Effects of two behavioral cardiac rehabilitation interventions on physical activity: A randomized controlled trial. A pedometer-based physical activity intervention for patients entering a maintenance cardiac rehabilitation program: a pilot study. Results of the Sedentary Intervention Trial in Cardiac Rehabilitation (SIT-CR Study): A pilot randomized controlled trial. Cost-effectiveness of a Population-based Lifestyle Intervention to Promote Healthy Weight and Physical Activity in Non-attenders of Cardiac Rehabilitation. Mobile and Wearable Device Features that Matter in Promoting Physical Activity. In-class Active Video Game Supplementation and Adherence to Cardiac Rehabilitation Correlates of cardiorespiratory and muscular fitness among Brazilian adolescents. Tai Chi Is a Promising Exercise Option for Patients With Coronary Heart Disease Declining Cardiac Rehabilitation Impact of feedback on physical activity levels of individuals with chronic obstructive pulmonary disease during pulmonary rehabilitation A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents Effects of physical activity on cancer survival: a systematic review. Physical activity patterns and prevention of weight gain in premenopausal women Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women The Effects of Physical Activity on Health and Quality of Life in Adolescent Cancer Survivors: A Systematic Review Effects of a Phase IV Home-Based Cardiac Rehabilitation Program on Cardiorespiratory Fitness and Physical Activity. Wearable Sensor/Device (Fitbit One) and SMS Text-Messaging Prompts to Increase Physical Activity in Overweight and Obese Adults: A Randomized Controlled Trial. Rationale and study protocol for the supporting children’s outcomes using rewards, exercise and skills (SCORES) group randomized controlled trial: A physical activity and fundamental movement skills intervention for primary schools in low-income communities Telephone support oriented by accelerometric measurements enhances adherence to physical activity recommendations in noncompliant patients after a cardiac rehabilitation program. Weight-Loss Induced Changes in Physical Activity and Activity Energy Expenditure in Overweight and Obese Subjects before and after Energy Restriction Effect of a diet and physical activity intervention on body weight and nutritional patterns in overweight and obese breast cancer survivors The impact of physical activity on fatigue and quality of life in lung cancer patients: a randomised controlled trial protocol Effects of a Pre-surgery Supervised Exercise Training 1 Year After Bariatric Surgery: a Randomized Controlled Study Effect of fitness and physical activity on bone mass in adolescents: the HELENA Study Feasibility and Effectiveness of a Wearable Technology-Based Physical Activity Intervention in Preschoolers: A Pilot Study Effects of a multi-pronged intervention on children's activity levels at recess: the Aventuras para Niños study. Walk2Bactive: A randomised controlled trial of a physical activity-focused behavioural intervention beyond pulmonary rehabilitation in chronic obstructive pulmonary disease. Seasonal variation of daily physical activity in individuals with heart failure Feasibility of a telephone and web-based physical activity intervention for women shift workers
BACKGROUND St and ard cardiac rehabilitation ( CR ) is insufficient to help patients achieve an active lifestyle . The effects of two advanced and extended behavioral CR interventions on physical activity ( PA ) and sedentary behavior ( SB ) were assessed . METHODS In total , 731 patients with ACS were r and omized to 1 ) 3months of st and ard CR ( CR-only ) ; 2 ) 3months of st and ard CR with three pedometer-based , face-to-face PA group counseling sessions followed by 9months of aftercare with three general lifestyle , face-to-face group counseling sessions ( CR+F ) ;  or 3 )  3months of st and ard CR , followed by 9months of aftercare with five to six general lifestyle , telephonic counseling sessions ( CR+T ) . An accelerometer recorded PA and SB  at r and omization , 3months , 12months , and 18months . RESULTS The CR+F group did not improve their moderate-to-vigorous intensity PA ( MVPA ) or SB time compared to CR-only ( between-group difference=0.24 % MVPA , P=0.349 ; and 0.39 % SB , P=0.529 ) . However , step count ( between-group difference=513 steps/day , P=0.021 ) and time in prolonged MVPA ( OR=2.14 , P=0.054 ) improved at 3months as compared to CR-only . The improvement in prolonged MVPA was maintained at 18months ( OR=1.91 , P=0.033 ) . The CR+T group did not improve PA or SB compared to CR-only . CONCLUSIONS Adding three pedometer-based , face-to-face group PA counseling sessions to st and ard CR increased daily step count and time in prolonged MVPA . The latter persisted at 18months . A telephonic after-care program did not improve PA or SB . Although after-care should be optimized to improve long-term adherence , face-to-face group counseling with objective PA feedback should be added to st and ard CR PURPOSE To compare the effects of an individualized pedometer-driven physical activity ( PA ) intervention with the usual time-based PA recommendations given to patients entering a maintenance cardiac rehabilitation ( CR ) program . METHODS A total of 18 subjects entering a maintenance CR program were recruited and completed the study . Subjects were r and omized into pedometer feedback [ PF : n=10 ( 2 women ) , 53.3±8.1 yrs ] and usual care [ UC : n=8 ( 2 women ) , 59.4±9.9 yrs ] groups . New Lifestyles NL-1000 pedometers were used to  monitor ambulatory PA . Subjects in both groups participated in the same maintenance CR program for a total of 8 weeks and all were encouraged to obtain a minimum of 30 - 40 min/d of moderate-vigorous-intensity physical activity ( MVPA ) , on days they did not attend CR . Subjects in the PF group were given individualized daily stepcount goals ( increase 10 % of baseline steps/d each week ) for weeks 2 - 8 . Ambulatory PA  was measured with pedometers , recording both total number of steps/d and min/d of MVPA . Measures were obtained during the first week of the maintenance CR program and during the 8th week . Data were also compared between days subjects attended and on days they did not attend . RESULTS By the 8th week of CR , PF subjects increased daily stepcounts by 42 % ( 2,297±1,606 steps/d , P=0.001 ) , with a 36 % increase on CR days ( 2,654±2,089 steps/d , P=0.003 ) and a 45 % increase on days they did not attend CR ( 1,872±2,026 steps/d , P=0.017 ) . There were no changes observed in the UC group . CONCLUSIONS Providing pedometers with individualized stepcount goals to patients entering a CR program was superior