Research on physical activity and health is actively being conducted. In the Korea National Health and Nutrition Examination Survey (KNHANES), the Global Physical Activity Questionnaire (GPAQ) was newly introduced in 2014. The purpose of this study was to investigate the levels of physical activity and related factors in Koreans who were assessed through the GPAQ by dividing the physical activity by occupation, leisure, and transport domain. This study used data from the KNHANES (2014–2016), the study population of which included 17,357 participants aged 12 to 80 years. We compared the differences in physical activity by sociodemographic factors, health-related factors, and psychological health-related factors. Moreover, we also compared the mean metabolic equivalent of task and daily sitting time according to physical activity domain by sex and age group. Finally, we investigated the sociodemographic factors, health-related factors, and psychological health-related factors that significantly affect the average physical activity per week. The various factors were found to differ in the frequency of physical activity levels. In addition, there was a difference in the amount of physical activity per occupation, leisure, and transport domain in each age group. Finally, age, sex, high-density lipoprotein cholesterol levels, arthritis, allergic rhinitis and sinusitis, sleeping time, and perceived health status significantly affected physical activity. The levels of physical activity significantly differed by sociodemographic factors, health-related factors, and psychological health-related factors. There was also a difference in the physical activity levels according to the age and sex per each domain of physical activity.
Arthritis ; Cholesterol ; Humans ; Korea ; Leisure Activities ; Lipoproteins ; Metabolic Equivalent ; Motor Activity ; Nutrition Surveys ; Occupations ; Physical Fitness ; Public Health ; Rhinitis, Allergic ; Risk Factors ; Sinusitis ; Social Determinants of Health ; Surveys and Questionnaires

PURPOSE: Metabolic syndrome (MetS) is a major public health problem related to increased risks of cardiovascular disease and type 2 diabetes. We investigated whether recommended levels of leisure time physical activity (LTPA) decrease the risk of MetS in a community-based prospective cohort study (Ansung and Ansan cohort).MATERIALS AND METHODS: A total of 3910 adults (1890 men, 2020 women) without MetS examined in 2001–2002 (baseline) were included in this study and followed up from 2013 to 2014. We measured LTPA energy expenditure using the standard metabolic equivalent value [metabolic equivalent of task (MET)-h/wk]. Individuals were categorized into five groups (physically inactive, 0.1 to <7.5, 7.5 to <15.0, 15.0 to <22.5, 22.5 to <40.0, and ≥40.0 MET-h/wk).RESULTS: The mean follow-up period was 11.8 years. Among the cohort, 482 men (25.5%) and 541 women (26.8%) were diagnosed with newly developed MetS. Multivariate logistic analysis revealed a 4.4% lower MetS risk among those performing two to three times the recommended minimum of 7.5 MET-h/wk [multivariate relative risk (RR), 0.956; 95% confidence interval (CI), 0.654–1.398] and a 21.9% lower risk among those performing three to four times the physical activity minimum (multivariate RR, 0.781; 95% CI, 0.574–1.063). This association was only significant in females performing three to four times the minimum (crude RR, 0.655; 95% CI, 0.432–0.994).CONCLUSION: We noted that physical activity at more than 2 times the recommended minimum prevents MetS. Healthcare professionals should encourage inactive adults to be physically active during their leisure time to take advantage of its health benefits.
Adult ; Cardiovascular Diseases ; Cohort Studies ; Delivery of Health Care ; Energy Metabolism ; Female ; Follow-Up Studies ; Gyeonggi-do ; Humans ; Insurance Benefits ; Korea ; Leisure Activities ; Male ; Metabolic Equivalent ; Motor Activity ; Prospective Studies ; Public Health

