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Bort-Roig J, Briones-Buixassa L, Felez-Nobrega M, Guàrdia-Sancho A, Sitjà-Rabert M, Puig-Ribera A. Sedentary behaviour associations with health outcomes in people with severe mental illness: a systematic review. Eur J Public Health 2021; 30:150-157. [PMID: 30793737 DOI: 10.1093/eurpub/ckz016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Although people with severe mental illness (SMI) show high sedentary behaviour (SB) levels, there is little research on how SB patterns influence health and which type of intervention is the most critical for reducing this behaviour. The aims of this study are to examine associations between SB and physical and mental health in people with SMI; and the extent to which physical activity interventions may effectively reduce SB. METHODS This systematic review was conducted according to the PRISMA guidelines. Experimental and observational studies were searched in Medline, PsycInfo, Embase, CINHAL and Scopus up to June 2018. Eighteen studies (n = 15 observational; n = 3 experimental) met the inclusion criteria. RESULTS Both subjective and objective measurements for SB (an average of 8.5 and 10 h day-1, respectively) were positively associated with an increased cardiovascular and metabolic risk, worse global functioning, less quality of life, more severity of depressive symptoms, longer illness duration and higher doses of antipsychotic medication. Regarding intervention studies, active-lifestyle interventions (n = 2) reduced sedentary time (1.7-2.4 h day-1) while structured exercise (n = 1) reported no changes on SB. CONCLUSIONS Levels of sedentariness in people with SMI are linked to an increased physical health risk, worse wellbeing and poorer mental health. Active-lifestyle interventions may be an indicated approach to reduce SB of people with SMI. However, a limited number of studies, their mixed quality and the heterogeneity of health outcomes made it difficult to provide robust conclusions on SB effects in people with SMI.Study protocol was registered to PROSPERO (CRD42017067592).
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Affiliation(s)
- Judit Bort-Roig
- Research Group on Sports and Physical Activity, Centre for Health and Social Care Research, University of Vic - Central University of Catalonia, Vic, Spain
| | - Laia Briones-Buixassa
- Research Group in Mental Health and Social Innovation, Centre for Health and Social Care Research, University of Vic - Central University of Catalonia, Vic, Spain
| | - Mireia Felez-Nobrega
- Research Group on Sports and Physical Activity, Centre for Health and Social Care Research, University of Vic - Central University of Catalonia, Vic, Spain
| | - Anna Guàrdia-Sancho
- Research Group on Sports and Physical Activity, Centre for Health and Social Care Research, University of Vic - Central University of Catalonia, Vic, Spain.,Osonament - Osona Psychopedagogical Medical Center, Vic, Spain
| | - Mercè Sitjà-Rabert
- Global Research on Wellbeing, Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Anna Puig-Ribera
- Research Group on Sports and Physical Activity, Centre for Health and Social Care Research, University of Vic - Central University of Catalonia, Vic, Spain
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Prince SA, Cardilli L, Reed JL, Saunders TJ, Kite C, Douillette K, Fournier K, Buckley JP. A comparison of self-reported and device measured sedentary behaviour in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:31. [PMID: 32131845 PMCID: PMC7055033 DOI: 10.1186/s12966-020-00938-3] [Citation(s) in RCA: 203] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/19/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Sedentary behaviour (SB) is a risk factor for chronic disease and premature mortality. While many individual studies have examined the reliability and validity of various self-report measures for assessing SB, it is not clear, in general, how self-reported SB (e.g., questionnaires, logs, ecological momentary assessments (EMAs)) compares to device measures (e.g., accelerometers, inclinometers). OBJECTIVE The primary objective of this systematic review was to compare self-report versus device measures of SB in adults. METHODS Six bibliographic databases were searched to identify all studies which included a comparable self-report and device measure of SB in adults. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses. RESULTS The review included 185 unique studies. A total of 123 studies comprising 173 comparisons and data from 55,199 participants were used to examine general criterion validity. The average mean difference was -105.19 minutes/day (95% CI: -127.21, -83.17); self-report underestimated sedentary time by ~1.74 hours/day compared to device measures. Self-reported time spent sedentary at work was ~40 minutes higher than when assessed by devices. Single item measures performed more poorly than multi-item questionnaires, EMAs and logs/diaries. On average, when compared to inclinometers, multi-item questionnaires, EMAs and logs/diaries were not significantly different, but had substantial amount of variability (up to 6 hours/day within individual studies) with approximately half over-reporting and half under-reporting. A total of 54 studies provided an assessment of reliability of a self-report measure, on average the reliability was good (ICC = 0.66). CONCLUSIONS Evidence from this review suggests that single-item self-report measures generally underestimate sedentary time when compared to device measures. For accuracy, multi-item questionnaires, EMAs and logs/diaries with a shorter recall period should be encouraged above single item questions and longer recall periods if sedentary time is a primary outcome of study. Users should also be aware of the high degree of variability between and within tools. Studies should exert caution when comparing associations between different self-report and device measures with health outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019118755.
