ORCID Profile
0000-0001-7323-3225
Current Organisation
University of Sydney
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Cognitive neuroscience | Biological psychology | Biological physics |
Publisher: BMJ
Date: 03-01-2020
Publisher: BMJ
Date: 24-05-2018
Publisher: BMJ
Date: 25-11-2020
Publisher: BMJ
Date: 25-04-2018
DOI: 10.1136/BJSPORTS-2017-097563
Abstract: To assess the relationship between time spent in light physical activity and cardiometabolic health and mortality in adults. Systematic review and meta-analysis. Searches in Medline, Embase, PsycInfo, CINAHL and three rounds of hand searches. Experimental (including acute mechanistic studies and physical activity intervention programme) and observational studies (excluding case and case–control studies) conducted in adults (aged ≥18 years) published in English before February 2018 and reporting on the relationship between light physical activity ( metabolic equivalents) and cardiometabolic health outcomes or all-cause mortality. Study quality appraisal with QUALSYST tool and random effects inverse variance meta-analysis. Seventy-two studies were eligible including 27 experimental studies (and 45 observational studies). Mechanistic experimental studies showed that short but frequent bouts of light-intensity activity throughout the day reduced postprandial glucose (−17.5% 95% CI −26.2 to −8.7) and insulin (−25.1% 95% CI −31.8 to –18.3) levels compared with continuous sitting, but there was very limited evidence for it affecting other cardiometabolic markers. Three light physical activity programme intervention studies (n ranging from 12 to 58) reduced adiposity, improved blood pressure and lipidaemia the programmes consisted of activity of min/week for at least 12 weeks. Six out of eight prospective observational studies that were entered in the meta-analysis reported that more time spent in daily light activity reduced risk of all-cause mortality (pooled HR 0.71 95% CI 0.62 to 0.83). Light-intensity physical activity could play a role in improving adult cardiometabolic health and reducing mortality risk. Frequent short bouts of light activity improve glycaemic control. Nevertheless, the modest volume of the prospective epidemiological evidence base and the moderate consistency between observational and laboratory evidence inhibits definitive conclusions.
Publisher: BMJ
Date: 07-08-2023
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.SLEH.2017.07.006
Abstract: Sleep is important for the physical, social and mental well-being of both children and adults. Over the years, there has been a general presumption that sleep will inevitably decline with the increase in technology and a busy 24-hour modern lifestyle. This narrative review discusses the empirical evidence for secular trends in sleep duration and the implications of these trends.
Publisher: BMJ
Date: 12-2020
Publisher: Elsevier BV
Date: 09-2019
Publisher: JMIR Publications Inc.
Date: 06-06-2022
DOI: 10.2196/35697
Abstract: There is increasing recognition of the need for more comprehensive surveillance data, including information on physical activity of all intensities, sedentary behavior, and sleep. However, meeting this need poses significant challenges for current surveillance systems, which are mainly reliant on self-report. The primary objective of this project is to develop and evaluate the feasibility of a sensor-based system for use in the surveillance of physical activity, sedentary behavior, and sleep (SurPASS) at a national level in Denmark. The SurPASS project involves an international, multidisciplinary team of researchers collaborating with an industrial partner. The SurPASS system consists of (1) a thigh-worn accelerometer with Bluetooth connectivity, (2) a smartphone app, (3) an integrated back end, facilitating the automated upload, analysis, storage, and provision of in idualized feedback in a manner compliant with European Union regulations on data privacy, and (4) an administrator web interface (web application) to monitor progress. The system development and evaluation will be performed in 3 phases. These phases will include gathering user input and specifications (phase 1), the iterative development, evaluation, and refinement of the system (phase 2), and the feasibility evaluation (phase 3). The project started in September 2020 and completed phase 2 in February 2022. Phase 3 began in March 2022 and results will be made available in 2023. If feasible, the SurPASS system could be a catalyst toward large-scale, sensor-based surveillance of physical activity, sedentary behavior, and sleep. It could also be adapted for cohort and interventional research, thus contributing to the generation of evidence for both interventions and public health policies and recommendations. DERR1-10.2196/35697
Publisher: Springer Science and Business Media LLC
Date: 12-2022
DOI: 10.1038/S41591-022-02100-X
Abstract: Wearable devices can capture unexplored movement patterns such as brief bursts of vigorous intermittent lifestyle physical activity (VILPA) that is embedded into everyday life, rather than being done as leisure time exercise. Here, we examined the association of VILPA with all-cause, cardiovascular disease (CVD) and cancer mortality in 25,241 nonexercisers (mean age 61.8 years, 14,178 women/11,063 men) in the UK Biobank. Over an average follow-up of 6.9 years, during which 852 deaths occurred, VILPA was inversely associated with all three of these outcomes in a near-linear fashion. Compared with participants who engaged in no VILPA, participants who engaged in VILPA at the s le median VILPA frequency of 3 length-standardized bouts per day (lasting 1 or 2 min each) showed a 38%–40% reduction in all-cause and cancer mortality risk and a 48%–49% reduction in CVD mortality risk. Moreover, the s le median VILPA duration of 4.4 min per day was associated with a 26%–30% reduction in all-cause and cancer mortality risk and a 32%–34% reduction in CVD mortality risk. We obtained similar results when repeating the above analyses for vigorous physical activity (VPA) in 62,344 UK Biobank participants who exercised (1,552 deaths, 35,290 women/27,054 men). These results indicate that small amounts of vigorous nonexercise physical activity are associated with substantially lower mortality. VILPA in nonexercisers appears to elicit similar effects to VPA in exercisers, suggesting that VILPA may be a suitable physical activity target, especially in people not able or willing to exercise.
