The influence of dog ownership on objective measures of free-living physical activity and sedentary behaviour in community-dwelling older adults: a longitudinal case-controlled study.

BACKGROUND: There is some evidence to suggest that dog ownership may improve physical activity (PA) among older adults, but to date, studies examining this, have either depended on self-report or incomplete datasets due to the type of activity monitor used to record physical activity. Additionally, the effect of dog ownership on sedentary behaviour (SB) has not been explored. The aim of the current study was to address these issues by using activPAL monitors to evaluate the influence of dog ownership on health enhancing PA and SB in a longitudinal study of independently-mobile, community-dwelling older adults. METHODS: Study participants (43 pairs of dog owners and non-dog owners, matched on a range of demographic variables) wore an activPAL monitor continuously for three, one-week data collection periods over the course of a year. Participants also reported information about their own and their dog demographics, caring responsibilities, and completed a diary of wake times. Diary data was used to isolate waking times, and outcome measures of time spent walking, time spent walking at a moderate cadence (>100 steps/min), time spent standing, time spent sitting, number of sitting events (continuous periods of sitting), and the number of and of time spent sitting in prolonged events (>30 min). For each measure, a linear mixed effects model with dog ownership as a fixed effect, and a random effects structure of measurement point nested in participant nested in pair was used to assess the effect of dog ownership. RESULTS: Owning a dog indicated a large, potentially health improving, average effect of 22 min additional time spent walking, 95%CI (12, 34), and 2760 additional steps per day, 95%CI (1667, 3991), with this additional walking undertaken at a moderate intensity cadence. Dog owners had significantly fewer sitting events. However, there were no significant differences between the groups for either the total time spent sitting, or the number or duration of prolonged sedentary events. CONCLUSIONS: The scale of the influence of dog ownership on PA found in this study, indicates that future research regarding PA in older adults should assess and report dog ownership and/or dog walking status.

Point-of-choice prompts to reduce sitting time at work: a randomized trial.

BACKGROUND: Prolonged sitting is prevalent in the workplace and is associated with adverse health markers. PURPOSE: Investigate the effects of point-of-choice (PoC) prompting software, on the computer used at work (PC), to reduce long uninterrupted sedentary periods and total sedentary time at work. DESIGN: Assessor-blinded, parallel group, active-controlled randomized trial. SETTING/PARTICIPANTS: A convenience sample of office workers from Glasgow, United Kingdom. Data were collected April to June 2010, and analyzed October 2010 to June 2011. INTERVENTION: The education group (n=14) received a brief education session on the importance of reducing long sitting periods at work. The PoC group (n=14) received the same education along with prompting software on their PC for 5 workdays, which reminded them to stand up every 30 minutes. MAIN OUTCOME MEASURES: Sitting time was measured objectively using the activPAL™ activity monitor for 5 workdays at baseline and 5 workdays during the intervention. The number and time spent sitting in events >30 minutes' duration were the main outcome measures. RESULTS: At baseline, participants spent 5.7±1.0 hours/day (76%±9%) of their time at work sitting. Of that time, 3.3±1.3 hours/day was spent sitting in 3.7±1.4 events >30 minutes. There was a significant difference between the groups in the change (intervention to baseline) of both the number (ANCOVA; -6.8%, p=0.014) and duration (-15.5%, p=0.007) of sitting events >30 minutes. During the intervention, compared with baseline, the PoC group reduced the number (paired t-test; -0.11 events/hour, p=0.045) and duration (-12.2%, p=0.035) of sitting events >30 minutes. However, there was no significant difference in total sitting time between groups (-4.4%, p=0.084). CONCLUSIONS: Point-of-choice prompting software on work computers recommending taking a break from sitting plus education is superior to education alone in reducing long uninterrupted sedentary periods at work. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.govNCT01628861.

Increasing older adults' walking through primary care: results of a pilot randomized controlled trial.

BACKGROUND: Physical activity can positively influence health for older adults. Primary care is a good setting for physical activity promotion. OBJECTIVE: To assess the feasibility of a pedometer-based walking programme in combination with physical activity consultations. DESIGN: Two-arm (intervention/control) 12-week randomized controlled trial with a 12-week follow-up for the intervention group. SETTING: One general practice in Glasgow, UK. PARTICIPANTS: PARTICIPANTS were aged ≥65 years. The intervention group received two 30-minute physical activity consultations from a trained practice nurse, a pedometer and a walking programme. The control group continued as normal for 12 weeks and then received the intervention. Both groups were followed up at 12 and 24 weeks. OUTCOME MEASURES: Step counts were measured by sealed pedometers and an activPALTM monitor. Psychosocial variables were assessed and focus groups conducted. RESULTS: The response rate was 66% (187/284), and 90% of those randomized (37/41) completed the study. Qualitative data suggested that the pedometer and nurse were helpful to the intervention. Step counts (activPAL) showed a significant increase from baseline to week 12 for the intervention group, while the control group showed no change. Between weeks 12 and 24, step counts were maintained in the intervention group, and increased for the control group after receiving the intervention. The intervention was associated with improved quality of life and reduced sedentary time. CONCLUSIONS: It is feasible to recruit and retain older adults from primary care and help them increase walking. A larger trial is necessary to confirm findings and consider cost-effectiveness.

