***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To compare the effects of behavioral interventions targeting decreased sedentary behavior versus increased moderate-to-vigorous intensity physical activity ( MVPA ) in older adults . Method : Inactive older adults ( N = 38 , 68 ± 7 years old , 71 % female ) were r and omized to 12-week interventions targeting decreased sedentary behavior ( Sit Less ) or increased MVPA ( Get Active ) . The SenseWear armb and was used to objective ly assess activity in real time . Assessment s included a blinded armb and , the Community Health Activites Model Program for Senior ( CHAMPS ) question naire , 400-meter walk , and the Short Physical Performance Battery ( SPPB ) . Results : Objective ly measured MVPA increased in Get Active ( 75 ± 22 min/week , p < .001 ) ; self-reported MVPA increased in both groups ( p < .05 ) . Sedentary behavior did not change in either group ( all p > .05 ) . Only the Sit Less group improved the SPPB score ( 0.5 ± 0.3 , p = .046 ) . Discussion : Targeting reduced sedentary behavior had a greater effect on physical function among inactive but high functioning older adults over 12 weeks . Future studies of longer duration and combining increased MVPA with reduced sedentary behavior are needed PURPOSE Although moderate-to-vigorous physical activity is related to premature mortality , the relationship between sedentary behaviors and mortality has not been fully explored and may represent a different paradigm than that associated with lack of exercise . We prospect ively examined  sitting time  and mortality in a representative sample of 17,013 Canadians 18 - 90 yr of age . METHODS Evaluation of  daily sitting time  ( almost none of the time , one fourth of the time , half of the time , three fourths of the time , almost all of the time ) ,  leisure time physical activity , smoking status , and alcohol consumption  was conducted at baseline . Participants were followed prospect ively for an average of 12.0 yr for the ascertainment of mortality status . RESULTS There were 1832 deaths  ( 759 of cardiovascular disease ( CVD ) and 547 of cancer ) during 204,732 person-yr of follow-up . After adjustment for potential confounders , there was a progressively higher risk of mortality across higher levels of sitting time from all causes ( hazard ratios ( HR ) : 1.00 , 1.00 , 1.11 , 1.36 , 1.54 ; P for trend < 0.0001 ) and CVD ( HR:1.00 , 1.01 , 1.22 , 1.47 , 1.54 ; P for trend < 0.0001 ) but not cancer . Similar results were obtained when stratified by sex , age , smoking status , and body mass index . Age-adjusted all-cause mortality rates per 10,000 person-yr of follow-up were 87 , 86 , 105 , 130 , and 161 ( P for trend < 0.0001 ) in physically inactive participants and 75 , 69 , 76 , 98 , 105 ( P for trend = 0.008 ) in active participants across sitting time categories . CONCLUSIONS These data demonstrate a dose-response association between  sitting time  and mortality from all causes and CVD , independent of leisure time physical activity . In addition to the promotion of moderate-to-vigorous physical activity and a healthy weight , physicians should discourage sitting for extended periods AIM To compare the effect of 7 h of prolonged sitting on resting blood pressure with a similar duration of sitting combined with intermittent brief bouts of light-intensity or moderate-intensity physical activity . METHODS AND RESULTS Overweight/obese adults ( n = 19 ; aged 45 - 65 years ) were recruited for a r and omized three-treatment crossover trial with a one-week washout between treatments : 1 ) uninterrupted sitting ; 2 ) sitting with 2 min bouts of light-intensity walking at 3.2 km/h every 20 min ; and , 3 ) sitting with 2 min bouts of moderate-intensity walking at between 5.8 and 6.4 km/h every 20 min . After an initial 2 h period seated , participants consumed a test meal ( 75 g carbohydrate , 50 g fat ) and completed each condition over the next 5 h. Resting blood pressure was assessed oscillometrically every hour as a single measurement , 5 min prior to each activity bout . GEE models were adjusted for sex , age , BMI , fasting blood pressure and treatment order . After adjustment for potential confounding variables , breaking up prolonged sitting with light and moderate-intensity activity breaks was associated with lower systolic blood pressure [ light : 120 ± 1 mmHg ( estimated marginal mean ± SEM ) , P = 0.002 ; moderate : 121 ± 1 mmHg , P = 0.02 ] , compared to uninterrupted sitting ( 123 ± 1 mmHg ) . Diastolic blood pressure was also significantly lower during both of the activity conditions ( light : 76 ± 1 mmHg , P = 0.006 ; moderate : 77 ± 1 mmHg , P = 0.03 ) compared to uninterrupted sitting ( 79 ± 1 mmHg ) . No significant between-condition differences were observed in mean arterial pressure or heart rate . CONCLUSION Regularly breaking up prolonged sitting may reduce systolic and diastolic blood pressure . TRIAL REGISTRATION NUMBER ACTRN12609000656235 ( http://www.anzctr.org.au ) TRIAL REGISTRATION DATE : August 4th 2009 Background Excessive sitting has been linked to poor health . It is unknown whether reducing total sitting time or increasing brief sit-to-st and transitions is more beneficial . We conducted a r and omized pilot study to assess whether it is feasible for working and non-working older adults to reduce these two different behavioral targets . Methods Thirty adults ( 15 workers and 15 non-workers ) age 50–70 years were r and omized to one of two conditions ( a 2-hour reduction in daily sitting or accumulating 30 additional brief sit-to-st and transitions per day ) . Sitting time , st and ing time , sit-to-st and transitions and stepping  were assessed by a thigh worn inclinometer ( activPAL ) . Participants were assessed for 7 days at baseline and followed while the intervention was delivered ( 2 weeks ) . Mixed effects regression analyses adjusted for days within participants , device wear time , and employment status . Time by condition interactions were investigated . Results Recruitment , assessment s , and intervention delivery were feasible . The ‘ reduce sitting ’ group reduced their sitting by