location, and need for agency in managing their child's health influenced parents' choice of source of information. Few participants actively sought information about digital technology use for their young child, with the main focus on screen time., Conclusion: Interactions with family and friends and online sources are important to parents when accessing health information for their child. Parents valued information sources which they considered trustworthy, credible, and relatable, as well as easily accessible and convenient. SO WHAT?: Dissemination of health information reflecting these values may empower parents during this early stage of parenthood., (© 2024 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Importance: The multifaceted nature of screen use has been largely overlooked in favor of a simplistic unidimensional measure of overall screen time when evaluating the benefits and risks of screen use to early childhood development., Objective: To conduct a systematic review and meta-analysis to examine associations of screen use contexts in early childhood with cognitive and psychosocial outcomes., Data Sources: PsycINFO, Embase, MEDLINE Ovid, ProQuest, CINAHL, Web of Science, and Scopus were searched from inception to December 31, 2023., Study Selection: A total of 7441 studies were initially identified. Studies were included if they examined associations between a contextual factor of screen use among children aged 0 to 5.99 years and cognitive or psychosocial development. Observational, experimental, and randomized clinical trial study designs were included., Data Extraction and Synthesis: All studies were independently screened in duplicate following PRISMA guidelines. Effect sizes of associations (r) from observational studies were pooled using random-effects 3-level meta-analyses. The remaining study designs were narratively synthesized., Main Outcomes and Measures: Screen use contexts included content (child directed and age inappropriate), type (program viewing and game or app use), co-use (or solo use), background television, caregiver screen use during child routines, and purpose. Outcomes were cognitive (executive functioning, language, and academic skills) or psychosocial (internalizing and externalizing behavior problems and socioemotional competence)., Results: Overall, 100 studies (176 742 participants) were included, and of these, 64 observational studies (pooled sample sizes ranging from 711 to 69 232) were included in meta-analyses. Program viewing (n = 14; k = 48; r, -0.16; 95% CI, -0.24 to -0.08) and background television (n = 8; k = 18; r, -0.10; 95% CI, -0.18 to -0.02) were negatively associated with cognitive outcomes, while program viewing (n = 6; k = 31; r, -0.04; 95% CI, -0.07 to -0.01), age-inappropriate content (n = 9; k = 36; r, -0.11; 95% CI, -0.17 to -0.04), and caregiver screen use during routines (n = 6; k = 14; r, -0.11; 95% CI, -0.20 to -0.03) were negatively associated with psychosocial outcomes. Co-use was positively associated with cognitive outcomes (n = 8; k = 28; r, 0.14; 95% CI, 0.03 to 0.25)., Conclusions and Relevance: Findings show small to moderate effect sizes that highlight the need to consider screen use contexts when making recommendations for families, clinicians, and educators beyond screen time limits; including encouraging intentional and productive screen use, age-appropriate content, and co-use with caregivers.

Background: Although widely accessible digital technology (DT) provided multiple opportunities for young children's play, learning, and development, it also raised parents and professionals' concerns regarding its impact on children's physical activity. This study aimed to identify practices involving DT that were valued by parents in helping their young child to be physically active., Methods: Participants were parents of ambulatory young children (less than 5 y of age) engaged with a playgroup. The study involved representatives from 3 service organizations, who compiled a list of digital resources related to using DT to promote children's physical activity that were suitable to be shared and trialed by parents and young children. During a pretrial workshop, researchers, participants, and organization representatives collaboratively developed the intervention, which involved the delivery of selected resources by weekly email, over a 12-week period. Participants provided weekly feedback about their experiences and participated in a postintervention semistructured qualitative interview., Results: Thirteen families, with children aged between 15 and 36 months, completed the trial. Participants reported several valued practices to promote their children's physical activity, including those where the child was active while engaging with DT, where child engagement with DT acted as a prompt for later physical activity, where DT assisted parents in planning physical activity, where DT assisted parents in integrating movement with learning and play, and where DT was used to reinforce the child's enthusiasm for physical activity., Conclusions: Parents reported several valued practices where children were physically active, rather than sedentary, while using digital technology.

