Self-determined motivational health coaching ('SAMI') during outpatient treatment to promote physical activity of people with serious mental illness: a pilot controlled trial.

BACKGROUND: Brief motivational coaching, integrated into health care; seems promising to address physical inactivity of people with serious mental illness (SMI). AIMS: To test the impact of a self-determined health coaching approach (the "SAMI" intervention) during outpatient mental health treatment on moderate-to-vigorous physical activity (MVPA) of people with SMI. METHODS: Adults (mean age = 41.9, SD = 10.9) with an ICD-10 diagnosis of mental illness were semi-randomized to the SAMI-intervention group (IG) or control group (CG). The IG received 30 minutes of health coaching based on the self-determination theory (SDT). MVPA and sedentary time (ST) were measured with the International Physical Activity Questionnaire - short form (IPAQ-SF) and symptoms of mental illness with the Brief Symptom Inventory (BSI-18), each at baseline and follow-up (3-4 months). Differences in primary (MVPA) and secondary (ST, BSI-18) outcomes were evaluated using negative binomial regressions and general linear models. RESULTS: In the IG (n = 30), MVPA increased from 278 (interquartile range [IQR] = 175-551) to 435 (IQR = 161-675) min/week compared to a decrease from 250 (IQR = 180-518) to 155 (IQR = 0-383) min/week in the CG (n = 26; adjusted relative difference at follow-up: Incidence Rate Ratio [IRR] = 2.14, 95% CI: 1.17-3.93, p = 0.014). There were no statistically significant differences in ST and BSI-18. CONCLUSIONS: Brief self-determined health coaching during outpatient treatment could increase post-treatment MVPA in people with SMI, potentially up to a clinically relevant level. However, great uncertainty (for all outcomes) weakens the assessment of clinical relevance.

Nutritional and physical fitness parameters in adolescence impact cardiovascular health in adulthood.

BACKGROUND & AIMS: Cardiovascular diseases are the leading cause of mortality worldwide, originating in the first decades of life. A better understanding of their early determinants would allow for better prevention. This study aimed to evaluate the impact of nutritional and activity-related characteristics during adolescence on young adult cardiovascular risk factors. METHODS: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study included adolescents (aged 12.5-17.5 years) in 10 European centres. Four centres designed a nested cohort including 236 participants who were reassessed as young adults (21-32 years). Food consumption was evaluated by dietary recalls, physical activity by accelerometers, physical fitness using physical tests and nutritional knowledge by questionnaires. Cardiovascular health was assessed by Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study risk scores and its components. Factors associated with cardiovascular risk were identified using a multivariable regression model. RESULTS: Higher Diet Quality Index (DQI, P = 0.012) and nutritional knowledge (P = 0.015) were significantly associated with lower modified PDAY risk scores. Ultra-processed foods were associated with a lower non-high-density lipoprotein (non-HDL) cholesterol (P = 0.003), whereas DQI (P = 0.014) and Planetary Health Diet Index (P = 0.016) were associated with a higher HDL cholesterol. Higher DQI was also related to a lower body mass index (BMI, P = 0.006). In addition, cardiorespiratory fitness was related to a lower BMI (P = 0.004). CONCLUSIONS: Nutritional knowledge, diet quality and adherence to a sustainable diet in adolescence decrease cardiovascular risk in adulthood, whereas ultra-processed food consumption increases risk. These factors appear as targeted prevention tools for promoting a healthier adolescent lifestyle to decrease long-term cardiovascular risk. CLINICAL TRIAL REGISTRY NUMBER: Clinicaltrials.gov NCT02899416.

Associations of pattern-recognition-measured daily activities with sarcopenia and sarcopenic obesity in old age: The IMPACT65+ study.

