Validity of physical activity monitors during daily life in patients with COPD A monitoring and feedback tool embedded in a counselling protocol to increase physical activity of patients with COPD or type 2 diabetes in primary care: study protocol of a three-arm cluster randomised controlled trial Promoting physical activity through hand-held computer technology. Physical activity for the prevention and treatment of major chronic disease: an overview of systematic reviews Promoting physical activity using an activity monitor and a tailored web-based advice: design of a randomized controlled trial [ISRCTN93896459] Health Promotion Through Primary Care: Enhancing Self-Management With Activity Prescription and mHealth The 'Women's Lifestyle Study', 2-year randomized controlled trial of physical activity counselling in primary health care: rationale and study design The value of a continuous ambulatory activity monitor to quantify the amount and intensity of daily activity in patients with rheumatoid arthritis. Objectively assessed physical activity and lower limb function and prospective associations with mortality and newly diagnosed disease in UK older adults: an OPAL four-year follow-up study Multidimensional individualised Physical ACTivity (Mi-PACT) – a technology-enabled intervention to promote physical activity in primary care: study protocol for a randomised controlled trial Self-monitoring of Physical Activity A Web-Based, Social Networking Physical Activity Intervention for Insufficiently Active Adults Delivered via Facebook App: Randomized Controlled Trial Ongoing physical activity advice by humans versus computers: the Community Health Advice by Telephone (CHAT) trial. Evaluation of a website-delivered computer-tailored intervention for increasing physical activity in the general population. Feasibility and Acceptability of a Wearable Technology Physical Activity Intervention With Telephone Counseling for Mid-Aged and Older Adults: A Randomized Controlled Pilot Trial Measurement of physical activity to assess health effects in free-living populations. It's LiFe! Mobile and Web-Based Monitoring and Feedback Tool Embedded in Primary Care Increases Physical Activity: A Cluster Randomized Controlled Trial
Symptoms during physical activity and physical inactivity are hallmarks of chronic obstructive pulmonary disease ( COPD ) . Our aim was to evaluate the validity and usability of six activity monitors in patients with COPD against the doubly labelled water ( DLW ) indirect calorimetry method . 80 COPD patients ( mean±sd age 68±6 years and forced expiratory volume in 1 s 57±19 % predicted ) recruited in four centres each wore simultaneously three or four out of six commercially available monitors vali date d in chronic conditions for 14 consecutive days . A priori validity criteria were defined . These included the ability to explain total energy expenditure ( TEE ) variance through multiple regression analysis , using TEE as the dependent variable with total body water ( TBW ) plus several physical activity monitor outputs as independent variables ; and correlation with activity energy expenditure ( AEE ) measured by DLW . The Actigraph GT3X ( Actigraph LLC , Pensacola , FL , USA ) , and DynaPort MoveMonitor ( McRoberts BV , The Hague , the Netherl and s ) best explained the majority of the TEE variance not explained by TBW ( 53 % and 70 % , respectively ) and showed the most significant correlations with AEE ( r=0.71 , p<0.001 and r=0.70 , p<0.0001 , respectively ) . The results of this study should guide users in choosing valid activity monitors for research or for clinical use in patients with chronic diseases such as COPD . This study vali date s six activity monitors in the field against indirect calorimetry ( DLW ) in patients with COPD Background Physical activity is important for a healthy lifestyle . Although physical activity can delay complications and decrease the burden of the disease , the level of activity of patients with chronic obstructive pulmonary disease ( COPD ) or type 2 Diabetes Mellitus ( DM2 ) is often far from optimal . To stimulate physical activity , a monitoring and feedback tool , consisting of an accelerometer linked to a smart phone and webserver ( It ’s LiFe ! tool ) , and a counselling protocol for practice nurses in primary care was developed ( the Self-management Support Program ) . The main objective of this study is to measure the longitudinal effects of this counselling protocol and the added value of using the tool . Methods / Design This three-armed cluster r and omised controlled trial with 120 participants with COPD and 120 participants with DM2 ( aged 40–70 ) , compares the counselling protocol with and without the use of the tool ( group 1 and 2 ) with usual care ( group 3 ) . Recruitment takes place at GP practice s in the southern regions of the Netherl and s. R and omisation takes place at the practice level . The intended sample ( three arms of 8 practice s ) powers the study to detect a 10-minute difference of moderate and intense physical activity per day between groups 1 and 3 . Participants in the intervention groups have to visit the