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Hopkins J, McVeigh JA, Hill KD, Burton E. Physical Activity Levels and Sedentary Behavior of People Living With Mild Cognitive Impairment: A Cross-Sectional Study Using Thigh-Worn Accelerometers. J Aging Phys Act 2024; 32:520-530. [PMID: 38684211 DOI: 10.1123/japa.2023-0176] [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: 05/15/2023] [Revised: 11/29/2023] [Accepted: 02/17/2024] [Indexed: 05/02/2024]
Abstract
Community-dwelling people with Mild Cognitive Impairment self-reporting not to be meeting recommended physical activity levels participated in this study to (a) determine compliance of wearing (thigh-worn) accelerometers, (b) describe physical activity levels and sedentary behavior, and (c) determine the validity of the Physical Activity Scale for the Elderly (PASE) compared with activPAL accelerometers. A total of 79 people had valid accelerometer data (median [interquartile range]: age, 71 [54-75] years). Compliance was 86.81%. Participants were sedentary for 10.6 hr per day and engaged in a median of 9 min per day of moderate-intensity physical activity. Fair correlations were found between the PASE and total stepping time per day (r = .35, p < .01), total number of steps per day (r = .36, p < .01), and number of steps in stepping activities completed for ≤1 min (r = .42, p < .01). The PASE and Standing time (r = .04, p = .724) and PASE and Sitting time (r = .04, p = .699) had little to no relationship. The use of thigh-worn accelerometers for this population is achievable. People with Mild Cognitive Impairment have high levels of sedentary behavior and minimal engagement in moderate-intensity physical activity. The PASE has fair, positive criterion validity with activity-based outcomes measured by activPAL accelerometers but not with sedentary behavior, which is high for this population.
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Affiliation(s)
- Jane Hopkins
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Joanne A McVeigh
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
- enAble Institute, Curtin University, Perth, WA, Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Center, Monash University, Frankston, VIC, Australia
- National Center for Healthy Ageing, Monash University and Peninsula Health, Frankston, VIC, Australia
| | - Elissa Burton
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- enAble Institute, Curtin University, Perth, WA, Australia
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Coll-Planas L, Fuente-Vidal A, Jerez-Roig J, Karkauskienė E, Romero-Mas M, Intxaurrondo A, Caserotti P, Skjødt M, Dallmeier D, Lefebvre G, Bassinah L, Forgione D, Castro R, Minobes-Molina E, Parés-Martínez C, Blancafort Alias S, Roman-Viñas B, Socorro-Cumplido JL, Nieto-Guisado A, Sansano-Nadal O, Giné-Garriga M. Boosting enjoyment and social inclusion to increase physical activity and reduce sedentary behaviour among older adults: protocol for a feasibility study to test the JOIN4JOY approach in five European countries. BMJ Open 2024; 14:e083291. [PMID: 39067876 DOI: 10.1136/bmjopen-2023-083291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024] Open
Abstract
INTRODUCTION Programmes for older people aimed at increasing physical activity (PA) and reducing sedentary behaviour (SB) traditionally focus on achieving functional and health improvements. Focusing on enjoyment and social inclusion could strengthen adherence and help reach older people with social disadvantages. The aim of this study is to assess the feasibility and acceptability of the Join4Joy approach in PA programmes and its assessment tools. METHODS AND ANALYSIS A multicentric, pragmatic, pre-post feasibility study using mixed methods will be conducted. The intervention will consist of a PA programme boosting enjoyment and social inclusion, grounded on a co-creation process. Trainers will offer twelve, 1-hour weekly sessions of structured, supervised, group-based PA. Participants will be encouraged to increase activity in daily living. 144 older people will be recruited from the community and nursing homes in Spain, Denmark, Italy, Germany, and France. Additionally, participants and trainers will be invited to join virtual communities of practice to share their experiences across settings and countries. Qualitative procedures will be used to explore the acceptability of the design via interviews and focus groups with participants and trainers. Quantitative methods will be used to assess uptake, adherence, retention, reach, satisfaction, enjoyment (PACES questionnaire), physical function (e.g., Short Physical Performance Battery), quality of life (EQ-5D-5L scale), perceived improvement (Patient Global Impression of Improvement scale-I), activities of daily living (Barthel index) and SB and PA patterns (IPAQ and accelerometry). The degree and type of participation in virtual communities of practice will also be assessed. SPSS software will be used for the analysis of quantitative variables. Qualitative data will be analysed using reflective thematic analysis following Braun and Clarke (2006). ETHICS AND DISSEMINATION A favourable report by the Research Ethics Committee of UVic-UCC (282/2023) was obtained on 26 June 26th, 2023. Participation and withdrawal will be voluntary. Participants' (or their legal guardians', when necessary) written permission will be required. Results of the study will be disseminated through publication of scientific articles, presentations at sport and health-related professional conferences and congresses, as well as through social media and via the Join4Joy website. STUDY REGISTRATION ClinicalTrials.gov, NCT06100835.
