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الملخص: أهداف البحث: يمكن زيادة النشاط البدني للأطفال من خلال دمج الأنشطة القائمة على الألعاب مثل الألعاب التقليدية خلال جلسات التربية البدنية. ولكن، مستوى النشاط البدني لهذه الألعاب لم يتم تحديد كميته. وتهدف هذه الدراسة إلى تحديد كمية مستوى القوة للألعاب الماليزية التقليدية الشائعة (بمعنى آخر، غالاه بانجانج، بولا بيراكون، بوليس سينتري، بلالانج بيلاتوك، ايام مسانغ وبالات تن) بين أطفال المدارس الابتدائية الذين أعمارهم ٩-١١ عاما (العدد=٣٠). طرق البحث: استخدمنا مقياس التسارع لقياس عدد الخطوات، ومهمة التمثيل الغذائي المكافئ، ومستوى القوة، وحجم النواقل خلال ٢٠ دقيقة من جلسات اللعب. كما تم توحيد مساحة اللعب لكل لعبة إلى حجم ملعب تنس الريشة (بمعنى آخر ١٣.٤ مترا في الطول و٦.١ في العرض). النتائج: أظهرت النتائج أن الألعاب التقليدية الماليزية الثلاثة، المسماة غالاه بانجانج، وبولا بيراكون، وبالات تن، استوفت متطلبات التصنيف كقوة النشاط البدني المعتدل إلى القوي من حيث عدد الخطوات، ومهمة التمثيل الغذائي المكافئ، ومعدل ضربات القلب والحركة في جميع المستويات. الاستنتاجات: أظهرت هذه الدراسة أن ممارسة الألعاب التقليدية لمدة ٢٠ دقيقة ممكن أن تزيد النشاط البدني بين طلاب المدارس الابتدائية. Abstract: Objective: Children's physical activity can be increased by integrating game-based activities, such as traditional games, into physical education sessions. However, the level of physical activity of these games has not been quantified. This study aims to quantify the level of intensity for common Malaysian traditional games (i.e. Galah Panjang, Bola Beracun, Polis Sentri, Belalang Belatuk, Ayam Musang, and Baling Tin) among primary school children aged nine to 11 years (N = 30). Methods: We used an accelerometer to measure step count, metabolic equivalent task, level of intensity and vector magnitude during 20 min playing sessions. The playing space was standardised for each game to the size of a badminton court (i.e. 13.4 m in length and 6.1 m in width). Results: The results showed that three traditional Malaysian games, namely Galah Panjang, Bola Beracun and Baling Tin, fulfilled the requirements to be classified as moderate-to vigorous-intensity physical activity in terms of step count, metabolic equivalent task, heart rate and motions in all planes. Conclusion: This study shows that playing traditional games for 20 min can increase physical activity among primary school students.

The purpose of this study was to investigate the relationship between meeting step count recommendations during the weekday and weekend and the weight status in school-aged children. A convenience sample of 855 fourth and fifth grade students (9.7 ± 1.0 years) was recruited from 4 elementary schools located in the Western United States. Body Mass Index (BMI) was calculated using standard procedures and then stratified to weight status categories (healthy weight, overweight/obese) using age- and sex-specific percentiles. Step counts were monitored for seven consecutive days using NL-1000 piezoelectric pedometers. A multilevel generalized linear mixed effect model was used to estimate the odds ratios of meeting segmented step counts recommendations and weight status. Students meeting weekday step count recommendations associated with 39% lower odds of overweight/obesity compared to those not meeting any recommendations (P = 0.02). Those meeting both weekday and weekend recommendations associated with 67% lower odds of overweight/obesity compared to children not meeting any recommendations (P = 0.01). Meeting weekend step count recommendations did not associate with weight status. This study supports the positive relationship between segmented step counts and the healthy weight status of school-aged children.

In this report, a unified biomimetic approach to all known macrocyclic lankacidins is presented. By taking advantage of the thermolysis of N,O-acetal to generate the requisite N-acyl-1-azahexatriene species, we eventually realized the biomimetic Mannich macrocyclization, from which all of the macrocyclic lankacidins can be conquered by orchestrated desilylation. The reassignments of the reported structures of isolankacidinol (7 to 10) and the discovery of a recently isolated "lankacyclinol" found to be in fact 2,18-bis-epi-lankacyclinol (72) unraveled the previously underappreciated chemical diversity exhibited by the enzymatic macrocyclization. In addition, the facile elimination/decarboxylation/protonation process for the depletion of C1 under basic conditions resembling a physiological environment may implicate more undiscovered natural products with variable C2/C18 stereochemistries (i.e., 62, 73, and 75). The notable aspect provided by a biomimetic strategy is significantly reducing the step count compared with the two previous entries to macrocyclic lankacidins.

