Comparison between ActiGraph GT3X and ActivPAL to assess sedentary behavior during the school period

Abstract Aims: This study aimed to compare the sedentary time measured using the ActiGraph GT3X accelerometer with the measurement of sitting and standing time obtained by ActivPAL inclinometers. Methods: This was a cross-sectional study conducted with a sample of 60 schoolchildren (34 males) of one elementary public school in Brazil. The students used both an ActiGraph GT3X accelerometer and an ActivPAL inclinometer, concurrently, positioned at the beginning and removed at the end of the school shift, for four days. For analysis, paired Student's t-tests, Pearson's correlation coefficients, intraclass correlation coefficients, and Bland-Altman plots were used. Results: When comparing sedentary time with sitting time, although correlated (r = 0.53; p < 0.001), the mean minutes were different (134.2 min/day in ActiGraph GT3X vs 120.3 min/day in ActivPAL; p < 0.001), with a bias of 13.9 min/day. When comparing the measurement of sedentary time with the sum of the sitting time plus standing time, different mean minutes were also observed (134.2 min/day in ActiGraph GT3X vs 177.0 min/day in ActivPAL; p < 0.001), and although the correlation was stronger (r = 0.75; p < 0.001), the bias was higher (−42.8 min/day). Conclusion: Sedentary time derived from the ActiGraph GT3X device should be used with caution to evaluate sedentary behavior in a school setting and may be interpreted only as non-moving activities (stationary behavior).

Light-intensity physical activity patterns and associated factors in adolescents

Abstract Aims: This study aimed to measure light-intensity physical activity (LPA) patterns in adolescents according to weekdays and school period and investigated associations between LPA patterns and associated factors. Methods: This is a cross-sectional study with 388 students of both genders, selected from public schools from Londrina city, Parana state. LPA was measured using accelerometry for seven consecutive days and was analyzed by the time spent in very short (15 to 30 s), short (30 to 60 s), intermediate (1 to 3 min), and long bouts (≥ 3 min). Results: Approximately 22% of the total daily time was spent in LPA. The time in LPA accumulated in short or intermediate bouts was higher than the time accumulated in very short or long bouts (P < 0.05). Gender was associated with short (β= 2.180; 95% confidence interval [CI], 0.357 to 4.003) and intermediate bouts (β = 2.822; 95% CI, 0.681 to 4.964), girls presented higher daily time. Age was inversely associated with very short (β = −0.925; 95% CI, −1.676 to −0.175) and intermediate bouts (β = −1.985; 95% CI, −3.579 to −0.390). The total time in LPA and time accumulated in very short, short, and intermediate bouts was higher in the school period when compared to the non-school period (P < 0.05). Conclusion: It could be concluded that the LPA patterns are predominantly composed of time spent in bouts between 30 seconds and three minutes. Gender, age, and school period appear to influence the LPA pattern in adolescents.

Medición mediante acelerometría de los niveles de actividad física de una muestra de adolescentes españoles / Measurement by accelerometry of physical activity levels in a sample of Spanish adolescents

RESUMEN Objetivos Conocer la relación existente entre el nivel de práctica de actividad física y el consumo máximo de oxígeno (VO2 máx.); y analizar el nivel de práctica de AF y su relación con el género, la localidad de residencia, el porcentaje que suponen las clases de Educación Física (EF) en dicha práctica y el Índice de Masa Corporal (IMC). Métodos Participaron 89 sujetos de la provincia de Salamanca (España), de 12 a 16 años (14±1,18 años), siendo el 55,1% (n=49) hombres y el 44,9% (n=40) mujeres. Los instrumentos utilizados fueron: acelerómetro Actigraph GT3X; Test Course Navette; monitor de composición corporal Tanita MC780MA; y se recogió información sobre el género y la localidad de residencia. Resultados Únicamente, el 18% de los sujetos cumplía con las recomendaciones mínimas de AF, establecidas por la Organización Mundial de la Salud (OMS). Los chicos y los sujetos de localidades urbanas realizaban mayor cantidad total de AF. Los sujetos con menor IMC y los de género masculino poseían mejores niveles de VO2 máx. Y las clases de EF no contribuyeron de manera sustancial al total de AF semanal. Conclusiones Estos resultados pueden considerarse relevantes, con el fin de orientar programas específicos de fomento de la AF y de prevención del sobrepeso y la obesidad en adolescentes, haciendo hincapié en la población femenina, del ámbito rural y aquella con mayor IMC.(AU)

