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      Frequency of a very brief intervention by physiotherapists to increase physical activity levels in adults: a pilot randomised controlled trial

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          Abstract

          Background

          There is evidence that brief physical activity interventions by health professionals can increase physical activity levels. In addition, there is some evidence that simply measuring physical activity alone can increase physical activity behaviour. However, preliminary work is required to determine the effects of potential measurement frequency. The aim of this pilot study was to examine whether frequency of physical activity measurement, with very brief advice from a physiotherapist, influenced objectively measured physical activity in insufficiently active adults.

          Methods

          Using concealed allocation and blinded assessments, eligible participants ( n = 40) were randomised to a lower-measurement-frequency (baseline and 18-weeks) or higher-measurement-frequency group (baseline, 6, 12 and 18-weeks). The primary outcome was daily minutes of moderate-to-vigorous physical activity (accelerometry). Secondary outcomes included functional aerobic capacity (STEP tool), quality-of-life (AQoL-6D), body mass index, waist circumference, waist-to-hip ratio and blood pressure.

          Results

          Between-group comparisons were not significant in intention-to-treat analyses. However, there was a trend for the higher-measurement-frequency group to complete more daily minutes of moderate-to-vigorous physical activity at 18-weeks (mean difference 19.6 vs − 11.9 mins/week, p = 0.084), with a medium effect size (Cohen’s d = 0.58). This was significant in per-protocol analysis ( p = 0.049, Cohen’s d = 0.77). Within-group comparisons indicated both groups increased their aerobic fitness ( p ≤ 0.01), but only the higher-measurement-frequency group decreased their waist circumference (mean decrease 2.3 cm, 95%CI 0.3–4.3, p = 0.024), diastolic blood pressure (mean decrease 3.4 mmHg, 95%CI 0.03–6.8, p = 0.048) and improved their quality-of-life for independent living (mean increase 3.3, 95%CI 0.2–6.4, p = 0.031).

          Conclusion

          Very brief physical activity interventions by physiotherapists may be an efficient approach to increase physical activity in community-dwelling adults. A larger trial is warranted.

          Trial registration

          Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616000566437, http://www.ANZCTR.org.au/ACTRN12616000566437.aspx, registered 2 May 2016.

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          Most cited references21

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          Calibration of the Computer Science and Applications, Inc. accelerometer.

          We established accelerometer count ranges for the Computer Science and Applications, Inc. (CSA) activity monitor corresponding to commonly employed MET categories. Data were obtained from 50 adults (25 males, 25 females) during treadmill exercise at three different speeds (4.8, 6.4, and 9.7 km x h(-1)). Activity counts and steady-state oxygen consumption were highly correlated (r = 0.88), and count ranges corresponding to light, moderate, hard, and very hard intensity levels were or = 9499 cnts x min(-1), respectively. A model to predict energy expenditure from activity counts and body mass was developed using data from a random sample of 35 subjects (r2 = 0.82, SEE = 1.40 kcal x min(-1)). Cross validation with data from the remaining 15 subjects revealed no significant differences between actual and predicted energy expenditure at any treadmill speed (SEE = 0.50-1.40 kcal x min(-1)). These data provide a template on which patterns of activity can be classified into intensity levels using the CSA accelerometer.
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            Test-retest reliability of four physical activity measures used in population surveys.

            Accurate monitoring of prevalence and trends in population levels of physical activity (PA) is a fundamental public health need. Test-retest reliability (repeatability) was assessed in population samples for four self-report PA measures: the Active Australia survey (AA, N=356), the short International Physical Activity Questionnaire (IPAQ, N=104), the physical activity items in the Behavioral Risk Factor Surveillance System (BRFSS, N=127) and in the Australian National Health Survey (NHS, N=122). Percent agreement and Kappa statistics were used to assess reliability of classification of activity status as 'active', 'insufficiently active' or 'sedentary'. Intraclass correlations (ICCs) were used to assess agreement on minutes of activity reported for each item of each survey and for total minutes. Percent agreement scores for activity status were very good on all four instruments, ranging from 60% for the NHS to 79% for the IPAQ. Corresponding Kappa statistics ranged from 0.40 (NHS) to 0.52 (AA). For individual items, ICCs were highest for walking (0.45 to 0.78) and vigorous activity (0.22 to 0.64) and lowest for the moderate questions (0.16 to 0.44). All four measures provide acceptable levels of test-retest reliability for assessing both activity status and sedentariness, and moderate reliability for assessing total minutes of activity.
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              Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews

              Objectives While there is strong evidence that regular participation in physical activity (PA) brings numerous health benefits to older adults, and interventions to effectively promote PA are being developed and tested, the characteristics and components of the most effective interventions remain unclear. This systematically conducted review of systematic reviews evaluated the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old. Methods Major databases were searched for reviews from January 1990 to May 2015. TIDieR guidelines aided data extraction and the ROBIS tool was used to assess the risk of bias. Primary outcomes were objective and self-reported levels of PA. Indicators of psychological wellbeing and participation rates were secondary outcomes. Results Of 1284 records identified, 19 reviews met inclusion criteria and eight included meta-analyses. Interventions typically incorporated behaviour change techniques (BCTs) and were delivered as face-to-face, remote, group, individual or as combined interventions. Despite their heterogeneity, interventions often resulted in sustained improvements in PA over the study period, typically at 12 months, and led to improvements in general wellbeing. However, ways to ensure effective maintenance beyond one year are unclear. Certain intervention components were more clearly associated with positive effects (e.g. tailoring promotion strategy with combination of cognitive and behavioural elements, low to moderate intensity activity recommended). We found no evidence that certain other intervention characteristics were superior in achieving positive outcomes (e.g. mode of delivery, setting, professional background of the intervention provider, type of PA recommended). Conclusion The evidence suggests that interventions to promote PA among older adults are generally effective but there is uncertainty around the most beneficial intervention components. There are indications that purely cognitive strategies and BCTs might be less suitable for older adults than motivators more meaningful to them, including social and environmental support, and enjoyment coming from being physically active. A whole system-oriented approach is required that is tailored to meet the needs of older adults and aligned with social, individual and environmental factors.
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                Author and article information

                Contributors
                +61 2 6201 5550 , nicole.freene@canberra.edu.au
                rachel.davey@canberra.edu.au
                steven.mcphail@qut.edu.au
                Journal
                BMC Sports Sci Med Rehabil
                BMC Sports Sci Med Rehabil
                BMC Sports Science, Medicine and Rehabilitation
                BioMed Central (London )
                2052-1847
                22 May 2019
                22 May 2019
                2019
                : 11
                : 6
                Affiliations
                [1 ]ISNI 0000 0004 0385 7472, GRID grid.1039.b, Physiotherapy, Faculty of Health, , University of Canberra, ; Bruce, 2617 Australia
                [2 ]ISNI 0000 0004 0385 7472, GRID grid.1039.b, Centre for Research & Action in Public Health, , University of Canberra, ; Bruce, 2617 Australia
                [3 ]ISNI 0000000089150953, GRID grid.1024.7, School of Public Health & Social Work and Institute of Health and Biomedical Innovation, , Queensland University of Technology, ; Victoria Park Road, Kelvin Grove, 4059 Australia
                [4 ]GRID grid.474142.0, Centre for Functioning and Health Research, , Metro South Health, ; Corner of Ipswich Road and Cornwall Street, Buranda, 4103 Australia
                Author information
                http://orcid.org/0000-0002-2047-7012
                Article
                118
                10.1186/s13102-019-0118-8
                6530136
                31139419
                6471c2cd-6f1f-445a-bc98-6ad67f1d3298
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 June 2018
                : 1 May 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001802, University of Canberra;
                Award ID: n/a
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                behaviour change,fitness,health status,accelerometry,measurement

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