A randomized controlled trial of continuous activity, short bouts, and a 10,000 step guideline in inactive adults. A randomized trial of physical activity interventions: design and baseline data from project active. A randomised controlled trial of three pragmatic approaches to initiate increased physical activity in sedentary patients with risk factors for cardiovascular disease. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study Design of the Quality of Life in Motion (QLIM) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of a combined physical exercise and psychosocial training program to improve physical fitness in children with cancer Very short intermittent vs continuous bouts of activity in sedentary adults. Prevalence of Physical Activity in the United States: Behavioral Risk Factor Surveillance System, 2001 Older adults recently discharged from the hospital: effect of aerobic interval exercise on health-related quality of life, physical fitness, and physical activity. Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. Evaluation of a website-delivered computer-tailored intervention for increasing physical activity in the general population. A 2-year follow-up of a lifestyle physical activity versus a structured exercise intervention in older adults. Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews Effect of a Web-Based Intervention to Promote Physical Activity and Improve Health Among Physically Inactive Adults: A Population-Based Randomized Controlled Trial Spectral and bout detection analysis of physical activity patterns in healthy, prepubertal boys and girls A structured physical activity and fitness programme for older adults with intellectual disabilities: results of a cluster‐randomised clinical trial Participation by US adults in sports, exercise, and recreational physical activities. Randomized controlled trial of physical activity counseling for older primary care patients.
OBJECTIVE Although several studies have examined the effect of accumulated bouts on health outcomes , the impact of recommending short bouts on activity-related behavior in health promotion efforts has received minimal investigation . METHOD During this 5-week study in 2007 - 2008 , 43 university employees ( 8 male , 35 female ) in the Southeastern United States were r and omly assigned to a group recommended to achieve ( a ) 10,000 steps ( 10 K ) , ( b ) 30-minutes ( 30 min ) of continuous physical activity , or ( c ) 30-minutes of activity in bouts of at least 10 minutes ( bouts ) . RESULTS AND CONCLUSIONS Repeated measures ANOVA revealed that the 10 K group showed the largest increase in step counts whereas the bouts group showed the smallest change over the intervention period , p=0.01 . Condition differences were most pronounced on days in which participants met their activity recommendation . Accelerometer results revealed that the 10 K ( d=1.1 ) and 30 min groups ( d=0.89 ) showed large increases in minutes of moderate to vigorous activity ( MVPA ) , whereas the bouts group showed minimal change ( d=0.11 ) . Although activity recommendations did not differentially affect self-efficacy , participants from all conditions showed decreased self-efficacy across the intervention ( p=0.02 ) , highlighting the need to develop strategies to increase self-efficacy in activity promotion efforts We report here the design and baseline data from Project Active , a 2-yr r and omized trial design ed to compare the effectiveness of a Lifestyle physical activity intervention with the traditional Structured exercise prescription approach . Primary outcome measures are energy expenditure in physical activity ( estimated by kcal per kilogram of body weight of energy expenditure ) and cardiorespiratory fitness ( measured by maximal oxygen uptake ) . The participants , 235 initially sedentary and apparently healthy adults , were r and omized into either the Lifestyle or Structured intervention groups . The Lifestyle treatment consists of a personalized approach that accounts for an individual 's motivational readiness and preferences for integrating physical activity into daily routines . The Structured approach is the familiar exercise prescription that is based on a frequency , intensity , and duration formula . The primary hypothesis to be tested is that there will be a difference in physical activity and cardiorespiratory fitness measures between the two conditions at the end of 24 months . The secondary hypothesis is that both groups will make significant improvements from baseline in physical activity and cardiorespiratory fitness at the end of 6 months . Six months of active intervention are followed by 18 months of a tapered follow-up maintenance intervention in both groups . Primary outcome measures are measured after 6 and 24 months BACKGROUND Physical activity is a major modifiable risk factor for cardiovascular disease , but it is unclear what combination of feasible approaches , using existing re sources in primary care , work best to initiate increased physical activity . AIM To assess