ABSTRACT Objectives To establish the relationship between the level of physical activity (PA) and maximum oxygen consumption (VO2 max.); and to analyze the level of PA and its relationship with sex, place of residence, influence of physical education (PE) classes in PA, and body mass index (BMI) in adolescents. Materials and Methods 89 subjects from the province of Salamanca (Spain), aged 12 to 16 (14±1.18 years), participated in the study; 55.1% (n=49) of the sample were men and 44.9% (n=40) women. The instruments used were: Actigraph GT3X accelerometer, Course Navette Test and Tanita Body Composition Analyzer MC780MA. Information on sex and place of residence was also collected. Results Only 18% of the individuals met the minimum PA recommendations set by the World Health Organization (WHO). Males and subjects from urban areas performed greater amounts of physical activity. Subjects with lower BMI and of the male sex had better levels of VO2max. PE classes did not contribute substantially to the total weekly amount of PA. Conclusions These results can be considered relevant to develop specific programs that promote PA and prevent overweight and obesity in adolescents, making emphasis on the female population, people from rural areas and those with higher BMI.(AU)

RESUMO OBJETIVOS Estabelecer a relação entre o nível de atividade física (AF) e o consumo máximo de oxigênio (VO 2 máx.); e analisar o nível de AF e sua relação com o sexo, local de residência, influência das aulas de educação física (EP) na AF e índice de massa corporal (IMC) em adolescentes. MATERIAIS E MÉTODOS 89 sujeitos da província de Salamanca (Espanha), com idades entre 12 e 16 anos (14 ± 1,18 anos), participaram do estudo; 55,1% (n = 49) da amostra eram homens e 44,9% (n = 40) mulheres. Os instrumentos utilizados foram: acelerômetro Actigraph GT3X, teste Course Navette e analisador de composição corporal Tanita MC780MA. Também foram coletadas informações sobre sexo e local de residência. RESULTADOS Apenas 18% dos indivíduos cumpriram as recomendações mínimas de AF estabelecidas pela Organização Mundial da Saúde (OMS). Homens e indivíduos de áreas urbanas realizavam maiores quantidades de atividade física. Indivíduos com menor IMC e sexo masculino apresentaram melhores níveis de VO 2 máx. As aulas de EF não contribuíram substancialmente para a quantidade semanal total de AF. CONCLUSÕES Esses resultados podem ser considerados relevantes para o desenvolvimento de programas específicos que promovam AF e previnem sobrepeso e obesidade em adolescentes, enfatizando a população feminina, pessoas da zona rural e aquelas com maior IMC.

Medición de la actividad física mediante acelerómetros triaxiales en escolares de tres ciudades del Perú / Measurement of physical activity by triaxial accelerometers n schoolchildren from three peruvian cities

RESUMEN Objetivos. Determinar la proporción de escolares de educación primaria que cumplen la recomendación de la Organización Mundial de la Salud (OMS) sobre actividad física y los factores asociados a menor tiempo de actividad física moderada intensa en zonas urbanas de tres ciudades del Perú. Materiales y métodos. Estudio transversal con selección aleatoria de escolares de 6 a 13 años de instituciones educativas públicas de zonas urbanas de los distritos de Chiclayo, Huaraz y Tarapoto. Para medir el tiempo y la intensidad de la actividad física en los escolares se les puso un acelerómetro durante una semana, además se evaluó el estado nutricional a través del cálculo del índice de masa corporal. Resultados. Participaron 1241 escolares de ambos sexos, con edades entre 6 a 13 años. El 40% de escolares en Chiclayo, 56% en Tarapoto y 66% en Huaraz cumplían la recomendación de OMS de realizar como mínimo 60 minutos de actividad física moderada intensa al día. La intensidad de la actividad física fue significativamente mayor en los escolares de menor edad y los de sexo masculino. Además se encontró que los factores asociados a menos minutos de actividad física moderada intensa al día fueron escolares de mayor edad, de sexo femenino, con obesidad, con madres de nivel educativo superior y residentes en Chiclayo o Tarapoto (p<0,05). Conclusiones. Cerca del 50% de escolares cumple la recomendación de OMS sobre actividad física diaria, los grupos menos activos son los escolares de mayor edad, obesos y de sexo femenino, por lo que se debe focalizar en ellos acciones para promover hábitos adecuados de actividad física.