to the usual time-based PA recommendations for increasing PA BACKGROUND Sedentary time ( ST ) is negatively associated with cardiometabolic health and fitness . Traditional cardiac rehabilitation ( CR ) programming may not significantly reduce ST . The objectives of the study were to assess the feasibility and practicality of activPAL devices for measuring ST in CR , and whether prompting cues to interrupt sedentary behaviour can decrease ST and improve clinical outcomes . METHODS An 8-week , two-arm pilot r and omized controlled trial allocated coronary artery disease patients to either a control ( usual care CR ) or intervention ( CR + sedentary prompts from an activPAL3-VT ) group . Primary outcomes included : recruitment ; acceptability ; completion ; and , adherence rates . Secondary outcomes included changes in : ST ; physical activity ( PA ) ; cardiometabolic health ; psychosocial health ; and , fitness . RESULTS Forty participants ( 16 females ; 19 intervention ; 62 ± 10 years ) were r and omized . Outcome data were available for 95 % of participants . All but one participant completed the full intervention . Most ( 73 % ) intervention participants felt the prompts had somewhat changed their sedentary behaviour . At baseline , participants spent 47 % of their day sedentary . No significant group differences in changes for any of the ST , PA or fitness outcomes were observed . The mean group difference for post-intervention ST ( controlling for baseline ) was 30.3 min/day ( 95 % CI : -51.7 , 112.2 ) in favour of the intervention . The intervention group reported significantly better physical health and had a lower ratio of total cholesterol-to-high density lipoprotein when compared to controls . CONCLUSIONS It is feasible to use activPAL devices to measure ST in a CR setting . Further studies are needed to assess the effectiveness of multi-component sedentary behaviour interventions BACKGROUND To evaluate the long-term cost-effectiveness of two home-based cardiac rehabilitation ( CR ) interventions ( Healthy Weight ( HW ) and Physical Activity ( PA ) ) for patients with cardiovascular disease ( CVD ) , who had been referred to cardiac rehabilitation ( CR ) but had not attended . The interventions consisted of pedometer-based telephone coaching sessions on weight , nutrition and physical activity ( HW group ) or physical activity only ( PA group ) and were compared to a control group who received information brochures about physical activity . METHODS A cost-effectiveness analysis was conducted using data from two r and omised controlled trials . One trial compared HW to PA ( PANACHE study ) , and the second compared PA to usual care . A Markov model was developed which used one risk factor , body mass index ( BMI ) to determine the CVD risk level and mortality . Patient-level data from the trials were used to determine the transitions to CVD states and healthcare related costs . The model was run for separate cohorts of males and females . Univariate and probabilistic sensitivity analysis were conducted to test the robustness of the results . RESULTS Given a willingness-to-pay threshold of $ 50,000/QALY , in the long run , both the HW and PA interventions are cost-effective compared with usual care . While the HW intervention is more effective , it also costs more than both the PA intervention and the control group due to higher intervention costs . However , the HW intervention is still cost-effective relative to the PA intervention for both men and women . Sensitivity analysis suggests that the results are robust . CONCLUSION The results of this paper provide evidence of the long-term cost-effectiveness of home-based CR interventions for patients who are referred to CR but do not attend . Both the HW and PA interventions can be recommended as cost-effective home-based CR programs , especially for people lacking access to hospital services or who are unable to participate in traditional CR programs BACKGROUND As wearable sensors/devices become increasingly popular to promote physical activity ( PA ) , research is needed to examine how and which components of these devices people use to increase their PA levels . AIMS ( 1 ) To assess usability and level of engagement with the Fitbit One and daily SMS-based prompts in a 6-week PA intervention , and ( 2 ) to examine whether use/ level of engagement with specific intervention components were associated with PA change . METHODS Data were analyzed from a r and omized controlled trial that compared ( 1 ) a wearable sensor/ device ( Fitbit One ) plus SMS-based PA prompts , and ( 2 ) Fitbit One only , among overweight/ obese adults ( N = 67 ) . We calculated average scores from Likert-type response items that assessed usability and level of engagement with device features ( e.g. , tracker , website , mobile app , and SMS-based prompts ) , and assessed whether such factors were associated with change in steps/day ( using Actigraph GT3X+ ) . RESULTS Participants reported the Fitbit One was easy to use and the tracker helped to be more active . Those who used the Fitbit mobile app ( 36 % ) vs. those who did not ( 64 % ) had an increase in steps at 6-week follow-up , even after adjusting for previous web/app use : + 545 steps/ day ( SE = 265 ) vs. -28 steps/ day ( SE = 242 ) ( p = .04 ) . CONCLUSIONS Level of engagement with the Fitbit One , particularly the mobile app , was associated with increased steps . Mobile apps can instantly display summaries of PA performance and could optimize self-regulation to activate change . More research is needed to determine whether such modalities might be cost-effective in future intervention research and practice Purpose : The application of active video games ( AVGs ) during cardiac rehabilitation ( CR ) sessions could potentially facilitate patient adherence . The feasibility , safety , and efficacy of in-class AVG supplementation as an alternative to conventional phase 2 programs were investigated . Methods : A pilot , evaluator-blinded , intention-to-treat , r and omized controlled trial recruited 32 low-moderate risk CR participants and allocated them to conventional or AVG-supplemented exercise . Both groups experienced equal exercise loads for 6 weeks . Patients were assessed at baseline , end of the program , and after an 8-week followup . Adherence and safety-related outcomes were the primary endpoints . Secondary outcomes included change in exercise capacity , daily physical activity ( PA ) , energy expenditure ( EE ) , and psychometric profiling . Results : Patients ( males 81 % ; 60 ± 10 years ) presented with typical cardiovascular risk factors and similar baseline characteristics . Participants did not perceive an