BACKGROUND: Physical activity has shown beneficial effects for a good state of muscles in aging, but the specific activities of daily living that could be protective remains unclear. This study aimed to analyse the associations of different pattern-recognition-measured daily activities with sarcopenia and sarcopenic obesity in a sample of older adults. METHODS: 200 community-dwelling older adults wore the Intelligent Device for Energy Expenditure and Activity for two consecutive days. Twelve major daily activities recorded were merged in to three common intensity categories: sedentary behaviour (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). For physical performance measurements included, hand grip dynamometer and chair-stand tests were used. Skeletal muscle mass and fat mass were estimated by bioelectrical impedance analysis. Associations of daily activities with the study variables were examined using linear regression models. RESULTS: There were no significant associations between total time spent in SB, LPA, or MVPA and sarcopenia. Sarcopenic obesity showed a negative association with total time spent in MVPA [ß (95%CI): -0.29 (-0.41, -0.17)]. Walk at a brisk pace was significatively associated with lower limb physical performance, muscle mass and fat mass % [ß (95%CI): 1.15 (0.40, 1.91); 1.45 (0.68, 2.22) and -2.63 (-4.12, -1.14) respectively]. Other MVPA activities were also significatively associated with the same sarcopenic obesity components [ß (95%CI): 4.65 (0.55, 8.75); 8.59 (4.51, 12.67) and -13.98 (-21.96, -5.99) respectively]. CONCLUSION: Time spent in daily activities of moderate-to-vigorous intensity is negatively associated with sarcopenic obesity but not with sarcopenia.

Effect of circuit training and walking on glycemic control in type 2 diabetic women assisted in primary care clinic in Pelotas/RS, 2017: A randomized trial / Efecto del entrenamiento en circuito y de la caminata sobre el control glicémico de mujeres diabéticas tipo 2 atendidas en clínicas de atención primária de Pelotas/RS, 2017: Ensayo aleatorio / Efeito do treinamento em circuito e da caminhada sobre o controle glicêmico de mulheres diabéticas tipo 2 assistidas em unidades básicas de saúde de Pelotas/RS, 2017: Ensaio randomizado

Objective: compare the effects of circuit training and walking on glycemic control in women with type 2 diabetes. Methods: this randomized trial in primary  care clinic. The primary outcomes assessed were glycated hemoglobin and fasting blood glucose. Two primary health care were randomized to the circuit training and three to the walking, including 41 women (circuit=28; walking=13). Intra- and inter-group comparisons were conducted by intention-to-treat. Results:  no changes were observed in glycated hemoglobin (p=0.209) and fasting blood glucose (p=0.123). Localized muscular resistance of the lower limbs and cardiorespiratory fitness increased in the functional training (p=0.002; p=0.009, respectively), and blood pressure decreased significantly in both groups (p=0.006; p=0.046, respectively). Conclusion: the interventions did not improve glycemic control. Circuit training was effective in improving physical fitness, and both models were effective in controlling participants' blood pressure.

Objetivo: comparar el efecto del entrenamiento en circuito y de la caminata sobre el control glicémico en mujeres diabéticas tipo 2. Métodos: se trata de ensayo randomizado en clínicas de atención primária. Los resultados primarios fueron la hemoglobina glucosilada y la glucosa. Fueron dos unidades para entrenamiento en circuito y tres para caminata, incluídas 41 mujeres (circuito=28; caminata=13). Comparaciones intra y entre grupos fueron conducidas por intención de tratar. Resultados: No se observaron cambios en el hemoglobina glucosilada (p=0,209) y la glucosa (p=0,123). La resistencia muscular localizada de miembros inferiores y la aptitud cardiorrespiratoria aumentaran en el entrenamiento en circuito (p=0,002; p=0,009, respectivamente), y la presión arterial sistólica e diastólica se redujo significativamente en los  grupos (p=0,006; p=0,046, respectivamente). Conclusión: las intervenciones no cambiaram el control glicémico. El entrenamiento en circuito mejoró la aptitud física y los dos modelos fueron eficaces para controlar la presión arterial de las participantes.