The role and potential impact of digital screen technology in the lives of children is heavily debated. Current evidence is limited by the weakness of measures typically used to characterise screen use, predominantly proxy- or self-reports with known inaccuracy and bias. However, robust and detailed evidence is needed to provide practical trustworthy guidance to families and professionals working with families. The purpose of this paper is to support researchers to select measurement method(s) that will provide robust and detailed evidence. The paper outlines the challenges in measuring contemporary screen use by children, using a child-technology interaction model to organise considerations. A range of different methods used to measure digital screen technology use in children and adolescents (i.e., questionnaires, diaries, electronically prompted sampling, direct observation, fixed room cameras, wearable/portable cameras, audio recorders, screen-device onboard logging, remote digital trace logging and proximity logging) are described along with examples of their use and constructs typically measured as well as a summary of the advantages and disadvantages of each method. A checklist and worked examples are provided to support researchers determining the best methods or combination of methods for a research project.

As families increase their use of mobile touch screen devices (smartphones and tablet computers), there is potential for this use to influence parent-child interactions required to form a secure attachment during infancy, and thus future child developmental outcomes. Thirty families of infants (aged 9-15 months) were interviewed to explore how parents and infants use these devices, and how device use influenced parents' thoughts, feelings and behaviours towards their infant and other family interactions. Two-thirds of infants were routinely involved in family video calls and one-third used devices for other purposes. Parent and/or child device use served to both enhance connection and increase distraction between parents and infants and between other family members. Mechanisms for these influences are discussed. The findings highlight a new opportunity for how hardware and software should be designed and used to maximise benefits and reduce detriments of device use to optimise parent-infant attachment and child development. Practitioner Summary: Many families with infants regularly use smartphones and tablet computers. This qualitative study found that how devices were used either enhanced or disrupted feelings of parent-infant attachment. Practitioners should be aware of the potential beneficial and detrimental impacts of device use among families given implications for attachment and future child development.

Given the importance of young children's postures and movements to health and development, robust objective measures are required to provide high-quality evidence. This study aimed to systematically review the available evidence for objective measurement of young (0-5 years) children's posture and movement using machine learning and other algorithm methods on accelerometer data. From 1663 papers, a total of 20 papers reporting on 18 studies met the inclusion criteria. Papers were quality-assessed and data extracted and synthesised on sample, postures and movements identified, sensors used, model development, and accuracy. A common limitation of studies was a poor description of their sample data, yet over half scored adequate/good on their overall study design quality assessment. There was great diversity in all aspects examined, with evidence of increasing sophistication in approaches used over time. Model accuracy varied greatly, but for a range of postures and movements, models developed on a reasonable-sized (n > 25) sample were able to achieve an accuracy of >80%. Issues related to model development are discussed and implications for future research outlined. The current evidence suggests the rapidly developing field of machine learning has clear potential to enable the collection of high-quality evidence on the postures and movements of young children.

