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Miaskowski C, Conley YP, Levine JD, Cooper BA, Paul SM, Hammer MJ, Oppegaard K, Harris C, Shin J, Abrams G, Asakitogum D, Fu MR, Alismal S. Chronic Decrements in Energy in Women with Breast Cancer are Associated with Cytokine Gene Polymorphisms. Semin Oncol Nurs 2024; 40:151652. [PMID: 38834449 DOI: 10.1016/j.soncn.2024.151652] [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: 01/31/2024] [Revised: 04/13/2024] [Accepted: 04/17/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES Decrements in energy were found in 67% of women who underwent breast cancer surgery. However, no information is available on chronic decrements in energy and associations with inflammation. Purposes were to identify latent classes of patients with distinct average energy profiles from prior to through 12 months after breast cancer surgery; evaluate for differences in demographic and clinical characteristics between the two extreme average energy classes; and evaluate for polymorphisms for cytokine genes associated with membership in the Low energy class. METHODS Women (n = 397) completed assessments of energy prior to and for 12 months following breast cancer surgery. Growth mixture modeling was used to identify classes of patients with distinct average energy profiles. Eighty-two single nucleotide polymorphisms (SNPs) among 15 cytokine genes were evaluated. RESULTS Three distinct energy profiles were identified (ie, Low [27.0%], Moderate [54.4%], Changing [18.6%]). Data from patients in the Low and Moderate energy classes were used in the candidate gene analyses. Five SNPs and one haplotype in six different genes remained significant in logistic regression analyses (ie, interleukin [IL]-1β rs1143623, IL1 receptor 1 rs3917332 IL4 rs2243263, IL6 HapA1 [that consisted of rs1800795, rs2069830, rs2069840, rs1554606, rs2069845, rs2069849, and rs2069861], nuclear factor kappa beta subunit 1 rs170731, tumor necrosis factor rs1799964). For several SNPs for IL6, expression quantitative trait locis were identified in subcutaneous and visceral adipose tissue and thyroid tissue. In addition, skeletal muscle was identified as an expression quantitative trait loci for nuclear factor kappa beta subunit 1. CONCLUSIONS Findings suggest that cytokine genes are involved in the mechanisms that underlie chronic decrements in energy in women following breast cancer surgery. Given the roles of subcutaneous and visceral adipose and thyroid tissues in metabolism and energy balance, the findings related to IL6 suggest that these polymorphisms may have a functional role in the development and maintenance of chronic decrements in energy.
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Affiliation(s)
- Christine Miaskowski
- School of Nursing, University of California, San Francisco; School of Medicine, University of California, San Francisco.
| | | | - Jon D Levine
- School of Medicine, University of California, San Francisco
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco
| | - Steven M Paul
- School of Nursing, University of California, San Francisco
| | | | | | - Carolyn Harris
- School of Nursing, University of Pittsburgh, Pittsburgh, PA
| | | | - Gary Abrams
- School of Medicine, University of California, San Francisco
| | | | - Mei R Fu
- University of Missouri, Kansas City
| | - Sarah Alismal
- Beckman Research Institute, City of Hope, Duarte, CA
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Asakitogum DA, Nutor JJ, Pozzar R, Hammer M, Alismail S, Kober KM, Miaskowski C. Multidimensional Model of Energy in Patients With Cancer. Semin Oncol Nurs 2024; 40:151644. [PMID: 38692969 DOI: 10.1016/j.soncn.2024.151644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Evidence suggests that energy is a distinct symptom from fatigue in patients with cancer. The purpose of this paper is to present the Multidimensional Model of Energy in Patients with Cancer (MMEPC) that is based on emerging evidence and to make recommendations for clinical practice and future research. METHODS The literature was reviewed to determine various factors associated with variations in energy in patients with cancer. In addition, some of the emerging evidence in the model is supported by studies of energy in the general population and in patients with other chronic conditions. RESULTS Based on a review of the literature, specific concepts in the MMEPC include: person factors, clinical factors, cancer-related factors, biological factors, factors associated with energy balance, and co-occurring symptoms. The evidence to support the association between each of these factors and variations in energy levels in patients with cancer is described and synthesized. CONCLUSION This article provides emerging evidence on factors that influence variations in energy levels in patients with cancer. While the fundamental biobehavioral and biologic mechanisms that underlie variations in energy levels are not well understood, the model can be used to design pre-clinical and clinical studies of energy in patients with cancer. In addition, while emerging evidence supports the hypothesis that fatigue and energy are distinct symptoms, additional research on common and distinct risk factors and underlying mechanisms is warranted to be able to develop and test precision interventions for one or both symptoms. IMPLICATIONS FOR NURSING PRACTICE The risk factors (eg, being female, sleep quality) associated with variations in energy levels in patients with cancer identified in this paper have important clinical implications. Clinicians can use the identified risk factors to guide their assessments; identify high-risk patients with decrements in energy decrement; and develop targeted energy conservation interventions for the patients.