Objetivo: comparar o efeito do treinamento em circuito e da caminhada sobre o controle glicêmico de mulheres diabéticas tipo 2. Métodos: trata-se de ensaio randomizado em unidades básicas de saúde. Os desfechos primários foram hemoglobina glicada e glicemia de jejum. Duas unidades foram randomizadas para o treinamento em circuito e três para caminhada, incluiu-se41 mulheres (circuito=28; caminhada=13). Comparações intra e entre grupos foram conduzidas por intenção de tratar. Resultados:  não foram observadas mudanças entre os grupos na hemoglobina glicada (p=0,209) e glicemia de jejum (p=0,123).   A resistência muscular localizada de membros inferiores e aptidão cardiorrespiratória aumentaram com o circuito (p=0,002; p=0,009, respectivamente) e a pressão arterial sistólica e diastólica reduziram significativamente nos grupos (p=0,006; p=0,046, respectivamente). Conclusão: as intervenções não melhoraram o controle glicêmico. O treinamento em circuito foi eficiente para melhorar a aptidão física e os dois modelos foram eficazes para controlar a pressão arterial das participantes.

How does planetary health redefine our steps? An integrative review on climate change and global physical activity

Introduction: Climate change is altering individual behaviors, particularly in terms of physical activity, with significant implications for body and mental health. Objective: This review aims to provide insights for researchers, public health professionals, and policymakers to promote physical activity effectively in the face of climate change challenges. Methods: We conducted an integrative review of studies involving adults published in English, Portuguese, or Spanish, using databases such as PubMed, Scielo, Lilacs, Web of Science, and Embase. Results: Eighty-three papers were included, revealing that heat waves reduce outdoor physical activity, while indoor activities are gaining popularity due to poor air quality. Sea level rise affects coastal areas and water-based sports, limiting access to these activities. Public policies are needed to promote physical activity for various groups, considering their specific needs and limitations. Despite these challenges, physical activity can increase resilience and be a catalyst for lifestyle changes, especially in areas most affected by climate change. Conclusion: A multidisciplinary approach is crucial for developing solutions to mitigate the negative impacts of climate change on physical activity. This review highlights the urgent need for adaptation strategies in promoting physical activity in the face of a changing environment and its implications for public health.

More Movement, Less Bodily Pain? Findings From a Large, Representative Multi-District Aging Study in Ghana.

OBJECTIVE: The association of physical activity (PA) with pain has been characterized. Although the literature largely comes from high-income countries, the mechanistic pathways underlying this association remain unknown, particularly in low- and middle-income countries (LMICs). We aim to examine the association between meeting the World Health Organization (WHO) PA guidelines and pain among aging adults and identify the factors that may mediate this association. DESIGN: We used a quantitative cross-sectional study design. SETTING AND PARTICIPANTS: Representative data from adults aged ≥50 years who participated in the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study were used. METHODS: PA was defined using the International Physical Activity Questionnaire (IPAQ). Self-reported pain experience using a cross-culturally validated item over the past month assessed pain severity. Adjusted multivariable ordinal logistic regression and mediation models quantified the hypothesized associations. RESULTS: The analysis included 1201 adults (mean 66.1 ± 11.9 years; 63.3% female). After adjusting for confounders, adhering to the WHO-recommended PA guidelines was associated with 42% lower odds for severe/extreme pain [odds ratio (OR) 0.58, 95% CI 0.44-0.77]. The association was much stronger among men (OR 0.52, 95% CI 0.31-0.85) than women (OR 0.60, 95% CI 0.42-0.87). The PA-pain association was explained by functional limitations (84.7%), self-rated health (76.6%), sleep problems (20.4%), and injury (6.6%). CONCLUSIONS AND IMPLICATIONS: Moving more was associated with less pain in older adults from LMICs. Interventions for pain management in old age may focus on enhancing compliance with PA doses, particularly in LMICs. However, longitudinal data will need to confirm these findings.

Determinants of moderate-to-high physical activity levels in hemodialysis patients: A multicenter cross-sectional study.

