Statement of the Problem: Understanding physical activity (PA) behaviors in children with cerebral palsy (CP) who are non-ambulatory is important to design optimal fitness interventions that reduce sedentary behaviors and promote health. There is a growing body of evidence for children with CP who are ambulatory that indicates they have decreased PA as compared to neurotypical peers. These children are at risk for poor health status and in need of adapted strategies to promote activity and reduce sedentary behaviors. However, information on PA behaviors is limited for children with CP who are non-ambulatory. Evaluating the amount and intensity of PA in children with CP who are non-ambulatory is challenging because of the heterogeneous nature of the disease and the limited repertoire of movements available to these children. Developing assessments that accurately describe PA in this population is essential to understand the nature of these limitations and to develop targeted interventions. Materials & Methods: In Study 1, PA amount and intensity in children with CP who were non-ambulatory were examined using PA (accelerometers) and HR monitors along with video observation and parent journaling over 7 days. Children were observed during a range of daily tasks to provide a detailed observation in their home and school. Parents were asked to rate their opinion of their child’s level of PA intensity during these tasks (easy, medium or hard), and these ratings were compared to the PA intensity derived from the PA and HR monitors. Levels of agreement were reported between parent report and HR and PA monitors during video recording. In Study 2, Interviews with parents of children with CP who were non-ambulatory and physical therapists (PTs) working with this population were conducted to understand how they operationalized PA and to evaluate the face validity of the Patient Reported Outcome Measurement Information System (PROMIS) ® PA parent proxy short form 8a survey as a measure of PA in this population. Each child was classified by Gross Motor Functional Classification Scale (GMFCS), the eating, drinking, classification scale (EDACS), the communication and feeding classification scale (CFCS), and the manual abilities classification scale (MACS).Results: For Study 1, 10 children and families participated in the exploratory observation with a video recording of PA in the home. A minimum of 4 consecutive days of monitor wear data was obtained for 7 of the 10 children; 3 children experienced equipment or use malfunction. There was a positive correlation between the parent level of PA intensity and intensity measured by the HR monitors, but no correlation with the PA monitors. The level of agreement of parent-reported PA intensity and HR monitors were correlated with PediCAT daily activity and mobility scores and the EDACS, CFCS, and MACS, There was no correlation between the parent responses and PA monitor-derived PA intensity levels with any functional measure. The PA monitor-derived level of intensity was correlated with the parent-reported PROMIS T-scores. No correlation was seen with the HR monitors. For Study 2, 22 PTs and 15 parents of children with CP who were non-ambulatory participated in the interviews. The PT’s and parents’ interview responses generated shared opinions about PA and how it should be operationally defined in this population. Four major themes emerged: a) PA is defined by functional activities and active movement; b) PA is challenging to measure objectively in this population; c) the environment plays a crucial role in supporting PA; and d) personal factors influence PA uptake. Both parents and PTs believed PA in this population should be increased to improve health related benefits. PA definition focused on active mobility and independent motor control by PTs, whereas the parent's definition of PA highlighted the functional and mobility achievements of their children with examples of communication and use of assistive technology and adaptive equipment. Level of assistance was used by both PTs and parents to indicate PA measurement. Parents and PTs agreed on the appropriateness of various questions on PROMIS scale, with the most appropriate questions being those that inquired about PA frequency during the week (Questions 6 and 7) Conclusions: Accelerometers, HR monitoring, and video monitoring can provide insight into daily PA in children with CP who are non-ambulatory. PA derived from HR monitors was correlated with parent-reported PA intensity during specific daily tasks, suggesting that HR monitors may better reflect PA intensity than accelerometry-based monitors in this population. In capturing PA over a longer period (e.g., 1 week), the PROMIS parent-proxy measure correlated with PA monitor-derived levels of intensity. PA monitors may best reflect general activity levels throughout the week rather than specific intensity levels during daily activities. Defining PA in children with CP who are non-ambulatory is challenging, however, parents and PTs provided insights into methods that can be used to conceptualize this challenging construct. The PROMIS short form 8a PA had some qualities that were deemed appropriate by PTs and parents alike with a preference for specific questions (Questions 6 and 7) for children with CP who are non-ambulatory. Methods to address the implementation of cardiovascular and fitness goals in this population need to be further explored.