practice nurse 3–4 times for physical activity counselling , in a 4 - 6-month period . Specific activity goals tailored to the individual patient 's preferences and needs will be set . In addition , participants in group 1 will be instructed to use the tool in daily life . The primary outcome , physical activity , will be measured in all groups with a physical activity monitor ( PAM ) . Secondary outcomes are quality of life , general - and exercise - self-efficacy , and health status . Follow-up will take place after 6 and 9 months . Separately , a process evaluation will be conducted to explore reasons for trial non-participation , and the intervention ’s acceptability for participating patients and nurses . Discussion Results of this study will give insight into the effects of the It ’s LiFe ! monitoring and feedback tool combined with care from a practice nurse for people with COPD or DM2 on physical activity . Trial registration Clinical Trials.gov : BACKGROUND Efforts to achieve population -wide increases in walking and similar moderate-intensity physical activities potentially can be enhanced through relevant applications of state-of-the-art interactive communication technologies . Yet few systematic efforts to evaluate the efficacy of h and -held computers and similar devices for enhancing physical activity levels have occurred . The purpose of this first-generation study was to evaluate the efficacy of a h and -held computer ( i.e. , personal digital assistant [ PDA ] ) for increasing moderate intensity or more vigorous ( MOD+ ) physical activity levels over 8 weeks in mid-life and older adults relative to a st and ard information control arm . DESIGN R and omized , controlled 8-week experiment . Data were collected in 2005 and analyzed in 2006 - 2007 . SETTING / PARTICIPANTS Community-based study of 37 healthy , initially underactive adults aged 50 years and older who were r and omized and completed the 8-week study ( intervention=19 , control=18 ) . INTERVENTION Participants received an instructional session and a PDA programmed to monitor their physical activity levels twice per day and provide daily and weekly individualized feedback , goal setting , and support . Controls received st and ard , age-appropriate written physical activity educational material s. MAIN OUTCOME MEASURE Physical activity was assessed via the Community Healthy Activities Model Program for Seniors ( CHAMPS ) question naire at baseline and 8 weeks . RESULTS Relative to controls , intervention participants reported significantly greater 8-week mean estimated caloric expenditure levels and minutes per week in MOD+ activity ( p<0.04 ) . Satisfaction with the PDA was reasonably high in this largely PDA-naive sample . CONCLUSIONS Results from this first-generation study indicate that h and -held computers may be effective tools for increasing initial physical activity levels among underactive adults Background The evidence that higher levels of physical activity and /or lower levels of physical inactivity are associated with beneficial health-related outcomes stems mainly from observational studies . Findings from these studies often differ from r and omised controlled trials and systematic review s currently demonstrate mixed results , due partly to heterogeneity in physical activity interventions , method ologies used and population s studied . As a result , translation into clinical practice has been difficult . It is therefore essential that an overview is carried out to compare and contrast systematic review s , and to identify those physical activity interventions that are the most effective in preventing and /or treating major chronic disease . This protocol has been registered on PROSPERO 2013 : CRD42013003523 . Methods We will carry out an overview of Cochrane systematic review s. We will search the Cochrane Data base of Systematic Review s for systematic review s of r and omised controlled trials that have a primary focus on disease-related outcomes . We will restrict review s to those in selected major chronic diseases . Two authors will independently screen search outputs , select studies , extract data and assess the quality of included review s using the assessment of multiple systematic review s tool ; all discrepancies will be resolved by discussing and reaching a consensus , or by arbitration with a third author . The data extraction form will summarise key information from each review , including details of the population ( s ) ( for example , disease condition ) , the context ( for example , prevention , treatment or management ) , the participants , the intervention(s ) , the comparison(s ) and the outcomes . The primary outcomes of interest are the prevention of chronic disease and /or improved outcomes , in the treatment or management of chronic disease . These outcomes will be summarised and presented for individual chronic diseases ( for example , any change in blood pressure in hypertension or glucose control in diabetes ) . Secondary outcomes of interest are to describe the structure and delivery of physical activity interventions  across chronic disease conditions and adverse events