Moderate physical activity is related to reduced mortality in hemodialysis patients. However, most hemodialysis patients have low physical activity levels for complex reasons. This study investigated the determinants of moderate-to-high physical activity levels and whether psychosocial correlates are associated with engagement in moderate-to-high physical activity among hemodialysis patients. A cross-sectional survey was conducted with 134 hemodialysis outpatients, aged 64.7 years, in three hemodialysis centers in Taiwan. Data on sociodemographics, comorbidities, lifestyles, and psychosocial correlates, including perceived benefits, barriers, and self-efficacy of physical activity, were collected. Multiple logistic regression analyses were performed. Results showed that patients with moderate-to-high physical activity levels constituted a significantly lower proportion of current smokers and had fewer perceived physical activity barriers and higher self-efficacy of physical activity compared with those with low levels. After adjusting for potential sociodemographic covariates, current employment, nonsmoking status, and high self-efficacy of physical activity were significantly associated with moderate-to-high physical activity levels. Developing strategies to improve the self-efficacy of physical activity, support employment, and enhance anti-smoking campaigns in hemodialysis patients can help them engage in moderate-to-high levels of physical activity.

Bone and muscle differences in children and adolescents with type 1 diabetes: The mediating role of physical activity.

Children with type 1 diabetes (T1D) experience an increased risk of fracture, which may be related to altered bone development. We aimed to assess differences in bone, muscle and physical activity (PA), and explore if better muscle and PA measures would mitigate bone differences between children and adolescents with T1D and typically developing peers (TDP). We matched 56 children and adolescents with T1D (mean age 11.9 yrs) and 56 TDP (11.5 yrs) by sex and maturity from 171 participants with T1D and 66 TDP (6-17 yrs). We assessed the distal radius and tibia with high-resolution peripheral quantitative computed tomography (HR-pQCT), and the radius and tibia shaft bone and muscle with pQCT. We also measured muscle function from force-related measures in neuromuscular performance tests (push-up, grip test, countermovement and long jump). We compared PA based on questionnaire scores and accelerometers between groups. Bone, muscle, and neuromuscular performance measures were compared using MANOVA. We used mediation to explore the role of PA and muscle in bone differences. Children and adolescents with T1D had 6-10 % lower trabecular density, bone volume fraction, thickness and number at both distal radius and tibia, and 11 % higher trabecular separation at the distal radius than TDP. They also had 3-16 % higher cortical and tissue mineral density, and cortical thickness at the distal radius, 5-7 % higher cortical density and 1-3 % higher muscle density at both shaft sites compared to TDP. PA mediated the between-group difference in trabecular number (indirect effect -0.04) at the distal radius. Children and adolescents with T1D had lower trabecular bone density and deficits in trabecular micro-architecture, but higher cortical bone density and thickness at the radius and tibia compared to TDP. They engaged in less PA but had comparable muscle measures to those of TDP. PA participation may assist in mitigating deficit in trabecular number observed in children and adolescents with T1D.

Revolutionizing Care: Unleashing the Potential of Digital Health Technology in Physiotherapy Management for People With Cystic Fibrosis.

Unlabelled: This viewpoint paper explores the dynamic intersection of physiotherapy and digital health technologies (DHTs) in enhancing the care of people with cystic fibrosis (CF), in the context of advancements such as highly effective modulator therapies that are enhancing life expectancy and altering physiotherapy needs. The role of DHTs, including telehealth, surveillance, home monitoring, and activity promotion, has expanded, becoming crucial in overcoming geographical barriers and accelerated by the recent pandemic. Physiotherapy, integral to CF care since 1946, has shifted toward patient-centered approaches, emphasizing exercise training and a physically active lifestyle. The reduction in inpatient admissions due to highly effective modulator therapies has led to increased home care and online or electronic consultations, and DHTs have revolutionized service delivery, offering flexibility, self-management, and personalized care options; however, there is a need to comprehensively understand user experiences from both people with CF and physiotherapists. This paper highlights the essential exploration of user experiences to facilitate clinician adaptation to the digital requirements of modern clinical management, ensuring equitable care in the "future hospitals" arena. Identifying research gaps, this paper emphasizes the need for a thorough evaluation of DHT use in CF physiotherapy education, training, and self-monitoring, as well as the experiences of people with CF with online or electronic consultations, self-monitoring, and remote interventions. Online group exercise platforms address historical challenges relating to infection control but necessitate comprehensive evaluations of user experiences and preferences. Future-proofing DHTs within the physiotherapy management of CF demands a shift toward full integration, considering stakeholder opinions and addressing barriers. While DHTs have the potential to extend physiotherapy beyond the hospital, this paper stresses the importance of understanding user experiences, addressing digital poverty, and working toward more equitable health care access. A flexible approach in the "future hospital" is advocated, emphasizing the need for a nuanced understanding of user preferences and experiences to optimize the integration of DHTs in CF care.

