Objective The purpose of this study was to investigate the relationship between body mass index (BMI) class and physical activity and sedentary behavior in patients with acute coronary syndrome (ACS) during cardiac rehabilitation (CR). Methods This study was a secondary analysis of the OPTICARE trial. Physical activity and sedentary behavior were measured in participants with ACS (n = 359) using actigraphy at baseline, directly after completion of a multidisciplinary 12-week exercise-based CR program and 9 months thereafter. Outcome measures were step count and duration of time (percentage of wear time) spent in light physical activity, moderate-to-vigorous physical activity, and sedentary behavior. Participants were classified as normal weight (BMI = 18.5–24.99 kg/m2; n = 82), overweight (BMI = 25.0–29.99 kg/m2; n = 182), or obese (BMI ≥ 30.0 kg/m2; n = 95). Linear mixed-effects models were applied to study the relationship between BMI class and physical activity and sedentary behavior. Results At the start of CR, compared with participants with normal weight, participants with obesity made on average 1.11 steps fewer per minute (952 steps/d), spent 2.9% (25 min/d) less time in light physical activity, and spent 3.31% (28 min/d) more time in sedentary behavior. Participants of all BMI classes improved their physical activity and sedentary behavior levels similarly during CR, and these improvements were maintained after completion of CR. Conclusion Participants with ACS who had obesity started CR with a less favorable physical activity and sedentary behavior profile than that of participants with normal weight. Because all BMI classes showed similar improvement during CR, this deficit was preserved. Impact This study indicates that reconsideration of the CR program in the Netherlands for patients with ACS and obesity is warranted, and development of more inclusive interventions for specific populations is needed. A new program for people with obesity should include added counseling on increasing physical activity and preventing sedentary behavior to facilitate weight loss and reduce mortality risk. Lay Summary People with ACS who have obesity are less active and sit more than individuals with normal weight, both during and after CR. This study suggests that CR needs to be changed to help individuals increase their physical activity to help them lose weight and reduce their risk of death.
Background: There is increasing interest in the role that technology can play in improving the vitality of knowledge workers. A promising and widely adopted strategy to attain this goal is to reduce sedentary behavior (SB) and increase physical activity (PA). In this paper, we review the state-of-the-art SB and PA interventions using technology in the office environment. By scoping the existing landscape, we identified current gaps and underexplored possibilities. We discuss opportunities for future development and research on SB and PA interventions using technology. Methods: A systematic search was conducted in the Association for Computing Machinery digital library, the interdisciplinary library Scopus, and the Institute of Electrical and Electronics Engineers Xplore Digital Library to locate peer-reviewed scientific articles detailing SB and PA technology interventions in office environments between 2009 and 2019. Results: The initial search identified 1130 articles, of which 45 studies were included in the analysis. Our scoping review focused on the technologies supporting the interventions, which were coded using a grounded approach. Conclusion: Our findings showed that current SB and PA interventions using technology provide limited possibilities for physically active ways of working as opposed to the common strategy of prompting breaks. Interventions are also often offered as additional systems or services, rather than integrated into existing office infrastructures. With this work, we have mapped different types of interventions and provide an increased understanding of the opportunities for future multidisciplinary development and research of technologies to address sedentary behavior and physical activity in the office context
Background: Multiple sclerosis often leads to fatigue and changes in physical behavior (PB). Changes in PB are often assumed as a consequence of fatigue, but effects of interventions that aim to reduce fatigue by improving PB are not sufficient. Since the heterogeneous nature of MS related symptoms, levels of PB of fatigued patients at the start of interventions might vary substantially. Better understanding of the variability by identification of PB subtypes in fatigued patients may help to develop more effective personalized rehabilitation programs in the future. This study aimed to identify PB subtypes in fatigued patients with multiple sclerosis based on multidimensional PB outcome measures. Methods: Baseline accelerometer (Actigraph) data, demographics and clinical characteristics of the TREFAMS-ACE participants (n = 212) were used for secondary analysis. All patients were ambulatory and diagnosed with severe fatigue based on a score of ≥35 on the fatigue subscale of the Checklist Individual Strength (CIS20r). Fifteen PB measures were used derived from 7 day measurements with an accelerometer. Principal component analysis was performed to define key outcome measures for PB and two-step cluster analysis was used to identify PB types. Results: Analysis revealed five key outcome measures: percentage sedentary behavior, total time in prolonged moderate-to-vigorous physical activity, number of sedentary bouts, and two types of change scores between day parts (morning, afternoon and evening). Based on these outcomes three valid PB clusters were derived. Conclusions: Patients with severe MS-related fatigue show three distinct and homogeneous PB subtypes. These PB subtypes, based on a unique set of PB outcome measures, may offer an opportunity to design more individually-tailored interventions in rehabilitation.