two hours , the ‘ increase sit-to-st and ’ group had no change in sitting time ( p < .001 ) . The sit-to-st and transition group increased their sit-to-st and transitions , the sitting group did not ( p < .001 ) . Conclusions This study was the first to demonstrate the feasibility and preliminary efficacy of specific sedentary behavioral goals . Trial Registration clinical trials.gov Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to 9 items in three Delphi rounds . The final criteria list ( the Delphi list ) was satisfactory to all participants . It is a starting point on the way to a minimum reference st and ard for RCTs on many different research topics . This list is not intended to replace , but rather to be used alongside , existing criteria lists Background . Overweight and obese older adults have high sedentary time . We tested the feasibility and preliminary effects of a sedentary time reduction intervention among adults over age 60 with a body mass index over 27 kg/m2 using a nonr and omized one-arm design . Methods . Participants ( N = 25 , mean age = 71.4 , mean body mass index = 34 ) completed an 8-week theory-based intervention targeting reduced total sitting time and increased sit-to-st and transitions . An inclinometer ( activPAL ™ ) measured the primary outcomes , change in total sitting time and sit-to-st and transitions . Secondary outcomes included physical activity ( ActiGraph GT3X+ accelerometer ) , self-reported sedentary behaviors , physical function ( Short Physical Performance Battery ) , depressive symptoms ( 8-item Patient Health Question naire ) , quality of life ( PROMIS ) , and study satisfaction . Paired t tests examined pre – post test changes in sitting time , sit-to-st and transitions , and secondary outcomes . Results . Inclinometer measured sitting time decreased by 27 min/day ( p < .05 ) and sit-to-st and transitions increased by 2 per day ( p > .05 ) , while st and ing time increased by 25 min/day ( p < .05 ) . Accelerometer measured sedentary time , light-intensity , and moderate-to-vigorous physical activity improved ( all p values ≤ .05 ) . Self-reported sitting time , gait speed , and depressive symptoms also improved ( all p values < .05 ) . Effect sizes were small . Study satisfaction was high . Conclusions . Reducing sitting time is feasible , and the intervention shows preliminary evidence of effectiveness among older adults with overweight and obesity . R and omized trials of sedentary behavior reduction in overweight and obese older adults , most of whom have multiple chronic conditions , may be promising Older adults represent the segment of the population that sits the most . This study evaluated the feasibility , acceptability , safety , and preliminary efficacy of an intervention to reduce sedentary behavior ( SB ) in older adults that can be disseminated broadly for limited cost and delivered by paraprofessionals with limited training . Senior centers in Central Pennsylvania were r and omized to receive one of two healthy aging programs ( i.e. , intervention or comparison ) . Participants in both groups attended three 90-min meetings over 2 weeks . Behavior change content was delivered at the second session ( i.e. , day 7 ) . Forty-two participants ( nintervention = 25 , ncomparison = 17 ) were recruited from five senior centers . Content for the intervention group focused on  reducing SB while comparison group content focused on reducing social isolation  . Self-reported SB was assessed on days 7 and 14 . Repeated- measures ANOVA revealed a significant group × time interaction for total and weekday , but not weekend , SB . In the week following the delivery of group content , participants in the intervention group reported an average decrease in total SB of 837.8 min/week ; however , the comparison group reported a nonsignificant average decrease of 263.0 min/week of total SB . Participants in the intervention group also reported an average decrease in weekday SB of 132.6 min/weekday ( d = −0.83 ) in the week following the delivery of group content ; however , the comparison group reported a nonsignificant decrease of 24.0 min/weekday ( d = −0.16 ) . There were no significant changes in weekend SB in either group in the week following the delivery of group content . Participants ’ attendance , measurement completion , and program ratings were high . Safety issues were minimal . This intervention was feasible to implement and evaluate , acceptable to older adults , and showed promise for reducing older adults ’ SB OBJECTIVE To test the safety , feasibility , and effectiveness of reducing sitting time in stroke survivors . DESIGN R and omized controlled trial with attention-matched controls and blinded assessment s. SETTING Community . PARTICIPANTS Stroke survivors ( N=35 ; 22 men ; mean age , 66.9±12.7y ) . INTERVENTIONS Four counseling sessions over 7 weeks with a message of sit less and move more ( intervention group ) or calcium for bone health ( attention-matched control group ) . MAIN OUTCOME MEASURES Measures included safety ( adverse events , increases in pain , spasticity , or fatigue ) and feasibility ( adherence to trial protocol ) . Secondary measures included time spent sitting ( including in prolonged bouts ≥30min ) , st and ing , and stepping as measured by the thigh-worn inclinometer ( 7d , 24h/d protocol ) and time spent in physical activity of at least moderate intensity as measured by a triaxial accelerometer . The Multimedia Activity Recall for Children and Adults was used to describe changes in use of time . RESULTS Thirty-three participants completed the full protocol . Four participants reported falls during the intervention period with no other adverse events . From a baseline average of 640.7±99.6min/d  , daily sitting time  reduced on average by 30±50.6min/d ( 95 % confidence interval [ CI ] , 5.8 - 54.6 ) in the intervention group and 40.4±92.5min/d in the control group ( 95 % CI , 13.0 - 93.8 ) . Participants in both groups also reduced their time spent in prolong 
    Output:
    
The narrative synthesis suggested that interventions have the potential to reduce sitting time in non-working older adults .