RESUMEN
(1) Background: Identifying groups with a misaligned physical capacity (PC) and physical activity (PA) is potentially relevant for health promotion. Although an important health determinant, deeper knowledge of underlying walking behavior patterns in older adults is currently missing. We aim to identify specific PA signatures of misaligned groups and determine PA variables discriminating between groups. (2) Methods: In total, 294 community-dwelling older adults (≥70 years) were divided into four quadrants based on thresholds for PA (≥ or <5000 steps/day) and PC (≤ or >12 s, Timed Up and Go test). Kruskal-Wallis and effect sizes were calculated to compare quadrants' PA variables and to determine the discriminative power of PA parameters on walking duration, frequency, and intensity. (3) Results: We identified quadrant-specific PA signatures. Compared with "can do-do do", the "cannot do-do do" group performs shorter continuous and lower-intensity walks; the "can do-do not do" group takes fewer steps and walks with less intensity. The "cannot do-do not do" group presents lower values in all PA variables. "Walking duration greater or equal 3 METs" was the strongest discriminative PA variable. (4) Conclusion: We provide distinct PA signatures for four clinically different groups of older adults. Walking intensity is most useful to distinguish community-dwelling older adults, which is relevant for developing improved customized health promotion interventions.
Asunto(s)
Ejercicio Físico , Equilibrio Postural , Estudios Transversales , Estudios de Tiempo y Movimiento , CaminataRESUMEN
BACKGROUND: The majority of older adults do not reach the physical activity guidelines. One possible explanation for this may be that older adults overestimate their physical activity levels, because they are unable to identify exercise intensity. METHODS: Forty-four older adults were recruited and randomly assigned into two walking groups lasting 6 weeks. The intervention group was asked to walk a minimum of 150 min per week at moderate intensity using walking cadence indicated with a pedometer. The control group did not get any feedback on walking intensity. RESULTS: The ability to identify moderate intensity while walking did not significantly improve in neither groups (p = 0.530). However, participants in the intervention group increased significantly the time spent at moderate intensity, in 10 min bouts (p < 0.01). DISCUSSION: A pedometer providing walking cadence to reach moderate intensity is a good tool for increasing time walked at the recommended intensity, but not because participants know more what is considered moderate intensity.
Asunto(s)
Ejercicio Físico , Velocidad al Caminar/fisiología , Anciano , Estudios de Casos y Controles , Terapia por Ejercicio/instrumentación , Femenino , Humanos , Masculino , Distribución AleatoriaRESUMEN
Exaggerated elevation of systolic blood pressure (SBP) during exercise is a risk factor for future cardiovascular disease. Although there are differences between the outdoor exercise and exercise tests in the laboratory setting, there is little information regarding SBP changes during practical outdoor exercise. We investigated SBP changes during self-paced outdoor walking and the relationship to air temperature. Subjects (n = 109, 47-83 years) walked outdoors at their own pace wearing a blood pressure monitor on their wrist. SBP increased during walking compared to rest, but was higher at the 1 km mark than both the 2 and 3 km marks (rest, 124 ± 14 mmHg; 1 km, 140 ± 16 mmHg; 2 km, 136 ± 18 mmHg; 3 km, 135 ± 18 mmHg). SBP at rest, air temperature, body mass index (BMI) and walking intensity during the first 1 km were identified as predictors of SBP at the 1 km mark in the stepwise regression analysis, independent of other confounders (R2 = 0·606). SBP at the 1 km mark was higher in the lower temperature group (11·6-14·3°C, 145 ± 14 mmHg) than in the intermediate (15·1-16·7°C, 140 ± 18 mmHg) and higher (17·0-19·6°C, 136 ± 16 mmHg) temperature groups, independent of SBP at rest, BMI and walking intensity. These results suggest that increases in SBP are higher on lower temperature days and are greater at 1 km than at 2 and 3 km. It is therefore recommended that measures are taken against the cold on lower temperature days to attenuate the SBP response during onset of walking.
