Background—: Cardiac mortality and electrophysiological dysfunction both increase with age. Heart rate variability (HRV) provides indices of autonomic function and electrophysiology that are associated with cardiac risk. How habitual physical activity among older adults prospectively relates to HRV, including nonlinear indices of erratic sinus patterns, is not established. We hypothesized that increasing the levels of both total leisure-time activity and walking would be prospectively associated with more favorable time-domain, frequency-domain, and nonlinear HRV measures in older adults. Methods and Results—: We evaluated serial longitudinal measures of both physical activity and 24-hour Holter HRV over 5 years among 985 older US adults in the community-based Cardiovascular Health Study. After multivariable adjustment, greater total leisure-time activity, walking distance, and walking pace were each prospectively associated with specific, more favorable HRV indices, including higher 24-hour standard deviation of all normal-to-normal intervals ( P _trend =0.009, 0.02, 0.06, respectively) and ultralow-frequency power ( P _trend =0.02, 0.008, 0.16, respectively). Greater walking pace was also associated with a higher short-term fractal scaling exponent ( P _trend =0.003) and lower Poincaré ratio ( P _trend =0.02), markers of less erratic sinus patterns. Conclusions—: Greater total leisure-time activity, and walking alone, as well, were prospectively associated with more favorable and specific indices of autonomic function in older adults, including several suggestive of more normal circadian fluctuations and less erratic sinoatrial firing. Our results suggest potential mechanisms that might contribute to lower cardiovascular mortality with habitual physical activity later in life.

Purpose: Survivors of Hodgkin lymphoma (HL) are at increased risk of treatment-related cardiovascular (CV) events; whether exercise modifies this risk is unknown. Methods: Survivors of HL (n = 1,187; median age, 31.2 years) completed a questionnaire evaluating vigorous-intensity exercise behavior. CV events were collected in follow-up questionnaires and graded according to Common Terminology Criteria for Adverse Events (version 4.03). The primary end point was incidence of any major (grade 3 to 5) CV event. Poisson regression analyses were used to estimate the association between exercise exposure (metabolic equivalent [MET] hours/week⁻¹) and risk of major CV events after adjustment for clinical covariates and cancer treatment. Results: Median follow-up was 11.9 years (range, 1.7 to 14.3 years). Cumulative incidence of any CV event was 12.2% at 10 years for survivors reporting 0 MET hours/week⁻¹ compared with 5.2% for those reporting ≥ 9 MET hours/week⁻¹. In multivariable analyses, the incidence of any CV event decreased across increasing MET categories (P_trend = .002). Compared with survivors reporting 0 MET hours/week⁻¹, the adjusted rate ratio for any CV event was 0.87 (95% CI, 0.56 to 1.34) for 3 to 6 MET hours/week⁻¹, 0.45 (95% CI, 0.26 to 0.80) for 9 to 12 MET hours/week⁻¹, and 0.47 (95% CI, 0.23 to 0.95) for 15 to 21 MET hours/week⁻¹. Adherence to national vigorous intensity exercise guidelines (ie, ≥ 9 MET hours/week⁻¹) was associated with a 51% reduction in the risk of any CV event in comparison with not meeting the guidelines (P = .002). Conclusion: Vigorous exercise was associated with a lower risk of CV events in a dose-dependent manner independent of CV risk profile and treatment in survivors of HL.

Background—: Although guidelines suggest that older adults engage in regular physical activity (PA) to reduce cardiovascular disease (CVD), surprisingly few studies have evaluated this relationship, especially in those >75 years. In addition, with advancing age the ability to perform some types of PA might decrease, making light-moderate exercise such as walking especially important to meet recommendations. Methods and Results—: Prospective cohort analysis among 4207 US men and women of a mean age of 73 years (standard deviation=6) who were free of CVD at baseline in the Cardiovascular Health Study were followed from 1989 to 1999. PA was assessed and cumulatively updated over time to minimize misclassification and assess the long-term effects of habitual activity. Walking (pace, blocks, combined walking score) was updated annually from baseline through 1999. Leisure-time activity and exercise intensity were updated at baseline, 1992, and 1996. Incident CVD (fatal or nonfatal myocardial infarction, coronary death, or stroke) was adjudicated using medical records. During 41 995 person-years of follow-up, 1182 CVD events occurred. After multivariable adjustment, greater PA was inversely associated with coronary heart disease, stroke (especially ischemic stroke), and total CVD, even in those ≥75 years. Walking pace, distance, and overall walking score, leisure-time activity, and exercise intensity were each associated with lower risk. For example, in comparison with a walking pace 3 mph had a lower risk of coronary heart disease (0.50; confidence interval, 0.38–0.67), stroke (0.47; confidence interval, 033–0.66), and CVD (0.50; confidence interval, 0.40–0.62). Conclusions—: These data provide empirical evidence supporting PA recommendations, in particular, walking, to reduce the incidence of CVD among older adults.

