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Shimizu N, Hashidate H, Ota T, Kawai Y. Physical activity according to sit-to-stand, standing, and stand-to-sit abilities in subacute stroke with walking difficulty: a cross-sectional study. Physiother Theory Pract 2023; 39:2327-2335. [PMID: 35543544 DOI: 10.1080/09593985.2022.2074928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study investigated the characteristics of physical activity according to sit-to-stand, standing, and stand-to-sit abilities in subacute stroke with walking difficulty. METHODS In this study, 29 participants with subacute stroke and walking difficulty were enrolled and classified into two groups: participants who successfully completed three items (i.e., sit-to-stand, standing, and stand-to-sit) of the Functional Balance Scale (independent group, n = 13) and those who showed incomplete scores on any of the three items (dependent group, n = 16). Light-intensity physical activity (LIPA) and moderate-to-vigorous physical activity (MVPA) were measured using an accelerometer at three periods (i.e. daytime, therapy time, and non-therapy time) for a week. RESULTS Two-way analysis of variance (groups × physical activity intensity) demonstrated a significant interaction in each period. Post-hoc tests showed significantly more LIPAs and MVPAs in the independent group in all periods, except for MVPA in the non-therapy time. Particularly, LIPA showed significant between-group differences in each period. CONCLUSIONS Among individuals with subacute stroke and walking difficulty, those who could completely perform sit-to-stand, standing, and stand-to-sit could perform more LIPAs. Increasing sit-to-stand, standing, and stand-to-sit abilities could be an important factor in increasing the opportunity to perform LIPAs.
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Affiliation(s)
- Natsuki Shimizu
- Department of Kaifukuki-suppot, Hatsudai Rehabilitation Hospital, Shibuya, Japan
| | - Hiroyuki Hashidate
- Department of Physical Therapy, Kyorin University School of Health Sciences, Mitaka-city, Japan
| | - Tomohiro Ota
- Department of Kaifukuki-suppot, Hatsudai Rehabilitation Hospital, Shibuya, Japan
| | - Yumi Kawai
- Department of Kaifukuki-suppot, Hatsudai Rehabilitation Hospital, Shibuya, Japan
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2
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Hasegawa Y, Yoshida M, Sato A, Fujimoto Y, Minematsu T, Sugama J, Sanada H. A change in temporal muscle thickness is correlated with past energy adequacy in bedridden older adults: a prospective cohort study. BMC Geriatr 2021; 21:182. [PMID: 33722195 PMCID: PMC7962248 DOI: 10.1186/s12877-021-02086-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 02/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Energy inadequacy has a great impact on health outcomes in older adult patients; however, it is difficult to evaluate energy adequacy in these patients, especially in home-care settings. We recently reported that temporal muscle thickness can be an indicator of nutritional status. The present study aims to examine whether a change in temporal muscle thickness is directly correlated with energy adequacy and, if so, to determine the cutoff value of a change in temporal muscle thickness to detect energy inadequacy. Methods A prospective cohort study was conducted from September 2015 to June 2016 in two hospitals in Japan, and included bedridden older adult patients aged ≥65 years. Temporal muscle thickness was measured using ultrasonography. Energy intake was estimated by photographic diet records. Total energy expenditure (TEE) was estimated by multiplying basal energy expenditure calculated using the Harris– Benedict equation by activity and stress factors. Energy adequacy was then calculated by dividing TEE by energy intake. Pearson’s correlation coefficient was used to examine the relationship between percentage change in temporal muscle thickness and energy adequacy. Multiple logistic regression analysis was conducted to determine the direct relationship between percentage change in temporal muscle thickness and moderate energy inadequacy (energy adequacy< 75%). Receiver operating characteristic (ROC) analysis was performed to determine the cutoff point for percentage change in temporal muscle thickness to detect moderate energy inadequacy. Results Forty-eight patients were analyzed (mean age 84.4 ± 7.8 years; 54.2% were women). The percentage change in muscle thickness was significantly correlated with energy adequacy (r = 0.733, p < 0.001). ROC analysis identified a percentage change in temporal muscle thickness of − 3.6% as the optimal cutoff point for detecting moderate energy inadequacy. Percentage change in muscle thickness was independently correlated with energy inadequacy after adjusting for age, sex, and masticatory status (AOR 0.281, 95% CI 0.125–0.635). Conclusions Changes in temporal muscle thickness are directly correlated with energy adequacy and can indicate moderate energy inadequacy in bedridden older adults. These results suggest the assessment of changes in temporal muscle thickness could be useful for guiding nutritional care in older adult patients in home-care settings.
