Objective Assessment of Physical Activity at Home Using a Novel Floor-Vibration Monitoring System: Validation and Comparison With Wearable Activity Trackers and Indirect Calorimetry Measurements.

BACKGROUND: The self-monitoring of physical activity is an effective strategy for promoting active lifestyles. However, accurately assessing physical activity remains challenging in certain situations. This study evaluates a novel floor-vibration monitoring system to quantify housework-related physical activity. OBJECTIVE: This study aims to assess the validity of step-count and physical behavior intensity predictions of a novel floor-vibration monitoring system in comparison with the actual number of steps and indirect calorimetry measurements. The accuracy of the predictions is also compared with that of research-grade devices (ActiGraph GT9X). METHODS: The Ocha-House, located in Tokyo, serves as an independent experimental facility equipped with high-sensitivity accelerometers installed on the floor to monitor vibrations. Dedicated data processing software was developed to analyze floor-vibration signals and calculate 3 quantitative indices: floor-vibration quantity, step count, and moving distance. In total, 10 participants performed 4 different housework-related activities, wearing ActiGraph GT9X monitors on both the waist and wrist for 6 minutes each. Concurrently, floor-vibration data were collected, and the energy expenditure was measured using the Douglas bag method to determine the actual intensity of activities. RESULTS: Significant correlations (P<.001) were found between the quantity of floor vibrations, the estimated step count, the estimated moving distance, and the actual activity intensities. The step-count parameter extracted from the floor-vibration signal emerged as the most robust predictor (r2=0.82; P<.001). Multiple regression models incorporating several floor-vibration-extracted parameters showed a strong association with actual activity intensities (r2=0.88; P<.001). Both the step-count and intensity predictions made by the floor-vibration monitoring system exhibited greater accuracy than those of the ActiGraph monitor. CONCLUSIONS: Floor-vibration monitoring systems seem able to produce valid quantitative assessments of physical activity for selected housework-related activities. In the future, connected smart home systems that integrate this type of technology could be used to perform continuous and accurate evaluations of physical behaviors throughout the day.

Body Cell Mass to Fat-Free Mass Ratio and Extra- to Intracellular Water Ratio Are Related to Maximal Oxygen Uptake.

Fat-free mass (FFM) is a heterogeneous compartment comprising body cell mass (BCM), intracellular water (ICW), extracellular solids, and extracellular water (ECW). The BCM/FFM and ECW/ICW ratios vary among individuals and decrease with age. This study aimed to determine whether BCM/FFM and ECW/ICW ratios are predictors of maximal oxygen uptake (V̇̇O2peak) independently of age, sex, and objectively measured physical activity (PA). A total of 115 Japanese males and females, aged 55.3 ± 8.0 years (mean ± standard deviation), were included in the study. Anthropometry, explosive leg muscle power, and V̇̇O2peak were measured, and BCM, FFM, ICW, and ECW were estimated. Step count and PA were objectively measured using a triaxial accelerometer. Blood flow volume was assessed using ultrasonography. BCM and ICW were negatively correlated with age, whereas FFM and ECW were not significantly correlated with age. FFM, ICW/ECW, BCM/FFM, step counts, moderate and vigorous PA, and leg muscle power were positively correlated with V̇̇O2peak, even after adjusting for age and sex (p < .05). Multiple regression analysis indicated that either BCM/FFM or ECW/ICW, leg power, and objectively measured PA were associated with V̇̇O2peak independent of age, sex, and FFM. Blood flow volume was significantly correlated with ECW (p < .05), but not with BCM. The BCM/FFM and ECW/ICW ratios were significant predictors of V̇̇O2peak, independent of age, sex, FFM, leg power, and objectively measured PA.

Random forest algorithms to classify frailty and falling history in seniors using plantar pressure measurement insoles: a large-scale feasibility study.

