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Objective: To examine the daily course of, and factors associated with, momentary fatigue after subarachnoid haemorrhage, and to explore subgroups of patients with distinct diurnal patterns of fatigue., Design: Observational study using ecological momentary assessment., Subjects: A total of 41 participants with subarachnoid haemorrhage., Methods: Patients with fatigue were included within one year post-onset. Momentary fatigue (scale 1-7) was assessed with repeated measurements (10-11 times/day) during 7 consecutive days. Multilevel-mixed-model analyses and latent-class trajectory modelling were conducted., Results: Mean (standard deviation; SD) age of the group was 53.9 (13.0) years, 56% female, and mean (SD) time post-subarachnoid haemorrhage onset was 9.3 (3.2) months. Mean (SD) momentary fatigue over all days was 3.22 (1.47). Fatigue increased significantly (p < 0.001) over the day, and experiencing more burden of fatigue and day type (working day vs weekend day) were significantly (p < 0.05) associated with higher momentary fatigue. Three subgroups could be distinguished based on diurnal patterns of fatigue. The largest group (n = 17, 41.5%) showed an increasing daily pattern of fatigue., Conclusion: Momentary fatigue in patients with subarachnoid haemorrhage increases over the day, and diurnal patterns of fatigue differ between  participants. In addition to conventional measures, momentary measures of fatigue might provide valuable information for physicians to optimize personalized management of fatigue after subarachnoid haemorrhage.

Background: Fatigue is one of the most commonly reported symptoms after subarachnoid hemorrhage (SAH) and is indirectly associated with physical activity (PA). Associations between fatigue and PA are primarily examined based on conventional measures (i.e. a single fatigue score or average PA levels), thereby assuming that fatigue and PA do not fluctuate over time. However, levels of fatigue and PA may not be stable and may interrelate dynamically in daily life. Insight in direct relationships between fatigue and PA in daily life, could add to the development of personalized rehabilitation strategies. Therefore we aimed to examine bidirectional relationships between momentary fatigue and PA in people with SAH., Methods: People (n = 38) with SAH who suffer from chronic fatigue were included in an observational study using Ecological Momentary Assessment (EMA) and accelerometry. Momentary fatigue was assessed on a scale from 1 to 7 (no to extreme fatigue), assessed with 10-11 prompts per day for 7 consecutive days using EMA with a mobile phone. PA was continuously measured during this 7-day period with a thigh-worn Activ8 accelerometer and expressed as total minutes of standing, walking, running and cycling in a period of 45 min before and after a momentary fatigue prompt. Multilevel mixed model analyses including random effects were conducted., Results: Mean age was 53.2 years (SD = 13.4), 58% female, and mean time post SAH onset was 9.5 months (SD = 2.1). Multilevel analyses with only time effects to predict fatigue and PA revealed that fatigue significantly (p < 0.001) increased over the day and PA significantly (p < 0.001) decreased. In addition, more PA was significantly associated with higher subsequent fatigue (β = 0.004, p < 0.05) and higher fatigue was significantly associated with less subsequent PA (β=-0.736, p < 0.05). Moreover, these associations significantly differed between participants (p < 0.001)., Conclusions: By combining EMA measures of fatigue with accelerometer-based PA we found that fatigue and PA are bidirectionally associated. In addition, these associations differ among participants. Given these different bidirectional associations, rehabilitation aimed at reducing fatigue should comprise personalized strategies to improve both fatigue and PA simultaneously, for example by combining exercise therapy with cognitive behavioral and/or energy management therapy., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Sedentary behavior has received much attention in the scientific community over the past decade. There is growing evidence that sedentary behavior is negatively associated with physical and mental health. However, an in-depth understanding of the social and environmental context of sedentary behavior is missing. Information about sedentary behavior, such as how everyday sedentary behavior occurs throughout the day (eg, number and length of sedentary bouts), where, when, and with whom it takes place, and what people are doing while being sedentary, is useful to inform the development of interventions aimed at reducing sedentary time. However, examining everyday sedentary behavior requires specific methods., Objective: The purpose of this paper is (1) to introduce sedentary behavior-triggered Ecological Momentary Assessment (EMA) as a methodological advancement in the field of sedentary behavior research and (2) to examine the accuracy of sedentary behavior-triggered EMA in 3 different studies in healthy adults. Moreover, we compare the accuracy of sedentary behavior-triggered EMA to simulations of random-trigger designs., Methods: Sedentary behavior-triggered EMA comprises a continuous assessment of sedentary behavior via accelerometers and repeated contextual assessments via electronic diaries (ie, an application on a smartphone). More specifically, the accelerometer analyzes and transfers data regarding body position (a sitting or lying position, or an upright position) via Bluetooth Low Energy (BLE) to a smartphone in real time and triggers the deployment of questionnaires. Each time a participant spends a specified time (eg, 20 minutes) in a sedentary position, the e-diary triggers contextual assessments. To test the accuracy of this method, we calculated a percentage score for all triggered prompts in relation to the total number of bouts that could trigger a prompt., Results: Based on the accelerometer recordings, 29.3% (5062/17278) of all sedentary bouts were classified as moderate-to-long (20-40 minutes) and long bouts (≥ 41 minutes). On average, the accuracy by participant was 82.77% (3339/4034; SD 21.01%, range 71.00-88.22%) on the study level. Compared to simulations of random prompts (every 120 minutes), the number of triggered prompts was up to 47.9% (n=704) higher through the sedentary behavior-triggered EMA approach. Nearly 40% (799/2001) of all prolonged sedentary bouts (≥ 20 minutes) occurred during work, and in 57% (1140/2001) of all bouts, the participants were not alone., Conclusions: Sedentary behavior-triggered EMA is an accurate method for collecting contextual information on sedentary behavior in daily life. Given the growing interest in sedentary behavior research, this sophisticated approach offers a real advancement as it can be used to collect social and environmental contextual information or to unravel dynamic associations. Furthermore, it can be modified to develop sedentary behavior-triggered mHealth interventions., (©Marco Giurgiu, Christina Niermann, Ulrich Ebner-Priemer, Martina Kanning. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 15.09.2020.)