Objective: To examine associations between three clinically significant sleep disorders (chronic insomnia, obstructive sleep apnoea, restless legs syndrome) and workplace productivity losses among young Australian adults., Design, Setting: Prospective, observational study; 22-year follow-up of participants in the longitudinal birth cohort Raine Study (Perth, Western Australia)., Participants: Currently employed 22-year-old Raine Study participants who underwent in-laboratory sleep disorder screening for moderate to severe obstructive sleep apnoea (apnoea-hypopnea index of more than fifteen events/hour or obstructive sleep apnoea syndrome) and were assessed for insomnia and restless legs syndrome using validated measures., Main Outcome Measures: Total workplace productivity loss over twelve months, assessed with the World Health Organization Health and Work Performance Questionnaire., Results: Of 1235 contactable 22-year-old Raine Study cohort members, 554 people (44.9%; 294 women [53%]) underwent overnight polysomnography, completed the baseline sleep questionnaire, and completed at least three quarterly workplace productivity assessments. One or more clinically significant sleep disorders were identified in 120 participants (21.7%); 90 participants had insomnia (17%), thirty clinically significant obstructive sleep apnoea (5.4%), and two restless legs syndrome (0.4%). Seventeen people (14% of those with sleep disorders) had previously been diagnosed with a sleep disturbance by a health professional, including fourteen with insomnia. Median total workplace productivity loss was greater for participants with sleep disorders (164 hours/year; interquartile range [IQR], 0-411 hours/year) than for those without sleep disorders (30 hours/year; IQR, 0-202 hours/year); total workplace productivity loss was 40% greater for participants with sleep disorders (adjusted incidence rate ratio, 1.40; bias-corrected and accelerated 95% confidence interval, 1.10-1.76). The estimated population total productivity loss (weighted for disorder prevalence) was 28 644 hours per 1000 young workers per year, primarily attributable to insomnia (28 730 hours/1000 workers/year)., Conclusion: Insomnia is a risk factor for workplace productivity loss in young workers. Tailored interventions are needed to identify and manage sleep disorders, particularly as most of the sleep disorders detected in the Raine Study had not previously been diagnosed., (© 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.)

The potential for human-computer interaction to have a substantial impact on adults is well documented. However, its potential importance prior to birth has rarely been reported. Parental use of smartphones and tablet computers could influence the relationship between parent and baby during pregnancy (prenatal attachment) and thus child development. Twenty-seven families were interviewed to explore how parents used these devices during pregnancy, and how device use influenced parents' thoughts, feelings and behaviours towards their baby while in utero. All used devices for a variety of purposes, and all described good levels of prenatal attachment. Parents described both disrupted and enhanced connectedness as a result of device use, and increased parental stress. The findings highlight a new opportunity for how device design and use guidelines could support families to maximise benefits and reduce detriments of device use to optimise prenatal attachment, and thus future parent-child attachment and child development. Practitioner summary: Many parents regularly use smartphones and tablet computers while pregnant. This qualitative study found that how devices were used either enhanced or disrupted feelings of prenatal attachment. Practitioners should be aware of potential beneficial and detrimental impacts of device use during pregnancy given implications for future attachment and child development.

Objective: Pelvic pain has been associated with augmented nociceptive processing, but large studies controlling for multiple potential confounding factors are lacking. This study investigated the association between pelvic pain bothersomeness and pain sensitivity in young adult women, accounting for potential confounding factors., Design: Cross-sectional study., Setting: Community-dwelling sample., Population: The Raine Study Gen2-22 year follow-up (n = 475)., Main Outcome Measures: The experience of bothersomeness related to pelvic pain was determined from a question in the Urogenital Distress Inventory short form. Pain sensitivity was measured using pressure pain and cold pain thresholds. Potential confounding factors included ethnicity, marital status, highest level of education, income, waist-hip ratio, level of activity, sleep quality, smoking, comorbidity history, C-reactive protein level, musculoskeletal pain experience and psychological distress., Results: Three hundred and sixty-two women (76.2%) reported no pelvic pain bothersomeness, 74 (15.6%) reported mild pelvic pain bothersomeness and 39 (8.2%) reported moderate-severe pelvic pain bothersomeness. After adjusting for marital status (and test site), moderate-severe pelvic pain bothersomeness was associated with a lower pressure pain threshold (i.e. greater pressure pain sensitivity) (coefficient -51.46, 95% CI -98.06 to -4.86, p = 0.030). After adjusting for smoking, moderate-severe pelvic pain bothersomeness was also associated with a higher cold pain threshold (i.e. greater cold pain sensitivity) (coefficient 4.35, 95% CI 0.90-7.79, p = 0.014)., Conclusions: This study suggests augmented nociceptive processing as a contributing factor in pelvic pain bothersomeness for some women. Thorough assessment of women who present clinically with pelvic pain should consider pain sensitivity as a potential contributing factor to their presentation., (© 2022 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)