BACKGROUND: Frailty and falls are two adverse characteristics of aging that impair the quality of life of senior people and increase the burden on the healthcare system. Various methods exist to evaluate frailty, but none of them are considered the gold standard. Technological methods have also been proposed to assess the risk of falling in seniors. This study aims to propose an objective method for complementing existing methods used to identify the frail state and risk of falling in older adults. METHOD: A total of 712 subjects (age: 71.3 ± 8.2 years, including 505 women and 207 men) were recruited from two Japanese cities. Two hundred and three people were classified as frail according to the Kihon Checklist. One hundred and forty-two people presented with a history of falling during the previous 12 months. The subjects performed a 45 s standing balance test and a 20 m round walking trial. The plantar pressure data were collected using a 7-sensor insole. One hundred and eighty-four data features were extracted. Automatic learning random forest algorithms were used to build the frailty and faller classifiers. The discrimination capabilities of the features in the classification models were explored. RESULTS: The overall balanced accuracy for the recognition of frail subjects was 0.75 ± 0.04 (F1-score: 0.77 ± 0.03). One sub-analysis using data collected for men aged > 65 years only revealed accuracies as high as 0.78 ± 0.07 (F1-score: 0.79 ± 0.05). The overall balanced accuracy for classifying subjects with a recent history of falling was 0.57 ± 0.05 (F1-score: 0.62 ± 0.04). The classification of subjects relative to their frailty state primarily relied on features extracted from the plantar pressure series collected during the walking test. CONCLUSION: In the future, plantar pressures measured with smart insoles inserted in the shoes of senior people may be used to evaluate aspects of frailty related to the physical dimension (e.g., gait and balance alterations), thus allowing assisting clinicians in the early identification of frail individuals.

Step-count outcomes of 13 different activity trackers: Results from laboratory and free-living experiments.

BACKGROUND: Many activity trackers have been developed, but steps can still be inconsistent from one monitor to another. RESEARCH QUESTION: What are the differences and associations between the steps of 13 selected consumer-based and research-grade wearable devices during 1 standardized day in a metabolic chamber and 15-day free-living trials? METHODS: In total, 19 healthy adults between 21 and 50 years-old participated in this study. Participants were equipped with 12 accelerometer-based active trackers and one pedometer (Yamasa) in order to monitor the number of steps per day. The devices were worn on the waist (ActiGraph, Omron, Actimarker, Lifedorder, Withings, and Yamasa) or non-dominant wrist (Fitbit, Garmin, Misfit, EPSON, and Jawbone), or placed in a pocket (Omron CaloriScan, and TANITA). Participants performed structured activities over a 24 h period in a chamber (Standardized day), and steps were monitored in the same participants in free-living trials for 15 successive days using the same monitors (free-living days). RESULTS: When the 13 monitors were ranked by their steps, waist-worn ActiGraph was located at the center (7th) of the monitors both in the Standardized (12,252 ± 598 steps/day, mean ± SD) and free-living days (9295 ± 4027 steps/day). The correlation between the accelerometer-based devices was very high (r = 0.87-0.99). However, the steps of Yamasa was significantly lower in both trials than ActiGraph. The wrist-worn accelerometers had significantly higher steps than other devices both trials (P < 0.05). The differences between ActiGraph and Actimarker or Lifecorder was less than 100 steps/day in the Standardized day, and the differences between ActiGraph and Active Style Pro was less than 100 steps/day in the free-living days. Regression equation was also performed for inter-device compatibility. SIGNIFICANCE: Step obtained from the wrist-worn, waist-worn, and pocket-type activity trackers were significantly different from each other but still highly correlated in free-living conditions.

Effect of a 1-year intervention comprising brief counselling sessions and low-dose physical activity recommendations in Japanese adults, and retention of the effect at 2 years: a randomized trial.

