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Iconaru EI, Tarcau E, Ciucurel C. The Influence of Weather Conditions on the Diurnal Variation in Range of Motion in Older Adults with Knee Osteoarthritis. J Clin Med 2024; 13:254. [PMID: 38202261 PMCID: PMC10780229 DOI: 10.3390/jcm13010254] [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: 11/17/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: This study investigated the relationship between weather conditions, diurnal patterns, and total knee range of motion (ROM), as well as the severity of symptoms (pain and stiffness) in older adults with knee osteoarthritis. (2) Methods: An exploratory longitudinal study was conducted on 28 older adults with knee osteoarthritis (mean age 71.86 ± 4.49 years; 46.4% men, 53.6% women). We used as assessment tools the Visual Analog Scales (VAS) for self-reported local knee pain and stiffness, and goniometry for ROM. Measurements were taken twice, six months apart, in winter and summer, in the morning and evening of each selected day. Recorded weather factors comprised temperature, relative humidity, barometric pressure, and maximum wind speed. (3) Results: The study revealed significant effects of season and time of day on pain and stiffness, respectively (p < 0.001). Additionally, a significant interaction between season and time influenced total knee ROM (p < 0.001). Moreover, there was a statistically significant relationship between time and total knee ROM (p < 0.001). (4) Conclusions: This research underscores the complex link between seasonal fluctuations and daily variations in some symptomatic and functional aspects of knee osteoarthritis in older adults.
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Affiliation(s)
- Elena Ioana Iconaru
- Department of Medical Assistance and Physical Therapy, University Center of Pitesti, National University for Science and Technology Politehnica Bucuresti, 110040 Pitesti, Romania; (E.I.I.); (C.C.)
| | - Emilian Tarcau
- Department of Physical Education, Sport and Physical Therapy, University of Oradea, 410087 Oradea, Romania
| | - Constantin Ciucurel
- Department of Medical Assistance and Physical Therapy, University Center of Pitesti, National University for Science and Technology Politehnica Bucuresti, 110040 Pitesti, Romania; (E.I.I.); (C.C.)
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Rausch Osthoff AK, Nast I, Niedermann K. Understanding beliefs related to physical activity in people living with axial Spondyloarthritis: a theory-informed qualitative study. BMC Rheumatol 2022; 6:40. [PMID: 35871641 PMCID: PMC9310396 DOI: 10.1186/s41927-022-00270-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/12/2022] [Indexed: 11/28/2022] Open
Abstract
Background People living with axial Spondyloarthrtis (axSpA) have an increased risk of cardiovascular diseases, which can be reduced by regular physical activity (PA) and its subset of cardiorespiratory training (CRT). To fulfil their crucial role in PA promotion, physiotherapists and other health professionals need to understand the beliefs that people living with axSpA possess concerning general PA and CRT. The aim of this study is to explore these behavioural, normative and control beliefs.
Methods A qualitative descriptive design approach was chosen. Five semi-structured focus group interviews with 24 individuals living with axSpA were performed. Data was analysed using structured thematic qualitative content analysis.
Results People with axSpA possessed multifaceted behavioural, normative and control beliefs concerning general PA and CRT. Behavioural beliefs revealed a positive attitude towards general PA, with participants mentioning numerous physical, psychological, and social benefits and only few risks. However, the conceptual difference between general PA and CRT, and the relevance of CRT, was unclear to some participants. Normative beliefs were expressed as the beliefs of significant others that influenced their motivation to comply with such beliefs, e.g. spouses, other people living with axSpA, rheumatologists. Regarding control beliefs, general PA and CRT were both mentioned as effective self-management strategies to control the disease. From experience, a high level of self-discipline, as well as technology, were shown to be useful.
Conclusions General PA is understood to be an important self-management strategy for people with axSpA and most participants build general PA into their daily routines. They believe that general PA beneficially impacts personal health and wellbeing. However, some participants are unaware of the difference between general PA and CRT and the important impact that this difference could have on their health. The consequences of CRT promotion for people living with axSpA should be the subject of further research. Supplementary Information The online version contains supplementary material available at 10.1186/s41927-022-00270-2.
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Using a Service Ontology to Understand What Influences Older Adults' Outdoor Physical Activities in Nanjing. J Aging Phys Act 2022; 31:230-239. [PMID: 36041733 DOI: 10.1123/japa.2021-0520] [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: 01/27/2022] [Revised: 05/28/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022]
Abstract
Older adults are not actively participating in outdoor physical activities. An understanding of what factors influence older adults' outdoor physical activities is important for informing interventions. This study aims to examine the potential effect of service ontology on the intention of outdoor physical activities in older adults. Face-to-face surveys were conducted with 421 older adults from eight districts in Nanjing, China. One-way analysis of variance and ordinal logistic regression analysis revealed that seven of the 20 factors have a positive effect on intention of outdoor physical activities, including gender, health self-assessment, family structure, accessibility, exercise instructors, emergency service, and staff in outdoor space. To further improve the intention of outdoor physical activities, governments and service designers should focus on providing age-friendly community infrastructures. Moreover, specific attention should be paid toward older females and people with low-income/poor health conditions, and strategies should also be adopted to significantly improve the quantity and instruction efficiency of exercise instructors.
