Assessment of objectively measured physical activity levels in individuals with intellectual disabilities with and without Down's syndrome

Objective

To investigate, using accelerometers, the levels of physical activity being undertaken by individuals with intellectual disabilities with and without Down''s syndrome.

Methods

One hundred and fifty two individuals with intellectual disabilities aged 12–70 years from East and South-East England. Physical activity levels in counts per minute (counts/min), steps per day (steps/day), and minutes of sedentary, light, moderate, vigorous, and moderate to vigorous physical activity (MVPA) measured with a uni-axial accelerometer (Actigraph GT1M) for seven days.

Results

No individuals with intellectual disabilities met current physical activity recommendations. Males were more active than females. There was a trend for physical activity to decline and sedentary behaviour to increase with age, and for those with more severe levels of intellectual disability to be more sedentary and less physically active, however any relationship was not significant when adjusted for confounding variables. Participants with Down''s syndrome engaged in significantly less physical activity than those with intellectual disabilities without Down''s syndrome and levels of activity declined significantly with age.

Conclusions

Individuals with intellectual disabilities, especially those with Down''s syndrome may be at risk of developing diseases associated with physical inactivity. There is a need for well-designed, accessible, preventive health promotion strategies and interventions designed to raise the levels of physical activity for individuals with intellectual disabilities. We propose that there are physiological reasons why individuals with Down''s syndrome have particularly low levels of physical activity that also decline markedly with age.     

Habitual physical activity in mitochondrial disease

Purpose

Mitochondrial disease is the most common neuromuscular disease and has a profound impact upon daily life, disease and longevity. Exercise therapy has been shown to improve mitochondrial function in patients with mitochondrial disease. However, no information exists about the level of habitual physical activity of people with mitochondrial disease and its relationship with clinical phenotype.

Methods

Habitual physical activity, genotype and clinical presentations were assessed in 100 patients with mitochondrial disease. Comparisons were made with a control group individually matched by age, gender and BMI.

Results

Patients with mitochondrial disease had significantly lower levels of physical activity in comparison to matched people without mitochondrial disease (steps/day; 6883±3944 vs. 9924±4088, p = 0.001). 78% of the mitochondrial disease cohort did not achieve 10,000 steps per day and 48%were classified as overweight or obese. Mitochondrial disease was associated with less breaks in sedentary activity (Sedentary to Active Transitions, % per day; 13±0.03 vs. 14±0.03, p = 0.001) and an increase in sedentary bout duration (bout lengths / fraction of total sedentary time; 0.206±0.044 vs. 0.187±0.026, p = 0.001). After adjusting for covariates, higher physical activity was moderately associated with lower clinical disease burden (steps / day; r_s = −0.49; 95% CI −0.33, −0.63, P<0.01). There were no systematic differences in physical activity between different genotypes mitochondrial disease.

Conclusions

These results demonstrate for the first time that low levels of physical activity are prominent in mitochondrial disease. Combined with a high prevalence of obesity, physical activity may constitute a significant and potentially modifiable risk factor in mitochondrial disease.     

Parent-offspring correlations in pedometer-assessed physical activity

Background

Physical activity is a major component of a healthy lifestyle in youth and adults. To identify determinants of this complex behavior is an important research objective in the process of designing interventions to promote physical activity at population level. In addition to individual determinants, there is evidence documenting familial influences on physical activity. However, the few studies that have addressed this issue with objective measures did not provide data on parent-offspring physical activity relationships throughout childhood and adolescence. The purpose of this study was to assess familial correlations in pedometer-assessed physical activity.

Methods

We measured ambulatory activity in 286 French nuclear families (283 mothers, 237 fathers, and 631 children aged 8–18 years) by pedometer recordings (Yamax Digiwalker DW 450) over a week. Correlations were computed with their 95% confidence intervals (CI) for spouse pairs, siblings, mother-offspring, and father-offspring. Data were expressed as steps per day and computed both for the full recording period and separately for weekdays and weekends.