BACKGROUND: In an effort to increase people's adherence to active lifestyles, contemporary physical activity (PA) guidelines now include low-dose PA. METHODS: PA was evaluated in 583 participants of the Nutritional and Physical Activity Intervention Study (NEXIS) cohort (30-65 years old); 349 inactive participants (MVPA, 2.7 ± 1.0 MET-h/day) were randomly assigned to the intervention or control groups, and 235 active participants participated in follow-up visits. The intervention aimed to increase MVPA and comprised five brief counseling sessions over 1 year. The 1-year target for the participant was increasing their step-count to 10,000 steps/d or +3000 steps/d, relative to the baseline score. The counseling sessions were designed to stimulate progressive changes in physical behaviors by recommendations promoting small and/or light-intensity bouts of PA. PA was measured at baseline, the end of the intervention, and 1 year after the intervention ended. Additionally, several nutrition, health, and fitness parameters were measured. RESULTS: Participants in the intervention group significantly increased their step-count from 8415 ± 1924 at baseline to 9493 ± 2575 at the end of the 1-year period. During the same period, MVPA significantly increased by 0.9 MET-h. The daily time spent in ≥ 3, ≥ 4 and ≥ 5 MET activities increased by 11, 6, and 3 min, respectively. This increase in PA remained observable 1 year after intervention concluded. The active group maintained higher physical activity levels throughout the two years. The intervention group showed smaller energy intakes at the end of the 2-year period. Significant correlations were noted between the 1-year change in MVPA and the change in resting heart rate (r = - 0.22), and between the 2-year change in MVPA and the change in waist circumference (r = - 0.08) and peak oxygen consumption capacity (r = 0.23) in the intervention group only. CONCLUSIONS: A prolonged and progressive PA intervention promoting small bouts of light-to-moderate PA may be used in healthy, not-optimally-active people to increase PA beyond the strict period of the intervention. Further studies are necessary to understand whether low-dose PA messages can be effective in initiating a progressive increase toward larger amounts of PA. TRIAL REGISTRATION: Clinical Trials.gov, NCT00926744, retrospectively registered.

Random forest algorithms for recognizing daily life activities using plantar pressure information: a smart-shoe study.

BACKGROUND: Wearable activity trackers are regarded as a new opportunity to deliver health promotion interventions. Indeed, while the prediction of active behaviors is currently primarily relying on the processing of accelerometer sensor data, the emergence of smart clothes with multi-sensing capacities is offering new possibilities. Algorithms able to process data from a variety of smart devices and classify daily life activities could therefore be of particular importance to achieve a more accurate evaluation of physical behaviors. This study aims to (1) develop an activity recognition algorithm based on the processing of plantar pressure information provided by a smart-shoe prototype and (2) to determine the optimal hardware and software configurations. METHOD: Seventeen subjects wore a pair of smart-shoe prototypes composed of plantar pressure measurement insoles, and they performed the following nine activities: sitting, standing, walking on a flat surface, walking upstairs, walking downstairs, walking up a slope, running, cycling, and completing office work. The insole featured seven pressure sensors. For each activity, at least four minutes of plantar pressure data were collected. The plantar pressure data were cut in overlapping windows of different lengths and 167 features were extracted for each window. Data were split into training and test samples using a subject-wise assignment method. A random forest model was trained to recognize activity. The resulting activity recognition algorithms were evaluated on the test sample. A multi hold-out procedure allowed repeating the operation with 5 different assignments. The analytic conditions were modulated to test (1) different window lengths (1-60 seconds), (2) some selected sensor configurations and (3) different numbers of data features. RESULTS: A window length of 20 s was found to be optimum and therefore used for the rest of the analysis. Using all the sensors and all 167 features, the smart shoes predicted the activities with an average success of 89%. "Running" demonstrated the highest sensitivity (100%). "Walking up a slope" was linked with the lowest performance (63%), with the majority of the false negatives being "walking on a flat surface" and "walking upstairs." Some 2- and 3-sensor configurations were linked with an average success rate of 87%. Reducing the number of features down to 20 does not alter significantly the performance of the algorithm. CONCLUSION: High-performance human behavior recognition using plantar pressure data only is possible. In the future, smart-shoe devices could contribute to the evaluation of daily physical activities. Minimalist configurations integrating only a small number of sensors and computing a reduced number of selected features could maintain a satisfying performance. Future experiments must include a more heterogeneous population.

Pulse wave velocity is lower in trained than in untrained sickle cell trait carriers.

BACKGROUND: Sickle cell trait (SCT) is a benign condition of sickle cell disease. Nevertheless, previous reports showed that SCT carriers have increased blood viscosity and decreased vascular reactivity compared to non-SCT carrier. The benefit of regular exercise on vascular function has been well documented in the general population but no study focused on the SCT population. PURPOSE: The aim of our study was to compare arterial stiffness and blood viscosity between trained and untrained SCT carriers, as well as a group of untrained non-SCT. METHODS: Arterial stiffness (finger-toe pulse wave velocity) and blood viscosity were evaluated in untrained non-SCT carriers (n = 10), untrained SCT carriers (n = 23) and trained SCT carriers (n = 17) who reported at least 10 hours of physical exercise per week. RESULTS: Untrained SCT carriers had higher pulse wave velocity (p = 0.032) and blood viscosity (p < 0.001) than their trained counterparts. In addition, untrained SCT carriers had higher blood viscosity (p < 0.001) than the untrained non-SCT group. A positive association was noted between blood viscosity and pulse wave velocity in the whole study population. CONCLUSION: Our study suggests that regular exercise may be beneficial for the vascular function of SCT carriers.