increased risk of injury and were more interactive . At the end of the program , there was a lower tendency for dropping out ( 6 % vs 19 % , P > .05 ) , a significant improvement in PA ( 322 vs 247 arbitrary acceleration units/min , P = .047 ) and related EE per body weight ( 13 vs 11 kcal/kg/d , P = .04 ) among AVG participants compared with controls . No significant differences between groups for adverse medical events , exercise capacity , affect toward exercise , anxiety , depression , or quality -of-life changes were reported . Conclusions : The additional use of AVGs during CR sessions is feasible , safe , and significantly improved daily PA and EE . A dropout reduction trend among its users , which needs to be confirmed in a larger trial , raises awareness to AVG supplementation as a promising strategy to increase CR adherence OBJECTIVE To analyze socioeconomic indicators , physical activity ( PA ) opportunities , and behavioral correlates of cardiorespiratory and muscular fitness among Brazilian boys and girls . METHODS A sample of 1555 adolescents was r and omly selected . Age- and sex-specific st and ard scores were calculated for each fitness component . RESULTS Among boys , head of household 's schooling , involvement in organized PA , meeting the PA recommendations , and computer/games use were associated with cardiorespiratory fitness . Involvement in organized PA and active time in Physical Education ( PE ) classes were predictors of muscular fitness . Among girls , active time in PE classes and TV watching were predictors of cardiorespiratory fitness . Meeting the PA recommendations was associated with muscular fitness . CONCLUSION PA variables and sedentary behaviors should be independently considered for physical fitness promotion in youth Background More than 60 % of patients decline participation in cardiac rehabilitation after a myocardial infa rct ion . Options to improve physical activity ( PA ) and other risk factors in these high‐risk individuals are limited . We conducted a phase 2 r and omized controlled trial to determine feasibility , safety , acceptability , and estimates of effect of  tai chi on PA , fitness , weight , and quality of life . Methods and Results Patients with coronary heart disease declining cardiac rehabilitation enrollment were r and omized to a “ LITE ” ( 2 sessions/week for 12 weeks ) or to a “ PLUS ” ( 3 sessions/week for 12 weeks , then maintenance classes for 12 additional weeks ) condition . PA ( accelerometry ) , weight , and quality of life ( Health Survey Short Form ) were measured at baseline and 3 , 6 , and 9 months after baseline ; aerobic fitness ( stress test ) was measured at 3 months . Twenty‐nine participants ( 13 PLUS and 16 LITE ) were enrolled . Retention at 9 months was 90 % ( LITE ) and 88 % ( PLUS ) . No serious tai chi – related adverse events occurred . Significant mean between group differences in favor of the PLUS group were observed at 3 and 6 months for moderate‐to‐vigorous PA ( 100.33 min/week [ 95 % confidence interval , 15.70–184.95 min/week ] and 111.62 min/week ; [ 95 % confidence interval , 26.17–197.07 min/week ] , respectively , with a trend toward significance at 9 months ) , percentage change in weight , and quality of life . No changes in aerobic fitness were observed within and between groups . Conclusions In this community sample of patients with coronary heart disease declining enrollment in cardiac rehabilitation , a 6‐month tai chi program  was safe and improved PA , weight , and quality of life compared with a 3‐month intervention . Tai chi could be an effective option to improve PA in this high‐risk population . Clinical Trial Registration URL : http://www . clinical trials.gov . Unique identifier : NCT02165254 This study aim ed at investigating whether providing feedback on physical activity ( PA ) levels to patients with chronic obstructive pulmonary disease ( COPD ) is feasible and enhances daily PA during pulmonary rehabilitation ( PR ) . Patients with COPD participated in a 12-week PR program  . Daily PA was measured using activity monitors on weeks 1 , 7 , and 12 , and feedback was given in the following weeks on the number of steps , time spent in sedentary , light , and moderate-to-vigorous intensity activities , and time spent st and ing , sitting , and lying . Compliance with PA monitoring was collected . Two focus groups were conducted to obtain patients ’ perspectives on the use of activity monitors and on the feedback given . Differences in PA data were also assessed . Sixteen patients ( 65.63 ± 10.57 years ; forced expiratory volume in one second ( FEV1 ) 70.31 ± 22.74 % predicted ) completed the study . From those , only eleven participants used the activity monitors during all monitoring days . Participants identified several problems regarding the use of activity monitors and monitoring duration . Daily steps ( p = 0.026 ) and st and ing time ( p = 0.030 ) were improved from week 1 to week 7 ; however , the former declined from week 7 to week 12 . Findings suggest that using feedback to improve PA during PR is feasible and results in improved daily steps and st and ing time on week 7 . The subsequent decline suggests that additional strategies may be needed to stimulate/maintain PA improvements . Further research with more robust design s is needed to investigate the impact of feedback on patients ’ daily PA ABSTRACT Lack of  physical activity  (  PA  ) and high levels of sedentary behaviour ( SB ) have been associated with health problems . This systematic review evaluates the effectiveness of school-based interventions to increase PA  and decrease SB  among 15–19-year-old adolescents , and examines whether intervention characteristics ( intervention length , delivery mode and intervention provider ) and intervention content ( i.e. behaviour change techniques , BCTs ) are related to intervention effectiveness . A systematic search of r and omised or cluster r and omised controlled trials with outcome measures of PA and /or SB rendered 10 results . Risk of bias was assessed using the Cochrane risk of bias tool . Intervention content was coded using Behaviour Change Technique Taxonomy v1 . Seven out of 10 studies reported significant increases in PA . Effects were generally small and short-term ( Cohen 's d ranged from 0.132 to 0.659 ) . Two out of four studies that measured SB reported significant reductions in SB . Interventions that increased PA  included a higher number of BCTs , specific BCTs ( e.g. , goal setting , action planning and self-monitoring ) , and were delivered by research staff . Intervention length and mode of delivery were unrelated to effectiveness . More studies are needed that evaluate long-term