Exploring the quality of participation and strategies to support meaningful engagement in an adapted paddleboard program among individuals with disabilities.

AIM: Adapted paddleboard provides an outdoor leisure-time physical activities (LTPA) opportunity with many health benefits (e.g., physical activity, reduced stress, social engagement). However, nearly 50% of individuals with disabilities do not participate in any LTPA. Quality of LTPA participation influences sustainable adherence, while optimizing participant experiences. An adapted paddleboard program is offered in Quebec City, for adults with physical disabilities, but little is known about how participants perceive their quality of participation. This study aimed to describe individuals with disabilities' perceived quality of participation in the adapted paddleboard program, and to explore their suggestions of strategies to support meaningful engagement in the program. METHODS: An ethnographic mixed-methods design was conducted, consisting of participant observations during the 13-week program and semi-structured interviews based on the Quality Parasport Participation Framework (QPPF). Measure of Experiential Aspects of Participation (MeEAP) questionnaire were collected. A mixed approach of data analysis was used for qualitative data and descriptive statistics were conducted for quantitative data. RESULTS: Nine participants (8F) with various disabilities (42±15 years old) participated in the study. Emergent dimensions of quality of participation included belongingness and autonomy. Facilitators to participation were identified, such as autonomy support through volunteers and provision of adaptive equipment. Barriers to participation included water access and level of individual challenge. Suggested strategies to improve engagement included water access closer to parking and multiple groups for variable skill levels. CONCLUSIONS: Participants expressed high-quality of participation in adapted paddleboarding. The study allows the development of knowledge about conditions that enhance the experience of participating in outdoor LTPA.

Adapted paddleboard is an increasingly popular activity that can be adapted with material and environmental accommodations for people with disabilities to enable and enhance participation in outdoor leisure-time physical activities (LTPA).Several facilitators, such as the safety of the site or the social support created by the group, enhance quality of experience in leisure-time physical activities (LTPA) including adapted paddleboard; therefore, support sustainable adherence in the practice of physical activities, well-being and social participation.Further opportunities to practice LTPA such as adapted paddleboard in a public space to promote social inclusion are necessary.

Healthcare providers' perceptions of infant physical activity and communication.

BACKGROUND: Healthcare providers (HPs) play a critical role in disseminating information about infant health and development. Two key developmental areas for infants are physical activity (PA) and communication. Few studies have examined HPs views of these topics. Thus, HPs may need support to promote these early development outcomes in infants. Thus, the study explored HPs' perceptions of infant PA and communication. METHODS: A total of 13 HPs with a wide variety of backgrounds were recruited. Zoom semi-structured interviews were based on the Health Belief Model. Deductive content analysis was utilized to analyze data. RESULTS: HPs knew little about PA guidelines. HPs were concerned about an infant's PA because of limited playtime and tummy time. Most HPs advised parents on PA and motor development milestones, with crawling, walking, and tummy time. HPs also wanted to learn about PA measurement tools. PA promotion was hindered by parents' busy schedules, lack of time, and language barriers. Most HPs advised parents on verbal and nonverbal communication. Many HPs were unfamiliar with communication assessment methods and wanted to learn more. CONCLUSIONS: HPs had limited knowledge about PA guidelines and communication measurement tools. Efforts are needed to identify easily accessible ways to educate HPs that could be disseminated to parents.

Social participation in the promoting activity, independence and stability in early dementia (PrAISED), a home-based therapy intervention for people living with dementia: a realist evaluation.

