Search

Aims/hypothesis: Adults with type 1 diabetes should perform daily physical activity to help maintain health and fitness, but the influence of daily step counts on continuous glucose monitoring (CGM) metrics are unclear. This analysis used the Type 1 Diabetes Exercise Initiative (T1DEXI) dataset to investigate the effect of daily step count on CGM-based metrics. Methods: In a 4 week free-living observational study of adults with type 1 diabetes, with available CGM and step count data, we categorised participants into three groups—below (<7000), meeting (7000–10,000) or exceeding (>10,000) the daily step count goal—to determine if step count category influenced CGM metrics, including per cent time in range (TIR: 3.9–10.0 mmol/l), time below range (TBR: <3.9 mmol/l) and time above range (TAR: >10.0 mmol/l). Results: A total of 464 adults with type 1 diabetes (mean±SD age 37±14 years; HbA1c 48.8±8.1 mmol/mol [6.6±0.7%]; 73% female; 45% hybrid closed-loop system, 38% standard insulin pump, 17% multiple daily insulin injections) were included in the study. Between-participant analyses showed that individuals who exceeded the mean daily step count goal over the 4 week period had a similar TIR (75±14%) to those meeting (74±14%) or below (75±16%) the step count goal (p>0.05). In the within-participant comparisons, TIR was higher on days when the step count goal was exceeded or met (both 75±15%) than on days below the step count goal (73±16%; both p<0.001). The TBR was also higher when individuals exceeded the step count goals (3.1%±3.2%) than on days when they met or were below step count goals (difference in means −0.3% [p=0.006] and −0.4% [p=0.001], respectively). The total daily insulin dose was lower on days when step count goals were exceeded (0.52±0.18 U/kg; p<0.001) or were met (0.53±0.18 U/kg; p<0.001) than on days when step counts were below the current recommendation (0.55±0.18 U/kg). Step count had a larger effect on CGM-based metrics in participants with a baseline HbA1c ≥53 mmol/mol (≥7.0%). Conclusions/interpretation: Our results suggest that, compared with days with low step counts, days with higher step counts are associated with slight increases in both TIR and TBR, along with small reductions in total daily insulin requirements, in adults living with type 1 diabetes. Data availability: The data that support the findings reported here are available on the Vivli Platform (ID: T1-DEXI; https://doi.org/10.25934/PR00008428). [ABSTRACT FROM AUTHOR]

BackgroundKaempferol (KMP), a flavonoid in edible plants, exhibits diverse pharmacological effects. Growing body of evidence associates extended lifespan with physical activity (PA) and sleep, but KMP’s impact on these behaviors is unclear. This double-blind, placebo-controlled, crossover trial assessed KMP’s effects on PA and sleep.MethodsA total of 33 city workers (17 males and 16 females) participated in this study. They were randomly assigned to take either 10 mg of KMP or placebo for 2 weeks in the order allocated, with a 7-day washout period in between. All participants wore an accelerometer-based wearable device (Fitbit Charge 4), which monitored daily PA, heart rate (HR), and HR variability during sleep.ResultsThe duration of wearing the device was 23.73 ± 0.04 h/day. HR decreased in each PA level, and the mean daily step count and distance covered increased significantly during KMP intake compared to placebo. The outing rate, number of trips, number of recreational activities, and time spent in recreation on weekends increased. Sleep quality improved following KMP intake. The decrease in HR and increase in RMSSD may be important in mediating the effects of these KMPs.ConclusionKMP leads to behavioral changes that subsequently improve sleep quality and potentially improve long-term quality of life.Clinical Trial Registrationhttps://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000048447, UMIN000042438.

Abstract Background Established health-related quality of life scores do not consider both subjective and objective indices of health. We propose the subjective and objective quality of life score (SOQOL) for the comprehensive assessment of health-related quality of life and aim to provide normative population data. The SOQOL is compatible with smartphone applications, allowing widespread use on a global scale. Methods Normative SOQOL population data was sourced from pre-existing datasets on the EQ-5D-5L, daily step count, and walking speed. Normative values were calculated using weighted grand means. We trialled the SOQOL in a group of five patients presenting to a spinal neurosurgery clinic. Results SOQOL scores decreased with age, and women had lower scores in every age group. In our case series, the spine patients with the biggest SOQOL deficit compared to age- and sex-matched population averages were found to be surgical while the rest were non-surgical. Conclusions The SOQOL shows promise as a simple and effective scoring tool that is compatible with smartphones, potentially useful for screening in primary and specialized care settings, and for assessment following healthcare interventions. This study, however, is preliminary, and the findings are primarily suggestive. They underline the necessity for future, more comprehensive studies to validate and expand upon these initial observations. The conclusion of both this abstract and the full paper will clearly state these limitations and the preliminary nature of the study.