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Affiliation(s)
| | | | - Rachel Pozzar
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA
| | - Marilyn Hammer
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA
| | | | - Kord M Kober
- School of Nursing, University of California, San Francisco
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco; School of Medicine, University of California, San Francisco
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3
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Ding X, Li Q, Tang YY. The thalamic clustering coefficient moderates the vigor-sleep quality relationship. Sleep Biol Rhythms 2023; 21:369-375. [PMID: 38476314 PMCID: PMC10899908 DOI: 10.1007/s41105-023-00456-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/06/2023] [Indexed: 03/28/2023]
Abstract
Sleep disorders affect more than one-quarter of the world's population, resulting in reduced daytime productivity, impaired immune function, and an increased risk of cardiovascular disease. It is important to identify the physiological and psychological factors related to sleep for the prevention and treatment of sleep disorders. In this study, we correlated measurements of emotional state, sleep quality, and some brain neural activity parameters to better understand the brain and psychological factors related to sleep. Resting-state functional magnetic resonance imaging (rs-fMRI) of 116 healthy undergraduates were analyzed using graph theory to assess regional topological characteristics. Among these, the left thalamic cluster coefficient proved to be the ablest to reflect the characteristics of the sleep neural graph index. The Profile of Mood States (POMS) was used to measure vigor, and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. The results showed that the left thalamic clustering coefficient was negatively correlated with sleep quality and vigor. Further, the left thalamic clustering coefficient moderated the relationship between vigor and sleep quality. When the left thalamic clustering coefficient was very low, there was a significant positive correlation between vigor and sleep quality. However, when the left thalamic clustering coefficient was high, the correlation between vigor and sleep quality became insignificant. The relationship between vigor and sleep quality is heterogeneous. Analyzing the function of the left thalamic neural network could help understand the variation in the relationship between vigor and sleep quality in different populations. Such observations may help in the development of personalized interventions for sleep disorders.
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Affiliation(s)
- Xiaoqian Ding
- College of Psychology, Liaoning Normal University, Dalian, 116029 China
| | - Qingmin Li
- College of Psychology, Liaoning Normal University, Dalian, 116029 China
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Tempe, AZ 85281 USA
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004 USA
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4
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Psychological and social health outcomes of physical activity around menopause: A scoping review of research. Maturitas 2022; 164:88-97. [DOI: 10.1016/j.maturitas.2022.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/30/2022] [Accepted: 07/27/2022] [Indexed: 12/18/2022]
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Tang R, Fan Y, Luo M, Zhang D, Xie Z, Huang F, Wang Y, Liu G, Wang Y, Lin S, Chen R. General and Central Obesity Are Associated With Increased Severity of the VMS and Sexual Symptoms of Menopause Among Chinese Women: A Longitudinal Study. Front Endocrinol (Lausanne) 2022; 13:814872. [PMID: 35557846 PMCID: PMC9086713 DOI: 10.3389/fendo.2022.814872] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/24/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Strong evidence has linked overweight and obesity to increased risks of cardiovascular disease and all-cause mortality in Chinese populations. Menopause is considered associated with increased obesity and central body fat distribution. However, the correlation between obesity and menopausal symptoms has not been well studied. OBJECTIVE To examine the associations between obesity or abdominal obesity and menopausal symptoms as women progressed from premenopausal to postmenopausal status. DESIGN This study included 430 midlife Chinese women who had experienced natural menopause and were followed up for 10 years. Physical examinations and questionnaires should be completed annually. The questionnaires include the