associated with physical activity . Discussion We anticipate that our results could inform research ers , guideline groups and policymakers of the most efficacious physical activity interventions in preventing and /or managing major chronic disease Background Ageing is associated with a decrease in physical activity . This decrease particularly occurs during specific transitional life stages . Especially during adolescence and young adulthood a steep decrease in physical activity is observed . Inactive people are often not aware of their inactivity . Providing feedback on the actual physical activity level by an activity monitor can increase awareness and may in combination with an individually tailored physical activity advice stimulate a physically active lifestyle . Methods In a r and omized controlled trial the effectiveness of providing an activity monitor in combination with a personal physical activity advice through the Internet will be examined . Outcome measures are level of physical activity , determinants of physical activity , quality of life , empowerment , aerobic fitness and body composition .  Participants are relatively inactive adolescents and young adults who are measured at baseline , after 3 months intervention and 5 months after the end of the intervention . In addition , facilitating and hindering factors for implementation of the intervention will be investigated . Discussion The use of a personal activity monitor in combination with web-based assisted individually tailored health promotion offers a good opportunity to work interactively with large groups of adolescents and young adults and provide them with advice based on their actual activity level . It has great potential to motivate people to change their behaviour and to our knowledge has not been evaluated before Abstract Background : It is well established in the literature that regular participation in physical activity is effective for chronic disease management and prevention . Remote monitoring technologies ( ie , mHealth ) hold promise for engaging patients in self-management of many chronic diseases . The purpose of this study was to test the effectiveness of an mHealth study with tailored physical activity prescription targeting changes in various intensities of physical activity ( eg , exercise , sedentary behavior , or both ) for improving physiological and behavioral markers of lifestyle-related disease risk . Methods : Forty-five older adults ( aged 55–75 years ; mean age 63 ± 5 years ) were r and omly assigned to receive a personal activity program targeting changes to either daily exercise , sedentary behavior , or both . All participants received an mHealth technology kit including smartphone , blood pressure monitor , glucometer , and pedometer . Participants engaged in physical activity programming at home during the 12-week intervention period and su bmi tted physical activity ( steps/day ) , blood pressure ( mm Hg ) , body weight ( kg ) , and blood glucose ( mmol/L ) measures remotely using study -provided devices . Results : There were no differences between groups at baseline ( P > 0.05 ) . The intervention had a significant effect ( F(10 488 ) = 2.947 , P = 0.001 , ηP2 = 0.057 ) , with similar changes across all groups for physical activity , body weight , and blood pressure ( P > 0.05 ) . Changes in blood glucose were significantly different between groups , with groups prescribed high-intensity activity ( ie , exercise ) demonstrating greater reductions in blood glucose than the group prescribed changes to sedentary behavior alone ( P < 0.05 ) . Conclusions : Findings demonstrate the utility of pairing mHealth technologies with activity prescription for prevention of lifestyle-related chronic diseases among an at-risk group of older men and women . Results support the novel approach of prescribing changes to sedentary behaviors ( alone , and in conjunction with exercise ) to reduce risk of developing lifestyle-related chronic conditions Background Physical inactivity is an independent risk factor for diabetes and heart disease . There is evidence that increasing physical activity can reduce the risk of developing these chronic diseases , but less evidence about effective ways to increase adherence to physical activity . Interventions are therefore needed that produce sustained increases in adherence to physical activity , are cost-effective and improve clinical endpoints . Methods The Women 's Lifestyle Study is a two year r and omized controlled trial involving a nurse-led intervention to increase physical activity in 40–74 year old physically inactive women recruited from primary care . Baseline measures were assessed in a face-to-face interview with a primary care nurse . The intervention involved delivery of a ' Lifestyle script ' by a primary care nurse followed by telephone counselling for nine months and a face-to-face nurse visit at six months . Outcome measurements are assessed at 12 and 24 months . The primary outcome is physical activity measured using a vali date d physical activity question naire . Secondary outcomes include blood pressure , weight , waist circumference , physical