Objective: The aim of this study was to investigate the relationship between leg strength, aerobic endurance and daily step count and the differences between the age groups among the retired and community-dwelling older adults. Material and Methods: Thirty healthy older adults (aged ≥65, range 65-83 yrs) were included in the study. Step counts were measured with a pedometer for seven days. Leg strength was measured with the 30 s chair stand test, aerobic endurance was determined with the six-minute walk test. Results: There were no significant relationships between daily step counts and leg strength (r=0.155, p=0.212) or aerobic endurance (r=0.129, p=0.252), (p>0.05), and neither between age and aerobic endurance (r=0.104, p=0.296), leg strength (r=-0.137, p=0.240), and daily step counts (r=-0.271, p=0.078). Between age groups, there were no significant differences in leg strength, aerobic endurance, daily step count, height and body weight, and body mass index (p>0.05). A significant relationship existed between daily step count and BMI (r=-0.340, p=0.036). Conclusion: The older adults in this study had good leg strength, poor aerobic endurance. Daily step counts were not sufficient in older adults. Leg strength and aerobic endurance were not determining factors for low daily step counts. Checking themselves with a pedometer can help seniors improve their daily activity levels.

Background: The aim of this study was to explore the relationship between ambulatory distance with steps/day and increased step length as children age. Methods: This is a prospective cohort study. Forty-five children from the QUALITY cohort were assessed at childhood (baseline) and seven years later during adolescence (follow-up). Daily step count was evaluated by accelerometry, step length by a standardized test, and daily ambulatory distance was calculated based on step count and length. Results: Children grew by an average of 0.33 m from childhood to adolescence (p

Pyrrolotriazine 1 is an important precursor to remdesivir. Initial results toward an efficient synthesis are disclosed consisting of sequential cyanation, amination, and triazine formation beginning from pyrrole. This route makes use of highly abundant, commoditized raw material inputs. The yield of triazine was doubled from 31% to 59%, and the synthetic step count was reduced from 4 to 2. These efforts help to secure the remdesivir supply chain.

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

Diminished balance confidence increases the risk of a fall and falls that occur when turning during walking are associated with an eightfold increase in hip fractures compared to when walking in a straight trajectory. Although an effect of aging on turning is revealed, the role of gender during turning is not yet clear.How can balance confidence impact turning behavior in younger, middle-aged, and older men and women?This cross-sectional study included 22 young adults (11 women), 13 middle-aged adults (9 women), and 13 older adults (6 women). Participants ranked their balance confidence using the activities-specific balance confidence (ABC) scale and completed two different turns: Turn1 (around the cone) and Turn2 (turn to sit). Measures obtained for each turn included: turning time, step count, and peak trunk velocities (PTV) in pitch, yaw, and roll.In Turn1, older adults exhibited an increase in turning time and step count relative to younger adults (both p 0.03). In Turn2, older adults showed an increase in turning time and roll PTV compared to the middle-aged group (both p 0.02). Lower scores in ABC were significantly correlated with an increase in Turn1 time (p 0.001) and step count (p = 0.04) in middle-aged and older adults, respectively. Bivariate correlations revealed that women with lower scores on the ABC took more time to complete both turns (both p = 0.01).Older adults demonstrated longer turning time, more steps, and higher roll PTV while turning that were associated with decreased balance confidence scores. The association between decreased balance confidence and turning kinematics implies a relationship between turning and increased fall risk. These results suggest that testing for fall risk requires tests of activities that are performed outside traditional clinical settings and gait laboratories.

Objectives Does adapted cardiac rehabilitation (CR) improve the physical behaviours of people with mild-to-moderate stroke in the sub-acute recovery phase using a compositional data analysis (CoDA) approach? Design Before-after. Setting University Hospitals of Leicester, Glenfield Hospital, UK. Participants 24 individuals completed CR and provided valid physical activity (PA) data (mean (SD) 63.1 (14.6) years, 58% male (14/24)). Intervention 6-week adapted CR program within 6-months of stroke. Main outcome measures Physical behaviours were assessed using waist-worn accelerometry. Step count, stationary time (ST), light PA (LPA), and moderate-to-vigorous PA (MVPA) were compared pre post CR using conventional analyses and CoDA. Analysed compositions were: Waking day (ST, LPA, MVPA); ST (1–9-minutes, 10–29-minutes, ≥30-minutes bouts); and MVPA (1–4-minutes, 5–9-minutes, ≥10-minutes bouts). Results Following CR, patients took significantly more steps (mean (SD) 3255 (2864) vs 3908 (3399) steps/day, P = 0.004) and engaged in more bouts of MVPA lasting ≥5 and ≥10-minutes (≥5-minutes: mean (SD) 0.7 (1.4) vs 1.2 (1.8) bouts/day, P = 0.008). Using CoDA, no changes in waking day or ST compositions occurred. For waking day, 42% (10/24) increased their LPA and MVPA at the expense of ST. For ST, 33% (8/24) increased their short bouts at the expense of medium and long bouts. For MVPA, 13% (3/24) increased their medium and long bouts at the expense of short bouts. Conclusion People with stroke in the sub-acute stage of recovery exhibited low levels of PA. CR appears to be an effective intervention to increase step count but did not alter the overall proportion of time individuals spent being sedentary, or engaging in LPA or in MVPA. Registration ISRCTN65957980.

This study examined whether the number of steps taken by frail older adults increased after two types of interventions (custom-made daily routine [CDR] vs. exercise) were conducted over 12 weeks. The participants were 36 frail older adults aged 84.5 ± 6.0 years who attended a day-care center. They were assigned to one of three groups: CDR (n = 13), home-based exercise (HE,n = 10), or control (CON,n = 13). A wrist-worn accelerometer was used to measure their step count in 24 hr for 6 days. The CDR group demonstrated a daily step count change of approximately 25%, which was significantly higher than that of the CON group (effect size [r] = .51,p = .040). There were no significant changes in the HE group. Thus, a CDR might be useful for increasing the number of steps in frail older adults.

