Publications by authors named "Sarah Burkart"

11 Publications

  • Page 1 of 1

Comparison of multichannel and single-channel wrist-based devices with polysomnography to measure sleep in children and adolescents.

J Clin Sleep Med 2021 Apr;17(4):645-652

Department of Exercise Science, University of South Carolina, Columbia, South Carolina.

Study Objectives: To compare sleep parameters produced by the Fitbit Charge 3 (Fitbit) and Actigraph GT9X accelerometer (Actigraph) to polysomnography in children and adolescents.

Methods: Participants (n = 56, ages 9.2 ± 3.3 years) wore a Fitbit and an Actigraph on their nondominant wrist concurrently with polysomnography during an overnight observation at a children's sleep laboratory. Total sleep time, sleep efficiency, wake after sleep onset, sleep onset, and sleep offset were extracted from the Fitabase and Actilife software packages, respectively, with the Sadeh algorithm. Bland-Altman plots were used to assess the agreement between wearable devices and polysomnography.

Results: Seventy-nine percent of participants were diagnosed with OSA. Compared with polysomnography, the Fitbit and the Actigraph underestimated total sleep time by 6.1 minutes (absolute mean bias [AMB] = 27.7 minutes) and 31.5 minutes (AMB = 38.2 minutes), respectively. The Fitbit overestimated sleep efficiency by 3.0% (AMB = 6.3%), and the Actigraph underestimated sleep efficiency by 12.9% (AMB = 13.2%). The Fitbit overestimated wake after sleep onset by 18.8 minutes (AMB = 23.9 minutes), and the Actigraph overestimated wake after sleep onset by 56.1 minutes (AMB = 54.7 minutes). In addition, the Fitbit and the Actigraph underestimated sleep onset by 1.2 minutes (AMB = 13.9 minutes) and 10.2 minutes (AMB = 18.1 minutes), respectively. Finally, the Fitbit and the Actigraph overestimated sleep offset by 6.0 minutes (AMB = 12.0 minutes) and 10.5 minutes (AMB = 12.6 minutes). Linear regression indicated significant trends, with the Fitbit underestimating wake after sleep onset and sleep efficiency at higher values.

Conclusions: The Fitbit provided comparable and in some instances better sleep estimates with polysomnography compared to the Actigraph. Findings support the use of multichannel devices to measure sleep in children and adolescents. Additional studies are needed in healthy children over several nights and in free-living settings.
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http://dx.doi.org/10.5664/jcsm.8980DOI Listing
April 2021

Cross-Sectional Associations of 24-Hour Sedentary Time, Physical Activity, and Sleep Duration Compositions with Sleep Quality and Habits in Preschoolers.

Int J Environ Res Public Health 2020 09 29;17(19). Epub 2020 Sep 29.

Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA 01003, USA.

Although some studies indicate physical activity and sleep quality are positively associated in children, most reports examined physical activity independent of other 24-h behaviors and focused on older children. The aim of this cross-sectional study was to examine the predicted changes in sleep efficiency and habits when reallocating time between movement behaviors using compositional isotemporal substitution in preschool-aged children. Accelerometers were worn by 288 participants (51.6 ± 9.5 months) for up to 16 days. Sleep outcomes included sleep efficiency, nap frequency, sleep disturbances, and bedtime resistance. Compositional isotemporal substitution analyses demonstrated that the combined effect of 24-h movement behaviors was associated with sleep efficiency ( < 0.001) and nap frequency ( < 0.003). When sleep increased by 30 min at the expense of stationary time or light physical activity, estimates of sleep efficiency and bedtime resistance decreased while nap frequency increased. When stationary time increased by 30 min from moderate to vigorous physical activity, estimated sleep efficiency increased and sleep disturbances decreased. Although this study presents preliminary evidence that 24-h movement behavior compositions in early childhood are associated with sleep quality and nap frequency, estimated effects from theoretical time reallocations across sleep outcomes were mixed.
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http://dx.doi.org/10.3390/ijerph17197148DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579350PMC
September 2020

The impact of a randomized controlled trial of a lifestyle intervention on postpartum physical activity among at-risk hispanic women: Estudio PARTO.

PLoS One 2020 24;15(7):e0236408. Epub 2020 Jul 24.

Department of Biostatistics and Epidemiology, School of Public Health & Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America.

Aims: To assess the impact of a culturally modified, motivationally targeted, individually-tailored intervention on postpartum physical activity (PA) and PA self-efficacy among Hispanic women.