three approaches to initiate increased physical activity . DESIGN OF STUDY R and omised controlled ( 2 X 2 X 2 ) factorial trial . SETTING Four general practice s. METHOD One hundred and fifty-one sedentary patients with computer documented risk factors for cardiovascular disease were r and omised to eight groups defined by three factors :  prescription by general practitioners ( GPs ) for brisk exercise not requiring a leisure facility ( for example , walking ) 30 minutes per day , 5 days per week ; counselling by practice nurses , based on psychological theory to modify intentions and perceived control of behaviour , and using behavioural implementation techniques ( for example , contracting , ' rehearsal ' ) ; use of the Health Education Authority booklet ' Getting active , feeling fit ' . RESULTS Single interventions had modest effects . There was a trend from the least intensive interventions ( control + /- booklet ) to the more intensive interventions ( prescription and counselling combined + /- booklet ) for both increased physical activity and fitness ( test for trend , P = 0.02 and P = 0.05 , respectively ) . Only with the most intense intervention ( prescription and counselling combined ) were there significant increases in both physical activity and fitness from baseline ( Godin score = 14.4 , 95 % confidence interval [ CI ] = 7.8 to 21 , which was equivalent to three 15-minute sessions of brisk exercise and a 6-minute walking distance = 28.5 m , respectively , 95 % CI = 11.1 to 45.8 ) . Counselling only made a difference among those individuals with lower intention at baseline . CONCLUSION Feasible interventions using available staff , which combine exercise prescription and counselling explicitly based on psychological theory , can probably initiate important increases in physical activity BACKGROUND The health benefits of leisure-time physical activity are well known , but whether less exercise than the recommended 150 min a week can have life expectancy benefits is unclear . We assessed the health benefits of a range of volumes of physical activity in a Taiwanese population . METHODS In this prospect i ve cohort study , 416,175 individuals ( 199,265 men and 216,910 women ) participated in a st and ard medical screening programme in Taiwan between 1996 and 2008 , with an average follow-up of 8·05 years ( SD 4·21 ) . On the basis of the amount of weekly exercise indicated in a self-administered question naire , participants were placed into one of five categories of exercise volumes : inactive , or low , medium , high , or very high activity . We calculated hazard ratios ( HR ) for mortality risks for every group compared with the inactive group , and calculated life expectancy for every group . FINDINGS Compared with individuals in the inactive group , those in the low-volume activity group , who exercised for an average of 92 min per week ( 95 % CI 71 - 112 ) or 15 min a day ( SD 1·8 ) , had a 14 % reduced risk of all-cause mortality ( 0·86 , 0·81 - 0·91 ) , and had a 3 year longer life expectancy . Every additional 15 min of daily exercise beyond the minimum amount of 15 min a day further reduced all-cause mortality by 4 % ( 95 % CI 2·5 - 7·0 ) and all-cancer mortality by 1 % ( 0·3 - 4·5 ) . These benefits were applicable to all age groups and both sexes , and to those with cardiovascular disease risks . Individuals who were inactive had a 17 % ( HR 1·17 , 95 % CI 1·10 - 1·24 ) increased risk of mortality compared with individuals in the low-volume group . INTERPRETATION 15 min a day or 90 min a week of moderate-intensity exercise might be of benefit , even for individuals at risk of cardiovascular disease . FUNDING Taiwan Department of Health Clinical Trial and Research Center of Excellence and National Health Research Institutes Background Childhood cancer and its treatment have considerable impact on a child 's physical and mental wellbeing . Especially long-term administration of chemotherapy and /or radiotherapy impairs physical fitness both during and after therapy , when children often present with muscle weakness and /or low cardiorespiratory fitness . Physical exercise can improve these two elements of physical fitness , but the positive effects of physical exercise might be further increased when a child 's wellbeing is simultaneously enhanced by psychosocial training . Feeling better may increase the willingness and motivation to engage in sports activities . Therefore , this multi-centre study evaluates the short and long-term changes in physical fitness of a child with a childhood malignancy , using a combined physical exercise and psychosocial intervention program , implemented during or shortly after treatment . Also examined is whether positive effects on physical fitness reduce inactivity-related adverse health problems , improve quality of life , and are cost-effective . Methods This multi-centre r and omized controlled trial compares a combined physical and psychosocial intervention program for children with cancer , with care as usual ( controls ) . Children with