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Koh YS, Asharani PV, Devi F, Roystonn K, Wang P, Vaingankar JA, Abdin E, Sum CF, Lee ES, Müller-Riemenschneider F, Chong SA, Subramaniam M. A cross-sectional study on the perceived barriers to physical activity and their associations with domain-specific physical activity and sedentary behaviour. BMC Public Health 2022; 22:1051. [PMID: 35614402 PMCID: PMC9132675 DOI: 10.1186/s12889-022-13431-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Physical inactivity and sedentary behaviour have detrimental consequences to the individual and the economy. Our study examined the prevalence of perceived barriers to physical activity in Singapore’s adult population and their associations with physical activity and sedentary behaviour. Methods This cross-sectional analysis utilised data from a nationwide survey in Singapore. Participants (n = 2867) were recruited from February 2019 to March 2020. The independent variables were internal (e.g. fatigue, age) and external (e.g. weather, cost) perceived barriers to physical activity. The outcomes were domain-specific physical activity (work, transport and leisure) and sedentary behaviour, all of which were assessed using the Global Physical Activity Questionnaire. The associations were examined using zero-inflated negative binomial regressions for physical activity and linear regression for sedentary behaviour. Results The median (Interquartile range) for work-related, transport-related and leisure-related physical activity were 0 (0 – 1440), 600 (160 – 1120) and 360 (0 – 1080) MET (metabolic equivalent)-minutes per week. The median sedentary behaviour (IQR) was 360 (240 – 540) minutes per day. The top three barriers were lack of time (65.3%), fatigue (64.7%) and pollution (56.1%). After adjustment, the level of transport-related physical activity was lower for respondents who cited lacking pavement or parks as a barrier, but higher for those who indicated cost and safety concerns. Respondents who reported pollution as a barrier were more likely to engage in transport-related physical activity. The level of leisure-related physical activity was lower for respondents indicating weather, lack of time and age as barriers, but higher for those reporting safety concerns. The odds of engaging in leisure-related physical activity was lower for those citing age, cost and fatigue as barriers, but higher for those indicating the weather. Sedentary behaviour was positively associated with work and limited accessibility to exercise facilities, but negatively with safety concerns. Conclusion Individuals can be motivated to overcome internal barriers (fatigue, lack of time, cost and age) through social support and emphasis on exercise benefits. External barriers (weather and lack of pavements or parks) can be reduced by raising awareness of existing infrastructure. Sedentary behaviour can be improved by implementing workplace measures, such as reducing the time spent sitting. Supplementary information The online version contains supplementary material available at 10.1186/s12889-022-13431-2.
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Affiliation(s)
- Yen Sin Koh
- Research Division, Institute of Mental Health, Singapore, Singapore.
| | - P V Asharani
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Self-Reported Weather Sensitivity is Associated with Clinical Symptoms and Structural Abnormalities in Patients with Knee Osteoarthritis: A Cross-Sectional Study. Rheumatol Ther 2021; 8:1405-1417. [PMID: 34389921 PMCID: PMC8380616 DOI: 10.1007/s40744-021-00340-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/17/2021] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Patients with knee osteoarthritis (KOA) often complain about clinical symptoms affected by weather-related factors. The purpose of the present study was to use cross-sectional analysis to determine whether weather sensitivity was associated with clinical symptoms, as well as structure abnormalities, in KOA patients. METHODS Data from 80 participants were obtained from the Feng Hans Shi Effects on OA (FHS) study, an OA cohort study initiated in China in 2015. The weather sensitivity of each participant was determined by a self-reported questionnaire. The following measurements were used to assess clinical outcomes: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for symptoms, and semi-quantitative Whole-Organ Magnetic Resonance Imaging Score (WORMS) for cartilage defects and marrow abnormalities of magnetic resonance imaging (MRI). Chi-square with Cochran-Armitage test for trend and regression analysis were used to evaluate the associations between weather sensitivity and WOMAC and WORMS of KOA patients. RESULTS Most of the KOA participants (57.5%) perceived the weather as affecting their knee-joint clinical symptoms. After adjusting for age, gender, and body mass index (BMI), weather sensitivity was not only associated with knee pain [OR = 3.3 (95% CI 1.1, 9.9), P = 0.032], dysfunction [OR = 5.5 (95% CI 1.8, 16.8), P = 0.003], and overall clinical symptoms [OR = 3.3 (95% CI 1.1, 10.2), P = 0.034], but also associated with cartilage defect [OR = 3.1 (95% CI 1.1, 8.5), P = 0.027] and marrow abnormality [OR = 3.0 (95% CI 1.1, 8.1), P = 0.029]. CONCLUSIONS In KOA patients, weather sensitivity was associated with clinical symptoms and structural abnormalities. Future longitudinal study is warranted for the causal relationship. INFOGRAPHIC.
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Zhang Y, Yang J, Yu T, Ma L, Cheng Y, Li X. Epidemiological Characteristics of Osteoarthritis in Yichang City - Hubei Province, China, 2017-2018. China CDC Wkly 2021; 3:335-339. [PMID: 34594879 PMCID: PMC8393073 DOI: 10.46234/ccdcw2021.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/08/2021] [Indexed: 11/14/2022] Open
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC? OA has been listed as the fastest increasing major public health problem and ranked second as a cause of disability by World Health Organization (WHO). With population aging, osteoarthritis (OA) is causing an increased economic burden for individuals and society and is attracting an increasing amount of scientific attention. WHAT IS ADDED BY THIS REPORT? This research used healthcare data to analyze the epidemiological characteristics of OA in Yichang City, Hubei Province, China. The exact number and distribution of patients were obtained, and a descriptive analysis of OA visits by age, gender, and season was performed. Knee joint disease among women was most common, followed by other joint diseases. Knee osteoarthritis was the most common OA diagnosis between 60 and 69 years of age. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE? In China, the prevalence of OA among middle-age and elderly people was high. With increases in the size of the elderly population, the burden of disease caused by OA may increase. It is necessary to strengthen publicity to improve people's awareness of self-health care of bone and joint. Interventions and preventive strategies targeting high-risk groups are urgently needed in order to improve healthy bones and healthy life quality among middle-age and elderly people.