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Affiliation(s)
- Yoko Hasegawa
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Clinical Nutrition Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, 2-1 Seiryoumachi, Aoba-ku, Sendai city, Miyagi, 980-8575, Japan
| | - Aya Sato
- Department of Gerontological Nursing, Kawasaki City College of Nursing, 4-30-1 Ogura, Saiwai-ku, Kawasaki city, Kanagawa, 212-0054, Japan
| | - Yumiko Fujimoto
- Department of Gerontological Nursing, School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, Wakayama city, Wakayama, 641-0011, Japan
| | - Takeo Minematsu
- Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Junko Sugama
- Institute for Frontier Science Initiative, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa city, Ishikawa, 920-0942, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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Kimura Y, Ohji S, Nishio N, Abe Y, Ogawa H, Taguchi R, Otobe Y, Yamada M. The impact of wheelchair propulsion based physical activity on functional recovery in stroke rehabilitation: a multicenter observational study. Disabil Rehabil 2020; 44:2027-2032. [PMID: 33026844 DOI: 10.1080/09638288.2020.1821249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE We aimed to evaluate the relationship between the daily wheelchair self-propulsion distance and functional recovery in subacute stroke survivors. METHODS Seventy-four patients with stroke were prospectively recruited from four convalescent rehabilitation hospitals. All participants were unable to walk independently and required manual wheelchairs for locomotion on admission. The daily wheelchair self-propulsion distance was measured using a cycle computer that was connected to a touch switch to exclude the assistance-propulsion distance. The outcome measures were represented as the relative gain of the Functional Independence Measure (FIM) effectiveness during hospitalization. Moreover, a better functional recovery was defined as a FIM effectiveness > 50%. Participants were categorized into three groups according to tertiles of the average daily wheelchair self-propulsion distance: lowest tertile (T1, ≤0.59 km/day); middle tertile (T2, 0.60-1.23 km/day); and highest tertile (T3, ≥1.24 km/day). RESULTS Multivariate logistic regression analysis adjusted for baseline characteristics showed that the T2 and T3 groups had a significant association with better FIM effectiveness, and their odds ratios (95% confidence interval, p) were 7.26 (1.13-45.85, p = .038), and 10.19 (1.15-91.75, p = .035), respectively. CONCLUSIONS The daily wheelchair self-propulsion distance was significantly associated with functional recovery in subacute stroke survivors.IMPLICATIONS FOR REHABILITATIONNon-ambulatory stroke survivors can obtain extra independent physical activity by using wheelchair self-propulsion, when they do not have someone to assist them with walking.This multicenter observational study revealed that the self-propulsion distance of a manual-wheelchair was significantly associated with functional recovery in subacute stroke survivors.
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Affiliation(s)
- Yosuke Kimura
- Department of Rehabilitation, Tokyo Shinjuku Medical Center, Japan Community Health care Organization, Tokyo, Japan.,Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Shunsuke Ohji
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Naohito Nishio
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,Department of Physical Therapy, Saitama Prefectural Rehabilitation Center, Saitama, Japan
| | - Yuki Abe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,Department of Rehabilitation Medicine, Kiminomori Rehabilitation Hospital, Chiba, Japan
| | - Hideyuki Ogawa
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,Department of Physical Therapy, Saitama Prefectural Rehabilitation Center, Saitama, Japan
| | - Ryota Taguchi
- Department of Rehabilitation Medicine, Kiminomori Rehabilitation Hospital, Chiba, Japan.,Department of Rehabilitation Medicine, Saitama Memorial Hospital, Saitama, Japan
| | - Yuhei Otobe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
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A Comparison of the Physiology of Sedentary Behavior and Light Physical Activity in Adults With and Without a Physical Disability. J Phys Act Health 2019; 16:894-901. [DOI: 10.1123/jpah.2019-0059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/16/2019] [Accepted: 06/17/2019] [Indexed: 11/18/2022]
Abstract
Background: It is questionable whether postures that are regarded as sedentary behavior in able-bodied persons evoke comparable physiological responses in adults with stroke or cerebral palsy (CP). This study aimed to compare metabolic demand and muscle activity in healthy controls, adults with stroke, and adults with CP during sedentary behavior and light physical activities. Methods: Seventy-one adults (45.6 [18.9] y, range 18–86) participated in this study, of which there were 18 controls, 31 with stroke, and 22 with CP. The metabolic equivalent of task (MET) and level of muscle activation were assessed for different sedentary positions (sitting supported and unsupported) and light physical activities (standing and walking). Results: During sitting supported and unsupported, people with mild to moderate stroke and CP show comparable MET and electromyographic values as controls. While sitting unsupported, people with severe stroke show higher METs and electromyographic values (P < .001), and people with severe CP only show higher METs compared with controls (P < .05) but all below 1.5 METs. Standing increased electromyographic values in people with severe stroke or CP (P < .001) and reached values above 1.5 METs. Conclusions: Physiologic responses during sedentary behavior are comparable for controls and adults with mild to moderate stroke and CP, whereas higher metabolic demands and muscle activity (stroke only) were observed in severely affected individuals.