fitness ( step test ) , serum HbA1c , fasting glucose , lipids , insulin , and quality of life ( SF36 ) . Costs were measured prospect ively to allow a subsequent cost-effectiveness evaluation if the trial is positive . Discussion Due to report in 2008 , the Women 's Lifestyle Study tests the effectiveness of an enhanced low-cost , evidence -based intervention in increasing physical activity , and improving cardiovascular and diabetes risk indicators over two years . If successful in demonstrating improvements in health outcomes , this r and omized controlled trial will be the first to demonstrate long-term cardiovascular and diabetes risk health benefit , in addition to improvements in physical activity , from a sustainable physical activity intervention based in primary care . Trial Registration Australian Clinical Trials Registry ( ACTR ) , ACTRN012605000490673 OBJECTIVE To examine the reliability , validity , and responsiveness of a continuous ambulatory activity monitor in patients with rheumatoid arthritis ( RA ) . METHODS Forty-one patients with RA , participating in a r and omized controlled trial examining the effect of an intensive exercise program  , were assessed by means of the  Dynaport ADL ( activities of daily living ) monitor ( AM ) .  The time spent on activities ( locomotion , st and ing , and active sitting ) during 24 hours and the intensity of trunk movement during these activities were recorded . To determine test-retest reliability 20 patients were reassessed with the AM one week after the first assessment . Construct validity of the AM was determined by comparing the AM results with physical fitness measures ( muscle strength , endurance , joint mobility ) , disease activity , and functional status . As well , 37 patients were assessed 18 months after the first assessment to determine responsiveness . RESULTS All AM measurements showed satisfactory test-retest reliability ( ICC 0.63 - 0.76 ) . AM measures were significantly associated with physical fitness , functional status , and disease activity , indicating construct validity of the AM . The AM could discriminate between patients with improvement and deterioration in physical fitness , indicating sufficient responsiveness of AM variables . CONCLUSION This study shows the value of an ambulatory activity monitor to quantify both the amount and intensity of physical activity of patients with RA during a day in their own environment . The ambulatory activity monitor seems to be a promising instrument for research into rehabilitation of patients with RA Background : objective measures of physical activity and function with a diverse cohort of UK adults in their 70s and 80s were used to investigate relative risk of all-cause mortality and diagnoses of new diseases over a 4-year period . Participants : two hundred and forty older adults were r and omly recruited from 12 general practice s in urban and suburban areas of a city in the United Kingdom . Follow-up included 213 of the baseline sample . Methods : socio-demographic variables , height and weight , and self-reported diagnosed diseases were recorded at baseline . Seven-day accelerometry was used to assess total physical activity , moderate-to-vigorous activity and sedentary time . A log recorded trips from home .  Lower limb function was assessed using the Short Physical Performance Battery . Medical records were accessed on average 50 months post baseline , when new diseases and deaths were recorded . Analyses : ANOVAs were used to assess socio-demographic , physical activity and lower limb function group differences in diseases at baseline and new diseases during follow-up . Regression models were constructed to assess the prospect i ve associations between physical activity and function with mortality and new disease . Results : for every 1,000 steps walked per day , the risk of mortality was 36 % lower ( hazard ratios 0.64 , 95 % confidence interval ( CI ) 0.44–0.91 , P = 0.013 ) . Low levels of moderate-to-vigorous physical activity ( incident rate ratio ( IRR ) 1.67 , 95 % CI 1.04–2.68 , P = 0.030 ) and low frequency of trips from home ( IRR 1.41 , 95 % CI 0.98–2.05 , P = 0.045 ) were associated with diagnoses of more new diseases . Conclusion : physical activity should be supported for adults in their 70s and 80s , as it is associated with reduced risk of mortality and new disease development Background Low physical activity is a major public health problem . New cost-effective approaches that stimulate meaningful long-term changes in physical activity are required , especially within primary care setting s. It is becoming clear that there are various dimensions to physical activity with independent health benefits . Advances in technology mean that it is now possible to generate multidimensional physical activity ‘ profiles ’ that provide a more complete representation of physical activity and offer a variety of options that can be tailored to the individual . Mi-PACT is a r and omised controlled trial design ed to examine whether personalised multidimensional physical activity feedback and self-monitoring alongside trainer-supportive sessions increases