Publisher: Human Kinetics
Date: 07-2023
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.PTSP.2018.12.008
Abstract: To investigate the effectiveness of incidental (non-structured) physical activity interventions for the management of people with low back pain (LBP). Systematic review and meta-analyses of randomised controlled trials. Eligible published trials from the earliest date available to November 2017. People with non-specific LBP aged 18 years or over. Pain, disability and physical activity-related outcomes. Three trials were included (including a total of 422 participants). The quality of trials, assessed by PEDro scale, was high (7 out of 10). For pain, the pooled results did not show any significant effects between the incidental physical activity intervention and other interventions at any time point. For disability, incidental physical activity was not statistically more effective than other interventions at short-term however, the pooled results favoured incidental physical activity at intermediate-term (weighted mean difference (WMD) = -6.05, 95%CI: -10.39 to -1.71) and long-term (WMD = -6.40 95%CI: -11.68 to -1.12) follow-ups among participants with chronic LBP. The overall quality of evidence was rated "moderate-quality" based on the GRADE system. The incidental physical activity intervention provided improvement in disability in intermediate- and long-term for people with chronic LBP, although this improvement was small and may not be clinically significant.
Publisher: BMJ
Date: 08-10-2021
DOI: 10.1136/BJSPORTS-2021-103987
Abstract: Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinicians and policy-makers implement results in practice. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and its accompanying Explanation and Elaboration document provide general reporting ex les for systematic reviews of healthcare interventions. However, implementation guidance for sport and exercise medicine, musculoskeletal rehabilitation, and sports science does not exist. The Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance attempts to address this problem. Nineteen content experts collaborated with three methods experts to identify ex les of exemplary reporting in systematic reviews in sport and exercise medicine (including physical activity), musculoskeletal rehabilitation (including physiotherapy), and sports science, for each of the PRISMA 2020 Statement items. PERSiST aims to help: (1) systematic reviewers improve the transparency and reporting of systematic reviews and (2) journal editors and peer reviewers make informed decisions about systematic review reporting quality.
Publisher: BMJ
Date: 31-07-2019
Publisher: BMJ
Date: 09-01-2019
Publisher: BMJ
Date: 04-11-2019
DOI: 10.1136/BJSPORTS-2018-100493
Abstract: To investigate the association of running participation and the dose of running with the risk of all-cause, cardiovascular and cancer mortality. Systematic review and meta-analysis. Journal articles, conference papers and doctoral theses indexed in Academic Search Ultimate, CINAHL, Health Source: Nursing/Academic Edition, MasterFILE Complete, Networked Digital Library of Theses and Dissertations, Open Access Theses and Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, SPORTDiscus and Web of Science. Prospective cohort studies on the association between running or jogging participation and the risk of all-cause, cardiovascular and/or cancer mortality in a non-clinical population of adults were included. Fourteen studies from six prospective cohorts with a pooled s le of 232 149 participants were included. In total, 25 951 deaths were recorded during 5.5–35 year follow-ups. Our meta-analysis showed that running participation is associated with 27%, 30% and 23% lower risk of all-cause (pooled adjusted hazard ratio (HR)=0.73 95% confidence interval (CI) 0.68 to 0.79), cardiovascular (HR=0.70 95% CI 0.49 to 0.98) and cancer (HR=0.77 95% CI 0.68 to 0.87) mortality, respectively, compared with no running. A meta-regression analysis showed no significant dose–response trends for weekly frequency, weekly duration, pace and the total volume of running. Increased rates of participation in running, regardless of its dose, would probably lead to substantial improvements in population health and longevity. Any amount of running, even just once a week, is better than no running, but higher doses of running may not necessarily be associated with greater mortality benefits.
Publisher: Informa UK Limited
Date: 21-09-2020
Publisher: Springer Science and Business Media LLC
Date: 26-10-2020
DOI: 10.1007/S40279-020-01368-8
Abstract: Recently revised public health guidelines acknowledge the health benefits of regular intermittent bouts of vigorous intensity incidental physical activity done as part of daily living, such as carrying shopping bags, walking uphill, and stair climbing. Despite this recognition and the advantages such lifestyle physical activity has over continuous vigorous intensity structured exercise, a scoping review we conducted revealed that current research in this area is, at best, rudimentary. Key gaps include the absence of an empirically-derived dose specification (e.g., minimum duration of lifestyle physical activity required to achieve absolute or relative vigorous intensity), lack of acceptable measurement standards, limited understanding of acute and chronic (adaptive) effects of intermittent vigorous bouts on health, and paucity of essential information necessary to develop feasible and scalable interventions (e.g., acceptability of this kind of physical activity by the public). To encourage collaboration and research agenda alignment among groups interested in this field, we propose a research framework to further understanding of vigorous intermittent lifestyle physical activity (VILPA). This framework comprises four pillars aimed at the development of: (a) an empirical definition of VILPA, (b) methods to reliably and accurately measure VILPA, (c) approaches to examine the short and long-term dose–response effects of VILPA, and (d) scalable and acceptable behavioural VILPA-promoting interventions.
