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BackgroundLow physical activity and high sedentary behaviour are unquestionably relevant for public health while also increasing direct and indirect costs.MethodsThe authors examined the direct and indirect costs attributable to low physical activity and high sedentary behaviour in Finland in 2017. Costs related to major non-communicable diseases drawn from Finnish registries covered direct costs (outpatient visits, days of inpatient care, medication and institutional eldercare) and indirect costs (sickness-related absences, disability pensions, unemployment benefits, all-cause mortality and losses of income tax revenue). Prevalences of low physical activity and high sedentary behaviour (≥8 hours per 16 waking hours) were based on self-reports among adolescents or accelerometer data among adults and the elderly from three Finnish population studies: FINFIT 2017, Health 2011 and the Cardiovascular Risk in Young Finns Study. Cost calculations used adjusted population attributable fractions (PAF) and regression models. Total annual costs were obtained by multiplying PAF by the total costs of the given disease.ResultsThe total costs of low physical activity in Finland in 2017 came to approximately €3.2 billion, of which direct costs accounted for €683 million and indirect ones for €2.5 billion. Costs attributable to high sedentary behaviour totalled roughly €1.5 billion.ConclusionThe findings suggest that low physical activity and high sedentary behaviour levels create substantial societal costs. Therefore, actions intended to increase physical activity and reduce excessive sedentary behaviour throughout life may yield not only better health but also considerable savings to society.

As a result of educational reforms in many countries, including Finland, new or renovated comprehensive schools have increasingly begun to incorporate open and flexible designs and principles. Multipurpose and adaptable open learning spaces can provide children with amplified opportunities to be physically active during general education. Classroom-based physical activity has been associated with better academic-related outcomes and students’ on-task behaviour, while overall physical activity has been associated with better health. In the present study, we investigated the effects of classroom type, gender and grade level on classroom-based physical activity, and the associations between systematically-observed teachers’ instructions about students’ movement and classroom-based physical activity. The participants consisted of 182 3rd and 5th grade students in one school with open learning space and two schools with conventional classrooms. Overall, classroom-based physical activity, assessed with accelerometery, was not higher in open learning space than in conventional classrooms. However, 5th grade students had more sedentary time and less moderate-to-vigorous physical activity in open learning spaces than conventional classrooms, but both 3rd and 5th graders had more breaks from sedentary time in open learning spaces than conventional classrooms. Girls were more sedentary than boys, while 5th graders were less physically active than 3rd graders. Teachers’ instructions regarding 5th graders’ movement in open learning spaces were more restrictive and both 3rd and 5th graders had more instructed transitions in open learning spaces. In conventional classrooms, students had more teacher-organised physical activity. Teachers’ restrictive guidance was associated with less light physical activity, while teachers’ organised physical activity was associated with more moderate-to-vigorous physical activity.

Background Meeting daily guidelines for physical activity, screen time, and sleep duration is associated with a host of health indicators for youth. In this cross-sectional observational study, we investigated the associations between adherence to the movement guidelines and health-related outcomes among youth with autism spectrum disorder (ASD). Methods Parents of youth with ASD (10–17 years) from seven countries and regions were invited to provide online proxy-reports for child’s movement behaviors (i.e., physical activity, sleep and screen time), and health-related outcomes (i.e., body mass index [BMI], general health, and quality of life). A series of multiple linear regression analyses were used to examine the associations between meeting movement guidelines and health-related outcomes, adjusted for covariates. Results The final sample consisted of 1165 youth with ASD. Compared with youth meeting all three guidelines, a higher BMI z-score was observed in those who met no guidelines (B = 0.62, P = 0.04), “sedentary time only” (B = 0.60, P = 0.047), and “physical activity plus sleep only” (B = 0.85, P = 0.04). Compared with meeting all three guidelines, meeting no guidelines was associated with poorer general health (B = − 0.46, P = 0.02). Further, compared with youth meeting all three guidelines, a lower quality of life score was observed in those who met no guidelines (B = − 0.47, P = 0.02) and “physical activity only” (B = − 0.62, P = 0.03). Lastly, there were dose–response associations between the number of guidelines met and all three health-related outcomes (all Ptrend Conclusions In conclusion, meeting more 24-h movement guidelines was generally associated with more favorable health-related outcomes in youth with ASD. The low level of adherence to all three guidelines (2.0%) suggests the urgent need to promote the adoption of all the guidelines in this group.

Background Information is limited for the benefits of physical activity (PA) in preschoolers. Previous research using accelerometer-assessed PA may be affected for multicollinearity issues. Objectives This study investigated the cross-sectional and prospective associations of sedentary behaviour (SB) and PA with body composition and physical fitness using compositional data analysis. Methods Baseline PA and SB were collected in 4-year-old (n = 315) using wrist-worn GT3X+ during seven 24 h-periods. Body composition (air-displacement plethysmography) and physical fitness (PREFIT test battery) were assessed at baseline and at the 12-month follow-up. Results Increasing vigorous PA at expenses of lower-intensity behaviours for 4-year-old was associated with body composition and physical fitness at cross-sectional and longitudinal levels. For example, reallocating 15 min/day from lower intensities to vigorous PA at baseline was associated with higher fat-free mass index (+0.45 kg/m(2), 95% confidence intervals [CI]: 0.18-0.72 kg/m(2)), higher upper-body strength (+0.6 kg, 95% CI: 0.1-1.19 kg), higher lower-body strength (+8 cm, 95% CI: 3-13 cm), and shorter time in completing the motor fitness test (-0.4 s, 95% CI: -0.82 to [-0.01] s) at the 12-month follow-up. Pairwise reallocations of time indicated that the behaviour replaced was not relevant, as long as vigorous PA was increased. Conclusions More time in vigorous PA may imply short- and long-term benefits on body composition and physical fitness in preschoolers. These findings using compositional data analysis corroborate our previously published results using isotemporal substitution models. Funding Agencies|Bo and Vera Axson Johnsons Foundation; Forskningsradet om Halsa, Arbetsliv och Valfard [2012-0906]; Karolinska InstitutetKarolinska Institutet; VetenskapsradetSwedish Research Council [2012-2883]

This study investigated the associations of accelerometer-measured physical activity, sedentary time and screen time with the incidence of neck and shoulder pain in school-aged children over a two-year follow-up. Children (aged 10–15) were measured at baseline 2013 (T0) (n = 970) and at follow-ups 2014 (T1) and 2015 (T2). Neck and shoulder pain frequency and screen time were determined with a web-based questionnaire. Daytime moderate to vigorous physical activity and sedentary time were measured with an accelerometer. Logistic regression was applied, and the results were adjusted for age, gender, body mass index and bedtime. Accelerometer-measured physical activity or sedentary time at baseline were not associated with the incidence of neck and shoulder pain at the two-year follow-up. Associations of neck and shoulder pain incidence with overall screen time (p = 0.020), and especially with passive gaming time (p = 0.036) and social media time (p = 0.023) were found at the first but not the second follow-up. The neck and shoulder pain incidence associated with overall screen time, passive gaming time and social media time at the first follow-up. The importance of limiting screen time, should be explored in order to find new approaches in preventing neck and shoulder pain in school-aged children. peerReviewed

Educational reforms worldwide have resulted in schools increasingly incorporating open and flexible classroom designs that may provide possibilities to reduce sedentary behavior among students during lessons. Cross-sectional associations of classroom type on accelerometry assessed sedentary bout durations and sit-to-stand transitions were investigated in 191 third and fifth grade students recruited from one school with open learning spaces and two schools with conventional classrooms. A three-way ANOVA for classroom type, gender and grade level indicated that students in open learning spaces had more 1-to-4-min sedentary bouts (mean difference 1.8 bouts/h, p < 0.001), fewer >10-min sedentary bouts (median 0.20 vs. 0.48 bouts/h, p = 0.004) and more sit-to-stand transitions (mean difference 0.9 STS/h, p = 0.009) than students in conventional learning spaces. Comparisons between schools by grade, which were conducted with a one-way ANCOVA adjusted for gender, indicated that most of the significant differences occurred between schools with different classroom types. There were only small and mostly statistically nonsignificant differences between the two schools with conventional classrooms. In conclusion, open learning spaces may improve children’s sedentary profiles towards shorter sedentary bout durations and facilitate also postural transitions during lessons, which may translate into beneficial health impacts over a longer period. peerReviewed