intervention effectiveness and target SBs among older adolescents PURPOSE Physical activity ( PA ) has been suggested to help increase the survival of individuals with cancer . The objective of this review was to systematic ally evaluate and summarize the available evidence investigating the effect of PA on the survival of individuals with cancer . METHODS Electronic data bases ( CINAHL , EMBASE , and MEDLINE ) were systematic ally search ed for r and omized controlled trials and cohort studies . Selected studies were assessed by two independent investigators for method ological quality , using the PEDro scale . RESULTS Ten prospect i ve cohort studies met the inclusion criteria . Quality - assessment scores averaged 5/10 on the PEDro scale , with two articles obtaining a score of 6/10 . The majority of studies found that individuals participating in higher levels of physical activity had a reduced risk of cancer-related mortality . This trend was observed specifically for breast , colon , and colorectal cancers . On average , it appears that engaging in higher levels of metabolic equivalent hours per week may help to improve survival rates among individuals diagnosed with cancer . CONCLUSION Patients diagnosed with cancer demonstrated a trend toward increased survival with greater levels of PA . However , because only prospect i ve cohort studies were included in the study , the conclusions drawn should be regarded with caution Background : Studies of the association between physical activity ( PA ) and weight maintenance have been inconsistent . Methods : We prospect ively examined the association between PA patterns and prevention of weight gain  among 46 754 healthy premenopausal women , aged 25–43 years in 1989 . Participants reported their PA and weight in 1989 and 1997 . The primary outcome was gaining > 5 % of baseline weight by 1997 ( 62 % of the population ) . Results : Compared with women who maintained < 30 min d−1 of total discretionary activity over 8 years , women were less likely to gain weight if they sustained 30 + min d−1 ( odds ratio (OR)=0.68 , 95 % confidence interval ( CI ) 0.64–0.73 ) or increased to 30 + min d−1 in 1997 ( OR=0.64 , 95%CI=0.60–0.68 ) . Among women whose only reported activity was walking , risk of gaining weight was lower in those who sustained 30 + min d−1 over 8 years ( OR=0.66 , 95%CI=0.49–0.91 ) , and brisk walking pace independently predicted less weight gain . For a 30 min d−1 increase between 1989 and 1997 , jogging/running was associated with less weight gain than brisk walking or other activities . Greater  duration of PA  was associated with progressively less weight gain , but even an 11–20 min d−1 increase was beneficial ; the benefits appeared stronger among those who were initially overweight . Sedentary behavior independently predicted weight gain . Conclusions : Sustained PA for at least 30 min d−1 , particularly if more intense , is associated with a reduction in long-term weight gain , and greater duration is associated with less weight gain . Sedentary women of any baseline weight who increase their PA will benefit , but overweight women appear to benefit the most Objective To examine the combined associations and relative contributions of leisure-time physical activity ( PA ) and cardiorespiratory fitness ( CRF ) with  all-cause mortality .  Design Prospect i ve cohort study . Setting Aerobics centre longitudinal study . Participants 31 818 men and 10 555 women who received a medical examination during 1978–2002 . Assessment of risk factors Leisure-time PA assessed by self-reported question naire ; CRF assessed by maximal treadmill test . Main outcome measures All-cause mortality until 31 December 2003 . Results There were 1492 ( 469 per 10 000 ) and 230 ( 218 per 10 000 ) deaths in men and women , respectively . PA and CRF were positively correlated in men ( r=0.49 ) and women ( r=0.47 ) controlling for age ( p<0.001 for both ) .  PA  was inversely associated with mortality in multivariable Cox regression analysis among men , but the association was eliminated after further adjustment for CRF . No significant association of  PA with mortality was observed in women . CRF was inversely associated with mortality in men and women , and the associations remained significant after further adjustment for PA . In the PA and CRF combined analysis , compared with the reference group “ not meeting the recommended PA ( < 500 metabolic equivalent-minute/week ) and unfit ” , the relative risks ( 95 % CIs ) of mortality were 0.62 ( 0.54 to 0.72 ) and 0.61 ( 0.44 to 0.86 ) in men and women “ not meeting the recommended PA and fit ” , 0.96 ( 0.61 to 1.53 ) and 0.93 ( 0.33 to 2.58 ) in men and women “ meeting the recommended PA and unfit ” and 0.60 ( 0.51 to 0.70 ) and 0.56 ( 0.37 to 0.85 ) in men and women “ meeting the recommended PA and fit ” , respectively . Conclusions CRF was more strongly associated with all-cause mortality than PA ; therefore , improving CRF should be encouraged in unfit individuals to reduce risk of mortality and considered in the development of future PA guidelines Background There are numerous published controlled trials assessing the safety and the benefits of physical activity ( PA ) for child and adult cancer survivors . However , trials exclusively comprised of adolescent cancer survivors aged 13 - 19 years , who may experience different health and quality of life ( QOL ) effects as a function of their developmental status , are lacking . Rather , some trials have included both adolescent and child cancer survivors together . Objective The aim of this systematic review was to synthesize the findings from r and omized controlled trails ( RCTs ) and controlled clinical trials ( CCTs ) investigating the effects of PA on health and QOL outcomes in sample s comprised of > 50 % adolescent cancer survivors to summarize the current state of evidence , identify knowledge gaps , and highlight areas in need of additional research within this population . Methods Using a search strategy developed for this review , 10 electronic data bases were search ed for RCTs and CCTs that reported on the effects of PA on at least 1 health and /or QOL outcome in sample s comprised of > 50 % adolescent cancer survivors . Results From the 2249 articles identified , 2 CCTs met the predetermined eligibility criteria and were included in this review . Combined , 28 adolescents ( of 41 participants ) who were receiving active treatment participated in the 2 studies review ed . A total of 4 health and QOL outcomes ( ie , bone mass , fatigue , grip strength , QOL ) were assessed pre- and post-PA intervention . Conclusions On the basis of the 2 studies review ed , PA appears to be safe and feasible .  