Menopause-Specific Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, and other physical and behavioral factors. RESULTS Among women who were not obese (n=345) or not abdominal obese (n=372) at baseline, 5.8% and 31.7% became obese or abdominal obese at the recent follow-up visit, respectively. Women at the recent follow-up visit had an increased body mass index (BMI) by 0.14%, and the waist-to-hip ratio (WHR) increased by 5.2% compared with the data at baseline. In multivariate analysis, more frequent hot flashes, moderate/severe bothered vasomotor symptoms (VMS), mild bothered sexual functioning, and less anxiety symptoms were significantly associated with obesity. Increasing age, moderate/severe bothered VMS, and less anxiety symptoms were independently associated with abdominal obesity. Multivariable analysis also showed that less education level is independently associated with both obesity and abdominal obesity. CONCLUSION Our findings suggest that the proportion of obesity and abdominal obesity increased gradually during menopause. The increase of abdominal obesity is more rapidly than obesity in middle-aged women. Both obesity and abdominal obesity are related with severe or frequent VMS and anxiety symptoms in Chinese women. Although the proportion of obese women in China is lower than in western countries, the problem of abdominal obesity and related complications cannot be ignored.
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Affiliation(s)
- Ruiyi Tang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Yubo Fan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Min Luo
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Duoduo Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Zhuolin Xie
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Feiling Huang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Yuchen Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Gaifen Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yaping Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Shouqing Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Rong Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
- *Correspondence: Rong Chen,
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Johansson LM, Lingfors H, Golsäter M, Kristenson M, Fransson EI. Physical activity related to mastery and vitality in a Swedish adult population with economic difficulties. BMC Public Health 2021; 21:2193. [PMID: 34847894 PMCID: PMC8638203 DOI: 10.1186/s12889-021-12194-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background People with low socio-economic status report lower levels of physical activity (PA). There is insufficient knowledge about the availability of psychological resources for those who are physically active despite having a low socio-economic status. The aim of this study is to investigate the association between PA level and mastery and vitality, respectively, within an adult population with self-reported economic difficulties. Method Data from a cross-sectional, population-based study (n = 817) were used. Linear regression was used to estimate the unstandardised regression coefficient (β) with 95% confidence intervals (95% CI), describing associations between PA levels (independent variable) and scale scores of psychological resources in terms of mastery and vitality (outcome variables). Three models were constructed: Model I unadjusted; Model II adjusted for sex and age; and Model III adjusted for sex, age, smoking and food quality. Result After adjusting for sex, age, smoking and food quality and using low-level PA as the reference, high-level PA, but not intermediate-level PA, was related to higher scale scores of mastery (β = 0.72 [95% CI 0.08 to 1.37]). For vitality, both high-level PA and intermediate-level PA were related to higher scale scores (β = 9.30 [95% CI 5.20 to 13.40] and β = 6.70 [95% CI 1.40 to 12.00] respectively). Conclusion In an adult population with self-reported economic difficulties, higher levels of physical activity were related to higher mastery and vitality. Our results support that the association between physical activity and psychological resources in terms of mastery and vitality should be considered in the context of targeted health dialogues. Trial registration number Not applicable. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12194-6.
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Affiliation(s)
- Lisbeth M Johansson
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden. .,Linköping University, Linköping, Sweden. .,The A.D.U.L.T. Research Group, School of Health and Welfare, Jönköping University, Box 1026, 551 11, Jönköping, Sweden.