ABSTRACT Objectives. To determine the proportion of primary school students who fulfill the World Health Organization (WHO)recommendations on physical activity and the factors associated with less time of moderate-intense physical activity in urban areas of three cities in Peru. Materials and methods. Cross-sectional study with a random selection of schoolchildren aged 6 to 13 from public educational institutions in urban areas of Chiclayo, Huaraz and Tarapoto. In order to measure the time and intensity of physical activity, schoolchildren were given an accelerometer for a week. Furthermore, nutritional conditions were evaluated through the calculation of their body mass index. Results. A total of 1241 schoolchildren of both sexes aged between 6 and 13 years participated. 40% of schoolchildren in Chiclayo, 56% in Tarapoto and 66% in Huaraz fulfilled the WHO recommendations to perform at least 60 minutes of moderate-intense physical activity per day. The intensity of physical activity was significantly higher in younger schoolchildren and males. It was also found that the factors associated with fewer minutes of moderate-intense physical activity per day were schoolchildren of older age, females, with an obesity condition, whose mothers had higher educational level, and lived in Chiclayo or Tarapoto (p <0.05). Conclusions. Nearly 50% of schoolchildren meet the WHO recommendation on daily physical activity, the less active groups were older schoolchildren, obese and female; therefore, actions should be focused on them to promote adequate physical activity habits.

Chronotropic incompetence in Chagas disease: effectiveness of blended sensor (volume/minute and accelerometer) / Competência cronotrópica em chagásicos: eficácia do duplo sensor (volume/minuto e acelerômetro)

AbstractIntroduction:Technological progress of pacemakers has allowed the association of two or more sensors in one heart rate system response. The accelerometer sensor measures the intensity of the activity; it has a relatively rapid response to the beginning of it, however, it may present insufficient response to less strenuous or of less impact exercise. The minute ventilation sensor changes the pacing rate in response to changes in respiratory frequency in relation to tidal volume, allowing responses to situations of emotional stress and low impact exercises.Objective:To evaluate the cardiorespiratory response of the accelerometer with respect to the blended sensor (BS=accelerometer sensor+minute ventilation sensor) to exercise in chagasic patients undergoing cardiopulmonary exercise test.Methods:This was a prospective, observational, randomized, cross-sectional study. Patients who met the inclusion criteria were selected. The maximum heart rate of the sensor was programmed by age (220-age). The results were analyzed through t test with paired samples (P<0.05).Results:Sample was comprised of 44 patients, with a mean age of 66±10.4 years, 58% were female, 54% as first implant, in 74% were functional class I and 26% were functional class II, left ventricular ejection fraction was 58±7. As for the cardiopulmonary test, maximum expected heart rate and VO2 were not achieved in both the accelerometer sensor and the blended sensor, however, metabolic equivalent in the blended sensor was higher than the expected, all data with P<0.001.Conclusion:Even though the maximal heart rate was not reached, the blended sensor provided a physiological electrical sequence when compared to the accelerometer sensor, providing better physical fitness test in cardiopulmonary hemodynamics and greater efficiency.