cancer ( aged 8 - 18 years ) treated with chemotherapy and /or radiotherapy , and who are no longer than 1 year post-treatment , are eligible for participation . A total of 100 children are being recruited from the paediatric oncology/haematology departments of three Dutch university medical centres . Patients are stratified according to pubertal stage ( girls : age ≤10 or > 10 years ; boys : ≤11 or > 11 years ) , type of malignancy ( haematological or solid tumour ) , and moment of inclusion into the study ( during or after treatment ) , and are r and omly assigned to the intervention or control group . Discussion Childhood cancer patients undergoing long-term cancer therapy may benefit from a combined physical exercise and psychosocial intervention program since it may maintain or enhance their physical fitness and increase their quality of life . However , the feasibility , patient need , and effectiveness of such a program should be established before the program can be implemented as part of st and ard care . Trial registration numberNTR1531 ( The Netherl and s National Trial Register OBJECTIVE Whether accumulating short intermittent bouts of light-to-moderate physical activity ( LMPA ) can elicit significant improvements in the fitness of sedentary adults , compared to one longer continuous bout . METHODS Fifty sedentary 35- to 60-year-old adults in Hong Kong were r and omly appointed to one of two gender-balanced intervention programs : Exercise Prescription Model ( EPM ) of 30-minute continuous activity , 3 - 4 days per week , or a Lifestyle group ( LIFE ) of 6-minute activity , 5 times per day , 4 - 5 days per week . Aerobic fitness ( VO(2)max ) , mass , body composition , blood pressure , waist-to-hip ratio , and body mass index ( BMI ) were assessed at baseline ( December 1995 ) and after 8 weeks . RESULTS Nearly half of bouts by the LIFE group were < or = 6 min , while 85 % of the EPM bouts were > or = 30 min , with no differences in additional energy expenditure between groups ( EPM : 163.0+/-89.6 MET h vs LIFE : 148.2+/-71.6 MET h ) . Both groups significantly improved their VO(2)max , 7.4 % ( ES=0.36 ) and 5.3 % ( ES=0.24 ) for the EPM and Lifestyle groups respectively ( F((1,43))=34.0 , p<0.0001 ) . CONCLUSIONS Accumulating multiple short bouts of LMPA , of which approximately 50 % were < or = 6 min , can provide significant improvements in the fitness of sedentary adults that is not dissimilar as one continuous bout of similar total duration Introduction The health benefits of regular cardiovascular exercise are well-known . Such exercise , however , has traditionally been defined as vigorous physical activity , such as jogging , swimming , or aerobic dance . Exercise of moderate intensity also promotes health , and many U.S. adults may be experiencing the health benefits of exercise through lifestyle activities of moderate intensity , such as yard work , housework , or walking for transportation . Until recently , public health surveillance systems have not included assessment s of this type of physical activity , focusing on exercise of vigorous intensity . We used an enhanced surveillance tool to describe the prevalence and amount of both moderate-intensity and vigorous-intensity physical activity among U.S. adults . Methods We analyzed data from the 2001 Behavioral Risk Factor Surveillance System , a state-based , r and om-digit  – dialed telephone survey administered to U.S. adults aged 18 years and older ( n = 82,834 men and 120,286 women ) .  Physical activity behavior was assessed using questions design ed to quantify the frequency of participation in moderate- or vigorous-intensity physical activities performed during leisure time or for household chores and transportation . Results Overall , 45 % of adults ( 48 % of men and 43 % of women ) were active at recommended levels during nonworking hours ( at least 30 minutes five or more days per week in moderate-intensity activities , equivalent to brisk walking , or at least 20 minutes three or more days per week in vigorous activities , equivalent to running , heavy yard work , or aerobic dance ) . Less than 16 % of adults ( 15 % of men and 17 % of women ) reported no moderate or vigorous activity in a usual week . Conclusion Integrating surveillance of lifestyle activities into national systems is possible , and doing so may provide a more accurate representation of the prevalence of recommended levels of physical activity . These results , however , suggest that the majority of U.S. adults are not active at levels associated with the promotion and maintenance of health OBJECTIVES To compare the effect of high-intensity aerobic interval exercise ( HIA ) with home-based exercise ( HB ) in older adults with chronic disease soon after discharge from the hospital . DESIGN R and omized controlled trial . SETTING Hospital . PARTICIPANTS Community-dwelling older adults aged 70 to 92 ( N = 115 ) were recruited while in the hospital . After discharge , they were r and omized to HIA group ( n = 59 ) or HB ( n = 56 ) . INTERVENTION