Although sleep quality and physical activity (PA) may influence on arterial stiffness, the combined effects of these two factors on arterial stiffness remain unknown. A total of 103 healthy middle-aged and older men and women (aged 50–83 years) with no history of cardiovascular disease and depression were included in this study. Arterial stiffness was measured using carotid-femoral pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), and femoral-ankle PWV (faPWV). Poor sleepers were defined as those with a Pittsburgh Sleep Quality Index score of >5.5. Using an accelerometer for seven consecutive days, low levels of PA were defined as low moderate-to-vigorous-intensity PA (MVPA)

Introduction: Physical activity is an essential component of a healthy lifestyle. Walking is an open-accessed form of physical activity that requires no specialized equipment and can be performed at practically any moment of the day. In recent years, it has gained increasing interest and stands out as one of the most widely recommended forms of exercise. Since the beginning of the 21st century, the number of studies focusing on the impact of mean daily step count on health has been growing each year, with a significant surge observed since 2017. Undoubtedly, this topic is relevant to current health trends. Hitherto, there are no evidence-based recommendations regarding the number of steps that should be taken per day. Within this review, we conducted an analysis on the impact of daily step count on the risk of death and the incidence of selected diseases. Aim of the study: The aim of our study is to review of current literature on the influence of daily step count on both physical and mental health. Materials and Methods: We reviewed the literature available in PubMed, using the key words: „daily step count”, „step count mental health”, „ physical activity”, „pedometr”. Results: The daily step count can prominently impact the improvement and maintenance of human health and significant health benefits can be achieved by taking 4000-10000 steps per day. Summary: Research has shown that individuals who take more steps throughout the day are less prone to certain diseases, experience milder symptoms, exhibit better overall physical fitness, and have a lower risk of all-cause mortality. In the upcoming years, we can expect further studies aimed at identifying the most optimal daily step count.

Purpose: Whether the association between objectively assessed physical activity and mortality differs between adults with versus those without frailty is unclear. We investigated this association in community-dwelling older adults. Methods: This prospective study used the data of 4165 older adults 65 yr or older from the Kyoto–Kameoka study in Japan who wore a triaxial accelerometer (EW-NK52). The number of steps was classified by quartiles using the average daily value of data obtained from the accelerometer across four or more days. Frailty was evaluated using the validated Kihon Checklist. We evaluated the association between mortality and daily steps using a multivariable Cox proportional hazards analysis and restricted spline model. Results: The average daily steps for the first, second, third, and fourth quartiles were 1786, 3030, 4452, and 7502, respectively. In total, 113 deaths were recorded during a median follow-up of 3.38 yr (14,061 person-years). After adjusting for confounders, the top quartile was associated with a lower hazard ratio (HR) for mortality than the bottom quartile (HR = 0.39, 95% confidence interval = 0.18–0.85). In a stratified model by frailty status, the daily step count dose–response curve at which the HR for mortality plateaued among nonfrail individuals was approximately 5000–7000 steps per day. By contrast, the daily step count showed an inverse relationship with mortality at approximately 5000 steps or more per day in frail individuals. Conclusions: The relationship between daily steps and mortality is different between those with and those without frailty, and people with frailty may require more daily steps than those with nonfrailty to achieve the inverse relationship with mortality. These findings may be useful for informing future physical activity guidelines. [ABSTRACT FROM AUTHOR]

This review aims to investigate the dose-response relationship between the daily step count and all-cause mortality. PubMed, the Cochrane Library, Embase, and Web of Science were searched for all articles of cohort studies investigating the association between the daily step count and all-cause mortality. Cohort research articles were included if they reported mortality with no less than 3 categories of the daily step count, and hazard ratio (HR) with a 95% Confidence Interval (CI) was reported. Dose-response association meta-analysis and subsequent sex subgroup analysis were performed. The final analysis included a total of nine studies. Compared with the low-step count population, the high-step count population had a 62% lower risk of all-cause death (HR = 0.38, 95% CI 0.27–0.49). There was a non-linear dose-response relationship between the daily step count and all-cause mortality. Compared with the least (1895 steps), the first quartile (4000 steps/day) had a 37% lower risk for all causes of death (HR = 0.63, 0.57–0.71), the second quartile (6388 steps/day) had a 60% lower risk for all causes of death (HR = 0.40, 0.32–0.49), the third quartile (9994.3 steps/day) had a 75% lower risk of all-cause death than the first quartile (HR = 0.25, 0.19–0.33). [ABSTRACT FROM AUTHOR]