physical activity and improves health outcomes in at-risk men and women . Methods / Design We aim to recruit 216 patients from within primary care aged 40 to 70 years and at medium or high risk of cardiovascular disease and /or type II diabetes mellitus . Adopting an unequal allocation ratio ( intervention : control ) of 2:1 , participants will be r and omised to one of two groups , usual care or the intervention . The control group will receive usual care from their general practitioner ( GP ) and st and ardised messages about physical activity for health . The intervention group will receive physical activity monitors and access to a web-based platform for a 3-month period to enable self-monitoring and the provision of personalised feedback regarding the multidimensional nature of physical activity . In addition , this technology-enabled feedback will be discussed with participants on 5 occasions during supportive one-to-one coaching sessions across the 3-month intervention . The primary outcome measure is physical activity , which will be directly assessed using activity monitors for a 7-day period at baseline , post intervention and at 12 months . Secondary measures ( at these time-points ) include weight loss , fat mass , and markers of metabolic control , motivation and well-being . Discussion Results from this study will provide insight into the effects of integrated physical activity profiling and self-monitoring combined with in-person support on physical activity and health outcomes in patients at risk of future chronic disease . Trial registration IS RCT N18008011 Trial registration date : 31 July Purpose : The purpose of this study was to test the effect of keeping daily activity records on physical activity levels and self-efficacy for physical activity in adults with type 2 diabetes , and to examine the feasibility and acceptability of this intervention from the perspective of the participants . Methods : This intervention study included 58 individuals with type 2 diabetes aged 40 to 65 years . Participants were r and omly assigned : individuals in the intervention group kept daily activity records for 6 weeks , mailed to the research er every 2 weeks . Data collection was completed at the beginning of the study and 6 weeks later , using the habitual physical activity index and the self-efficacy for exercise scale . Participants in the intervention group also completed the perceived feasibility checklist . Results : The intervention result ed in enhanced self-efficacy . Physical activity improved in both the intervention and control groups . Activity recording was judged to be acceptable and feasible . Conclusions : Daily activity recording can be used as part of a program to increase physical activity self-efficacy levels . Focused interactions between health care providers and patients may be enough to motivate people to higher levels of physical activity . The relationship between self-efficacy and behavior is complex and should be the subject of further research Background Online social networks offer considerable potential for delivery of socially influential health behavior change interventions . Objective To determine the efficacy , engagement , and feasibility of an online social networking physical activity intervention with pedometers delivered via Facebook app . Methods A total of 110 adults with a mean age of 35.6 years ( SD 12.4 ) were recruited online in teams of 3 to 8 friends . Teams were r and omly allocated to receive access to a 50-day online social networking physical activity intervention which included self-monitoring , social elements , and pedometers ( “ Active Team ” Facebook app ; n=51 individuals , 12 teams ) or a wait-listed control condition ( n=59 individuals , 13 teams ) . Assessment s were undertaken online at baseline , 8 weeks , and 20 weeks . The primary outcome measure was self-reported weekly moderate-to-vigorous physical activity ( MVPA ) . Secondary outcomes were weekly walking , vigorous physical activity time , moderate physical activity time , overall quality of life , and mental health quality of life . Analyses were undertaken using r and om-effects mixed modeling , accounting for potential clustering at the team level . Usage statistics were reported descriptively to determine engagement and feasibility . Results At the 8-week follow-up , the intervention participants had significantly increased their total weekly MVPA by 135 minutes relative to the control group ( P=.03 ) , due primarily to increases in walking time ( 155 min/week increase relative to controls , P<.001 ) . However , statistical differences between groups for total weekly MVPA and walking time were lost at the 20-week follow-up . There were no significant changes in vigorous physical activity , nor overall quality of life or mental health quality of life at either time point . High levels of engagement with the intervention , and particularly the self-monitoring features , were observed . Conclusions An online , social networking physical activity intervention with pedometers can produce sizable short-term physical activity changes . Future work is needed to determine how