Caffeine Consumption Is Associated With Higher Level of Physical Activity in Japanese Women.

Caffeine has been described as a sports performance-enhancing substance. However, it is unclear whether it can increase the level of physical activity (PA) in nonathletic individuals. This study investigates the relationship between daily caffeine consumption and (a) daily PA/fitness or (b) intervention-induced changes in PA in women and men. On the basis of responses to a dietary habit questionnaire, which included items on caffeinated beverages, 1,032 Japanese adults, were categorized into lower or higher caffeine consumption groups (relative to the median caffeine consumption). In each group, daily step count; sedentary time; and light, moderate, and vigorous PA outcomes were objectively measured. Physical fitness, including peak oxygen consumption, was also evaluated. The relationship between daily caffeine consumption and the change in the levels of PA was investigated in a subgroup of 202 subjects who participated in a 1-year PA counseling intervention. Women in the higher caffeine consumption group presented higher moderate-to-vigorous PA and step count compared with their counterparts in the lower consumption group (4.0 ± 2.1 vs. 3.3 ± 2.1 MET-hr/day, p < .001; 10,335 ± 3,499 vs. 9,375 ± 3,527 steps/day, p < .001). A significant positive correlation was noted between caffeine consumption and peak oxygen consumption among women (r = .15, p < .001). No caffeine-related effects were noted in men. The lower and higher caffeine consumption groups showed no significant differences in their levels of PA at the end of the 1-year intervention. Therefore, caffeine consumption appears to be associated with higher levels of PA in Japanese women. Further studies are needed to clarify this association.

The contribution of Nintendo Wii Fit series in the field of health: a systematic review and meta-analysis.

BACKGROUND: Wii Fit was originally designed as a health and fitness interactive training experience for the general public. There are, however, many examples of Wii Fit being utilized in clinical settings. This article aims to identify the contribution of Wii Fit in the field of health promotion and rehabilitation by: (1) identifying the health-related domains for which the Wii Fit series has been tested, (2) clarifying the effect of Wii Fit in those identified health-related domains and (3) quantifying this effect. METHOD: A systematic literature review was undertaken. The MEDLINE database and Games for Health Journal published content were explored using the search term "Wii-Fit." Occurrences resulting from manual searches on Google and material suggested by experts in the field were also considered. Included articles were required to have measurements from Wii Fit activities for at least one relevant health indicator. The effect of Wii Fit interventions was assessed using meta-analyses for the following outcomes: activity-specific balance confidence score, Berg balance score (BBC) and time-up-and-go test (TUG). FINDINGS: A total of 115 articles highlighted that the Wii Fit has been tested in numerous healthy and pathological populations. Out of these, only a few intervention studies have focused on the prevention of chronic diseases. A large proportion of the studies focus on balance training (N = 55). This systematic review highlights several potential benefits of Wii Fit interventions and these positive observations are supported by meta-analyses data (N = 25). For example, the BBC and the TUG respond to a similar extend to Wii Fit interventions compared with traditional training. CONCLUSION: Wii Fit has the potential to be used as a rehabilitation tool in different clinical situations. However, the current literature includes relatively few randomized controlled trials in each population. Further research is therefore required.

Management of surgical instruments with radio frequency identification tags.