Background Longitudinal studies demonstrate that physical activity (PA) declines on average from adolescence to early adulthood. However, some subgroups of adolescents increase activity while others decrease or maintain high or low activity. Determinants of change or maintenance of (in)activity may differ between subgroups and are valuable information for targeted health promotion. The purpose of this study was to identify PA patterns from adolescence to early adulthood, and also to explore how different activity domains and Sedentary Behaviour (SB) are associated with PA patterns. Methods The data of this observational cohort study (collected in 2013/2014 and 2017/2018) consisted of 254 Finns at age 15 and 19 participating the Health Promoting Sports Club study. K-means cluster analysis for longitudinal data was performed to identify participant clusters (patterns) based on their accelerometry-measured moderate-to-vigorous PA (MVPA). Associations of sports club participation (SC), active commuting (AC), and SB with PA patterns were examined by logistic regression analysis. Results (preliminary) Five MVPA patterns were identified: inactivity maintainers (n = 71), activity maintainers (n = 70), decreasers from moderate (to low) PA (n = 61), decreasers from high (to moderate) PA (n = 32), and increasers (n = 20). At age 15, SC participation (41-97%) and AC (47-75%) were common in all the patterns. By age 19, clear dropout from these activities was prevalent (SC participation mean 32%, AC 31-63%). Maintained SC participation was associated with a higher likelihood of belonging to the decreasers from high PA (OR = 11.2, CI = 1.4-90.0) and to the combined group of increasers and activity maintainers (OR = 3.6, CI = 1.8-7.4); also with a lower likelihood of being an inactivity maintainer (OR = 0.1, CI = 0.02-0.2). Dropout from SC was related to a higher likelihood of being a decreaser from high PA (OR = 10.9, CI = 1.3-90.7). Maintenance/adoption of AC was associated with a lower likelihood of being an inactivity maintainer (OR = 0.3, CI = 0.1-0.7). Decreased SB was related to a higher likelihood of belonging to the activity maintainers and increasers (OR = 0.96, CI = 0.93-0.98). Conclusions PA patterns diverge greatly over the transition to adulthood. Changes in SC participation, AC, and SB show different associations with diverging PA patterns. Hence, tailored PA promotion is recommended. nonPeerReviewed

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European children and adolescents spend most of their daily life and especially their school hours being sedentary which may increase their risk for chronic non-communicable diseases later in life. After the curriculum reform of Finnish basic education in 2014, most of the new or renovated comprehensive schools in Finland incorporate open and flexible classroom designs. Their open learning spaces may provide students opportunities to reduce sedentary behavior during school hours. Thus, waist-worn accelerometers were used to assess classroom-based sedentary time (ST), the number of breaks from sedentary time (BST), and physical activity (PA) among cross-sectional samples of 3rd and 5th grade students during two separate academic years in a school that underwent a renovation from conventional classrooms to open learning spaces. The cohort of 5th grade students before renovation had a smaller proportion of ST from total classroom time (56.97 ± 12.24%, n = 42 vs. 67.68 ± 5.61%, n = 28, mean difference = 10.71%-points, 95%CI = −15.65 to−5.77, p < 0.001), a greater number of BST per 60 min of classroom time (7.41 ± 1.16 breaks/h vs. 9.19 ± 1.59 breaks/h, mean difference = −1.78 breaks/h, 95%CI = −2.486 to −1.079, p < 0.001) and a greater proportion of light intensity PA (28.66 ± 9.99% vs. 22.56 ± 4.59%, mean difference = 6.10%, 95%CI = 2.56 to 9.64, p = 0.001) than the 5th grade cohort assessed after renovation. The cohort of 3rd grade student had a greater proportion of moderate-to-vigorous intensity PA (MVPA) after the renovation compared to the cohort assessed before the renovation [Mean Rank (Before) = 27.22, Mean Rank (After) = 37.58, U =524.0, p = 0.033]. Despite the greater ST found in 5th graders, schools with open learning spaces may facilitate BST or MVPA as observed in the 5th and 3rd grade cohorts in open learning spaces compared to the cohorts in conventional classrooms, respectively. Future studies should seek to investigate and develop teacher practices to capitalize the potential of open classrooms to reduce ST, since classroom renovation alone may not be a sufficient intervention as of itself. Longitudinal studies utilizing randomized controlled trials are warranted.

This is a pre-print of a published study: Renko, E., Knittle, K., Palsola, M. et al. Acceptability, reach and implementation of a training to enhance teachers’ skills in physical activity promotion. BMC Public Health 20, 1568 (2020). https://doi.org/10.1186/s12889-020-09653-x Background: In order to achieve real-world impacts, successful behavior change interventions need to be scaled up and broadly implemented. Implementation is challenging however, and the factors influencing successful implementation are not fully understood. This study describes the nationwide implementation of a complex theory-based program to promote physical activity and reduce sedentary behavior in vocational schools (Let’s Move It; LMI). The implementation primarily involved a systematic and theory-based training intervention and user manual for school staff. This study explores how the perceived acceptability of this training intervention (using the dimensions of the Theoretical Framework of Acceptability) relate to (un)successful implementation. The purpose is to evaluate (1) the experienced acceptability of the training intervention and anticipated acceptability of later delivering the program; (2) the reach and implementation, including adaptations and barriers; (3) the extent to which acceptability ratings predict teachers’ intentions for implementation.Methods: School staff (n=194) enrolled in a two-part training intervention, covering implementation of the LMI program and training in motivational interaction styles. Participants reported their perceived acceptability of the training intervention and their implementation efforts in online questionnaires at baseline, after training sessions and at long-term follow-up. Qualitative data were analysed with content analysis and quantitative data with correlations and logistic regression.Results: School staff rated the acceptability of the training intervention as very high on all assessed dimensions (average ratings exceeded 4.0 on a 5-point scale). The nationwide implementation reached at least 6,100 students and 341 school classes. Most teachers intended to continue program implementation, and higher ratings of acceptability were related to stronger subsequent intentions to implement the program. Teachers commonly reported condensing program content during implementation, and reported lacks of time and collegial support as the most common barriers to implementation. Conclusion: This case study presents the development and evaluation of the national real-world implementation of a physical activity program. Considerably high acceptability and reach of the training intervention indicates high potential for implementation success. The role of addressing the multiple facets of acceptability in implementation projects warrant more research focus.

Objectives: The aim of this study is to evaluate the effects of multicomponent rehabilitation on physical activity, sedentary behavior, and mobility in older people recently discharged from hospital. Design: Randomized controlled trial. Setting: Home and community. Participants: Community-dwelling people aged ⩾60 years recovering from a lower limb or back musculoskeletal injury, surgery, or disorder were recruited from local health center hospitals and randomly assigned into an intervention ( n = 59) or a control (standard care, n = 58) group. Intervention: The six-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program, physical activity counseling, and standard care. Measurements: Physical activity and sedentary time were assessed using an accelerometer and a single question. Mobility was evaluated with the Short Physical Performance Battery, self-reported use of a walking aid, and ability to negotiate stairs and walk outdoors. Intervention effects were analyzed with generalized estimating equations. Results: Daily physical activity was 127 ± 78 minutes/day and 121 ± 70 at baseline and 167 ± 81 and 164 ± 72 at six months in the intervention and control group, respectively; mean difference of 3.4 minutes (95% confidence interval (CI) = −20.3 to 27.1). In addition, no significant between-group differences were shown in physical performance. Conclusion: The rehabilitation program was not superior to standard care for increasing physical activity or improving physical performance. Mobility-limited older people who had recently returned home from hospital would have needed a longer and more frequently monitored comprehensive geriatric intervention.