Asunto(s)
Aire , Presión Sanguínea , Marcha , Temperatura , Caminata , Actigrafía/instrumentación , Anciano , Anciano de 80 o más Años , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Índice de Masa Corporal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
In patients with chronic obstructive pulmonary disease (COPD), reduced levels of daily physical activity are associated with the degree of impairment in lung, peripheral muscle, and central hemodynamic function. There is, however, limited evidence as to whether limitations in tidal volume expansion also, importantly, determine daily physical activity levels in COPD. Eighteen consecutive patients with COPD [9 active (forced expiratory volume in 1 s, FEV1: 1.59 ± 0.64 l) with an average daily movement intensity >1.88 m/s(2) and 9 less active patients (FEV1: 1.16 ± 0.41 l) with an average intensity <1.88 m/s(2)] underwent a 4-min treadmill test at a constant speed corresponding to each individual patient's average movement intensity, captured by a triaxial accelerometer during a preceding 7-day period. When chest wall volumes, captured by optoelectronic plethysmography, were expressed relative to comparable levels of minute ventilation (ranging between 14.5 ± 4.3 to 33.5 ± 4.4 l/min), active patients differed from the less active ones in terms of the lower increase in end-expiratory chest wall volume (by 0.15 ± 0.17 vs. 0.45 ± 0.21 l), the greater expansion in tidal volume (by 1.76 ± 0.58 vs. 1.36 ± 0.24 l), and the larger inspiratory reserve chest wall volume (IRVcw: by 0.81 ± 0.25 vs. 0.39 ± 0.27 l). IRVcw (r(2) = 0.420), expiratory flow (r(2) change = 0.174), and Borg dyspnea score (r(2) change = 0.123) emerged as the best contributors, accounting for 71.7% of the explained variance in daily movement intensity. Patients with COPD exhibiting greater ability to expand tidal volume and to maintain adequate inspiratory reserve volume tend to be more physically active. Thus interventions aiming at mitigating restrictions on operational chest wall volumes are expected to enhance daily physical activity levels in COPD.
Asunto(s)
Ejercicio Físico/fisiología , Pulmón/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Volumen de Ventilación Pulmonar/fisiología , Acelerometría , Anciano , Disnea/fisiopatología , Prueba de Esfuerzo , Femenino , Volumen Espiratorio Forzado/fisiología , Humanos , Masculino , Persona de Mediana Edad , Mecánica Respiratoria/fisiologíaRESUMEN
In chronic obstructive pulmonary disease (COPD), daily physical activity is reported to be adversely associated with the magnitude of exercise-induced dynamic hyperinflation and peripheral muscle weakness. There is limited evidence whether central hemodynamic, oxygen transport, and peripheral muscle oxygenation capacities also contribute to reduced daily physical activity. Nineteen patients with COPD (FEV1, 48 ± 14% predicted) underwent a treadmill walking test at a speed corresponding to the individual patient's mean walking intensity, captured by a triaxial accelerometer during a preceding 7-day period. During the indoor treadmill test, the individual patient mean walking intensity (range, 1.5 to 2.3 m/s2) was significantly correlated with changes from baseline in cardiac output recorded by impedance cardiography (range, 1.2 to 4.2 L/min; r = 0.73), systemic vascular conductance (range, 7.9 to 33.7 ml·min(-1)·mmHg(-1); r = 0.77), systemic oxygen delivery estimated from cardiac output and arterial pulse-oxymetry saturation (range, 0.15 to 0.99 L/min; r = 0.70), arterio-venous oxygen content difference calculated from oxygen uptake and cardiac output (range, 3.7 to 11.8 mlO2/100 ml; r = -0.73), and quadriceps muscle fractional oxygen saturation assessed by near-infrared spectrometry (range, -6 to 23%; r = 0.77). In addition, mean walking intensity significantly correlated with the quadriceps muscle force adjusted for body weight (range, 0.28 to 0.60; r = 0.74) and the ratio of minute ventilation over maximal voluntary ventilation (range, 38 to 89%, r = -0.58). In COPD, in addition to ventilatory limitations and peripheral muscle weakness, intensity of daily physical activity is associated with both central hemodynamic and peripheral muscle oxygenation capacities regulating the adequacy of matching peripheral muscle oxygen availability by systemic oxygen transport.