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Background The surge in telework due to technological advances and confinement during the coronavirus disease pandemic of 2019 (COVID-19) has drawn attention to its effects on physical activity (PA) and sedentary behavior (SB). This review aimed to analyze the impact of telework compared to office work in PA and SB, assessed by validated questionnaires and accelerometers during the COVID-19 pandemic. Methods Observational studies that evaluated the effect of telework in PA and SB compared to office work were identified by literature searches in three electronic databases (PubMed, Web of Science, and Scopus) published up to January 2023. Studies were included when written in English, including observational design, evaluating the effect of telework on PA and/or SB compared to office work, and using validated questionnaires and accelerometers to assess PA and/or SB. The meta-analysis evaluated continuous outcomes with a random-effect model using Review Manager Web 5 (Cochrane Collaboration, Oxford, UK). The risk of bias was assessed using the National Heart, Lung, and Blood Institute quality assessment tool for Observational studies. Results Twelve observational studies, with a total of 9,059 participants, were included in this study. Ten studies assessed PA and SB with questionnaires and two with accelerometers. A significant decrease of -0.33 (95% CI -0.59, -0.08) in light PA was observed, while no significant changes were observed for total PA (-0.19 [-0.42, 0.04]), moderate to vigorous PA (-0.44 [-1.32, 0.44]) and SB (0.12 [-0.20, 0.44]). Conclusions Telework significantly decreases light PA in a working population during the COVID-19 pandemic. More research using validated measurement tools to assess PA and SB is needed to confirm this result. Given the extensive health benefits of physical activity and reduced sedentary behavior, public health resources must focus on encouraging PA and minimizing SB, especially among teleworkers. Trail registration The review protocol was registered in the Prospero database (CRD42024502374).

Background The spread of COVID-19 has affected people’s daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people’s mental health. Aim To identify correlates of adults’ mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular. Methods A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates. Results Participants ( N  = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β = −.33). Loss of meaningful activities was strongly related to mental health (β = −.36) and explained 9% incremental variance (R 2 change = .092, p  < .001) above control variables. Conclusions The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults’ mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics.

Physical performance is an important determinant of quality of life in patients on haemodialysis. An association between physical performance and survival could further enhance the importance of physical performance. We aimed to assess the association between different measures of physical performance and survival in dialysis patients. 117 patients on haemodialysis were included from December 2016 and followed up to September 2020. Muscle strength (quadriceps, handgrip strength, and sit-to-stand), exercise capacity (six-minute walking test, 6MWT) and the risk of falls (Dialysis Fall Index, Tinetti, and Frailty and Injuries: Cooperative Studies of Intervention Techniques) were measured at the time of inclusion. Hospitalisation, morbidity (Davies Stoke index) and death were recorded. Data were analysed by least squares linear regression models and competing risks survival hazard models. During the observation period (median 33, min 30 max 45 months), 45 patients died (= 38.5%), resulting in a mortality rate of 15% per year. Cardiovascular disease (42.9%) was the most common cause of death. All domains of physical performance were associated with mortality, with the highest hazards for an increased risk of falls (Hazard Ratio (HR) = 20.4, p = 0.003) and poor exercise capacity (HR = 7.4, p<0.001). A score lower than 298 meters (specificity = 0.583; sensitivity = 0.889) on the 6MWT was established as a haemodialysis-specific cut-off point for mortality risk. Each increase in 6MWT (m) corresponded with a 0.4% decrease in mortality risk (HR = 0.996, 95%CI [0.994; 0.998]). The 6MWT as also associated with comorbidity (F-value = 6.1, p = 0.015). Physical performance was not associated with hospitalisation. The 6MWT is associated with mortality in patients on haemodialysis and can be considered as a valid assessment tool to identify high-risk patients.

Ehlers-Danlos syndrome and hypermobility spectrum disorder affect daily life. There is a lack of research that investigates how the disease affects aspects of participation. This study investigates whether there is a difference in the level of participation in society in persons with vascular EDS (N = 18), hypermobile EDS (N = 20), classical EDS (N = 4) and Hypermobility Spectrum Disorder (N = 27), compared to a healthy control group (N = 69) and fibromyalgia (N = 69). In this retrospective case-control study, the Ghent Participation Scale was completed by all participants. Each patient with EDS and HSD was matched by age and sex to healthy controls. The hEDS and HSD group were compared with the healthy control group and a positive control group (persons with fibromyalgia). The results show that there was a significant lower overall participation score for persons with hEDS/HSD compared to the healthy control group. In addition, significant differences were observed in the subscores self-performed activities and delegated activities in the hEDS/HSD group compared to healthy controls, being HEDS/HSD patients who obtained the lower scores. Further research is needed to obtain representative results of the participation level for the EDS/HSD population. In this way, interventions can be set up for patients with EDS in an evidence-based way and that are appropriate to the patient’s level of participation.