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Affiliation(s)
- Yingying Zhang
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiajuan Yang
- Yichang Center for Disease Control and Prevention, Yichang, Hubei, China
| | - Tanchun Yu
- Zhongguancun Institute of National Health Big Data, Beijing, China
| | - Li Ma
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuewei Cheng
- Shandong Provincial Armed Police Corps Hospital, Jinan, Shandong, China
| | - Xudong Li
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
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Hobbs M, Moltchanova E, Wicks C, Pringle A, Griffiths C, Radley D, Zwolinsky S. Investigating the environmental, behavioural, and sociodemographic determinants of attendance at a city-wide public health physical activity intervention: Longitudinal evidence over one year from 185,245 visits. Prev Med 2021; 143:106334. [PMID: 33227345 DOI: 10.1016/j.ypmed.2020.106334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/23/2020] [Accepted: 11/18/2020] [Indexed: 10/23/2022]
Abstract
Understanding the determinants of attendance at public health interventions is critical for effective policy development. Most research focuses on individual-level determinants of attendance, while less is known about environmental-level determinants. Data were obtained from the Leeds Let's Get Active public health intervention in Leeds, England. Longitudinal data (April 2015-March 2016) on attendance were obtained for n = 25,745 individuals (n = 185,245 total visits) with baseline data on sociodemographic determinants and lifestyle practices obtained for n = 3621 individuals. This resulted in a total of n = 744,468 days of attendance and non-attendance. Random forests were used to explore the relative importance of the determinants on attendance, while generalised linear models were applied to examine specific associations (n = 3621). The probability that a person will attend more than once, the number of return visits, and the probability that a person will attend on a particular day were investigated. When considering if a person returned to the same leisure centre after one visit, the most influential determinant was the distance from their home. When considering number of return visits overall however, age group was the most influential. While distance to a leisure centre was less important for predicting the number of return visits, the difference between estimates for 300 m and 15,000 m was 7-10 visits per year. Finally, calendar month was the most important determinant of daily attendance. This longitudinal study highlights the importance of both individual and environmental determinants in predicting various aspects of attendance. It has implications for strategies aiming to increase attendance at public health interventions.
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Affiliation(s)
- M Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand; Health Sciences, University of Canterbury, Christchurch, Canterbury, New Zealand.
| | - E Moltchanova
- School of Mathematics & Statistics, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - C Wicks
- School of Health and Social Care, University of Essex, Colchester, United Kingdom
| | - A Pringle
- Sport, Outdoor & Exercise Sciences, University of Derby, Derby, United Kingdom
| | - C Griffiths
- Leeds Beckett University, Leeds, United Kingdom
| | - D Radley
- Leeds Beckett University, Leeds, United Kingdom
| | - S Zwolinsky
- West Yorkshire & Harrogate Cancer Alliance, Wakefield, United Kingdom
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Herbolsheimer F, Ungar N, Portegijs E, Dallmeier D, Schaap L, Smith T, Stubbs B, Deeg D, Peter R, Castell MV, Otero Á, Edwards M, Siviero P, Limongi F, Dennison E, van Schoor N, Veronese N, Timmermans EJ, van der Pas S. Neighborhood environment, social participation, and physical activity in older adults with lower limb osteoarthritis: A mediation analysis. Health Place 2021; 68:102513. [PMID: 33508711 DOI: 10.1016/j.healthplace.2021.102513] [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] [Received: 06/16/2020] [Revised: 11/04/2020] [Accepted: 01/12/2021] [Indexed: 01/03/2023]
Abstract
Older adults with lower limb osteoarthritis (LLOA) are highly dependent on their physical and social environment for being physically active. Longitudinal data from 2286 older adults (Mage = 73.8 years; 50.3% female) in six European countries were analyzed using cross-lagged Structural Equation Modeling (SEM) and multi-group SEM. In cross-sectional analyses, neighborhood resources were associated with physical activity (r = 0.26;p < .001) and social participation (r = 0.13;p = .003). Physical activity at follow-up was associated with neighborhood resources, with this relationship mediated by social participation in people with LLOA (β = 0.018;p = .013). To promote future physical activity, opportunities to socially engage in neighborhoods need to be targeted primarily to people with LLOA.
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Affiliation(s)
| | - Nadine Ungar
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Erja Portegijs
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyvaskyla, Finland
| | - Dhayana Dallmeier
- Research Unit on Aging, AGAPLESION Bethesda Clinic Ulm, Ulm, Germany; Dept. of Epidemiology, Boston University, School of Public Health, Boston, USA
| | - Laura Schaap
- Vrije Universiteit Amsterdam, Department of Health Sciences, Amsterdam Public Health Research Institute, Faculty of Sciences, Amsterdam, the Netherlands
| | - Toby Smith
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Positive Ageing Research Institute, Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Dorly Deeg
- Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Richard Peter
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Maria Victoria Castell
- Department of Preventive Medicine and Public Health, Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Ángel Otero
- Department of Preventive Medicine and Public Health, Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Mark Edwards
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Paola Siviero
- National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy
| | - Federica Limongi
- National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Natasja van Schoor
- Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Nicola Veronese
- National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy
| | - Erik J Timmermans
- Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Suzan van der Pas
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; Faculty of Social Work & Applied Psychology, University of Applied Sciences Leiden, the Netherlands
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Thermal Personalities of Older People in South Australia: A Personas-Based Approach to Develop Thermal Comfort Guidelines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228402. [PMID: 33202798 PMCID: PMC7698095 DOI: 10.3390/ijerph17228402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
An important consideration for future age-friendly cities is that older people are able to live in housing appropriate for their needs. While thermal comfort in the home is vital for the health and well-being of older people, there are currently few guidelines about how to achieve this. This study is part of a research project that aims to improve the thermal environment of housing for older Australians by investigating the thermal comfort of older people living independently in South Australia and developing thermal comfort guidelines for people ageing-in-place. This paper describes the approach fundamental for developing the guidelines, using data from the study participants' and the concept of personas to develop a number of discrete "thermal personalities". Hierarchical Cluster Analysis (HCA) was implemented to analyse the features of research participants, resulting in six distinct clusters. Quantitative and qualitative data from earlier stages of the project were then used to develop the thermal personalities of each cluster. The thermal personalities represent different approaches to achieving thermal comfort, taking into account a wide range of factors including personal characteristics, ideas, beliefs and knowledge, house type, and location. Basing the guidelines on thermal personalities highlights the heterogeneity of older people and the context-dependent nature of thermal comfort in the home and will make the guidelines more user-friendly and useful.