Purpose: The study aimed to analyze the average daily step counts of 12- and 13-year-old children in all-day or double-shift schools for defined periods. Materials and Methods: Sixty students (30 all-day, 30 double-shift) participated in the study; their mean age was 12.5±0.5 years. Children were asked to wear FitbitFlex 2 accelerometer on their dominant wrist. Data were collected from children for a minimum of eight hours for seven days (minimum of four weekdays and a weekend day). Findings: It was observed that the daily average step count of boys was higher than girls for after school, outside school, the weekend, and the entire week (p

Background/Objectives: We hypothesized that physical activity (PA) improves insulin sensitivity in adolescents with severe obesity beyond that attributable to metabolic bariatric surgery (MBS). Subjects/Methods: StepWatch™ monitors objectively measured PA in 88 participants in the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study. Primary outcomes included absolute change in fasting insulin, HOMA-IR, and fasting glucose from pre-surgery (baseline) to 6, 12, 24, and 36 months post-MBS. SAS PROC TRAJ generated activity trajectories based on probability and individual participant step count trajectories. Linear regression models were used, adjusted for baseline value, visit, surgical procedure, sex, and percent change in BMI. Additional models adjusted for percent change in iliac waist circumference (IWC) or percent body fat (BF), measured by bio-impedance. Results: Two activity trajectories were identified: more active (MA, n=13) and less active (LA, n=75). MA baseline mean daily step count was >6 000, increasing to > 9 000 at 2 years. LA mean daily step count remained at approximately 4 000. Few participants recorded moderate step activity (cadence >80 steps/minute). Still, fasting insulin and HOMA-IR differed in association with activity trajectory. MA was associated with a greater absolute decrease in fasting insulin (−7.8μU/ml [95% CI: (−11.8, −3.7)], p =

BackgroundType 1 diabetes (T1D) has been increasing globally over the past three decades. Self-monitoring of blood glucose is a challenge in both developed as well as developing countries. Self-management guidelines include maintaining logbooks for blood glucose, physical activity, and dietary intake that affect glycated hemoglobin (HbA1c) and a multitude of life-threatening acute complications. Innovative, cost-effective interventions along with beneficial lifestyle modifications can improve home-based self-monitoring of blood glucose in T1D patients. The overall objective of this study is to evaluate the relationship between maintaining log books for blood glucose levels, reinforcement by e-messages, and/or daily step count and changes in HbA1c.Methods/designA randomized controlled trial will enroll participants aged 15 years and above in four groups. Each group of 30 participants will be working with a newly designed standard log book for documenting their blood glucose. The first group will be entirely on routine clinical care, the second group will be on routine care and will receive an additional e-device for recording step count (fit bit), the third group will receive routine care and daily motivational e-messages to maintain the log book, and the fourth group along with routine care will receive an e-device for measuring step count (fit bit) and e-messages about maintaining the log book. Patients will be enrolled from pediatric and endocrine clinics of a tertiary care hospital in Karachi. All groups will be followed up for a period of 6 months to evaluate outcomes. Log book data will be obtained every 3 months electronically or during a patient’s clinic visit. HbA1c as a main outcome will be measured at baseline and will be evaluated twice every 3 months. A baseline questionnaire will determine the socio-demographic, nutritional, and physical activity profile of patients. Clinical information for T1D and other co-morbidities for age of onset, duration, complications, hospitalizations, habits for managing T1D, and other lifestyle characteristics will be ascertained. Behavioral modifications for maintaining daily log books as a routine, following e-messages alone, fit bit alone, or e-messages plus using fit bit will be assessed for changes in HbA1c using a generalized estimated equation.DiscussionThe proposed interventions will help identify whether maintaining log books for blood glucose, motivational e-messages, and/or daily step count will reduce HbA1c levels.Trial registrationClinicalTrials.gov,NCT03864991. March 6, 2019.

Background Top tier commercial physical activity apps rarely undergo peer-reviewed evaluation. Even fewer are assessed beyond six months, the theoretical threshold for behaviour maintenance. The purpose of this study was to examine whether a multi-component commercial app rewarding users with digital incentives for walking was associated with an increase in physical activity over one year. Methods This 12-month quasi-experimental study was conducted in two Canadian provinces (n = 39,113 participants). Following a two-week baseline period, participants earned digital incentives ($0.04 CAD/day) every day they reached a personalized daily step goal. Mixed-effects models estimated changes in weekly mean daily step count between the baseline period and the last two recorded weeks. Models were fit for several engagement groups and separately by baseline physical activity status within engagement groups. Results Nearly half of participants (43%) were categorized as physically inactive at baseline (fewer than 5000 daily steps), and 60% engaged with the app for at least six months [‘Regular’ (24–51 weeks of step data) or ‘Committed’ sub-groups (52 weeks)]. Weekly mean daily step count increased for physically inactive users regardless of engagement status (P P Conclusions A commercial app providing small but immediate digital incentives for individualized goals was associated with an increased weekly mean daily step count on a population-scale over one year. This effect was more evident for physically inactive and more engaged participants.

