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  • Can quantifying the relative intensity of a person’s free-living physical activity predict how they respond to a physical activity intervention? Findings from the PACES RCT

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Original research
Can quantifying the relative intensity of a person’s free-living physical activity predict how they respond to a physical activity intervention? Findings from the PACES RCT
  1. Alex V Rowlands1,2,3,
  2. Mark W Orme1,2,4,
  3. Ben Maylor1,2,3,
  4. Andrew Kingsnorth1,2,3,
  5. Louisa Herring2,
  6. Kamlesh Khunti3,5,6,
  7. Melanie Davies2,3,
  8. Tom Yates2,3
  1. 1 Assessment of Movement Behaviours (AMBer) Group, Diabetes Research Centre, University of Leicester, Leicester, UK
  2. 2 National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
  3. 3 Diabetes Research Centre, University of Leicester, Leicester, UK
  4. 4 Department of Respiratory Sciences, University of Leicester, Leicester, UK
  5. 5 Leicester Real World Evidence Unit, Dabetes Research Centre, University of Leicester, Leicester, UK
  6. 6 NIHR Applied Research Collaboration - East Midlands (ARC-EM), Leicester General Hospital, Leicester, UK
  1. Correspondence to Dr Alex V Rowlands, Assessment of Movement Behaviours (AMBer) Group, Diabetes Research Centre, University of Leicester, Leicester, UK; alex.rowlands{at}leicester.ac.uk

Abstract

Objectives To determine whether quantifying both the absolute and relative intensity of accelerometer-assessed physical activity (PA) can inform PA interventions. We hypothesised that individuals whose free-living PA is at a low relative intensity are more likely to increase PA in response to an intervention, as they have spare physical capacity.

Method We conducted a secondary data analysis of a 12-month randomised controlled trial, Physical Activity after Cardiac EventS, which was designed to increase PA but showed no improvement. Participants (N=239, 86% male; age 66.4 (9.7); control N=126, intervention N=113) wore accelerometers for 7 days and performed the incremental shuttle walk test (ISWT) at baseline and 12 months. PA intensity was expressed in absolute terms (intensity gradient) and relative to acceleration at maximal physical capacity (predicted from an individual’s maximal ISWT walking speed). PA outcomes were volume and absolute intensity gradient.

Results At baseline, ISWT performance was positively correlated with PA volume (r=0.50, p<0.001) and absolute intensity (r=0.50, p<0.001), but negatively correlated with relative intensity (r=−0.13, p=0.025). Relative intensity of PA at baseline moderated the change in absolute intensity (p=0.017), but not volume, of PA postintervention. Low relative intensity at baseline was associated with increased absolute intensity gradient (+0.5 SD), while high relative intensity at baseline was associated with decreased absolute intensity gradient (−0.5 SD).

Conclusion Those with low relative intensity of PA were more likely to increase their absolute PA intensity gradient in response to an intervention. Quantifying absolute and relative PA intensity of PA could improve enables personalisation of interventions.

  • Physical activity
  • Physical fitness
  • Methods

Data availability statement

Data are available on reasonable request. PACES data are available on reasonable request to researchers who provide a methodologically sound proposal, to achieve the aims outlined in their proposal. Proposals should be directed to melanie.davies@uhl-tr.nhs.uk. To gain access, data requestors will need to sign a data sharing agreement.

https://doi.org/10.1136/bjsports-2023-106953

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    Data availability statement

    Data are available on reasonable request. PACES data are available on reasonable request to researchers who provide a methodologically sound proposal, to achieve the aims outlined in their proposal. Proposals should be directed to melanie.davies@uhl-tr.nhs.uk. To gain access, data requestors will need to sign a data sharing agreement.

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    Footnotes

    • Twitter @Maylor_Science

    • Contributors Conception/design: AVR and MWO; Data analysis/interpretation: AVR, MWO, BM, AK and TY; Data acquisition: MD, TY, KK and LH; Drafting/revision critically for important content: all authors. Final approval: all authors. AVR acts as guarantor and takes responsibility for the integrity of the data and the accuracy of the data analysis

    • Funding PACES was funded by the NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands (CLAHRC EM), now recommissioned as NIHR Applied Research Collaboration East Midlands (ARC EM). Authors are supported by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre and ARC EM.

    • Disclaimer The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.