Abstract Background Walking is a fundamental part of living, and its importance is not limited by age or medical status. Reduced walking speed (WS), or gait velocity, is a sign of advancing age, various disease states, cognitive impairment, mental illness and early mortality. Activity levels, as defined in the literature as “daily step count” (DSC), is also a relevant measure of health status. A deterioration in our walking metrics, such as reduced WS and DSC, is associated with poor health outcomes. These objective measures are of such importance, that walking speed has been dubbed “the 6th vital sign”. We report a new objective measure that scores walking using the relevant metrics of walking speed and daily step count, into an easy-to-understand score from 0 (nil mobility) to 100 (excellent mobility), termed the Simplified Mobility Score (SMoS™). We have provided equal weighting to walking speed and daily step count, using a simple algorithm to score each metric out of 50. Methods Gait data was collected from 182 patients presenting to a tertiary hospital spinal unit with complaints of pain and reduced mobility. Walking speed was measured from a timed walk along an unobstructed pathway. Daily step count information was obtained from patients who had enabled step count tracking on their devices. The SMoS of the sample group were compared to expected population values calculated from the literature using 2-tailed Z tests. Results There were significantly reduced SMoS in patients who presented to the spinal unit than those expected at each age group for both genders, except for the 50–59 age bracket where no statistically significant reduction was observed. Even lower scores were present in those that went on to have surgical management. There was a significant correlation of SMoS scores with subjective disability scores such as the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) in this cohort. Conclusions The SMoS is a simple and effective scoring tool which is demonstrably altered in spinal patients across age and gender brackets and correlates well with subjective disability scores. The SMoS has the potential to be used as a screening tool in primary and specialised care settings.

The aim of the study was to understand the dynamic changes in daily step counts (DSC) during the development of chickens and to further explore the effects of exercise on the growth performance, carcass yield, meat quality, and tibial strength of cocks. A total of 600 (half male and half female) 1-day-old Wannan chickens with similar hatching weights were raised under the same rearing conditions. All birds were wing banded and housed in identical cages for from 1 to 8 wk in the experimental poultry house. The dimensions of the cages were 70 × 70 × 40 cm (length × width × height). At the age of 9 to 16 wk, these birds were reared in indoor pens (2 m × 2 m, 1,000 cm2 per bird). In addition, they also had a free-range grass paddock (20 m × 30 m, 1 m2 per bird). The DSC of male and female Wannan chicks were recorded from 70 to 112 d by using a pedometer. At 112 d of age, based on the average DSC, birds were divided into groups representing the highest (HS), medium, and lowest (LS) number of step groups. Fifteen cocks from each group were selected for subsequent experiments. Compared with the LS group, the HS group displayed higher tibial strength (P = 0.025) and lower BW, cooking loss (P = 0.014), shear force (P = 0.023), and drip loss (P = 0.008). The DSC had no effects on the female BW or male carcass parameters. There was no significant change in the DSC of all birds from 70 to 112 d. However, male chickens took more steps than females at 15 (P = 0.025) and 16 (P = 0.012) week of age. In conclusion, the effects of the DSC on the BW of Wannan chickens depend on sex, and enhanced exercise could improve the meat quality and tibial strength of cocks.

Purpose: Despite the potential for commercial activity devices to promote moderate to vigorous physical activity (MVPA), limited information is available in older adults, a high-priority target population with unique gait dynamics and energy expenditure. The study purpose was to investigate the content validity of the Garmin Vivosmart HR device for step counts and MVPA in adults ≥65 years of age in free-living conditions.Methods: Thirty-five participants (M age= 73.7 (6.3) years) wore Garmin and ActiGraph GT3X+ devices for a minimum of 2 days. Accuracy and intra-person reliability were tested against a hip worn ActiGraph device. Separate analyses were conducted using different accelerometer cut-off values to define MVPA, a population-based threshold (≥2,020 counts/minute) and a recommended threshold for older adults (≥1,013 counts/minute).Results: Overall, the Garmin device overestimated MVPA compared with the hip-worn ActiGraph. However, the difference was small using the lower, age-specific, MVPA cut-off value [median (IQR) daily minutes; 50(85) vs. 32(49), p = 0.35] in contrast to the normative standard (50(85) vs. 7(24), p < 0.001). Regardless of the MVPA cut-off, intraclass correlation showed poor reliability [ICC (95% CI); 0.16(-0.40, 0.55) to 0.35(−0.32, 0.7)] which was supported by Bland-Altman plots. Garmin step count was both accurate (M step difference: 178.0, p = 0.22) and reliable [ICC (95% CI; 0.94) (0.88, 0.97)].Conclusion: Results support the accuracy of a commercial activity device to measure MVPA in older adults but further research in diverse patient populations is needed to determine clinical utility and reliability over time.