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Shimizu N, Hashidate H, Ota T, Yatsunami M. Daytime physical activity at admission is associated with improvement of gait independence 1 month later in people with subacute stroke: a longitudinal study. Top Stroke Rehabil 2019; 27:25-32. [PMID: 31405344 DOI: 10.1080/10749357.2019.1649916] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Little is known about the benefits of daytime physical activity on gait ability in subacute stroke.Objectives: We investigated association between daytime physical activity at hospital admission and improvement of gait independence 1 month later in subacute stroke.Methods: Thirty-four participants with subacute stroke who could not walk independently were assessed. An accelerometer (HJA 350-IT, OMRON) was used to record the mean duration of light-intensity physical activity (LIPA) and moderate-to-vigorous-intensity physical activity (MVPA). LIPA and MVPA were recorded for 12 h per day for 7 consecutive days, and at three different time periods (daytime, therapy time, non-therapy time) at rehabilitation hospital admission (baseline). Gait independence was assessed by the functional ambulation category (FAC) at baseline and 1 month later. Participants were categorized into two groups based on the change of gait independence, as follows: the improved group, in which the FAC increased by ≥1; the non-improved group, in which the FAC did not increase.Results: Compared with the non-improved group, the improved group demonstrated significantly higher values of all physical activity variables, except for non-therapy time MVPA (p < .05). Logistic regression analysis showed that higher daytime LIPA was significantly associated with FAC improvement (OR = 1.068, 95% CI 1.009 to 1.140). In particular, higher non-therapy time LIPA was closely associated with FAC improvement (OR = 1.253, 95% CI 1.002 to 1.568).Conclusions: To promote recovery of gait independence in first month from admission, increasing daytime physical activity, especially LIPA during daytime or non-therapy time, is an important treatment target in subacute stroke.
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Affiliation(s)
- Natsuki Shimizu
- Department of rehabilitation and care, Hatsudai Rehabilitation Hospital, Shibuya, Japan
| | - Hiroyuki Hashidate
- Department of Physical Therapy, Kyorin University School of Health Sciences, Mitaka, Japan
| | - Tomohiro Ota
- Department of rehabilitation and care, Hatsudai Rehabilitation Hospital, Shibuya, Japan
| | - Mitsunobu Yatsunami
- Department of Physical Therapy, Kyorin University School of Health Sciences, Mitaka, Japan
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6
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Shimizu N, Hashidate H, Ota T, Suzuki T, Yatsunami M. Characteristics of intensity-based physical activity according to gait ability in people hospitalized with subacute stroke: a cross-sectional study. Phys Ther Res 2019; 22:17-25. [PMID: 31289708 DOI: 10.1298/ptr.e9971] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 03/03/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Gait ability may be related to the level of intensity-based physical activity in people who have experienced a stroke; however, this relationship has not been explored in previous studies. This study aimed to investigate the characteristics of intensity-based physical activity according to gait ability and to explore the factors related to different intensity physical activity. METHOD Eighty hospitalized participants with subacute stroke were assigned to three groups based on their gait ability: group 1 (n = 28) could walk independently with a maximal gait speed (MGS) of more than 0.9 m/s; group 2 (n = 11) could walk independently with a MGS of less than 0.9 m/s; group 3 (n = 41) could not walk independently. Light-intensity physical activity (LIPA) and moderate-to-vigorous physical activity (MVPA) were measured for 12 hours using an accelerometer (OMRON, HJA350-IT) for 7 consecutive days and were calculated throughout three time periods (daytime, non-therapy time, or therapy time). RESULTS In each time period, a two-way ANOVA showed an interaction between the groups and intensity-based physical activity (p < 0.05). Bonferroni post hoc test showed a significantly higher LIPA in groups 1 and 2 compared with group 3 in daytime or non-therapy time. In contrast, group 1 showed a significantly higher MVPA compared with group 2 and 3 for each time period. CONCLUSION During daytime and non-therapy time, the results suggested that gait independence is related to LIPA rather than gait speed, and gait speed and gait independence is related to MVPA.