| | - Hans Lingfors
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.,Linköping University, Linköping, Sweden
| | - Marie Golsäter
- Linköping University, Linköping, Sweden.,Child Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| | - Margareta Kristenson
- Unit for Health, Medicine and Care, Department of Medicine and Health, Linköping University, Linköping, Sweden
| | - Eleonor I Fransson
- The A.D.U.L.T Research Group, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Dotlic J, Radovanovic S, Rancic B, Milosevic B, Nicevic S, Kurtagic I, Markovic N, Gazibara T. Mental health aspect of quality of life in the menopausal transition. J Psychosom Obstet Gynaecol 2021; 42:40-49. [PMID: 32131666 DOI: 10.1080/0167482x.2020.1734789] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To evaluate factors associated with mental health quality of life (QOL), such as depressed mood, anxiety, poor memory and sleep, among midlife women according to the menopausal status. MATERIAL AND METHODS Participants were 500 women aged 40-65 years. Data were collected using socio-demographic questionnaire, Women's Health Questionnaire (domains of depressed mood-DEP, anxiety-ANX, memory-MEM and sleep-SLE) and Short Form-36 (Mental Composite Score) for assessment of health-related QOL. Factors associated with poorer DEP, ANX, MEM and SLE were examined using adjusted linear regression models. RESULTS In premenopausal women, lower household monthly income (p = .046) was associated with higher level of DEP; higher body mass index (p = .045) was associated with higher ANX; having gynecological illnesses (p = .017) and menopause-related symptoms (p = .039) were associated with poorer MEM; being married (p = .036), drinking alcohol (p = .036) and having more physical activity (p = .041) was associated with better SLE. In postmenopausal women, worse DEP was more likely among women residing in city outskirts (p = .009), who are not married (p = .038) and with sedentary occupations (p = .049); lower education level (p = .030) was associated with more ANX; lower education level (p = .045) and having menopause-related symptoms (p = .044) were associated with poorer MEM; not engaging in regular recreation (p = .031) was associated with better SLE. CONCLUSIONS To improve QOL, pre- and postmenopausal women should not only be supported in the management of menopause-specific symptoms. Women should also receive recommendations as to the behavioral and personal changes when approaching the midlife period.
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Affiliation(s)
- Jelena Dotlic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Biljana Rancic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Branislav Milosevic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - Selmina Nicevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ilma Kurtagic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Tatjana Gazibara
- Institute for Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Miller M, Lee-Chambers J, Cooper B, Boolani A, Jansen E. Associations between physical activity and energy and fatigue depend on sleep quality. FATIGUE: BIOMEDICINE, HEALTH & BEHAVIOR 2020. [DOI: 10.1080/21641846.2020.1843790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Matthew Miller
- Department of Physical Therapy, Clarkson University, Potsdam, NY, USA
| | | | - Briana Cooper
- Department of Physical Therapy, Clarkson University, Potsdam, NY, USA
| | - Ali Boolani
- Department of Physical Therapy, Clarkson University, Potsdam, NY, USA
- Department of Biology, Clarkson University, Potsdam, NY, USA
| | - Erica Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Division of Sleep Medicine, Department of Neurology, University of Michigan Medicine, Ann Arbor, MI, USA
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Liu HY, Chang CC, Gill DL, Wu SC, Lu FJH. Male Weight Trainers' Body Dissatisfaction and Exercise Dependence: Mediating Role of Muscularity Drive. Psychol Rep 2018; 122:2137-2154. [PMID: 30360688 DOI: 10.1177/0033294118805010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In considering that body image-related perceptions may be associated with weight trainers’ exercise dependence, the purpose of this study was to examine the (a) relationship between body dissatisfaction and drive for muscularity and (b) drive for muscularity as a mediator of the body dissatisfaction–exercise dependence relationship. In sum, 278 male weight trainers ( Mage =29.03 years, SD = 7.83) residing in a southern city of Taiwan completed scales of body dissatisfaction, drive for muscularity, and exercise dependence. Pearson correlation analysis found that body dissatisfaction, drive for muscularity, and exercise dependence were all correlated. Further, the indirect mediation model with bootstrapping found that drive for muscularity partially mediated the body dissatisfaction–exercise dependence relationship (c path: β = .51, SE = 0.07, p=.001: c′ path: β = .13, SE = 0.80, p = .03). We concluded that male weight trainers’ body image-related perceptions influence exercise behavior and suggested that body image-related perceptions might be considered in studying exercise dependence.