Background: Kaempferol (KMP), a flavonoid in edible plants, exhibits diverse pharmacological effects. Growing body of evidence associates extended lifespan with physical activity (PA) and sleep, but KMP's impact on these behaviors is unclear. This double-blind, placebo-controlled, crossover trial assessed KMP's effects on PA and sleep., Methods: A total of 33 city workers (17 males and 16 females) participated in this study. They were randomly assigned to take either 10 mg of KMP or placebo for 2 weeks in the order allocated, with a 7-day washout period in between. All participants wore an accelerometer-based wearable device (Fitbit Charge 4), which monitored daily PA, heart rate (HR), and HR variability during sleep., Results: The duration of wearing the device was 23.73 ± 0.04 h/day. HR decreased in each PA level, and the mean daily step count and distance covered increased significantly during KMP intake compared to placebo. The outing rate, number of trips, number of recreational activities, and time spent in recreation on weekends increased. Sleep quality improved following KMP intake. The decrease in HR and increase in RMSSD may be important in mediating the effects of these KMPs., Conclusion: KMP leads to behavioral changes that subsequently improve sleep quality and potentially improve long-term quality of life., Clinical Trial Registration: https://center6.umin.ac.jp/cgi-open-bin/ctr&#95;e/ctr&#95;view.cgi?recptno=R000048447, UMIN000042438., Competing Interests: YI, AG-K and TM were employed by Otsuka Pharmaceutical Co. Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ikeda, Gotoh-Katoh, Okada, Handa, Sato, Mizokami and Saito.)

Background: Walking is a fundamental part of living, and its importance is not limited by age or medical status. Reduced walking speed (WS), or gait velocity, is a sign of advancing age, various disease states, cognitive impairment, mental illness and early mortality. Activity levels, as defined in the literature as "daily step count" (DSC), is also a relevant measure of health status. A deterioration in our walking metrics, such as reduced WS and DSC, is associated with poor health outcomes. These objective measures are of such importance, that walking speed has been dubbed "the 6th vital sign". We report a new objective measure that scores walking using the relevant metrics of walking speed and daily step count, into an easy-to-understand score from 0 (nil mobility) to 100 (excellent mobility), termed the Simplified Mobility Score (SMoS™). We have provided equal weighting to walking speed and daily step count, using a simple algorithm to score each metric out of 50. Methods: Gait data was collected from 182 patients presenting to a tertiary hospital spinal unit with complaints of pain and reduced mobility. Walking speed was measured from a timed walk along an unobstructed pathway. Daily step count information was obtained from patients who had enabled step count tracking on their devices. The SMoS of the sample group were compared to expected population values calculated from the literature using 2-tailed Z tests. Results: There were significantly reduced SMoS in patients who presented to the spinal unit than those expected at each age group for both genders, except for the 50–59 age bracket where no statistically significant reduction was observed. Even lower scores were present in those that went on to have surgical management. There was a significant correlation of SMoS scores with subjective disability scores such as the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) in this cohort. Conclusions: The SMoS is a simple and effective scoring tool which is demonstrably altered in spinal patients across age and gender brackets and correlates well with subjective disability scores. The SMoS has the potential to be used as a screening tool in primary and specialised care settings. [ABSTRACT FROM AUTHOR]

Although sleep quality and physical activity (PA) may influence on arterial stiffness, the combined effects of these two factors on arterial stiffness remain unknown. A total of 103 healthy middle-aged and older men and women (aged 50–83 years) with no history of cardiovascular disease and depression were included in this study. Arterial stiffness was measured using carotid-femoral pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), and femoral-ankle PWV (faPWV). Poor sleepers were defined as those with a Pittsburgh Sleep Quality Index score of >5.5. Using an accelerometer for seven consecutive days, low levels of PA were defined as low moderate-to-vigorous-intensity PA (MVPA) <19.0 min/day and low step counts <7100 steps/day, respectively. Poor sleepers with low PA levels, as determined by MVPA and daily steps, showed higher cfPWV, but not faPWV or baPWV, in middle-aged and older adults. Furthermore, in the analysis of covariance (ANCOVA) analyses adjusted for age, obesity, dyslipidemia, and sedentary behavior, the cfPWV result remained significant. Our study revealed that the coexistence of poor sleep quality and decreased PA (low MVPA or daily steps) might increase central arterial stiffness in middle-aged and older adults. Therefore, adequate sleep (good and sufficient sleep quality) and regular PA, especially at appropriate levels of MVPA (i.e., at least of 7100 steps/day), should be encouraged to decrease central arterial stiffness in middle-aged and older adults. [ABSTRACT FROM AUTHOR]