Publisher: BMJ
Date: 07-08-2023
Publisher: BMJ
Date: 23-09-2021
Publisher: MDPI AG
Date: 29-01-2021
DOI: 10.3390/S21030904
Abstract: Body postural allocation during daily life is important for health, and can be assessed with thigh-worn accelerometers. An algorithm based on sedentary bouts from the proprietary ActivePAL software can detect lying down from a single thigh-worn accelerometer using rotations of the thigh. However, it is not usable across brands of accelerometers. This algorithm has the potential to be refined. Aim: To refine and assess the validity of an algorithm to detect lying down from raw data of thigh-worn accelerometers. Axivity-AX3 accelerometers were placed on the thigh and upper back (reference) on adults in a development dataset (n = 50) and a validation dataset (n = 47) for 7 days. Sedentary time from the open Acti4-algorithm was used as input to the algorithm. In addition to the thigh-rotation criterion in the existing algorithm, two criteria based on standard deviation of acceleration and a time duration criterion of sedentary bouts were added. The mean difference (95% agreement-limits) between the total identified lying time/day, between the refined algorithm and the reference was +2.9 (−135,141) min in the development dataset and +6.5 (−145,159) min in the validation dataset. The refined algorithm can be used to estimate lying time in studies using different accelerometer brands.
Publisher: BMJ
Date: 08-02-2023
DOI: 10.1136/BJSPORTS-2022-105435
Abstract: To examine if in idual-level and area-level socioeconomic status (SES) modifies the association of moderate-to-vigorous physical activity (MVPA), domain-specific physical activity and sedentary behaviour with all-cause mortality (ACM) and incident cardiovascular disease (CVD). We used self-reported (International Physical Activity Questionnaire short form) and accelerometer-measured physical activity and sedentary behaviour data from the UK Biobank. We created an in idual-level composite SES index using latent class analysis of household income, education and employment status. The Townsend Index was the measure of area-level SES. Cox proportional hazards regression models stratified across SES were used. In 328 228 participants (mean age 55.9 (SD 8.1) years, 45% men) with an average follow-up of 12.1 (1.4) years, 18 033 deaths and 98 922 incident CVD events occurred. We found an increased ACM risk of low physical activity and high sedentary behaviour and an increased incident CVD risk of low accelerometer-measured moderate-to-vigorous physical activity (ACCEL_MVPA) and high sitting time. We observed statistically significant interactions for all exposures in ACM analyses by in idual-level SES (p .05) but only for screen time in area-level SES–ACM analysis (p .001). Compared with high self-reported moderate-to-vigorous physical activity (IPAQ_MVPA), adjusted ACM HRs for low IPAQ_MVPA were 1.14 (95% CI 1.05 to .25), 1.15 (95% CI 1.06 to 1.24) and 1.22 (95% CI 1.13 to 1.31) in high, medium and low in idual-level SES, respectively. There were higher detrimental associations of low ACCEL_MVPA with decreasing area-level SES for both outcomes and of high screen time with ACM in low area-level SES. We found modest evidence suggesting that the detrimental associations of low MVPA and high screen time with ACM and incident CVD are accentuated in low SES groups.
Publisher: BMJ
Date: 29-06-2021
DOI: 10.1136/BJSPORTS-2021-104046
Abstract: Although both physical inactivity and poor sleep are deleteriously associated with mortality, the joint effects of these two behaviours remain unknown. This study aimed to investigate the joint association of physical activity (PA) and sleep with all-cause and cause-specific mortality risks. 380 055 participants aged 55.9 (8.1) years (55% women) from the UK Biobank were included. Baseline PA levels were categorised as high, medium, low and no moderate-to-vigorous PA (MVPA) based on current public health guidelines. We categorised sleep into healthy, intermediate and poor with an established composited sleep score of chronotype, sleep duration, insomnia, snoring and daytime sleepiness. We derived 12 PA–sleep combinations, accordingly. Mortality risks were ascertained to May 2020 for all-cause, total cardiovascular disease (CVD), CVD subtypes (coronary heart disease, haemorrhagic stroke, ischaemic stroke), as well as total cancer and lung cancer. After an average follow-up of 11.1 years, sleep scores showed dose-response associations with all-cause, total CVD and ischaemic stroke mortality. Compared with high PA-healthy sleep group (reference), the no MVPA-poor sleep group had the highest mortality risks for all-cause (HR (95% CIs), (1.57 (1.35 to 1.82)), total CVD (1.67 (1.27 to 2.19)), total cancer (1.45 (1.18 to 1.77)) and lung cancer (1.91 (1.30 to 2.81))). The deleterious associations of poor sleep with all outcomes, except for stroke, was lified with lower PA. The detrimental associations of poor sleep with all-cause and cause-specific mortality risks are exacerbated by low PA, suggesting likely synergistic effects. Our study supports the need to target both behaviours in research and clinical practice.
