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Kubota A, Hamaguchi T. Seasonal changes in daily steps of community-dwelling older individuals with and without lifestyle-related diseases: a retrospective cohort study. J Phys Ther Sci 2024; 36:252-258. [PMID: 38694007 PMCID: PMC11060769 DOI: 10.1589/jpts.36.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 01/29/2024] [Indexed: 05/03/2024] Open
Abstract
[Purpose] Physical activity helps prevent diseases and mitigate their severity in older individuals with lifestyle-related conditions. We investigated whether seasonal factors and existing diseases affect physical activity in this demographic to identify lifestyle guidance indicators for health maintenance. [Participants and Methods] We compared the daily steps of older individuals (age of ≥65 years) by month, sex, and disease status from August to January by using three-way analysis of covariance. We evaluated a total of 115 participants (83 females and 32 males). [Results] Females with diseases had significantly fewer monthly daily steps than females without diseases in November (mean difference=1,138 ± 220) and December (mean difference=1,578 ± 239). Throughout, males with diseases completed significantly fewer monthly daily steps than did males without diseases. Furthermore, monthly daily steps never differed significantly between females with diseases and their male counterparts. [Conclusion] Compared with healthy older individuals, in older persons with diseases, physical activity was lower year-round among males and in November and December among females. Separate daily step count goals may be required for health maintenance in both sexes. It is important to determine the daily steps necessary to prevent various diseases and mitigate their severity while maintaining physical activity among older persons with diseases.
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Affiliation(s)
- Akihito Kubota
- Department of Rehabilitation, Graduate School of Health
Sciences, Saitama Prefectural University: 820 Sannomiya, Koshigaya-city, Saitama 343-8540,
Japan
| | - Toyohiro Hamaguchi
- Department of Rehabilitation, Graduate School of Health
Sciences, Saitama Prefectural University: 820 Sannomiya, Koshigaya-city, Saitama 343-8540,
Japan
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Areias AC, Molinos M, Moulder RG, Janela D, Scheer JK, Bento V, Yanamadala V, Cohen SP, Correia FD, Costa F. The potential of a multimodal digital care program in addressing healthcare inequities in musculoskeletal pain management. NPJ Digit Med 2023; 6:188. [PMID: 37816899 PMCID: PMC10564877 DOI: 10.1038/s41746-023-00936-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/29/2023] [Indexed: 10/12/2023] Open
Abstract
Digital interventions have emerged as a solution for time and geographical barriers, however, their potential to target other social determinants of health is largely unexplored. In this post-hoc analysis, we report the impact of social deprivation on engagement and clinical outcomes after a completely remote multimodal musculoskeletal (MSK) digital care program managed by a culturally-sensitive clinical team. Patients were stratified in five categories according to their social deprivation index, and cross-referenced with their race/ethnicity, rurality and distance to healthcare facilities. From a total of 12,062 patients from all U.S. states, 8569 completed the program. Higher social deprivation was associated with greater baseline disease burden. We observed that all categories reported pain improvements (ranging from -2.0 95%CI -2.1, -1.9 to -2.1 95%CI -2.3, -1.9, p < 0.001) without intergroup differences in mean changes or responder rates (from 59.9% (420/701) to 66.6% (780/1172), p = 0.067), alongside reduction in analgesic consumption. We observed significant improvements in mental health and productivity across all categories, with productivity and non-work-related functional recovery being greater within the most deprived group. Engagement was high but varied slightly across categories. Together these findings highlight the importance of a patient-centered digital care program as a tool to address health inequities in musculoskeletal pain management. The idea of investigating social deprivation within a digital program provides a foundation for future work in this field to identify areas of improvement.