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Xu R, Xiong X, Abramson MJ, Li S, Guo Y. Ambient temperature and intentional homicide: A multi-city case-crossover study in the US. ENVIRONMENT INTERNATIONAL 2020; 143:105992. [PMID: 32738768 DOI: 10.1016/j.envint.2020.105992] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/30/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND There has been an increasing interest in the association between ambient temperature and violence and crime, in the context of global warming. We aimed to evaluate the association between daily ambient temperature and intentional homicide-a proxy for overall inter-personal violence. METHODS We collected daily weather and crime data from 9 large US cities (Chicago, Detroit, Fort Worth, Kansas City, Los Angeles, Louisville, New York, Tucson and Virginia Beach) from 2007 to 2017. A time-stratified case-crossover design was used. The associations were quantified by conditional logistic regression with distributed lag models, adjusting for relative humidity, precipitation and effects of public holidays. City-specific odds ratios (OR) were used to calculate the attributable fractions in each city. RESULTS Based on 19,523 intentional homicide cases, we found a linear temperature-homicide association. Every 5 °C increase in daily mean temperature was associated with a 9.5% [95% confidence interval (CI): 4.3-15.0%] and 8.8% (95% CI: 1.5-16.6%) increase in intentional homicide over lag 0-7 days in Chicago and New York, respectively. The association was not statistically significant in the other seven cities and seemed to be stronger for cases that happened during the hot season, at night (18:00-06:00) and on the street. During the study period, 8.7% (95%CI: 4.3-12.7%) and 7.1% (95% CI: 1.4-12.0%) intentional homicide cases could be attributed to temperatures above city-specific median temperatures, corresponding to 488 and 316 excess cases in Chicago and New York, respectively. CONCLUSIONS Our study suggests that the interpersonal violence might increase with temperature in some US cities. We also provide some insights into the mechanisms and targeted prevention strategies for heat-related violence.
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Affiliation(s)
- Rongbin Xu
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Xiuqin Xiong
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia.
| | - Yuming Guo
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia.
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Planning for Supportive Green Spaces in the Winter City of China: Linking Exercise of Elderly Residents and Exercise Prescription for Cardiovascular Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165762. [PMID: 32784951 PMCID: PMC7460147 DOI: 10.3390/ijerph17165762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 12/26/2022]
Abstract
The elderly population have a high incidence of cardiovascular disease and are the main users of green spaces, such as city parks. Creating supportive green spaces for exercise for the elderly is of great significance to promote their cardiovascular health. The winter cities have a severely cold climate and high incidence of cardiovascular disease, while the elderly, especially those with cardiovascular disease, face more challenges when participating in exercise in the green spaces. In the context of the winter cities, the kinds of exercise the elderly participate in are more conducive to their cardiovascular health, and determining the factors of the green spaces that are supportive for exercise for cardiovascular health in the winter are of particular interest. Taking Harbin, a typical winter city in China, as an example, this study aims to identify the exercise characteristics of elderly residents in the green spaces in winter, to link them with the principles and contents of exercise prescription for cardiovascular health, to identify the deficient factors of the green spaces in supporting exercise for cardiovascular health, and to put forward optimization design implications. Mixed qualitative methods including interviews, a questionnaire, and field observation were used to identify special behavioral characteristics and spatial factors involving winter exercise in the green spaces among the elderly. The results showed that: (1) about 42.4% of the participants had a gap with the principles of exercise prescription for cardiovascular health. Their exercise items were generally consistent with the principle of low-intensity exercise, but some of them had the problems regarding early exercise time and insufficient exercise duration and frequency. (2) Insufficient supportive factors of the green spaces mainly included facilities allocation, comfort, safety, accessibility, and air quality. Facilities allocation involved walking paths, rehabilitation facilities, auxiliary facilities, and guidance facilities; comfort involved sunlight conditions of the exercise areas; safety involved slippery roads and sites with ice and snow and medical accidents; accessibility involved the proximity, the safety of connecting roads, and the movement of the elderly; air quality involved the planting of evergreen trees. Accordingly, the design implications were given in order to bridge the supportive gap of the green spaces for exercise for cardiovascular health in the elderly population.