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Affiliation(s)
- Hong-Yu Liu
- Department of Exercise and Health Promotion, Chinese Culture University, Taiwan
| | - Chiu-Chen Chang
- Department of Kinesiology, Health, and Leisure Studies, National University of Kaohsiung, Taiwan
| | - Diane L Gill
- Department of Kinesiology, University of North Carolina at Greensboro, USA
| | - Shu-Ching Wu
- Center for General Education, Ling-Tung University, Taiwan
| | - Frank J H Lu
- Department of Physical Education, Chinese Culture University, Taiwan
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Brandes M, Wirsik N, Niehoff H, Heimsoth J, Möhring B. Impact of a tailored activity counselling intervention during inpatient rehabilitation after knee and hip arthroplasty - an explorative RCT. BMC Musculoskelet Disord 2018; 19:209. [PMID: 29960605 PMCID: PMC6026519 DOI: 10.1186/s12891-018-2130-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 06/11/2018] [Indexed: 01/24/2023] Open
Abstract
Background The aim of the study was to improve physical activity (PA), well-being and clinical outcome after total knee and hip arthroplasty through tailored activity counselling during inpatient rehabilitation. Methods 65 patients (aged 70.4 ± 7.3 years, BMI 28.5 ± 4.3) starting inpatient rehabilitation after primary knee or hip arthroplasty due to osteoarthritis were recruited and pseudo-randomized into an intervention (IG) and a control group (CG). Twice a week, the IG was encouraged to increase their daily step count by 5%. PA, e. g. number of steps, step frequency, or active minutes, was measured by step activity monitoring. Well-being and clinical outcome were assessed using the SF-36, Oxford Knee/Hip Score and Global rating of Change. Procedures were conducted at the onset of inpatient rehabilitation, and repeated one and 6 months after inpatient rehabilitation. Results Data sets were obtained from 49 patients (IG: n = 23, CG: n = 26). Both groups significantly increased their number of daily steps from the 1 month to the 6 months follow up after rehabilitation: CG: 9019 (95%CI: 7812, 10,226), IG: 9280 (7972, 10,588) and CG: 10921 (9571, 12,271), IG: 11326 (9862, 12,791) respectively. Additionally, well-being and clinical outcome improved significantly in both groups. No significant differences in physical activity, clinical outcome and well-being were found between the groups. Conclusions PA counselling during inpatient rehabilitation does not improve PA, well-being and clinical outcome in patients with primary knee or hip arthroplasty in addition to the rehabilitation program. PA interventions may be more effective after the completion of the inpatient rehabilitation phase. Trial registration DRKS DRKS00012682. Registered retrospectively on 03–07- 2017.
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Affiliation(s)
- Mirko Brandes
- Department of Prevention and Evaluation, Unit Applied Health Intervention Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Achterstraße 30, 28359, Bremen, Germany.
| | - Norman Wirsik
- Department of Biometry and Data Management, Unit Statistical Modelling of Primary Data, Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
| | - Hanna Niehoff
- Institute of Sports Science, Oldenburg University, Oldenburg, Germany
| | - Jörg Heimsoth
- Orthopaedic Department, Rehabilitation Centre Oldenburg, Oldenburg, Germany
| | - Bernd Möhring
- Orthopaedic Department, Rehabilitation Centre Oldenburg, Oldenburg, Germany
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Are BMI and inflammatory markers independently associated with physical fatigability in old age? Int J Obes (Lond) 2018; 43:832-841. [PMID: 29795469 PMCID: PMC6477893 DOI: 10.1038/s41366-018-0087-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/21/2018] [Accepted: 03/05/2018] [Indexed: 12/27/2022]
Abstract
Background Obesity and chronic low-grade inflammation have both been implicated in the onset of physical fatigue. However, few studies have investigated the independence of these associations in older community-dwelling populations. We therefore aimed to investigate the associations of body mass index (BMI) and inflammatory markers at age 60–64 with perceived physical fatigability at age 68 and to assess whether any such associations were independent of each other and potential confounding factors. A secondary aim was to investigate whether any association with BMI extended back into earlier adulthood. Methods Participants of the MRC National Survey of Health and Development (N = 1580) had BMI and levels of interleukin-6 (IL-6) and C-reactive protein (CRP) measured during clinical assessments at age 60–64. These were related to self-perceived physical fatigability assessed at age 68 using the Pittsburgh Fatigability Scale (PFS) (total score:0 (no physical fatigue)–50 (extreme physical fatigue)). Resuts Women had higher mean PFS scores than men (mean (SD): 16.0 (9.1) vs 13.2 (8.9), p < 0.01). In sex-adjusted models, BMI, CRP and IL-6 were each associated with PFS scores. When all three factors were included in the same model, BMI and IL-6 remained associated with PFS scores whereas CRP did not. After adjustment for a range of potential confounders, associations of BMI and IL-6 with PFS scores were still evident; fully adjusted differences in mean PFS score = 3.41 (95% CI: 0.59, 6.24) and 1.65 (0.46, 2.84) for underweight and obese participants when compared with normal weight and, 2.78 (1.65, 3.91) when comparing those with an IL-6 of 2.51–8.49 pg/mL with levels <1.50. Conclusions BMI and inflammation may both be suitable targets for intervention to reduce the burden of physical fatigability in later life. Further, interventions that target both obesity and elevated levels of IL-6 are likely to be more effective than those focusing on only one.