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Affiliation(s)
| | | | - Robert G Moulder
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | | | - Justin K Scheer
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | | | - Vijay Yanamadala
- Sword Health, Inc, Draper, UT, USA
- Department of Surgery, Quinnipiac University Frank H. Netter School of Medicine, Hamden, CT, USA
- Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, CT, USA
| | - Steven P Cohen
- Department of Anesthesiology & Critical Care Medicine, Physical Medicine and Rehabilitation, Neurology, and Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Anesthesiology and Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Fernando Dias Correia
- Sword Health, Inc, Draper, UT, USA
- Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
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Rossen J, Hagströmer M, Larsson K, Johansson UB, von Rosen P. Physical Activity Patterns among Individuals with Prediabetes or Type 2 Diabetes across Two Years-A Longitudinal Latent Class Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3667. [PMID: 35329362 PMCID: PMC8949382 DOI: 10.3390/ijerph19063667] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/11/2022] [Accepted: 03/16/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aimed to identify distinct profiles of physical activity (PA) patterns among individuals with prediabetes or type 2 diabetes participating in a two-year PA trial and to investigate predictors of the profiles. METHODS Data (n = 168, collected 2013-2020) from the cohort of a randomized trial aimed at increasing PA in individuals with prediabetes and type 2 diabetes were used. PA and sedentary behaviours were assessed by waist-worn ActiGraph GT1M accelerometers at baseline and at 6, 12, 18 and 24 months. Fifteen PA and sedentary variables were entered into a latent class mixed model for multivariate longitudinal outcomes. Multinominal regression analysis modelled profile membership based on baseline activity level, age, gender, BMI, disease status and group randomisation. RESULTS Two profiles of PA patterns were identified: "Increased activity" (n = 37, 22%) included participants increasing time in PA and decreasing sedentary time. "No change in activity" (n = 131, 78%) included participants with no or minor changes. "Increased activity" were younger (p = 0.003) and more active at baseline (p = 0.011), compared to "No change in activity". No other predictor was associated with profile membership. CONCLUSIONS A majority of participants maintained PA and sedentary patterns over two years despite being part of a PA intervention. Individuals improving PA patterns were younger and more active at baseline.
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Affiliation(s)
- Jenny Rossen
- Department of Health Promoting Science, Sophiahemmet University, Lindstedtsvägen 8, 114 86 Stockholm, Sweden; (M.H.); (K.L.); (U.-B.J.)
| | - Maria Hagströmer
- Department of Health Promoting Science, Sophiahemmet University, Lindstedtsvägen 8, 114 86 Stockholm, Sweden; (M.H.); (K.L.); (U.-B.J.)
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 52 Huddinge, Sweden;
- Academic Primary Care Center, Region Stockholm, Solnavägen 1E, 104 31 Stockholm, Sweden
| | - Kristina Larsson
- Department of Health Promoting Science, Sophiahemmet University, Lindstedtsvägen 8, 114 86 Stockholm, Sweden; (M.H.); (K.L.); (U.-B.J.)
| | - Unn-Britt Johansson
- Department of Health Promoting Science, Sophiahemmet University, Lindstedtsvägen 8, 114 86 Stockholm, Sweden; (M.H.); (K.L.); (U.-B.J.)