ResumoIntrodução:O progresso tecnológico dos marca passos permitiu a associação de dois ou mais sensores em um único sistema de resposta de frequência cardíaca. O sensor acelerômetro afere a intensidade da atividade, possui uma resposta relativamente rápida ao início da mesma, porém pode apresentar respostas insuficientes a exercícios físicos menos intensos ou de menor impacto. O sensor volume-minuto altera a taxa de estimulação cardíaca em resposta à variação da frequência respiratória quanto ao volume corrente, permitindo, assim, respostas a situações de estresse emocional e exercícios de baixo impacto.Objetivo:Avaliar a resposta cardiorrespiratória do acelerômetro em relação ao duplo sensor ao exercício em pacientes chagásicos submetidos ao teste ergoespirométrico.Métodos:Pesquisa prospectiva, observacional, randomizada e cruzada. Foram selecionados pacientes que preenchiam os critérios de inclusão. A frequência cardíaca máxima do sensor foi programada por idade (220-idade). Os resultados obtidos foram analisados pelo Teste T com amostras pareadas (P<0,05).Resultados:Amostra de 44 pacientes, com idade média de 66±10,4, com 58% do sexo feminino, 54% como primeiro implante, classe funcional I em 74% e II em 26%, fração de ejeção do ventrículo esquerdo de 58±7. Quanto ao ergoespirométrico, a frequência cardíaca máxima prevista e a VO2 máxima prevista não foram atingidas tanto no sensor acelerômetro quanto no sensor volume-minuto, contudo, o equivalente metabólico no sensor volume- minuto foi superior à prevista, todos os dados com P<0,001.Conclusão:Apesar da frequência cardíaca máxima não ter sido atingida, o duplo sensor proporcionou uma sequência elétrica mais fisiológica quando comparado ao sensor acelerômetro.

Barriers associated with reduced physical activity in COPD patients / Barreiras associadas à menor atividade física em portadores de DPOC

OBJECTIVE: To evaluate the ability of COPD patients to perform activities of daily living (ADL); to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT), and an ADL limitation score. METHODS: In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL) scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT. RESULTS: We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001), as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001). The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results. CONCLUSIONS: Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures. .

OBJETIVO: Avaliar a capacidade de portadores de DPOC em realizar atividades de vida diária (AVD), identificar barreiras que impedem a sua realização, e correlacionar essas barreiras com gravidade da dispneia, teste de caminhada de seis minutos (TC6) e um escore de limitação de AVD. MÉTODOS: Nos pacientes com DPOC e controles saudáveis pareados por idade, o número de passos, a distância percorrida e o tempo de caminhada foram registrados por um acelerômetro tridimensional durante sete dias consecutivos. Um questionário de barreiras percebidas e a escala London Chest Activity of Daily Living (LCADL) foram utilizados para identificar os fatores que impedem a realização de AVD. A dispneia foi medida por duas escalas distintas, e a capacidade física submáxima foi determinada com base no TC6. RESULTADOS: Foram avaliados 40 sujeitos com DPOC e 40 controles. Os pacientes com DPOC, comparados aos controles, realizaram menor tempo de caminhada (68,5 ± 25,8 min/dia vs. 105,2 ± 49,4 min/dia; p < 0,001), menor distância caminhada (3,9 ± 1,9 km/dia vs. 6,4 ± 3,2 km/dia; p < 0,001) e menor número de passos/dia. As principais barreiras referidas para realização de AVD foram falta de estrutura, influência social e falta de vontade. A distância caminhada no TC6 correlacionou-se com os resultados do acelerômetro, mas não os resultados da LCADL. CONCLUSÕES: Portadores de DPOC são menos ativos quando comparados a adultos saudáveis com idade comparável. O sedentarismo e as barreiras para a realização de AVD têm implicações imediatas na prática clínica, exigindo medidas precoces de intervenção. .

Actividad física, comportamiento sedentario y estado nutricional en escolares de la ciudad de Buenos Aires / Physical activity, sedentary behavior and nutritional status in schoolchildren in the city of Buenos Aires