Daily and hourly frequency of the sit to stand movement in older adults: a comparison of day hospital, rehabilitation ward and community living groups.

BACKGROUND AND AIMS: The sit to stand (STS) movement is commonly performed in daily life, and can be used as an indicator of activity. This study aimed to quantify the usual frequency and distribution of the STS movement performed by older adults in both home and rehabilitation settings. METHODS: Three groups of older adults were recruited; healthy older adults living in the community, older adults living in the community attending rehabilitation services at a day hospital, and frail older patients in a rehabilitation ward. Participants wore an activity monitor, which reported posture continuously for a week. The number of STS movements was the primary outcome measure, and mean values of daily STS frequency were reported. The pattern of activity was investigated using median values of STS hourly rate. RESULTS: Healthy older adults living in the community performed significantly more STS movements per day (n=20; 71±25) than either older adults attending a day hospital (n=20; 57±23) or frail older patients in a rehabilitation ward (n=30; 36±16). For all participants, the hourly rate of STS movements ranged from zero to 48, although the median hourly rate was two (healthy older adults) and one (both rehabilitation groups). CONCLUSION: Measurement of the number of STS movements performed over the course of a week in three groups of older adults, demonstrated significant differences in daily number of STS movements and in the hourly pattern between the groups. Activity patterns can provide additional information on clinically relevant aspects of physical activity and function to daily averages.

Analyzing free-living physical activity of older adults in different environments using body-worn activity monitors.

This study measured objectively the postural physical activity of 4 groups of older adults (> or =65 yr). The participants (N = 70) comprised 3 patient groups--2 from rehabilitation wards (city n = 20, 81.8 +/- 6.7 yr; rural n = 10, 79.4 +/- 4.7 yr) and the third from a city day hospital (n = 20, 74.7 +/- 7.9 yr)--and a healthy group to provide context (n = 20, 73.7 +/- 5.5 yr). The participants wore an activity monitor (activPAL) for a week. A restricted maximum-likelihood-estimation analysis of hourly upright time (standing and walking) revealed significant differences between day, hour, and location and the interaction between location and hour (p < .001). Differences in the manner in which groups accumulated upright and sedentary time (sitting and lying) were found, with the ward-based groups sedentary for prolonged periods and upright for short episodes. This information may be used by clinicians to design appropriate rehabilitation interventions and monitor patient progress.

Individuals with chronic low back pain have a lower level, and an altered pattern, of physical activity compared with matched controls: an observational study.

QUESTION: Is there a difference in the level and pattern of free-living physical activity between individuals with chronic low back pain and matched controls? DESIGN: Observational, cross-sectional study. PARTICIPANTS: Fifteen individuals with chronic low back pain and fifteen healthy controls matched for age, gender, and occupation. OUTCOME MEASURES: Participants wore an activity monitor for seven days. Level of physical activity was measured as time standing and walking, and number of steps averaged over a 24-hour day (midnight to midnight), day time (9.00 am - 4.00 pm), and evening time (6.00 pm - 10.00 pm), and work days versus non-work days. Pattern of physical activity was measured as number of steps and cadence during short (< 20 continuous steps), moderate (20-100 continuous steps), long (> 100-499 continuous steps), and extra long walks (>or= 500 continuous steps). RESULTS: Over an average 24-hour day, the chronic low back pain group spent 0.7 fewer hours (95% CI 0.3 to 1.1) walking, and took 3480 fewer steps (95% CI 1754 to 5207) than the healthy controls. They took 793 fewer steps/day (95% CI -4 to 1591) during moderate walks, and 1214 fewer steps/day (95% CI 425 to 2003) during long walks, and 11 fewer steps/min (95% CI 4 to 17) during extra long walks than the healthy controls. CONCLUSION: Individuals with chronic low back pain have a lower level, and an altered pattern, of physical activity compared with matched controls.

Activity-monitor accuracy in measuring step number and cadence in community-dwelling older adults.

The primary purpose of this study was to investigate the accuracy of the activPAL physical activity monitor in measuring step number and cadence in older adults. Two pedometers (New-Lifestyles Digi-Walker SW-200 and New-Lifestyles NL2000) used in clinical practice to count steps were simultaneously evaluated. Observation was the criterion measure. Twenty-one participants (65-87 yr old) recruited from community-based exercise classes walked on a treadmill at 5 speeds (0.67, 0.90, 1.12, 1.33, and 1.56 m/s) and outdoors at 3 self-selected speeds (slow, normal, and fast). The absolute percentage error of the activPAL was <1% for all treadmill and outdoor conditions for measuring steps and cadence. With the exception of the slowest treadmill speed, the NL-2000 error was <2%. The SW-200 was the least accurate device, particularly at slower walking speeds. The activPAL monitor accurately recorded step number and cadence. Combined with its ability to identify primary postures, the activPAL might be a useful and versatile device for measuring activity in older adults.