Publisher: BMJ
Date: 06-05-2020
Publisher: Springer Science and Business Media LLC
Date: 30-09-2015
Publisher: Wiley
Date: 21-04-2023
DOI: 10.1111/SMS.14363
Abstract: The associations between different types and contexts of stepping behaviors and cardiometabolic (CM) health markers are unclear. This study aimed to examine the associations of daily total, walking, stair, incidental and purposeful steps with cardiometabolic risk. A total of 943 women (mean age ± SD = 44.1 ± 1.6 years) from the Australian Longitudinal Study on Women's Health (ALSWH) were included in this cross‐sectional study. Daily total, walking, stair, incidental, and purposeful steps were measured using thigh‐worn accelerometry. Outcomes comprised of CM markers of adiposity, blood pressure, resting heart rate, lipids, glycaemia, and the composite CM score. We used generalized linear modeling and multiple linear regression to assess the associations. We observed that all stepping behaviors were beneficial to CM health, for ex le, compared to the lowest quartile (Q1), the change of the composite CM score across low to high quartile of purposeful steps was −0.12 (Q2, 95% CI: −0.41, 0.17), −0.16 (Q3, −0.46, 0.14), and −0.36 (Q4, −0.66, −0.05). Stair steps showed linear associations with blood pressure and adiposity biomarkers, for ex le, the change of quartile of waist circumference was −1.45 cm (Q2, −4.35, 1.44), −3.56 cm (Q3, −6.52, −0.60), and −7.08 cm (Q4, −10.31, −3.86). Peak 30‐min walking intensity showed independent association with adiposity biomarkers ( p linear 0.001 and p = 0.002 for waist circumference and BMI, respectively). Our study showed that all stepping forms were beneficial to CM health. Higher stair steps and peak 30‐min walking cadence were associated with a steep decline of adiposity biomarkers. Purposeful steps showed more consistent associations with CM biomarkers than incidental steps.
Publisher: JMIR Publications Inc.
Date: 19-07-2023
DOI: 10.2196/45599
Abstract: Cardiovascular disease accounts for 17.9 million deaths globally each year. Many research study data sets have been collected to answer questions regarding the relationship between cardiometabolic health and accelerometer-measured physical activity. This scoping review aimed to map the available data sets that have collected accelerometer-measured physical activity and cardiometabolic health markers. These data were then used to inform the development of a publicly available resource, the Global Physical Activity Data set (GPAD) catalogue. This review aimed to systematically identify data sets that have measured physical activity using accelerometers and cardiometabolic health markers using either an observational or interventional study design. Databases, trial registries, and gray literature (inception until February 2021 updated search from February 2021 to September 2022) were systematically searched to identify studies that analyzed data sets of physical activity and cardiometabolic health outcomes. To be eligible for inclusion, data sets must have measured physical activity using an accelerometric device in adults aged ≥18 years a s le size participants (unless recruited participants in a low- and middle-income country where a s le size threshold was reduced to 100) used an observational, longitudinal, or trial-based study design and collected at least 1 cardiometabolic health marker (unless only body mass was measured). Two reviewers screened the search results to identify eligible studies, and from these, the unique names of each data set were recorded, and characteristics about each data set were extracted from several sources. A total of 17,391 study reports were identified, and after screening, 319 were eligible, with 122 unique data sets in these study reports meeting the review inclusion criteria. Data sets were found in 49 countries across 5 continents, with the most developed in Europe (n=53) and the least in Africa and Oceania (n=4 and n=3, respectively). The most common accelerometric brand and device wear location was Actigraph and the waist, respectively. Height and body mass were the most frequently measured cardiometabolic health markers in the data sets (119/122, 97.5% data sets), followed by blood pressure (82/122, 67.2% data sets). The number of participants in the included data sets ranged from 103,712 to 120. Once the review processes had been completed, the GPAD catalogue was developed to house all the identified data sets. This review identified and mapped the contents of data sets from around the world that have collected potentially harmonizable accelerometer-measured physical activity and cardiometabolic health markers. The GPAD catalogue is a web-based open-source resource developed from the results of this review, which aims to facilitate the harmonization of data sets to produce evidence that will reduce the burden of disease from physical inactivity.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.AMEPRE.2018.07.022
Abstract: Although muscle-strengthening exercise has multiple independent health benefits, little is known about muscle-strengthening exercise participation and associations with adverse health conditions among U.S. adults. In 2017, data were analyzed from the U.S. 2015 Behavioral Risk Factor Surveillance System. During telephone surveys, respondents reported how many times during the past week they engaged in muscle-strengthening exercise. Weighted weekly muscle-strengthening exercise frequencies were calculated for the total s le and across sociodemographic and lifestyle characteristics. A multivariable logistic regression assessed the odds of having self-reported adverse health conditions (e.g., diabetes, coronary heart disease) according to weekly muscle-strengthening exercise frequency. Data were available on 397,423 adults (aged 18-80 years). Overall, 30.2% (95% CI=29.9, 30.5) met the muscle-strengthening exercise recommendations (two or more times/week) and 57.8% (95% CI=57.5, 58.2) reported no muscle-strengthening exercise. Older age, insufficient aerobic activity, lower income, lower education, poorer self-rated health, being female, and being overweight/obese were significantly associated with lower odds of meeting the muscle-strengthening exercise recommendations independently of other characteristics. After adjusting for confounders (e.g., age, sex, income, smoking, aerobic activity), when compared with those who did none, muscle-strengthening exercise was associated with lower odds for several adverse health conditions, including prevalent diabetes, cancer (non-skin), poor self-rated health, and obesity. Three in five U.S. adults do not engage in any muscle-strengthening exercise, despite an association for muscle-strengthening exercise with better health conditions. Future muscle-strengthening exercise promotion strategies should target older adults, females, those with low education/income, and those with a poor health status.
Publisher: BMJ
Date: 07-06-2019
Publisher: JMIR Publications Inc.