Introducción: la obesidad en niños y adolescentes se relaciona con la disminución de la actividad física y el estilo de vida sedentario. El objetivo de este trabajo ha sido determinar estado nutricional, niveles de actividad física y sedentarismo en un grupo de escolares y estudiantes secundarios de clase media baja y media alta de la Ciudad Autónoma de Buenos Aires utilizando acelerometría. Población y métodos: entre agosto y diciembre de 2013 se estudiaron 174 sujetos, 87 varones y 87 mujeres, de 7 a 17 años, 40,8% asistente a escuelas de nivel primario y 59,2% al nivel secundario; 44,3% de nivel socioeconómico medio alto y 55,7% medio bajo. Se estudió edad, sexo, peso, talla, nivel de actividad física y tiempo sedentario. Los sujetos portaron por siete días un acelerómetro uniaxial CSA 7164. Se utilizó el coeficiente correlación de Pearson y test t al comparar actividad física y tiempo sedentario por edad y sexo. Resultados: en el nivel socioeconómico medio-bajo, el 34,0% presentó sobrepeso y el 21,6% obesidad, en el medio-alto el 14,3% y 5,2%. La actividad física promedio fue de 31,5 minutos (±19,7) y 552,05 (±126,9) los minutos de comportamiento sedentario. La actividad física realizada por niños, 37,07 minutos (±20,0) fue significativamente mayor que en adolescentes (27,28 minutos; ±18,5). El tiempo sedentario fue significativamente mayor en adolescentes, 621,37 minutos (±106,1) que en niños (460,78 minutos; ±89,0). Tanto en niños como en adolescentes, los varones registraron mayor actividad física que las mujeres. No hubo diferencias significativas en tiempo sedentario. Conclusiones: es elevado el sobrepeso y la obesidad, siendo mayor en el nivel socioeconómico medio-bajo. La mayoría de la muestra no alcanzó las recomendaciones de actividad física, y el tiempo de conducta sedentaria fue elevado.

Introduction: obesity in children and adolescents is associated with decreased physical activity and sedentary lifestyle. The aim of this study was to determine nutritional status, levels of physical activity and inactivity in a group of children and high school students from average lower middle and high middle classes in the city of Buenos Aires by accelerometry. Population and methods: 174 subjects, 87 males and 87 females, aged 7 to 17 years old, 40,8% attending primary schools and 59,2% attending high school were studied between August and December 2013; 44,3% of subjects with high socioeconomic status, and 55,7% average. Age, sex, weight, height, level of physical activity and sedentary time were studied. Subjects carried the CSA 7164 uniaxial accelerometer device or seven days. The Pearson correlation coefficient and t test were used to compare physical activity and sedentary time by age and sex. Results: in the middle-low socioeconomic status, 34,0% were overweight and 21,6% obese, in the middle-high 14,3% and 5,2% respectively. The average physical activity was 31,5 minutes (±19,7) and sedentary behavior 552,05 (±126,9) minutes. The physical activity of children, 37,07 minutes (±20,0) was significantly higher than in adolescents, 27,28 minutes (±18,5). Sedentary time was significantly greater in adolescents, 621,37 minutes (±106,1) than in children, 460,78 minutes (±89,0). Both school and adolescent boys reported more physical activity than women did. No significant differences in sedentary time were observed. Conclusions: high overweight and obesity, are higher in the medium-low socioeconomic status. The majority of samples did not meet the recommendations for physical activity and sedentary behavior time was high.

Validação da acelerometria para medida do gasto energético: revisão sistemática / Validation of accelerometry for measuring energy expenditure: a systematic review

Objetivo: Examinar a qualidade dos estudos de validação da acelerometria comparados com o consumo máximo de oxigênio (VO2máx) e como objetivo secundário apresentar as principais características dos estudos inseridos e os principais modelos de acelerômetros testados.Método: Após pesquisa na base de dados MedLine, LILACS, Embase e CLINAHL com os descritores "Oxygen Consumption" OR "Energy Metabolism" AND "Accelerometry" AND "Validation Studies" , os dois autores realizaram a seleção dos artigos de acordo com título, leitura do resumo e do texto completo. Após a inclusão dos artigos, estes tiveram sua qualidade avaliada pela ferramenta QUADAS-2 que avalia o risco de viés e a preocupação com a aplicabilidade do teste. Resultado: Foram selecionados 11 trabalhos que se ajustaram aos critérios de inclusão. A análise QUADAS-2 mostrou que para o risco de viés houve problemas com a sua identificação principalmente no que diz respeito ao teste proposto e o padrão-ouro, em relação à aplicabilidade na maioria dos estudos o risco foi baixo. O acelerômetro mais utilizado foi o Actgraph e SenseWear Armband Pro3 que foi testado em 3 estudos. Conclusão: Conclui-se através desta revisão sistemática que são necessárias mais informações a respeito da metodologia proposta nos estudos para classificação da qualidade dos mesmos e que a acelerometria é uma alternativa válida para medida do gasto energético em condições de atividades livres e controladas independente do tipo de acelerômetro.