PA also shows promise to mitigate reductions in bone mass and might be a viable strategy to improve fatigue , grip strength , and QOL . High- quality controlled trials with larger sample s exclusively comprised of adolescent cancer survivors that assess a wide range of outcomes are needed to determine the effects of PA on health and QOL outcomes in this population BACKGROUND Cardiovascular diseases are the leading cause of death globally and sedentary lifestyle is one of the main risk factors . Home-based cardiac rehabilitation ( CR ) programs appear to be effective to improve exercise tolerance . The aim of the study , therefore , was to evaluate the effects of a phase IV ( maintenance ) home-based CR program on cardiorespiratory fitness and daily physical activity of patients recovering from an acute myocardial infa rct ion . METHODS This pilot study , with a sub-group r and omised controlled trial , included 32 individuals recovering from a myocardial infa rct ion , r and omly divided into the experimental group ( EG , n=16 ) and the control group ( CG , n=16 ) . The EG performed an exercise program , three times per week , at home during eight weeks . The two groups received health education sessions . Baseline and final assessment s included cardiorespiratory fitness , resting and peak heart rate , blood pressure and rate pressure , heart rate recovery and daily physical activity . ( Clinical Trials.gov : NCT01887080 ) . RESULTS At baseline no significant differences were observed between groups . After eight weeks of exercise , the EG significantly increased peak oxygen uptake ( p=0.02 ) , test duration ( p=0.019 ) , peak rate pressure ( p=0.003 ) , peak heart rate ( p=0.003 ) and heart rate recovery ( 0.025 ) when compared to the CG . No changes were observed on daily physical activity in both groups . CONCLUSION This specific phase IV home-based exercise program seems to improve cardiorespiratory fitness , haemodynamics at peak exercise and heart rate recovery , an indicator of cardiac autonomic function BACKGROUND Studies have shown self-monitoring can modify health behaviors , including physical activity ( PA ) . This study tested the utility of a wearable sensor/device ( Fitbit ( ® ) One ™ ; Fitbit Inc. , San Francisco , CA ) and short message service ( SMS ) text-messaging prompts to  increase PA  in overweight and obese adults . MATERIAL S AND METHODS Sixty-seven adults wore a Fitbit One tracker for 6 weeks ; half were r and omized to also receive three daily SMS-based PA prompts . The Fitbit One consisted of a wearable tracker for instant feedback on performance and a Web site/mobile application ( app ) for detailed summaries . Outcome measures were objective ly measured steps and minutes of PA by intensity using two accelerometers : Actigraph ™ ( Pensacola , FL ) GT3X+ ( primary measure ) at baseline and Week 6 and Fitbit One ( secondary measure ) at baseline and Weeks 1 , 2 , 3 , 4 , 5 , and 6 . RESULTS Mixed-model repeated- measures analysis of primary measures indicated a significant within-group increase of + 4.3 ( st and ard error [SE]=2.0 ) min/week of moderate- to vigorous-intensity PA ( MVPA ) at 6-week follow-up ( p=0.04 ) in the comparison group ( Fitbit only ) , but no study group differences across PA levels . Secondary measures indicated the SMS text-messaging effect lasted for only 1 week : the intervention group increased by + 1,266 steps ( SE=491 ; p=0.01 ) , + 17.8 min/week MVPA ( SE=8.5 ; p=0.04 ) , and + 38.3 min/week total PA ( SE=15.9 ; p=0.02 ) compared with no changes in the comparison group , and these between-group differences were significant for steps ( p=0.01 ) , fairly/very active minutes ( p<0.01 ) , and total active minutes ( p=0.02 ) . CONCLUSIONS These data suggest that the Fitbit One achieved a small increase in MVPA at follow-up and that the SMS-based PA prompts were insufficient in increasing PA beyond 1 week . Future studies can test this intervention in those requiring less help and /or test strategies to increase participants ' engagement levels Background Many Australian children are insufficiently active to accrue health benefits and physical activity ( PA ) levels are consistently lower among youth of low socio-economic position .  PA levels decline dramatically during adolescence and evidence suggests that competency in a range of fundamental movement skills ( FMS ) may serve as a protective factor against this trend . Methods / design The Supporting Children ’s Outcomes Using Rewards Exercise and Skills ( SCORES ) intervention is a multi-component PA and FMS intervention for primary schools in low-income communities , which will be evaluated using a group r and omized controlled trial . The socio-ecological model provided a framework for the 12-month intervention , which includes the following components : teacher professional learning , student leadership workshops ( including leadership accreditation and rewards , e.g. , stickers , water bottles ) , PA policy review , PA equipment packs , parental engagement via newsletters , FMS homework and a parent evening , and community partnerships with local sporting organizations . Outcomes will be assessed at baseline , 6- and 12-months . The primary outcomes are PA ( accelerometers ) , FMS ( Test of Gross Motor Development II ) and cardiorespiratory fitness ( multi-stage fitness test ) . Secondary outcomes include body mass index [ using weight (kg)/height ( m2 ) ] , perceived competence , physical self-esteem , and resilience . Individual and environmental mediators of behavior change ( e.g. social support and enjoyment ) will also be assessed . The System for Observing Fitness Instruction Time will be used to assess the impact of the intervention on PA within physical education lessons . Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA behavior change will be explored . Discussion SCORES is an innovative primary school-based PA and FMS intervention design ed to support students attending schools in low-income communities to be more skilled and active . The findings from the study may be used to guide teacher pre-service education , professional learning and school policy in primary schools . Trial registration Australian New Zeal and Clinical Trials Registry No : OBJECTIVE To assess the efficacy of a strategy , based on telephone support oriented by accelerometer measurements , on the adherence to physical activity ( PA ) recommendations in cardiac patients not achieving PA recommendations . DESIGN Prospect i ve and r and omized study . SETTING A cardiac rehabilitation program ( CRP ) at a clinic . PARTICIPANTS Stable , noncompliant cardiac ( coronary artery disease , heart failure , post-cardiovascular surgery ) patients ( weekly moderate-intensity PA < 150 min ) were r and omly assigned to an intervention group ( n=19 ) or a control group ( n=10 ) . INTERVENTIONS The intervention group wore an accelerometer for 8 weeks . Every 15 days , feedback and support were provided by telephone . The control group wore the accelerometer during the 8th week of the intervention only . MAIN OUTCOME MEASURES Active energy expenditure ( EE ) ( in kilocalories ) and the time spent doing light , moderate , or intense PA ( minutes per week ) . RESULTS In the intervention group , the time spent at moderate-intensity PA increased from 95.6±80.7 to 137.2±87.5 min/wk between the 1st and 8th week ( P=.002 ) , with 36.8 % of the sample achieving the target amount of moderate-intensity PA . During the 8th week , the EE averaged 543.7±144.1 kcal and 266.7±107.4 kcal in the intervention group and control group , respectively ( P=.004 ) . CONCLUSIONS Telephone support based on accelerometer recordings appeared to be an effective strategy to improve adherence to PA in noncompliant patients . This intervention could be implemented after a CRP as an inexpensive , modern , and easy-to-use strategy Activity energy expenditure ( AEE ) is the component of daily energy expenditure that is mainly influenced by the amount of physical activity ( PA ) and by the weight of the body displaced . This study aim ed at analyzing the effect of weight loss on PA and AEE . The body weight and PA of 66 overweight and obese subjects were measured at baseline and after 12 weeks of 67 % energy restriction .  PA was measured using a tri-axial accelerometer for movement registration ( Tracmor ) and quantified in activity counts . Tracmor recordings were also processed using a classification algorithm to recognize 6 common activity types engaged in during the day . A doubly-labeled water vali date d equation based on Tracmor output was used to estimate AEE . After weight loss , body weight decreased by 13±4 % , daily activity counts augmented by 9 % ( 95 % CI : + 2 % , + 15 % ) , and this increase was weakly associated with the decrease in body weight ( R(2 ) = 7 % ; P<0.05 ) . After weight loss subjects were significantly ( P<0.05 ) less sedentary ( -26 min/d ) , and increased the time spent walking ( + 11 min/d ) and bicycling ( + 4 min/d ) . However , AEE decreased by 0.6±0.4 MJ/d after weight loss . On average , a 2-hour/day reduction of sedentary time by increasing ambulatory and generic activities was required to restore baseline levels of AEE . In conclusion , after weight loss PA increased but the related metabolic dem and did not offset the reduction in AEE due to the lower body weight . Promoting physical activity according to the extent of weight loss might increase successfulness of weight maintenance Energy restriction from a low-calorie diet and increased energy expenditure induced by physical activity ( PA ) could promote weight loss/maintenance and be important determinants of breast cancer ( BC ) prognosis . The aim of this study was to assess participation and adherence of overweight and obese BC survivors to a lifestyle intervention and to demonstrate the capacity of this intervention to induce weight loss and nutritional changes . This single-arm pre – post study , which involved one-hourly weekly diet sessions delivered by a dietician and 75-min bi-weekly PA sessions of moderate-to-high intensity led by PA monitors , was offered to overweight and obese BC survivors shortly after treatment . Before and after the intervention , anthropometry , dietary information , quality of life ( QoL ) and cardiorespiratory fitness ( CRF ) were collected . A total of 112 BC survivors were invited to participate : 42 of them started the intervention and 37 completed it . Participants attended more than 90 % of the sessions offered and showed a significant weight loss of 5.6 ± 2.0 kg , as well as significant decreases in body mass index , fat mass and waist circumference . Significant decreases in total energy ( −25 % ) , fat ( −35 % ) , saturated fat ( −37 % ) and carbohydrate ( −21 % ) intakes were observed while QoL and CRF showed significant increases . This feasibility study demonstrated the success of a short-term diet and PA intervention to induce weight loss and promote healthful changes in BC survivors . Assessing the long-term effects of these changes , and in particular their possible impact of BC prognosis , and design ing interventions reaching a wider number of BC survivors are still issues to be addressed Background People with lung cancer have substantial symptom burden and more unmet needs than the general cancer population . Physical activity ( PA ) has been shown to positively influence quality of life ( QOL ) , fatigue and daily functioning in the curative treatment of people with breast and colorectal cancers and lung diseases , as well as in palliative setting s. A r and omised controlled trial ( RCT ) is needed to determine if lung cancer patients benefit from structured PA intervention . The Physical Activity in Lung Cancer ( PAL ) trial is design ed to evaluate the impact of a 2-month PA intervention on fatigue and QOL in patients with non-resectable lung cancer . Biological mechanisms will also be studied . Methods / design A multi-centre RCT with patients r and omised to usual care or a 2-month PA programme  , involving supervised PA sessions including a behavioural change component and home-based PA . QOL question naires , disease and functional status and body composition will be assessed at baseline , 2 , 4 and 6 months follow-up . The primary endpoint is comparative levels of fatigue between the 2 arms . Secondary endpoints include : QOL , functional abilities and physical function . Exploratory endpoints include : anxiety , depression , distress , dyspnoea , PA behaviour , fitness , hospitalisations , survival , cytokines and insulin-like growth factor levels . Discussion This study will provide high-level evidence of the effect of PA programmes on cancer-related fatigue and QOL in patients with advanced lung cancer . If positive , the study has the potential to change care for people with cancer using a simple , inexpensive intervention to improve their QOL and help them maintain independent function for as long as possible . Trial registration Australian New Zeal and Clinical Trials Registry No. Background We have previously reported on the benefits of Pre-Surgical Exercise Training ( PreSET ) on physical fitness and social interactions in subjects awaiting bariatric surgery ( BS ) . However , data are needed to know whether these benefits are maintained post-BS . Objectives The purpose of this paper was to evaluate