BACKGROUND: Interventions promoting social activity may reduce behavioural psychological symptoms and improve quality of life in people living with dementia. This study aimed to identify social benefits for participants living with dementia in the context of Promoting Activity, Independence and Stability in Early Dementia (PrAISED), an exercise intervention programme promoting physical activity and independence in participants living with dementia in England. METHODS: This was a multi-method realist evaluation undertaking secondary analysis of data collected during the PrAISED process evaluation, including qualitative interviews with participants with dementia, caregivers and therapists, personal notes of researchers, and video recordings of therapy sessions. The study consisted of four phases: (1) Setting operational definition of social outcomes in PrAISED; (2) Developing Context, Mechanisms, Outcome (CMO) configurations; (3) Testing and refining CMOs; and (4) Synthesising definitive CMOs into a middle range theory. RESULTS: Two CMOs were identified. (1) When therapists were able to make therapy sessions engaging and had the caregivers' support, the participants experienced therapy sessions as an opportunity to achieve goals in areas they were interested in. They also found the sessions enjoyable. This all led to the participants being highly engaged in their social interactions with the therapists. (2) When the participants realised that they were gaining benefits and progress through the PrAISED intervention, such as increased balance, this boosted their confidence in physical ability. It might also reduce caregivers' risk-aversion/gatekeeping attitude, which in turn would lead to participants' increased participation in social activities. CONCLUSION: The PrAISED intervention supported social participation in participants living with dementia. Under certain circumstances, home-based therapy interventions can be beneficial for social health (regardless of physical health gains). Given the limitations of currently available outcome measures to assess social participation, qualitative methods should be used to explore social health outcomes.

Comparison of step-count outcomes across seven different activity trackers: a free-living experiment with young and older adults.

BACKGROUND: There are now many different types of activity trackers, including pedometers and accelerometers, to estimate step counts per day. Previous research has extensively examined step-count measurements using activity trackers across various settings while simultaneously wearing different devices.; however, older adults frequently display distinct walking patterns and gait speeds compared to younger adults. This study aimed to compare the step-count between older and younger adults by having them simultaneously wear seven different activity trackers in free-living experiments. METHODS: This study included 35 younger adults (21-43 yrs) and 57 physically independent older adults (65-91 yrs). All participants simultaneously wore one pedometer and six activity trackers: ActiGraph GT3X + Wrist and Hip, Omron Active Style Pro HJA-350IT, Panasonic Actimarker, TANITA EZ-064, Yamasa TH-300, and Yamasa AS-200 for seven days. A regression equation was also used to assess inter-device compatibility. RESULTS: When comparing wrist-worn ActiGraph to the six hip-worn activity trackers, the wrist-worn ActiGraph consistently recorded step counts over 4,000 steps higher than hip-worn activity trackers in both groups (range, 3000-5000 steps). Moreover, when comparing the ActiGraph worn on the wrist to that worn on the hip, the proportion was higher among older adults compared to younger ones (younger: 131%, older: 180%). The Actimarker recorded the highest average step counts among six hip-worn devices, with 8,569 ± 4,881 overall, 9,624 ± 5,177 for younger adults, and 7,890 ± 4,562 for older adults. The difference between the hip-worn ActiGraph and Active Style Pro was just about 70 steps/day overall. The correlation among all devices demonstrated a very high consistency, except for the wrist-worn ActiGraph (r = 0.874-0.978). CONCLUSIONS: Step counts recorded from seven selected consumer-based and research-grade activity trackers and one pedometer, except for the wrist-worn ActiGraph. showed a variation of approximately 1700 steps (range, 1265-2275 steps) steps for both groups, yet maintained a high correlation with each other. These findings will be valuable for researchers and clinicians as they compare step counts across different studies or representative surveys conducted globally.

Circulating microRNAs as potential biomarkers of physical activity in geriatric patients with HCV.

