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The improvements of physical activity observed in our study confirm a recent open-label study with Indacaterol [ 19].
To show the longitudinal improvements of physical activity in addition to the presented non-communicable diseases of a large number of adults within normal communities, no studies with subsamples or unhealthy participants alone were considered.
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There are examples of multiple comprehensive worksite health promotion programs that focus on improvement of physical activity [ 73, 74].
These data suggest that improvement of physical activity may occur even before a significant weight gain is achieved.
This contrasts with a recent study demonstrating that open-label treatment with indacaterol resulted in an improvement of physical activity in 23 patients with COPD [ 19].
Apart from the objective improvement of physical activity in the cardiopulmonary exercise test, the significant improvement in quality of life in patients based on the SF-36 was also noted.
In addition, there was a slight improvement of physical activity (patients who do exercise: 32.6 % at baseline vs 56.5 % after 6 months; McNemar's test, p = 0.091), which was closer to the levels of physical activity noted in the controls (65.1%%).
Finally, natural experiments have assessed the impact of park improvements on physical activity [ 13– 15].
However, little evidence has been gathered from intervention studies in which the effect of infrastructural improvements on physical activity has been measured [ 7, 8]; nor can such evidence easily be generated by researchers, who are rarely in a position to implement their own interventions in the built environment.
Alongside the decline in dietary quality, we observed improvements in levels of physical activity among all women taking part in the study.
There were small statistically significant improvements in measures of physical activity (average daily steps and average daily METs) at eight weeks in the EG compared to the CG (Table 3).
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