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Affiliation(s)
- Stephanie A Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada.
| | - Luca Cardilli
- Birmingham Community Healthcare NHS Foundation Trust, Community Cardiac Services, Birmingham, United Kingdom
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury, United Kingdom
| | - Jennifer L Reed
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Travis J Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Chris Kite
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury, United Kingdom
- School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - Kevin Douillette
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Karine Fournier
- Health Sciences Library, University of Ottawa, Ottawa, Canada
| | - John P Buckley
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury, United Kingdom
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Bueno-Antequera J, Munguía-Izquierdo D. Exercise and Depressive Disorder. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:271-287. [PMID: 32342464 DOI: 10.1007/978-981-15-1792-1_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Depression is a psychiatric disorder characterized by low mood, loss of interest/enjoyment, and reduced energy and one of the five leading causes of disability and a major contributor to all-cause mortality worldwide. People with depression have, between others, a reduced life expectancy, worse quality of life and cardiorespiratory fitness, and increased risk of type 2 diabetes, compared to the general population. Furthermore, the economic burden of mental disorders including depression is evident, and it is expected to increase to more than double by 2030. Therefore, reducing the growing burden of mental disorders such as depression should be a health priority. Improved prevention and treatment are two key factors that may reduce the burden of depression. Pharmacological- and psychotherapy-based interventions have been traditionally considered for treating depression disorders; however, there is an increasing amount of scientific evidence confirming that physical activity and physical exercise should be highly considered in prevention and treatment of depressive disorders. In this chapter, we aim to summarize and discuss the research progress of physical activity and exercise in prevention and treatment of depressive disorder. Specifically, we summarized and discussed the research progress of the prognostic use of physical activity for incident depression, the importance of sedentary behavior and other outcomes typically improved by physical activity/exercise such as cardiorespiratory fitness for future depression, the research progress of the evidence of the benefits of exercise in people with depression disorders, the resistance training effects in adults and older adults with depression, and the recommendations for the prescription of exercise for people with depression.
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Affiliation(s)
- Javier Bueno-Antequera
- Physical Performance Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
- Research group in development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain
| | - Diego Munguía-Izquierdo
- Physical Performance Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain.
- Research group in development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain.
- Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain.
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Bueno-Antequera J, Munguía-Izquierdo D. Exercise and Schizophrenia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:317-332. [PMID: 32342467 DOI: 10.1007/978-981-15-1792-1_21] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Schizophrenia is a psychiatric disorder characterized by distortions of thinking and perception, with no strictly pathognomonic symptoms that can be divided into positive, negative, and cognitive symptom domains. People with schizophrenia have, between others, a reduced life expectancy and cardiorespiratory and muscular fitness and increased risk of cardiovascular disease, metabolic syndrome, obesity, hypertension, and hyperlipidemia compared to the general population. Furthermore, the economic burden of mental disorders including schizophrenia is evident and it is expected to increase to more than double by 2030. Therefore, reducing the growing burden of mental disorders such as schizophrenia should be a health priority. Improved prevention and treatment are two key factors that may reduce the burden of schizophrenia. Pharmacological- and psychotherapy-based interventions have been traditionally considered for treating schizophrenia disorders; however, there is an increasing amount of scientific evidence confirming that physical activity and physical exercise should be highly considered in prevention and treatment of schizophrenia disorders. In this chapter, we aim to summarize and discuss the research progress of physical activity and exercise in prevention and treatment of schizophrenia disorder. Specifically, we summarized and discussed the research progress of the prognostic use of physical activity for incident schizophrenia; the importance of other outcomes typically improved by physical activity/exercise such as obesity and fitness (cardiorespiratory and muscular fitness) for future schizophrenia; the research progress of the evidence of the benefits of exercise in people with schizophrenia disorders differentiating between effects of exercise on varied health outcomes, cognitive functioning, and cardiorespiratory fitness; and finally the clinical practice recommendations.
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Affiliation(s)
- Javier Bueno-Antequera
- Physical Performance Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
- Research Group in Development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain
| | - Diego Munguía-Izquierdo
- Physical Performance Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain.
- Research Group in Development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain.
- Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain.
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Bueno-Antequera J, Oviedo-Caro MÁ, Munguía-Izquierdo D. Ideal cardiovascular health and its association with sedentary behaviour and fitness in psychiatric patients. The PsychiActive project. Nutr Metab Cardiovasc Dis 2018; 28:900-908. [PMID: 29898823 DOI: 10.1016/j.numecd.2018.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/02/2018] [Accepted: 05/03/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND AIMS Ideal cardiovascular health (CVH) was defined as meeting ideal levels of 4 health behaviours (smoking, body mass index, physical activity, and diet) and 3 biological factors (blood pressure, total cholesterol, and glucose) and is inversely related to cardiovascular disease and mortality. However, the prevalence of ideal CVH in patients with severe mental illness and the possible independent associations of sedentary behaviour and fitness with CVH score are unexplored. METHODS AND RESULTS This study included 142 (34 women) outpatients with severe mental illness (primarily schizophrenia, n = 92). CVH was evaluated according to the American Heart Association guidelines. Sedentary behaviour, cardiorespiratory fitness, and muscular strength were measured by an activity-monitor, the 6-min walk test, and handgrip dynamometry. Cardiorespiratory fitness and strength values were combined in a composite fitness score. The prevalence of ideal CVH was: non-smoking (47.9%), body mass index (16.9), physical activity (83.1%), diet (10.4%), blood pressure (40.4%), total cholesterol (62.9%), and plasma glucose (66.7%). Low levels of sedentary behaviour and high cardiorespiratory, strength, and composite fitness score were associated with meeting the ideal threshold in most CVH metrics and having higher global CVH score; however, only cardiorespiratory and composite fitness score remained significantly related to global CVH score independent of sedentary behaviour and multiple confounders. CONCLUSIONS Patients with severe mental illness generally have low prevalence of ideal CVH metrics, especially diet and body mass index. Additionally, our findings suggest the need or considering cardiorespiratory fitness, regardless of sedentary behaviour, to promote ideal CVH in this population.