Aim: This research is aimed at the possibilities of physical training of Army of the Czech Republic personnel (soldiers of the 7th mechanised brigade) during a routine week spent in garrison and the follow-up analysis of the amount of their physical activity.Methodology: The observed group was made up of 52 professional soldier volunteers in the age range of 29.9 ± 4.5 years. The measurement has been performed continuously during the time span of one week. Physical activity has been measured with the utilization of the ActiGraph GT1M accelerometers supplemented with the use of a weekly physical activity protocol.Results: Based on the results it is possible to infer that the average daily physical activity (7.66 hours) has been greater than the average daily physical inactivity (5.89 hours). No difference in the amount of weekly physical activity of professional soldiers in relation to age (≤ 30 years and  30 years) has been found, nor in relation to being a smoker/non-smoker, nor in relation to BMI ( 24.9 kg/m2 and ≥ 24.9 kg/m2).Conclusion: With an average daily step count of 10169.84 the amount of physical activity of the soldiers is sufficient and meets the health recommendation for the daily step count (Aoyagi & Shephard, 2009).

Purpose: We examined and compared the daily step counts and health-related quality of life of patients before undergoing either bilateral or unilateral (with or without arthritis in the opposite joint) total hip arthroplasty (THA), and for 6 months afterwards. Participants and Methods: Participants were patients who were living at home and were requested to wear accelerometers and log their daily step count preoperatively and again 6 months postoperatively. Additionally, they completed the Oxford Hip Score and EuroQol 5-Dimension questionnaires at both time points. Results: Data from 40 patients were analyzed. Patients underwent bilateral total hip arthroplasty (n=13), unilateral total hip arthroplasty with arthritis in the opposite joint (n=13), and unilateral total hip arthroplasty without arthritis in the opposite joint (n=14). The Oxford Hip Score and EuroQol 5-Dimension score showed that the daily step counts of patients who underwent bilateral or unilateral total hip arthroplasty without arthritis in the opposite joint significantly increased postoperatively, but that of patients who received unilateral THA with arthritis in the opposite joint did not change significantly. The Oxford Hip Score indicated an improvement in hip joint function after surgery, but the EuroQol 5-Dimension score did not show a significant change postoperatively in patients who received bilateral total hip arthroplasty. Conclusion: The pre- and postoperative comparisons of the participant’s daily step count after bilateral and unilateral operations without arthritis on the other side showed improvements in their amount of daily life activities. In all surgeries, Oxford Hip Score improvements were confirmed. The EuroQol 5-Dimension score of bilateral operations did not change. Bilateral operations and an understanding of unilateral postoperative qualitative support will be necessary in the future.

Background/Objective: This study aimed to explore differences in rates of achieving the weekly physical activity (PA) recommendation between adolescents who preferred fitness PA and those who did not. Furthermore, we investigated the types of PA practiced by adolescents. Methods: In total, 9513 participants from the Czech Republic and Poland, aged 15–18 years took part in the study between 2009 and 2016. Out of this source sample, 4977 self-reported their weekly PA using the IPAQ-Long Form, and 1348 objectively monitored their weekly PA using pedometers and recorded the type of PA. Results: Boys ranked fitness PA third, after team and individual sports. For girls, the preference for fitness PA grew at the expense of dance and outdoor PA. Among Czech and Polish boys as well as Czech girls, those who preferred fitness PA were more likely to achieve the recommended weekly PA level than those who did not prefer fitness PA. We did not find a significant difference in other types of PA and rates of achieving the recommendation of 11,000 steps/day. Preference for fitness PA was associated with an increased likelihood (OR = 1.30; 95% CI = 1.12–1.52; p

Objective Tools to measure physical activity, such as pedometers, have become more prevalent and attracted popular interest in recent years. Despite this trend, research has not yet quantified pedometer-measured physical activity among Emergency Physicians. This study aims to provide the first characterization of physical activity among on-duty Emergency Physicians in terms of step count. Methods Emergency Physicians wore Empatica E4 research-grade accelerometers while performing routine clinical care in the Emergency Department. A publicly available algorithm was used to estimate the number of steps taken. Results Fifty-one Emergency Physicians, including thirty-four residents and seventeen attending physicians, contributed over 1500 h of accelerometer data. On average, this cohort took 577 steps per hour (SD: 72.6), totaling 4950 steps per recorded shift (SD: 737.8), which is approximately 2.6 miles (SD: 0.31). Residents walked more than attending physicians (595.9 steps per hour (SD: 99.7) vs 563.0 steps per hour (SD: 89.0), respectively; p = 0.02). Conclusion The average emergency physician in this cohort walked roughly half the daily recommended number of steps during their recorded shift. Residents walk significantly more than attending physicians.

Objective: This study aimed to measure the physical activity (exercise and non-exercise) of community-dwelling elderly Japanese individuals and to investigate the relationships between physical activity and daily life behaviors. Methods: Community-dwelling elderly Japanese individuals who resided in town A, city B, Gunma Prefecture, Japan, and were not certified as requiring long-term care were included in this study. Physical activity in 1 week was measured using a triaxial accelerometer. A self-administered questionnaire was applied to assess daily life behaviors. Hierarchical multiple regression analysis was used to examine the factors affecting physical activity. Results: A total of 107 elderly Japanese (46 men and 61 women) individuals were included. The mean amount of physical activity in men was 37.9 Metabolic equivalents (METs)*h/wk, whereas that in women was 33.8 METs*h/wk. The proportion of exercise to physical activity for men and women was 43.2% and 26.0%, respectively. Men and women took an average of 47,393.7 and 35,305.6 steps/wk, respectively. Step counts and the presence or absence of plant cultivation were the factors associated with the amount of physical activity. The exercise component of physical activity was associated with step count, whereas the non-exercise component was associated with step count, plant cultivation, and frequent outings. Conclusion: Among community-dwelling elderly Japanese individuals, physical activity levels appear to be affected by step count and the presence or absence of certain factors, such as plant cultivation and frequent outings.