The purpose of this study was twofold: first to document the gender differences in Moderate to Vigorous Physical Activity (MVPA) according to two epoch systems (5 vs. 60 s) in preschoolers, and, second to document the differences in physical activity (PA) patterns according to two different epoch choices. The sample comprised 59 preschoolers (31 girls) aged 2–5 years old. PA was assessed by accelerometer during school hours. The time spent in MVPA was significantly higher (p < .001) when a 5-s epoch was considered compared to the 60-s epoch, regardless gender. Further, it was found a difference of ?17 min difference between the 2 epoch systems for MVPA. Different epoch times might affect the time spent in MVPA among preschool children.

The randomized controlled trial “Physical Activity in Pediatric Cancer” determined the effects of an inhospital exercise intervention combining aerobic and muscle strength training on pediatric cancer patients with solid tumors undergoing neoadjuvant chemotherapy. Participants were allocated to an exercise (n = 24, 17 boys; mean ± SEM age, 10 ± 1 yr) or control group (n = 25, 18 boys; 11 ± 1 yr). Training included three sessions per week for 19 ± 2 wk. Participants were assessed at treatment initiation, termination, and 2 months after end treatment. The primary endpoint was muscle strength (as assessed by upper and lower-body five-repetition-maximum tests). Secondary endpoints included cardiorespiratory fitness, functional capacity during daily life activities, physical activity, body mass and body mass index, and quality of life. Most sessions were performed in the hospital’s gymnasium. Adherence to the program averaged 68% ± 4% and no major adverse events or health issues were noted. A significant interaction (group–time) effect was found for all five-repetition maximum tests (leg/bench press and lateral row; all P < 0.001). Performance significantly increased after training (leg press: 40% [95% confidence interval [CI], 15–41 kg); bench press: 24% [95% CI, 6–14 kg]; lateral row 25% [95% CI, 6–15 kg]), whereas an opposite trend was found in controls. Two-month post values tended to be higher than baseline for leg (P = 0.017) and bench press (P = 0.014). In contrast, no significant interaction effect was found for any of the secondary endpoints. An inhospital exercise program for pediatric cancer patients with solid tumors undergoing neoadjuvant treatment increases muscle strength despite the aggressiveness of such therapy.

The aims of this study were (1) to document differences in physical activity (both total and moderate-to-vigorous physical activity) between the sexes on weekdays and weekend days in preschoolers, and (2) to assess compliance with recommendations for total physical activity (National Association for Sport and Physical Education guidelines) and moderate-to-vigorous physical activity on weekdays and weekend days in the same children. The sample comprised 245 preschoolers (105 girls, 140 boys) aged 3.5–6.0 years old. Physical activity was assessed using an Actigraph accelerometer. Data were analysed with specific software and activity was measured as counts per minute. An independent t-test and general linear model with repeated-measures were used to assess differences between the sexes and differences between days (weekdays and weekend days) within each sex, respectively. A chi-square test was used to determine differences between the sexes in the proportion of children complying with physical activity guidelines. In both sexes, sedentary behaviour accounted for the majority of the time on weekdays and weekend days (weekdays: 83%; weekend days: 83.9%). Boys engaged in significantly more (P < 0.05) total physical activity and moderate-to-vigorous physical activity than girls (weekdays: boys 155.4 min vs. girls 128.22 min; weekend days: boys 111.2 min vs. girls 90.5 min). On average, preschool children engaged in significantly more (P < 0.05) total physical activity and moderate-to-vigorous physical activity on weekdays than weekend days. Altogether, 74.3% and 93.5% of the children met the National Association for Sport and Physical Education guidelines and moderate-to-vigorous physical activity recommendations respectively on weekdays, whereas compliance with both recommendations was substantially less in both sexes on weekend days. The results of this study suggest that despite 83% of time during the day being spent in sedentary behaviour, most preschool children met the daily physical activity and moderate-to-vigorous physical activity recommendations on weekdays. Future research should consider the two constructs of physical activity and sedentary behaviour independently, as they might not necessarily counteract each other.