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Affiliation(s)
- Laura Coll-Planas
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalunya, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Andrea Fuente-Vidal
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalunya, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalunya, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
- Department of Health Promotion and Rehabilitation, Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Erika Karkauskienė
- Department of Health Promotion and Rehabilitation, Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Montse Romero-Mas
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalunya, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Aimar Intxaurrondo
- Fundació Salut i Envelliment (Foundation on Health and Ageing), Autonomous University of Barcelona, Barcelona, Catalunya, Spain
| | | | | | | | - Guillaume Lefebvre
- Sport Initiative et Loisir Bleu Association, Strasbourg, France
- Sport Initiative et Loisir Bleu Association, Barcelona, Spain
| | - Lucie Bassinah
- Sport Initiative et Loisir Bleu Association, Strasbourg, France
| | - Dolores Forgione
- Istituto Europeo Per Lo Sviluppo Socio Economico (ISES), Alexandria, Italy
| | - Ricard Castro
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalunya, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalunya, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Carles Parés-Martínez
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalunya, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Sergi Blancafort Alias
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalunya, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
- Fundació Salut i Envelliment (Foundation on Health and Ageing), Autonomous University of Barcelona, Barcelona, Catalunya, Spain
| | - Blanca Roman-Viñas
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - José Luis Socorro-Cumplido
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Ainhoa Nieto-Guisado
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Oriol Sansano-Nadal
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Maria Giné-Garriga
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, Universitat Ramon Llull, Barcelona, Spain
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Porserud A, Karlsson P, Aly M, Rydwik E, Torikka S, Henningsohn L, Nygren-Bonnier M, Hagströmer M. Effects of an exercise intervention in primary care after robot-assisted radical cystectomy for urinary bladder cancer: a randomised controlled trial. BMC Cancer 2024; 24:891. [PMID: 39048933 PMCID: PMC11267740 DOI: 10.1186/s12885-024-12647-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION After radical cystectomy physical activity is important to reduce risk of complications, but patients with urinary bladder cancer have difficulties in achieving general recommendations on physical activity and exercise. The aim of this randomised controlled trial was therefore to evaluate the effects of a physical exercise programme in primary care, following discharge from hospital after robot-assisted radical cystectomy for urinary bladder cancer. MATERIALS AND METHODS Patients with urinary bladder cancer scheduled for robot-assisted radical cystectomy at Karolinska University Hospital, Sweden between September 2019 and October 2022 were invited to join the study. At discharge, they were randomised to intervention or active control group. The intervention group was planned to start exercise with physiotherapist in primary care during the third week; the programme included aerobic and strengthening exercises, twice a week for 12 weeks, and daily walks. The control group received unsupervised home-based exercise with daily walks and a sit-to-stand exercise. Assessments were conducted before surgery, at discharge and after four months regarding the primary outcome physical function (Six-minute walk test), and secondary outcomes physical activity, pain, health-related quality of life, fatigue, and psychological wellbeing. RESULTS Ninety patients were included, mean (sd) age 71.5 (8.5) years. An intention-to-treat analysis showed no intervention effect on the primary outcome physical function, or on pain or psychological wellbeing, but effect on physical activity with a difference from discharge to four months with a median (IQR) of 4790 (3000) and 2670 (4340) daily steps in the intervention and control group, respectively (p = 0.046), and for fatigue, and health-related quality of life, in favour of the intervention group. CONCLUSION Both the intervention and control groups improved physical function, but the patients who exercised in primary care experienced additional positive effects on physical activity, fatigue, and health-related quality of life. Hence, exercise in primary care after discharge from hospital could be a promising method after radical cystectomy for urinary bladder cancer. TRIAL REGISTRATION The study was registered in Clinical Trials with registration number NCT03998579, 20,190,607.