This algorithm integrates second level Built in self-test (BIST) into multiple memory grouping wrapper. Second level BIST brings additional reliability into the memory system while fastening testing time. Main approach is to test whole memory modules from top level by numerous step count of which can be modified based on power consumption requirement and overheat conditions. The worst case of the algorithm can be observed by the time when the number of steps is equal to the number of memory modules, otherwise the testing time will be relative to 1/N (N is the number of steps). The main advantage of memory wrapping methodology is the possibility of increasing variety of the number of bits and the number of cells in the memory, while using limited memories provided by foundry.

We compared the improvement in components of metabolic syndrome (MS) before and after lifestyle modification, as determined by daily step counts (on a wrist-worn Fitbit®) in participants with and without MS recruited from volunteers attending medical health checkup programs. A linear mixed model was used to analyze the change in MS components between participants with and without MS by group × time interaction. Multiple logistic regression analysis after adjustment for confounders was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) for improvements in MS components per 1000-steps/day increments. Waist circumference, triglycerides, fasting plasma glucose, and diastolic blood pressure were significantly different between participants with and without MS (group × time: p = 0.010, p < 0.001, p = 0.025, and p = 0.010, respectively). Multivariable-adjusted ORs (95% CI) of improvement in MS components per 1000-steps/day increments were 1.24 (1.01–1.53) in participants with and 1.14 (0.93–1.40) in participants without MS. Walking improved MS components more in individuals with than without MS. From a public health perspective, walking should be encouraged for high-risk MS individuals.

International audience; Background: Disturbances of glycemic control and large glycemic variability have been associated with increased risk of type 2 diabetes in the general population as well as complications in people with diabetes. Long-term health benefits of physical activity are well documented but less is known about the timing of potential short-term effects on glycemic control and variability in free-living conditions. Materials and Methods: We analyzed data from 85 participants without diabetes from the Food & You digital cohort. During a 2-week follow-up, device-based daily step count was studied in relationship to glycemic control and variability indices using generalized estimating equations. Glycemic indices, evaluated using flash glucose monitoring devices (FreeStyle Libre), included minimum, maximum, mean, standard deviation, and coefficient of variation of daily glucose values, the glucose management indicator, and the approximate area under the sensor glucose curve. Results: We observed that every 1000 steps/day increase in daily step count was associated with a 0.3588 mg/dL (95% confidence interval [CI]: -0.6931 to -0.0245), a 0.0917 mg/dL (95% CI: -0.1793 to -0.0042), and a 0.0022% (95% CI: -0.0043 to -0.0001) decrease in the maximum glucose values, mean glucose, and in the glucose management indicator of the following day, respectively. We did not find any association between daily step count and glycemic indices from the same day. Conclusions: Increasing physical activity level was linked to blunted glycemic excursions during the next day. Because health-related benefits of physical activity can be long to observe, such short-term physiological benefits could serve as personalized feedback to motivate individuals to engage in healthy behaviors.

The authors investigated the agreement between StepWatch3™ (SW3) and ActiGraph™ wGT3X+ monitors for measuring step-based metrics in patients with peripheral artery disease and older adults. In 23 patients with peripheral artery disease and 38 older participants, the authors compared the metrics obtained during an outdoor (400-m track) walking session (step count) and a 7-day free-living period (step count and 60/30/5/1-min maximal or peak step accumulation) using the SW3 (ankle) and the wGT3X+ (hip) with the low-frequency extension filter enabled (wGT3X+/LFE) or not (wGT3X+/N). During outdoor walking session, agreement was high, particularly for wGT3X+/LFE: correlations ≥.98, median absolute percentage errors

The Verisense Step Count Algorithm facilitates generation of steps from wrist-worn accelerometers. Based on preliminary evidence suggesting a proportional bias with overestimation at low steps/day, but underestimation at high steps/day, the algorithm parameters have been revised. We aimed to establish validity of the original and revised algorithms relative to waist-worn ActiGraph step cadence. We also assessed whether step cadence was similar across accelerometer brand and wrist. Ninety-eight participants (age: 58.6 +/- 11.1 y) undertook six walks (similar to 500 m hard path) at different speeds (cadence: 92.9 +/- 9.5-127.9 +/- 8.7 steps/min) while wearing three accelerometers on each wrist (Axivity, GENEActiv, ActiGraph) and an ActiGraph on the waist. Of these, 24 participants also undertook one run (1000 m). Mean bias for the original algorithm was -21 to -26.1 steps/min (95% limits of agreement (LoA) similar to +/- 65 steps/min) and mean absolute percentage error (MAPE) 17-22%. This was unevenly distributed with increasing error as speed increased. Mean bias and 95%LoA were halved with the revised algorithm parameters (similar to-10 to -12 steps/min, 95%LoA similar to 30 steps/min, MAPE similar to 10-12%). Performance was similar across brand and wrist. The revised step algorithm provides a more valid measure of step cadence than the original, with MAPE similar to recently reported wrist-wear summary MAPE (7-11%). Refereed/Peer-reviewed