Background As sedentary behavior is a global health issue, there is a need for methods of self-reported sitting assessment. The accuracy and reliability of these methods should also be tested in various populations and different cultural contexts. This study examined the validity of long-term and short-term recall of occupational sitting time in Finnish and Chinese subgroups. Methods Two cohort groups of office-based workers (58.6% female, age range 22–67 years) participated: a Finnish group (FIN, n = 34) and a Chinese group (CHI, n = 36). Long-term (past 3-month sitting) and short-term (daily sitting assessed on 5 consecutive days) single-item measures were used to assess self-reported occupational sitting time. Values from each participant were compared to objectively measured occupational sitting time assessed via thigh-mounted accelerometers, with Spearman's rho (ρ) used to assess validity and the Bland-Altman method used to evaluate agreement. Coefficients of variation depicted day-to-day variability of time spent on sitting at work. Results In the total study sample, the results showed that both long-term and short-term recall correlated with accelerometer-derived sitting time (ρ = 0.532, 95% confidence intervals (CI): 0.336–0.684, p

Objectives The potential effects of physical activity and sedentary time on children’s increasing neck and shoulder pain are unclear. The aim of this cross-sectional study was to evaluate the associations between objectively measured physical activity or sedentary time and neck and shoulder pain in children. Methods Children (n=905; 10–15 years old) filled in an electronic questionnaire during school hours on the frequency of their neck and shoulder pain. Daytime moderate to vigorous physical activity and sedentary time were measured objectively with an ActiGraph accelerometer. A multinomial logistic regression was applied to study the associations. The results were adjusted for age, gender, body mass index and bedtime. Results Neck and shoulder pain experienced at least once a week was reported by 26.1% of children. A higher proportion of boys (45.9%) than girls (24.2%) achieved at least 60 min of moderate to vigorous physical activity/day (p Conclusions A quarter of the girls and boys reported frequent neck and shoulder pain. Boys achieved more moderate to vigorous physical activity than girls and higher moderate to vigorous physical activity was associated with a lower probability of having neck and shoulder pain, but only in boys. Neck and shoulder pain is the most common musculoskeletal pain and its prevalence is increasing. Preventing childhood pain is important, as neck and shoulder pain causes restrictions in daily living and is persistent to adulthood. Our study showed, that boys with more moderate to vigorous physical activity, had less weekly neck and shoulder pain symptoms. The present results are an addition to the list of benefits of physical activity and are valuable to, for example, healthcare personnel and teachers, who guide and teach children and adolescents. Families can benefit from new knowledge when considering supportive parenting activities. Municipalities can use the new information to design services for children or families.

Despite the central role of human resources in determining the success of software companies, relatively little academic research has been conducted on the well-being at work aspect of software professionals. This study aims to address the aforementioned gap by examining the effects of using standing instead of sitting workstations on the well-being at work of software professionals in terms of their physical activity, mental alertness, stress, and musculoskeletal strain. An intervention study consisting of two measurements was conducted for 29 employees of a large Finnish software company by using questionnaires and the Firstbeat Lifestyle Assessment service. The findings of the study suggest that the usage of standing instead of sitting workstations results in only modest promotions of physical activity, does not have an effect on mental alertness, actually tilts the stress-recovery balance towards stress, but decreases musculoskeletal strain in the neck and shoulders, although increasing it in the legs and feet.

Purpose. To study the associations of physical activity (PA), sedentary time (ST), and cardiorespiratory fitness (CRF) with heart rate variability (HRV) in children. Methods. The participants were a population sample of 377 children aged 6–9 years (49% boys). ST, light PA (LPA), moderate PA (MPA), vigorous PA (VPA), and moderate-to-vigorous PA (MVPA), and PA energy expenditure (PAEE) were assessed using a combined heart rate and movement sensor, maximal power output per kilograms of lean body mass as a measure of CRF by maximal cycle ergometer exercise test, and HRV variables (SDNN, RMSSD, LF, and HF) using 5 min resting electrocardiography. Data were analysed by linear regression adjusted for years from peak height velocity. Results. In boys, ST was inversely associated (β = − 0.185 to − 0.146, p ≤ 0.049) and MVPA, VPA, PAEE, and CRF were directly associated (β = 0.147 to 0.320, p ≤ 0.048) with HRV variables. CRF was directly associated with all HRV variables and PAEE was directly associated with RMSSD after mutual adjustment for ST, PAEE, and CRF (β = 0.169 to 0.270, p ≤ 0.046). In girls, ST was inversely associated (β = − 0.382 to − 0.294, p

We investigated the ability of energy expenditure, movement sensing, and muscle activity to discriminate sedentary and non-sedentary activities in children. Thirty-five 7–11-year-old children participated in the study. Simultaneous assessment of oxygen uptake (V̇O2), triaxial accelerometry, and thigh muscle electromyography (EMG) were performed during eight different sedentary and non-sedentary activities including lying down, sitting-, standing-, and walking-related activities, which were performed in a random order. Mean values of V̇O2, accelerometry, and EMG from the concurrent 2 min epochs during each activity were computed. Resting energy expenditure (REE) was measured during 30 min supine rest. Directly measured metabolic equivalent of tasks (METs, V̇O2 in activities/V̇O2 in REE) were calculated for each activity. Mean amplitude deviation (MAD) was computed for accelerometry. EMG was normalized for mean muscle activity during self-paced walking. The classification accuracy of METs, MAD, and EMG to discriminate sedentary activities from physical activities was investigated by receiver operating characteristic curves and optimal cut-offs based on maximal sensitivity and specificity. Mean (SD) REE was 5.0 ± 0.8 ml/kg/min. MET, MAD, and EMG values ranged from 1.0 to 4.9, 0.0020 to 0.4146 g, and 4.3 to 133.9% during lying down and walking at 6 km/h, respectively. Optimal cut-offs to discriminate sedentary activities from non-sedentary activities were 1.3 for METs (sensitivity = 82%, specificity = 88%), 0.0033 g for MAD (sensitivity = 80%, specificity = 91%), and 11.9% for EMG (sensitivity = 79%, specificity = 92%). In conclusion, this study provides applicable thresholds to differentiate sitting and standing and sedentary and non-sedentary activities based on METs, MAD, and EMG in young children. peerReviewed

Background: This study examined the distribution of objectively measured physical activity (PA) and sedentary time of fifth-grade students during school, leisure time, and physical education (PE) classes. Demographic, anthropometric, and PA data were collected from 17 representative Finnish schools. Methods: To estimate the PA and sedentary time, participants (N = 592) wore wGT3X-BT ActiGraphs for 7 consecutive days. Comparisons were made between genders and different BMI groups. Results: From the study sample, 43.7% met the moderate to vigorous PA (MVPA) guidelines. Participants spent 62.2% of the day sedentary and 8.2% in moderate and vigorous activities. Boys performed more MVPA than girls, and girls were more sedentary during school days. Boys had more MVPA than girls in leisure time, but there were no differences in sedentary time. However, an examination of PA assessed during PE classes revealed no differences between boys and girls. Normal-weight boys engaged in more MVPA than overweight and obese boys. No differences were found for girls. Conclusions: The PA levels differ between different BMI groups in leisure time and during school but not during PE lessons. PA for overweight children should be targeted and compulsory PE time should be increased to achieve the PA guidelines.

ObjectivesTo examine the relationships of late-career physical heaviness of work and sitting at work with mortality. A national-level job exposure matrix was used to determine the occupation-specific level of physical heaviness and sitting.DesignProspective cohort study between years 1990 and 2015.SettingCommunity.Participants5210 men and 4725 women from the Helsinki Birth Cohort Study with an occupational code at baseline (ages 45–57 years).Primary and secondary outcome measuresTotal, cardiovascular (International Classification of Diseases 10th Revision I00–I99), cancer (C00–C97) and external (S00–Y84) mortality.ResultsThe exposures, physical heaviness and sitting had a non-linear, inverse relationship. During the 26-year follow-up, 1536 men and 759 women died. Among men, physical heaviness of work was positively associated and sitting at work was negatively associated with all-cause, cardiovascular and external cause mortality but they were not associated with cancer mortality. The HRs for men in the highest quartile of physical heaviness of work compared with men in the lowest quartile were 1.54 (1.31–1.80) for all-cause mortality, 1.70 (1.30–2.23) for cardiovascular mortality and 3.18 (1.75–5.78) for external cause mortality (adjusted for age and years of education). Compared with the lowest quartile, the HRs for the highest quartile of sitting at work among men were 0.71 (0.61–0.82) for all-cause mortality, 0.59 (0.45–0.77) for cardiovascular mortality and 0.38 (0.22–0.66) for external cause mortality. In women, neither physical heaviness of work nor sitting at work was associated with mortality.ConclusionsMen in physically heavy work at their late-work career are at higher risk of death than men in physically light work.