Children diagnosed with Autism Spectrum Disorder (ASD) may not be meeting the recommended amounts of physical activity (PA) or obtain a sufficient amount of sleep, however, few studies have objectively compared PA, sedentary behavior, and sleep quality between typically developing (TD) youth, and youth with ASD. Therefore, the purpose of this study was to compare levels of PA, sedentary behavior, and sleep quality between youth with ASD and TD youth. Twenty-three children with ASD and 12 TD children wore the Actigraph GT9X accelerometer over seven days and nights to assess activity and sleep. Youth with ASD had significantly greater levels of sedentary behavior (p=.02), and had less sleep efficiency compared to TD youth (p=.0001). Additionally, TD youth were more likely to achieve the recommended levels of PA compared to youth with ASD (p=.003). Results suggest that youth with ASD have poorer health habits compared to TD youth. Interventions should be developed to target health behaviors in youth with ASD.

The first study (Chapter 3) examined the reliability and validity of the modified Children's Leisure Activities Study Survey (CLASS) questionnaire in assessing physical activity and sedentary behavior of the Hong Kong Chinese children. The modified Chinese questionnaire (CLASS-C) consisted of a checklist of 31 physical activities and 13 sedentary pursuits. The test-retest reliability of the questionnaire was examined in 84 boys and 136 girls aged 9 to 14 years by the comparison of data from the two survey administrations carried out one week apart. Intraclass correlation coefficients (ICCs) were analyzed to determine consistency in results. A sub-sample of 139 children completed the 7-day accelerometer protocol. The validity of the questionnaire was determined by comparing data from the second administration with the accelerometer estimates of moderate- and/or vigorous-intensity physical activity. Bland-Altman plots were performed to further examine the agreement of the two methods. Acceptable reliability was found in self-reported time in moderate-to-vigorous physical activity (MVPA) (ICC = 0.71, 95%CI: 0.61-0.77) and in the sedentary behaviors (ICC = 0.69, 95%CI: 0.59-0.77). Self-reported estimate in daily MVPA was moderately correlated with minutes assessed by the accelerometer (girls: r = 0.48, P<0.05; boys: r = 0.27, P>0.05). Bland-Altman plots showed that self-reports of vigorous physical activity were higher than those assessed by the accelerometer. / The second study (Chapter 4) developed an instrument based on the social ecological model to evaluate the socio-environmental correlates of the children's physical activity and sedentary behavior. The instrument consisted of segments that incorporated reports from both the children and their parents. Children were asked about intrapersonal factors and perceived environments at home and in the neighborhood. Corresponding parents reported demographic information (age, education, occupation, income, and weight status), their physical activity and sedentary behavior habits, the control on their child's sedentary behavior, and perception of physical environment in the neighborhood. The questionnaires were administrated in a group of 160 primary schoolchildren aged 10 to 14 years and their parents on two occasions with 8 to 10 days apart. The test-retest reliability of each individual item was determined using percent agreement and kappa statistics for the categorical variables and intraclass correlation coefficients (ICCs) for the continuous variables. The overall missing rates were 2.5% to 5.6% for children- and parent-reported items. The ICC values for continuous variables in children-reported individual and familial factors ranged from 0.66 to 0.79. For self-reported categorical variables, kappa values ranged from 0.27 to 0.76, and an percent agreement statistics were greater than 80%. Meanwhile, reliability statistics for parent-reported home and environment variables showed acceptable consistency with most of the ICC values greater than 0.70. / The third study (Chapter 5) aimed to investigate the physical activity and sedentary behavior patterns among a sample of 1013 primary 4-6 schoolchildren using the