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12
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Hodges A, Harmer AR, Dennis S, Nairn L, March L, Crawford R, Parker D, Fransen M. Prevalence and determinants of physical activity and sedentary behaviour before and up to 12 months after total knee replacement: a longitudinal cohort study. Clin Rehabil 2018; 32:1271-1283. [PMID: 29690780 DOI: 10.1177/0269215518769986] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aims to evaluate the prevalence and determinants of inadequate physical activity and excessive sedentary behaviour before and after total knee replacement. DESIGN, SETTING AND SUBJECTS Secondary analysis was performed on data from a cohort of 422 adults (45-74 years), drawn from 12 public or private hospitals, undergoing primary unilateral or bilateral total knee replacement surgery. MAIN MEASURES Questionnaires were used to determine the presence of inadequate physical activity and excessive sedentary behaviour before and 6 and 12 months after total knee replacement surgery. Knee pain, activity limitations, comorbidities, muscle strength, psychological well-being, fatigue, sleep and body mass index were measured/assessed as possible determinants of physical activity or sedentary behaviour. RESULTS Before surgery, 77% ( n = 326) of the cohort participated in inadequate physical activity according to World Health Organization guidelines, and 60% ( n = 253) engaged in excessive sedentary behaviour. Twelve months after surgery, 53% ( n = 185) of the cohort engaged in inadequate physical activity and 45% ( n = 157) in excessive sedentary behaviour. Inadequate physical activity before surgery ( P = 0.02), obesity ( P = 0.07) and comorbidity score >6 ( P = 0.04) predicted inadequate physical activity 12 months after surgery. Excessive sedentary behaviour and activity limitations before surgery predicted excessive sedentary behaviour 12 months after surgery. CONCLUSION Although there were improvements after total knee replacement, 12 months after surgery about half the cohort did not meet World Health Organization recommendations for activity. Pre-surgery assessment of physical activity, activity limitations, sedentary behaviour and body mass index is essential to identify patients at risk for long-term inactivity.
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Affiliation(s)
- Alison Hodges
- 1 Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Alison R Harmer
- 1 Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Sarah Dennis
- 1 Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia.,2 South Western Sydney Local Health District, Warwick Farm, NSW, Australia.,3 Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Lillias Nairn
- 4 Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Lyn March
- 5 Royal North Shore Hospital, St Leonard's; Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - Ross Crawford
- 6 Queensland University of Technology, Brisbane, QLD, Australia
| | - David Parker
- 7 Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia
| | - Marlene Fransen
- 1 Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
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13
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Guérin E, Goldfield G, Prud'homme D. Trajectories of mood and stress and relationships with protective factors during the transition to menopause: results using latent class growth modeling in a Canadian cohort. Arch Womens Ment Health 2017; 20:733-745. [PMID: 28707156 DOI: 10.1007/s00737-017-0755-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
Abstract
The menopause transition is characterized by significant hormonal changes that may predispose women to psychosocial maladjustment. Prospective studies to date have focused primarily on negative mood states and show equivocal findings. The primary goal of this study was to identify patterns of change with respect to positive and negative mood states (vigor, depression, tension, and stress) over a 5-year period in a cohort of women undergoing the transition to menopause. A secondary aim was to determine whether the identified trajectories were associated with menopause status as well as baseline health-related and psychological characteristics. This longitudinal study observed 102 healthy Canadian women who were premenopausal at baseline (age 47-55 years). Analyses consisted of latent class growth modeling. Mood states were predominantly normal and stable, raising doubts regarding the notion that psychosocial distress is a common and natural occurrence during the transition to menopause. Neither time spent in perimenopause nor BMI had a significant influence on levels of mood indicators. However, higher scores on body image, self-esteem, and general health perceptions were predictive of more positive psychological outcomes over the 5-year period. Targeting improvements in self-perceptions may promote a healthier psychological adjustment during this natural transitional period in a women's lifespan.