Results

The correlations were the highest between siblings (r = 0.28, 95%CI: 0.17–0.38). Parent–offspring correlations were significant in mothers (r = 0.21, 95%CI: 0.12–0.30), especially between mothers and daughters (r = 0.24, 95%CI: 0.12–0.36 vs. r = 0.18, 95%CI: 0.05–0.31 for sons), but were almost nonexistent in fathers. Correlations were generally higher on weekend days compared to weekdays. Mother-offspring correlations did not decrease with increasing age of children (r = 0.17, 95%CI: 0.00–0.34 in 8–11-year-olds, r = 0.20, 95%CI: 0.07–0.33 in 12–15-year-olds, and r = 0.25, 95%CI: 0.07–0.39 in ≥16-year-olds). Finally, between-spouse correlations were significant only during weekend days (r = 0.14, 95%CI: 0.01–0.27).

Conclusion

Ambulatory activity correlated within families, with a possible mother effect. Mother-offspring correlations remained significant through the transition from childhood to adolescence. Further studies are required to better understand the respective influences of shared activities, parental modeling and support as well as genetic factors on the familial aggregation of physical activity.     

Assessment of physical activity by questionnaire and personal interview with particular reference to fitness and coronary mortality

Physical work capacity was measured by means of a symptom limited, near maximal cycle ergometer exercise test in two populations: a random sample of 95 military officers, and 2014 apparently healthy working males, 40-59 years old. Physical activity during leisure hours was assessed by means of a standardized questionnaire and by a personal interview with the officers and with 1769 of the other men. A 3 year total incidence of coronary heart disease (CHD) was recorded in the case of the officers and a 7 year CHD incidence and of CHD deaths was obtained for the 2014 working men. The data show that: A marked underestimation of the habitual levels of physical activity of the officers was obtained from the standardized questionnaire, as compared with that shown by the interview data. A far better agreement between the questionnaire and interview data on leisure time activity was observed among the mainly sedentary men. Physical work capacity was fairly well predicted from the questionnaire data in the sedentary men, but poorly predicted in the officers. CHD mortality in the sedentary men was highly correlated with working capacity in all age groups. Of 58 who died from CHD, 28 belonged to the lowest physical fitness quartile. This study indicates that questionnaires should be used with caution when assessing levels of habitual physical activity. It also suggests that a low physical work capacity is an important risk factor in CHD mortality.     

Assessment of daily life physical activities in pulmonary arterial hypertension

Background

In pulmonary arterial hypertension (PAH), the six-minute walk test (6MWT) is believed to be representative of patient''s daily life physical activities (DL_PA). Whether DL_PA are decreased in PAH and whether the 6MWT is representative of patient''s DL_PA remain unknown.

Methods

15 patients with idiopathic PAH (IPAH) and 10 patients with PAH associated with limited systemic sclerosis (PAH-SSc) were matched with 15 healthy control subjects and 10 patients with limited systemic sclerosis without PAH. Each subject completed a 6MWT. The mean number of daily steps and the mean energy expenditure and duration of physical activities >3 METs were assessed with a physical activity monitor for seven consecutive days and used as markers of DL_PA.

Results

The mean number of daily steps and the mean daily energy expenditure and duration of physical activities >3 METs were all reduced in PAH patients compared to their controls (all p<0.05). The mean number of daily steps correlated with the 6MWT distance for both IPAH and PAH-SSc patients (r = 0.76, p<0.01 and r = 0.85, p<0.01), respectively.

Conclusion

DL_PA are decreased in PAH and correlate with the 6MWT distance. Functional exercise capacity may thus be a useful surrogate of DL_PA in PAH.     

Aspects of physical activity in high altitude natives

Altitude adaptation was measured at sea level and high altitudes in sea level adapted and high altitude adapted natives. Tests of work capacity as measured by O₂ consumption, pulse rate, and ventilation rate are reported. It is noted that comparing our results with those of other investigators is difficult due to variations in terminology and procedure. This suggests the necessity of more precise definitions in studies of the physical activity of high altitude natives.     