Purpose Healthcare professionals (HCPs) such as Physical Activity on Prescription (PAP)-coaches and physiotherapists might play a crucial role in activating sedentary and/or inactive adults, which in turn might benefit their health. We aimed to explore the perceived facilitating factors to shift sedentary behavior (SB) into more physical activity (PA) comparing two perspectives 1) sedentary and/or inactive adults and 2) HCPs in their role to activate these adults. Methods A mixed method approach, i.e. concept mapping, was used to explore the facilitating factors among 1) HCPs ( n  = 10) and 2) adults ( n  = 40). During a brainstorm, perceived facilitating factors were gathered in response to one seeding statement ‘what help(s) you/your clients to shift SB into (more) PA?’. Thereafter, all answers were sorted by relatedness into different piles and each answer was rated on effectiveness, feasibility, changeability and enjoyment (5-point Likert scale). Data analysis was done via RCMap. Results Clusters identified by both HCPs and adults included ‘social networks’, ‘everyday activities as opportunities for PA’, ‘awareness of PA benefits’, ‘motivation regarding PA’, ‘integration of PA into daily routines’, ‘goal-setting to facilitate PA’, ‘environmental facilities’, ‘financial resources’, and ‘technology, digital tools and external tools to facilitate PA’. Each group created unique clusters such as factors related to the ‘work environment’ by adults and factors related to ‘tailored support to facilitate PA’ by HCPs. The average rating for each cluster was higher for HCPs compared to adults for effectiveness (4/5 vs 3.5/5), feasibility (3.8/5 vs 3.1/5), and changeability (3.7/5 vs 3.2/5). Conclusions HCPs and sedentary and/or inactive adults identified factors at the intra- and interpersonal level which were rated as feasible, effective and changeable, as well as factors at the responsibility of external stakeholders such as employers or policy makers. These results highlight that future interventions aimed at shifting SB into PA include a multilevel challenge.

CKD is associated with several comorbidities, cardiovascular disease being the most significant. Aerobic training has a beneficial effect on cardiovascular health in healthy and some well-defined non-healthy populations. However, the effect of aerobic training on glomerular filtration rate in patients with CKD stages 3-4 is unclear. To review the effects of aerobic exercise training on kidney and cardiovascular function in patients with chronic kidney disease (CKD) stages 3-4. A random-effects meta-analysis was performed to analyse published randomized controlled trials through February 2018 on the effect of aerobic training on estimated glomerular filtration rate, blood pressure and exercise tolerance in patients with CKD stages 3-4. Web of Science, PubMed and Embase databases were searched for eligible studies. 11 randomized controlled trials were selected including 362 participants in total. Favourable effects were observed on estimated glomerular filtration rate (+2.16 ml/min per 1.73m2; [0.18; 4.13]) and exercise tolerance (+2.39 ml/kg/min; [0.99; 3.79]) following an on average 35-week aerobic training program when compared to standard care. No difference in change in blood pressure was found. There is a small beneficial effect of aerobic training on estimated glomerular filtration rate and exercise tolerance, but not on blood pressure, in patients with CKD stages 3-4. However, data are limited and pooled findings were rated as of low to moderate quality.

Older adults with type 2 Diabetes Mellitus are at increased risk of falling. The current study aims to identify risk factors that mediate the relationship between diabetes and falls. 199 older adults (104 with diabetes and 95 healthy controls) underwent a medical screening. Gait (GAITRite®), balance (AccuGait® force plate), grip strength (Jamar®), and cognitive status (Mini-Mental State Examination and Clock Drawing Test) were assessed. Falls were prospectively recorded during a 12-month follow-up period using monthly calendars. Compared to controls, diabetes participants scored worse on all physical and cognitive measures. Sixty-four participants (42 diabetes vs. 22 controls) reported at least one injurious fall or two non-injurious falls (\"fallers\"). Univariate logistic regression identified diabetes as a risk factor for future falls (Odds Ratio 2.25, 95%CI 1.21-4.15, p = 0.010). Stepwise multiple regressions defined diabetes and poor balance as independent risk factors for falling. Taking more medications, slower walking speed, shorter stride length and poor cognitive performance were mediators that reduced the Odds Ratio of the relationship between diabetes and faller status relationship the most followed by reduced grip strength and increased stride length variability. Diabetes is a major risk factor for falling, even after controlling for poor balance. Taking more medications, poorer walking performance and reduced cognitive functioning were mediators of the relationship between diabetes and falls. Tailored preventive programs including systematic medication reviews, specific balance exercises and cognitive training might be beneficial in reducing fall risk in older adults suffering from diabetes.