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12
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Fu K, Metcalf B, Bennell KL, Zhang Y, Deveza LA, Robbins SR, Ferreira ML, Hunter DJ. Association of weather factors with the risk of pain exacerbations in people with hip osteoarthritis. Scand J Rheumatol 2020; 50:68-73. [PMID: 32614268 DOI: 10.1080/03009742.2020.1760929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objectives: Our objective was to evaluate the association of weather factors with the risk of pain exacerbations in people with symptomatic hip osteoarthritis (OA). Method: Eligible participants with symptomatic hip OA were instructed to log on to the study website and complete questionnaires every 10 days and additionally whenever they considered they were experiencing a pain exacerbation (case period) during the 90 day follow-up. Pain exacerbation was defined as an increase of two points in pain intensity on an 11-point numeric rating scale (0-10) during the follow-up compared with baseline. Each case period was anchored to four control periods within a 35 day interval using a time-stratified approach. Weather data were obtained for both periods from the publicly available meteorological database of the Australian Bureau of Meteorology. We examined the association of weather factors across 72 h before the index date with the risk of pain exacerbation, using conditional logistic regression. Results: Among 252 participants recruited, 129 participants had at least one episode of pain exacerbation and were included in the analysis. A significant dose-response relationship was found between average daily temperature variation in the prior 72 h and risk of pain exacerbations (p = 0.04 for linear trend). There was no significant association between maximum daily temperature, minimum daily temperature, relative humidity, precipitation, or barometric pressure and hip pain exacerbations. Conclusion: The overall results suggest that only daily temperature variation among different weather factors was associated with hip pain exacerbations in people with symptomatic hip OA.
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Affiliation(s)
- K Fu
- Department of Joint Surgery, The First Affiliated Hospital, Sun Yat-sen University , Guangzhou, Guangdong, China.,Institute of Bone and Joint Research, Kolling Institute, The University of Sydney , Sydney, NSW, Australia.,Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, The University of Sydney , Sydney, NSW, Australia
| | - B Metcalf
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne , Melbourne, VIC, Australia
| | - K L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne , Melbourne, VIC, Australia
| | - Y Zhang
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard School of Medicine , Boston, MA, USA
| | - L A Deveza
- Institute of Bone and Joint Research, Kolling Institute, The University of Sydney , Sydney, NSW, Australia.,Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, The University of Sydney , Sydney, NSW, Australia
| | - S R Robbins
- Institute of Bone and Joint Research, Kolling Institute, The University of Sydney , Sydney, NSW, Australia.,Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, The University of Sydney , Sydney, NSW, Australia
| | - M L Ferreira
- Institute of Bone and Joint Research, Kolling Institute, The University of Sydney , Sydney, NSW, Australia.,Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, The University of Sydney , Sydney, NSW, Australia
| | - D J Hunter
- Institute of Bone and Joint Research, Kolling Institute, The University of Sydney , Sydney, NSW, Australia.,Department of Rheumatology, Royal North Shore Hospital and Northern Clinical School, The University of Sydney , Sydney, NSW, Australia
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13
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Vencloviene J, Radisauskas R, Vaiciulis V, Kiznys D, Bernotiene G, Kranciukaite-Butylkiniene D, Tamosiunas A. Associations between Quasi-biennial Oscillation phase, solar wind, geomagnetic activity, and the incidence of acute myocardial infarction. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:1207-1220. [PMID: 32291532 DOI: 10.1007/s00484-020-01895-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/28/2020] [Accepted: 03/04/2020] [Indexed: 06/11/2023]
Abstract
An increase in the daily rate of acute myocardial infarction (AMI) has been observed during days of geomagnetic storm (GS). However, the analysis of associations between the daily number of AMI and geomagnetic activity (GMA) over longer periods sometimes yields controversial results. The study aimed to detect the complex association between the daily numbers of AMI and weather, the Quasi-biennial Oscillation (QBO) phase, GMA, and solar wind variables. We used data of Kaunas population-based Ischemic Heart Disease Register of residents of Kaunas city (Lithuania) for 2000-2012. The associations between weather and space weather variables and the daily number of AMI were evaluated by applying the multivariate Poisson regression. A higher risk of AMI was positively associated with active-stormy local GMA (rate ratio (RR) = 1.06 (95% CI 1.01-1.10)), solar wind dynamic pressure with a lag of 4 days (RR = 1.02 (1.01-1.04) per 1 nPa increase), and solar wind speed with a lag of 3-7 days (RR = 1.03 (1.01-1.05) per 100 km/s increase). A positive association was found between the west QBO phase and the risk of AMI during winter (RR = 1.08 (1.01-1.16)), and a negative association was observed between them during March-November (RR = 0.93 (0.90-0.97)). The risk of AMI positively associated with the GS due to stream interaction regions with a lag of 0-2 days during the east QBO phase (RR = 1.10, p = 0.046) and was negatively associated with them during the west QBO phase (RR = 0.82, p = 0.024). These results may help understand the population's sensitivity under different weather and space weather conditions. The QBO phase may modify the effect of GS.
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Affiliation(s)
- Jone Vencloviene
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, LT-50103, Kaunas, Lithuania.