Date: 12-01-2023
Abstract: ardiovascular disease accounts for 17.9 million deaths globally each year. Many research study data sets have been collected to answer questions regarding the relationship between cardiometabolic health and accelerometer-measured physical activity. This scoping review aimed to map the available data sets that have collected accelerometer-measured physical activity and cardiometabolic health markers. These data were then used to inform the development of a publicly available resource, the Global Physical Activity Data set (GPAD) catalogue. his review aimed to systematically identify data sets that have measured physical activity using accelerometers and cardiometabolic health markers using either an observational or interventional study design. atabases, trial registries, and gray literature (inception until February 2021 updated search from February 2021 to September 2022) were systematically searched to identify studies that analyzed data sets of physical activity and cardiometabolic health outcomes. To be eligible for inclusion, data sets must have measured physical activity using an accelerometric device in adults aged ≥18 years a s le size & participants (unless recruited participants in a low- and middle-income country where a s le size threshold was reduced to 100) used an observational, longitudinal, or trial-based study design and collected at least 1 cardiometabolic health marker (unless only body mass was measured). Two reviewers screened the search results to identify eligible studies, and from these, the unique names of each data set were recorded, and characteristics about each data set were extracted from several sources. total of 17,391 study reports were identified, and after screening, 319 were eligible, with 122 unique data sets in these study reports meeting the review inclusion criteria. Data sets were found in 49 countries across 5 continents, with the most developed in Europe (n=53) and the least in Africa and Oceania (n=4 and n=3, respectively). The most common accelerometric brand and device wear location was Actigraph and the waist, respectively. Height and body mass were the most frequently measured cardiometabolic health markers in the data sets (119/122, 97.5% data sets), followed by blood pressure (82/122, 67.2% data sets). The number of participants in the included data sets ranged from 103,712 to 120. Once the review processes had been completed, the GPAD catalogue was developed to house all the identified data sets. his review identified and mapped the contents of data sets from around the world that have collected potentially harmonizable accelerometer-measured physical activity and cardiometabolic health markers. The GPAD catalogue is a web-based open-source resource developed from the results of this review, which aims to facilitate the harmonization of data sets to produce evidence that will reduce the burden of disease from physical inactivity.
Publisher: BMJ
Date: 07-08-2023
Publisher: Public Library of Science (PLoS)
Date: 26-08-2021
DOI: 10.1371/JOURNAL.PONE.0256459
Abstract: Although chronic low back pain (LBP) is a leading cause of disability and accounts for large costs, none of the available conventional treatments are clearly more favourable in treating people at increased risk of chronicity. To examine the feasibility and initial efficacy of a wearables-based walking intervention in addition to usual physiotherapy care in people with LBP at risk of chronicity. Twenty-six adult participants, diagnosed with non-specific LBP with medium or high risk of chronicity, were recruited from physiotherapy private practices. Participants were randomized into usual physiotherapy care (control, n = 14) and usual physiotherapy care plus a wearables-based walking intervention (experimental, n = 12). The intervention duration was 8 weeks. Feasibility outcomes included recruitment rate, adherence to the intervention, dropout rate, and serious adverse events reporting rate. Other outcomes included disability and pain (primary) and physical activity level, daily walking steps, depression, pain catastrophizing and fear of movement (secondary). The outcomes were assessed at baseline, post-intervention and 26 weeks post-randomization follow-up. Adherence of experimental participants with the prescribed walking program was moderate. Four participants dropped out during the intervention, and no serious adverse events were reported. Participants in the experimental group showed significant improvement in pain at 26 weeks (β = -0.38 95% confidence interval (CI) -0.66, -0.10 P = .013), compared with the control group. No between-group differences were found for disability at any time point and pain immediately post-intervention. Experimental participants demonstrated post-intervention improvement in light-intensity (β = 156.71 95% CI 86.79, 226.64 P .001), moderate-intensity physical activity (β = 0.46 95% CI 0.12, 0.80 P = .012), and daily walking steps (β = 7099.13 95% CI 4522.93, 9675.32 P .001). Experimental participants demonstrated post-intervention increase in pain catastrophizing (β = 0.52, 95% CI 0.18, 0.86 P = .006). No between-group differences were found for pain catastrophizing at 26 weeks and other secondary outcomes. Usual physiotherapy care plus a wearables-based walking intervention program was safe and moderately feasible, and provided significant reduction in pain at 26 weeks as well as increasing the total volume of light- and moderate-intensity physical activity, and daily walking steps immediately post-intervention.
Publisher: BMJ
Date: 31-05-2018
DOI: 10.1136/BJSPORTS-2017-098677
Abstract: Walking pace is associated with risk of premature mortality. However, whether this relationship is independent of total volume of physical activity and highest physical activity intensity remains unclear. We examined the associations between walking pace and cause-specific mortality, investigating the potential modifying effect of factors such as total physical activity volume, highest physical activity intensity, age, sex and body mass index (BMI). Prospective pooled analysis of 11 population-based baseline surveys in England and Scotland between 1994 and2008 that were linked with mortality records. Multivariate-adjusted Cox proportional hazards models examined associations between walking pace (slow, average, brisk/fast) and all-cause, cancer and cardiovascular disease (CVD) mortality. 50 225 walkers were entered in the core analyses. Among participants who did not experience an event in the first 2 years of follow-up (n=49 731), walking at an average or brisk/fast pace was associated with a reduced risk of all-cause (20% (95% CI 12% to 28%) and 24% (95% CI 13% to 33%), respectively) and CVD mortality (24% (95% CI 9% to 36%) and 21% (95% CI 1% to 38%), respectively), compared with reporting walking at a slow pace. In stratified analyses, such associations were evident among those over 50 years, those not meeting the physical activity recommendations and those who did not undertake vigorous-intensity activity. There were no interactions by sex or BMI. No associations were seen between pace and cancer mortality. Walking benefits health. Assuming causality, these analyses suggest that increasing walking pace could reduce risk for all-cause and CVD mortality. Walking pace could be emphasised in public health messages, especially in situations when increase in walking volume or frequency is less feasible.