BACKGROUND: Circulating microRNAs have been implicated in a diverse array of biological and pathological phenomena. Their potential utility as noninvasive biomarkers for screening and diagnosing various diseases has been proposed. OBJECTIVE: This study aimed to explore the potential role of the miRNAs miR-122 and miR-486 as molecular biomarkers in the pathogenesis of hepatitis C virus (HCV) infection. Thus, miR-122 and miR-486 were detected in the serum of HCV patients and healthy controls. Moreover, the potential correlations of miR-122 and miR-486 with viral complications, such as physical activity, pain, muscle fatigue, and HCV infection, were identified. METHODS: A total of 150 subjects aged 30 to 66 years were included in this study. The patients were classified as patients with chronic hepatitis C virus (CHC) (n = 110) or healthy controls (n = 40). Real-time polymerase chain reaction (PCR) analyses were performed to determine miR-122 and miR-486 expression. Physical activity (PA), pain score, HCV genotyping, viral overload, aspartate transaminase (AST), alanine transaminase (ALT), lactic acid dehydrogenase (LDH), creatine kinase (CK), and antioxidant status were also estimated by using prevalidated questionnaires, PCR, and spectrophotometric analyses. RESULTS: Compared with those in normal controls, significant increases in the serum levels of miR-122 and miR-486 were reported in patients with CHC. In physically active CHC patients, there was a significant correlation between the expression of miRNAs and increased alanine transaminase (ALT), aspartate transaminase (AST), fibrosis scores, and inflammation activity, but no association was reported for hepatitis C virus (HCV) RNA or viral load. Additionally, significant decreases in LDH, CK, GSSG, and pain scores and increases in TAC, GSH, and the GSH/GSSG ratio were reported. Moreover, the expression of miR-122 and miR-486 was positively correlated with changes in body mass index (BMI) and liver fibrosis stage, as well as negatively correlated with sex, PA, TAC, GSH, GSSG, and the GSH/GSSG ratio. CONCLUSION: MiR-122 and miR-486 expression levels were strongly correlated with physical activity, pain perception, and muscle fatigue biomarkers in HCV-infected patients. These miRNA levels were associated with elevated AST, ALT, fibrosis scores, LDH, CK, and antioxidant status, thus suggesting their potential as biomarkers for disease severity and oxidative stress. However, no correlation was observed with viral load or HCV-RNA expression, thus implying that these miRNAs may impact disease progression and symptoms through host factors, rather than directly affecting viral replication. In summary, the results demonstrated that molecular studies of miR-22 and miR-468 and their associations with PA, pain, adiposity, sex differences, and muscle fatigue, as well as routine biomarkers, could be useful as prognostic nanoninvasive biomarkers, thus providing novel therapeutic targets for CHC infection.

Effect of Elastic Resistance on Exercise Intensity and User Satisfaction While Playing the Active Video Game BoxVR in Immersive Virtual Reality: Empirical Study.

Background: One of the main contemporary forms of physical activity (PA) involves exercises and games in an immersive virtual reality (VR) environment, which allows the user to practice various forms of PA in a small space. Unfortunately, most of the currently available VR games and workout applications are mostly based on upper body movements, especially the arms, which do not guarantee sufficiently high exercise intensity and health benefits. Therefore, it is worth seeking solutions to help increase the exercise load during PA in VR. Objective: The main aim of this study was to evaluate the effect of elastic arm resistance in the form of latex resistance bands of different elasticity levels on the intensity of students' PA while playing the BoxVR game. We further assessed the satisfaction of this form of exercise and its associations with PA intensity. Methods: A total of 21 healthy and physically fit men (mean age 22.5, SD 2.0 years) were included in the study. The tests consisted of 3 10-minute games. One game was run with no load and the other two were run with 1.5-meter latex resistance bands (low and high resistance). The order of the tests was randomized and the participants rested for 20 minutes after each exercise. Exercise intensity was estimated using objective (heart rate monitoring) and subjective (Borg scale) methods. The Physical Activity Enjoyment Scale was used to assess satisfaction with the PA. The effect of elastic resistance on exercise intensity and user enjoyment was estimated using ANOVA for repeated measures. Results: The ANOVA results indicated that incorporation of elastic resistance caused a significant change (F2,40=20.235, P<.001; η²p=0.503) in the intensity of PA in VR, which was low while playing without resistance and then increased to a moderate level with additional resistance. The use of elastic bands also changed participants' perceptions of the enjoyment of exercise in VR (F2,40=9.259, P<.001; η²p=0.316). The students rated their satisfaction with PA in VR on a 7-point scale highly and similarly when exercising without an upper limb load (mean 6.19, SD 0.61) and with slight elastic resistance (mean 6.17, SD 0.66), whereas their satisfaction declined significantly (mean 5.66, SD 0.94) when incorporating a higher load. Conclusions: The intensity of PA among students playing the BoxVR game is at a relatively low level. With the added resistance of elastic bands attached to the upper limbs, the intensity of the exercise increased to a moderate level, as recommended for obtaining health benefits. Participants rated the enjoyment of PA in VR highly. The use of slight elastic resistance did not negatively affect satisfaction with the BoxVR game, although user satisfaction declined with a higher load. Further research should be undertaken to increase the effectiveness of exercise in VR so that regular users can enjoy the health benefits.

