Examining accelerometer validity for estimating physical activity in pre-schoolers during free-living activity.

The present study examined the efficacy of accelerometers for the assessment of free play physical activity (PA) in pre-school-aged children with consideration of epoch length and wear location. Following ethics approval, parental informed consent, and child assent, 66 pre-schoolers aged 3-4 years (30 females and 36 males) wore an accelerometer (ActiGraph GT3X; sampling at 100 Hz) on their non-dominant wrist and their right hip during 1 hour of free play. Concurrently, direct observation, using the OSRAC-P, was used to determine sedentary behavior (SB), light (LPA), or moderate-to-vigorous (MVPA) intensity PA. For the ActiGraph, vertical axis counts and summed vector magnitude (VM) for hip, and VM for wrist, were downloaded using 5-, 10-, 15-, and 30-second epoch lengths. Accelerometer counts were averaged over each 30 seconds to match the observation periods. Receiver operating curve analysis was used to evaluate the ability of the ActiGraph to predict SB, LPA, and MVPA. SB and MVPA obtained from wrist- and hip-worn accelerometers demonstrated fair agreement with direct observation (AUC => 0.7). LPA determined by accelerometer had poor agreement with observed LPA, for both the hip and wrist placement (AUC = 0.53-0.56), with weak levels of specificity (0.34-0.43), although sensitivity was fair (0.74-0.84). This study is the first to examine accelerometer validity, considering wear location and epoch in pre-schoolers during free play, and suggests that the ActiGraph is a fair measure for SB and MVPA in pre-school children. Neither placement performed predominantly better irrespective of epochs or used count data (vertical axis, VM).

Feasibility and effectiveness of a walking program for community-dwelling older adults with mild cognitive impairment.

This study examined the feasibility and effect on aerobic fitness of a 1-yr, twice-weekly, group-based moderate-intensity walking program (MI-WP, n = 77) compared with a low-intensity activity program (LI-AP, n = 75) for community-dwelling older adults with mild cognitive impairment (MCI). Thirty participants did not start a program; median attendance in the other 122 participants was 71%. Small but significant associations were observed between attendance and memory in the MI-WP and general cognition in the LI-AP. Associations were no longer significant when both groups were analyzed together. Intensity, assessed using percentage of heart-rate reserve and the Borg scale, equaled intended intensity for both programs. Aerobic fitness improved significantly in participants in the MI-WP. In conclusion, cognition was not clearly associated with attendance in the 62 participants starting the MI-WP, and average attendance was good. The intensity was feasible for participants who continued the MI-WP. The findings support the proposal that regular moderate-intensity walking improves aerobic fitness in adults with MCI.

Physical exercise interventions in haematological cancer patients, feasible to conduct but effectiveness to be established: a systematic literature review.

PURPOSE: To summarize and define the methodological quality of primary research findings obtained in exercise interventions, aimed at improving physical function or psychological well-being in patients treated for haematological malignancies. METHODS: Relevant trials were identified through a computerized Mesh-search in MEDLINE and PubMed up to September 2007. Two reviewers independently screened the trials for eligibility, rated their quality, and extracted data. RESULTS: Ten studies published between 1996 and 2007 were included in this review. Two were performed in children and eight in adults. Only three studies were randomised controlled trials, one a controlled trial and the remaining six were single-group studies. Four trials were performed during treatment for cancer. The remainder was performed post-treatment. A wide variety of exercise protocols were applied, differing in exercise type, frequency, duration and intensity. Even though the trials were of poor methodological quality, encouraging results were obtained for a diverse set of outcomes, such as physical fitness, health-related quality of life and psychological well-being. CONCLUSION: Although none of the trials presented in this review are of high methodological quality, the findings suggest that it is feasible to conduct exercise interventions in this particular population of cancer patients. Future interventions should include larger study populations, use appropriate control groups, and a standard collection of valid outcome measures to improve comparability between studies.

Go4it; study design of a randomised controlled trial and economic evaluation of a multidisciplinary group intervention for obese adolescents for prevention of diabetes mellitus type 2.

BACKGROUND: In the Netherlands, the first adolescents with diabetes mellitus type 2 as a result of obesity have recently been diagnosed. Therefore, it is very important that programs aiming at the prevention of type 2 diabetes of obese adolescents are developed and evaluated. METHODS: Go4it is a multidisciplinary group treatment that focuses on: 1) increasing awareness of the current dietary and physical activity behaviour (i.e. energy balance behaviour), 2) improving diet, 3) decreasing sedentary behaviour, 4) increasing levels of physical activity, and 5) coping with difficult situations. Go4it consists of 7 sessions with an interval of 2-3 weeks.The effectiveness of the multidisciplinary group treatment compared with usual care (i.e. referral to a dietician) was evaluated in a randomised controlled trial. We examined effects on BMI(sds), body composition, energy expenditure, glucose tolerance and insulin resistance (primary outcome measure), as well as dietary and physical activity behaviour and quality of life. An economic evaluation from a societal perspective was conducted alongside the randomised trial to evaluate the cost-effectiveness of the multidisciplinary treatment program vs. usual care. DISCUSSION: In this paper we described a multidisciplinary treatment program (Go4it) for obese adolescents and the design of a randomised controlled trial and economic evaluation to evaluate its effectiveness and cost-effectiveness. TRIAL REGISTRATION: Netherlands Trial Register (ISRCTN27626398).