This study explores how the first wave of the COVID-19 pandemic influenced family routines, relationships and technology use (smartphones and tablet computers) among families with infants. Infancy is known to be an important period for attachment security and future child development, and a time of being susceptible to changes within and outside of the family unit. A qualitative design using convenience sampling was employed. A total of 30 mothers in Perth, Western Australia participated in semi-structured interviews by audio or video call. All mothers were parents of infants aged 9 to 15 months old. Interviews were audio-recorded and transcribed, and data were analysed using thematic analysis to code and identify themes in an inductive manner. Families described staying home and stopping all external activities. Three themes relating to family interactions and wellbeing were found: enhanced family relationships; prompted reflection on family schedules; and increased parental stress. Two themes related to family device use were found: enabled connections to be maintained; and source of disrupted interactions within the family unit. Overall, participants described more advantages than downsides of device use during COVID-19. Findings will be of value in providing useful information for families, health professionals and government advisors for use during future pandemic-related restrictions.

Mobile touch screen devices (smartphones and tablet computers) have become an integral part of many parents' and children's lives, with this interaction linked to physical, mental and social outcomes. Despite the known importance of parent-child attachment, evidence on the association between device use and attachment was yet to be reviewed. Following protocol pre-registration, databases were searched, papers screened, and methodological quality assessed. Three papers met the inclusion criteria, and reported some negative associations between duration of parent/child smartphone use and attachment outcomes. A narrative synthesis on two groups of related papers found child time using any screen technology (including television viewing), and child 'problematic' internet, mobile phone, gaming and social media use, was negatively associated with attachment outcomes. Currently there is limited direct evidence on any association between time parents or children spend using these devices and parent-child attachment to support time guidelines for families and professionals working with families. Practitioner summary: Many parents and children regularly spend time using smartphones and tablet computers. This systematic review found limited evidence evaluating associations between child/adolescent or parent time using devices and parent-child attachment. Until quality evidence exists, practitioners should be alert to potential impacts of device use on family relationships and child outcomes.

Purpose: The aim of this study is to investigate changes in physical activity (PA) and sedentary time (ST) over 12 months following bariatric surgery., Methods: Pre-surgery and at 3, 6, 9, and 12 months post-surgery, wearable devices were used to measure PA at different intensities, grouped according to energy expenditure and daily step count, and ST. Measures were also collected of weight and self-efficacy for exercise. Pre- and 12 months post-surgery, measures were collected of body composition and cardiovascular fitness., Results: Thirty adults scheduled for bariatric surgery were recruited (20 females, 44.1 [range, 22.0 to 65.0] years, body mass index 39.6 [range, 30.9 to 50.9] kg/m 2 ). When compared to pre-surgery measures, over the 12 months post-surgery, there were no changes in the percentage of waking hours (mean [95% CI]) spent in ST (- 2% [- 6 to 3]), light intensity PA (1% [- 3 to 5]), and moderate-to-vigorous intensity PA (1% [- 1 to 3]). At all time points, participants spent most (> 70%) of their waking hours accumulating ST, with little time spent in light intensity PA (~ 21%) and almost no time in moderate-to-vigorous intensity PA (~ 5%). Step count and cardiovascular fitness were also unchanged. There were significant changes in weight, self-efficacy for exercise, and body composition., Conclusions: Although bariatric surgery resulted in substantial weight loss and improved self-efficacy for exercise, it was insufficient to effect change in PA, ST or cardiovascular fitness. Complementing surgical intervention with behavioral interventions may optimize change in PA and ST.