PURPOSE: To prevent malpractices, medical staff has adopted inventory time-outs and/or checklists. Accurate inventory and maintenance of surgical instruments decreases the risk of operating room miscounting and malfunction. In our previous study, an individual management of surgical instruments was accomplished using Radio Frequency Identification (RFID) tags. The purpose of this paper is to evaluate a new management method of RFID-tagged instruments. DESIGN/METHODOLOGY/APPROACH: The management system of RFID-tagged surgical instruments was used for 27 months in clinical areas. In total, 13 study participants assembled surgical trays in the central sterile supply department. FINDINGS: While using the management system, trays were assembled 94 times. During this period, no assembly errors occurred. An instrument malfunction had occurred after the 19th, 56th, and 73 th uses, no malfunction caused by the RFID tags, and usage history had been recorded. Additionally, the time it took to assemble surgical trays was recorded, and the long-term usability of the management system was evaluated. ORIGINALITY/VALUE: The system could record the number of uses and the defective history of each surgical instrument. In addition, the history of the frequency of instruments being transferred from one tray to another was recorded. The results suggest that our system can be used to manage instruments safely. Additionally, the management system was acquired of the learning effect and the usability on daily maintenance. This finding suggests that the management system examined here ensures surgical instrument and tray assembly quality.

"+10 min of Physical Activity per Day": Japan Is Looking for Efficient but Feasible Recommendations for Its Population.

Prospective cohort studies have shown that people with a larger amount of physical activity (PA) and exercise have lower risks of non-communicable diseases (NCDs). In Japan, the Ministry of Health, Labour and Welfare published in March 2013 the "Active-Guide," i.e. the Japanese official PA guidelines for health promotion. In this document, the most important message is "+10," standing for "add 10 min of MVPA per day." The establishment of the "+10" recommendation is supported by strong scientific evidence. Firstly, a meta-analysis including 26 cohort studies indicated that an increment of 10 min of moderate-to-vigorous PA per day can result in a 3.2% reduction of the average relative risk of NCDs, dementia, joint-musculoskeletal impairment, and mortality. Secondly, the National Health and Nutrition Survey (Japan, 2010) reported that 60.8% of the Japanese population is inclined to add the equivalent of 10 min of PA in their daily life. In line with these results, the "+10" recommendation is viewed as feasible and efficient for the Japanese population. To our knowledge, this implementation of an additional low-dose PA recommendation in a governmental health promotion policy is a world first. We hope that the Japanese PA policy will inspire other national and international public health agencies.

Installation of a stationary high desk in the workplace: effect of a 6-week intervention on physical activity.

BACKGROUND: Extended sitting time at work is viewed as a crucial public health issue. Encouraging workers to stand during their office hours via the installation of standing desks maybe one effective option to combat this. Here, we investigate whether the installation of high desks in the workplace can induce positive changes in the amount of physical activity (PA) and thereby lead to subsequent improvements in anthropometric parameters. METHODS: Thirty-two white-collar workers (22 men and 10 women, mean age 44.2) were randomly divided into two groups. A randomised crossover trial was performed for 13 weeks. During the experimental period, subjects completed their office work in a standing position using stationary high desks (standing work, SW) for 10 hours per week or more (SW period). The subjects were asked to maintain their normal sitting working habits during the control period (CONT period). The primary outcome was PA, which was assessed objectively using a triaxial accelerometer during weekdays and weekends. The secondary outcomes were anthropometric measurements. For each group and each parameter, the mean values during each period were recorded and were compared by paired t test. RESULTS: The daily total PA (10.2 ± 2.4 vs. 9.7 ± 2.3 METs · h/day, P = 0.043), MVPA (4.2 ± 2.2 vs. 3.7 ± 1.8 METs · h/day, P = 0.025), time spent in moderate PA (58.2 ± 20.7 vs. 53.4 ± 17.0 min/day, P = 0.019) and time spent in MVPA (62.8 ± 25.1 vs. 57.0 ± 20.3 min/day, P = 0.019) were significantly higher during the SW period compared to the CONT period. A weekdays verses weekends subanalysis revealed that these parameters were significantly higher during the SW period compared to the CONT period during weekdays only. No significant differences were noted before and after SW periods for most of the anthropometric measures, except waist circumference (83.7 ± 7.9 vs. 83.0 ± 7.9 cm, respectively, P = 0.007). CONCLUSIONS: Standing work, via the installation of high desks, significantly increases moderate to vigorous physical activity, especially on weekdays. TRIAL REGISTRATION: UMIN-CRT, UMIN000016731, 7th March 2015.

In vivo venous assessment of red blood cell aggregate sizes in diabetic patients with a quantitative cellular ultrasound imaging method: proof of concept.