Objective The daily step count is associated with mortality in idiopathic pulmonary fibrosis (IPF). However, the factors associated with this phenomenon are not yet fully understood. We therefore clarified its association with clinical parameters. Methods Fifty-nine patients with IPF with available data for daily step counts; 6-minute walk distance (6MWD); chest, abdominal, and pelvic computed tomography (CT); pulmonary function; psychological evaluations; and sarcopenia assessments were prospectively enrolled. The daily step count was measured continuously for seven consecutive days. The cross-sectional areas of the erector spinae muscles at the level of the 12th vertebra (ESM CSA ) and psoas major muscle volume (PMV) obtained by CT were assessed. Results The average age of the patients was 73.3±8.1 years old, and the percent predicted forced vital capacity was 81.6%±15.8%. The median daily step count was 4,258 (2,155-6,991) steps. The average 6MWD, ESM CSA , and PMV were 413±97 m, 25.5±6.7 cm 2 , and 270±75.6 cm 3 , respectively. A linear regression analysis for daily step count showed that the ESM CSA and 6MWD were independent factors for the daily step count, whereas the PMV and skeletal muscle index were not. The daily step count, ESM CSA , and 6MWD were lower in patients with sarcopenia than in those without sarcopenia. Conclusion A lower daily step count was associated with a smaller erector spinae muscle area and sarcopenia in patients with IPF. Further studies are warranted to confirm the importance of physical therapy for muscle strengthening in patients with IPF.

Abstract Background Although the benefits of physical activity are well-known, levels of physical inactivity are increasing in many countries. Physical activity, particularly for preventive care of the elderly, must be encouraged. The level of physical activity undertaken by people is influenced by season; however, little is known about seasonal fluctuations of physical activity and its relation to muscle strength/mass. Consequently, we clarified the association between physical activity levels and muscle strength/skeletal muscle mass during non-snowy and snowy seasons in northern Japan. Methods Participants were community-dwelling elderly people aged 65 years or older living in Tobetsu, northern Japan. A 30-s chair-stand test (CS-30) and body composition measurements using bioelectrical impedance analysis were conducted prior to physical activity measurement using a three-dimensional acceleration sensor in both non-snowy and snowy seasons. Daily steps for the non-snowy and snowy seasons were compared using Welch’s t test. The association between the CS-30/skeletal muscle index and daily steps in both seasons was estimated by fitting multiple linear regression models, with age and sex as covariates. Results Average daily step counts were significantly lower during the snowy season, compared to the non-snowy season (P

Up to 10,000 steps per day may be associated with lower risk of all-cause mortality as well as cancer and cardiovascular disease mortality. Here, we evaluate daily step count in patients seen in spine clinic and its association with step goal knowledge, step tracking, and physical factors affecting walking. Of the 575 clinic patients, 368 met criteria and agreed to participate (mean age range 60-69 years; 52% female; 54% prior spine surgery). Of the population surveyed for actual daily steps, 55% reported <2000 and 9% reported >8000. Patients with a higher knowledge of the ideal step goal and who possessed a step counter (64%) had a higher number of actual daily steps ( P < .001). The main prohibiting factor to actual walking was pain (64%). Prior spine surgery and the use of a walking assist was associated with less daily steps ( P < .04, 6% reported >8000 steps; and P < .001, 0% reported >8000 steps, respectively). Patients presenting for evaluation in spine clinic underestimate the recommended number of steps taken daily to help decrease all-cause mortality, and cancer and cardiovascular disease mortality., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 The Author(s).)

Aims: Health data captured by commercially available smart devices may represent meaningful patient‐reported outcome measures (PROMs) in heart failure (HF) patients. The purpose of this study was to test this hypothesis by evaluating the feasibility of a new telemonitoring concept for patients following initial HF hospitalization. Methods and results: We designed a cardio patient monitoring platform (CPMP) that comprised mobile iOS‐based applications for patients' smartphone/smartwatch and the equivalent application on a physicians' tablet. It allowed for safe and continuous data transmission of self‐measured physiological parameters, activity data, and patient‐reported symptoms. In a prospective feasibility trial with 692 patient days from 10 patients hospitalized for newly diagnosed HF with reduced ejection fraction (mean left ventricular ejection fraction (LVEF) 26.5 ± 9.8%), we examined the CPMP during the first 2 months following discharge (69 ± 15 observation days per patient). The mean daily step count recorded by the mobile devices emerged as a promising new PROM. Its 14 day average increased over the study period (3612 ± 3311 steps/day at study inclusion and 7069 ± 5006 steps/day at end of study; P < 0.0001). It is unique for continuously reflecting real‐life activity and correlated significantly with traditional surrogate parameters of cardiac performance including LVEF (r = 0.44; 95% CI 0.07–0.71; P = 0.0232), 6 min walk test (r = 0.67; 95% CI 0.38–0.84; P = 0.0002), and scores in health‐related quality of life questionnaires. Conclusions: We provide the first patient monitoring platform for HF patients that relies on commercially available iOS/watchOS‐based devices. Our study suggests it is ready for implementation as a tool for recording meaningful PROMs in future HF trials and telemonitoring. [ABSTRACT FROM AUTHOR]