High-intensity aerobic interval exercise ( HIA ) consisted of endurance , strength , and balance exercises . The HB consisted of low-intensity exercises and telephone follow-up from a physical therapist . MEASUREMENTS Health-related quality of life ( HRQOL ) was assessed using the Medical Outcomes Study 36-item Short Form Survey , physical fitness was measured using the Senior Fitness Test , and physical activity was assessed using the Physical Activity Scale for the Elderly . RESULTS Intention-to-treat analysis showed that both groups improved their HRQOL and physical activity after 3 months . Improvements on the Senior Fitness Test ( chair st and , arm curl and 6-minute walk ( 6MWT ) ) were significantly greater in the HIA group than the HB group . The mean difference was 25.9 m on the 6MWT ( P = .001 , effect size d = 0.2 ) , 1.3 per 30 seconds on the chair st and s mean ( P = .001 , effect size d = 0.3 ) , and 1.6 per 30 seconds on the arm curl ( P = .001 , effect size d = 0.4 ) . CONCLUSION High-intensity aerobic interval exercise ( HIA ) participants significantly improved their physical fitness . Both groups increased their HRQOL and physical activity . The findings suggest that exercise therapy should be incorporated as a part of the treatment for older people at risk for functional decline CONTEXT Even though the strong association between physical inactivity and ill health is well documented , 60 % of the population is inadequately active or completely inactive . Traditional methods of prescribing exercise have not proven effective for increasing and maintaining a program of regular physical activity . OBJECTIVE To compare the 24-month intervention effects of a lifestyle physical activity program with traditional structured exercise on improving physical activity , cardiorespiratory fitness , and cardiovascular disease risk factors . DESIGN R and omized clinical trial conducted from August 1 , 1993 , through July 31 , 1997 . PARTICIPANTS Sedentary men ( n = 116 ) and women ( n = 119 ) with self-reported physical activity of less than 36 and 34 kcal/kg per day , respectively . INTERVENTIONS Six months of intensive and 18 months of maintenance intervention on either a lifestyle physical activity or a traditional structured exercise program . MAIN OUTCOME MEASURES Primary outcomes were physical activity assessed by the 7-Day Physical Activity Recall and peak oxygen consumption ( VO2peak ) by a maximal exercise treadmill test . Secondary outcomes were plasma lipid and lipoprotein cholesterol concentrations , blood pressure , and body composition . All measures were obtained at baseline and at 6 and 24 months . RESULTS Both the lifestyle and structured activity groups had significant and comparable improvements in physical activity and cardiorespiratory fitness from baseline to 24 months . Adjusted mean changes ( 95 % confidence intervals [ CIs ] ) were 0.84 ( 95 % CI , 0.42 - 1.25 kcal/kg per day ; P<.001 ) and 0.69 ( 95 % CI , 0.25 - 1.12 kcal/kg day ; P = .002 ) for activity , and 0.77 ( 95 % CI , 0.18 - 1.36 mL/kg per minute ; P = .01 ) and 1.34 ( 95 % CI , 0.72 - 1.96 mL/kg per minute ; P<.001 ) for VO2peak for the lifestyle and structured activity groups , respectively . There were significant and comparable reductions in systolic blood pressure ( -3.63 [ 95 % CI , -5.54 to -1.72 mm Hg ; P<.001 ] and -3.26 [ 95 % CI , -5.26 to -1.25 mm Hg ; P = .002 ] ) and diastolic blood pressure ( -5.38 [ 95 % CI , -6.90 to -3.86 mm Hg ; P<.001 ] and -5.14 [ 95 % CI , -6.73 to -3.54 mm Hg ; P<.001 ) for the lifestyle and structured activity groups , respectively . Neither group significantly changed their weight ( -0.05 [ 95 % CI , -1.05 to 0.96 kg ; P = .93 ] and 0.69 [ 95 % CI , -0.37 to 1.74 kg ; P = .20 ] ) , but each group significantly reduced their percentage of body fat ( -2.39 % [ 95 % CI , -2.92 % to -1.85 % ; P<.001 ] and -1.85 % [ 95 % CI , -2.41 % to -1.28 % ; P<.001 ] ) in the lifestyle and structured activity groups , respectively . CONCLUSIONS In previously sedentary healthy adults , a lifestyle physical activity intervention is as effective as a structured exercise program in improving physical activity , cardiorespiratory fitness , and blood pressure 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 OBJECTIVES To evaluate the long-term effects of a lifestyle intervention and a structured exercise intervention on physical fitness and cardiovascular risk factors in older adults . DESIGN Controlled trial with r and omization between the intervention groups . SETTING Belgium , Vlaams-Brabant . PARTICIPANTS One hundred eighty-six sedentary but healthy men and women aged 60 to 83 . INTERVENTIONS Participants in the lifestyle intervention were stimulated to integrate physical activity into their daily routines and received an individualized home-based program supported by telephone calls . The structured intervention consisted of three weekly supervised sessions in a fitness center . Both interventions lasted 11 months and focused on endurance , strength , flexibility , and postural