What happened to my legs when I broke my arm?

This case report describes an incident that occurred during the course of a research intervention study. Participants in the study were continually monitored with an activPAL activity monitor. Whilst wearing the monitor a participant had a fall causing musculoskeletal trauma requiring hospital admission. The patient was admitted for an acute hospital stay (3 days) for management of the upper limb injury. The case report presents the measurement of the participant’s sedentary time before the incident, during hospitalisation and post discharge. The report is relevant for education and service design both in hospital and in the community settings as it demonstrates the rapid influence of an upper limb injury and consequences beyond the hospital bed. This report is novel as it presents not only hospitalisation and post hospital activity, but also provides insight into the individual’s actual objective (rather than retrospective self-report) activity patterns before hospitalisation. The infographic presentation has been chosen to allow quick and easy understanding of information

Consequences of short interruptions of bouts walking on estimates of compliance to physical activity guidelines

Current guidelines on physical activity suggest that 30 min of moderate intensity physical activity can be accumulated in continuous bouts of at least 10 min. It has been shown by use of activity monitoring that it is difficult to achieve 10 min of completely uninterrupted walking in the free-living urban environment where we have obstacles such as roads to cross. The aim of this study was to examine the effect of short interruptions in walking on the rate of oxygen uptake (ml . kg . min(-1)) to determine if walking with short interruptions can still be considered continuous. This leads to a more meaningful understanding as to what is a physiological break in activity. This is an important consideration for measurement of physical activity especially when exploring measurement by accelerometry. In a laboratory setting a repeated measure design was used to replicate interrupted walking in urban setting. Healthy volunteers (N = 10) walked on a treadmill with walking interruptions of 10 s, 50 s and 100 s. Oxygen uptake was measured using a gas analysis system. 10 s interruptions in walking had no significant effect on the VO2 . kg . min(-1). However two breaks of 50 s or 100 s introduced into a 5 min brisk walking bout showed a significant reduction in oxygen uptake requirements and metabolic equivalent of task (MET) (p < 0.001) compared to continuous walking for the same amount of effective walking, but only the 100 s walking period could not be considered greater than 3 MET during the interval. Short periods of brisk walking interrupted by 10 s breaks can be considered continuous physical activity, but when walking is interrupted by longer breaks e.g. 50 s, there is a significant reduction in oxygen uptake requirement suggesting that it is not continuous anymore and should be considered as fragmented

Co-creating a tailored public health intervention to reduce older adults’ sedentary behaviour

Objective: The increasing health care costs associated with an ageing population and chronic disease burden are largely attributable to modifiable lifestyle factors that are complex and vary between individuals and settings. Traditional approaches to promoting healthy lifestyles have so far had limited success. Recently, co-creating public health interventions with end-users has been advocated to provide more effective and sustainable solutions. The aim of this study was to document and evaluate the co-creation of a public health intervention to reduce sedentary behaviour in older adults. Design: Community-dwelling older adults (N = 11, mean age = 74 years) and academic researchers attended 10 interactive co-creation workshops together. Setting: Workshops took place on university campus and the co-creators completed fieldwork tasks outside the workshops. Method: Workshops were informed by the Participatory and Appreciative Action and Reflection methodology. Data were collected using field notes, video recording and worksheet tasks. Analysis was conducted using a qualitative content analysis approach. Results: The co-creators developed a tailored intervention delivered through a mode congruent with older adults' lives. Key elements of the intervention included (1) education on sedentary behaviour, (2) resources to interrupt sedentary behaviour, (3) self-monitoring, (4) action planning and (5) evaluating the benefits of interrupting sedentary behaviour. Conclusion: Co-creation is a feasible approach to develop public health interventions; however, it is limited by the lack of a systematic framework to guide the process. Future work should aim to develop principles and recommendations to ensure co-creation can be conducted in a more scientific and reproducible way. The effectiveness and scalability of the intervention should be assessed

Compositional analyses of the associations between sedentary time, different intensities of physical activity, and cardiometabolic biomarkers among children and youth from the United States