Physical activity is beneficial for human physical health and well‐being. Accordingly, the association between physical activity and mood in everyday life has been a subject of several Ambulatory Assessment studies. This mechanism has been studied in children, adults, and the elderly, but neglected in adolescents. It is critical to examine this mechanism in adolescents because adolescence plays a key role in human development and adolescents' physical activity behavior translates into their behavior in adulthood. We investigated adolescents' mood in relation to distinct physical activities: incidental activity such as climbing stairs; exercise activity, such as skating; and sports, such as playing soccer. We equipped 134 adolescents aged 12‐17 years with accelerometers and GPS‐triggered electronic diaries to use in their everyday life. Adolescents reported on mood repeatedly in real time across 7 days, and these data were analyzed using multilevel‐modeling. After incidental activity, adolescents felt better and more energized. After exercise, adolescents felt better but less calm. After sports, adolescents felt less energized. Analyses of the time course of the effects confirmed our findings. Physical activity influences mood in adolescents' everyday life, but has distinct effects depending on the kind of physical activity. Our results suggest incidental and exercise activities entail higher post‐bout valence compared to sports in competitive settings. These findings may serve as an important empirical basis for the targeted application of distinct physical activities to foster well‐being in adolescence. [ABSTRACT FROM AUTHOR]

Humans in the industrialized world spend a large amount of daily time in sedentary behavior. Since sedentariness negatively impacts a variety of psychophysiological outcomes, the identification of antecedents that lead to sedentary behavior is an important public health issue. In this context, mood, a central indicator for both psychological well‐being and mental health, is severely understudied. To investigate whether mood dimensions influence subsequent sedentary behavior, we assessed both constructs at baseline via questionnaires and via ambulatory assessment (AA) over 5 days in 92 university employees. We continuously measured sedentary behavior using accelerometers and assessed mood repeatedly 10 times each day on smartphone diaries. We employed multiple regression analyses to analyze between‐subject effects and multilevel modeling to analyze within‐subject effects. Higher momentary ratings of valence (P <.05) and energetic arousal (P <.01) predicted lower amounts of subsequent sedentary behavior, whereas higher ratings of calmness (P <.01) predicted higher amounts of subsequent sedentary behavior. The context moderated the effect of energetic arousal and calmness on sedentary behavior with increased effects in the home compared to the work context. Mood significantly predicted sedentary behavior on a within‐subject level but not on a between‐subject level. Preliminary evidence suggests that mood regulates sedentary behavior in everyday life. Time‐sensitive analyses, such as from moment to moment revealed an association between mood and sedentary behavior (within‐subject), whereas analyses between different individuals revealed no associations (between‐subject). These preliminary findings may inform multicomponent intervention strategies that target mood, to reduce sedentary behavior in daily life. [ABSTRACT FROM AUTHOR]