CLASS-C questionnaire. The individual, social and physical environmental correlates of the activity behaviors were investigated through a sub-sample of 303 children, whose habitual activity was objectively assessed by ActiGraph accelerometer, in addition to subjective measures by the CLASS-C questionnaire. The multiple correlates of activity behavior for the children in the sub-sample group were assessed using the environmental correlates questionnaire which was developed in Study II. Cluster analyses were used to group children with similar activity patterns. Hierarchical regression analyses were performed to assess the associations of the multiple variables with activity behaviors. Approximately half of the children did not reach the recommended physical activity level and one fifth of them engaged in excessive TV viewing of 2 hr every day. Cluster analysis identifies 5 clusters of children who shared similar patterns of physical activity and sedentary behaviors. Hierarchical regression analyses showed that participation in school sports team and having higher self-efficacy was positively associated with self-reports in MVPA in boys after controlling age, body mass index (BMI), and parental education. Girls who reported participation in school sports team and perceived the availability of more sports facilities at home self-reported more time spent in MVPA after controlling socio-demographic variables. Perception of parental support on physical activity was positively correlated with accelerometer-assessed MVPA among girls, while it was inversely associated with sedentary behaviors in boys. Residence density was positively associated with boys' sedentary behaviors, while girls whose parents reported more safety concerns on neighborhood environment were more likely to be sedentary. (Abstract shortened by UMI.) / Huang, Ya Jun. / Adviser: Stephen H. S. Wong. / Source: Dissertation Abstracts International, Volume: 70-06, Section: A, page: 1972. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 149-175). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2016-03-16T14:55:22Z No. of bitstreams: 1 PDF - Ivelise Fhrideraid Alves Furtado da Costa.pdf: 915520 bytes, checksum: ed4df9679f8b40eaccee586af421895a (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2016-07-22T13:12:07Z (GMT) No. of bitstreams: 1 PDF - Ivelise Fhrideraid Alves Furtado da Costa.pdf: 915520 bytes, checksum: ed4df9679f8b40eaccee586af421895a (MD5) / Made available in DSpace on 2016-07-22T13:12:20Z (GMT). No. of bitstreams: 1 PDF - Ivelise Fhrideraid Alves Furtado da Costa.pdf: 915520 bytes, checksum: ed4df9679f8b40eaccee586af421895a (MD5) Previous issue date: 2015-07-23 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / AIM: To evaluate the prevalence of inactivity/lack of physical activity and sedentary behavior among adolescent students and their association with cardiovascular risk scoring Pathobiological Determinants of Atherosclerosis in Youth. METHODS: Cross-sectional study developed in the public schools of the city of Campina Grande, Paraiba, Brazil, with 576 adolescents aged 15 to 19 years. Socioeconomic variables were studied (maternal education and economic class), demographic (age, sex and race), lifestyle (physical activity, sedentary behavior and smoking), clinical (nutritional status, abdominal adiposity and blood pressure) and biochemical (cholesterol HDL and non-HDL cholesterol, fasting glucose and glycosylated hemoglobin A1c). For data collection was used validated form; anthropometric and blood collection procedures. The study was approved by the ethics committee. The results were analyzed with SPSS 22.0. Descriptive measures were used, the Pearson chi-square test for the bivariate analysis and logistic regression binomial to test the association between and cardiovascular risk predictor. 