Background Dynamic high-intensity physical activity is thought to be beneficial for older adults’ bone health. Traditional volume-based processing of accelerometer-measured physical activity data, quantified on a minute-per-minute basis, may average out sporadic high impact activity, whereas accelerometer data processing approaches based on identifying impacts can capture also these potentially beneficial short activity bursts. We investigated the associations between habitual physical activity and proximal femur bone traits among sedentary older adults utilizing three different numerical treatments of accelerometer-data to examine, if impact-based processing approaches are more suitable to assess bone loading than volume-based processing of physical activity data among older adults. Methods This cross-sectional study utilized the baseline data from the PASSWORD-study (n=284, mean ± SD age 74 ± 4 years, 57 % women). Total femur bone mineral content (BMC) and bone mineral density (BMD), femoral neck BMC, BMD, section modulus and minimal width (MNW) were measured with dual energy x-ray absorptiometry. Physical activity was measured for seven consecutive days with a tri-axial accelerometer. Raw acceleration data was processed in three different ways and quantified as i) mean daily minutes in sedentary, light and moderate-to-vigorous-intensity activity, ii) mean daily number of acceleration peaks divided into low (1.5 g to 2.0 g), medium (2.0 g to 2.5 g) and high (> 2.5 g) impacts, and iii) mean daily osteogenic index, which is a summary score calculated from log-transformed number of impact peaks in 32 intensity bands (≥ 1.3 g). Associations between physical activity measures and each bone trait were estimated with multiple linear regression adjusted with covariates (age, sex, weight, height, smoking, physical function, medication). Results Participants recorded on average 10 h sedentary, 2.5 hrs light and 32 min moderate-to-vigorous activity, and 3937 low, 494 medium and 157 high impacts per day. Mean osteogenic index score was 173. Light physical activity was positively associated with all bone traits (beta = 0.147 to 0.182, p

The aim of the Finnish Schools on the Move program is to create a more active and pleasant school day through physical activity (PA). In this quasi-experimental design, we compared changes in moderate-to-vigorous-intensity physical activity (MVPA) and sedentary time (ST) during the school day and outside school hours for Grades 1–9 over two academic years in four program schools and two reference schools. Altogether 319 girls and boys aged 7–15 participated in the study between 2010 and 2012. MVPA and ST were measured four times over the 1.5-year follow-up period for seven consecutive days, using a hip-worn ActiGraph accelerometer. Linear growth curve modeling was used to examine the effect of the program on MVPA and ST during follow-up. School day MVPA increased (P = 0.010) and school day ST decreased (P = 0.008) in program primary schools (Grades 1–6) more compared with the reference schools. The effect sizes (Cohen's d) for the difference in change (from the first to the last measurement) were small (d = 0.18 and d = −0.27, respectively). No differences in the changes of leisure-time or whole-day MVPA and ST between the program and reference schools were observed during follow-up. In conclusion, the changes in school day MVPA and ST did not translate into positive effects across the whole day. More effective and longer promotion actions are needed for positive changes in PA and ST, especially in lower secondary schools and for all daily segments. peerReviewed

Background: The purpose of this study was to examine trajectories of leisure-time physical activity (LTPA) and television-viewing (TV) time and their associations in adults over 10 years. Methods: The sample comprised 2934 participants (men, 46.0%) aged 24–39 years in 2001 and they were followed up for 10 years. LTPA and TV time were assessed using self-report questionnaires in 2001, 2007, and 2011. Longitudinal LTPA and TV-time trajectories and their interactions were analyzed with mixture modeling. Results: Three LTPA (persistently highly active, 15.8%; persistently moderately active, 60.8%; and persistently low active, 23.5%) and 4 TV time (consistently low, 38.6%; consistently moderate, 48.2%; consistently high, 11.7%; and consistently very high, 1.5%) trajectory classes were identified. Persistently highly active women had a lower probability of consistently high TV time than persistently low-active women (P = .02), whereas men who were persistently highly active had a higher probability of consistently moderate TV time and a lower probability of consistently low TV time than their persistently low-active counterparts (P = .03 and P = .01, respectively). Conclusions: Maintaining high LTPA levels were accompanied by less TV over time in women, but not in men. The associations were partially explained by education, body mass index, and smoking.

Individuals with intellectual disabilities (ID) are at high risk for high levels of sedentary behaviour. To inform the development of programmes to reduce sedentary behaviour, insight into the correlates is needed. Therefore, the aim of this study is to review the evidence on correlates of sedentary behaviour in adults with ID. We performed a systematic literature search in Ovid Medline, Ovid Embase, Web of Science and Google Scholar up to 19 January 2018, resulting in nine included studies that were published from 2011 to 2018. Correlates were categorized according to the ecological model. Studies predominantly focused on individual level correlates. Of those correlates studied in more than one study, having epilepsy was associated with less sedentary behaviour and inconsistent results were found for sex, genetic syndromes, weight status, physical health, mobility, level of ID, and mental health. Of the few interpersonal and environmental factors studied, only living arrangements were studied in more than one study, with inconsistent results. To date, we have limited and inconclusive evidence about correlates of sedentary behaviour in adults with ID. Only when future studies unravel correlates and determinants, across all domains of the ecological model, will the potential opportunities to improve health by reducing sedentary behaviour come within reach., Unrestricted funding to facilitate meetings of the European Network of Physical Activity Research in People with Intellectual Disabilities (ENPARID) was provided by Ramon Llull University and Obra Social La Caixa (reference 2016-URL-Trac-005) to MGB.

Mikkonen, T. 2018. Fyysisen aktiivisuuden ja istumisen yhteys niskahartiaseudun ja alaselän kipujen esiintyvyyteen työikäisillä. Liikuntatieteellinen tiedekunta, Jyväskylän yliopisto, Liikuntalääketieteen pro gradu -tutkielma, 62 s, 1 liite. Niskahartiaseudun ja alaselän kivut ovat Suomessa ja maailmanlaajuisesti suurin työikäisten sairaslomapäiviä aiheuttava syy. Samaan aikaan fyysisen aktiivisuuden tiedetään vähentyneen ja päivittäisen istumisen ja muun paikallaanolon lisääntyneen. Viime vuosikymmeninä useat tutkimukset ovat osoittaneet, että fyysisellä aktiivisuudella voidaan parantaa terveyttä. Istumisen taas tiedetään olevan itsenäisenä tekijänä yhteydessä huonompaan terveyteen. Fyysisen aktiivisuuden ja istumisen yhteys niskahartiaseudun ja alaselän kipujen esiintyvyyteen ei ole täysin selvä. Tämän tutkimuksen tarkoituksena on selvittää, onko vapaa-ajalla, työmatkalla tai työajalla mitattu fyysinen aktiivisuus ja vapaa-ajalla tai työajalla mitattu istuminen yhteydessä niskahartiaseudun tai alaselän kipujen esiintyvyyteen Tampereen alueen työikäisillä. Tutkimusaineisto, jota tässä tutkimuksessa käytettiin, on saatu kokonaisuudessaan UKK- instituutilta. Aineisto on osa KÄPY- hankkeessa (Kävelyn- ja pyöräilyn edistämishanke) kerättyä aineistoa. Tässä tutkimuksessa käytetty aineisto on kerätty vuosien 2014–2015 välillä. Aineisto koostui sekä kyselylomakkeella kerätystä datasta että objektiivisesti HookieAM20 liikemittarilla mitatusta datasta. 1117 henkilöä täytti kyselylomakkeen ja 422 käytti liikemittaria. Kyselylomakkeesta saatiin tutkittavien niskahartiaseudun ja alaselän kipua sekä työmatkaliikuntaa kuvaavat arvot. Liikemittarista saatiin vapaa-ajan ja työajan fyysistä aktiivisuutta ja istumista kuvaavat arvot. Tilastollisista menetelmistä käytettiin Khiin neliö (χ2) -testiä, Kruskal-Wallis-testiä, Spearmanin korrelaatiokerrointa ja binääristä logistista regressioanalyysia. Kyselylomakkeella mitattu työmatkoilla tapahtunut fyysinen aktiivisuus oli tilastollisesti merkitsevästi yhteydessä niskahartiaseudun kipujen esiintyvyyteen, silloin kun työmatkalla käytettiin pyörää. Kävellen kuljetun työmatkan ja niskahartiaseudun kipujen välillä ei havaittu tilastollisesti merkitsevää yhteyttä. Harvemmin 1–2 kertaa viikossa kuljettu työmatka lisäsi kipujen esiintyvyyttä, kun usein 3–5 viikossa kuljettu työmatka vähensi kipujen esiintymistä. Monimuuttuja-analyysissa niskahartiaseudun kipujen esiintyvyyttä selitti työmatkapyöräilyn lisäksi naissukupuoli, nuorempi ikä ja koettu huonompi terveydentila. Työmatkalla tapahtunut fyysinen aktiivisuus ei ollut yhteydessä alaselän kipujen esiintyvyyteen. Objektiivisesti mitattu vapaa-ajan ja työajan fyysinen aktiivisuus tai istuminen ei ollut tilastollisesti merkitsevästi yhteydessä niskahartiaseudun tai alaselän kipuihin. Heikko korrelaatio havaittiin niskahartiaseudun kipujen ja työaikaisen istumisen välillä. Tämä tutkimus antaa viitteitä siitä, että 3-5 kertaa viikossa pyörällä kuljettu työmatka saattaisi vähentää niskahartiaseudun kipujen esiintyvyyttä työikäisillä, kun 1-2 kertaa viikossa kuljettu työmatka pyörällä saattaa lisätä kipuja. Aikaisempia tutkimuksia työmatkapyöräilyn ja niskahartiaseudun kivun esiintyvyyden yhteydestä ei juurikaan ole. Työmatkapyöräilyllä on kuitenkin havaittu olevan muita terveyttä edistäviä vaikutuksia. Erityisesti työnantajien kannattaa panostaa työmatkaliikuntaan, koska parempi terveys on yhteydessä vähentyneisiin sairaspoissaoloihin. Jatkossa on tärkeää, että aihetta tutkitaan lisää. Avainsanat: Niskahartiaseudun kipu, alaselän kipu, fyysinen aktiivisuus, istuminen, vapaa-aika, työaika ja työmatkaliikunta. Mikkonen T. 2018. Association of physical activity and sedentary behavior with neck shoulder and low back pain in sample of working aged population. Department of Health Sciences, University of Jyväskylä, Sports and Exercise Medicine, Master’s thesis, 62 pp, 1 appendix. Neck and shoulder pain as well as low back pain are major health problems among working age population. At the same time, we know that physical activity has decreased and that daily sedentary behavior has increased. In recent decades researchers have published several studies with evidence that physical activity can improve health. Recently studies have also found that sedentary behavior is associated with poorer health status as an independent factor. However, associations between physical activity and sedentary behavior to the neck shoulder pain and low back pain are not completely clear. The aim of this study is to investigate the associations between physical activity, sedentary behavior (leisure time, occupational or commute periods), neck shoulder pain and low back pain among working age population in the Tampere region. The data for this study was provided by UKK Institute and it was part of the study Socio-Ecological Intervention to Promote Active Commuting to Work. The data in this study was collected by using questionnaires and the objective data was collected with the triaxle accelerometer HookieAM20 in 2014 and 2015. 1117 participants filled the questionnaire and 422 wore accelerometers. The questionnaire included questions about neck shoulder pain, low back pain and active commuting by using a bicycle or walking. The accelerometer included data about leisure time, occupational physical activity and sedentary behavior. The associations between variables were then analyzed by using Chi-square (χ²)-test, Kruskall-Wallis test, Spearman correlation coefficients and multinomial logistic regression analysis. Active commuting measured by the questionnaire was associated to the incidence of neck shoulder pain when a bicycle was used. Commuting by walking was not associated to the neck shoulder pain. Participants using a bicycle 1-2 times per week for commuting seemed to have more neck shoulder pain than those using it 3-5 times per week. Multinomial regression analysis showed that also female gender, younger age and poorer health status were associated to the incidence of neck shoulder pain. Active commuting was not associated to the low back pain. Objective measured physical activity or sedentary behavior were not associated to the neck shoulder pain or low back pain. Weak correlation was noticed between the occupational sedentary behavior and neck shoulder pain. This study shows that active commuting by using a bicycle 3-5 times per week may decrease the incidence of neck shoulder pain; correspondingly using it 1-2 per week for commuting may increase the incidence of neck shoulder pain. There is a relatively small amount of recent studies on the association between commuting by using a bicycle and the incidence of neck shoulder pain though they have shown that commuting by using a bicycle has other health promoting factors. Because better health is associated with reduced sick leave employers should promote active commuting. In the future this topic needs to be further researched. Keywords: Neck shoulder pain, low back pain, physical activity, sedentary behavior, leisure time, occupational time and active commuting.