Methods: Estudio PARTO was a randomized controlled trial conducted in Western Massachusetts from 2013-17. Hispanic women who screened positive for gestational diabetes mellitus were randomized to a Lifestyle Intervention (LI, n = 100) or to a comparison Health and Wellness (HW, n = 104) group during late pregnancy. Exercise goals in LI were to meet American College of Obstetrician & Gynecologists guidelines for postpartum PA. The Pregnancy Physical Activity Questionnaire (PPAQ) and the Self-Efficacy for Physical Activity Questionnaire were administered at 6 weeks, 6 months, and 1 year postpartum.

Results: Compared to baseline levels, both groups had significant increases in moderate-to-vigorous PA at 6 months and one year postpartum (i.e., LI: mean change = 30.9 MET-hrs/wk, p = 0.05; HW: 27.6 MET-hrs/wk, p = 0.01), with only LI group experiencing significant increases in vigorous PA (mean change = 1.3 MET-hrs/wk, p = 0.03). Based on an intent-to-treat analysis using mixed effects models, we observed no differences in pattern of change in PA intensity and type over time between intervention groups (all p > 0.10). However, there was the suggestion of a greater decrease in sedentary activity in the LI group compared to the HW group (β = -3.56, p = 0.09).

Conclusions: In this randomized trial among high-risk Hispanic women, both groups benefitted from participation in a postpartum intervention.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236408PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7380594PMC
September 2020

Validity of Wrist-Worn photoplethysmography devices to measure heart rate: A systematic review and meta-analysis.

J Sports Sci 2020 Sep 19;38(17):2021-2034. Epub 2020 Jun 19.

Department of Exercise Science, Arnold School of Public Health, University of South Carolina , Columbia, SC, USA.

Heart rate (HR), when combined with accelerometry, can dramatically improve estimates of energy expenditure and sleep. Advancements in technology, via the development and introduction of small, low-cost photoplethysmography devices embedded within wrist-worn consumer wearables, have made the collection of heart rate (HR) under free-living conditions more feasible. This systematic review and meta-analysis compared the validity of wrist-worn HR estimates to a criterion measure of HR (electrocardiography ECG or chest strap). Searches of PubMed/Medline, Web of Science, EBSCOhost, PsycINFO, and EMBASE resulted in a total of 44 articles representing 738 effect sizes across 15 different brands. Multi-level random effects meta-analyses resulted in a small mean difference (beats per min, bpm) of -0.40 bpm (95 confidence interval (CI) -1.64 to 0.83) during sleep, -0.01 bpm (-0.02 to 0.00) during rest, -0.51 bpm (-1.60 to 0.58) during treadmill activities (walking to running), while the mean difference was larger during resistance training (-7.26 bpm, -10.46 to -4.07) and cycling (-4.55 bpm, -7.24 to -1.87). Mean difference increased by 3 bpm (2.5 to 3.5) per 10 bpm increase of HR for resistance training. Wrist-worn devices that measure HR demonstrate acceptable validity compared to a criterion measure of HR for most common activities.
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http://dx.doi.org/10.1080/02640414.2020.1767348DOI Listing
September 2020

Feasibility, Acceptability, and Preliminary Efficacy of a Recess-Based Fitness Intervention in Elementary School Children.

Int J Exerc Sci 2019 1;12(4):1225-1243. Epub 2019 Nov 1.

Department of Kinesiology, University of Massachusetts-Amherst, Amherst, MA, USA.

Although fitness may benefit cognition in youth, most attention has been given to cardiorespiratory fitness despite the health benefits of muscular fitness. Few studies have examined interventions that incorporate both cardiorespiratory and muscular fitness or have been offered during school recess. Furthermore, most fitness intervention studies examining cognitive outcomes have not reported on implementation information. The purpose of this pilot study was to examine the feasibility, acceptability, and preliminary efficacy on fitness and cognition of a recess intervention in elementary school children. Two schools were randomized to either a 3-month cardiorespiratory and muscular fitness intervention (15 minutes/weekday during recess) or control condition (standard recess activities). Process evaluation (feasibility and acceptability) measures were recorded daily (research staff questionnaire), weekly (accelerometer and heart rate monitors), and post-intervention (participant and school-staff questionnaires). Preliminary efficacy measures included pre- and post-intervention inhibition/attention, working memory, and cardiorespiratory and muscular fitness scores. Some feasibility and acceptability measures were favorable (88% of the lessons were implemented, 78% of the lessons were implemented as planned, and the majority of students and school staff were satisfied with most aspects of the intervention). However, intensity adherence during the intervention sessions based on accelerometry (% of time spent in moderate-to-vigorous activity: 41.7 ± 14.5) and participation (19.4% attendance rate) were lower than expected. Preliminary efficacy of the intervention on cognitive and fitness outcomes was not demonstrated. This study provided evidence that some aspects of the fitness intervention were acceptable during school recess. However, important implementation factors (i.e., intervention exposure) should be targeted to improve youth fitness programs offered during this school setting.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886619PMC
November 2019

Feasibility of Integrating Physical Activity Into Early Education Learning Standards on Preschooler's Physical Activity Levels.