Estimates of the minimal clinically important difference (MCID) for physical activity (PA) in chronic obstructive pulmonary disease (COPD) are needed. The objective is to provide an anchor-based estimate of the MCID for daily step count. PA was promoted in persons with COPD using a pedometer (Omron HJ-720ITC) alone or a pedometer plus interactive website for 3 months. Participants wore the pedometer daily and received phone calls monthly to ascertain medical events. Medical events were counted when a participant self-reported that he/she had (1) worsening of breathing, (2) change to breathing medications, (3) medical care from an emergency room for any reason, or (4) hospitalization for any reason. Generalized linear regression models assessed daily step count as change at the end of study and averaged over the 15, 31, or 61 days centered on the event, in those with an event compared to those without one. All categories of events carried equal weight in the analyses. We studied 93 persons, 46 of whom had an event. Participants who experienced an event had a decrease of 1086 (95% confidence interval (CI): -2124 to -48) or 887 (95% CI: -2030 to 257) steps/day in the pedometer plus website or pedometer alone groups, respectively, compared to those without one. In the days centered on an event, participants who had an event experienced a decrease of 882-983 steps/day (pedometer plus website) or a decrease of 351-495 steps/day (pedometer alone), compared to those without one. The MCID for PA in COPD ranges from 350 steps/day to 1100 steps/day. [ABSTRACT FROM AUTHOR]

Pulmonary rehabilitation (PR) is the standard of care for chronic obstructive pulmonary disease (COPD) management. However, significant barriers limit access and adherence to PR and alternatives are needed. The purpose of this randomized controlled trial is to test the efficacy of a web-based, pedometer-mediated intervention to increase physical activity (PA) for persons with COPD who decline PR or meet U.S. guidelines for referral to PR but have not participated (CAPRI-1). In addition, we will test whether the intervention maintains PA following PR in an exploratory aim (CAPRI-2). Participants with COPD (N = 120) will be recruited and randomized 1:1 to a 12-week web-based, pedometer-mediated intervention or usual care (UC) (CAPRI-1). The intervention provides: 1) objective monitoring of walking and iterative feedback, 2) individualized step-count goals, 3) motivational messages and educational content, and 4) an online community. The primary outcome is change in daily step count from baseline to 12 weeks. Secondary outcomes include: (a) exercise capacity; (b) self-reported PA; (c) PA intensity; (d) exercise self-regulatory efficacy, (e) health-related quality of life, (f) dyspnea, (g) depression symptoms, and (h) healthcare utilization. CAPRI-2 will test whether participants (N = 96) assigned to the intervention following PR completion show greater maintenance of daily step count compared to UC at 3, 6, 9, and 12 months. If the intervention is efficacious, it may be an alternative for those who cannot attend PR or a maintenance program following completion of conventional PR. We also present adaptations made to the protocol in response to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Higher street connectivity, land use mix and residential density (collectively referred to as neighbourhood walkability) have been linked to higher levels of walking. The objective of our study was to summarize the current body of knowledge on the association between neighbourhood walkability and biosensor-assessed daily steps in adults. Methods: We conducted a systematic search of PubMed, SCOPUS, and Embase (Ovid) for articles published prior to May 2014 on the association between walkability (based on Geographic Information Systems-derived street connectivity, land use mix, and/or residential density) and daily steps (pedometer or accelerometer-assessed) in adults. The mean differences in daily steps between adults living in high versus low walkable neighbourhoods were pooled across studies using a Bayesian hierarchical model. Results: The search strategy yielded 8,744 unique abstracts. Thirty of these underwent full article review of which six met the inclusion criteria. Four of these studies were conducted in Europe and two were conducted in Asia. A meta-analysis of four of these six studies indicates that participants living in high compared to low walkable neighbourhoods accumulate 766 more steps per day (95 % credible interval 250, 1271). This accounts for approximately 8 % of recommended daily steps. Conclusions: The results of European and Asian studies support the hypothesis that higher neighbourhood walkability is associated with higher levels of biosensor-assessed walking in adults. More studies on this association are needed in North America. [ABSTRACT FROM AUTHOR]