95% confidence interval was adopted. RESULTS: The mean age was 16.8 years, most were female (66.8%), not white (78.7%), belonging to classes C, D and E (69.1%). As for the sedentary and physical activity failure, the prevalences were 78.1% and 60.2%, respectively. According to the PDAY score, 10.4% of adolescents had high cardiovascular risk, 31.8% and 57.8% intermediate risk, low. There was PDAY association with sex and abdominal adiposity. CONCLUSION: It was proved the positive association between abdominal fat and males as important cardiovascular risk factors in adolescents. Considering the presence of a modifiable risk factor, preventive measures aimed at lifestyle are essential. / OBJETIVO: Avaliar a prevalência de inatividade física e do comportamento sedentário em escolares adolescentes, bem como sua associação com o risco cardiovascular mensurado pelo escore Pathobiological Determinants of Atherosclerosis in Youth (PDAY). MÉTODOS: Estudo transversal desenvolvido nas escolas públicas estaduais do município de Campina Grande, Paraíba, Brasil, com 576 adolescentes de 15 a 19 anos. Para a coleta dos dados foi utilizado formulário validado; procedimentos antropométricos e coleta sanguínea. Foram estudadas variáveis socioeconômicas (escolaridade materna e classe econômica), demográficas (idade, sexo e cor), de estilo de vida (prática de atividade física, comportamento sedentário e tabagismo), clínicas (estado nutricional, adiposidade abdominal e pressão arterial) e bioquímicas (colesterol HDL e não HDL, glicemia de jejum e hemoglobina glicosilada A1c). O estudo foi aprovado pelo comitê de ética. Os resultados foram analisados no SPSS, 22.0. Foram utilizadas medidas descritivas, o teste do qui quadrado de Pearson para a análise bivariada e a regressão logística binomial para testar a associação entre variáveis previsoras e o risco cardiovascular. Adotou-se intervalo de confiança de 95%. RESULTADOS: A idade média foi de 16,8 anos, a maioria era do sexo feminino (66,8%), não branco (78,7%), pertencentes às classes C, D e E (69,1%). Quanto ao sedentarismo e insuficiência de atividade física, as prevalências foram de 78,1% e 60,2%, respectivamente. De acordo com o escore PDAY, 10,4% dos adolescentes apresentaram alto risco cardiovascular; 31,8% risco intermediário e 57,8%, baixo. Verificou-se associação do PDAY com o sexo e com a adiposidade abdominal. CONCLUSÃO: Ficou comprovada a associação positiva entre a adiposidade abdominal e o sexo masculino como importantes fatores de risco cardiovascular em adolescentes. Considerando-se a presença de um fator de risco modificável, medidas preventivas voltadas ao estilo de vida são essenciais.

Syfte. Syftet med studien var att med accelerometri kartlägga det fysiska aktivitetsmönstret hos äldre vid två separata förtest och i slutet av en tvåmånadersperiod med ledarledd träning två gånger per vecka. En vidare målsättning var att studera överensstämmelsen mellan enkätfrågorna om fysisk aktivitet och stillasittande gentemot uppmätt accelerometer­data. Metod. En grupp 65-91 år (medel 71 år, BMI 25 kg/m2) studerades. Två förtest (F1 & F2) samt ett efter­test (E) utfördes under sista träningsveckan. Totalt ingick 97 individer vid F1 & F2 samt 78 vid E som jämfördes mot resultat vid F2. Resultat. Vid F1 sågs vid accelerometri för minst måttlig fysisk ak­tivitet medelvärdet 42,7 min/d (MVPA/d), men endast 22, 2 min/d för tid i perioder à minst 10 min (Freedson bouts/d). Vid analys av separata dagar kom bara 15% av deltagar­na upp till rekommenderade 5 dgr/v à minst 30 min av sammanhängande 10-min-perioder fysisk aktivitet (med lägst måttlig intensitet). Median för högintensiv aktivitet (VPA) var mycket låg för denna grupp (0,9 min/d). Medel för stillasittande var 10,2 timmar (SED/d) samt 4,3 timmar total tid i minst 20-min-perioder (Sedentary bouts/d). Mellan F1 & F2 sågs ingen signifikant förändring för MVPA/d eller Freedson bouts/d. Däremot fram­kom en ytterst liten sänkning som var signifikant för stillasittande tid (20,0  resp. 13,7 min/d i SED/d resp. Sed bouts/d). Förändring av VPA visade en minimal ökning med 0,4 min/d (sign.). Korrelationen mellan F1 & F2 var 0,86 för MVPA/d, 0,81 för Freedson/d, 0,59 för Vig/d, 0,59 för SED/d samt 0,74 för Sed bouts/d, alla signifikanta. Vid E sågs, gentemot F2, en liten men signifikant ökning av medel för MVPA/d (till 50,6 min/d), men inte för Freedson bouts (20,9 min/d) eller för målet minst 5 dgr/v med 30 min i Freedson bouts/d (12%). Stillasittande sjönk signifikant för E till 9,7 tim/d (SED/d) samt 3,6 tim/d (Sed. bouts/d). VPA ökade minimalt med 0,5 min/d (sign.) till