Assessment of sympathoneural activity in clinical research

The assessment of autonomic nervous activity is a frequent and challenging goal of clinical research. The diverse current approaches are reviewed. Direct recording from the sympathetic input to muscle has the advantage of excellent time resolution and directness, but gives no information on the sympathetic input to the internal organs. Plasma noradrenaline concentration has limitations of specificity, some of which are overcome by single isotope radiotracer kinetic techniques. Other chemical markers are less satisfactory. End organ responses are generally limited to cardiovascular and cutaneous autonomic assessment, but sophisticated information is obtainable using power spectral analysis of heart rate variability. Assessment of receptor systems, of first and second messengers and radionuclide imaging of adrenergic nerves all give complimentary information. It is likely that a combination of these diverse techniques will advance understanding of the role of the autonomic nervous system in many disease states.     

Assessment of inhomogeneities in an E. coli physical map.

A statistical method based on r-fragments, sums of distances between (r + 1) consecutive restriction enzyme sites, is introduced for detecting nonrandomness in the distribution or too markers in sequence data. The technique is applicable whenever large numbers of markers are available and will detect clumping, excessive dispersion or too much evenness of spacing of the markers. It is particularly adapted to varying the scale on which inhomogeneities can be detected, from nearest neighbor interactions to more distant interactions. The r-fragment procedure is applied primarily to the Kohara et al. (1) physical map of E. coli. Other applications to DAM methylation sites in E. coli and NotI sites in human chromosome 21 are presented. Restriction sites for the eight enzymes used in (1) appear to be randomly distributed, although at widely differing densities. These conclusions are substantially in agreement with the analysis of Churchill et al. (3). Extreme variability in the density of the eight restriction enzyme sites cannot be explained by variability in mono-, di- or trinucleotide frequencies.     

Anthropometric indices and physical fitness in university undergraduates with different physical activity.

Physical activity and fitness have important health promoting effects with respect to arterosclerosis and coronary heart disease in particular. An intervention study of physical status and physical activity in university undergraduates (University of Tartu) has been carried out. The physically inactive (Group I) consisted of 310 undergraduates (235 females and 75 males) of the Faculty of Medicine. The physically active (Group II) was recruited from among undergraduates (22 females and 23 males) of the Faculty of Exercise and Sport Sciences, who participated in training sessions regularly, 3 to 5 times per week. Anthropometric body measurements, arm force, vital capacity and exercise test on the bicycle ergometer (PWC170) were performed. There were no statistically significant differences between the mean values of anthropometric indices in case of physically inactive and physically active female subjects. In the group of physically active male undergraduates, weight and shoulder width were larger than in students with physically sedentary life style (p < 0.05). Most of the female and male students had normal BMI. There were statistically significant differences in the mean values of vital capacity, arm force and aerobic working capacity between the study groups, while physically active students had higher physical capacity (p < 0.001). Mean anthropometric indices demonstrated a statistically significant increase in both female and male university undergraduates after the interval of 30 years. Normal BMI and anthropometric indices do not serve a as guarantee of physical fitness for university undergraduates who are involved in sedentary life style. Regular physical activity has a strong positive impact on physical fitness, particularly on aerobic capacity which is the most important health promoting component of physical fitness with respect to coronary heart disease.     

Validation of a physical activity questionnaire in the elderly

The purpose of this study was to validate a physical activity (PA) questionnaire, Questionnaire d'Activité Physique Saint-Etienne (QAPSE), in an homogenous population of elderly subjects and to estimate its potential for application in routine PA assessments in that age group. A group of 65 (31 men and 34 women) community dwelling, healthy people aged 65–84 years volunteered to participate in a validation substudy comparing maximal oxygen uptake ( ) and anthropometric data. correlated positively with mean habitual daily energy expenditure (MHDEE) (r=0.56,P<0.0001), greater than 3MET (metabolic equivalent) daily energy expenditure (DEE) activity (r=0.371,P=0.002), leisure activity (r=0.368,P=0.003), sports activity (r=0.461,P<0.0001), basic daily activity (r=0.325,P=0.008) and moving DEE activity (r=0.273,P=0.028) in both sexes, with MHDEE (r=0.366,P=0.043) and moving DEE activity (r=0.388,P=0.031) in the men and with MHDEE (r=0.624;P<0.001), greater than 3MET DEE activity (r=0.513,P=0.002), leisure activity (r=0.388,P=0.024) and sports activity (r=0.683,P<0.001) in the women. The MHDEE was positively correlated with body mass (r=0.464) and with fat free mass (r=0.639) and negatively correlated with percentage body fat (r=−0.501). In a reproducibility substudy (n=44) a paired Student'st-test, based on mean differences between the two administrations of the questionnaire did not reach statistical significance for any of the QAPSE activity scores studied. Test-retest correlation coefficients ranged from 0.648 for moving score to 0.967 for MHDEE with correlation coefficientP values being less than 0.001 for all of the QAPSE activity scores. We concluded that QAPSE demonstrated excellent repeatability and good validity in relation to physical fitness and anthropometric data in the population of these healthy elderly volunteers.     