the effect of PreSET on physical activity ( PA ) level , physical fitness , PA barriers , and quality of life ( QoL ) 1 year ( 1-Y ) after BS . Methods Of the 30 participants r and omized into two groups ( PreSET and usual care ) , 25 were included in the final analysis . One year after BS , time spent in different PA intensities and number of steps were assessed with an accelerometer . Before BS and until 1-Y after BS , physical fitness was assessed with  symptom-limited cardiac exercise test , 6-min walk test ( 6MWT ) , and sit-to-st and , half-squat , and arm curl tests . QoL , PA barriers , and PA level were evaluated with question naires . Results The number of steps ( 7460 vs 4287 ) and time spent in light ( 3.2 vs 2.2 h/day ) and moderate ( 0.6 vs 0.3 h/day ) PA were higher in the PreSET group 1-Y after BS . The changes in 6MWT heart cost ( 1.3 vs 0.6 m/beats/min ) , half-squat test ( 38.8 vs 10.3 s ) , and BMI ( − 16.8 vs − 13.5 kg/m2 ) were significantly greater in the PreSET group compared to those in the usual care group . No other significant difference between groups was observed . Conclusion The addition of the PreSET to individual lifestyle counseling seems effective to improve PA level and submaximal physical fitness 1-Y after BS . Studies with larger cohorts are now required to confirm these results .The trial was registered at clinical trials.gov ( NCT01452230 ) Our aim is to analyse the effect on bone mass of : ( 1 ) physical fitness performance on a specific group of physical activity ( PA ) and , ( 2 ) PA on a specific physical fitness performance group . Bone mineral content ( BMC ) by dual energy X-ray absorptiometry ( DXA ) and PA by accelerometers was assessed in 373 Spanish adolescents ( 182 males ) . Adolescents were classified as : active and non-active ( ≥60 or < 60 min day−1 of moderate-vigorous PA ) . Fitness was assessed through speed/agility , strength and cardiorespiratory tests . Adolescents were classified by tertiles ( T1 , T2 and T3 ) . ANCOVA was used for the analysis with sex , height , lean mass , calcium intake and pubertal status as covariates . Adolescents with lower strength , speed/agility and cardiorespiratory fitness ( CRF ) showed lower BMC in the whole body and extremities compared with adolescents with better results in these tests , mainly those non-active adolescents . Non-active adolescents with high fitness levels showed higher BMC ( whole body and upper limbs ) than active ones . The conclusions included : ( 1 ) within the non-active group , lower levels of fitness were associated with lower BMC ; this might be through PA or trough an effect of PA on muscle mass . ( 2 ) Non-active adolescents with high level of fitness in most fitness tests showed higher BMC than their active peers , in spite of their lower PA levels . These unexpected results could be influenced by several factors such as genetics , nutrition , type of exercise or sport , hormones and skeletal age The purpose of this pilot study was to evaluate the feasibility and the effectiveness of an intervention that employed a technology-based physical activity ( PA ) monitoring system and teacher-regulated strategies to promote PA  in preschoolers . A total of 93 preschoolers ( 53 % girls , 4.7 years ) from 5 child care centers were recruited for a one-week intervention and r and omly assigned into control ( 2 centers , n = 45 ) or intervention ( 3 centers , n = 48 ) group . Key intervention components included : ( 1 ) wearable device-based , real-time monitoring of children ’s PA by classroom teachers and ( 2 ) teacher-regulated strategies for providing more opportunities for PA . Sedentary behavior ( SED ) and PA were measured using accelerometers . Overall , children in the intervention group showed significantly lower level of SED ( 31.6 vs. 33.6 min/h ) and higher level of total PA ( 28.4 vs. 26.4 min/h ) than children in the control group , after adjusting for age , sex , race , parent education level , parent perception of their child ’s PA , BMI , and childcare centers . Teachers in the intervention group reported that the intervention was highly feasible to be implemented in their current classroom setting s. In conclusion , we observed high acceptability and initial effectiveness of the current intervention . Subsequent research at larger-scale is warranted to fully evaluate the effectiveness of the intervention strategies tested in this study Latino children spend more time in sedentary activities than other American children , and only ~1 in 5 Latino children in public elementary and middle schools meet all 6 fitness st and ards in statewide fitness testing . Schools that facilitate physical activity ( PA ) by maintaining playgrounds and providing physical education classes have children who are more active and less overweight . The aims of the present study were to examine the extent to which several social and physical environmental changes in school setting s result ed in observed changes in area characteristics and children 's activity levels during recess . Thirteen elementary schools serving predominantly Mexican American children were r and omized into  control or activity and nutrition environmental intervention conditions . Playgrounds and activities were restructured in 6 intervention schools to promote more PA . After 1 y , there were no overall statistical differences between treatment groups in PA or sedentary behavior in these setting s and results did not differ by gender . Changing the social and physical environments to promote children 's moderate-to-vigorous PA is important to the design of active and healthy recess environments . The present results are not conclusive as to the link between these interventions and actual behavior , but show sufficient promise for further population and setting specific research The aim of this study was to investigate the impact of a physical activity (PA)-focused behavioural intervention during and after  pulmonary rehabilitation ( PR ) on PA levels ( primary aim ) , health-related outcomes and self-efficacy ( secondary aims ) of patients with COPD . Thirty-two patients were r and omly assigned to an experimental group ( EG ) or control group ( CG ) . The EG received a PA-focused behavioural intervention during PR ( 3 months ) and follow-up support ( 3 months ) . The CG received PR ( 3 months ) . Daily PA was collected : number of steps ; time spent in moderate-to-vigorous PA ( MVPA ) , total PA and sedentary activities ( SA ) . Secondary outcomes comprised exercise capacity , muscle strength , health-related quality of life ( HRQOL ) and self-efficacy . Measures were collected at baseline , 3 and 6 months . Compared with the CG , the EG improved