Introduction : Compositional data analysis is one appropriate method for co-dependent data, even when data are collected for a subdivision of the 24-hour period, such as the waking day. Objectives were to use compositional analyses to examine the combined and relative associations of sedentary time (ST), light-intensity physical activity (LPA), moderate-intensity physical activity (MPA), and vigorous-intensity physical activity (VPA) with cardiometabolic biomarkers in a representative sample of children and youth. Methods : This cross-sectional study included 2544 participants aged 6-17 years from the 2003-2006 United States National Health and Nutrition Examination Survey. ST (= 7 METs) were accelerometer-derived. Cardiometabolic biomarkers included waist circumference, body mass index (BMI) z-score, HDL-cholesterol, C-reactive protein, and blood pressure. Triglycerides, glucose, insulin, and LDL-cholesterol were measured in a fasting sub-sample of adolescents (n = 670). Compositional linear regression models were conducted. Results : The composition of ST, LPA, MPA, and VPA was significantly associated with BMI z-score, log waist circumference, systolic and diastolic blood pressure, HDL-cholesterol, and log plasma glucose (variance explained: 1-29%). Relative to the other three behaviors, VPA was negatively associated with BMI z-score (gamma VPA = -0.206, p = 0.005) and waist circumference (gamma VPA = -0.03, p = 0.001). Conversely, ST was positively associated with waist circumference (gamma ST = 0.029, p = 0.013). ST and VPA were also positively associated with diastolic blood pressure (gamma ST = 2.700, p = 0.018; gamma VPA = 1.246, p = 0.038), relative to the other behaviors, whereas negative associations were observed for LPA (gamma LPA = -2.892, p = 0.026). Finally, VPA was positively associated with HDL-cholesterol, relative to other behaviors (gamma VPA = 0.058, p<0.001). Conclusions : The ST and physical activity composition appears important for many aspects of cardiometabolic health in children and youth. Compositions with more time in higher-intensity activities may be better for some aspects of cardiometabolic health

Are glucose profiles well-controlled within the targets recommended by the International Diabetes Federation in type 2 diabetes? A meta-analysis of results from continuous glucose monitoring based studies

AIMS: To assess continuous glucose monitoring (CGM) derived intra-day glucose profiles using global guideline for type 2 diabetes recommended by the International Diabetes Federation (IDF). METHODS: The Cochrane Library, MEDLINE, PubMed, CINAHL and Science Direct were searched to identify observational studies reporting intra-day glucose profiles using CGM in people with type 2 diabetes on any anti-diabetes agents. Overall and subgroup analyses were conducted to summarise mean differences between reported glucose profiles (fasting glucose, pre-meal glucose, postprandial glucose and post-meal glucose spike/excursion) and the IDF targets. RESULTS: Twelve observational studies totalling 731 people were included. Pooled fasting glucose (0.81 mmol/L, 95% CI, 0.53-1.09 mmol/L), postprandial glucose after breakfast (1.63 mmol/L, 95% CI, 0.79-2.48 mmol/L) and post-breakfast glucose spike (1.05 mmol/L, 95% CI, 0.13-1.96 mmol/L) were significantly higher than the IDF targets. Pre-lunch glucose, pre-dinner glucose and postprandial glucose after lunch and dinner were above the IDF targets but not significantly. Subgroup analysis showed significantly higher fasting glucose and postprandial glucose after breakfast in all groups: HbA1c <7% and ≥7% (53 mmol/mol) and duration of diabetes <10 years and ≥10 years. CONCLUSIONS: Independent of HbA1c, fasting glucose and postprandial glucose after breakfast are not well-controlled in type 2 diabetes

A co-created intervention with care home residents and university students following a service-learning methodology to reduce sedentary behaviour: the GET READY project protocol

Background: There is a growing demand for long-term care settings. Care-home residents are a vulnerable group with high levels of physical dependency and cognitive impairment. Long-term care facilities need to adapt and offer more effective and sustainable interventions to address older residents’ complex physical and mental health needs. Despite the increasing emphasis on patient and public involvement, marginalised groups such as care-home residents, can be overlooked when including people in the research process. The GET READY project aims to integrate servicelearning methodology into Physical Therapy and Sport Sciences University degrees by offering students individual service opportunities with residential care homes, in order to co-create the best suited intervention with researchers, older adults of both genders (end-users) in care homes, health professionals, caregivers, relatives and policy makers. Methods: Stage 1 will integrate a service-learning methodology within a Physical Therapy module in Glasgow and Sport Sciences module in Barcelona, design two workshops for care home residents and one workshop for staff members, relatives and policy makers and conduct a co-creation procedure. Stage 2 will assess the feasibility, safety and preliminary effects of the co-created intervention in a group of 60 care home residents, within a two-armed pragmatic randomized clinical trial. ClinicalTrials.gov Identifier: NCT03505385