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Donelaicio St. 58, LT-44248, Kaunas, Lithuania.
| | - Ricardas Radisauskas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, LT-50103, Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, LT-47181, Kaunas, Lithuania
| | - Vidmantas Vaiciulis
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, LT-47181, Kaunas, Lithuania
| | - Deivydas Kiznys
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Donelaicio St. 58, LT-44248, Kaunas, Lithuania
| | - Gailute Bernotiene
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, LT-50103, Kaunas, Lithuania
| | - Daina Kranciukaite-Butylkiniene
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, LT-50103, Kaunas, Lithuania
- Department of Family Medicine, Lithuanian University of Health Sciences, Eiveniu St. 2, LT-50009, Kaunas, Lithuania
| | - Abdonas Tamosiunas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, LT-50103, Kaunas, Lithuania
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, LT-47181, Kaunas, Lithuania
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14
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Haque MS, Kangas M, Jämsä T. A Persuasive mHealth Behavioral Change Intervention for Promoting Physical Activity in the Workplace: Feasibility Randomized Controlled Trial. JMIR Form Res 2020; 4:e15083. [PMID: 32364506 PMCID: PMC7235808 DOI: 10.2196/15083] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/18/2019] [Accepted: 03/23/2020] [Indexed: 01/25/2023] Open
Abstract
Background Employees in an office setting are more likely to remain physically inactive. Physical inactivity has become one of the major barriers to overcoming the risk factors for anxiety, depression, coronary heart disease, certain cancers, and type 2 diabetes. Currently, there is a gap in mobile health (mHealth) apps to promote physical activity (PA) for workers in the workplace. Studies on behavior change theories have concluded that health apps generally lack the use of theoretical constructs. Objective The objective of this study was to study the feasibility of a persuasive app aimed at encouraging PA among employees and to understand the motivational aspects behind the implementation of mHealth apps among office workers. Methods A 4-week study using a mixed methods (quantitative and qualitative) design was conducted with office-based employees in cities in 4 countries: Oulu, Finland; Carlow, Ireland; London, United Kingdom; and Dhaka, Bangladesh. Of the 220 invited participants (experimental group, n=115; control group, n=105), 84 participated (experimental group, n=56; control group, n=28), consisting of working-age volunteers working in an office setting. Participants used 2 different interventions: The experimental group used an mHealth app for PA motivation, and the control group used a paper diary. The purpose was to motivate employees to engage in healthier behavior regarding the promotion of PA in the workplace. A user-centered design process was followed to design, develop, and evaluate the mHealth app, incorporating self-determination theory (SDT) and using game elements. The paper diary had no specific theory-driven approach, design technique, nor game elements. Results Compliance with app usage remained relatively low, with 27 participants (experimental group, n=20; control group, n=7) completing the study. The results support the original hypothesis that the mHealth app would help increase PA (ie, promoting daily walking in the workplace) in comparison to a paper diary (P=.033). The mHealth app supported 2 of the basic SDT psychological needs, namely autonomy (P=.004) and competence (P=.014), but not the needs of relatedness (P=.535). Conclusions The SDT-based mHealth application motivated employees to increase their PA in the workplace. However, compliance with app usage remained low. Future research should further develop the app based on user feedback and test it in a larger sample.
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Affiliation(s)
- Md Sanaul Haque
- Research Unit of Medical Imaging Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Maarit Kangas
- Research Unit of Medical Imaging Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Timo Jämsä
- Research Unit of Medical Imaging Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
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15
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Albrecht BM, Stalling I, Recke C, Bammann K. Accelerometer-assessed outdoor physical activity is associated with meteorological conditions among older adults: Cross-sectional results from the OUTDOOR ACTIVE study. PLoS One 2020; 15:e0228053. [PMID: 31978178 PMCID: PMC6980536 DOI: 10.1371/journal.pone.0228053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 01/06/2020] [Indexed: 12/03/2022] Open
Abstract
Background Meteorological conditions are potential determinants of physical activity (PA). A profound understanding of the determinants of PA behaviour is required for PA promotion. This study examined the association between accelerometer-assessed PA and meteorological conditions among older adults. Methods This cross-sectional study included data of 577 adults aged 65–75 years living in Bremen, Germany (52% female; 3278 days). PA was measured with accelerometers for seven consecutive days (10/15-08/16). A threshold of 240 lx was used to differentiate between outdoor physical activity (OPA) and indoor physical activity (IPA). Linear mixed models estimated the association between PA (daily accelerometer counts per minute (CPM)) and meteorological factors (temperature, cloud cover, wind, and no precipitation) derived by principal component analysis. Results The analyses showed associations between PA in CPM and the meteorological factors temperature (93.7; 95%-CL: 64.9, 122.5) and no precipitation (48.4; 95%-CL: 19.8, 77.0) in women and wind (-40.3; 95%-CL: -59.7, -20.8) and no precipitation (30.1; 95%-CL: 5.6, 54.6) in men. After distinguishing in OPA and IPA for a subsample of 128 participants (473 days), the sex differences were no longer present. OPA in CPM was associated with temperature (women: 174.5; 95%-CL: 81.3, 267.6; men: 183.3; 95%-CL: 81.2, 285.4), cloud cover (women: -153.0; 95%-CL: -200.3, -105.7; men: -123.2; 95%-CL: -174.7, -71.7), and wind (women: -118.6; 95%-CL: -189.6; -47.7; men: -96.9; 95%-CL: -177.0, -16.7). No association between OPA and no precipitation was found (women: 2.9; 95%-CL: -89.0, 94.8; men: -17.1; 95%-CL: -116.7, 82.4). Conclusions The results of this study emphasize the importance of meteorological conditions as environmental determinants of PA among older adults. Meteorological conditions should be accounted for in the unbiased assessment of habitual PA and the development of PA promotion programs. Future research should focus on the associations of OPA and IPA with meteorological conditions in different climatic regions.