Determinants affecting physical activity levels in animal models

Weight control is dependent on energy balance. Reduced energy expenditure (EE) associated with decreased physical activity is suggested to be a major underlying cause in the increasing prevalence of weight gain and obesity. Therefore, a better understanding of the biological determinants involved in the regulation of physical activity is essential. To facilitate interpretation in humans, it is helpful to consider the evidence from animal studies. This review focuses on animal studies examining the biological determinants influencing activity and potential implications to human. It appears that physical activity is influenced by a number of parameters. However, regardless of the parameter involved, body weight appears to play an underlying role in the regulation of activity. Furthermore, the regulation of activity associated with body weight appears to occur only after the animal achieves a critical weight. This suggests that activity levels are a consequence rather than a contributor to weight control. However, the existence of an inverse weight-activity relationship remains inconclusive. Confounding the results are the multifactorial nature of physical activity and the lack of appropriate measuring devices. Furthermore, many determinants of body weight are closely interlocked, making it difficult to determine whether a single, combination, or interaction of factors is important for the regulation of activity. For example, diet-induced obesity, aging, lesions to the ventral medial hypothalamus, and genetics all produce hypoactivity. Providing a better understanding of the biological determinants involved in the regulation of activity has important implications for the development of strategies for the prevention of weight gain leading to obesity and subsequent morbidity and mortality in the human population.     

Traffic accidents and environmental physical activity

Environmental physical activity (EPA) is considered as one of main regulators of human homeostasis. Evidence is growing that components of this activity through the “human factor” (i.e., changing human physiological and psychological status) can affect the dynamics of traffic accidents (TA)—the modern life epidemic. This paper presents results of studies conducted in order to reveal the potential influence of EPA [solar (SA), geomagnetic (GMA) and cosmic ray (CRA) activities] on the number of TA and related casualties in the years of the maximum and declining phase of SA cycle 23 (2000–2005). We selected the 7,160 most severe TA and their related 7,558 deaths and 1,647 severe injuries, registered in the Grand Baku Area (Azerbaijan, middle latitudes), for analysis. A significant increase of TA and victims was observed during the whole year and also during the last months of the year. The monthly numbers of TA and victims were inversely related to SA (probability p = 0.0002), and non-significantly to background GMA, but were significantly affected by major geomagnetic disturbances and storms. A strong correlation between CRA variations (cosmic ray intensity measured by ground-based neutron monitors on the Earth’s surface) and the number of TA (p = 0.001) has been observed. It was found that the number of TA which occur within a month depends significantly on the particular month of the year, the CRA, and the SA levels (inverse correlation). The increase of the number of TA is also significantly linked to geomagnetic storms, but not to steady GMA. These effects can be related to changes in human functional and behavioral markers provoked by EPA influences.     

Adaptations of heart activity to physical exercise in female physical education teachers in the European North

Characteristics of heart activity were studied in female residents of the European North with ages between 25 and 59 years who were adapted to physical exercise. The results of studies of the biological age and the degree of training are presented. The mechanisms of adaptation and the specific features of the cardiovascular system (CVS) response to physical exercise depending on the duration of professional experience of subjects were determined. The greatest changes in the functional CVS characteristics were observed in the youngest (25–35 years) and oldest (46–59 years) subjects. This was shown to depend on the type of adaptation, age-specific characteristics, and moderately severe climatic conditions. Comparison of groups of subjects with different durations of professional experience showed that the speed of nervous processes decreased, the regulation of blood circulation became inert, and age-related shifts in some of the variables accelerated. These changes are considered to be the result of an increased expenditure of the physiological reserves of the body under different environmental conditions.