OBJECTIVE: The circadian pattern of the onset time of aneurysmal subarachnoid hemorrhage (aSAH) has been reported by various authors. However, the effect of the degree of physical exertion on the circadian pattern has not been studied in detail. Therefore, we conducted this study to investigate the effect of physical exertion on the circadian pattern of aSAH.METHODS: Of the 335 patients presenting with aSAH from January 2012 to December 2017, 234 patients with identifiable onset time and metabolic equivalent (MET) values were enrolled. The onset time of aSAH was divided into 4-hour intervals. The patient’s physical exertion was then assessed on a scale between 1 and 8 METs using generally accepted MET values, and categorized into two groups—light exertion (1 to 4 METs) and moderate to heavy exertion (5 to 8 METs)—to determine the effect of the degree of physical exertion on the onset time distribution of aSAH. Multivariate analysis was used to calculate the odds ratio (OR) between the two groups to determine the effect of the degree of physical exertion on each set of time periods.RESULTS: There was a definite bimodal onset pattern that peaked at 08:00–12:00 hours followed by 16:00–20:00 hours (p <0.001). MET values at all time intervals were found to be significantly higher than the night time (00:00–04:00 hours) values (p<0.031). The MET value distribution showed a unimodal pattern that slightly differed from the bimodal distribution of the onset time of aSAH. There were no significant differences in the ORs of each time interval according to the degree of the MET value.CONCLUSION: This study reaffirmed that aSAH occurs in a bimodal pattern, especially showing the highest prevalence in the morning. Although aSAH could be related to daily activity, there were no significant changes in diurnal variations affected by the degree of physical exertion.
Aneurysm ; Epidemiology ; Humans ; Metabolic Equivalent ; Motor Activity ; Multivariate Analysis ; Odds Ratio ; Physical Exertion ; Prevalence ; Risk Factors ; Subarachnoid Hemorrhage

PURPOSE: Clinical use of cardiopulmonary exercise tests (CPETs) is increasing in elderly patients with cardiovascular (CV) diseases. However, data on Korean populations are limited. In this study, we aimed to examine the characteristics and safety of CPET in an elderly Korean population with CV disease. MATERIALS AND METHODS: We retrospectively analyzed records of 1485 patients (older than 65 years in age, with various underlying CV diseases) who underwent CPET. All CPET was performed using the modified Bruce ramp protocol. RESULTS: The mean age of patients was 71.6±4.7 years with 63.9% being men, 567 patients aged 60–65 years, 818 patients aged 70–79 years, and 100 patients aged 80–89 years. The mean respiratory exchange ratio was 1.09±0.14. During CPET, three adverse cardiovascular events occurred (total 0.20%), all ventricular tachycardia. All subjects showed an average exercise capacity of 21.3±5.5 mL/kg/min at peak VO2 and 6.1±1.6 metabolic equivalents of task, and men showed better exercise capacity than women on most CEPT parameters. A significant difference was seen in peak oxygen uptake according to age group (65–69 years, 22.9±5.8; 70–79 years, 20.7±5.1; 80–89 years, 17.0±4.5 mL/kg/min, p<0.001). The most common causes for CPET termination were dyspnea (64.8%) and leg pain (24.3%), with higher incidence of leg pain in octogenarians compared to other age groups (65–69 years, 22.4%; 70–79 years, 24.6%; 80–89 years, 32.0%, p<0.001). CONCLUSION: CPET was relatively a safe and useful modality to assess exercise capacity, even in an elderly Korean population with underlying CV diseases.
Aged ; Aged, 80 and over ; Architectural Accessibility ; Cardiovascular Diseases ; Dyspnea ; Exercise Test ; Female ; Humans ; Incidence ; Korea ; Leg ; Male ; Metabolic Equivalent ; Oxygen ; Retrospective Studies ; Tachycardia, Ventricular

OBJECTIVE: To compare a center-based cardiac rehabilitation (CR) program with a home-based CR program in terms of improving obesity related index and cardiopulmonary exercise capacity after the completing a phase II CR program. METHODS: In this study, there were seventy-four patients with acute myocardial infarction after percutaneous coronary intervention who were analyzed. Patients with mild to moderate risk (ejection fraction >40%) were included in the group. The patients underwent an exercise tolerance test by measurement of the modified Bruce protocol at three assessment points. Those in the center-based CR group participated in a 4-week training program with electrocardiography monitoring of the patient’s progress and results, while those patients who were in the home-based CR group underwent self-exercise training. We measured the obesity related indices such as body mass index, fat free mass index (FFMI), and cardiopulmonary exercise capacity including peak oxygen consumption (VO(2max)), metabolic equivalents (METs), heart rate, resting systolic blood pressure and the diastolic blood pressure of the participants and noted the results. RESULTS: Of the 74 patients, 25 and 49 participated in the center-based and home-based CR programs, respectively. Both groups showed significant improvement in VO(2max) and METs at 1-month and 6-month follow-up. However, FFMI was significantly improved only in the center-based CR group after 1 month of the phase II CR. CONCLUSION: Both groups identified in the study showed significant improvement of VO(2max) and METs at 1-month and 6-month follow-up. However, there was no significant difference in the intergroup analysis. A significant improvement of FFMI was seen only in the center-based CR group after phase II CR.
Blood Pressure ; Body Mass Index ; Education ; Electrocardiography ; Exercise Tolerance ; Follow-Up Studies ; Heart Rate ; Home Care Services ; Humans ; Metabolic Equivalent ; Myocardial Infarction ; Obesity ; Oxygen Consumption ; Percutaneous Coronary Intervention ; Rehabilitation