the number of steps ( p = 0.006 ) and time spent in MVPA ( p = 0.007 ) , total PA ( p = 0.014 ) and SA ( p = 0.018 ) at 3 months . Differences were maintained after follow-up support ( 0.025 ≤ p ≤ 0.040 ) , except for SA ( p = 0.781 ) . Exercise capacity , muscle strength and HRQOL were increased at 3 and 6 months ( p ≤ 0.002 ) with no between-group differences ( 0.148 ≤ p ≤ 0.987 ) . No changes were observed in self-efficacy ( p = 0.899 ) . A PA-focused behavioural intervention during and after PR may improve patients ' PA levels . Further research is warranted to assess the sustainability of the findings Background Previous studies indicate that seasonal variation affects daily physical activity ( PA ) , but none have investigated this relationship in individuals with heart failure ( HF ) who also have implanted cardioverter defibrillators and cardiac resynchronization therapy ( ICD/CRT ) devices . The purpose of the present study was to determine if seasonal variation in temperature affects daily PA in patients with HF and ICD/CRTs . Patients and methods Secondary analysis of data from 16 subjects with HF and Medtronic ® ICD/CRT devices enrolled in a r and omized trial investigating interventions to improve daily PA . Due to the rolling study enrollment , daily PA data for all subjects were not available for the entire time frame and were divided into two groups . Determination of seasonal variation of daily PA was determined using visual analysis of daily PA plotted with average temperature , autocorrelation , visual analysis of seasonal subseries plots and boxplot analysis , as well as Wilcoxon signed-rank tests . Results Subjects 1 - 8 demonstrated the greatest differences in daily PA during periods of seasonal transition whereas subjects 9 - 16 demonstrated the greatest variation in daily PA with greatest seasonal temperature difference . Wilcoxon signed-rank testing of the lowest and highest months for daily PA revealed median differences of 0.30 ( p = 0.050 ) and 0.36 hours ( p = 0.036 ) for subjects 1 - 8 and 9 - 16 , with effect sizes of 0.69 and 0.74 , respectively . Conclusions Seasonal variation in mean temperature appears to affect daily PA in individuals with HF and ICD/CRT devices by a magnitude of 0.30 - 0.36 hours , which may need to be accounted for in future research investigating interventions to improve daily PA INTRODUCTION Shift work ( an occupation requiring work between 2200 and 0500H ) comprises approximately 20 % of the workforce in Europe and North America [ 1 ] . This is likely to increase , with many shift workers ( SWs ) in emergency services , retail , hospitality , healthcare , transportation and manufacturing [ 2 ] . SWs are at increased risk for negative health outcomes , including cancer and other chronic diseases [ 3 , 4 ] . Biological changes from poor lifestyle habits related to shift work ( e.g. low physical activity ( PA ) , poor nutrition , obesity ) are thought to contribute to this risk ; these factors are also amenable to lifestyle intervention [ 5 ] . PA in particular , reduces cancer risk [ 6 ] , and has many positive physical and psychological benefits [ 7 ] . It is a simple , cost-effective strategy that may be implemented by individual workers or within workplaces to mitigate risk . Unfortunately , SWs are unlikely to engage in regular PA [ 8 ] . In Canada , only 15.9 % of SWsmeet the PA guidelines and have lower levels of aerobic fitness than those of day workers [ 9 ] . Few behavioural interventions improving health outcomes in SWs have been published [ 10 ] . In a targeted PA intervention , nurses r and omised to 4 months of supervised PA  improved aerobic fitness , muscular strength , fatigue and musculoskeletal symptoms . However , authors reported low adherence and large loss to follow-up , perhaps due to the supervised scheduled sessions [ 11 , 12 ] . Sustained behaviour change is a challenge and requires targeted efforts to encourage individuals to reach an adequate dose of PA to change health outcomes [ 13 ] . Due to irregular schedules and time constraints , SWs may be less likely to adhere to a traditional supervised PA intervention with face-to-face behavioural support [ 12 ] . Women SWs cite work schedule interference and lack of time as PA barriers and report scheduling flexibility as the most important in PA [ 14 ] . This highlights the need for a creative and innovative programming to promote PA in SWs . Distance-based interventions , in which individuals exercise independent of study staff or participants , may include telephone counselling and website or smart phone app-based technology . These interventions are highly flexible and may help overcome barriers related to timing and scheduling that are important for SWs . In a review of telephone-based PA interventions , 14 of 17 found evidence for behaviour change [ 15 ] . These may be a way to implement scalable , individuallytailored interventions in SWs . The primary objective of this study was to test the feasibility of a distance-based PA intervention in women SWs . Feasibility studies are important for establishing effective processes and underst and ing re sources required before attempting a r and omised controlled trial ( RCT ) , in order to put forward interventions that are most likely to be efficacious [ 16 ] . As this work was funded by a grant to examine the role of lifestyle in reducing breast cancer risk in SWs , only women were included . A secondary objective was to conduct a preliminary evaluation of intervention efficacy , to estimate effect size for future studies
There was no significant between group difference in six-minute walk test distance .
Conclusions Our meta- analysis showed WPAM with exercise prescription or advice are superior to no device in improving CRF in the maintenance phase of CR and no cardiac adverse events were reported with WPAM use .
Our qualitative analysis showed evidence in favour of WPAM with exercise prescription or advice for both CRF and step count .
WPAM with exercise prescription or advice did not change sedentary time .
Background Physical activity ( PA ) is a component of cardiac rehabilitation ( CR ) .
However , life-long engagement in PA is required to maintain benefits gained .
Wearable PA monitoring devices ( WPAM ) are thought to increase PA .
There appear to be no review s which investigate the effect of WPAM in cardiac population s. We firstly aim ed to systematic ally review r and omised controlled trials within the cardiac population that investigated the effect WPAM had through the maintenance phase of CR .
We specifically examined the effect on cardiorespiratory fitness ( CRF ) , amount and intensity of daily PA , and sedentary time .