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, 118 83 Stockholm, Sweden
| | - Philip von Rosen
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 141 52 Huddinge, Sweden;
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Ratz T, Pischke CR, Voelcker-Rehage C, Lippke S. Distinct physical activity and sedentary behavior trajectories in older adults during participation in a physical activity intervention: a latent class growth analysis. Eur Rev Aging Phys Act 2022; 19:1. [PMID: 34986783 PMCID: PMC8903622 DOI: 10.1186/s11556-021-00281-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/08/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND This study aimed to identify latent moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior (SB) trajectories in older adults participating in a randomized intervention trial and to explore associations with baseline social-cognitive predictors. METHODS Data were assessed at baseline (T0, participants were inactive or had recently become active), after a ten-week physical activity intervention (T1), and a second 24-week intervention phase (T2). Latent class growth analysis was used on accelerometer-assessed weekly MVPA and daily SB, respectively (n = 215 eligible participants). Activity changes within trajectory classes and baseline social-cognitive predictor differences between trajectory classes were analyzed. RESULTS A "stable insufficient MVPA" (n = 197, p for difference in MVPA level at T0 and T2 (pT0-T2) = .789, effect size (Cohen's d) = .03) and a "stable high MVPA" trajectory (n = 18, pT0-T2 = .137, d = .39), as well as a "slightly decreasing high SB" (n = 63, p for difference in SB (pT0-T2) = .022, d = .36) and a "slightly increasing moderate SB" trajectory (n = 152, pT0-T2 = .019, d = .27) emerged. Belonging to the "stable high MVPA" trajectory was associated with higher action planning levels compared to the "stable insufficient MVPA" trajectory (M = 5.46 versus 4.40, d = .50). Belonging to the "decreasing high SB" trajectory was associated with higher action self-efficacy levels compared to the "increasing moderate SB" trajectory (M = 5.27 versus 4.72, d = .33). CONCLUSIONS Change occurred heterogeneously in latent (not directly observed) subgroups, with significant positive trajectories only observed in the highly sedentary. TRIAL REGISTRATION German Registry of Clinical Trials, DRKS00016073 , Registered 10 January 2019.
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Affiliation(s)
- Tiara Ratz
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany.
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, Muenster, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
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Garriga A, Sempere-Rubio N, Molina-Prados MJ, Faubel R. Impact of Seasonality on Physical Activity: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:2. [PMID: 35010262 PMCID: PMC8751121 DOI: 10.3390/ijerph19010002] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The purpose of this study was to collect and analyze the available scientific evidence of the impact of seasonality on physical activity (PA). PA refers to walking, biking, sports and/or active recreation. METHODS The search was performed in the following databases: PubMed, PEDro, Cochrane and Embase. All publications from January 2015 to September 2020 assessing seasonal variations on physical activity development in adults were selected. RESULTS A total of 1159 articles were identified, of which 26 fulfilled the selection criteria involving 9300 participants from 18 different countries. The results obtained suggest that seasonality affects PA independently of the countries, pathologies of the participants and the tool to collect PA information. CONCLUSIONS PA level varies across the seasons, with higher PA level in summer compared with other seasons, especially in winter. Sedentary behavior follows the opposite trend. Impact of seasonality variations should be considered in clinical research involving PA as a primary outcome as well as in interventions on PA promotion.
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Affiliation(s)
- Antonio Garriga
- Faculty of Physiotherapy, Universitat de València, 46010 Valencia, Spain;
| | - Nuria Sempere-Rubio
- Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain; (M.J.M.-P.); (R.F.)
- Clinical Biomechanics Research Unit (UBIC), Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain
| | - María José Molina-Prados
- Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain; (M.J.M.-P.); (R.F.)
| | - Raquel Faubel
- Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain; (M.J.M.-P.); (R.F.)
- Joint Research Unit in IctAapplied to Reengineering Socio-Sanitary Process, IIS La Fe—Universitat Politècnica de València, 46026 Valencia, Spain
- PTinMOTION—Physiotherapy in Motion Multispeciality Research Group, Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain
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Cooke AB, Rahme E, Defo AK, Chan D, Daskalopoulou SS, Dasgupta K. A trajectory analysis of daily step counts during a physician-delivered intervention. J Sci Med Sport 2020; 23:962-967. [PMID: 32354681 DOI: 10.1016/j.jsams.2020.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/23/2020] [Accepted: 04/08/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Higher steps are associated with lower mortality and cardiovascular event rates. We previously demonstrated that tailored physician-delivered step count prescriptions successfully increased steps/day in adults with type 2 diabetes mellitus (T2DM) and/or hypertension. In the present analysis, we examined patterns of step count change and the factors that influence different responses. DESIGN Longitudinal observational study METHODS: Active arm participants (n=118) recorded steps/day. They received a step count prescription from their physician every 3-4 months. We computed mean steps/day and changes from baseline for sequential 30-day periods. Group-based trajectory modeling was applied. RESULTS Four distinct trajectories of mean steps/day emerged, distinguishable by differences in baseline steps/day: sedentary (19%), low active (40%), somewhat active (30%) and active (11%). All four demonstrated similar upward slopes. Three patterns emerged for the change in steps from baseline: gradual decrease (30%), gradual increase with late decline (56%), and rapid increase with midpoint decline (14%); thus 70% had an increase from baseline. T2DM (odd ratios [OR]: 3.7, 95% CI 1.7, 7.7) and age (OR per 10-year increment: 2, 95% CI 1.3, 2.8) were both associated with starting at a lower baseline but participants from these groups were no less likely than others to increase steps/day. CONCLUSIONS T2DM and older age were associated with lower baseline values but were not indicators of likelihood of step count increases. A physician-delivered step count prescription and monitoring strategy has strong potential to be effective in increasing steps irrespective of baseline counts and other clinical and demographic characteristics.