medianvärdet 1,7 min/d. De starkaste signifikanta (*) korrelationerna mellan olika frågor och accelerometri noterades för MVPA/d resp. Freedson bouts/d (som mest 0.53- 0,60*), följt av stillasittande 0,40* resp. 0,39* (i SED/d resp. Sed bouts/d). För VPA noterades inga eller ytterst låga samband, som högst r=0,24* mot frågorna. Slutsats. Värdena för högintensiv aktivitet vid accelerometri visade genomgående förvånansvärt låga nivåer. En orsak kan vara att datoranalysprogrammen för aktivitetsmätarna inte är tillräckligt känsliga såsom de idag är inställda för seniorers högsta intensitetsnivåer. Bäst signifikanta samband gentemot accelerometri sågs för frågor om minst måttligt intensiv fysisk aktivitet. Visst signifikant samband sågs även för en fråga om stillasittande, medan aktivitetsmätarens data stämde vanligtvis inte överens med självskattad data för högintensiv fysisk aktivitet för äldre. Så dessa seniordata är inte helt lika jämfört med tidigare studier på yngre vuxna som vanligtvis visat en högre validitet för frågor med högintensiv jämfört med måttligt intensiv fysisk aktivitet. / Aim. The purpose of the study was to identify that with accelerometry the physical activity patterns of elderly, at two separate pre-test and at the end of a two-month period with instructor-led training twice per week. A further aim was to study the correlation between survey questions about physical activity and sedentary against measured accelerometer data. Method. A group of 65-91 years (mean 71 years, BMI 25 kg/m2) were studied. Two pre-test (F1 & F2) and an aftertest (E) was performed during the last training week. A total of 97 individuals at F1 & F2 and 78 at E compared to F2 were investigated. Results. In F1 was seen for accelerometer data (at least moderate physical activity) mean values 42.7 min/d (MVPA/d), but only 22,2 min/d in time periods of at least 10 minutes (Freedson bouts /d). In the analysis of separate days came only 15% of participants came up to the recom­men­ded 5 days/week with at least 30 minutes of continuous 10-min periods of physical activity (with at least moderate intensity). Vigorous intensity activity (VPA) was very low for this group (0.9 min/d). The average for sedentary time was 10.2 hours (SED/d) and 4.3 hours total time in 20-min periods (Sedentary bouts/d). Between F1 and F2 no significant changes were seen for MVPA/d or Freed­son bouts/d. A tiny reduction, which was significant, was seen for sedentary time (20.0 resp. 13.7 min/d SED/d, resp. Sed bouts/d). Change of VPA showed a minimal increase of 0.4 min/d (s.). The correlation between F1 & F2 was 0.86 for MVPA/d, 0.81 for Freedson/d, 0.59 for Vig/d, 0.59 SED/d and 0.74 for Sed bouts/d, all significant. At E emerged, against F2, a small but significant increase for MVPA/d (to 50.6 min/d), but not for Freedson bouts/d (20.9 min/d) or to target at least 5 days/week with 30 min in Freedson bouts/d (12%). Sedentary fell significantly for E to 9.7 h/d (SED/d) and 3.6 h/d (Sed. bouts/d). VPA increased minimally by 0.5 min/d (s.) to median 1.7 min/d. The strongest significant (*) correlations between different questions and the accelerome­ters was noted for MVPA/d, resp. Freedson bouts/d (at most 0.53-0.60 *), followed by sedentary time 0.40 * resp. 0.39 * (in SED/d resp. Sed bouts/d). VPA showed no or very low correlation (highest r = 0.24 *) to the questions. Conclusion. The values ​​of vigorous activities in accelerometer data consistently showed surprisingly low levels. One reason may be that the computer analysis programs for the activity counters are not sufficiently sensitive as they currently are set for senior´s highest intensity levels. Best significant correlation against the accelerometers was seen for questions about at least moderately intense physical activity. Some significant correlation was also seen for sedentary time, while accelerometer data was generally not consistent with self-reported data for high-intensity physical activity for older people. So these senior data show somewhat different results as compared to previous studies in younger adults who usually present a higher validity of the questions with high-intensity compared with moderate-intensity physical activity.