BACKGROUND: Diabetic patients present higher level of red blood cell (RBC) aggregation contributing to the development of vascular complications. While it has been suggested that this hematology/rheology parameter could bring additional prognostic information for the management of those patients, RBC aggregation screening is not included as a clinical practice. Most medical centers are not equipped to measure properly this parameter, although sedimentation tests can bring some indication. Here, we aimed at evaluating the feasibility of using ultrasound to assess in-vivo hyper-aggregation in type 2 diabetic patients. RESEARCH DESIGN AND METHODS: Seventeen diabetic patients and 15 control subjects underwent ultrasound measurements of RBC aggregation in both cephalic and great saphenous veins. Non-invasive in-vivo ultrasound measurements were performed using a newly developed cellular imaging technique, the structure factor size and attenuation estimator (SFSAE). Comparisons with an ex-vivo gold standard rheometry technique were done, along with measurements of pro-aggregating plasma molecule concentrations. RESULTS: In-vivo RBC aggregation was significantly higher in diabetic patients compared with controls for cephalic vein measurements, while a trend (p = 0.055) was noticed in the great saphenous vein. SFSAE measurements were correlated with gold standard in-vitro measures, fibrinogen and C-reactive protein plasma concentrations. CONCLUSION: RBC aggregation can be measured in-vivo in diabetic patients using ultrasound. Prospective studies are needed to determine whether the SFSAE method could help clinicians in the early management of vascular complications in this patient population.

Wii Fit U intensity and enjoyment in adults.

BACKGROUND: The Wii Fit series (Nintendo Inc., Japan) provides active video games (AVGs) to help adults to maintain a sufficient level of daily physical activity (PA). The second generation of home AVG consoles is now emerging with new game modalities (including a portable mini screen in the case of the new Wii U). The present study was performed to investigate the intensity and enjoyment of Wii Fit U games among adults. FINDINGS: Metabolic equivalent (METs, i.e., intensity) of the Wii Fit U activities were evaluated using metabolic chambers in 16 sedentary adults (8 women and 8 men). A short version of the physical activity enjoyment scale was completed for each activity. Wii Fit U activities were distributed over a range from 2.2  ±  0.4 METs (Hula dance) to 4.7  ±  1.2 (Hip-hop dance). Seven activities were classified as light-intensity PA (<3 METs) and 11 activities as moderate-intensity PA (3 - 6 METs). The new portable mini screen game modality does not induce higher METs. Men exercised at higher intensities than women. There was no correlation between enjoyment and MET values in women or men. CONCLUSIONS: More and more moderate-intensity activities are available through video gaming, but the average intensity (3.2  ±  0.6) is still low. Users should be aware that AVGs alone cannot fulfill the recommendations for PA, and the video games industry still must innovate further to enhance gaming intensity and make the tool more attractive to health and fitness professionals.

Evaluation of active video games intensity: comparison between accelerometer-based predictions and indirect calorimetric measurements.

BACKGROUND: Several active video game (AVG) intervention studies failed in showing an increase in physical activity by using accelerometry measurements. OBJECTIVE: To test the validity of accelerometry for monitoring AVG playing intensity. METHOD: Twenty-two adults performed 80 activities included in the Wii Sports and Wii Fit Plus series. The energy expenditure (EE) and subsequent MET values were measured by indirect calorimetry using metabolic chambers. Subjects wore an accelerometer-based monitor displaying MET values. For each activity, METs values obtained from indirect calorimetry and accelerometry were compared. Each activity was classified as light or moderate to vigorous physical activity (LPA: < 3METs or MVPA: ⩾ 3METs) for the two methods. RESULTS: AVG intensities have been slightly but significantly underestimated by the acceleromater-based monitor compared to the indirect calorimetry (2.5 ± 1.0 instead of 2.7 ± 0.9 METs). Fourty percent of activities have been significantly misestimated, and 20% have been misclassified. CONCLUSION: Those results point out the potential bias of accelerometry measurements for evaluating AVG intensities. Because average AVG intensity lays at the boundary between LPA and MVPA classes, misclassifications can frequently occur. Accelerometry data should be interpreted with caution in intervention studies using AVG.

Home-based active video games to promote weight loss during the postpartum period.