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Affiliation(s)
- Alexandra B Cooke
- Division of Experimental Medicine, Department of Medicine, McGill University Health Centre, McGill University, Canada
| | - Elham Rahme
- Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Alvin Kuate Defo
- Division of Internal Medicine, Department of Medicine, McGill University Health Centre, McGill University, Canada
| | - Deborah Chan
- Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Stella S Daskalopoulou
- Division of Experimental Medicine, Department of Medicine, McGill University Health Centre, McGill University, Canada; Division of Internal Medicine, Department of Medicine, McGill University Health Centre, McGill University, Canada
| | - Kaberi Dasgupta
- Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Division of Internal Medicine, Department of Medicine, McGill University Health Centre, McGill University, Canada.
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Lounassalo I, Salin K, Kankaanpää A, Hirvensalo M, Palomäki S, Tolvanen A, Yang X, Tammelin TH. Distinct trajectories of physical activity and related factors during the life course in the general population: a systematic review. BMC Public Health 2019; 19:271. [PMID: 30841921 PMCID: PMC6404287 DOI: 10.1186/s12889-019-6513-y] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 02/04/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND In recent years, researchers have begun applying a trajectory approach to identify homogeneous subgroups of physical activity (PA) in heterogeneous populations. This study systematically reviewed the articles identifying longitudinal PA trajectory classes and the related factors (e.g., determinants, predictors, and outcomes) in the general population during different life phases. METHODS The included studies used finite mixture models for identifying trajectories of PA, exercise, or sport participation. Three electronic databases, PubMed (Medline), Web of Science, and CINAHL, were searched from the year 2000 to 13 February 2018. The study was conducted according to the PRISMA recommendations. RESULTS Twenty-seven articles were included and organized into three age group: youngest (eleven articles), middle (eight articles), and oldest (eight articles). The youngest group consisted mainly of youth, the middle group of adults and the oldest group of late middle-aged and older adults. Most commonly, three or four trajectory classes were reported. Several trajectories describing a decline in PA were reported, especially in the youngest group, whereas trajectories of consistently increasing PA were observed in the middle and oldest group. While the proportion of persistently physically inactive individuals increased with age, the proportion was relatively high at all ages. Generally, male gender, being Caucasian, non-smoking, having low television viewing time, higher socioeconomic status, no chronic illnesses, and family support for PA were associated either with persistent or increasing PA. CONCLUSIONS The reviewed articles identified various PA subgroups, indicating that finite mixture modeling can yield new information on the complexity of PA behavior compared to studying population mean PA level only. The studies also provided novel information how different factors relate to changes in PA during life course. The recognition of the PA subgroups and their determinants is important for the more precise targeting of PA promotion and PA interventions. TRIAL REGISTRATION PROSPERO registration number: CRD42018088120 .
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Affiliation(s)
- Irinja Lounassalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kasper Salin
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anna Kankaanpää
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Mirja Hirvensalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sanna Palomäki
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Asko Tolvanen
- Methodology Center for Human Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Xiaolin Yang
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Tuija H. Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
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