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Affiliation(s)
- Natsuki Shimizu
- The Graduate School of Kyorin University Major in Health Sciences.,Hatsudai Rehabilitation Hospital
| | - Hiroyuki Hashidate
- Department of Physical Therapy, Kyorin University School of Health Sciences
| | - Tomohiro Ota
- The Graduate School of Kyorin University Major in Health Sciences.,Hatsudai Rehabilitation Hospital
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Lankhorst K, van den Berg-Emons RJ, Bussmann JBJ, Horemans HLD, de Groot JF. A Novel Tool for Quantifying and Promoting Physical Activity in Youths With Typical Development and Youths Who Are Ambulatory and Have Motor Disability. Phys Ther 2019; 99:354-363. [PMID: 30649497 DOI: 10.1093/ptj/pzy152] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 08/22/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Several device-based instruments have been validated in the pediatric population, but none of these are clinically applicable and provide real-time feedback on actual physical activity in terms of postures and movements. A new device (Activ8) is promising for that purpose. OBJECTIVE The objective was to investigate the criterion validity of the Activ8 for measuring static (sitting, standing) and dynamic (walking, bicycling, running) activities, and for separating postures and movements within basic and complex activities in children and adolescents (youths) with typical development (TD) and peers with motor disability (not typical development [NTD]). DESIGN This was a criterion validation study. METHODS Ten participants with TD (mean age [standard deviation] = 14 [2.5] years) and 10 participants with NTD (mean age = 12.9 [2.1] years) performed a standardized series of basic and daily life (complex) activities. The Activ8 measured postures and movements, while camera recording served as a reference. The outcome measures were the mean time differences between the Activ8 output and video data for the merged categories "static" and "dynamic" and for the separate postures and movements. RESULTS For the merged categories static and dynamic, the criterion validity was found to be excellent both in participants with TD and participants with NTD within basic activities, and was found to be good to excellent in participants with TD and moderate to good in participants with NTD within complex activities. The detection of separate postures and movements was found to be poor to excellent in both groups within complex activities. LIMITATIONS The sample of youths with NTD was small and limited to youths who could be considered to be at least ambulatory within a household. CONCLUSIONS Activ8 is a valid tool when the merged categories static and dynamic are used to interpret physical activity in daily life in both youths with TD and youths with NTD and mild motor impairment. To optimize the quantification of separate postures and movements, adjustment of the existing algorithm is required.