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Affiliation(s)
- J Bueno-Antequera
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
| | - M Á Oviedo-Caro
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain
| | - D Munguía-Izquierdo
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain
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Bueno-Antequera J, Oviedo-Caro MÁ, Munguía-Izquierdo D. Relationship between objectively measured sedentary behavior and health outcomes in schizophrenia patients: The PsychiActive project. Schizophr Res 2018; 197:87-92. [PMID: 29174336 DOI: 10.1016/j.schres.2017.11.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 11/14/2017] [Accepted: 11/18/2017] [Indexed: 12/21/2022]
Abstract
This study aimed to investigate possible relationships between sedentary behavior and body mass index (BMI), cardiorespiratory fitness (CRF), and health-related quality of life (HRQoL) in schizophrenia patients. Variables contributing to the variability in sedentary behavior were identified. Eighty-two schizophrenia outpatients (mean age±SD: 41.0±8.7years, 87% men, mean illness duration±SD: 17.1±8.9years) wore a multisensor armband for 7 consecutive full days to objectively measure sedentary behavior. BMI, walking capacity (6-minute walking test) as a proxy for CRF estimation and HRQoL (Short Form 36-Item Health Survey questionnaire version 2) were also assessed. Correlation (Pearson or Spearman coefficients) and multiple regression analysis were used. Sedentary behavior was significantly associated with BMI, CRF, and the physical component summary score of HRQoL (r values, -0.34-0.41; all P<0.001) and remained significant after adjustments for age, illness duration, symptom severity, adherence to Mediterranean diet, smoking, and antipsychotic medication (all P<0.05). BMI, CRF and vitality were identified as determinants of sedentary behavior. Consistent relationships between sedentary behavior and BMI, CRF, and the physical component summary score of HRQoL were found in schizophrenia patients. All the identified determinants of sedentary behavior are modifiable and may be important areas for future interventions in this population.
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Affiliation(s)
- Javier Bueno-Antequera
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
| | - Miguel Ángel Oviedo-Caro
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
| | - Diego Munguía-Izquierdo
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
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Bueno-Antequera J, Oviedo-Caro MÁ, Munguía-Izquierdo D. Sedentary behaviour, physical activity, cardiorespiratory fitness and cardiometabolic risk in psychosis: The PsychiActive project. Schizophr Res 2018; 195:142-148. [PMID: 29033281 DOI: 10.1016/j.schres.2017.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 09/29/2017] [Accepted: 10/08/2017] [Indexed: 10/18/2022]
Abstract
This study aimed to explore the possible independent associations of sedentary behaviour (SB), physical activity (PA), and cardiorespiratory fitness (CRF) with clustered (CCRS) and individual cardiometabolic risk (waist circumference [waist], systolic/diastolic blood pressure, triglycerides, high-density lipoprotein-cholesterol, and fasting blood glucose) in patients with psychosis. In 43 outpatients with psychosis (mean age±SD: 42.3±8.5years, 86% men), SB and light, moderate-to-vigorous, and total PA were measured with the SenseWear Pro3 Armband, and CRF with the 6-minute walking test. Multiple linear regression models adjusted for multiple confounders were applied. High SB, low PA and low CRF levels were associated with an unfavourable cardiometabolic risk profile (increased presence of metabolic syndrome and number of cardiometabolic abnormalities, as well as worse values and elevated presence of abnormalities for all individual cardiometabolic risk factors). SB was associated with CCRS, number of cardiometabolic abnormalities, waist, and fasting blood glucose (all p<0.05). After adjusting for PA and CRF, waist and fasting blood glucose remained significant. Light PA was associated with waist, moderate-to-vigorous PA with CCRS, and total PA with CCRS and waist (all p<0.05). These results became non-significant after adjusting for SB and CRF. CRF was associated with CCRS, waist, and systolic blood pressure (all p<0.05). The associations with CCRS and waist remained significant after adjusting for SB and PA. Together, these results suggest the importance of considering SB and CRF, regardless PA, in the prevention and treatment of cardiometabolic disorders among patients with psychosis.
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Affiliation(s)
- Javier Bueno-Antequera
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
| | - Miguel Ángel Oviedo-Caro
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
| | - Diego Munguía-Izquierdo
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
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