Vammaisista henkilöistä puhutaan usein yhtenäisenä ryhmänä ikään kuin vamma olisi kaikilla samanlainen tai sen vaikutukset toimintakykyyn samankaltaiset. Vaikka erilaisten vammojen ja pitkäaikaissairauksien tiedetään rajoittavan ihmisten tekemistä eri lailla, liikunta-aktiivisuutta mittaavissa tutkimuksissa tai tilastoinneissa niitä ei ole useinkaan eroteltu. Syinä ovat voineet olla esimerkiksi pienet tutkittavien määrät tai liian yleiset mittausmenetelmät. Tämän tutkimuksen tavoitteena on tarkastella vuoden 2016 ”Lasten ja nuorten liikuntakäyttäytyminen Suomessa” (LIITU) -tutkimuksen aineistossa toimintarajoitteisuutta, liikunta-aktiivisuutta, liikuntaseuraan kuulumista ja istumisen määrää ja verrata niitä vammattomiin nuoriin. LIITU-tutkimuksessa 11–15-vuotiaita nuoria (n=4724) pyydettiin raportoimaan kokemansa toimintarajoitteet (nähdä, kuulla, puhua sujuvasti, liikkua tai käsitellä esineitä, hengittää tai muistaa asioita/ keskittyä). Lisäksi selvitettiin toimintarajoitteisuuden yhteyksiä liikuntakäyttäytymiseen, urheiluseurassa harrastamiseen ja istumiseen. Noin 15 prosenttia nuorista raportoi kokemansa toimintarajoitteen, joka häiritsee heidän arkeaan. Erilaisista toimintarajoitteista liikkumisen vaikeudet vaikuttavat liikunta-aktiivisuuteen eniten. Erityisesti liikkumisen vaikeuksia kokevat nuoret raportoivat tilastollisesti merkitsevästi vähemmän reipasta/rasittavaa liikuntaa, vähemmän urheiluseura-aktiivisuutta ja enemmän istumista viikonloppuisin kuin ne nuoret, joilla ei ollut toimintarajoitteita. Liikkumisen vaikeuksia koke vat pojat harrastivat myös selvästi vähemmän reipasta liikuntaa verrattuna muihin toimintarajoitteita kokeviin nuoriin. Enemmän huomiota tulisi kiinnittää olosuhteiden ja palveluiden esteettömyyteen ja saavutettavuuteen, jotta kaikilla olisi mahdollisuus liikkua omien edellytystensä sallimissa rajoissa ja osallistua urheiluseuratoimintaan. Often people with disabilities are referred to as a heterogeneous group of people, with the same ability to function. Rather than use the term ‘disability’, it would be best to use terms that describe functional limitations, because functions can restrict performance in physical activity tasks. Many studies or statistics that measure physical activity do not distinguish various types of functional limitations, such as visual, hearing or moving impairments. Therefore, the purpose of this study was to explore differences in physical activity, sports club membership, and sitting time in adolescents with and without disabilities through the Finnish School-aged Physical Activity (SPA) study (in Finnish LIITU). All adolescents aged between 11–15 years old (n=4724) were asked to report levels of functional difficulties as indicators of disability and their physical in/activity behaviours during the spring of 2016. About 15 % of adolescents had one kind of functional limitation that affects their daily activities. More specifically adolescents with moving difficulties reported significantly less days of moderate to vigorous physical activities, fewer were sports club members, and sat for more hours during the weekend than adolescents without disabilities. Moreover, boys with moving difficulties clearly fell behind their peers with other functional limitations when examining their moderate to vigorous physical activities. More effort is needed to create accessible services and space needed to allow everybody to be active within their own capabilities, and to participate in physical activities, join sports clubs, and spend less time sitting. peerReviewed

Introduction We studied whether objectively measured physical activity (PA) and sedentary behavior (SB) are associated with cognition in Finnish elderly twins. Methods This cross-sectional study comprised twins born in Finland from 1940 to 1944 in the Older Finnish Twin Cohort (mean age, 72.9 years; 726 persons). From 2014 to 2016, cognition was assessed with a validated telephonic interview, whereas PA was measured with a waist-worn accelerometer. Results In between-family models, SB and light physical activity had significant linear associations with cognition after adjusting for age, sex, wearing time, education level, body mass index, and living condition (SB: β-estimate, −0.21 [95% confidence intervals, −0.42 to −0.003]; light physical activity: β-estimate, 0.30 [95% confidence intervals, 0.02–0.58]). In within-family models, there were no significant linear associations between objectively measured PA and cognition. Discussion Objectively measured light physical activity and SB are associated with cognition in Finnish twins in their seventies, but the associations were attributable to genetic and environmental selection., Highlights • Objectively measured physical activity was associated with cognition in elderly. • Light physical activity was associated with better cognition in individuals. • Sedentary behavior was associated with worse cognition in individuals. • Twin analyses show similar genetics and environment contributing to the associations.