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Affiliation(s)
- Birte Marie Albrecht
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
- * E-mail:
| | - Imke Stalling
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Carina Recke
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Karin Bammann
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
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16
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Beghin L, Vanhelst J, Drumez E, Migueles J, Manios Y, Moreno LA, De Henauw S, Gottrand F. Influence of meteorological conditions on physical activity in adolescents. J Epidemiol Community Health 2020; 74:395-400. [DOI: 10.1136/jech-2019-212459] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 12/05/2019] [Accepted: 01/05/2020] [Indexed: 12/24/2022]
Abstract
BackgroundIt has been shown that meteorological conditions and season affect physical activity (PA) during adolescence. Today, meteorological conditions have never been combined to study their influence on PA level in a single sample of a large adolescent multicountries population. The aim of this study was to explore the influence of meteorological conditions on PA in adolescents from several European countries.MethodsThe study included 2024 healthy adolescents aged 12.5–17.4 years who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional study. Participants wore a uniaxial accelerometer for 7 consecutive days to measure total PA and moderate to vigorous physical activity (MVPA) in a one-off measurement manner. Comparison of PA according to meteorological conditions was done using linear mixed models.ResultsThe highest difference of MVPA was observed in boys on free days when comparing the best meteorological conditions versus the worse (ie, +39% with highest temperature, +29% without rainfall, +39% with highest sunlight duration and +21% with highest length of day) and in girls on free days (ie, +26% with highest sunlight duration). This increase in MVPA contributed to a simultaneous increase in total PA when considering the same meteorological condition parameters.ConclusionsMeteorological conditions act as a determinant of PA differentially between boys and girls. PA and MVPA in boys are mainly modified by meteorological conditions on free days whereas PA and MVPA in girls are modified by sunlight duration.
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17
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Uijtdewilligen L, Waters CNH, Aw S, Wong ML, Sia A, Ramiah A, Wong M, Müller-Riemenschneider F. The Park Prescription Study: Development of a community-based physical activity intervention for a multi-ethnic Asian population. PLoS One 2019; 14:e0218247. [PMID: 31185057 PMCID: PMC6559668 DOI: 10.1371/journal.pone.0218247] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 05/29/2019] [Indexed: 11/30/2022] Open
Abstract
This mixed-methods study aims to inform the development of a 'Park Prescription' intervention, including face-to-face counseling on physical activity and park use and providing weekly structured exercise sessions in the park to promote physical activity. Participants aged 40-65 years were recruited from regional health screening events in Singapore where they completed a questionnaire (N = 97) and consented to focus group (FG) participation (N = 16). The questionnaire assessed current park use, and the type, duration, and intensity of park-based activities that would be of interest. FGs explored the barriers and facilitators of physical activity (in parks). Short interviews (N = 16) with 'doers', i.e., people already engaging in park-based physical activity, identified motivational factors and ways to overcome common barriers. Participants acknowledged the health benefits of parks and valued them because of their pleasant landscapes, greenery and facilities. However, few participants engaged in physical activity at the parks, because they were too busy or too tired. Participants mostly indicated doing informal activities, such as walking, cycling or playing traditional Asian games when using the parks for exercise. A variety of low-to-moderate intensity park-based activities such as walking, cycling or aerobics were of interest to participants who expressed the willingness to engage in structured exercise sessions on weekday evenings or weekend mornings. Strategies to increase physical activity in parks included: encourage planning, create social support, identify alternatives for bad weather, improve proximity/accessibility to parks and park safety. The effectiveness of the Park Prescription intervention in promoting physical activity, park use, as well as physical and mental well-being will be tested in a one-year Randomized Controlled Trial.
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Affiliation(s)
| | | | - Su Aw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Angelia Sia
- Centre for Urban Greenery & Ecology, National Parks Board Singapore, Singapore
| | | | - Michael Wong
- Health for Life Centre, Alexandra Health Pte Ltd, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Institute for Social Medicine, Epidemiology and Health Economics, Charite Univeristy Medical Centre, Berlin, Germany
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18
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Zhu Z, Aitken D, Cicuttini F, Jones G, Ding C. Ambulatory activity interacts with common risk factors for osteoarthritis to modify increases in MRI-detected osteophytes. Osteoarthritis Cartilage 2019; 27:650-658. [PMID: 30654117 DOI: 10.1016/j.joca.2018.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 12/10/2018] [Accepted: 12/24/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the longitudinal association between objectively measured ambulatory activity (AA) and knee MRI-detected osteophytes (OPs), and to test whether this relationship was modified by common risk factors for OA including sex, obesity, disease severity and knee injury history. METHODS 408 community-dwelling adults aged 51-81 years were assessed at baseline and 2.7 years. T1-weighted fat-suppressed MRI was used to evaluate knee OPs at both time points. AA was assessed at baseline by pedometers and categorized as: less active (≤7499 steps per day), moderately active (7500-9999 steps per day) and highly active (≥10,000 steps per day). RESULTS Statistically significant interactions were detected between knee OA risk factors and AA on increases in MRI-detected OPs (all P < 0.05). In stratified analyses, being moderately active, compared to being less active, was protective against an increase in MRI-detected OPs (score change of ≥1) in females (relative risk (RR) = 0.42, 95%CI, 0.25-0.70, P < 0.01), those who were obese (RR = 0.50, 95%CI, 0.30-0.83, P < 0.01), those with radiographic OA (ROA) (RR = 0.68, 95%CI, 0.47-0.97, P = 0.02) and those with a history of knee injury (RR = 0.27, 95%CI, 0.08-0.88, P = 0.02) in almost every knee compartment, after adjustment for confounders. No statistically significant associations were found in males, non-obese, non-ROA or non-injury groups. CONCLUSIONS Being moderately active is protective against an increase in MRI-detected OPs in females, those with ROA, those who are obese and those with a history of knee injury. These findings suggest that being moderately active is beneficial for individuals who are at higher risk of knee OA.
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Affiliation(s)
- Z Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - D Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliate Hospital of Anhui Medical University, Hefei, China.