Excess body fatness is a consequence of a chronic energy surplus (energy intake is greater than energy expenditure). Given the serious health consequences of excess body fatness, factors that influence energy balance and body composition are increasingly important to understand. Methods - A total of 34 adults between the ages of 19-40 years made a laboratory visit in which height, weight, body composition, and cardiometabolic risk factors were quantified. Participants wore accelerometers for 21-28 days, then returned to the laboratory for a second body composition assessment. Changes in weight and body composition were used to quantify energy balance, and data derived from accelerometers provided markers of physical activity and sedentariness. Results - Of the markers of physical activity that we measured, daily step counts expressed relative to fat mass was most strongly and consistently associated with body fatness and cardiometabolic risk status. Conclusions - Step counts expressed relative to fat mass were strongly associated with body composition and cardiometabolic risk in adults eating ad libitum. Longitudinal interventional studies are necessary to determine the efficacy of step count prescriptions expressed relative to existing and target body fatness and cardiometabolic risk levels for improving weight management and metabolic outcomes.

The COVID-19 outbreak resulted in the shutdown of athletic training facilities. Although the effects of these restrictions on daily activity and sleep patterns have been widely analyzed, the employed tools often lacked accuracy, and were based on subjective measures. This study assessed the effects of home confinement on objective physical activity (PA), physiological and sleep parameters in active individuals. Sixteen male elite fitness coaches (age: 29±3 years; height: 183±6 cm; body mass: 82±5 kg, body mass index: 24.7±1.8 kg/m2) participated in this retrospective study. One-way analysis of variance was conducted to analyze selected PA, physiological and sleep parameters collected by smartwatch (Garmin Fenix 6 pro, USA) data during four consecutive months [i.e., pre-confinement, 1st and 2nd months of confinement, and post-confinement, year 2020]. Ramadan intermittent fasting (RIF) month occurred during the 2nd month of confinement. Compared to pre-confinement, significant changes were registered for almost all parameters during the 1st and/or the 2nd month of confinements (p, EXCLI Journal; 21:Doc1084; ISSN 1611-2156

(1) Background: This study examined the cross-sectional association between metabolic syndrome (MetS) status classified into three groups and daily physical activity (PA; step count and active minutes) using a wearable device in Japanese office workers. (2) Methods: This secondary analysis used data from 179 participants in the intervention group of a randomized controlled trial for 3 months. Individuals who had received an annual health check-up and had MetS or were at a high risk of MetS based on Japanese guidelines were asked to use a wearable device and answer questionnaires regarding their daily life for the entire study period. Multilevel mixed-effects logistic regression models adjusted for covariates associated with MetS and PA were used to estimate associations. A sensitivity analysis investigated the associations between MetS status and PA level according to the day of the week. (3) Results: Compared to those with no MetS, those with MetS were not significantly associated with PA, while those with pre-MetS were inversely associated with PA [step count Model 3: OR = 0.60; 95% CI: 0.36, 0.99; active minutes Model 3: OR = 0.62; 95% CI: 0.40, 0.96]. In the sensitivity analysis, day of the week was an effect modifier for both PA (p < 0.001). (4) Conclusions: Compared to those with no MetS, those with pre-MetS, but not MetS, showed significantly lower odds of reaching their daily recommended PA level. Our findings suggest that the day of the week could be a modifier for the association between MetS and PA. Further research with longer study periods and larger sample sizes are needed to confirm our results.

Supplementary Material: The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fresc.2021.737384/full#supplementary-material Copyright © 2022 Lavelle, Norris, Flemming, Harper, Bradley, Johnston, Fortune, Stennett, Kilbride and Ryan. Multiple wearable devices that purport to measure physical activity are widely available to consumers. While they may support increases in physical activity among people with multiple sclerosis (MS) by providing feedback on their performance, there is little information about the validity and acceptability of these devices. Providing devices that are perceived as inaccurate and difficult to use may have negative consequences for people with MS, rather than supporting participation in physical activity. The aim of this study was, therefore, to assess the validity and acceptability of commercially available devices for monitoring step-count and activity time among people with MS. Nineteen ambulatory adults with MS [mean (SD) age 52.1 (11.9) years] participated in the study. Step-count was assessed using five commercially available devices (Fitbit Alta, Fitbit Zip, Garmin Vivofit 4, Yamax Digi Walker SW200, and Letscom monitor) and an activPAL3μ while completing nine everyday activities. Step-count was also manually counted. Time in light activity, moderate-to-vigorous activity, and total activity were measured during activities using an Actigraph GT3X accelerometer. Of the 19 participants who completed the validity study, fifteen of these people also wore the five commercially available devices for three consecutive days each, and participated in a semi-structured interview regarding their perception of the acceptability of the monitors. Mean percentage error for step-count ranged from 12.1% for the Yamax SW200 to −112.3% for the Letscom. Mean step-count as manually determined differed to mean step-count measured by the Fitbit Alta (p = 0.002), Garmin vivofit 4 (p < 0.001), Letscom (p < 0.001) and the research standard device, the activPAL3μ (p < 0.001). However, 95% limits of agreement were smallest for the activPAL3μ and largest for the Fitbit Alta. Median percentage error for activity minutes was 52.9% for the Letscom and 100% for the Garmin Vivofit 4 and Fitbit Alta compared to minutes in total activity. Three inductive themes were generated from participant accounts: Interaction with device; The way the device looks and feels; Functionality. In conclusion, commercially available devices demonstrated poor criterion validity when measuring step-count and activity time in people with MS. This negatively affected the acceptability of devices, with perceived inaccuracies causing distrust and frustration. Additional considerations when designing devices for people with MS include an appropriately sized and lit display and ease of attaching and charging devices. RCSI University of Medicine and Health Sciences STAR Programme; Brunel University London. https://www.frontiersin.org/articles/10.3389/fresc.2021.737384/full#supplementary-material