Background: The strength, assistance in walking, rising from a chair, climbing stairs, and falls questionnaire (SARC-F) is widely used for screening sarcopenia. We aimed to examine the association of SARC-F scores with the measurements of quality of life and activity in patients with idiopathic pulmonary fibrosis (IPF)., Methods: This cross-sectional pilot study prospectively enrolled 54 patients with IPF who completed pulmonary function tests, the 6-min walk test, the chronic obstructive pulmonary disease assessment test (CAT), St. George's Respiratory Questionnaire (SGRQ), the Hospital Anxiety and Depression Scale, and a daily step count. The daily step count was measured continuously for 7 consecutive days using a tri-axis accelerometer device., Results: The mean age was 73.6±7.9 years and the mean percent predicted forced vital capacity was 80.4%±15.6%. The median [interquartile range] SARC-F score, SGRQ total scores, and CAT scores were 2 [1-3.25], 28.8 [14.4-46.9], and 13 [7-22], respectively. SARC-F scores were correlated with the percent predicted forced vital capacity (r=-0.51, P<0.001), CAT score (r=0.57, P<0.001), SGRQ total score (r=0.77, P<0.001), Hospital Anxiety and Depression Scale anxiety score (r=0.31, P=0.025), and Hospital Anxiety and Depression Scale depression score (r=0.28, P=0.041). Linear regression analyses revealed that the 6-minute walk test (6MWT) (standardized β=0.33, P=0.011) and SARC-F score (standardized β=-0.39, P=0.005), but not the CAT score and SGRQ total score, were significant predictors for daily step count., Conclusions: SARC-F scores were correlated with health status and daily activity in patients with IPF. Further studies are warranted to validate the utility of the SARC-F in patients with IPF., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-813/coif). ANi serves as an unpaid editorial board member of Journal of Thoracic Disease. HO received research grants from Fukuda Life Tech Chubu, and Nippon Boehringer Ingelheim Co., Ltd, regarding the submitted work. The authors have the following competing interests outside the submitted work. HO received honoraria for lectures from Nippon Boehringer Ingelheim Co., Ltd. Kensuke Fukumitsu received research grants from Novartis Pharma and GSK. SF received honoraria for lectures from AstraZeneca and Eli Lilly. YK received research grants from Novartis Pharma, MSD, Sanofi, and Kyowa- Kirin Corporation and honoraria for lectures from GSK, Novartis Pharma, AstraZeneca, Sanofi, and Kyorin. TU received honoraria for lectures from AstraZeneca and Eli Lilly. KM received research support from Nippon Boehringer Ingelheim Co., Ltd., and honoraria for lectures from Pfizer and Chugai Pharmaceutical. TO reports honoraria for lectures from AstraZeneca, Eli Lilly Japan, Taiho Pharmaceutical, Pfizer, Chugai Pharmaceutical, MSD, Daiichi Sankyo, and Asahi Kasei Pharma, as well as research grants from Kyowa Hakko Kirin, Nippon Boehringer Ingelheim Co., Ltd., Ono Pharmaceutical, and Novartis. ANi reports honoraria for lectures from Astellas, AstraZeneca, Kyorin, GSK, MSD, Shionogi, Bayer, Sanofi, Taiho, and Nippon Boehringer Ingelheim Co., Ltd., and research grants from Astellas, Kyorin, Nippon Boehringer Ingelheim Co., Ltd., Novartis, MSD, Daiichi Sankyo, Taiho, Teijin, Ono, Takeda, and Sanofi Pharmaceutical. The other authors have no conflicts of interest to declare., (2022 Journal of Thoracic Disease. All rights reserved.)

Objective: Exercise, like daily walking, may improve overall health and impede progression of chronic kidney disease (CKD); however, no specific walking dose has been recommended for patients with CKD. We aimed to investigate the association between daily walking steps and health-related quality of life (HRQOL) in adults with CKD., Design and Methods: The walking steps of patients with CKD were extracted from the We Run mobile application. Their average daily walking steps were calculated and subdivided into the low-, middle-, and high-level groups. HRQOL was assessed using the physical component summary (PCS) and mental component summary (MCS) of the MOS 36 Short Form Health Survey (SF-36)., Results: A total of 558 adults (50.5%, men) with an average age of 40.2 (±13.8) years were enrolled. The median daily step count was 7,404 steps. The daily walking step count demonstrated an inverse U-shaped relationship with the SF-36 and subscale scores. Participants with daily walking steps between 7,000 and 12,000 have the highest PCS (68.1 ± 12.2) and MCS scores (70.0 ± 19.5). The multiple linear regression model showed that compared with patients with a daily step count of 7,000 to 12,000, patients with a daily step count >12,000 had a significantly lower MCS score (P < .001), while patients with a daily step count <7,000 had significantly lower PCS (P < .001) and MCS scores (P = .034). Moreover, the multivariable logistic regression model showed that patients with a daily step count >12,000 had significantly lower mental health-related quality (odds ratio [OR], 2.188; 95% confidence interval [CI], 1.079-1.439 for low MCS), while those with a daily step count <7,000 had a significantly lower HRQOL than the 7,000 to 12,000 daily step count group (OR, 2.113; 95% CI, 1.203-3.711 for low PCS; OR, 2.099; 95% CI, 1.210-3.643 for low MCS)., Conclusions: These findings suggest that daily walking steps between 7,000 and 12,000 are associated with high HRQOL in adults with CKD., (Copyright © 2022 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