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Affiliation(s)
- Andrea Porserud
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
| | - Patrik Karlsson
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Markus Aly
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Patient Area Pelvic Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Elisabeth Rydwik
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Simon Torikka
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Henningsohn
- Division of Urology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Malin Nygren-Bonnier
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
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Rockette-Wagner B, Aggarwal R. A review of the evidence for the utility of physical activity monitor use in patients with idiopathic inflammatory myopathies. Rheumatology (Oxford) 2024; 63:1815-1824. [PMID: 38243707 DOI: 10.1093/rheumatology/keae004] [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: 09/19/2023] [Revised: 11/13/2023] [Accepted: 12/13/2023] [Indexed: 01/21/2024] Open
Abstract
Few proven therapies exist for patients with idiopathic inflammatory myopathies (IIMs), partly due to the lack of reliable and valid outcome measures for assessing treatment responses. The current core set measures developed by the International Myositis Assessment and Clinical Studies group were developed to standardize assessments of disease activity and treatment effect. None of the current measures address functional improvement in muscle weakness. Therefore, supplemental measures to more objectively assess physical activity levels and fatiguability in free-living settings are needed to assess disease activity more comprehensively. Validated physical activity monitors (PAMs) have the potential to serve as an objective functional outcome measure in clinical trials and observational studies. This review examines the current evidence for the use of body-worn PAMs in clinical settings with IIM patients. A practical overview of methods for PAM use in clinical patient populations (including measurement details and data processing) that focuses on IIM patients is also presented.
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Affiliation(s)
- Bonny Rockette-Wagner
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Rohit Aggarwal
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Raffin J, Rolland Y, Aubertin‐Leheudre M, Aragoni da Silva J, Guyonnet S, Pillard F, Vellas B, de Souto Barreto P. Cross-sectional interactive associations of physical activity and sedentary behaviour with physical capacity across adulthood. J Cachexia Sarcopenia Muscle 2024; 15:1134-1145. [PMID: 38638004 PMCID: PMC11154759 DOI: 10.1002/jcsm.13457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/22/2024] [Accepted: 02/16/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The way physical activity (PA) and sedentary behaviour (SB) independently and interactively modify the age-related decline in physical capacity remains poorly understood. This cross-sectional study investigated the independent and interactive associations of PA and SB with physical function and performance throughout the adult life course. METHODS Data from 499 community-dwelling adults (63% female) aged 20-92 years, involved in the INSPIRE Human Translational Cohort, were used in this cross-sectional study. Daily time spent on moderate-to-vigorous PA (MVPA, min/day) and SB (h/day) was measured with activPAL triaxial accelerometers. Physical function and performance were assessed through the measurement of the 4-m usual gait speed (m/s), handgrip strength (kg), lower-limb strength (isokinetic knee extension torque, N·m), estimated lower-limb power (five-time chair-rise test performance, s) and cardiorespiratory fitness (V̇O2max, mL/kg/min). Confounder-adjusted multiple linear and curvilinear regressions were performed to investigate how MVPA, SB and their interactions were associated with the physical outcomes (all square root-transformed except gait speed) throughout the adulthood spectrum. RESULTS Interaction analyses revealed that the combination of higher levels of MVPA with lower levels of SB favourably reshaped the negative relationship between handgrip strength and age (age2 × SB × MVPA: B = -7E-08, SE = 3E-08, P < 0.05). In addition, higher levels of MVPA were independently associated with an improved age-related profile in gait speed (age2 × MVPA: B = 3E-06, SE = 1E-06, P < 0.05), chair-rise performance (age × MVPA: B = -9E-05, SE = 4E-05, P < 0.05) and V̇O2max (MVPA at 21 years: B = 3E-02, SE = 7E-03, P < 0.05; age × MVPA: B = -5E-04, SE = 2E-04, P < 0.05). Conversely, the detrimental association of age with lower-limb muscle strength (age × SB: B = -1E-04, SE = 6E-05, P < 0.05) and chair-rise performance (age × SB: B = 1E-05, SE = 7E-06, P < 0.05) was exacerbated with increasing duration of SB, independently of MVPA. Supplementary analyses further revealed that some of these associations were age and sex specific. CONCLUSIONS This cross-sectional study demonstrated that reduced sedentary time and increased activity duration were independently and synergistically associated with an attenuated age-related loss in physical capacity. These findings need to be confirmed with longitudinal data but encourage both adopting an active lifestyle and reducing sedentary time as preventive measures against physical aging.