and balance exercises . MEASUREMENTS Cardiorespiratory fitness , muscular strength , functional performance , blood pressure , and body composition were measured before ( pretest ) , at the end ( 11 months , posttest ) , and 1 year after the end ( 23 months , follow-up ) of the interventions . RESULTS The results from pretest to posttest have already been published . The current study analyzed the results from posttest to follow-up . There was a decrease in cardiorespiratory fitness , muscular fitness , and functional performance from posttest to follow-up in the structured intervention group but not in the control group or the lifestyle intervention group . At 23 months , participants in both groups still showed improvements in cardiorespiratory fitness . In addition , the structured group showed long-term improvements in muscular fitness , whereas the lifestyle group showed long-term improvements in functional performance . No long-term effects were found for blood pressure or body composition . CONCLUSION These results highlight the potential of a structured fitness center-based intervention and a home-based lifestyle intervention in the battle against inactivity in older adults . Lifestyle programs are especially valuable because they require fewer re sources and less time from health institutions and health practitioners Objectives : This umbrella review aim ed to determine the effectiveness of exercise interventions , alone or in combination with other interventions , in improving physical function in community-dwelling older people identified as pre-frail or frail . Introduction : Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty . Several systematic review s discuss the effects of exercise interventions on physical function parameters , such as strength , mobility , gait , balance and physical performance , and indicate that multi-component exercise , including resistance , aerobic , balance and flexibility training , appears to be the best way in which to improve physical function parameters in frail older people . However , there is still uncertainty as to which exercise characteristics ( type , frequency , intensity , duration and combinations ) are the most effective and sustainable over the long-term . Inclusion criteria : Participants were adults , 60 years or over , living in the community and identified as pre-frail or frail . Quantitative systematic review s , with or without meta- analysis that examined the effectiveness of exercise interventions of any form , duration , frequency and intensity , alone or in combination with other interventions design ed to alter physical function parameters in frail older people , were considered . The quantitative outcome measures were physical function , including muscular strength , gait , balance , mobility and physical performance . Methods : An iterative search strategy for ten bibliometric data bases and gray literature was developed . Critical appraisal of seven systematic review s was conducted independently by two review ers using a st and ard Joanna Briggs Institute tool . Data was extracted independently by two review ers using a st and ard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach . Results : Seven systematic review s were included in this umbrella review , with a total of 58 relevant r and omized controlled trials and 6927 participants . Five systematic review s examined the effects of exercise only , while two systematic review s reported on exercise in combination with a nutritional approach , including protein supplementations , as well as fruit and dairy products . The average  exercise frequency was 2–3 times per week ( mean 3.0 ± 1.5 times per week ; range 1–7 weekly ) for 10–90 minutes per session ( mean of 52.0 ± 16.5 mins ) and a total duration of 5–72 weeks with the majority lasting a minimum of 2.5 months ( mean 22.7 ± 17.7 weeks ) . Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength , gait speed , balance and physical performance , including resistance , aerobic , balance and flexibility tasks . Resistance training alone also appeared to be beneficial , in particular for improving muscular strength , gait speed and physical performance . Other types of exercise were not sufficiently studied and their effectiveness is yet to be established . Conclusions : Interventions for pre-frail and frail older adults should include multi-component exercises , including in particular resistance training , as well as aerobic , balance and flexibility tasks . Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made Background Many people in Western countries do not follow public health physical activity ( PA ) recommendations . Web-based interventions provide cost- and time-efficient means of delivering individually targeted lifestyle modification at a population level . Objective To examine whether access to a website with individually tailored feedback and suggestions on how to increase PA led to improved PA , anthropometrics , and health measurements . Methods Physically inactive adults ( n = 12,287 ) participating in a nationwide eHealth survey and health examination in Denmark were r and omly assigned to either an intervention ( website ) ( n = 6055 ) or a no-intervention control group ( n = 6232 ) in 2008 . The intervention website was founded on the theories of stages of change and of planned behavior and , apart from a forum page where a physiotherapist answered questions about PA and training , was fully automated . After 3 and again after 6 months we emailed participants invitations to answer a Web-based follow-up question naire , which included the long version of the International Physical Activity Question naire . A subgroup of participants ( n = 1190 ) were invited to a follow-up health examination at 3 months . Results Less than 22.0 % ( 694/3156 ) of the participants logged on to the website once and only 7.0 % ( 222/3159 ) logged on frequently . We found no difference in PA level between the website and control groups at 3- and 6-month follow-ups . By dividing participants into three groups according to use of the intervention website , we found a significant difference in total and leisure-time PA in the website group . The follow-up health examination showed no significant reductions in body mass index , waist circumference , body fat percentage , and blood pressure , or improvements in arm strength and aerobic fitness in the website group . Conclusions Based on our findings , we suggest that active users of a Web-based PA intervention can improve their level of PA . However , for unmotivated users , single-tailored feedback may be too brief . Future research should focus on developing more sophisticated interventions with the potential to reach both motivated and unmotivated sedentary individuals . Trial Registration Clinical trials.gov NCT01295203 ; http:// clinical trials.gov/ct2/show/NCT01295203 ( Archived by WebCite at http://www.webcitation.org/6B7HDMqiQ Little is known about the frequency‐intensity patterns of naturally occurring physical activity in children . A data set obtained previously by direct observation of  physical activity in 8 girls and 7 boys ( all prepubertal , ages 6–10 ) was analyzed with spectral analysis to detect significant frequency‐intensity relationships . Pulse detection algorithms were used to characterize the number of exercise bouts , their duration and relative intensity . Spectral analysis revealed that physical activity bouts were frequent , pulsatile , and r and om with no significant frequencies detected during many 24‐min periods of observation . An average of 83 ± 11 bouts per hour were observed in boys and 89 ± 12 bouts per hour in girls , and the mean duration of an exercise bout was 21 ± 5 sec for boys and 20 ± 4 sec for girls ( NS ) . While high‐intensity exercise bouts comprised less than 20 % of the time spent in physical activity , duration of high intensity exercise bouts tended to be longer and accounted for about 40 % of the energy expenditure associated with physical activity . Spontaneous physical activity in prepubertal children is characterized by frequent bouts of brief , mostly low intensity exercise , r and omly interspersed with less frequent , but metabolically substantial high intensity bouts . These findings are potentially useful in assessing the impact of disease on quality of life in children , investigating the relationship between physical activity and mechanisms of growth and development , and creating new approaches for in‐laboratory exercise testing in children . Am . J. Hum . Biol . 10:289–297 , 1998 . © 1998 Wiley‐Liss , BACKGROUND The physical activity level of older adults with intellectual disabilities ( ID ) is extremely low , and their fitness levels are far beneath accepted norms for older people with normal intelligence and comparable with frail older people . A physical activity programme , including an education programme , was developed for older adults with ID using behaviour change techniques . The programme aim ed at improving or maintaining adequate levels of physical activity ( primary outcome measure ) and motor fitness , cardio respiratory fitness , morphologic and metabolic fitness , activities of daily living , cognitive functioning and depressive symptoms ( secondary outcome measures ) . METHOD The programme 's efficacy was evaluated in a cluster-r and omised clinical trial among people aged 43 years and over with mild-moderate levels of ID . Five day-activity centres were r and omised to the participation group . In these centres , 81 older adults participated in groups of 8 to 10 in the programme , three times a week during 8 months . The programme was executed by physical activity instructors and staff of day-activity centres . Five other day-activity centres were r and omised to the control group ; 70 older adults in these centres received care as usual . The generalised linear model with mixed effects was used to test the programme 's effectiveness . RESULTS Significant effects were found on physical activity , muscle strength , systolic and diastolic blood pressure , serum cholesterol