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Affiliation(s)
- Eva Guérin
- Institut du Savoir Montfort - Recherche, 202-745A Montréal Rd, Ottawa, ON, K1K 0T1, Canada
| | - Gary Goldfield
- Healthy Active Living and Obesity (HALO) Research group, Children's Hospital of Eastern Ontario (CHEO) Research Institute, 40 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Denis Prud'homme
- Institut du Savoir Montfort - Recherche, 202-745A Montréal Rd, Ottawa, ON, K1K 0T1, Canada. .,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Pr, Ottawa, ON, K1N 1A2, Canada.
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14
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Guérin E, Biagé A, Goldfield G, Prud'homme D. Physical activity and perceptions of stress during the menopause transition: A longitudinal study. J Health Psychol 2017; 24:799-811. [PMID: 28810371 DOI: 10.1177/1359105316683787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The transition to menopause is a critical period of significant biopsychosocial change. The purpose of this study was to examine the influence of the transition to menopause and volume of physical activity on levels of perceived stress over five years in 102 healthy middle-aged women. Questionnaire and accelerometer data were analyzed using linear mixed models. Adjusting for age and body mass index, there were no significant effects of menopause status or time on perceived stress. Independent of menopause status, minutes per week of vigorous activity was associated with lower perceived stress in years 1 and 2 of the study.
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Affiliation(s)
- Eva Guérin
- 1 Institut de Recherche de l'Hôpital Montfort, Canada
| | - Alyssa Biagé
- 1 Institut de Recherche de l'Hôpital Montfort, Canada.,2 University of Ottawa, Canada
| | - Gary Goldfield
- 3 Children's Hospital of Eastern Ontario (CHEO) Research Institute, Canada
| | - Denis Prud'homme
- 1 Institut de Recherche de l'Hôpital Montfort, Canada.,2 University of Ottawa, Canada
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15
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Nicklas BJ, Beavers DP, Mihalko SL, Miller GD, Loeser RF, Messier SP. Relationship of Objectively-Measured Habitual Physical Activity to Chronic Inflammation and Fatigue in Middle-Aged and Older Adults. J Gerontol A Biol Sci Med Sci 2016; 71:1437-1443. [PMID: 27382039 DOI: 10.1093/gerona/glw131] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/22/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Habitual (non-exercise) physical activity (PA) declines with age, and aging-related increases in inflammation and fatigue may be important contributors to variability in PA. METHODS This study examined the association of objectively-measured PA (accelerometry over 7 days) with inflammation (plasma interleukin-6 and C-reactive protein) and with self-reported fatigue (SF-36 Vitality) at baseline and 18 months after a diet-induced weight loss, exercise, or diet-induced weight loss plus exercise intervention in 167 overweight/obese, middle-aged, and older adults. RESULTS At baseline, individuals with higher plasma interleukin-6, as well as those who reported feeling less energetic (more fatigued), took less steps per day and had lower PA energy expenditure and minutes of light and moderate-vigorous PA (p < .05 for all). At the 18-month follow-up, inflammation was lower in both weight loss groups, fatigue was reduced in all three groups with larger decreases in the combined group, and mean levels of habitual PA were not changed in any group. In longitudinal analyses with all groups combined, we found that participants reporting larger increases in vitality (eg, declines in fatigue) had greater increases in PA (p < .05 for all). Also, changes in steps/d and physical activity energy expenditure were indirectly associated with changes in interleukin-6 (β [SEM] for steps/d = -565 [253]; β [SEM] for physical activity energy expenditure = -22.4 [10.17]; p < .05). CONCLUSIONS Levels of habitual PA are lower in middle-aged and older adults with higher levels of chronic inflammation and greater self-reported fatigue. In addition, participants who experienced greater declines in inflammation during the interventions had greater declines in fatigue and larger increases in PA.