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Affiliation(s)
- Kristel Lankhorst
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands; and Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, PO Box 85083, 3508 AB, Utrecht, the Netherlands
| | - Rita J van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | | | | | - Janke F de Groot
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab; Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences; and Netherlands Institute for Health Services Research, Utrecht, the Netherlands
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8
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Derungs A, Schuster-Amft C, Amft O. Physical Activity Comparison Between Body Sides in Hemiparetic Patients Using Wearable Motion Sensors in Free-Living and Therapy: A Case Series. Front Bioeng Biotechnol 2018; 6:136. [PMID: 30386777 PMCID: PMC6199363 DOI: 10.3389/fbioe.2018.00136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/12/2018] [Indexed: 11/27/2022] Open
Abstract
Background: Physical activity (PA) is essential in stroke rehabilitation of hemiparetic patients to avoid health risks, and moderate to vigorous PA could promote patients' recovery. However, PA assessments are limited to clinical environments. Little is known about PA in unguided free-living. Wearable sensors could reveal patients' PA during rehabilitation, and day-long long-term measurements over several weeks might reveal recovery trends of affected and less-affected body sides. Methods: We investigated PA in an observation study during outpatient rehabilitation in a day-care center. PA of affected and less-affected body sides, including upper and lower limbs were derived using wearable motion sensors. In this analysis we focused on PA during free-living and clinician guided therapies, and investigated differences between body-sides. Linear regressions were used to estimate metabolic equivalents for each limb at comparable scale. Non-parametric statistics were derived to quantify PA differences between body sides. Results: We analyzed 102 full-day movement data recordings from eleven hemiparetic patients during individual rehabilitation periods up to 79 days. The comparison between free-living and clinician guided therapy showed on average 16.1 % higher PA in the affected arm during therapy and 5.3 % higher PA in the affected leg during therapy. Average differences between free-living and therapy in the less-affected side were below 4.5 %. Conclusion: We analyzed PA of patients with a hemiparesis in two distinct rehabilitation settings, including free-living and clinician guided therapies over several weeks and compared MET values of affected and less-affected body sides. In particular, we investigated PA using individual regression models for each limb. We demonstrated that wearable motion sensors provide insights in patient's PA during rehabilitation. Although, no clear PA trends were found, our analysis showed patients' tendency to sedentary behavior, confirming previous lab study results. Our PA analysis approach could be used beyond clinical rehabilitation to devise personalized patient and limb-specific exercise recommendations in future remote rehabilitation.
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Affiliation(s)
- Adrian Derungs
- Lehrstuhl für Digital Health, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Corina Schuster-Amft
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland.,Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Burgdorf, Switzerland.,Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Oliver Amft
- Lehrstuhl für Digital Health, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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English C, Janssen H, Crowfoot G, Callister R, Dunn A, Mackie P, Oldmeadow C, Ong LK, Palazzi K, Patterson AJ, Spratt NJ, Walker FR, Bernhardt J, Dunstan DW. Breaking up sitting time after stroke (BUST-stroke). Int J Stroke 2018; 13:921-931. [PMID: 30226448 DOI: 10.1177/1747493018801222] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES People with stroke sit for long periods each day, which may compromise blood glucose control and increase risk of recurrent stroke. Studies in other populations have found regular activity breaks have a significant immediate (within-day) positive effect on glucose metabolism. We examined the effects of breaking up uninterrupted sitting with frequent, short bouts of light-intensity physical activity in people with stroke on post-prandial plasma glucose and insulin. METHODS Randomized within-participant crossover trial. We included people between 3 months and 10 years post-stroke, ambulant with minimal assistance and not taking diabetic medication other than metformin. The three experimental conditions (completed in random order) were: sitting for 8 h uninterrupted, sitting with 3 min bouts of light-intensity exercise while standing every 30 min, or sitting with 3 min of walking every 30 min. Meals were standardized and bloods were collected half- to one-hourly via an intravenous cannula. RESULTS A total of 19 participants (9 female, mean [SD] age 68.2 [10.2]) completed the trial. The majority ( n = 12, 63%) had mild stroke symptoms (National Institutes of Stroke Scale score 0-13). There was no significant effect of experimental condition on glucose (mean [SD] positive incremental area [+iAUC] mmol·L·h-1 under the curve during sitting 42.3 [29.5], standing 47.4 [23.1], walking 44.6 [26.5], p = 0.563) or insulin (mean + iAUC pmol·L·h-1 sitting 14,161 [7,560], standing 14,043 [8,312], walking 14,008 [8,269], p = 0.987). CONCLUSION Frequent, short bouts of light-intensity physical activity did not have a significant effect on post-prandial plasma glucose and insulin in this sample of people with stroke. Further studies are needed to identify strategies that improve inactivity-related glucose metabolism after stroke.