Aim: This systematic review and meta-analyses of randomised controlled trials (RCTs) investigated the effectiveness of interventions to reduce sedentary behaviour amongst people with overweight or obesity. Secondarily, it aimed to investigate the effectiveness of these interventions on body mass index (BMI), time spent in moderate-to-vigorous physical activity (MVPA) and health-related quality of life (HRQoL)., Methods: A search of six databases (CENTRAL, PubMed, Embase, PEDro, CINAHL and PsycINFO) was conducted from inception to July 2018. RCTs in which sedentary behaviour was measured by accelerometry or inclinometry, with participants of any age with overweight or obesity were included. Subgroup analyses were undertaken comparing studies that included adults versus children and studies with an active component (e.g., treadmill desk, physically active breaks) versus no active component to their intervention., Results: Nine studies (n=1859) were included. Compared to the control group, the interventions significantly reduced time spent in sedentary behaviour (standardised mean difference [95% confidence interval] -0.33 [-0.59 to -0.08] overall; -0.53 [-0.95 to -0.11] in adults). Subgroup analyses demonstrated that only interventions that included active components reduced time spent in sedentary behaviour (-0.54 [-0.88 to -0.20]) and increased time spent in MVPA (1.29 [0.02 to 2.56]). Subgroup analyses demonstrated that interventions only reduced BMI in studies of children (-0.09 [-0.18 to -0.00]) and in those with no active component (-0.09 [-0.18 to -0.01]). There were insufficient data to investigate the effectiveness of these interventions on HRQoL., Conclusions: This novel systematic review and meta-analyses suggests interventions aiming to effectively reduce objectively-measured sedentary behaviour need to specifically include an active component., (Copyright © 2018 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

Aims: To explore participants' ability to participate in physical activity (PA), and barriers and facilitators to PA, at 12 months following restrictive bariatric surgery, and how these differed from participants' pre-surgery perceptions. Motivators for PA post-surgery were also explored., Methods: Qualitative one-on-one in-depth interviews were conducted pre- and 12 months post-surgery. Data were analysed using inductive thematic analysis., Results: Fourteen adults (12 females), with a mean (range) age of 41.4 years (25.0-56.0), body mass index (BMI) of 31.7kg/m 2 (22.3-48.2), and excess weight loss of 66% (2-127) completed both interviews. Lack of participation in PA during the first 3-6 months post-surgery was a common theme. Although participants reported increased ability to participate in PA, attributing this to a reduction in obesity-related physical barriers to PA, many participants reported that some pre-surgery obesity-related barriers to PA remained at 12 months post-surgery. For most participants, pre-surgery non-obesity related barriers to PA also remained at 12 months post-surgery. Facilitators to PA were consistent pre- and post-surgery. Weight loss and improvement in physical appearance were the most common motivators for PA post-surgery., Conclusions: At 12 months following surgery, many participants reported residual obesity and non-obesity related barriers to PA. These barriers may explain the small, if any, pre- to post-surgery change in PA levels reported by earlier research. Facilitators to PA did not change and post-surgery motivators for PA were mostly esteem-related. These data are relevant to shape interventions aimed at optimising PA in this population., (Copyright © 2017 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

Background: Bariatric surgery candidates engage in less physical activity (PA) and spend longer periods in sedentary behaviour (SB) when compared to the general adult population. The aim of this study was to explore the beliefs about PA and perceived barriers and facilitators to PA in obese adults scheduled for bariatric surgery., Methods: Nineteen obese adults (15 females), with a mean (SD) age of 41.6 (12.1) years, weight of 119.2 (20.5) kg and body mass index of 41.6 (6.7) kg/m(2) participated in a one-on-one in-depth qualitative interview before undergoing bariatric surgery. Data were analysed using inductive thematic analysis., Results: Most participants believed that engaging in regular PA confers important health benefits, however reported insufficient PA levels to obtain those benefits. The perceived barriers to PA reported by participants were both obesity related (e.g. bodily pain, physical limitation and self-presentational concerns) and non-obesity related (e.g. lack of motivation, environment and restricted resources). All participants stated weight loss to be the main perceived facilitator to PA, together with social factors, better time management and access to financial resources., Conclusions: In bariatric surgery candidates, many of the perceived barriers and facilitators to PA are not obesity related and are therefore unlikely to change as a result of bariatric surgery. This may explain why earlier research shows little change in PA or SB following surgery. It is likely that an approach that aims to address the barriers and facilitators identified in this study is needed to change the inactive lifestyle adopted in this population.