Objective: The primary objective of this review was to examine the quality of the validation studies of the accelerometry tool as compared with measuring maximal oxygen uptake (VO2 max). A secondary objective was to present the main characteristics of the studies and of the main models of accelerometers tested. Method: After searching the MedLine, LILACS, Embase e CLINAHL databases with the descriptors ?Oxygen Consumption? OR ?Energy Metabolism? AND ?Accelerometry? AND ?Validation Studies,? the two authors made the selection according to the title, the abstract, and the full text. After that, the quality of the articles was assessed by theQUADAS-2 tool for risk of bias and for concerns regarding the applicability of the test. Results: We selected 10 studies that fit the inclusion criteria. The QUADAS-2 analysis showed that for the risk of bias there were problems with identification, particularly with regard to the proposed test andwith the gold standard. In relation to the applicability, in most studies the risk was low. The most used accelerometers were the Actgraph and the SenseWear Armband Pro3 that was tested in 3 studies. Conclusion: This systematic review concluded that more information is needed aboutthe proposed methodology in studies to classify their quality and that accelerometry is a valid alternative to measure energy metabolism in conditions of free-living and controlled activities, regardless of the accelerometer.

Atividade física e fatores associados em idosos do Estudo SABE: avaliação por acelerometria / Physical activity and associated factors in the elderly of the SABE Study assessment by accelerometry

Com o crescimento da população idosa cresce a necessidade de incentivo a hábitos de vida saudáveis como a prática de atividade física (AF), bem como sua investigação, a fim de se prevenir a instalação de incapacidades. No entanto, são enormes as dificuldades de medida dessa atividade. O acelerômetro surge como uma das formas objetivas de avaliação da AF destacando-se por sua praticidade e capacidade de armazenamento de dados. Objetivo - Avaliar os níveis e intensidades de AF de idosos através da acelerometria e examinar as associações com fatores sócio-demográficos, de saúde e estilo de vida. Métodos - Estudo transversal com 568 idosos de 65 anos e mais da coorte de 2010 do estudo SABE. Os idosos usaram o acelerômetro ActiGraph (GT3X) por três dias posicionado na cintura. Resultados - A média geral de cpm foi de 341,29 (95 por cento IC 326,79 - 355,80). Não houve diferença entre homens e mulheres. A média de cpm diminuiu com a idade e para os idosos acometidos por todas as doenças, exceto hipertensão, doença pulmonar e doença articular. A mobilidade e CP reduzidas, um maior número de doenças e uma pior autopercepção de saúde estiveram associados de forma independente com menores cpm. Os homens divorciados/separados, os que viviam sozinho e os que possuíam de cino a oito anos de escolaridade apresentaram maiores cpm que as mulheres dessas categorias. A idade, o declínio cognitivo isolado ou associado à disfunção, a hipertensão, a doença cerebrovascular...

Togetherwith the growth of the elderly population, it also grows the necessity of encouraging a healthy lifestyle, with the practice of physical activity (PA), as well as its investigation, aiming at the prevention of potential disabilities. Nevertheless, the difficulties related to the measurement of such physical activity pose a considerable level of challenge. The accelerometer appears as an objective way of evaluating the PA, being distinguished by its practicality and ability to store data. Objective To evaluate the levels and intensities of PA in elderly people through accelerometry and examine the associations with socio-demographic, health and lifestyle factors.Methods Transversal study with 568 elderly citizens, aged 65 and above, who attended 2010 cohort of SABE Study. The elderly used the accelerometer ActiGraph (GT3X) for three days, placed in their waist. Results The general average cpm was 341,29 (95 per cent CI 326,79 355,80). There was no variation between men and women. The average cpmreduced according to the persons age and presence of diseases, except for hypertension, lung diseases and articular diseases. The reduced mobility and CP, a greater number of diseases and a worse auto health perceptionwere associated independently with lower cpm figures. The divorced/separated men, those who live on their own and those with five to eight years in the education system present higher cpm than women in those categories...