Purpose An accurate assessment of time spent in 24-hour movement behaviors (24 h-MBs) is crucial in exploring health related associations. This study aims to evaluate the concurrent validity of the Daily Activity Behavior Questionnaire (DABQ) compared to the ActiGraph using absolute and relative indicators of validity. Methods This cross-sectional observational study included 105 adults (45 ± 13 y/o, 54% female). Participants wore an ActiGraph during seven consecutive days followed by filling in the DABQ recalling the past seven days. Intraclass correlations (95% confidence intervals), Bland-Altman plots, Spearman’s correlations and the magnitude of error were calculated to estimate the absolute agreement and validity. Interaction effects between sociodemographic variables and the measurement methods were explored in mixed models. All analyses were compared by four commonly used data processing methods for ActiGraph data (cut-points and data reduction method-specific). Results Moderate absolute agreement (ICC = 0.56) and validity (rho sleep =0.58) was found for sleep comparing the DABQ with the ActiGraph. Time spent in sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) showed poor absolute agreement (ICC SB : 0.01–0.38, ICC LPA : 0.00-0.31; ICC MVPA : 0.23–0.30) and validity (rho SB : 0.01–0.43, rho LPA : 0.10–0.46; rho MVPA : 0.38–0.44) comparing the DABQ with the ActiGraph. The Ranges in ICC and Spearmans’ rho include the comparison between the four data processing methods. A significant interaction was found between the measurement method and educational level ( p  < 0.001), in specific for sleep, SB and LPA. Conclusion Compared to the ActiGraph, the DABQ showed accurate time-use estimates for sleep but presented poor to moderate evidence of validity regarding SB, LPA and MVPA. This was shown in underestimations regarding SB and MVPA, and overestimations regarding LPA. However, educational level and data processing methods contributed to these variations.

To provide an extensive review on the associations between knee inflammation and altered pain perception mechanisms in people with knee osteoarthritis (OA). MEDLINE, Web of Science, EMBASE and Scopus were searched up to 13 December 2022. We included articles reporting associations between knee inflammation (measured by effusion, synovitis, bone marrow lesions (BMLs) and cytokines) and signs of altered pain processing (assessed by quantitative sensory testing and/or questionnaire for neuropathic-like pain) in people with knee OA. Methodological quality was evaluated using the National Heart, Lung and Blood Institute Study Quality Assessment Tool. Level of evidence and strength of conclusion were determined using the Evidence-Based Guideline Development method. Nine studies were included, comprising of 1889 people with knee OA. Signs of greater effusion/synovitis may be positively associated with lower knee pain pressure threshold (PPT) and neuropathic-like pain. Current evidence could not establish an association between BMLs and pain sensitivity. Evidence on associations between inflammatory cytokines and pain sensitivity or neuropathic-like pain was conflicting. There are indications of a positive association between higher serum C reactive protein (CRP) levels and lower PPT and presence of temporal summation. Methodological quality varied from level C to A2. Signs of effusion/synovitis may be positively associated with neuropathic-like pain and pain sensitivity. There are indications of a possible positive association between serum CRP levels and pain sensitivity. Given the quality and the small amount of included studies, uncertainty remains. Future studies with adequate sample size and follow-up are needed to strengthen the level of evidence.PROSPERO registration number: CRD42022329245.

PurposeTo describe the impairments in physical fitness in individuals who were previously diagnosed and treated for childhood cancer.MethodsUsing the PRISMA-guidelines, a systematic search was performed in PubMed, Web of Science, and Embase using a combination of the following predefined keywords: “exercise capacity” OR “aerobic capacity” OR “fitness” OR “cardiorespiratory fitness” OR “cardiopulmonary fitness” OR “physical fitness” OR “exercise testing” OR “exercise tolerance” OR “exercise” OR “oxygen consumption” AND “leukemia” OR “childhood cancer” OR “childhood cancer survivors (CCS)”. Studies that met our inclusion criteria were reviewed on methodological quality, while the Newcastle-Ottawa Scale was used for evidence synthesis.ResultsA total of 2644 articles were identified from the database search. After screening based on the eligibility (abstracts) and inclusion (full texts) criteria, 49 articles remained. Even though the risk-of-bias scores in the studies were generally low, yet the results from those with high-quality studies revealed that poor fitness levels were prevalent in individuals with acute lymphoblastic leukemia, brain tumor, and mixed cancer histories, compared to healthy controls.ConclusionsA global glance at CCS shows poor levels of fitness that is continuous and life-long even after active cancer treatment has ended. Nevertheless, the results presented in this review were based on a limited number of high-quality studies suggesting the need to for additional clinical trials in the topic area.