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Affiliation(s)
- Coralie English
- 1 School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.,2 Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia
| | - Heidi Janssen
- 1 School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.,2 Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia.,3 Hunter Stroke Services, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - Gary Crowfoot
- 1 School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.,2 Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia
| | - Robin Callister
- 4 School of Biomedical Sciences and Pharmacy, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
| | - Ashlee Dunn
- 4 School of Biomedical Sciences and Pharmacy, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
| | - Paul Mackie
- 1 School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.,2 Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia
| | - Christopher Oldmeadow
- 5 Clinical Research Design, Information Technology and Statistical Support (CReDITSS), Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Lin K Ong
- 2 Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia.,6 School of Biomedical Sciences and Pharmacy and the Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
| | - Kerrin Palazzi
- 5 Clinical Research Design, Information Technology and Statistical Support (CReDITSS), Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Amanda J Patterson
- 7 School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Neil J Spratt
- 2 Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia.,8 Department of Neurology, John Hunter Hospital, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - F Rohan Walker
- 2 Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia.,6 School of Biomedical Sciences and Pharmacy and the Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
| | - Julie Bernhardt
- 2 Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia
| | - David W Dunstan
- 9 Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,10 Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
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Energy expenditure and muscle activity during lying, sitting, standing, and walking in people with motor-incomplete spinal cord injury. Spinal Cord 2018; 56:1008-1016. [PMID: 29955089 DOI: 10.1038/s41393-018-0167-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/28/2018] [Accepted: 05/29/2018] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional exploratory study. OBJECTIVES To determine oxygen uptake (VO2), energy expenditure (EE), and muscle activity (MA) during lying (rest), sitting, standing, and walking among ambulatory individuals with spinal cord Injury (SCI) and to compare VO2, EE, and MA between individuals with different levels of ambulation. SETTING Rehabilitation institution with a spinal cord injury unit. METHODS A total of 22 adults with motor-incomplete SCI, ten in a low-ambulation group (non-functional or household walker) and 12 in a high-ambulation group (community or normal walker). VO2 was measured using indirect calorimetry. EE was expressed in metabolic equivalent of task (MET). MA was measured using a wireless surface electromyography device. RESULTS Mean VO2 was 3.19 ml/kg/min. During lying and sitting, EE was below 1.5 METs for all participants. During standing, three participants of the low-ambulation group and none in the high-ambulation group showed MET values of >1.5. In the walking condition, all participants showed MET values above 1.5. MA during stance was higher compared to the sitting condition and significantly higher in the low-ambulation group compared to the high-ambulation group. CONCLUSION Lying, supported- and unsupported sitting, without moving, appear to be sedentary behaviors for ambulatory individuals with a motor-incomplete SCI (MET values of <1.5 and a lack of MA). Walking, but not standing, is a moderate physical activity (>1.5 METs), which can be used by all individuals with motor-incomplete SCI to interrupt sedentary behavior.
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Shimizu N, Hashidate H, Ota T, Saito A. The known-groups validity of intensity-based physical activity measurement using an accelerometer in people with subacute stroke. J Phys Ther Sci 2018; 30:507-513. [PMID: 29706696 PMCID: PMC5908992 DOI: 10.1589/jpts.30.507] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/09/2018] [Indexed: 01/15/2023] Open
Abstract
[Purpose] This study aimed to assess the known-groups validity of the estimated metabolic
equivalents during physical activities using accelerometer, Active Style Pro HJA 350-IT,
in people with subacute stroke. [Subjects and Methods] Ten participants with subacute
stroke and ten healthy people performed six activities (lying, sitting, standing, sitting
with reaching task, standing with reaching task, and walking) and metabolic equivalents
were estimated using the accelerometer during each activity. These estimated metabolic
equivalents were compared with reported metabolic equivalents through compendiums or
previous studies. Additionally, the estimated metabolic equivalents were compared between
subacute stroke and healthy control participants. [Results] The estimated metabolic
equivalents of both groups during maintaining posture showed significantly lower values in
comparison with previous studies. There were no significant differences between the
estimated metabolic equivalents during sitting with reaching tasks or standing with
reaching tasks when compared with compendium metabolic equivalents across both groups. The
estimated metabolic equivalents during walking were inevitable values significantly
differed from previous study which conducted with stroke patients with lower gait
abilities in both groups. [Conclusion] The estimated metabolic equivalents using
accelerometer may be suitable to assess movement activity rather than motionless activity,
and accelerometer demonstrated acceptable validity in people with subacute stroke.