The overall aim of this thesis was to assess measurement properties of methods suitable for screening or monitoring of physical capacity and physical activity in subjects with chronic obstructive pulmonary disease (COPD), and to explore factors associated with physical activity levels. Methods: Four observational studies were conducted. Participants in studies I-III (sample sizes) (n=49, n=15, n=73) were recruited from specialist clinics, and in study IV from a population-based cohort (COPD n=470 and Non-COPD n=659). Psychometric properties of methods assessing physical capacity (study I) and physical activity (study II) were investigated in laboratory settings. Daily physical activity and clinical characteristics were assessed with objective methods (study III) and with subjective methods (study IV). Results: Physical capacity as measured by walking speed during a 30-metre walk test displayed high test-retest correlations (ICC>0.87) and small measurement error. The accuracy for step count and body positions differed between activity monitors and direct observations. In study III 92% of subjects had an activity level below what is recommended in guidelines. Forty five percent of subjects’ activity could be accounted for by clinical characteristics with lung function (22.5%), walking speed (10.1%), quadriceps strength (7.0%) and fat-free mass index (3.0%) being significant predictors. In study IV, low physical activity was significantly more prevalent in COPD subjects from GOLD grade ≥II than among Non-COPD subjects (22.4 vs. 14.6%, p = 0.016). The strongest factors associated with low activity in COPD subjects were a history of heart disease, OR (CI 95%) 2.11 (1.10-4.08) and fatigue, OR 2.33 (1.31-4.13) while obesity was the only significant factor in Non-COPD subjects, OR 2.26 (1.17-4.35). Conclusion: The 30 meter walk test and activity monitors are useful when assessing physical capacity and physical activity, respectively in patients with COPD. Impaired physical activity in severe COPD is related to low lung function, low walking speed, low muscle strength and altered body composition, whereas comorbidities and fatigue are linked to insufficient physical activity in patients with moderately severe COPD.

Introduction: Insufficient physical activity (NIAF) and exposure to sedentary behavior (ECS) are risk behaviors that may adversely affect the health of adolescents. Objectives: To analyze the prevalence of NIAF and ECS and their associations to indicators of socioeconomic status in adolescent schoolchildren in the State of Sergipe in 2011 and 2016. Methods: The study deals with two epidemiological surveys with a cross-sectional design carried out in 2011 and 2016, with a representative sample of students from the State Public Network of Sergipe, comprising 8,143 students (2011 = 3,992, 2016 = 4,151), aged 14 to 19 years. We investigated NIAF and ECS associated with indicators of socioeconomic status. For the statistical analysis, descriptive and chi-square statistics were used. We used the raw and adjusted binary logistic regression. Results: In the first study, the prevalence of NIAF was 83.1% (2011) and 83.5% (2016) and was associated with the age group 14 to 15 years old (OR = 1.38; %: 1.05-1.82), female (2011 = OR: 2.20, 95% CI: 1.83-2.64 / 2016 = OR: 2.03, 95% CI: 1.69- 2.45), adolescents living in rural areas (2011 = OR: 1.23, 95% CI: 1.01-1.50 / 2016 = OR 1.28, 95% CI 1.05-1.57) and that