Background Physical activity is effective for the prevention and treatment of chronic disease, yet insufficient evidence is available to make comparisons regarding adherence to aerobic physical activity interventions among chronic disease populations, or across different settings. The purpose of this review is to investigate and provide a quantitative summary of adherence rates to the aerobic physical activity guidelines among people with chronic conditions, as physical activity is an effective form of treatment and prevention of chronic disease. Methods Randomized controlled (RCTs) trials where aerobic physical activity was the primary intervention were selected from PsychInfo, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Clinical Key, and SCOPUS from 2000 to 2018. Studies were included if the program prescription aligned with the 2008 aerobic physical activity guidelines, were at least 12 weeks in length, and included adult participants living with one of three chronic diseases. The data was extracted by hand and the PRISMA (preferred reporting items for systematic review and meta-analysis) guidelines were used to evaluate risk-of-bias and quality of evidence. Data were pooled using random-effect models. The primary outcome measure was program adherence and the secondary outcome measures were dropout and setting (e.g. home vs. clinic-based). Pooled effect sizes and 95% CiIs (confidence intervals) were calculated using random-effect models. Results The literature search identified 1616 potentially eligible studies, of which 30 studies (published between 2000 and 2018, including 3,721 participants) met the inclusion criteria. Three clinical populations were targeted: cancer ( n = 14), cardiovascular disease ( n = 7), and diabetes ( n = 9). Although not statistically significant, adherence rates varied across samples (65, 90, and 80%, respectively) whereas dropout rates were relatively low and consistent across samples (5, 4, and 3%). The average adherence rate, regardless of condition, is 77% (95% CI = 0.68, 0.84) of their prescribed physical activity treatment. The pooled adherence rates for clinic-based and home-based programs did not differ (74% [95% CI, 0.65, 0.82] and 80% [95% CI, 0.65, 0.91], respectively). Conclusions The current evidence suggests that people with chronic conditions are capable of sustaining aerobic physical activity for 3+ months, as a form of treatment. Moreover, home-based programs may be just as feasible as supervised, clinic-based physical activity programs.
of 16 studies were identified, in which six adopted a cross-sectional study design, nine adopted a longitudinal study design, and the remaining one adopted a casecontrol study design. Thirteen studies assessed the relationship between economic globalization and obesity at the country level, whereas the remaining three analyzed individual-level data. Fourteen studies found at least one aspect and/or measure of economic globalization to be positively associated with overweight/obesity, one found an inverse association, and the remaining one reported a null finding. Through market deregulation, tariff reduction, and investment liberalization, economic globalization tends to accelerate the market entry of modern food manufacturers, supermarket chains, and fast-food restaurants, resulting in substantially increased supply of high-sugar/fat energy-dense foods with enhanced variety and accessibility and reduced price. The potential impact of economic globalization on obesity through the adoption of modern workplace and domestic technologies and motorized transportation and through changes in social norms and culture were hypothesized in the literature but not empirically examined, which warrants future data-driven research.
With the onset of the coronavirus disease 2019 pandemic, several studies have shown changes in health-related behaviors, including dietary behaviors, quality and quantity of sleep, and time spent in physical activity and sedentary behaviors (1,2). Individuals with obesity have reported engaging in less exercise time and intensity and increased stress eating during 4), which could make weight management efforts more difficult. Recent studies have shown that following shelter-in-place orders, people are gaining weight at a rate of 1.5 kg per month (5).During a time when it is challenging to participate in face-to-face obesity treatment, evidence-based digital treatments have become more frequently used. It is unknown, however, the degree to which the efficacy of these programs is affected by COVID-19. Within the United States, the COVID-19 pandemic lockdown period has been considered to start around the week of March 23, with restrictions starting to lift around the end of April in some states. In order to address this question, we conducted a natural experiment among those who enrolled in a popular, evidence-based digital weight management program (WW). We examined the effects of the COVID-19 pandemic through the comparison of initial weight change (percentage) and in-app self-monitoring among participants who joined the digital WW program over a 30-week period in 2020 (during the COVID-19 pandemic) and those who joined during same time the prior year in 2019 (when COVID-19 was not present).
The purpose of this pilot study was to test the feasibility and efficacy of an iPad-enhanced aerobic exercise intervention designed to enhance wayfinding efficacy and performance and relevant cognitive functioning among middle-aged adults at risk for cognitive impairment. Twenty-seven low active adults (21 females) aged 45 to 62 years (51.22 ± 5.20) participated in a ten-week randomized controlled trial. Participants were randomized to an iPad-enhanced aerobic exercise group (experimental group) or an aerobic exercise-only group (control group) following baseline assessment. Both groups exercised at 50% to 75% of age-predicted heart rate maximum for 30 to 50 min/d, 2 d/wk for 10 weeks. During aerobic exercise, the experimental group engaged in virtual tours delivered via iPad. Baseline and post-intervention assessments of wayfinding self-efficacy, wayfinding task performance, cognitive functioning, electroencephalogram (EEG), and psychosocial questionnaires were administered. The results suggest that ten weeks of iPad-enhanced, moderately intense aerobic exercise had specific effects on wayfinding self-efficacy; however, no statistical differences were found between groups on the behavioral wayfinding task or spatial memory performance at follow-up. Performance scores on an inhibitory attentional-control cognitive assessment revealed significant differences between groups, favoring the experimental group (p < 0.05). Virtual reality-enhanced aerobic exercise may prove to be an effective method for improving cognitive function and increasing confidence to navigate real-world scenarios among individuals at risk of cognitive impairment.
The Activity Choice Index (ACI) has been designed to account for transient moments in one’s daily life and the extent to which effortful decisions to choose physically active tasks are made. It has only been validated in Portuguese samples and little is known about the extent to which choices are associated with executive functioning (EF) and explicit (physical activity self-beliefs) vs. implicit motives. The purpose of this study was to validate the ACI in a U.S. sample of middle-aged adults and to test theorized mechanisms underlying the activity choices targeted by the ACI. Data from this study were derived from 133 middle-aged adults (Mage = 53.82; 79% women; BMI = 32.06) who were randomized to 20 hours of supervised cognitive-motor training or attention control (video) interventions. Participants completed baseline (M0) and post-intervention testing at Month 1 (M1), including 7-day Fitbit monitoring and self-report measures of physical activity, self-regulation strategies, self-efficacy, explicit and implicit attitudes, and cognitive assessments (e.g., dual task). Pre-intervention ACI was not collected (true M0), and no group differences were found, so M1 associations were analyzed with the collapsed sample. Bivariate correlations were low but statistically significant (p < .05) between ACI and M0 and M1 Fitbit steps and self-reported physical activity. Self-regulation strategies (r’s = .46, .40), future self-identity (r’s = .39, .31), and exercise self-efficacy (r’s = .21, .27) were also positively associated with ACI. Interestingly, implicit attitudes were not associated with ACI and negative correlations were found with specific ACI items “park further away” and “standing over sitting” (r’s = -.21, -.30). Dual task correlated only with the “park further away” item at M1 (r = .22). Together, these findings offer support for the theorized role of EF and self-regulation in conscious activity choices and support the ACI’s construct validity and reliability.
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