This study aimed to evaluate the association between locomotive syndrome (LS) and daily physical activity (PA) in community-dwelling older adults. This cross-sectional study included 80 healthy Japanese older adults (40 men and 40 women; age: 60-79 years). Habitual daily PA was evaluated using a triaxial wrist accelerometer. Participants were divided into two groups based on the results of the two-step test, stand-up test, and 25-question geriatric locomotive function scale. Binomial logistic regression analysis was conducted to examine the statistical relationships between daily PA and category of LS, adjusting for age from adjusted odds ratio (adjusted OR) with the 95 percent confidence intervals (95%CI) and bootstrap 95%CI. The mean step count and time spent on moderate to vigorous physical activity (MVPA) were significantly higher among non-LS participants than among LS participants in women, but not in men. Logistic regression analyses indicated that spending longer than 28 min/day on MVPA was significantly associated with a lower likelihood of LS relative to short time category under 28 min/day in women (adjusted OR = 0.12, 95%CI = 0.02-0.59, bootstrap 95%CI = 0.01-0.43), but not in men. This study suggests that in community-dwelling older women, those with higher MVPA had lower odds of LS, and daily MVPA was associated with LS, but not in men. Therefore, the associations between LS and daily physical activity were partly dependent on sex differences.

Purpose: Despite the potential for commercial activity devices to promote moderate to vigorous physical activity (MVPA), limited information is available in older adults, a high-priority target population with unique gait dynamics and energy expenditure. The study purpose was to investigate the content validity of the Garmin Vivosmart HR device for step counts and MVPA in adults ≥65 years of age in free-living conditions. Methods: Thirty-five participants ( M age= 73.7 (6.3) years) wore Garmin and ActiGraph GT3X+ devices for a minimum of 2 days. Accuracy and intra-person reliability were tested against a hip worn ActiGraph device. Separate analyses were conducted using different accelerometer cut-off values to define MVPA, a population-based threshold (≥2,020 counts/minute) and a recommended threshold for older adults (≥1,013 counts/minute). Results: Overall, the Garmin device overestimated MVPA compared with the hip-worn ActiGraph. However, the difference was small using the lower, age-specific, MVPA cut-off value [median (IQR) daily minutes; 50(85) vs. 32(49), p = 0.35] in contrast to the normative standard (50(85) vs. 7(24), p < 0.001). Regardless of the MVPA cut-off, intraclass correlation showed poor reliability [ICC (95% CI); 0.16(-0.40, 0.55) to 0.35(-0.32, 0.7)] which was supported by Bland-Altman plots. Garmin step count was both accurate ( M step difference: 178.0, p = 0.22) and reliable [ICC (95% CI; 0.94) (0.88, 0.97)]. Conclusion: Results support the accuracy of a commercial activity device to measure MVPA in older adults but further research in diverse patient populations is needed to determine clinical utility and reliability over time., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Briggs, Hall, Jain, Macrea, Morey and Oursler.)

The aim of the study was to understand the dynamic changes in daily step counts (DSC) during the development of chickens and to further explore the effects of exercise on the growth performance, carcass yield, meat quality, and tibial strength of cocks. A total of 600 (half male and half female) 1-day-old Wannan chickens with similar hatching weights were raised under the same rearing conditions. All birds were wing banded and housed in identical cages for from 1 to 8 wk in the experimental poultry house. The dimensions of the cages were 70 × 70 × 40 cm (length × width × height). At the age of 9 to 16 wk, these birds were reared in indoor pens (2 m × 2 m, 1,000 cm 2 per bird). In addition, they also had a free-range grass paddock (20 m × 30 m, 1 m 2 per bird). The DSC of male and female Wannan chicks were recorded from 70 to 112 d by using a pedometer. At 112 d of age, based on the average DSC, birds were divided into groups representing the highest (HS), medium, and lowest (LS) number of step groups. Fifteen cocks from each group were selected for subsequent experiments. Compared with the LS group, the HS group displayed higher tibial strength (P = 0.025) and lower BW, cooking loss (P = 0.014), shear force (P = 0.023), and drip loss (P = 0.008). The DSC had no effects on the female BW or male carcass parameters. There was no significant change in the DSC of all birds from 70 to 112 d. However, male chickens took more steps than females at 15 (P = 0.025) and 16 (P = 0.012) week of age. In conclusion, the effects of the DSC on the BW of Wannan chickens depend on sex, and enhanced exercise could improve the meat quality and tibial strength of cocks., (Copyright © 2020. Published by Elsevier Inc.)