they have illiterate mothers (2011 = OR: 1.97 / 95% CI: 1.27-3.06 / 2016 = OR 1.89; 95% CI: 1.27-2.87). In the second study, the prevalence of SCS was 46.2% (2011) and 44.8% (2016) and was associated with the age group 14 to 15 years old (OR = 1.45, 95% CI: 1.19-1.78 / 2016 = OR: 1.58; 95% CI: 1.28-1.94); (95% CI: 1.27-1.68 / 2016 = OR: 1.22, 95% CI: 1.06-1.40), adolescents living in the urban area ( 95% CI: 1.27-1.72), with monthly family income above two wages (OR = 1.22; 95% CI: 1.05-1.42 / 2016 = OR: 1.48; 2011 = OR: 2.22, 95% CI: 1.83-2.68 / 2016 = OR 1.55, 95% CI: 1.22-1.96) and who have mothers with high school education (2011 = OR : 1.73, 95% CI: 1.32-2.28) and with higher education (2016 = OR: 1.57, 95% CI: 1.16-2.11). Conclusion: It was evidenced the increase in the prevalence of NIAF and a tendency to reduce the ECS, as well as associations to socioeconomic characteristics in adolescents from Sergipe-Brazil. It is suggested interventions in the spaces inside and outside the school to allow the reflection and construction of healthy lifestyles in adolescents. / Introdução: O nível insuficiente de atividade física (NIAF) e a exposição ao comportamento sedentário (ECS) são comportamentos de risco que podem prejudicar a saúde dos adolescentes. Objetivos: Analisar a prevalência do NIAF e ECS e suas associações a indicadores de condição socioeconômica em escolares adolescentes no Estado de Sergipe nos anos 2011 e 2016. Métodos: O estudo trata-se de dois levantamentos epidemiológicos com delineamento transversal, realizados em 2011 e 2016, com amostra representativa de estudantes da Rede Pública Estadual de Sergipe, composta por 8.143 escolares (2011=3.992; 2016=4.151), com idade entre 14 e 19 anos. Foram investigados o NIAF e a ECS associados com indicadores de condição socioeconômica. Para a análise estatística, foi utilizada estatística descritiva e o qui-quadrado. Recorreu-se à regressão logística binária bruta e ajustada. Resultados: No primeiro estudo, a prevalência do NIAF foi de 83,1% (2011) e 83,5% (2016) e associou-se a faixa etária de 14 a 15 anos (2011= OR:1,38; IC 95%: 1,05-1,82), sexo feminino (2011= OR: 2,20; IC 95%: 1,83-2,64 / 2016= OR: 2,03; IC 95%: 1,69-2,45), adolescentes residentes na área rural (2011= OR: 1,23; IC 95%:1,01-1,50 / 2016 = OR 1,28; IC 95%: 1,05-1,57) e que possuem mães analfabetas (2011= OR: 1,97/ IC 95%: 1,27-3,06 / 2016 = OR 1,89; IC 95%: 1,27-2,87). No segundo estudo, a prevalência de ECS foi de 46,2% (2011) e 44,8% (2016) e associou-se a faixa etária de 14 a 15 anos (2011= OR: 1,45; IC 95%: 1,19-1,78 / 2016 = OR: 1,58; IC 95%: 1,28-1,94); sexo feminino (2011= OR: 1,46; IC 95%: 1,27-1,68 / 2016 = OR: 1,22; IC 95%: 1,06-1,40), adolescentes residentes na área urbana (2011= OR: 1,22; IC 95%: 1,05-1,42 / 2016= OR: 1,48; IC 95%: 1,27-1,72), com renda familiar mensal acima de dois salários (2011= OR: 2,22; IC 95%: 1,83-2,68 / 2016= OR 1,55; IC 95%: 1,22-1,96) e que possuem mães com ensino médio (2011= OR: 1,73; IC 95%: 1,32-2,28) e com ensino superior (2016= OR: 1,57; IC 95%: 1,16-2,11). Conclusão: Foi evidenciado o aumento na prevalência do NIAF e uma tendência para redução da ECS, bem como associações a características socioeconômicas em adolescentes de Sergipe-Brasil. Sugere-se intervenções nos espaços dentro e fora da escola para oportunizar a reflexão e construção de estilos de vida saudáveis nos adolescentes. / São Cristóvão, SE

No description available.