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19
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Hoffman SA, Ledford G, Cameron KA, Phillips SM, Pellegrini CA. A qualitative exploration of social and environmental factors affecting diet and activity in knee replacement patients. J Clin Nurs 2018; 28:1156-1163. [PMID: 30461097 DOI: 10.1111/jocn.14719] [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: 05/04/2018] [Revised: 10/31/2018] [Accepted: 11/03/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To examine perceived social and environmental barriers and facilitators for healthy eating and activity before and after knee replacement. BACKGROUND Many patients undergoing knee replacement surgery are overweight or obese. While obesity treatment guidelines encourage diet and activity modifications, gaps exist in understanding social and environmental determinants of these behaviours for knee replacement patients. Identifying these determinants is critical for treatment, as they are likely amplified due to patients' mobility limitations, the nature of surgery and reliance on others during recovery. DESIGN This qualitative study used semi-structured interviews. METHODS Twenty patients (M = 64.7 ± 9.8 years, 45% female, 90% Caucasian, body mass index 30.8 ± 5.5 kg/m2 ) who were scheduled for or had recently undergone knee replacement were interviewed. Participants were asked to identify social and environmental factors that made it easier or harder to engage in healthy eating or physical activity. Deidentified transcripts were analysed via constant comparative analysis to identify barriers and facilitators to healthy eating and activity. This paper was written in accordance with COnsolidated criteria for REporting Qualitative research standards. RESULTS Identified social and environmental healthy eating barriers included availability of unhealthy food and attending social gatherings; facilitators included availability of healthy food, keeping unhealthy options "out of sight," and social support. Weather was the primary activity barrier, while facilitators included access to physical activity opportunities and social support. CONCLUSIONS Results provide salient factors for consideration by clinicians and behavioural programmes targeting diet, activity, and weight management, and patient variables to consider when tailoring interventions. RELEVANCE TO CLINICAL PRACTICE Practitioners treating knee replacement patients would be aided by an understanding of patients' perceived social and environmental factors that impede or facilitate surgical progress. Particularly for those directly interacting with patients, like nurses, physiotherapists, or other professionals, support from health professionals appears to be a strong facilitator of adherence to diet and increased activity.
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Affiliation(s)
- Sara A Hoffman
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Gwendolyn Ledford
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kenzie A Cameron
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Division of General Internal Medicine and Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Siobhan M Phillips
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Christine A Pellegrini
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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20
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Daugaard R, Tjur M, Sliepen M, Lipperts M, Grimm B, Mechlenburg I. Are patients with knee osteoarthritis and patients with knee joint replacement as physically active as healthy persons? J Orthop Translat 2018; 14:8-15. [PMID: 30035028 PMCID: PMC6042525 DOI: 10.1016/j.jot.2018.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/09/2018] [Accepted: 03/02/2018] [Indexed: 11/30/2022] Open
Abstract
Background It is well documented that patients with knee osteoarthritis (KOA) suffer from reduced physical function and that function of the affected knee is improved after knee joint replacement (KJR). However, it remains uncertain whether patients with KOA are less physically active than healthy people and whether patients increase their level of physical activity after surgery to a level comparable with that of healthy people. The aim of this study was to examine whether patients with KOA are less physically active than healthy participants and whether patients who have undergone KJR show an increased activity and achieve the same level of physical activity as healthy participants 5 years postoperatively. Methods Fifty-four patients with KOA (29 women; mean age 62 ± 8.6; mean body mass index (BMI) 27 ± 5), 52 patients who had KJR due to KOA 5 years earlier (26 women; mean age 66 ± 7.2; mean BMI 30 ± 5) and 171 healthy participants (76 women, mean age 64 ± 9.7, mean BMI 26 ± 5) were included in this cross-sectional study. The level of physical activity was measured over a mean period of 5.5 days with a triaxial accelerometer mounted on the thigh. Number of daily steps, number of daily short walking bouts of <10 s duration and number of daily transfers from sitting to standing position were recorded. Data were analysed using two sample t tests and were adjusted for age, gender and BMI. Results Patients with KOA did not differ significantly from healthy participants regarding daily steps (+321, p = 0.50) or daily transfers from sitting to standing (+1.9, p = 0.52) but performed significantly less daily short walking bouts <10 s (-11.9, p = 0.02). Patients after KJR did not differ significantly from healthy participants regarding daily steps (-281, p = 0.60) of transfers from sitting to standing position (-3.2, p = 0.32) but performed significantly less daily short walking bouts <10 s (-21.7, p = 0.001). Conclusion Patients with KOA and KJR showed no significant reduction in number of daily step counts and transfers from sitting to standing position when compared with matched healthy controls. However, the number of short walking bouts was reduced in patients with KOA and by twice as much in patients with KJR. This indicates that KOA and treatment with KJR hardly affect health-related general activity but do affect specific physical activity behaviour potentially indicative of KOA or post-KJR functional limitations. The translational potential of this article Activity monitoring with an accelerometer-based method gives insights into health-related general activity levels such as total daily steps and specific parameters such as short walking bouts, which may serve as an objective outcome measure in clinical practice.
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Affiliation(s)
- Rikke Daugaard
- Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Marianne Tjur
- Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Maik Sliepen
- Institut für Experimentelle Muskuloskelettale Medizin, Universitätsklinikum Münster, Münster, Germany
| | - Matthijs Lipperts
- Department of Medical Information and Communication and Technology, St. Anna Hospital, Geldrop, The Netherlands
| | - Bernd Grimm
- AHORSE Research Foundation, Department of Orthopaedic Surgery, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Inger Mechlenburg
- Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.,Centre of Research in Rehabilitation (CORIR), Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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