Yoshiaki Minakata, Seigo Sasaki, Yuichiro Azuma, Kazumi Kawabe, Hideya Ono Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, JapanCorrespondence: Yoshiaki Minakata Tel +81-738-22-3256Fax +81-738-22-2126Email minakata.yoshiaki.qy@mail.hosp.go.jpBackground: To improve physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD), providing a target PA value based on the individual patient’s condition may be a useful interventional strategy. However, to determine the target value, a predictive PA value for each patient is required.Research Question: What is the reference equation consisting of PA-related factors to determine the predictive PA value for each patient with COPD?Material and Methods: In this prospective cross-sectional observational study, we measured the PA with a triaxial accelerometer and several other factors including demographic factors, pulmonary function, dyspnea, exercise capacity, muscle strength, nutrition, and indicators of several comorbidities in stable Japanese outpatients with COPD aged ≥ 40 years old and detected PA-related factors by a multiple regression analysis and stepwise method. We created reference equations for four indices of PA using multiple linear regression equations.Results: Two hundred and twenty-seven patients were registered. The equations of duration at ≥ 2.0 metabolic equivalents (METs) and step count consisted of 4 factors: 6-minute walk distance, modified Medical Research Council dyspnea scale, anxiety score of the Hospital Anxiety and Depression Scale, and the forced expiratory volume in 1 second % of predicted value. Those of duration at ≥ 3.0 METs and total activity at ≥ 3.0 METs consisted of 5 factors: the above 4 factors and age or brain natriuretic peptide. There was no fixed bias or proportional bias between the measured and predictive values in patients with non-high measured PA values.Conclusion: We determined reference equations for four indicators of PA using PA-related factors in Japanese patients with COPD. The predictive values calculated using the equations could be useful for deciding target PA values for each patient.Clinical Trial Registration: UMIN-CTR; No.: UMIN000025459; URL: https://www.umin.ac.jp/ctr/index.htm.Keywords: predictive value, COPD, metabolic equivalents, step count

Purpose: Wearable biometric monitoring devices (WBMD) show promise as a cutting edge means to improve health and prevent disease through increasing accountability. By regularly providing real-time quantitative data regarding activity, sleep quality, and recovery, users may become more aware of the impact that their lifestyle has on their health. The purpose of this study was to examine the efficacy of a biometric tracking ring on improving sleep quality and increasing physical fitness over a one-year period.Methods: Fifty-six participants received a biometric tracking ring and were placed in one of two groups. One group received a 3-month interactive behavioral modification intervention (INT) that was delivered virtually via a smartphone app with guided text message feedback (GTF). The other received a 3-month non-directive wellness education control (CON). After three months, the INT group was divided into a long-term feedback group (LT-GTF) that continued to receive GTF for another nine months or short-term feedback group (ST-GTF) that stopped receiving GTF. Weight, body composition, and VO2max were assessed at baseline, 3months, and 12months for all participants and additionally at 6 and 9months for the ST-GTF and LT-GTF groups. To establish baseline measurements, sleep and physical activity data were collected daily over a 30-day period. Daily measurements were also conducted throughout the 12-month duration of the study.Results: Over the first 3months, the INT group had significant (p2max, body fat percentage, and heart rate variability (rMSSD HRV) compared to the CON group. Over the next 9months, the LT-GTF group continued to improve significantly (p2max, and rMSSD HRV. The ST-GTF group neither improved nor regressed over the latter 9months except for a small increase in sleep latency.Conclusion: Using a WBMD concomitantly with personalized education, encouragement, and feedback, elicits greater change than using a WBMD alone. Additionally, the improvements achieved from a short duration of personalized coaching are largely maintained with the continued use of a WBMD.

Background Past studies have reported nurses working day shifts engage in high amounts of light and moderate-intensity occupational physical activity. However, little is known regarding how occupational physical activity and sedentary behavior is accumulated within shifts and/or over consecutive shifts. Objective This study compared occupational physical activity and sedentary behavior patterns of nurses working 12-h. day vs. 12 -h. night shifts. We hypothesized nurses working day shifts would be more active and less sedentary while at work compared to nurses working night shifts and that within shift and between shift differences would emerge. Design Prospective-cohort study design Setting(s) Midwestern trauma one academic medical center medical units (medical surgical, critical care, pediatrics, mother and baby, and other) Participants A total of 56 registered nurses working 12-h. day and night shifts participated in this study. Methods Occupational physical activity and sedentary behaviors (e.g., step count, time spent sitting, standing, and walking) were measured for 14 continuous days using the ActivPAL 3 micro activity monitor. Repeated measures mixed-effects regression models were used to examine the effects of shift type, consecutive shifts, and time within a shift on occupational physical activity and sedentary behaviors. Results Nurses spent more time standing and walking, and less time sitting overall during day shifts compared to night shifts. Nurses walked less during the third consecutive night shift and stood less and sat more during the second and third consecutive night shifts, compared to day shifts. Nurses tended to walk less and sit more during the middle portion of each night shift compared to day shifts. Conclusions Our findings suggest nurses spend more than half of each shift either standing or walking and that differential patterns of occupational physical activity and sedentary behavior exist between day and night shifts. These findings should be used to inform future interventions designed to advance the health and work performance of nurses.