Publisher: BMJ
Date: 10-07-2018
Publisher: BMJ
Date: 10-07-2022
DOI: 10.1136/BJSPORTS-2021-105195
Abstract: To examine independent and interactive associations of physical activity and diet with all-cause, cardiovascular disease (CVD) and physical activity, diet and adiposity-related (PDAR) cancer mortality. This population-based prospective cohort study (n=346 627) is based on the UK Biobank data with linkage to the National Health Service death records to 30 April 2020. A left-truncated Cox proportional hazards model was fitted to examine the associations between exposures (self-reported total moderate-to-vigorous intensity physical activity (MVPA), vigorous-intensity physical activity (VPA) and a diet quality index (score ranged 0–3)) and outcomes (all-cause, CVD and PDAR cancer mortality). During a median follow-up of 11.2 years, 13 869 participants died from all causes, 2650 from CVD and 4522 from PDAR cancers. Compared with quartile 1 (Q1, 0–210 min/week), Q2–Q4 of MVPA were associated with lower risks of all-cause (HR ranged from 0.87 (95% CI: 0.83 to 0.91) to 0.91 (95% CI: 0.87 to 0.96)), CVD (HR ranged from 0.85 (95% CI: 0.76 to 0.95) to 0.90 (95% CI: 0.81 to 1.00)) and PDAR cancer mortality (HR ranged from 0.86 (95% CI: 0.79 to 0.93) to 0.94 (95% CI: 0.86 to 1.02)). Compared with no VPA, any VPA was associated with lower risk for all-cause and CVD mortality (HR ranged from 0.85 (95% CI: 0.80 to 0.89) to 0.88 (95% CI: 0.84 to 0.93) and from 0.75 (95% CI: 0.68 to 0.83) to 0.90 (95% CI: 0.80 to 1.02), respectively). Although not reaching statistical significance for all-cause and CVD mortality, being in the best dietary category (diet quality index=2–3) was associated with a reduction in PDAR cancer mortality (HR=0.86, 95% CI: 0.78 to 0.93). No additive or multiplicative interactions between physical activity categories and dietary quality was found. When comparing across physical activity and diet combinations, the lowest risk combinations consistently included the higher levels of physical activity and the highest diet quality score. Adhering to both quality diet and sufficient physical activity is important for optimally reducing the risk of mortality from all causes, CVD and PDAR cancers.
Publisher: Informa UK Limited
Date: 02-01-2021
Publisher: Informa UK Limited
Date: 14-01-2020
DOI: 10.1080/07420528.2019.1704771
Abstract: Objective measures of circadian disruption are difficult to capture in a free-living environment hence the importance of validating subjective measures of jetlag. We aimed to assess the internal consistency of the 15-item Liverpool Jetlag Scale and its convergent and ergent validity with indicators of fatigue and anxiety in a large s le of air passengers. Online survey of passengers was conducted after travel on a range of long-haul flights. Jetlag was captured using the Liverpool scale, fatigue was measured using the Vitality subscale of the Short-Form Health Survey (SF-36), and the presence of anxiety or worry before, during, and after flight was self-reported. Inter-item correlations and Cronbach's alpha were calculated to assess the internal consistency of the scale. Exploratory factor analysis was used to examine whether the scale was consistent with one underlying construct of circadian disruption. Correlations between fatigue and anxiety (flying, situational, symptoms) with jetlag were used to assess convergent and ergent validity. Linear regression was used to determine the most important symptoms contributing to subjective jetlag rating. N = 460 passengers (57% female, mean age 50, SD 16 years) were surveyed. Cronbach's alpha indicated high internal reliability (alpha = 0.85). Jetlag was more strongly correlated with fatigue (rho = 0.47) than any type of anxiety (rho = 0.10-0.22). Exploratory factor analysis indicated responses were consistent with four factors: (i) fatigue/daytime impairment, (ii) sleep disturbance, (iii) changes in appetite and (iv) changes in bowel function. Regression analysis indicated that only changes in concentration, sleep time, fatigue, sleep quality and frequency of bowel motions were independent correlates of subjective jetlag (R
Publisher: BMJ
Date: 31-05-2018
Publisher: BMJ
Date: 04-05-2020
DOI: 10.1136/BJSPORTS-2019-101323
Abstract: High quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best practice methods—methods matter (greatly!). The 1st METHODS MATTER Meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting.