to maintain behavior change in the longer term , how to reach at-need population s , and how to disseminate such interventions on a mass scale . Trial Registration Australian New Zeal and Clinical Trials Registry ( ANZCTR ) : ACTRN12614000488606 ; https://www.anzctr.org.au/Trial/ Registration /Trial Review .aspx?id=366239 ( Archived by WebCite at http://www.webcitation.org/6ZVtu6TMz ) PURPOSE Given the prevalence of physical inactivity among American adults , convenient , low-cost interventions are strongly indicated . This study determined the 6- and 12-month effectiveness of telephone interventions delivered by health educators or by an automated computer system in promoting physical activity . DESIGN Initially inactive men and women age 55 years and older ( N = 218 ) in stable health participated . Participants were r and omly assigned to human advice , automated advice , or health education control . MEASURES The vali date d 7-day physical activity recall interview was used to estimate minutes of moderate to vigorous physical activity . Physical activity differences by experimental arm were verified on a r and om sub sample via accelerometry . RESULTS Using intention-to-treat analysis , at 6 months , participants in both interventions , although not differing from one another , showed significant improvements in weekly physical activity compared with controls . These differences were generally maintained at 12 months , with both intervention arms remaining above the target of 150 min per week of moderate to vigorous physical activity on average . CONCLUSION Automated telephone-linked delivery systems represent an effective alternative for delivering physical activity advice to inactive older adults OBJECTIVE To examine if a website-delivered physical activity intervention , that provides participants with computer-tailored feedback , can improve physical activity in the general population . METHODS Healthy adults ( n=434 ) , recruited from parents and staff of 14 primary and secondary schools in Belgium in the spring of 2005 , were allocated into one of two intervention groups ( receiving intervention with or without repeated feedback ) or a no-intervention control group .  Physical activity-levels were self-reported at baseline and at 6 months ( n=285 ) , using a computerized long version of the International Physical Activity Question naire online . Repeated measures analysis of co-variances were used to examine differences between the three groups . RESULTS Intent-to-treat analysis showed significant time by group interaction effects in favor of both intervention groups compared with the control group . Significant increases were found for active transportation ( + 20 , + 24 , + 11 min/week respectively ) and leisure-time physical activity ( + 26 , + 19 , -4 min/week respectively ) ; a significant decrease for minutes sitting on weekdays ( -22 , -34 , + 4 min/day respectively ) . No significant differences were found between both intervention groups . CONCLUSION A website-delivered intervention , including computer-tailoring , was able to increase physical activity when compared to a no-intervention control group . High drop-out rate and the low number of participants who received repeated feedback indicated that engagement and retention are important challenges in e-health studies Background As adults age , their physical activity decreases and sedentary behavior increases , leading to increased risk of negative health outcomes .  Wearable electronic activity monitors have shown promise for delivering effective behavior change techniques . However , little is known about the feasibility and acceptability of non-Fitbit wearables ( Fitbit , Inc , San Francisco , California ) combined with telephone counseling among adults aged more than 55 years . Objective The purpose of our study was to determine the feasibility , acceptability , and effect on physical activity of an intervention combining a wearable physical activity monitor , tablet device , and telephone counseling  among adults aged 55 - 79 years . Methods Adults ( N=40 , aged 55 - 79 years , body mass index=25 - 35 , < 60 min of activity per week ) were r and omized to receive a 12-week intervention or to a wait list control . Intervention participants received a Jawbone Up24 monitor , a tablet with the Jawbone Up app installed , and brief weekly telephone counseling . Participants set daily and weekly step goals and used the monitor ’s idle alert to notify them when they were sedentary for more than 1 h. Interventionists provided brief counseling once per week by telephone .  Feasibility was measured using observation and study records , and acceptability was measured by self-report using vali date d items . Physical activity and sedentary time were measured using ActivPAL monitors following st and ard protocol s. Body composition was measured using dual-energy x-ray absorptiometry scans , and fitness was measured using a 6-min walk test . Results Participants were 61.48 years old ( SD 5.60 ) , 85 % ( 34/40 ) female , 65 % ( 26/40 ) white .  