Introduction: Experimental evidence shows that breaking-up sedentary behavior is positively associated with positive mental health outcomes. However, whether sedentary breaks influence mood in everyday life is largely unknown. Moreover, it is unclear which break patterns are most beneficial to enhance mood. Methods: To investigate the degree to which sedentary break patterns influence mood dimensions in everyday life, we conducted an Ecological Momentary Assessment study in 92 university employees over 5 d. We continuously measured physical behavior (physical activity and sedentary behavior) objectively via accelerometers and assessed mood 10 times a day on smartphone diaries. We defined distinct break patterns, such as variations in frequency (number of breaks), duration (length of breaks), intensity (metabolic equivalent), and context (home or work) and used multilevel modeling to analyze the within-subject effects of sedentary break patterns on mood. Results: Break intensity was positively associated with subsequent valence (P < 0.01), energetic arousal (P < 0.01), and calmness (P < 0.05). Break frequency was positively associated with subsequent valence and energetic arousal (all P 's < 0.01), but break duration was not associated with mood. Exploratory analyses indicated that breaking-up sedentary behavior was more beneficial at home than at work. Conclusions: These ecologically valid findings suggest breaking-up sedentary behavior as a promising strategy to enhance mood in everyday life. In particular, breaking-up sedentary behavior frequently and intensively, for example, by walking instead of standing, may be most beneficial. We call for future studies to substantiate these accounts and to identify both practical and optimal break patterns among different samples. This evidence informs official public health recommendations aiming to "minimize sedentary time in everyday life." [ABSTRACT FROM AUTHOR]

Empirical evidence shows that physical behavior positively impacts human health. Recently, researchers have started to differentiate between physical activity and sedentary behavior showing independent effects on somatic health. However, whether this differentiation is also relevant for mood dimensions is largely unknown. For investigating the dynamic relationships between sedentary behavior and mood dimensions in daily life, ambulatory assessment (AA) has become the state‐of‐the‐art methodology. To investigate whether sedentary behaviors influence mood dimensions, we conducted an AA study in the everyday life of 92 university employees over 5 days. We continuously measured sedentary behavior via accelerometers and assessed mood repeatedly 10 times each day on smartphone diaries. To optimize our sampling strategy, we used a sophisticated sedentary‐triggered algorithm. We employed multilevel modeling to analyze the within‐subject effects of sedentary behavior on mood. Sedentary time (15‐minute intervals prior to each e‐diary assessment) and sedentary bouts (30‐minute intervals of uninterrupted sedentary behavior) negatively influenced valence and energetic arousal (all Ps < 0.015). In particular, the more participants were sedentary in their everyday life, the less they felt well and energized. Exploratory analyses of the temporal course of these effects supported our findings. Sedentary behavior can be seen as a general risk factor because it impacts both somatic and mental health. Most importantly, physical activity and sedentary behavior showed independent effects on mood dimensions. Accordingly, future studies should consider the two sides of the physical behavior coin: How should physical activity be promoted? and How can sedentary behavior be reduced? [ABSTRACT FROM AUTHOR]

Physical activity is known to preserve both physical and mental health. However, the physical activity levels of a large proportion of adolescents are insufficient. This is critical, since physical activity levels in youth have been shown to translate into adulthood. Whereas in adult populations, mood has been supposed to be one important psychological factor that drives physical activity in everyday life, this issue has been poorly studied in adolescent populations. Ambulatory Assessment is the state-of-the-art approach to investigate how mood and non-exercise activity fluctuate within persons in everyday life. Through assessments in real time and real life, this method provides ecological validity, bypassing several limitations of traditional assessment methods (e.g., recall biases). To investigate whether mood is associated with non-exercise activity in adolescents, we equipped a community-based sample comprising 113 participants, aged 12-17 years, with GPS-triggered e-diaries querying for valence, energetic arousal, and calmness, and with accelerometers continuously measuring physical activity in their everyday lives for 1 week. We excluded all acceleration data due to participants' exercise activities and thereafter we parameterized non-exercise activity as the mean value across 10-min intervals of movement acceleration intensity following each e-diary prompt. We used multilevel analyses to compute the effects of the mood dimensions on non-exercise activity within 10-min intervals directly following each e-diary prompt. Additionally, we conducted explorative analyses of the time course of the effects, i.e., on different timeframes of non-exercise activity up to 300 min following the mood assessment. The results showed that valence (p < 0.001) and energetic arousal (p < 0.001) were positively associated with non-exercise activity within the 10 min interval, whereas calmness (p < 0.001) was negatively associated with non-exercise activity. Specifically, adolescents who felt more content, full of energy, or less calm were more physically active in subsequent timeframes. Overall, our results demonstrate significant associations of mood with non-exercise activity in younger ages and converge with the previously observed association between mood and physical activity in adults. This knowledge on distinct associations of mood-dimensions with non-exercise activity may help to foster physical activity levels in adolescents. [ABSTRACT FROM AUTHOR]