OBJECTIVES: Previous studies have shown relatively low correlations between self-reported and accelerometer-assessed physical activity (PA). However, this association differs by socio-demographic factors, and this relationship has not been fully investigated in the general population. Thus, we investigated the correlation between self-reported and accelerometer-assessed PA and whether it differed by demographic and socioeconomic factors among the Korean general population. METHODS: This cross-sectional study included 623 participants (203 men and 420 women) aged 30 to 64 years, who completed a PA questionnaire and wore a wrist-worn accelerometer on the non-dominant wrist for 7 days. We examined the agreement for metabolic equivalent task minutes per week (MET-min/wk) between the 2 measures and calculated Spearman correlation coefficients according to demographic and socioeconomic factors. RESULTS: The kappa coefficient between tertiles of self-reported and accelerometer-assessed total MET-min/wk was 0.16 in the total population, suggesting overall poor agreement. The correlation coefficient between the 2 measurements was 0.26 (p < 0.001) in the total population, and the correlation tended to decrease with increasing age (p for trend < 0.001) and depression scores (p for trend < 0.001). CONCLUSION: We found a low correlation between self-reported and accelerometer-assessed PA among healthy Korean adults, and the correlation decreased with age and depression score. When studying PA using accelerometers and/or questionnaires, age and depression need to be considered, as should differences between self-reported and accelerometer-assessed PA.
Adult* ; Cross-Sectional Studies ; Depression ; Humans ; Korea ; Male ; Metabolic Equivalent ; Motor Activity* ; Socioeconomic Factors ; Wrist

OBJECTIVES: Previous studies have shown relatively low correlations between self-reported and accelerometer-assessed physical activity (PA). However, this association differs by socio-demographic factors, and this relationship has not been fully investigated in the general population. Thus, we investigated the correlation between self-reported and accelerometer-assessed PA and whether it differed by demographic and socioeconomic factors among the Korean general population.METHODS: This cross-sectional study included 623 participants (203 men and 420 women) aged 30 to 64 years, who completed a PA questionnaire and wore a wrist-worn accelerometer on the non-dominant wrist for 7 days. We examined the agreement for metabolic equivalent task minutes per week (MET-min/wk) between the 2 measures and calculated Spearman correlation coefficients according to demographic and socioeconomic factors.RESULTS: The kappa coefficient between tertiles of self-reported and accelerometer-assessed total MET-min/wk was 0.16 in the total population, suggesting overall poor agreement. The correlation coefficient between the 2 measurements was 0.26 (p < 0.001) in the total population, and the correlation tended to decrease with increasing age (p for trend < 0.001) and depression scores (p for trend < 0.001).CONCLUSION: We found a low correlation between self-reported and accelerometer-assessed PA among healthy Korean adults, and the correlation decreased with age and depression score. When studying PA using accelerometers and/or questionnaires, age and depression need to be considered, as should differences between self-reported and accelerometer-assessed PA.
Adult ; Cross-Sectional Studies ; Depression ; Humans ; Korea ; Male ; Metabolic Equivalent ; Motor Activity ; Socioeconomic Factors ; Wrist

OBJECTIVE: To evaluate the effect of high-intensity interval training (HIIT) on psychological symptoms, activity states, and cardiovascular functions in patients with myocardial infarction (MI) of low and moderate risk stratification. METHODS: This prospective study randomly allocated 44 patients with MI to 18 sessions of HIIT or conventional moderate-intensity continuous training (MICT). Outcome measures were assessed at baseline and after 18 sessions. RESULTS: Post-exercise cardiovascular and functional states, maximal oxygen uptake (VO2max), metabolic equivalents (METs), 6-Minute Walking Test (6MWT), and Korean Activity Scale/Index (KASI) scores were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. In particular, VO2max was significantly (p < 0.005) improved in the HIIT group (7.58 mL/kg/min) compared to that in the MICT group (2.42 mL/kg/min). In addition, post-exercise psychological states (i.e., scores of Fatigue Severity Scale [FSS] and depression items of the Hospital Anxiety and Depression Scale [HADS_D]) were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. HADS-D was improved by 1.89 in the HIIT group compared to decrement of 0.47 in the MICT group. FSS was improved by 6.38 in the HIIT group compared to decrement of 0.77 in the MICT group (p < 0.005). CONCLUSION: This study demonstrates that HIIT can improve cardiac function, psychological, and activity states in low and moderate risk MI patients. Compared to conventional MICT, HIIT can improve cardiovascular functions, activity states, depression, and fatigue more effectively.
Anxiety ; Depression ; Fatigue ; Humans ; Metabolic Equivalent ; Myocardial Infarction ; Outcome Assessment (Health Care) ; Oxygen ; Prospective Studies ; Walking