Average activity monitor wear time was 81.85 ( SD 3.73 ) of 90 days . Of the 20 Up24 monitors , 5 were reported broken and 1 lost . No related adverse events were reported . Acceptability items were rated at least 4 on a scale of 1 - 5 . Effect sizes for most outcomes were small , including stepping time per day ( d=0.35 ) , steps per day ( d=0.26 ) , sitting time per day ( d=0.21 ) , body fat ( d=0.17 ) , and weight ( d=0.33 ) . Conclusions The intervention was feasible and acceptable in this population . Effect sizes were similar to the sizes found using other wearable electronic activity monitors , indicating that when combined with telephone counseling , wearable activity monitors are a potentially effective tool for increasing physical activity and decreasing sedentary behavior . Trial registration Clinical trials.gov NCT01869348 ; https:// clinical trials.gov/ct2/show/NCT01869348 ( Archived by WebCite at http://www.webcitation.org/6odlIolqy For physical activity surveys that would identify relations to chronic diseases , quality of life , and longevity , the method of choice remains the question naire , especially if it can be st and ardized and administered in uniform fashion to large population s. A sample question naire derived largely from epidemiological experience with the Harvard Alumni Health Study is presented that requests anthropometric estimates ; physician-diagnosed diseases by year of onset ; contemporary physical activities including walking , stair-climbing , and recreational pursuits ; food-frequency data that estimate nutrient values and caloric intakes ; and social habits affecting health . The question naire presents opportunities for cross-sectional , retrospective , and prospect i ve studies . Personal characteristics , physical activities , and other elements of lifestyle may be used as predictor or outcome variables in testing specific hypotheses . Representative surveys are described that have vali date d and used question naires of various complexities , some complemented by measures of physiological fitness . The epidemiological survey question naire , when properly design ed and administered , can measure effectively energy intake , energy retention , energy expenditure , physiological fitness , quality of life , and health maintenance Background Physical inactivity is a major public health problem . The It ’s LiFe ! monitoring and feedback tool embedded in the Self-Management Support Program ( SSP ) is an attempt to stimulate physical activity in people with chronic obstructive pulmonary disease or type 2 diabetes treated in primary care . Objective Our aim was to evaluate whether the SSP combined with the use of the monitoring and feedback tool leads to more physical activity compared to usual care and to evaluate the additional effect of using this tool on top of the SSP . Methods This was a three-armed cluster r and omised controlled trial . Twenty four family practice s were r and omly assigned to one of three groups in which participants received the tool + SSP ( group 1 ) , the SSP ( group 2 ) , or care as usual ( group 3 ) . The primary outcome measure was minutes of physical activity per day . The secondary outcomes were general and exercise self-efficacy and quality of life . Outcomes were measured at baseline after the intervention ( 4 - 6 months ) , and 3 months thereafter . Results The group that received the entire intervention ( tool + SSP ) showed more physical activity directly after the intervention than Group 3 ( mean difference 11.73 , 95 % CI 6.21 - 17.25 ; P<.001 ) , and Group 2 ( mean difference 7.86 , 95 % CI 2.18 - 13.54 ; P=.003 ) . Three months after the intervention , this effect was still present and significant ( compared to Group 3 : mean difference 10.59 , 95 % CI 4.94 - 16.25 ; P<.001 ; compared to Group 2 : mean difference 9.41 , 95 % CI 3.70 - 15.11 ; P<.001 ) . There was no significant difference in effect between Groups 2 and 3 on both time points . There was no interaction effect for disease type . Conclusions The combination of counseling with the tool proved an effective way to stimulate physical activity . Counseling without the tool was not effective . Future research about the cost-effectiveness and application under more tailored conditions and in other target groups is recommended . Trial Registration Clinical Trials.gov : NCT01867970 , https:// clinical trials.gov/ct2/show/NCT01867970 ( archived by WebCite at http://www.webcitation.org/6a2qR5BSr )
For total EE , correlation coefficients were statistically significantly lower in uniaxial compared to multisensor devices .
For active EE , correlations were slightly but not significantly lower in uniaxial compared to triaxial and multisensor devices .
The high level of heterogeneity in the validation studies is only partly explained by the type of activity monitor and the activity monitor outcome .
Triaxial and multisensor devices tend to be more valid monitors .
The assessment of physical activity in healthy population s and in those with chronic diseases is challenging .
The aim of this systematic review was to identify whether available activity monitors ( AM ) have been appropriately vali date d for use in assessing physical activity in these groups .