level and cognitive functioning , in favour of the programme 's participants . No significant improvements were found on balance , serum glucose , weight , waist circumference , walking speed , mobility , depression or instrumental activities of daily living . CONCLUSIONS The physical activity and fitness programme has established small but significant effects in this sample , but generalising the findings to other setting s is difficult due to significant participant dropout . Implementation of evidence -based physical activity programmes among older adults with ID is recommended . Further research is needed to investigate the effectiveness of physical activity on daily life functioning and the development on chronic diseases in the long run BACKGROUND Given the evidence that regular physical activity produces substantial health benefits , participation in sports , exercise , and recreation is widely encouraged . The objective of this study was to describe participation in sports , exercise , and recreational physical activities among US adults . METHODS Data from 2 national surveys of respondents age 18 years and older were analyzed . Respondents to the American Time Use Survey ( ATUS ) from 2003 through 2005 ( N=45,246 ) reported all activities on 1 r and omly selected survey day . Respondents to the National Health and Nutrition Examination Survey ( NHANES ) from 1999 through 2004 ( N=17,061 ) reported leisure-time physical activities in the 30 days before the interview . RESULTS One-quarter of adults participated in any  sport , exercise , or recreational activity  on a r and om day , and 60.9 % of adults participated in any leisure-time activity in the previous 30 days . The most common types of activities were walking , gardening and yard work , and other forms of exercise . The sports and recreational activities had typical duration s of 1/2 to 3 hours per session , and the exercise activities typically lasted 1 hour or less . CONCLUSIONS The prevalence of sports , exercise , and recreational physical activities is generally low among US adults ; exercise is the most commonly reported type of activity BACKGROUND Regular physical activity reduces the risk for chronic diseases among older adults . Older adults are likely to be seen by primary care clinicians who can play a role in promoting physical activity among their patients . DESIGN In this r and omized controlled trial ( 1998 - 2003 ; data analyzed 2004 - 2005 ) , we compared the effects of brief advice to exercise from a clinician supplemented by telephone-based counseling by health educators ( extended advice ) to brief advice from a clinician alone ( brief advice ) . SETTING / PARTICIPANTS A total of 100 primary care patients ( 63.2 % female , 14.7 % minority , mean age=68.5 years ) participated in the trial . INTERVENTIONS The extended-advice intervention consisted of clinician advice plus exercise counseling via telephone provided by research staff , and the brief advice condition consisted of clinician advice alone . Both interventions focused on promoting moderate-intensity physical activity . MAIN OUTCOME MEASURES Self-reported physical activity using the 7-Day Physical Activity Recall instrument and objective activity monitoring using Biotrainers were assessed at baseline , and at 3 and 6 months . RESULTS Participants in the extended-advice arm reported significantly greater participation in moderate-intensity physical activity than the brief-advice group at 3 months ( + 57.69 minutes vs 12.45 minutes ; 3.84 kcal/week vs 0.83 kcal/week ) and 6 months ( + 62.84 minutes vs 16.60 minutes ; 4.19 kcal/week vs 1.1 kcal/week ) . Objective activity monitoring also showed significantly increased physical activity among extended-advice versus brief-advice participants at both time points ( + 50.79 vs -11.11 ; + 42.39 vs -24.18 , respectively ) . CONCLUSIONS These data indicate that clinician advice with follow-up counseling can promote adoption of moderate-intensity physical activity among older , primary care patients
There is no difference between continuous and accumulated patterns of exercise in terms of effects on fitness , blood pressure , lipids , insulin and glucose .
There is some evidence from a small number of studies that changes in body mass and LDL cholesterol are more favourable following the accumulated condition .
Collectively our findings suggest that adults are likely to accrue similar health benefits from exercising in a single bout or accumulating activity from shorter bouts throughout the day .
Public health guidelines suggest that physical activity can be accumulated in multiple short bouts dispersed through the day .
A synthesis of the evidence for this approach is lacking .
Our objective was to undertake a systematic review and meta- analysis to examine if exercise interventions consisting of a single bout of exercise compared with interventions comprising the same total duration , mode , and intensity of exercise accumulated over the course of the day have different effects on health outcomes in adults .