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The main objective is to write a scientific paper in a peer-reviewed Open Access journal on the results of our feasibility study on increasing physical activity in home dwelling adults with chronic stroke. We feel this is important as this article aims to close a gap in the existing literature on behavioral interventions in physical therapy practice. Though our main target audience are other researchers, we feel clinical practice and current education on patients with stroke will benefit as well.
In recent years, disasters are increasing in numbers, location, intensity and impact; they have become more unpredictable due to climate change, raising questions about disaster preparedness and management. Attempts by government entities at limiting the impact of disasters are insufficient, awareness and action are urgently needed at the citizen level to create awareness, develop capacity, facilitate implementation of management plans and to coordinate local action at times of uncertainty. We need a cultural and behavioral change to create resilient citizens, communities, and environments. To develop and maintain new ways of thinking has to start by anticipating long-term bottom-up resilience and collaborations. We propose to develop a serious game on a physical tabletop that allows individuals and communities to work with a moderator and to simulate disasters and individual and collective action in their locality, to mimic real-world scenarios using game mechanics and to train trainers. Two companies–Stratsims, a company specialized in game development, and Society College, an organization that aims to strengthen society, combine their expertise as changemakers. They work with Professor Carola Hein (TU Delft), who has developed knowledge about questions of disaster and rebuilding worldwide and the conditions for meaningful and long-term disaster preparedness. The partners have already reached out to relevant communities in Amsterdam and the Netherlands, including UNUN, a network of Ukrainians in the Netherlands. Jaap de Goede, an experienced strategy simulation expert, will lead outreach activities in diverse communities to train trainers and moderate workshops. This game will be highly relevant for citizens to help grow awareness and capacity for preparing for and coping with disasters in a bottom-up fashion. The toolkit will be available for download and printing open access, and for purchase. The team will offer training and facilitate workshops working with local communities to initiate bottom-up change in policy making and planning.
Dutch Cycling Intelligence (DCI) embodies all Dutch cycling knowledge to enhances customer-oriented cycling policy. Based on the data-driven cycle policy enhancement tools and knowledge of the Breda University of Applied Sciences, DCI is the next step in creating a learning community between road authorities, consultants, cycling industry, and knowledge institutes with their students. The DCI consists of three pilars:- Connecting- Accelerating knowledge- Developing knowledgeConnecting There are many stakeholders and specialists in the cycling domain. Specialists with additional knowledge about socio-cultural impacts, geo-special knowledge, and technical traffic solutions. All of these specialists need each other to ensure a perfect balance between the (electric) bicycle, the cyclist and the cycle path in its environment. DCI connects and brings together all kind of different specialists.Accelerating knowledge Many bicycle innovations take place in so-called living labs. Within the living lab, the triple helix collaboration between road authorities the industry and knowledge institutes is key. Being actively involved in state-of-the-art innovations creates an inspiring work and learning environment for students and staff. A practical example of a successful living lab is the cycle superhighway F261 between Tilburg and Waalwijk, where BUAS tested new cycle route signage. Next, the Cycling Lab F58 is created, where the road authorities Breda and Tilburg opened up physical cycling infrastructure for entrepreneurs in the bicycle domain and knowledge institutes to develop e-cycling innovation. The living labs are test environments where pilots can be carried out in practice and an excellent environment for students to conduct scientifically applied research.Developing knowledge Ultimately, data and information must be translated into knowledge. With a team of specialists and partners Breda University of applied sciences developed knowledge and tools to monitor and evaluate cycling behavior. By participating in (inter)national research programs BUAS has become one of the frontrunners in data-driven cycle policy enhancement. In close collaboration with road authorities, knowledge institutes as well as consultants, new insights and answers are developed in an international context. By an active knowledge contribution to the network of the Dutch Cycling Embassy, BUAS aims to strengthen its position and add to the global sustainability challenges. Partners: Province Noord-Brabant, Province Utrecht, Vervoerregio Amsterdam, Dutch Cycling Embassy, Tour de Force, University of Amsterdam, Technical University Eindhoven, Technical University Delft, Utrecht University, DTV Capacity building, Dat.mobility, Goudappel Coffeng, Argaleo, Stratopo, Move.Mobility Clients:Province Noord-Brabant, Province Utrecht, Province Zuid-Holland, Tilburg, Breda, Tour de Force