J Phys Act Health 2019 02 9;16(2):101-107. Epub 2019 Jan 9.

Background: For a health behavior intervention to be sustainable within preschool centers, the intervention should be implemented by classroom teachers. Unfortunately, teachers are constrained by demands such as meeting early childhood education standards. Therefore, the purpose of this pilot study was to examine the feasibility and preliminary efficacy of integrating a health behavior intervention into early education learning standards on physical activity (PA), diet, and sleep (PADS) behavior of preschoolers.

Methods: Two preschool centers were randomized to either the PADS (children, n = 60) or the control (CON; children, n = 54) group. The PADS intervention consisted of PADS lesson plans and activities embedded into Massachusetts early learning standards and were implemented for 4 days per week for 12 weeks. The CON preschool participated in their usual curriculum. PA was assessed using accelerometers for 7 consecutive days at baseline, 6 weeks, and 12 weeks. Other outcome variables were assessed with parental surveys at baseline and 12 weeks.

Results: Significant group by time interactions were observed for moderate to vigorous PA (percentage of time) during the preschool day (PADS: baseline = 10.6% (4.2%), 12 wk = 13.2% (2.3%); CON: baseline = 12.4% (3.9%), 12 wk = 11.2% (3.6%); P = .02).

Conclusion: This pilot study provides preliminary evidence that integrating health behaviors into learning standards is feasible and potentially an effective way for increasing preschoolers' PA levels.
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http://dx.doi.org/10.1123/jpah.2017-0628DOI Listing
February 2019

Effect of a culturally-tailored mother-daughter physical activity intervention on pre-adolescent African-American girls' physical activity levels.

Prev Med Rep 2018 Sep 9;11:7-14. Epub 2018 May 9.

University of Minnesota, School of Kinesiology, Minneapolis, MN, United States.

Positive parent-child attachment can be determined by opportunities for the child to interact with his/her parent and can influence a child's physical activity (PA) behavior. Therefore, an intervention that provides children and their parent more time to interact positively could impact children's PA. We examined the efficacy of a 12-week mother-daughter intervention on African-American girls' PA levels. In Spring of 2013 and 2014, mother-daughter dyads (n = 76) from Springfield, MA, were randomly assigned to one of three groups [child-mother (CH-M, n = 28), child alone (CH, n = 25), or control (CON, n = 23)] that participated in an afterschool culturally-tailored dance intervention (60 min/day, 3 days/week, 12 weeks). Girls in the CH-M group participated in the intervention with their maternal figure, while girls in the CH group participated in the intervention alone. CON group participants received weekly health-related newsletters. PA was assessed with accelerometers for seven days at baseline, 6-weeks, and 12-weeks. Hierarchical linear modeling was used to examine rates of change in PA. During the afterschool intervention time, girls in the CH-M group displayed a significantly steeper rate of increase in their percent time spent in vigorous PA compared to both the CON ( = 0.80,  < 0.001) and the CH group ( (1)=13.01,  < 0.001). Mothers in the CH-M group displayed a significantly steeper rate of increase in their percent time spent in total daily moderate-to-vigorous PA compared to CH group's mothers ( = 0.07,  = 0.01). This culturally-tailored mother-daughter afterschool intervention influenced African-American girls' afterschool hour PA levels, but not total daily PA. Study is registered at www.clinicaltrials.govNCT01588379.
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http://dx.doi.org/10.1016/j.pmedr.2018.05.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066471PMC
September 2018

Process evaluation of a culturally-tailored physical activity intervention in African-American mother-daughter dyads.

Prev Med Rep 2017 Dec 18;8:88-92. Epub 2017 Aug 18.

Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, United States.

The purpose of this study was to describe process evaluation data including intervention fidelity, dosage, quality, participant responsiveness, and program reach for the Mothers And dauGhters daNcing togEther Trial (MAGNET) in Springfield, MA, in Spring 2013 and 2014. Seventy-six mother-daughter dyads were randomized to the mother-daughter group (CH-M, n = 28), the child-only group (CH, n = 25), or the health education group (CON, n = 23). CH-M consisted of 60 min of moderate-to-vigorous culturally-tailored dance classes for dyads. CH consisted of dance classes for the child. All groups received homework tutoring and weekly health newsletters. Process evaluation data were assessed at each intervention session (three days/week, 6-months) with semi-structured questionnaires by researchers. CH dance classes were slightly longer (58.2 ± 3.5 min) than CH-M (54.4 ± 5.5 min). In both groups, participants spent the majority of the dance intervention in light intensity physical activity (PA). Participants in the CH-M group enjoyed participating in MAGNET > 90% of the time. Mothers (92%) indicated that they wanted to continue dance as a form of PA. Mothers expressed that transportation, time commitment, and assessments were barriers to participation. Participants suggested future interventions should include longer intervention length and more communications between research staff and mothers. The MAGNET intervention matched the originally intended program in most aspects. A lower intervention dose was delivered to the CH-M group potentially due to barriers described by mothers. Because mother-daughter interventions have shown minimal effects on increasing PA, it is imperative that researchers utilize process evaluation data to shape future studies.
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http://dx.doi.org/10.1016/j.pmedr.2017.08.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577404PMC
December 2017