Publisher: BMJ
Date: 10-06-2018
DOI: 10.1136/BJSPORTS-2018-099131
Abstract: Sedentary behaviour (SB) has been proposed as an ‘independent’ risk factor for chronic disease risk, attracting much research and media attention. Many countries have included generic, non-quantitative reductions in SB in their public health guidelines and calls for quantitative SB targets are increasing. The aim of this narrative review is to critically evaluate key evidence areas relating to the development of guidance on sitting for adults. We carried out a non-systematic narrative evidence synthesis across seven key areas: (1) definition of SB, (2) independence of sitting from physical activity, (3) use of television viewing as a proxy of sitting, (4) interpretation of SB evidence, (5) evidence on ‘sedentary breaks’, (6) evidence on objectively measured sedentary SB and mortality and (7) dose response of sitting and mortality/cardiovascular disease. Despite research progress, we still know little about the independent detrimental health effects of sitting, and the possibility that sitting is mostly the inverse of physical activity remains. Unresolved issues include an unclear definition, inconsistencies between mechanistic and epidemiological studies, over-reliance on surrogate outcomes, a very weak epidemiological evidence base to support the inclusion of ‘sedentary breaks’ in guidelines, reliance on self-reported sitting measures, and misinterpretation of data whereby methodologically inconsistent associations are claimed to be strong evidence. In conclusion, public health guidance requires a consistent evidence base but this is lacking for SB. The development of quantitative SB guidance, using an underdeveloped evidence base, is premature any further recommendations for sedentary behaviour require development of the evidence base and refinement of the research paradigms used in the field.
Publisher: BMJ
Date: 07-03-2018
Publisher: Oxford University Press (OUP)
Date: 27-10-2022
DOI: 10.1093/EURHEARTJ/EHAC572
Abstract: Vigorous physical activity (VPA) is a time-efficient way to achieve recommended physical activity levels. There is a very limited understanding of the minimal and optimal amounts of vigorous physical activity in relation to mortality and disease incidence. A prospective study in 71 893 adults [median age (IQR): 62.5 years (55.3, 67.7) 55.9% female] from the UK Biobank cohort with wrist-worn accelerometry. VPA volume (min/week) and frequency of short VPA bouts (≤2 min) were measured. The dose–response associations of VPA volume and frequency with mortality [all-cause, cardiovascular disease (CVD) and cancer], and CVD and cancer incidence were examined after excluding events occurring in the first year. During a mean post-landmark point follow-up of 5.9 years (SD ± 0.8), the adjusted 5-year absolute mortality risk was 4.17% (95% confidence interval: 3.19%, 5.13%) for no VPA, 2.12% (1.81%, 2.44%) for & to & min, 1.78% (1.53%, 2.03%) for 10 to & min, 1.47% (1.21%, 1.73%) for 30 to & min, and 1.10% (0.84%, 1.36%) for ≥60 min. The ‘optimal dose’ (nadir of the curve) was 53.6 (50.5, 56.7) min/week [hazard ratio (HR): 0.64 (0.54, 0.77)] relative to the 5th percentile reference (2.2 min/week). There was an inverse linear dose-response association of VPA with CVD mortality. The ‘minimal’ volume dose (50% of the optimal dose) was ∼15 (14.3, 16.3) min/week for all-cause [HR: 0.82 (0.75, 0.89)] and cancer [HR: 0.84 (0.74, 0.95)] mortality, and 19.2 (16.5, 21.9) min/week [HR: 0.60 (0.50, 0.72)] for CVD mortality. These associations were consistent for CVD and cancer incidence. There was an inverse linear association between VPA frequency and CVD mortality. 27 (24, 30) bouts/week was associated with the lowest all-cause mortality [HR: 0.73 (0.62, 0.87)]. VPA of 15–20 min/week were associated with a 16–40% lower mortality HR, with further decreases up to 50–57 min/week. These findings suggest reduced health risks may be attainable through relatively modest amounts of VPA accrued in short bouts across the week.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.MAYOCP.2021.11.026
Abstract: To examine the association of changes in physical activity and adiposity with all-cause mortality and incident cardiovascular disease (CVD). Physical activity, body mass index (BMI), body fat percentage, waist circumference, and waist to hip ratio changes were categorized on the basis of public health and clinical guidelines. Among 29,610 participants (mean ± SD follow-up, 5.1±2.1 years), 545 deaths and 2970 CVD events occurred. Participants were observed from baseline (March 13, 2006, to October 10, 2010) and follow-up (August 1, 2012 to November 9, 2018) assessment through March 31, 2021. Compared with stable-insufficient physical activity, increasing physical activity to meet guidelines at follow-up was associated with lower all-cause mortality (hazard ratio, 0.64 [0.49 to 0.85]) and CVD (0.83 [0.72 to 0.96]) risk. This risk was similar to that of those who achieved physical activity guidelines at both time points (all-cause mortality, 0.74 [0.60 to 0.92] CVD, 0.88 [0.79 to 0.99]). For obese and overweight participants, decreasing BMI category was associated with a lower CVD risk (0.70 [0.47 to 1.04]) similar to the risk of those who had a healthy weight at both time points (0.85 [0.76 to 0.96]). In the joint analyses, the only combination that lowered all-cause mortality and CVD risk was physical activity increase and adiposity decrease over time (eg, CVD risk: BMI, 0.64 [0.42 to 0.96] body fat percentage, 0.76 [0.55 to 0.97] waist circumference, 0.66 [0.48 to 0.89] waist to hip ratio, 0.78 [0.62 to 0.97]) compared with the reference group (stable physical activity and adiposity). Increases in physical activity to meet guidelines lowered all-cause mortality and CVD risk equal to that of those who continually met guidelines. The risk was effectively eliminated in those who had concurrent adiposity decrease.
Publisher: BMJ
Date: 25-11-2020
DOI: 10.1136/BJSPORTS-2020-102955
Abstract: To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews new primary reviews addressed additional health outcomes or subpopulations. The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018–2030 and to strengthen surveillance systems that track progress towards national and global targets.