Purpose While merely standing up interrupts sedentary behavior, it is important to study acute metabolic responses during single bouts of sitting and standing to understand the physiological processes affecting the health of office workers. Methods Eighteen healthy middle-age women 49.4 ± 7.9 yr old (range: 40–64) with a body mass index of 23.4 ± 2.8 kg·m−2 volunteered for this laboratory-based randomized crossover trial where they performed 2 h desk work in either sitting or standing postures after overnight fasting. Muscle activity (normalized to walking at 5 km·h−1), respiratory gas exchange, and blood samples were assessed after glucose loading (75 g). Results Compared with seated work, continuous standing resulted in greater activity in the thigh muscles (mean of biceps femoris and vastus lateralis: 17% ± 8% vs 7% ± 2%, P < 0.001) and leg muscles (mean of tibialis anterior, gastrocnemius medialis, and soleus: 16% ± 6% vs 7% ± 3%, P < 0.001), but no increases in back muscle activity (thoracic erector spinae, lumbar erector spinae, and multifidus). Concomitant with 9% higher energy expenditure (EE) (P = 0.002), standing resulted in higher fat oxidation (48% ± 9% EE vs 39% ± 7% EE, P = 0.008) and lower carbohydrate oxidation (52% ± 9% EE vs 61% ± 7% EE, P = 0.008) than sitting. Glucose total and net incremental area under the curve were approximately 10% (P = 0.026) and 42% (P = 0.017) higher during standing than sitting, respectively. Insulin concentration did not differ between conditions. Conclusion Compared with sitting, 2 h of standing increased muscle activity, fat oxidation, and circulating glucose level. These results suggest fuel switching in favor of fat oxidation during standing despite extra carbohydrate availability. peerReviewed

Purpose: To investigate the relationships of objectively measured physical activity (PA) and sedentary time (ST) to arterial stiffness in pre-pubertal children. Method: Altogether 136 children (57 boys, 79 girls) aged 6–8-years participated in the study. Stiffness index (SI) was assessed by pulse contour analysis based on photoplethysmography. ST, light PA, moderate PA, and vigorous PA were assessed using combined acceleration and heart rate monitoring. We investigated the associations of ST (, final draft, peerReviewed

Given that a high amount of sedentary behavior is a global health issue, reducing sitting time is emerging as a novel intervention strategy and a workplace health priority. Sit-stand workstations have been introduced to the workplace, and can be used to rotate between sitting and standing postures at work. It is important to develop and evaluate sit-stand interventions that aim to induce behavioral changes and potential health benefits, in order to effectively implement them into practice. Therefore, this thesis examined whether and to what extent sit-stand workstations can reduce occupational sitting and improve health indexes in a real workplace. The thesis included four studies in field and laboratory settings using several methodological approaches such as EMG and accelerometry to examine: 1) validity of self-report occupational sitting time (n = 70); 2) intervention effectiveness (n = 45); 3) comparison of muscle activity patterns and spinal loading (n = 24); 4) acute physiological responses to sitting and standing (n = 18). Overall, occupational sitting represented ~80% or less of daily work hours among office-based workers. A validation study using long-term questionnaire and short-term daily recall showed that while at the group level both of these self-reported measures are acceptable (< 3% difference compared to thigh- mounted accelerometry) for assessing the proportion of work time spent sitting, they are not necessarily reliable at an individual level due to large individual variability. When the questionnaire was used in a 6-month intervention study, working at a sit- stand workstation led to a ~7% reduction in occupational sitting, and improved perceived musculoskeletal comfort and work ability in office workers. About 42% of the participants who had a sit-stand desk used its function on a daily basis and showed ~14% reduction in sitting time. The cross-sectional comparison study showed that office workers using sit–stand workstations had ~15% less muscle inactivity time and ~11% more light muscle activity time during one work day, but the same amount of spinal shrinkage compared to office workers using sit workstations. In a laboratory- based randomized crossover trial, two hours of standing as compared to seated work increased muscle activity, energy expenditure and circulating glucose level after glucose loading. The results highlighted fuel switching in favor of fat oxidation during standing, in spite of extra carbohydrate availability. In conclusion, using sit-stand workstations seems to be a promising strategy to reduce occupational sitting time and improve health-related outcomes, although more studies are required to address the best practices for implementing these workstations into workplace settings.

Päivittäisen istumisajan tiedetään olevan yhteydessä kasvaneisiin terveysriskeihin, vaikka liikuntasuositukset muuten täyttyisivät. Jo hyvin pieni istumisen vähentäminen vaikuttaa ehkäisevän epäedullisia muutoksia. Istumistutkimus on antanut uuden perspektiivin fyysisesti aktiivisen elämän tavoitteluun. Fyysisesti aktiivisen elämän määritelmän laajentaminen on tärkeää etenkin ihmisille, jotka taistelevat sen ensimmäisen kynnyksen ylittämisestä: sohvalta ylös nousemisesta. nonPeerReviewed

Replacing sitting by standing has been hypothesized to reduce the health risks of sitting, based on the assumption that muscles are passive during sitting and active during standing. Interventions have been more effective in overweight (OW) than in normal weight (NW) individuals, but subjects’ muscle activities have not been quantified. This study compared quadriceps and hamstring muscle electromyographic (EMG) activity between 57 NW (body mass index (BMI) 22.5 ± 1.5 kg/m2, female n = 36) and 27 OW (BMI 28.4 ± 2.9 kg/m2, female n = 8) subjects during non-fatiguing standing (15 s, EMGstanding) and sitting (30 min). EMG amplitude was normalized to EMG measured during maximal isometric knee extension and flexion (% EMGMVC), and sitting muscle inactivity and bursts were determined using 4 thresholds (60% or 90% EMGstanding and 1% or 2% EMGMVC). Comparisons were adjusted for sex, age, knee extension strength, and the individual threshold. Standing EMG amplitude was 36% higher in OW (1.9% ± 1.5% EMGMVC) than in NW (1.4% ± 1.4% EMGMVC, P < 0.05) subjects. During sitting, muscles were inactive 89.8% ± 12.7% of the measurement time with 12.7 ± 14.2 bursts/min across all thresholds. On average, 6% more activity was recorded in NW than in OW individuals for 3 of the 4 thresholds (P < 0.05 for 60% or 90% EMGstanding and 1% EMGMVC). In conclusion, the OW group had higher muscle activity amplitude during standing but more muscle inactivity during sitting for 3/4 of the thresholds tested. Interventions should test whether the observed heterogeneity in muscle activity affects the potential to gain cardiometabolic benefits from replacing sitting with standing. peerReviewed

Säännöllisen liikunnan terveyshyödyt ovat kiistattomat. Viime vuosina lisääntynyt epidemiologinen näyttö on osoittanut liiallisen istumisen olevan terveysriski, vaikka henkilö täyttäisi nykyiset liikuntasuositukset. Istuminen on itsenäinen terveysriski kahdesta syystä: liikunnan harrastaminen ei vähennä istumisaikaa, eikä liikunnan lisääminen vaikuta kaikkiin istumisen terveysriskien taustalla oleviin mekanismeihin. Istuessa lihasten passiivisuus suurentaa insuliiniresistenssiä ja vaikuttaa rasvahappojen kuljetukseen ja hapetukseen lihaskudoksessa, eikä akuutti liikunta riitä palauttamaan kaikkia muutoksia. Riittävä arkiaktiivisuus näyttääkin olevan tärkeää insuliiniherkkyyteen vaikuttavien signalointireittien yllä pitämisessä. Istumisen vähentämiseen tähtäävät interventiot ovat antaneet näyttöä jo pienenkin passiivisuuden vähentämisen terveyshyödyistä. peerReviewed

Liikunta-aktiivisuuden drop-off -ilmiö eli liikkumisen väheneminen iän myötä on edelleen kansallinen erityispiirteemme. Samalla lapset ja nuoret käyttävät noin puolet valveillaoloajastaan istuen tai makuulla. Paikallaanolo lisääntyy selvästi iän myötä. Päivittäistä ruutuaikaa kertyy paljon. Suositellun korkeintaan kaksi tuntia ruudun ääressä vietti vain viisi prosenttia 9–15-vuotiaista. nonPeerReviewed