The increasing ubiquity of smartphone data, with greater spatial and temporal coverage than achieved by traditional study designs, have the potential to provide insight into habitual physical activity patterns. This study implements and evaluates the utility of both K-means clustering and agglomerative hierarchical clustering methods in identifying weekly and yearlong physical activity behaviour trends. Characterising the demographics and choice of activity type within the identified clusters of behaviour. Across all seven clusters of seasonal activity behaviour identified, daylight saving was shown to play a key role in influencing behaviour, with increased activity in summer months. Investigation into weekly behaviours identified six clusters with varied roles, of weekday versus weekend, on the likelihood of meeting physical activity guidelines. Preferred type of physical activity likewise varied between clusters, with gender and age strongly associated with cluster membership. Key relationships are identified between weekly clusters and seasonal activity behaviour clusters, demonstrating how short-term behaviours contribute to longer-term activity patterns. Utilising unsupervised machine learning, this study demonstrates how the volume and richness of secondary app data can allow us to move away from aggregate measures of physical activity to better understand temporal variations in habitual physical activity behaviour.

Background: Research in high income countries shows that people with cerebral palsy (CP) are less physically active than typically developing (TD) peers, but less is known regarding physical activity (PA) in those with CP in low-to-middle income countries. The aim of this study was to determine daily step count and levels of PA in adolescents and adults with CP living in urban South Africa, compared to TD peers, and to determine associations with sex, Gross Motor Function Classification System (GMFCS) level, body mass index and socio-economic status.Materials and Methods: This case–control study included 26 adolescents and 22 adults with CP (GMFCS Level I-V) and matched TD peers (25 and 30, respectively). Participants wore an ActiGraph GT3X for 7 consecutive days to determine step count and time (minutes per hour) spent in PA levels, including sedentary (SED), low physical activity (LPA) and moderate to vigorous physical activity (MVPA).Results: The daily step count and PA levels for ambulant adolescents with CP (GMFCS level I-III) were similar to TD peers, while this was less for adolescents classified in GMFCS level IV-V. Daily step count, SED and MVPA were similar for adults classified in GMFCS level I-II compared to TD adults, while all parameters were lower for adults using assistive devices (GMFCS level III) and non-ambulant adults (GMFCS level IV-V) compared to TD peers. Daily step count and PA levels were inversely associated with GMFCS, while no other associations were found.Conclusion: People with CP who were more mobile dependent (higher GMFCS level) were less active. However, adolescents and adults with CP classified as GMFCS levels I-II living in urban South Africa recorded similar step count and PA levels as their TD peers. This was also the case for adolescents using assistive devices, though not for those in the adult group (GMFCS level III). Furthermore, it was apparent that even the ambulant individuals with CP and TD cohorts were relatively inactive. Intervention programs for CP and TD adolescents should be aimed at finding strategies to keep adolescents physically active well into adulthood, in order to promote physical health, social and emotional well-being and independence.

Background: Pulmonary rehabilitation (PR) is a highly effective intervention for individuals with chronic obstructive pulmonary disease (COPD). Physical activity (PA) has been shown to increase after a centre-based programme, yet it is not clear if a home-based programme can offer the same benefit. This study aimed to evaluate the effect of home-based PR compared with the centre-based PR on the PA levels post 7 weeks of PR and 6 months follow-up.Method: In this study, 51 participants with COPD, of them, 36 (71%) men completed physical activity monitoring with a SenseWear Armband, at three time points (baseline, 7 weeks, and 6 months). The participants were randomly assigned to either centre-based supervised PR (n = 25; 69 ± 6 years; FEV1 55 ± 20% predicted) or home-based PR (n = 26; 68 ± 7 years; FEV1 42 ± 19% predicted) programmes lasting 7 weeks. The home-based programme includes one hospital visit, a self-management manual, and two telephone calls. The PA was measured as step count, time in moderate PA (3–6 metabolic equivalent of tasks [METs]) in bouts of more than 10 min and sedentary time (Results: Home-based PR increased step count significantly more than the centre-based PR after 7 weeks (mean difference 1,463 steps: 95% CI 280–2,645, p = 0.02). There was no difference in time spent in moderate PA was observed (mean difference 62 min: 95% CI −56 to 248, p = 0.24). Sedentary behaviour was also significantly different between the centre and home-based groups. The home group spent 52 min less time sedentary compared with the centre-based (CI −106 to 2, p = 0.039). However, after 6 months, the step count and time spent in moderate PA returned to baseline in both the groups.Conclusion: This study provides an important insight into the role of home-based PR which has the potential to be offered as an alternative to the centre-based PR. Understanding who may best respond from the centre or home-based PR warrants further exploration and how to maintain these initial benefits for the long-term.Trial Registry: ISRCTN: No.: ISRCTN81189044; URL: isrctn.com.