Bakgrund: Kontorsarbetare är arbetare som tillbringar delar eller större delar av arbetstiden stillasittandes framför en dator. Stillasittandet har negativa effekter fysiskt, psykiskt och socialt. Dem här delarna innefattas även i begreppet ergonomi där man ska anpassa arbete och miljö efter människans förutsättningar. Fysioterapi och fysioterapeuter ser till människans förutsättningar för att underlätta hälsa och minska lidande. För att främja hälsa behöver man se ergonomi som fysiologiskt fenomen och beteende, vilket görs i beteendemedicinskt inriktad fysioterapi. Detta för att kunna påverka den fysiska, psykiska och sociala kontexten. Syfte: Syftet med studien är att studera kontorsarbetares upplevelser av hinder och möjligheter för god ergonomi i det dagliga arbetet.   Metod: En kvalitativ semistrukturerad intervjustudie med induktiv ansats och ett ändamålsenligt urval på sex informanter. Data analyserades genom manifest analys. Resultat: Informanterna upplevde att inredning, samspel arbetsgivare och individ, andras påverkan, beteende på arbetsplatsen, kroppsliga begränsningar, tankar och föreställningar, och emotioner påverkade ergonomin. Slutsats: Av resultatet framgick att ergonomin påverkas av biopsykosociala faktorer, vilket styrs av beteende, individ och omgivning. / Background: Office workers are workers who spend part or most of their time sitting in front of a computer. A sedentary behavior has negative effects physically, mentally and socially. These parts are also included in the concept of ergonomics, where work and the environment must be adapted to human conditions. Physiotherapy and physiotherapists look at the human conditions to facilitate health and reduce suffering. To promote health, you need to see ergonomics as a physiological phenomenon and a behavior. You do this in behavioral medicine – oriented physiotherapy, where you are able to influence the physical, mental and social context. Aim: The aim of the study was to study office workers’ experiences of obstacles and opportunities for good ergonomics in daily work. Method: A qualitative semi-structured interview study with an inductive approach and a purposive sampling with six informants. Data were analyzed by manifest analysis.  Results: The informants experienced that interior design, interaction between employer and individual, the influence of others, behavior in workplace, physical limitations, thoughts and ideas, and emotions affected ergonomics.  Conclusion: The results showed that ergonomics is affected by biopsychosocial factors, which are governed by behavior, individual and environment.

Introduktion: Långvarigt stillasittande och repetitivt arbete har visat på negativa kroppsliga effekter som till exempel muskuloskeletala besvär och ökad risk för hjärt-kärlsjukdomar. Som motvikt finns evidens för att variation under arbetsdagen i form av korta, aktiva pauser ger positiva effekter där så lite som två minuter styrketräning per dag räcker. Att implementera aktiva pauser är dock utmanande och flera faktorer spelar in både hos medarbetare och chefer.  Syfte: Syftet är att undersöka prevalensen av muskuloskeletal smärta före och efter implementering av aktiva styrkepauser, i form av fysisk aktivitet under arbetstid, på Klinik A. Studien ska även undersöka deltagandet och attityden till implementeringen av aktiva styrkepauser på klinik A, B och C.  Metod: Uppföljning av implementering av aktiva styrkepauser infördes på tre avdelningar på ett större sjukhus. Medarbetarna på avdelningarna fick en enkät, utformad av författarna, utskickad via mail som frågade om deltagande och attityd av implementeringen. En avdelning besvarade ytterligare en enkät om muskuloskeletal smärta. Denna enkät var en ett-årsuppföljning mellan oktober 2022 och oktober 2023.  Resultat: Resultatet från besvärsenkäten visade att muskuloskeletala besvär i nacke, axlar och övre rygg minskade efter ett år. Implementeringsenkäten visade att det var 30 av 32 som deltog i de aktiva styrkepauserna. Deltagarna hade en positiv attityd och upplevelse av implementeringen. Stöttning från chefer och starka individuella motivationsfaktorer, såsom tävlingsmoment, visade sig vara viktiga aspekter.   Konklusion: Den minskade muskuloskeletala smärtan stämmer överens med andra studier. Majoriteten av de som svarade på implementeringsenkäten deltog i de aktiva pauserna och hade en positiv attityd till de aktiva styrkepauserna. Mer forskning i olika arbetsmiljöer krävs dock för att säkerställa hur en lyckad implementering av aktiva styrkepauser ska genomföras.