PURPOSE: Weight retention during the postpartum period is critical for the later development of obesity in women. Traditional physical activity is frequently discontinued because of incompatibility with mothers' agenda (i.e., baby care). In the present study, active video games (AVG) are proposed for postpartum women to improve their body composition. METHODS: Thirty-four postpartum women (body mass index = 24.5 ± 3.4 kg·m) were randomized to an AVG group or a control group. Subjects assigned to the AVG group were given a Wii Nintendo console with the game Wii Fit Plus for 40 d. The two groups were tested for weight, body mass index, body fat mass, waist and hip circumferences, and other anthropometric parameters. Physical fitness, energy expenditure, energy intake, and adverse events were also investigated. RESULTS: The AVG group lost more weight than the control group (-2.2 ± 0.9 vs. -0.5 ± 0.7 kg, P < 0.001). They also exhibited more important reductions of BMI, waist and hip circumferences, and body fat (P < 0.05). During the 40-d period, subjects expended an estimated 4682 ± 2874 kcal just by playing AVG. Daily energy intake was reduced by 206 ± 559 kcal. There were significant positive correlations between playing frequency, total playing time, total energy expenditure during the 40-d period, and decrease in daily energy intake respectively, and weight loss (P < 0.05). Playing time data suggested no conflict with baby care activities. CONCLUSIONS: AVGs could represent an interesting spare physical activity for postpartum women. In the present study, these games promoted physical activity, induced a reduction of energy intake, and subsequently minimized weight retention.

Time-dependent hardening of blood clots quantitatively measured in vivo with shear-wave ultrasound imaging in a rabbit model of venous thrombosis.

OBJECTIVE: Provide in vivo blood clot hardening evolution with ultrasound using supersonic imaging of shear waves. METHODS: We conducted a prospective study in flow stasis-induced venous thrombosis within jugular veins of white female New Zealand rabbits. Blood clot elasticity was noninvasively measured in vivo using the Young's modulus (in kilopascals), on a 2-hour and a 2-week periods after thrombus induction. Monitoring was followed by a necropsy and ex vivo mechanical characterization to validate the existence and elasticity of explanted thrombi. RESULTS: Stagnant blood in the region of interest underwent clotting and progressive hardening with thrombus aging. The mean Young's moduli varied from 1.0 ± 0.6 kPa (at 10 min) to 5.3 ± 1.6 kPa (at 2 hours), then to 25.0 ± 6.8 kPa (at 14 days) post-surgery. Mean ex vivo moduli of 6.2 ± 0.7 kPa at 2 hours and 29.0 ± 2.4 kPa at 2 weeks agreed with in vivo measures. CONCLUSIONS: Supersonic imaging of shear waves provides consistent quantitative non-invasive elasticity measurements not available with standard compression ultrasound imaging for diagnosing and following venous thromboembolism. This information translatable to humans could aid in determining whether continued anticoagulant treatment is necessary, especially in the setting of unprovoked venous thromboembolism.

Intraday blood rheological changes induced by Ramadan fasting in sickle cell trait carriers.

The goal of the present study was to test whether fasting during the holy period of Ramadan may disturb blood rheology in sickle cell trait (SCT) carriers more than in a group of subjects with normal hemoglobin. Twenty African male students participated in the study: 10 SCT carriers and 10 subjects with normal hemoglobin (CONT). Biochemical parameters (plasma glucose and lipids levels), hematocrit, blood viscosity, and urine specific gravity were measured in the two groups on the 14th day of the Ramadan period (Ramadan condition) and 6 wks after the end of Ramadan (baseline condition). All the measurements were performed twice for each experimental day to measure intraday variation: 8:00 and 18:00 h. Plasma glucose level and lipid profile were not significantly different between the two groups. Although Ramadan did not affect the lipid profile, the plasma glucose concentration was lower during the Ramadan period compared with the baseline condition in the two groups. Hematocrit and urine specific gravity did not differ between the two groups and was greater in the evening than in the morning, independently of the condition. SCT carriers had higher blood viscosity than the CONT group. However, whereas blood viscosity remained unchanged through the day in the CONT group, whatever the condition, SCT carriers were characterized by a large increase of blood viscosity in the evening during the Ramadan period, indicating higher risk for microcirculatory blood flow impairments. Specific medical recommendations are needed for SCT carriers engaged in religious fasting.