Publisher: JMIR Publications Inc.
Date: 15-12-2021
Abstract: here is increasing recognition of the need for more comprehensive surveillance data, including information on physical activity of all intensities, sedentary behavior, and sleep. However, meeting this need poses significant challenges for current surveillance systems, which are mainly reliant on self-report. he primary objective of this project is to develop and evaluate the feasibility of a sensor-based system for use in the surveillance of physical activity, sedentary behavior, and sleep (SurPASS) at a national level in Denmark. he SurPASS project involves an international, multidisciplinary team of researchers collaborating with an industrial partner. The SurPASS system consists of (1) a thigh-worn accelerometer with Bluetooth connectivity, (2) a smartphone app, (3) an integrated back end, facilitating the automated upload, analysis, storage, and provision of in idualized feedback in a manner compliant with European Union regulations on data privacy, and (4) an administrator web interface (web application) to monitor progress. The system development and evaluation will be performed in 3 phases. These phases will include gathering user input and specifications (phase 1), the iterative development, evaluation, and refinement of the system (phase 2), and the feasibility evaluation (phase 3). he project started in September 2020 and completed phase 2 in February 2022. Phase 3 began in March 2022 and results will be made available in 2023. f feasible, the SurPASS system could be a catalyst toward large-scale, sensor-based surveillance of physical activity, sedentary behavior, and sleep. It could also be adapted for cohort and interventional research, thus contributing to the generation of evidence for both interventions and public health policies and recommendations. ERR1-10.2196/35697
Publisher: BMJ
Date: 20-02-2019
Publisher: BMJ
Date: 13-02-2019
Publisher: BMJ
Date: 09-09-2022
Abstract: It is hypothesised that lifelong physical activity behaviours are established in early life, however there is minimal, and contradictory, evidence examining prenatal and postnatal factors in relation to adulthood physical activity. We investigated associations between prospectively ascertained prenatal ostnatal factors and device-measured moderate-to-vigorous physical activity (MVPA) in midlife. Analyses included 5011 participants from the 1970 British Cohort Study, a birth cohort study of in iduals born within the same week. At birth, the following factors were ascertained: socioeconomic position (SEP), maternal age, number of previous pregnancies, maternal smoking, maternal diabetes, gestational age, birth weight, breastfeeding status and infant health concerns. MVPA was captured at age 46 with a thigh-worn accelerometer device following a 24-hour protocol over 7 days. In sex-adjusted models, lower SEP (−6.7 min/day (95% CI: −9.0 to –4.4) in those with a partly or unskilled paternal occupation), younger maternal age (0.4 min/day (0.2 to 0.5) per additional year of maternal age), maternal smoking during pregnancy (−2.5 min/day (−4.0 to –1.0)) and post-term gestational age (−7.4 min/day (−11.5 to –3.4) boys only) were associated with lower MVPA at age 46. In the mutually adjusted model, associations did not change but there was some evidence that birth weight may also be associated with MVPA levels. SEP, maternal age, maternal smoking, post-term birth in boys and birth weight were associated with MVPA in midlife, indicating that midlife physical activity behaviours may be partially established at birth. Early interventions in disadvantaged environments may have a positive impact on physical activity throughout the life course.
Publisher: BMJ
Date: 16-10-2019
DOI: 10.1136/BJSPORTS-2018-100502
Abstract: This review provides the first meta-analysis of the impact of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes. Systematic review and meta-analysis of controlled studies. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias. PubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019. Physically active lessons compared with a control group in a randomised or non-randomised design, within single component interventions in general school populations. 42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible to be included in the systematic review and 37 of them were included across the six meta-analyses (n=12 663). Physically active lessons were found to produce large, significant increases in lesson-time PA ( d =2.33 95% CI 1.42 to 3.25: k =16) and small, increases on overall PA ( d =0.32 95% CI 0.18 to 0.46: k =8), large, improvement in lesson-time educational outcomes ( d =0.81 95% CI 0.47 to 1.14: k =7) and a small improvement in overall educational outcomes ( d =0.36 95% CI 0.09 to 0.63: k =25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least two domains. In elementary and preschool settings, when physically active lessons were added into the curriculum they had positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool setting. CRD42017076933.
Publisher: Elsevier BV
Date: 03-2019
Publisher: BMJ
Date: 03-2019
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1093/AJCN/NQAC024
Publisher: BMJ
Date: 29-04-2021
Publisher: BMJ
Date: 03-08-2020
Publisher: BMJ
Date: 25-11-2020
DOI: 10.1136/BJSPORTS-2020-102621
Abstract: Public health guidelines on physical activity (PA) establish national policy agendas and provide the basis for setting goals and targets. Advances in measurement and resulting new scientific findings lead to evolution of PA guidelines. PA surveillance serves to track compliance with national guidelines, usually expressed as the proportion of the population ‘meeting’ the main quantitative guidelines. The WHO recently completed a process to review and update the global PA guidelines. Changes to the guidelines, such as removal of a 10-min bout criterion, pose challenges for PA surveillance. We review the evolution of PA guidelines and associated surveillance methods and explore implications of the updated guidelines for changes in population surveillance and opportunities for technological approaches to PA to enhance surveillance.
Publisher: BMJ
Date: 08-03-2021
Publisher: BMJ
Date: 10-2020
Start Date: 07-2023
End Date: 06-2026
Amount: $790,276.00
Funder: Australian Research Council
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