Improving the identification of bone-specific physical activity using wrist-worn accelerometry: A cross-sectional study in 11-12-year-old Australian children.

Physical activity (PA) during childhood and adolescence is important for the accrual of maximal peak bone mass. The precise dose that benefits bone remains unclear as methods commonly used to analyze PA data are unsuitable for measuring bone-relevant PA. Using improved accelerometry methods, this study identified the amount and intensity of PA most strongly associated with bone outcomes in 11-12-year-olds. Participants (n = 770; 382 boys) underwent tibial peripheral quantitative computed tomography to assess trabecular and cortical density, endosteal and periosteal circumference and polar stress-strain index. Seven-day wrist-worn raw acceleration data averaged over 1-s epochs was used to estimate time accumulated above incremental PA intensities (50 milli-gravitational unit (mg) increments from 200 to 3000 mg). Associations between time spent above each 50 mg increment and bone outcomes were assessed using multiple linear regression, adjusted for age, sex, height, weight, maturity, socioeconomic position, muscle cross-sectional area and PA below the intensity of interest. There was a gradual increase in mean R2 change across all bone-related outcomes as the intensity increased in 50 mg increments from >200 to >700 mg. All outcomes became significant at >700 mg (R2 change = 0.6%-1.3% and p = 0.001-0.02). Any further increases in intensity led to a reduction in mean R2 change and associations became non-significant for all outcomes >1500 mg. Using more appropriate accelerometry methods (1-s epochs; no a priori application of traditional cut-points) enabled us to identify that ∼10 min/day of PA >700 mg (equivalent to running ∼10 km/h) was positively associated with pQCT-derived measures of bone density, geometry and strength in 11-12-year-olds.

Reliability and Validity of the Global Physical Activity Questionnaire for Portuguese Adults.

The Global Physical Activity Questionnaire (GPAQ) has been used often to assess physical activity (PA) patterns. However, the European Portuguese version of this instrument has not been validated. We aimed to validate the self-administered GPAQ, version 2, (GPAQv2) for Portuguese adults. We included 32 participants in a pilot study of a Portuguese adaptation of the test and 108 participants in an assessment of their PA patterns and sedentary behavior (SB) through the GPAQv2. For its validation, we compared the GPAQv2 to the International PA Questionnaire-Long Form (IPAQ-LF) (concurrent validity) and the ActiGraph wGT3X-BT accelerometer (criterion validity). We evaluated PA and SB at baseline and after seven consecutive days. Test-retest reliability with the Kappa test (k) and the Intraclass Correlation Coefficient (ICC) ranged from strong to almost perfect (k: 0.864-0.976) and from moderate to excellent (ICC: 0.56-0.994), respectively. Concurrent validity, assessed by Spearman's Correlation Coefficient, was moderate to substantial (rho: 0.471-0.680), and there was fair to substantial criterion validity (rho: 0.226-0.672). Bland-Altman plots showed that the GPAQv2 overestimated vigorous and moderate to vigorous PA and underestimated moderate PA. The largest difference values were related to SB, since the GPAQv2 underestimated sitting time. In sum, we found the GPAQv2 to have acceptable validity and reliability for assessing PA and SB patterns, and we recommend its use for Portuguese adults.