Behavioral Effects of a Locomotor-Based Physical Activity Intervention in Preschoolers.

J Phys Act Health 2018 01 20;15(1):46-52. Epub 2017 Oct 20.

Background: Poor adaptive learning behaviors (ie, distractibility, inattention, and disruption) are associated with behavior problems and underachievement in school, as well as indicating potential attention-deficit hyperactivity disorder. Strategies are needed to limit these behaviors. Physical activity (PA) has been suggested to improve behavior in school-aged children, but little is known about this relationship in preschoolers. This study examined the effects of a PA intervention on classroom behaviors in preschool-aged children.

Methods: Eight preschool classrooms (n = 71 children; age = 3.8 ± 0.7 y) with children from low socioeconomic environments were randomized to a locomotor-based PA (LB-PA) or unstructured free playtime (UF-PA) group. Both interventions were implemented by classroom teachers and delivered for 30 minutes per day, 5 days per week for 6 months. Classroom behavior was measured in both groups at 3 time points, whereas PA was assessed at 2 time points over a 6-month period and analyzed with hierarchical linear modeling.

Results: Linear growth models showed significant decreases in hyperactivity (LB-PA: -2.58 points, P = .001; UF-PA: 2.33 points, P = .03), aggression (LB-PA: -2.87 points, P = .01; UF-PA: 0.97 points, P = .38) and inattention (LB-PA: 1.59 points, P < .001; UF-PA: 3.91 points, P < .001).

Conclusions: This research provides promising evidence for the efficacy of LB-PA as a strategy to improve classroom behavior in preschoolers.
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http://dx.doi.org/10.1123/jpah.2016-0479DOI Listing
January 2018

Energy Expenditure for 70 Activities in Children and Adolescents.

J Phys Act Health 2016 06;13(6 Suppl 1):S24-8

Graduate Program in Physical Education, Federal University of Triangulo Mineiro, Brazil.

Background: Thirty-five percent of the activities assigned MET values in the Compendium of Energy Expenditures for Youth were obtained from direct measurement of energy expenditure (EE). The aim of this study was to provide directly measured EE for several different activities in youth.

Methods: Resting metabolic rate (RMR) of 178 youths (80 females, 98 males) was first measured. Participants then performed structured activity bouts while wearing a portable metabolic system to directly measure EE. Steady-state oxygen consumption data were used to compute activity METstandard (activity VO2/3.5) and METmeasured (activity VO2/measured RMR) for the different activities.

Results: Rates of EE were measured for 70 different activities and ranged from 1.9 to 12.0 METstandard and 1.5 to 10.0 METmeasured.

Conclusion: This study provides directly measured energy cost values for 70 activities in children and adolescents. It contributes empirical data to support the expansion of the Compendium of Energy Expenditures for Youth.
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http://dx.doi.org/10.1123/jpah.2015-0712DOI Listing
June 2016

Influence of age on neuromuscular control during a dynamic weight-bearing task.

J Aging Phys Act 2009 Jul;17(3):327-43

Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA.

Neuromuscular control strategies might change with age and predispose the elderly to knee-joint injury. The purposes of this study were to determine whether long latency responses (LLRs), muscle-activation patterns, and movement accuracy differ between the young and elderly during a novel single-limb-squat (SLS) task. Ten young and 10 elderly participants performed a series of resistive SLSs (approximately 0-30 degrees) while matching a computer-generated sinusoidal target. The SLS device provided a 16% body-weight resistance to knee movement. Both young and elderly showed significant overshoot error when the knee was perturbed (p < .05). Accuracy ofthe tracking taskwas similar between the young and elderly (p = .34), but the elderly required more muscle activity than the younger participants (p < .05). The elderly group had larger LLRs than the younger group (p < .05). These results support the hypothesis that neuromuscular control of the knee changes with age and might contribute to injury.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758540PMC
http://dx.doi.org/10.1123/japa.17.3.327DOI Listing
July 2009