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Affiliation(s)
- Natsuki Shimizu
- The Graduate School of Kyorin University: 5-4-1 Shimorenjaku, Mitaka, Tokyo 181-8612, Japan.,Hatsudai Rehabilitation Hospital, Japan
| | - Hiroyuki Hashidate
- Department of Physical Therapy, Kyorin University School of Health Science, Japan
| | - Tomohiro Ota
- The Graduate School of Kyorin University: 5-4-1 Shimorenjaku, Mitaka, Tokyo 181-8612, Japan.,Hatsudai Rehabilitation Hospital, Japan
| | - Akihiko Saito
- Department of Physical Therapy, Kyorin University School of Health Science, Japan
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12
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Almeida CBD, Casotti CA, Sena ELDS. Reflexões sobre a complexidade de um estilo de vida saudável. AVANCES EN ENFERMERÍA 2018. [DOI: 10.15446/av.enferm.v36n2.67244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJETIVO: Reflexionar, a la luz del pensamiento complejo de Edgar Morin, sobre lo que Significa estilo de vida saludable.SÍNTESIS DEL CONTENIDO: Se consideraron lãs temáticas "Complementaridad y el concepto de salud", "Estilo de vida, condición humana y multidimensionalidad" y "El estilo de vida sano en la perspectiva del pensamiento complejo" relacionadas al referencial teórico propuesto. La reflexión permitió pensar el estilo de vida sano distanciado de un paradigma simplificador, y constituyente de un sistema marcado por La interacción entre sus partes constitutivas y toda organización en el contexto en que está inserto.CONCLUSIÓN: Se percibió que la búsqueda por la complementariedad posibilita una nueva perspectiva em relación al significado de lo que sea estilo de vida saludable, como un constructo que no se reduce a la suma de sus partes.
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13
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Barrett M, Snow JC, Kirkland MC, Kelly LP, Gehue M, Downer MB, McCarthy J, Ploughman M. Excessive sedentary time during in-patient stroke rehabilitation. Top Stroke Rehabil 2018; 25:366-374. [PMID: 29609499 DOI: 10.1080/10749357.2018.1458461] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background and Purpose Previous research suggests that patients receiving inpatient stroke rehabilitation are sedentary although there is little data to confirm this supposition within the Canadian healthcare system. The purpose of this cross-sectional study was to observe two weeks of inpatient rehabilitation in a tertiary stroke center to determine patients' activity levels and sedentary time. Methods Heart rate (HR) and accelerometer data were measured using an Actiheart monitor for seven consecutive days, 24 h/day, on the second week and the last week of admission. Participants or their proxies completed a daily logbook. Metabolic equivalent (MET) values were calculated and time with MET < 1.5 was considered sedentary. The relationship between patient factors (disability, mood, and social support) and activity levels and sedentary time were analyzed. Results Participants (n = 19; 12 males) spent 10 h sleeping and 4 h resting each day, with 86.9% of their waking hours sedentary. They received on average 8.5 task-specific therapy sessions; substantially lower than the 15 h/week recommended in best practice guidelines. During therapy, 61.6% of physical therapy and 76.8% of occupational therapy was spent sedentary. Participants increased their HR about 15 beats from baseline during physical therapy and 8 beats during occupational therapy. There was no relationship between sedentary time or activity levels and patient factors. Discussion Despite calls for highly intensive stroke rehabilitation, there was excessive sedentary time and therapy sessions were less frequent and of lower intensity than recommended levels. Conclusions In this sample of people attending inpatient stroke rehabilitation, institutional structure of rehabilitation rather than patient-related factors contributed to sedentary time.
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Affiliation(s)
- Matthew Barrett
- a Recovery & Performance Laboratory, Faculty of Medicine , Memorial University of Newfoundland , St. John's , Canada
| | - John Charles Snow
- a Recovery & Performance Laboratory, Faculty of Medicine , Memorial University of Newfoundland , St. John's , Canada
| | - Megan C Kirkland
- a Recovery & Performance Laboratory, Faculty of Medicine , Memorial University of Newfoundland , St. John's , Canada
| | - Liam P Kelly
- a Recovery & Performance Laboratory, Faculty of Medicine , Memorial University of Newfoundland , St. John's , Canada
| | - Maria Gehue
- a Recovery & Performance Laboratory, Faculty of Medicine , Memorial University of Newfoundland , St. John's , Canada
| | - Matthew B Downer
- a Recovery & Performance Laboratory, Faculty of Medicine , Memorial University of Newfoundland , St. John's , Canada
| | - Jason McCarthy
- a Recovery & Performance Laboratory, Faculty of Medicine , Memorial University of Newfoundland , St. John's , Canada.,b Rehabilitation and Continuing Care Program , Eastern Health Authority , St. John's , Canada
| | - Michelle Ploughman
- a Recovery & Performance Laboratory, Faculty of Medicine , Memorial University of Newfoundland , St. John's , Canada
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14