A driving hypothesis of the evolving field of sedentary behavior is that frequent muscle activity short-circuits detrimental physiological effects of sedentary time. However, the field relies mostly on observational health associations of proxy measures of muscle inactivity, like television viewing or lack of accelerometer-derived impacts. This study tested effectiveness of a family-based cluster-randomized controlled trial aimed at reducing and breaking up sedentary time at work and leisure time of families on muscle inactivity patterns, sedentary time and cardio-metabolic biomarkers. The intervention consisted of a lecture, face-to-face tailored counseling, two follow-up calls and five emails during the first six months, and six months follow-up without the intervention. Detailed muscle inactivity and activity patterns of sitting, standing, normal daily life and the short-term efficacy of the counseling were quantified by special shorts capable of measuring average rectified EMG signal. The long-term effectiveness of the intervention was studied in 133 sedentary parents by measuring accelerometer-derived sedentary time, anthropometrics and blooddrawn cardio-metabolic biomarkers to report if short-term changes in muscle inactivity patterns translate to long-term behavioral and physiological benefits. The main findings of this study were that while muscles were inactive 90% of sitting time and the average muscle activity amplitude was threefold higher in standing (1.6% of EMGMVC) than sitting (0.5% of EMGMVC), the inter-individual differences were tenfold. However, within two weeks of the counseling muscle inactivity time decreased by 37 min in intervention group compared to controls without affecting high intensity activities suggesting that sedentary-time targeted intervention can change specifically muscle inactivity patterns. At three months the intervention was successful in reducing accelerometer-derived sedentary leisure time by 27 min in the intervention group as compared to controls. At 12 months the control group’s sedentary leisure time tended to increase whereas that of the intervention group remained at the baseline level suggesting that acutely effective intervention methods may prevent unfavorable long-term changes. Between baseline and endline, significant intervention effects in weight, total lean mass, leg’s lean mass, apoA-1 and apoB/apoA-1 -ratio favored intervention group and remained independent of moderate-to-vigorous -intensity physical activity and energy intake. In conclusion, the family-based tailored counseling was effective in reducing muscle inactivity and sedentary leisure time acutely, and in preventing an increase in sedentary leisure time during one year without reducing work or weekend sedentary time. This resulted also in some modest positive changes in anthropometrics and apolipoproteins independent of moderate-to-vigorous physical activity and energy intake. Reducing muscle inactivity produces causal health benefits and may bear public health potential.

Istumisen terveyshaitat ovat puhuttaneet viime vuosina yhä enemmän. Yksi istumisen stereotypia on toimistotyöntekijä, joka joutuu istumaan toimistotuolissaan pitkät päivät. Työt on tehtävä, eikä perinteiselle työpisteelle ole järkevää vaihtoehtoa. Vai onko sittenkin? Säädettävä istuma-seisomatyöpiste on kerännyt viime vuosina ihastusta osakseen, koska se mahdollistaa istumajaksojen katkaisun työtehon kärsimättä. Tässä artikkelissa annan sinulle taustaa siihen, miksi pienikin istumisen tauottaminen kannattaa ja mikä on uusin tieto istuma-seisoma-työpisteiden hyödyllisyydestä. Onko toimistotyöntekijällä sittenkin toivoa? nonPeerReviewed

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Petra Ihalainen. Kevät 2014. Lihasaktiivisuuden puute alaraajojen lihaksissa toimistotyöläisillä – dynaamisen työtuolin vaikutus. Liikuntabiologian laitos, Jyväskylän Yliopisto. Valmennus- ja testausopin Pro Gradu -tutkielma.57 s, 5 liitettä. Maailman terveysjärjestö WHO on nostanut fyysisen inaktiivisuuden lisääntymisen merkittäväksi terveysriskiksi maailmanlaajuisesti. Fyysisen inaktiivisuuden haittavaikutukset terveyteen ovat riippumattomia fyysisen aktiivisuuden terveyttä edistävistä vaikutuksista. Inaktiivisuusaika kertyy hereillä oloaikana muun muassa toistuvista istumisjaksoista. Toimistotyötä tekevillä päivittäinen istuen kulutettu aika voi olla huomattavan suuri. Lihasaktiivisuuden tuottamat paikalliset vasteet ovat avainasemassa fyysisen aktiivisuuden terveyshyötyjä tarkasteltaessa. Inaktiivisuusjakson keskeyttävien aktiivisuusjaksojen lukumäärällä on havaittu olevan terveysvaikutusten kannalta suurempi merkitys, kuin aktiivisuuden intensiteetillä. Tässä tutkimuksessa tutkittiin istumisen aikaista lihasaktiivisuutta jalkojen lihaksissa suomalaisilla toimistotyöläisillä (n=4) työpäivän aikana. Vertasimme kahta dynaamista työtuolia (HG ja HM tuolit) perinteiseen staattiseen toimistotuoliin (SC tuoli) koehenkilöiden istuessa kolmen viikon aikana 5 peräkkäistä työpäivää kullakin tuolilla satunnaisessa järjestyksessä. Lihasaktiivisuutta rekisteröitiin vaatteeseen integroiduilla tekstiilielektrodeilla nelipäisen reisilihaksen, hamstring-, kaksoiskanta- sekä etummaisen säärilihaksen päältä. Elektromyografia (EMG) data keskiarvoistettiin etu- ja takareiden lihaksista (QH) sekä säärten (LL) lihaksista. Tuoleihin kiinnitettiin kiihtyvyysmittarit (ACC) rekisteröimään istuimen liikkeitä istumisen aikana. Koehenkilöt istuivat keskimäärin 5.16 ± 1.04 h työpäivän aikana omalla työpisteellään. LL-lihakset olivat inaktiiviset 82 ± 1.63 % ja QH-lihakset 92 ± 0.66 % ajasta istumisen aikana. Dynaamisilla tuoleilla istuttaessa LL-lihaksissa rekisteröitiin lievästi korkeampi aktiivisuustaso staattiseen tuoliin verrattuna (+10 % ero), kun tarkasteltiin aktiivisuuden keskiarvoa tai aktiivisuusburstien lukumäärää. QH-lihaksissa tuloksissa ei havaittu systemaattisia eroavaisuuksia. Inaktiivisuusjaksot LL-lihaksissa olivat lyhyempiä dynaamisella tuolilla istuttaessa, mutta inaktiivisuusajassa ei havaittu suurta eroa tuolien välillä. Tulokset tukevat oletusta, että dynaamiset työtuolit saattavat lisätä aktiivisuutta alaraajojen lihaksissa staattiseen tuoliin verrattuna. Lisätutkimuksia tarvitaan, jossa kyetään osoittamaan, onko istumisen aikana rekisteröity lihasaktiivisuus intensiteetiltään riittävää terveyshyötyjen saavuttamiseksi. Petra Ihalainen, Fall 2014. Lack of muscle activity in leg muscles of office workers – effect of a dynamic office chair. Department of Biology of Physical Activity, University of Jyväskylä. M.Sc Thesis in the science of sport coaching and fitness testing. 57 pp, 5 appendicies. The World Health Organization has named physical inactivity as a world-wide health risk. Physical inactivity has shown to induce harmful health responses, independently from physical activity. A great deal of daily physical inactivity is accumulated from prolonged sitting periods. Furthermore, daily sitting may accumulate at work. Office work, in particular, has been identified highly passive due to the high rates of sitting during working hours. Recent findings indicate that local muscular activation is the key factor signaling the metabolic responses to activity behavior. When interrupting prolonged inactivity period, the number of activity breaks has shown to be more significant for health parameters, than the intensity of the activity. In the present study, we investigated local muscle activity in lower extremities during occupational sitting in Finnish office workers (n=4). We expected, that replacing a static office chair with a dynamic chair might induce enhanced muscle activity, and, thus, decrease the inactivity time in lower extremities during sitting. We compared two dynamic chairs (HG and HM) to a conventional static chair (SC) that were used by the office workers, each chair being used for one week in randomized order. Electromyographic (EMG) activity was recorded from quadriceps, hamstring, gastrocnemius and tibialis anterior muscles with textile electrodes embedded into clothing and averaged for quadriceps and hamstring muscles (QH) and lower leg muscles (LL). The average sitting time in the office was 5.16 h ± 1.04 h during the 12 days of measurements. The LL muscles were inactive for 82 ± 1.63 % and QH muscles for 90 ± 0.66 % of sitting time, LL muscles being proportionally more active during sitting than QH muscles. No marked difference between dynamic chairs and SC chair was observed in inactivity time. However, a positive trend was seen in LL muscle activity when dynamic chairs were compared to SC chair: greater than 10 % difference in average EMG, mean amplitude and burst rate was detected with dynamic chairs, when compared to SC chair. The results from the present study give slight support for the hypothesis that dynamic chairs would enhance muscle activity during sitting. Dynamic chairs might predispose leg muscles to more “active” sitting, yet further research is needed to determine if the intensity of the muscle activity induced by dynamic chairs is enough for significant health benefits.