Background: Programs aimed at increasing physical activity in daily life (PADL) have generated growing interest to prevent the deleterious effects of physical inactivity. Recent literature has shown that a short-term protocol using pedometers increased PADL in smokers with normal lung function. However, the long-term effects of such a protocol were not yet studied. The objective of this study was to evaluate the results of 1-year follow-up after a program aimed at increasing PADL in smokers with normal lung function., Methods: Twenty-four smokers were followed (15 men; mean [interquartile range (IQR)], 51 [41-57] years of age; BMI, 26 [22-29] kg/m2; 20 [20-30] cigarettes/d). Subjects were assessed at baseline, immediately after completion of the program, and 1 year later for PADL, lung function, 6-min walking distance (6MWD), smoking habits, quality of life, anxiety, and depression. The 5-month program used pedometers and informative booklets as interventions., Results: The gains achieved after the program were maintained in the long term: steps/d (postprogram vs 1-year follow-up, mean [IQR]: 10,572 [9,804-12,237] vs 10,438 [9,151-12,862]); 6MWD (625 [530-694] m, 88 [81-97] % predicted vs 609 [539-694] m, 89 [81-96] % predicted), anxiety (34 [26-41] points vs 35 [36-47] points) and depression (6 [2-9] points vs 5 [2-11] points) (P > .05 for all). One year after the program, 20% of the subjects had quit smoking., Conclusions: In smokers with normal lung function, improvements in daily physical activity, exercise capacity, anxiety, and depression obtained through a 5-month program aimed at increasing physical activity are sustained 1 year after completion of the program. Furthermore, such a program can contribute to smoking cessation in this population.

Introduction: This randomized crossover trial aimed to compare the effects of 2 different protocols using pedometers and informative booklets to increase physical activity in daily life (PADL) in smokers., Methods: PADL level was assessed at baseline (A1), and subjects were randomly assigned to 2 groups for a month: booklet + pedometer (GB + P; n = 13), which started the protocol receiving a booklet with encouragement to walk as much as possible in everyday life; pedometer + booklet (GP + B; n = 18), which started the protocol wearing a pedometer aiming to achieve 10,000 steps/day. PADL was reassessed (A2), and the interventions were crossed over for 1 month, followed by PADL reassessment (A3). After A3, both groups used pedometers for 3 months aiming to reach 10,000 steps/day, and final PADL assessment was performed (A4). For the analysis, each group was subdivided according to baseline PADL as physically active or inactive, according to having reached or not reached 10,000 steps/day at baseline., Results: The physically active subgroups of GB + P and GP + B showed no change in steps/day. The physically inactive subgroup of GP + B significantly increased steps/day at A2 and maintained this increase until A4. The physically inactive subgroup of GB + P initially increased to a lesser extent, reaching borderline statistical significance at A2 and A3 (p = .06) and statistically significant increase only at A4 (p = .02)., Conclusions: Both strategies were effective in increasing the number of steps/day in physically inactive smokers after 5 months, although the increase was more quickly obtained in smokers who used pedometers as the first intervention.

Background and Objective: In smokers without airflow obstruction, detailed, objective and controlled quantification of the level of physical inactivity in daily life has never been performed. This study aimed to objectively assess the level of physical activity in daily life in adult smokers without airflow obstruction in comparison with matched non-smokers, and to investigate the determinants for daily physical activity in smokers., Methods: Sixty smokers (aged 50 (39-54) years) and 50 non-smokers (aged 48 (40-53) years) matched for gender, age, anthropometric characteristics, educational level, employment status and seasons of the year assessment period were cross-sectionally assessed regarding their daily physical activity with a step counter, besides assessment of lung function, functional exercise capacity, quality of life, anxiety, depression, self-reported comorbidities carbon monoxide level, nicotine dependence and smoking habits., Results: When compared with non-smokers, smokers walked less in daily life (7923 ± 3558 vs 9553 ± 3637 steps/day, respectively), presented worse lung function, functional exercise capacity, quality of life, anxiety and depression. Multiple regression analyses identified functional exercise capacity, Borg fatigue, self-reported motivation/physical activity behaviour and cardiac disease as significant determinants of number of steps/day in smokers (partial r(2)  = 0.10, 0.12, 0.16 and 0.05; b = 15, -997, 1207 and -2330 steps/day, respectively; overall fit of the model R(2)  = 0.38; P < 0.001)., Conclusions: Adult smokers without airflow obstruction presented reduced level of daily physical activity. Functional exercise capacity, extended fatigue sensation, aspects of motivation/physical activity behaviour and self-reported cardiac disease are significant determinants of physical activity in daily life in smokers., (© 2014 The Authors. Respirology © 2014 Asian Pacific Society of Respirology.)