Empirical evidence points to sedentary behavior as a ubiquitous health-related risk factor. Given the increasing number of mental disorders, a growing body of studies now focuses on the relationship between sedentary behavior and mental health. However, momentary interactions between sedentary bouts, mood, and type of cognitive load in daily life are highly understudied. To investigate whether sedentary bouts influence mood, we conducted an Ambulatory Assessment study in the everyday life of 103 university students over 5 days. We continuously measured sedentary behavior via accelerometers and assessed mood and type of cognitive load up to six times each day on smartphone diaries. We employed multilevel modeling to analyze the within-person effects of sedentary behavior, and cognitive load on mood. Sedentary bouts (20-min intervals prior to each e-diary assessment) negatively influenced energetic arousal (p < 0.001) and valence (p = 0.023). Cognitive load (mentally active vs. mentally passive) influenced negatively energetic arousal (p < 0.001) and positively calmness (p = 0.031). Exploratory interaction analyses revealed significant differences between cognitive load and bouts of SB (interrupted vs. uninterrupted). The negative association between sedentary behavior and two of three mood dimensions (i.e., valence and energetic arousal) suggests sedentary behavior is an important risk factor for mental health among healthy young adults. Additionally, the cognitive load, specifically the distinction between mentally active and mentally passive activities, is an important factor in shaping momentary mood. We strongly recommend reducing prolonged SB and recognizing the potential benefits of engaging in mentally active activities. • Bouts of sedentary behavior had a negative impact on pleasantness of mood and energetic arousal. • Cognitive load was associated with energetic arousal and calmness. • Interaction between cognitive load and sedentary bouts varied on mood outcomes. [ABSTRACT FROM AUTHOR]

Technological and digital progress benefits physical activity (PA) research. Here we compiled expert knowledge on how Ambulatory Assessment (AA) is utilized to advance PA research, i.e., we present results of the 2nd International CAPA Workshop 2019 "Physical Activity Assessment – State of the Science, Best Practices, Future Directions" where invited researchers with experience in PA assessment, evaluation, technology and application participated. First, we provide readers with the state of the AA science, then we give best practice recommendations on how to measure PA via AA and shed light on methodological frontiers, and we furthermore discuss future directions. AA encompasses a class of methods that allows the study of PA and its behavioral, biological and physiological correlates as they unfold in everyday life. AA includes monitoring of movement (e.g., via accelerometry), physiological function (e.g., via mobile electrocardiogram), contextual information (e.g., via geolocation-tracking), and ecological momentary assessment (EMA; e.g., electronic diaries) to capture self-reported information. The strengths of AA are data assessments near real-time, which minimize retrospective biases in real-world settings, consequentially enabling ecological valid findings. Importantly, AA enables multiple assessments across time within subjects resulting in intensive longitudinal data (ILD), which allows unraveling within-person determinants of PA in everyday life. In this paper, we show how AA methods such as triggered e-diaries and geolocation-tracking can be used to measure PA and its correlates, and furthermore how these findings may translate into real-life interventions. In sum, AA provides numerous possibilities for PA research, especially the opportunity to tackle within-subject antecedents, concomitants, and consequences of PA as they unfold in everyday life. In-depth insights on determinants of PA could help us design and deliver impactful interventions in real-world contexts, thus enabling us to solve critical health issues in the 21st century such as insufficient PA and high levels of sedentary behavior. • Study physical activity's correlates (e.g., behavioral, biological) in REAL-LIFE. • assess data near REAL-TIME, WITHIN-PERSONS across multiple assessments. • Minimize retrospective biases for ECOLOGICAL VALID FINDINGS. • Unravel within-subject ANTECEDENTS, CONCOMITANTS, and CONSEQUENCES of PA. • Design and deliver impactful INTERVENTIONS in REAL-WORLD contexts. [ABSTRACT FROM AUTHOR]