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Affiliation(s)
- Jérémy Raffin
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
| | - Yves Rolland
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
| | - Mylène Aubertin‐Leheudre
- Département des Sciences de l'activité physique, Faculté des sciencesUniversité du Québec à MontréalMontréalCanada
- Centre de recherche, Institut universitaire de gériatrie de Montréal (IUGM), CIUSSS du Centre‐Sud‐de‐l'Île‐de‐MontréalMontréalCanada
| | - Jaqueline Aragoni da Silva
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
| | - Sophie Guyonnet
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
| | - Fabien Pillard
- Unité de Médecine du Sport, Clinique Universitaire du Sport, Hôpital Pierre Paul RIQUET (Centre Hospitalo‐Universitaire)ToulouseFrance
- Centre RESTORE (Geroscience and Rejuvenation Center), UMR 1301 (INSERM)/UMR 5070 (CNRS)ToulouseFrance
| | - Bruno Vellas
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
| | - Philipe de Souto Barreto
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
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Park C, Larsen B, Mogos M, Muchira J, Dietrich M, LaNoue M, Jean J, Norfleet J, Doyle A, Ahn S, Mulvaney S. A multiple technology-based and individually-tailored Sit Less program for people with cardiovascular disease: A randomized controlled trial study protocol. PLoS One 2024; 19:e0302582. [PMID: 38722831 PMCID: PMC11081313 DOI: 10.1371/journal.pone.0302582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/04/2024] [Indexed: 05/13/2024] Open
Abstract
Sedentary behavior, a key modifiable risk factor for cardiovascular disease, is prevalent among cardiovascular disease patients. However, few interventions target sedentary behavior in this group. This paper describes the protocol of a parallel two-group randomized controlled trial for a novel multi-technology sedentary behavior reduction intervention for cardiovascular disease patients (registered at Clinicaltrial.gov, NCT05534256). The pilot trial (n = 70) will test a 12-week "Sit Less" program, based on Habit Formation theory. The 35 participants in the intervention group will receive an instructional goal-setting session, a Fitbit for movement prompts, a smart water bottle (HidrateSpark) to promote hydration and encourage restroom breaks, and weekly personalized text messages. A control group of 35 will receive the American Heart Association's "Answers by Heart" fact sheets. This trial will assess the feasibility and acceptability of implementing the "Sit Less" program with cardiovascular disease patients and the program's primary efficacy in changing sedentary behavior, measured by the activPAL activity tracker. Secondary outcomes include physical activity levels, cardiometabolic biomarkers, and patient-centered outcomes (i.e. sedentary behavior self-efficacy, habit strength, and fear of movement). This study leverages commonly used mobile and wearable technologies to address sedentary behavior in cardiovascular disease patients, a high-risk group. Its findings on the feasibility, acceptability and primary efficacy of the intervention hold promise for broad dissemination.
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Affiliation(s)
- Chorong Park
- School of Nursing, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Britta Larsen
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, La Jolla, California, United States of America
| | - Mulubrhan Mogos
- School of Nursing, Vanderbilt University, Nashville, Tennessee, United States of America
| | - James Muchira
- School of Nursing, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Mary Dietrich
- School of Nursing, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Marianna LaNoue
- School of Nursing, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Jason Jean
- School of Nursing, Vanderbilt University, Nashville, Tennessee, United States of America
| | - John Norfleet
- School of Nursing, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Abigail Doyle
- School of Nursing, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Soojung Ahn
- School of Nursing, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Shelagh Mulvaney
- School of Nursing, Vanderbilt University, Nashville, Tennessee, United States of America
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Zablocki RW, Hartman SJ, Di C, Zou J, Carlson JA, Hibbing PR, Rosenberg DE, Greenwood-Hickman MA, Dillon L, LaCroix AZ, Natarajan L. Using functional principal component analysis (FPCA) to quantify sitting patterns derived from wearable sensors. Int J Behav Nutr Phys Act 2024; 21:48. [PMID: 38671485 PMCID: PMC11055353 DOI: 10.1186/s12966-024-01585-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Sedentary behavior (SB) is a recognized risk factor for many chronic diseases. ActiGraph and activPAL are two commonly used wearable accelerometers in SB research. The former measures body movement and the latter measures body posture. The goal of the current study is to quantify the pattern and variation of movement (by ActiGraph activity counts) during activPAL-identified sitting events, and examine associations between