Background: In adults it is recommended that the minimum of 10,000 steps/day should be performed in order to consider an individual as active. The pedometer, a small device that counts steps, has been used to monitor and/or motivate physical activity in various populations., Objective: To investigate the short-term effects of a protocol using a pedometer or an informative booklet to increase daily physical activity in apparently healthy smokers who reached or did not reach the minimum public health recommendation of 10,000 steps/day., Methods: Subjects were randomly assigned to 2 groups: group pedometer (GP, n = 23), who wore a pedometer every day during 1 month, aiming to achieve 10,000 steps/day; and group booklet (GB, n = 17), who received a booklet with encouragement to walk as much as possible in everyday life. Each group was subdivided according to their baseline daily physical activity level: active (subjects who achieved 10,000 steps/day), and inactive (those who did not achieve this minimum)., Results: Only the physically inactive GP increased significantly its daily physical activity (pre vs post 7,670 [6,159-9,402] steps/day vs 10,310 [9,483-11,110] steps/day, P < .001), with a concomitant increase in the 6-min walking test (6MWT) distance (mean and interquartile range 540 m [501-586 m] vs 566 m [525-604 m], P = .03). In GP, Δ post-pre steps/day correlated significantly with baseline number of steps/day (r = -0.63, P = .01), but not with 6MWT. In the inactive subjects (summing GP and GB), there were significant correlations between steps/day and cigarettes/day, pack-years, and Fagerström questionnaire (r = -0.55, -0.40, and -0.59, P ≤ .05 for all). Furthermore, improvement in steps/day in the inactive subjects of GP was correlated with baseline cigarettes smoked per day, pack-years, and Fagerström questionnaire (r = 0.51, 0.65 and 0.53, P ≤ .05 for all)., Conclusions: Physically inactive smokers improve their daily physical activity level by using a simple tool (pedometer), and larger improvement occurs in subjects with the lowest levels of physical activity.

The study aimed to compare the responsiveness of three instruments to assess self-reported changes in functional status after exercise training in patients with COPD: Pulmonary Functional Status and Dyspnea Questionnaire -modified version (PFSDQ-M), London Chest Activity of Daily Living (LCADL) and Medical Research Council scale (MRC). Twenty-two patients (11 female, 66[62-71] years, FEV1 42[33-61]%predicted) participated in a 3-month high-intensity exercise program. The three instruments were applied pre- and post-program, as well as assessment of lung function, muscle strength, exercise capacity (6-minute walking test, 6MWT) and quality of life (St. George's Respiratory Questionnaire, SGRQ). SGRQ, 6MWT and quadriceps femoris, biceps and triceps brachialis strength improved significantly after the program (p < 0.05 for all). Training also yielded significant improvement in the LCADL total score and self-care, domestic and leisure domains and in the PFSDQ-M 'change in activities' domain, with no improvement in the MRC (p = 0.11). Calculation of effects sizes also indicated higher responsiveness in the LCADL than the other instruments. There were no significant correlations between changes in the three instruments and changes in lung function, SGRQ or 6MWT. In conclusion, PFSDQ-M's 'change in activity' domain and specially the LCADL (to a higher extent) showed responsiveness to detect changes in functional status after three months of high-intensity exercise training in patients with COPD, whereas the MRC scale did not. In this population, the improvement in functional status was not related with improvement in exercise capacity, lung function or quality of life.