OBJECTIVE: To evaluate the effect of hospital-based cardiac rehabilitation (CR) on quality of life (QOL) and physical ability in patients with myocardial infarction (MI). METHODS: Patients with MI who were referred to the Cardiac Health and Rehabilitation Center 2 weeks after percutaneous coronary intervention were divided into CR and non-CR groups. The CR group performed supervised exercises 3 times a week for 2 months. QOL assessment, using the 36-item Short-Form Health Survey (SF-36) and physical ability evaluation were performed at the beginning and end of CR. RESULTS: The CR group demonstrated statistically significant improvements in physical functioning (PF), physical role functioning (RP), bodily pain (BP), general health perceptions (GH), vitality (VT), social role functioning (SF), emotional role functioning (RE), mental health (MH), physical component summary (PCS), and mental component summary (MCS). The non-CR group showed improvement in RP. Secondary outcomes, including resting heart rate (RHR), maximal oxygen consumption (VO(2max)), metabolic equivalent of task (MET), maximal exercise time (ET(max)), stage 3 Borg rating of perceived exertion (3RPE), maximal Borg rating of perceived exertion (RPEmax), and stage 3 rate pressure product (3RPP), improved in the CR group. The non-CR group showed improvements in VO(2max), MET, ET(max), and 3RPE. There were significant differences in improvements in PF, RP, BP, VT, SF, MH, MCS, RHR, VO(2max), MET, ET(max), 3RPE, and 3RPP between the two groups. CONCLUSION: Male patients with MI demonstrated improvements in QOL and physical ability following hospital-based CR; the impact on the mental component was greater than that on the physical component.
Exercise ; Health Surveys ; Heart Rate ; Home Care Services, Hospital-Based ; Humans ; Male ; Mental Health ; Metabolic Equivalent ; Myocardial Infarction* ; Oxygen Consumption ; Percutaneous Coronary Intervention ; Physical Fitness ; Quality of Life* ; Rehabilitation Centers ; Rehabilitation*

PURPOSE: The purpose of this study was to measure energy expenditure (EE) the metabolic equivalents (METs) of 13 common physical activities by using a portable telemetry gas exchange system (K4b2) and to assess the accuracy of the accelerometer (Actigraph GT3X+) by gender in Korean adults. METHODS: A total of 109 adults (54 males, 55 females) with normal BMI (body mass index) participated in this study. EE and METs of 13 selected activities were simultaneously measured by the K4b2 portable indirect calorimeter and predicted by the GT3X+ Actigraph accelerometer. The accuracy of the accelerometer was assessed by comparing the predicted with the measured EE and METs. RESULTS: EE (kcal/kg/hr) and METs of treadmill walking (3.2 km/h, 4.8 km/h and 5.6 km/h) and running (6.4 km/h) were significantly higher in female than in male participants (p < 0.05). On the other hand, the accelerometer significantly underestimated the EE and METs for all activities except descending stairs, moderate walking, and fast walking in males as well as descending stairs in females. Low intensity activities had the highest rate of accurate classifications (88.3% in males and 91.3% females), whereas vigorous intensity activities had the lowest rate of accurate classifications (43.6% in males and 27.7% in females). Across all activities, the rate of accurate classification was significantly higher in males than in females (75.2% and 58.3% respectively, p < 0.01). Error between the accelerometer and K4b2 was smaller in males than in females, and EE and METs were more accurately estimated during treadmill activities than other activities in both males and females. CONCLUSION: The accelerometer underestimated EE and METs across various activities in Korean adults. In addition, there appears to be a gender difference in the rate of accurate accelerometer classification of activities according to intensity. Our results indicate the need to develop new accelerometer equations for this population, and gender differences should be considered.
Adult* ; Calorimetry, Indirect ; Classification ; Energy Metabolism* ; Female ; Hand ; Humans ; Male ; Metabolic Equivalent ; Motor Activity* ; Running ; Telemetry ; Walking