patterns and health-related outcomes, such as systolic and diastolic blood pressure (SBP and DBP). METHODS The current study included 314 overweight postmenopausal women, who were instructed to wear an activPAL (at thigh) and ActiGraph (at waist) simultaneously for 24 hours a day for a week under free-living conditions. ActiGraph and activPAL data were processed to obtain minute-level time-series outputs. Multilevel functional principal component analysis (MFPCA) was applied to minute-level ActiGraph activity counts within activPAL-identified sitting bouts to investigate variation in movement while sitting across subjects and days. The multilevel approach accounted for the nesting of days within subjects. RESULTS At least 90% of the overall variation of activity counts was explained by two subject-level principal components (PC) and six day-level PCs, hence dramatically reducing the dimensions from the original minute-level scale. The first subject-level PC captured patterns of fluctuation in movement during sitting, whereas the second subject-level PC delineated variation in movement during different lengths of sitting bouts: shorter (< 30 minutes), medium (30 -39 minutes) or longer (> 39 minute). The first subject-level PC scores showed positive association with DBP (standardized β ^ : 2.041, standard error: 0.607, adjusted p = 0.007), which implied that lower activity counts (during sitting) were associated with higher DBP. CONCLUSION In this work we implemented MFPCA to identify variation in movement patterns during sitting bouts, and showed that these patterns were associated with cardiovascular health. Unlike existing methods, MFPCA does not require pre-specified cut-points to define activity intensity, and thus offers a novel powerful statistical tool to elucidate variation in SB patterns and health. TRIAL REGISTRATION ClinicalTrials.gov NCT03473145; Registered 22 March 2018; https://clinicaltrials.gov/ct2/show/NCT03473145 ; International Registered Report Identifier (IRRID): DERR1-10.2196/28684.
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Affiliation(s)
- Rong W Zablocki
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA
| | - Chongzhi Di
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, 98109, Washington, USA
| | - Jingjing Zou
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA
| | - Jordan A Carlson
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, 610 E. 22nd St., Kansas City, 64108, Missouri, USA
| | - Paul R Hibbing
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W Taylor St, Chicago, IL, 60612, USA
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, 98101, Washington, USA
| | | | - Lindsay Dillon
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA.
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8
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Etzkorn LH, Heravi AS, Knuth ND, Wu KC, Post WS, Urbanek JK, Crainiceanu CM. Classification of Free-Living Body Posture with ECG Patch Accelerometers: Application to the Multicenter AIDS Cohort Study. STATISTICS IN BIOSCIENCES 2024; 16:25-44. [PMID: 38715709 PMCID: PMC11073799 DOI: 10.1007/s12561-023-09377-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/11/2023] [Accepted: 05/30/2023] [Indexed: 05/12/2024]
Abstract
Purpose As health studies increasingly monitor free-living heart performance via ECG patches with accelerometers, researchers will seek to investigate cardio-electrical responses to physical activity and sedentary behavior, increasing demand for fast, scalable methods to process accelerometer data. We extend a posture classification algorithm for accelerometers in ECG patches when researchers do not have ground-truth labels or other reference measurements (i.e., upright measurement). Methods Men living with and without HIV in the Multicenter AIDS Cohort study wore the Zio XT® for up to two weeks (n = 1,250). Our novel extensions for posture classification include (1) estimation of an upright posture for each individual without a reference upright measurement; (2) correction of the upright estimate for device removal and re-positioning using novel spherical change-point detection; and (3) classification of upright and recumbent periods using a clustering and voting process rather than a simple inclination threshold used in other algorithms. As no posture labels exist in the free-living environment, we perform numerous sensitivity analyses and evaluate the algorithm against labelled data from the Towson Accelerometer Study, where participants wore accelerometers at the waist. Results On average, 87.1% of participants were recumbent at 4am and 15.5% were recumbent at 1pm. Participants were recumbent 54 minutes longer on weekends compared to weekdays. Performance was good in comparison to labelled data in a separate, controlled setting (accuracy = 96.0%, sensitivity = 97.5%, specificity = 95.9%). Conclusions Posture may be classified in the free-living environment from accelerometers in ECG patches even without measuring a standard upright position. Furthermore, algorithms that fail to account for individuals who rotate and re-attach the accelerometer may fail in the free-living environment.