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Affiliation(s)
- Barbara J Nicklas
- Section on Gerontology and Geriatric Medicine, J. Paul Sticht Center on Aging, Department of Internal Medicine, and
| | - Daniel P Beavers
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Shannon L Mihalko
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
| | - Gary D Miller
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
| | - Richard F Loeser
- Thurston Arthritis Research Center and the Division of Rheumatology, Allergy, and Immunology, University of North Carolina, Chapel Hill
| | - Stephen P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
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16
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Mahieu MA, Ahn GE, Chmiel JS, Dunlop DD, Helenowski IB, Semanik P, Song J, Yount S, Chang RW, Ramsey-Goldman R. Fatigue, patient reported outcomes, and objective measurement of physical activity in systemic lupus erythematosus. Lupus 2016; 25:1190-9. [PMID: 26869353 DOI: 10.1177/0961203316631632] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 01/14/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Fatigue is a common symptom in systemic lupus erythematosus (SLE), and engaging in physical activity may reduce fatigue. We aimed to characterize relationships between fatigue, other health status measures assessed with the Patient Reported Outcomes Measurement Information System (PROMIS) instruments, and accelerometer-based physical activity measurements in patients with SLE. The internal consistency of each PROMIS measure in our SLE sample was also evaluated. METHODS This cross-sectional study analyzed 123 adults with SLE. The primary fatigue outcome was Fatigue Severity Scale score. Secondary outcomes were PROMIS standardized T-scores in seven health status domains. Accelerometers were worn for seven days, and mean daily minutes of light, moderate/vigorous, and bouted (10 minutes) moderate/vigorous physical activity were estimated. Cronbach's alpha was determined for each PROMIS measure to assess internal consistency. Relationships between Fatigue Severity Scale, PROMIS, and physical activity were summarized with Spearman partial correlation coefficients (r), adjusted for average daily accelerometer wear time. RESULTS Mean Fatigue Severity Scale score (4.3, SD 1.6) was consistent with clinically relevant levels of fatigue. Greater daily and bouted moderate/vigorous physical activity minutes correlated with lower Mean Fatigue Severity Scale score (r = -0.20, p = 0.03 and r = -0.30, p = 0.0007, respectively). For PROMIS, bouted moderate/vigorous physical activity minutes correlated with less fatigue (r = -0.20, p = 0.03). PROMIS internal consistency was excellent, with Cronbach's alpha > 0.90 for each domain. Mean PROMIS T-scores for fatigue, pain interference, anxiety, sleep disturbance, sleep-related impairment, and physical function were worse than reported for the general US population. More moderate/vigorous physical activity minutes were associated with less pain interference (r = -0.22, p = 0.01). Both light physical activity and moderate/vigorous physical activity minutes correlated with better physical function (r = 0.19, p = 0.04 and r = 0.25, p = 0.006, respectively). CONCLUSION More time spent in moderate/vigorous physical activity was associated with less fatigue (Fatigue Severity Scale and PROMIS), less pain interference, and better physical function (PROMIS). PROMIS had excellent internal consistency in our SLE sample, and six of seven PROMIS measures indicated poorer average health status in SLE patients compared with the general US population.
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Affiliation(s)
- M A Mahieu
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - G E Ahn
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Arthritis and Rheumatism Associates, Wheaton, MD, USA
| | - J S Chmiel
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - D D Dunlop
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - I B Helenowski
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - P Semanik
- Department of Adult Health and Gerontological Nursing, Rush University College of Nursing, Chicago, IL, USA
| | - J Song
- Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Yount
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - R W Chang
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - R Ramsey-Goldman
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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17
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Tadayon M, Abedi P, Farshadbakht F. Impact of pedometer-based walking on menopausal women’s sleep quality: a randomized controlled trial. Climacteric 2016; 19:364-8. [DOI: 10.3109/13697137.2015.1123240] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- M. Tadayon
- Menopause and Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - P. Abedi
- Menopause and Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - F. Farshadbakht
- Menopause and Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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