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Saeidifard F, Medina-Inojosa JR, Supervia M, Olson TP, Somers VK, Erwin PJ, Lopez-Jimenez F. Differences of energy expenditure while sitting versus standing: A systematic review and meta-analysis. Eur J Prev Cardiol 2018; 25:522-538. [PMID: 29385357 DOI: 10.1177/2047487317752186] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Replacing sitting with standing is one of several recommendations to decrease sedentary time and increase the daily energy expenditure, but the difference in energy expenditure between standing versus sitting has been controversial. This systematic review and meta-analysis aimed to determine this difference. Designs and methods We searched Ovid MEDLINE, Ovid Embase Scopus, Web of Science and Google Scholar for observational and experimental studies that compared the energy expenditure of standing versus sitting. We calculated mean differences and 95% confidence intervals using a random effects model. We conducted different predefined subgroup analyses based on characteristics of participants and study design. Results We identified 658 studies and included 46 studies with 1184 participants for the final analysis. The mean difference in energy expenditure between sitting and standing was 0.15 kcal/min (95% confidence interval (CI) 0.12-0.17). The difference among women was 0.1 kcal/min (95% CI 0.0-0.21), and was 0.19 kcal/min (95% CI 0.05-0.33) in men. Observational studies had a lower difference in energy expenditure (0.11 kcal/min, 95% CI 0.08-0.14) compared to randomised trials (0.2 kcal/min, 95% CI 0.12-0.28). By substituting sitting with standing for 6 hours/day, a 65 kg person will expend an additional 54 kcal/day. Assuming no increase in energy intake, this difference in energy expenditure would be translated into the energy content of about 2.5 kg of body fat mass in 1 year. Conclusions The substitution of sitting with standing could be a potential solution for a sedentary lifestyle to prevent weight gain in the long term. Future studies should aim to assess the effectiveness and feasibility of this strategy.
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Affiliation(s)
- Farzane Saeidifard
- 1 Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, USA
| | - Jose R Medina-Inojosa
- 1 Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, USA
| | - Marta Supervia
- 1 Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, USA.,2 Department of Physical Medicine and Rehabilitation, Gregorio Marañon University Hospital, Spain
| | - Thomas P Olson
- 1 Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, USA
| | - Virend K Somers
- 1 Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, USA
| | | | - Francisco Lopez-Jimenez
- 1 Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, USA
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15
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Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, Chastin SF, Altenburg TM, Chinapaw MJ. Sedentary Behavior Research Network (SBRN) - Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act 2017; 14:75. [PMID: 28599680 PMCID: PMC5466781 DOI: 10.1186/s12966-017-0525-8] [Citation(s) in RCA: 1860] [Impact Index Per Article: 265.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/16/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The prominence of sedentary behavior research in health science has grown rapidly. With this growth there is increasing urgency for clear, common and accepted terminology and definitions. Such standardization is difficult to achieve, especially across multi-disciplinary researchers, practitioners, and industries. The Sedentary Behavior Research Network (SBRN) undertook a Terminology Consensus Project to address this need. METHOD First, a literature review was completed to identify key terms in sedentary behavior research. These key terms were then reviewed and modified by a Steering Committee formed by SBRN. Next, SBRN members were invited to contribute to this project and interested participants reviewed and provided feedback on the proposed list of terms and draft definitions through an online survey. Finally, a conceptual model and consensus definitions (including caveats and examples for all age groups and functional abilities) were finalized based on the feedback received from the 87 SBRN member participants who responded to the original invitation and survey. RESULTS Consensus definitions for the terms physical inactivity, stationary behavior, sedentary behavior, standing, screen time, non-screen-based sedentary time, sitting, reclining, lying, sedentary behavior pattern, as well as how the terms bouts, breaks, and interruptions should be used in this context are provided. CONCLUSION It is hoped that the definitions resulting from this comprehensive, transparent, and broad-based participatory process will result in standardized terminology that is widely supported and adopted, thereby advancing future research, interventions, policies, and practices related to sedentary behaviors.
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Affiliation(s)
- Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
| | - Salomé Aubert
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
| | - Joel D. Barnes
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
| | - Travis J. Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PEI C1A 4P3 Canada
| | - Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9 Canada
| | - Amy E. Latimer-Cheung
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Sebastien F.M. Chastin
- Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Teatske M. Altenburg
- VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Mai J.M. Chinapaw
- VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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