Marko Karppi (2013). Akuutin pitkäaikaisen istumisen vaikutukset hermolihas-järjestelmän toimintaan lentopalloilijoilla. Liikuntabiologian laitos, Jyväskylän yliopisto, Biomekaniikan Pro-gradu – tutkielma, s 81. Tässä tutkimuksessa selvitetään matkustamisen yhteydessä tapahtuvaa istumisen vaikusta urheilusuoritukseen. Urheilijalle on tuttu käsite ”jalat jäi bussiin”. Tällä tarkoitetaan esim. ottelun alun vaikeuksia, jolloin jalat eivät toimi kunnolla ja saattavat olla esim. raskaan, kankean ja hitaan tuntuiset. Tämän tutkimuksen kirjallisuuskatsauksessa käydään läpi istumisen biomekaniikkaa ja pitkäaikaisesta akuutista istumisesta (matkustaminen) liikkumattomuudesta johtuvia asioita, jotka voivat vaikuttaa negatiivisesti urheilusuoritukseen. Myös optimaaliseen istuma-asentoon ja istuimeen kiinnitetään huomiota. Tutkimuksessa yritetään selvittää, kuinka n. 8 tunnin linja-autossa istuminen vaikuttaa pelaajien hermo-lihasjärjestelmän toimintaan ja suorituskykyyn lentopallo-ottelussa. Tämän tutkimuksen tarkoituksena oli tutkia linja-automatkustamisen vaikutusta sm-liiga tason mieslentopalloilijoiden hermo-lihasjärjestelmään ja suorituskykyyn staattisen (HIK = hyppy ilman kevennystä) ja esikevennetyn (HK = hyppy kevennyksellä) hypyn avulla. Tutkimuksessa käytettiin voimalevyjä hyppyjen testaamiseen. Lihasaktiivisuutta mitattiin soleus, tibial anterior, rectus femoris ja vastus lateral lihaksesta hyppyjen aikana. Synkronoidusta voimalevy- ja EMG signaalista määriteltiin voimatuotto, voimantuottonopeus, lihasaktiivisuus, hyppykorkeudet ja soleus lihaksesta venytysrefleksiä vastaavat komponentit ja esiaktiivisuus esikevennyshypyn aikana. Staattinen hyppy (HIK) heikkeni kotipelimittauksesta linja-automatkustamisen jälkeiseen vieraspelimittaukseen 11 mm (n. 2,5 %) ja sen konsentrinen voimantuotto oli laskenut 62N (9 %), mikä oli tilastollisesti merkittävä (p < 0.05). Esikevennyshyppy (HK) oli parantunut kotipelimittauksesta vieraspelimittaukseen 6 mm (n. 1 %, n.s.). Venytysrefleksi komponenteissa M1, M2 ja M3 ei havaittu tilastollisesti merkittäviä eroja koti- ja vieraspelimittausten välillä, vaikka venytysrefleksin esiaktiivisuus oli tilastollisesti merkittävästi suurempaa ( p < 0.05) 32 % vieraspelimittauksessa. Hypyssä ilman kevennystä (HIK) konsentrisen voimantuoton ja voimantuotonajan heikkenemiset saattavat liittyä istumisen aiheuttamasta lihasten ja kudosten väsymykseen ja puutumiseen, mikä johtuu heikentyneestä aineenvaihdunnasta, verenvirtauksesta ja kuormituksesta alaraajoissa. Myös iskemia saattaa aiheuttaa alaraajoissa hermoston heikentyneen toiminna, jolloin räjähtävän HIK hypyn suorittaminen hidastuisi ja voimataso laskisi, koska kyky motoristen yksiköiden rekrytointiin on heikentynyt. Toisaalta tämä ei näy HK hypyssä niin selkeästi, mikä johtuneen siitä, että HK hyppy on luonteeltaan erilainen, missä korostuu lonkan ojentajalihasten suurempi käyttö, elastisuus ominaisuudet ja venytysrefleksi. Yllättävää oli, että HK hyppy tulos oli hiukan parempi vieraspelimittauksessa kuin kotipelimittauksessa linja-automatkustamisen jälkeen. Näyttäisi siltä, että n.8 tunnin istumisen jälkeen linja-autossa, elastiset ominaisuudet eivät heikkene. HK hypyn venytysrefleksin mittaus olisi ollut parempi toteuttaa pudotushyppyinä, sillä HK hypyn esikevennys alkaa reiden liikkeestä, jolloin Soleus lihaksen venytysrefleksiaktiivisuuden alkamisajankohta pitenee (n. 400 ms) ja siihen saattaa sekoittua tahdonalaista lihasaktiivisuutta. Myös venytysrefleksi komponentit tulisivat selkeämmin esille törmäystyyppisissä hypyissä. Marko Karppi (2013). Acute prolonged sitting effects to neuromuscular system in volleyball players. The Department of Biology of Physical Activity, University of Jyväskylä, Biomechanics Pro Gradu thesis. 81 pages. Sitting effects of traveling to sport performance are studied in thesis. Among athletes it is quite well known phrase ”leave your feet in the buss”. That means problems at the beginning of performance after traveling e.g. athlete’s feet don’t work well. Athlete may feel feet e.g. as heavy, stiff-legged or slow. The literature review of this thesis include sitting biomechanics and acute prolonged sitting (traveling) and immobility effects that may affect sport performance negatively. Optimal sitting position and optimal seat have also been discussed in the part of literature view. The purpose of thesis is to study how 8 hours sitting in the buss affects to men volleyball players’ neuromuscular system and performance using counter movement jump (CMJ) and static jump (SJ) tests. Force plate was used for measuring jump performances. Electrical activity of soleus, tibial anterior, vastus lateral and rectus femoris muscle was measured during jump tests. Force plate signal was synchronized with EMG signal and force produced, force produced speed, electrical muscle activity, jump heights and corresponding components and pretension of stretch reflex of soleus muscle were measured in CMJ. Static jump (SJ) height decreased 11 mm (about 2,5 %) and concentric force produced decreased 62N (9 %), that was statistically significant (p < 0.05) after buss traveling from home game measurement to visit game measurement. Counter movement jump (CMJ) height increased 6 mm (about 1 %, n.s.) to visit game measurement. There were no statistically significant differences in stretch reflex components of M1, M2 and M3 between home game and visit game measurement although pretension of stretch reflex of soleus muscle was statistically significantly higher (p < 0.05) 32 % in visit game measurement. Decreased concentric force produced and decreased force produced speed in SJ may relate to fatigue and numbness of muscles and tissues caused by sitting that result from impaired metabolism, blood flow and loaded lower limbs. Ischemia may also affects negatively to function of nervous system of lower limb in which case the execution speed of SJ would slow down and force level would decrease because the ability to recruit motor units has weakened. In turn this doesn’t occur in CMJ that may result from fact that CMJ is different jump by nature where extensor muscles of hip are used more effectively, elastic properties and stretch reflex. It was surprise that the result of CMJ was little bit better in visit game measurement than in home game measurement after buss travel. It seems that elastic properties will not be weakened after sitting 8 hours in the buss. It would have been better to use drop jump for estimating stretch reflex of soleus because pretension of jump starts in this study from lowering thighs when starting time for stretch reflex activity extended for about 400 ms. In this case it may be possible that voluntary muscle activity will mix with stretch reflex. Also stretch reflex components would appear more clearly in drop jump where feet hit to floor more powerfully.

Pesola, Arto 2011. Inactivity is an independent health risk: objectively measured muscle activity and inactivity during normal daily life of ordinary people. Master’s thesis in exercise physiology. Department of Biology of Physical Activity, University of Jyväskylä. 96 pages. Today’s society promotes oversitting, and physical inactivity appears to be an independent health risk. The continuum from total inactivity to vigorous intensity training contains different physiological actions and objective measurements are needed to find out associations between physical activity, inactivity and health. The purpose of this study was to describe muscle activity and inactivity during normal daily life of ordinary people measured objectively with sophisticated EMG-shorts. Activity and inactivity patterns were compared between the age groups and associations between EMG results and metabolic health markers were studied. Eighty four healthy volunteers (20-30 yrs, n=27; 30-60 yrs, n=40; 60-76 yrs, n=17) were measured in the laboratory and during 1-6 days of their normal daily life with shorts measuring muscle activity (EMG). EMG was normalized to maximum voluntary contraction (EMGMVC) and inactivity threshold was defined as an EMG level below that required during standing. Moderate and vigorous activity thresholds were defined as EMG values corresponding to 3 and 6 METs measured by indirect calorimetry during incremental treadmill walking test. The EMG results were compared between the age groups by One-way ANOVA with Tukey post-hoc test. Complete blood count, anthropometrics and blood pressure were measured in the morning in fasting condition and compared with the EMG results in a cross-sectional manner by bivariate correlation analyses (Pearson correlation coefficient, r) and forced-entry regression models. Activity burst amplitude was 5.8±3.4% of EMGMVC and was higher in the elderly (60-76 yrs) compared to the younger (p