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Affiliation(s)
| | | | | | | | | | - Jacek K. Urbanek
- School of Medicine, Johns Hopkins University
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Rd, Tarrytown NY 10591
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9
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Porserud A, Karlsson P, Nygren-Bonnier M, Aly M, Hagströmer M. The feasibility of an exercise intervention after robotic-assisted radical cystectomy for urinary bladder cancer, prior to the CanMoRe trial. Pilot Feasibility Stud 2024; 10:12. [PMID: 38254174 PMCID: PMC10802056 DOI: 10.1186/s40814-024-01443-1] [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: 08/04/2021] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Complications after radical cystectomy for urinary bladder cancer are common. Physical activity after surgery is thought to reduce complications. However, patients with urinary bladder cancer have low levels of physical activity, and interventions supporting physical exercise are needed. This study aimed to evaluate the feasibility of a physical exercise intervention in primary health care. One of the aims of the larger clinical trial will be to reduce complications. METHODS Patients with urinary bladder cancer and who were scheduled for a robotic-assisted radical cystectomy were recruited from Karolinska University Hospital, between February and May 2019. The patients had to be mobile, understand Swedish, and live in Stockholm. The exercise programme was conducted at one primary health care setting over 12 weeks. The exercise programme included supervised aerobic and strengthening exercises, which were performed twice a week, as well as daily walks. Feasibility was measured with process feasibility, including eligibility criteria, adherence, and acceptability, and scientific feasibility, including the ability of outcomes to indicate change, safety, and progression in the exercise programme. RESULTS Ten patients with a median age of 70 years (min 53-max 86) were included. Adherence to all parts of the intervention was not feasible because of patients' postoperative complications, resulting in dropouts. For the patients who took part in the exercise programme, adherence and acceptability for the exercise period were feasible, but the 6-min walk test was not feasible at discharge from the hospital. Physiotherapists in the primary health care setting perceived the process as feasible. Moreover, the ability of outcomes to indicate change and progression in the exercise programme was feasible, meanwhile no adverse events were registered. CONCLUSIONS The exercise intervention was feasible for the patients that took part in the exercise programme, with respect to safety and progression through the exercise programme. Furthermore, this study suggests that some improvements needed to be implemented in the process, prior to the upcoming randomised controlled trial.
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Affiliation(s)
- Andrea Porserud
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, 23100, 141 83, Huddinge, Sweden.
- Medical Unit Occupational Therapy and Physiotherapy, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, 171 76, Stockholm, Sweden.
| | - Patrik Karlsson
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, 23100, 141 83, Huddinge, Sweden
- Medical Unit Occupational Therapy and Physiotherapy, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, 171 76, Stockholm, Sweden
| | - Malin Nygren-Bonnier
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, 23100, 141 83, Huddinge, Sweden
- Medical Unit Occupational Therapy and Physiotherapy, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, 171 76, Stockholm, Sweden
| | - Markus Aly
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden
- Patient Area Pelvic Cancer, Cancer Theme, Karolinska University Hospital, 171 76, Stockholm, Sweden
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, 23100, 141 83, Huddinge, Sweden
- Medical Unit Occupational Therapy and Physiotherapy, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, 171 76, Stockholm, Sweden
- Academic Primary Health Care Centre, 113 65, Stockholm, Region Stockholm, Sweden
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10
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Doherty F, Powell P, McBride C, Monaghan K. Physical Telerehabilitation interventions for Gait and balance in Multiple sclerosis: A Scoping review. J Neurol Sci 2024; 456:122827. [PMID: 38134564 DOI: 10.1016/j.jns.2023.122827] [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: 09/26/2023] [Revised: 12/01/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Gait and balance impairments affects approximately a quarter of people with multiple sclerosis (pwMS) at onset and increases to almost half by five years. Physical rehabilitation has been recognised as the gold standard method to restore physical function in multiple sclerosis (MS). Emerging evidence in the literature is suggesting that a remote therapy rehabilitation platform (Telerehabilitation) is cost-effective, beneficial, and satisfying for patients and health care practitioners. The overarching aim of this review is to identify and summarise the evidence on the different types of telerehabilitation interventions available to manage gait and balance. METHODS This review followed a methodological framework for conducting scoping reviews. PubMed, Science Direct and Web of Science were searched in April 2023 for relevant published literature. The inclusion criteria were peer-reviewed journal articles written in English which included telerehabilitation interventions for pwMS. Search keywords included multiple sclerosis and telerehabilitation. A reviewer screened titles and abstracts and eligible articles were fully reviewed. The included studies were categorised based on the type of intervention. RESULTS Eight studies were included in this review. The participants (n = 355) had an average age of 48 years (SD = 9.9) with 50% who had relapsing remitting multiple sclerosis who were living with MS for 12 years on average. Study designs included randomised control trials (n = 3), pilot studies and feasibility studies (n = 4). Two types of interventions were identified: Exergaming (n = 5) and Web-Based Physical Therapy (n = 2) of which exergaming appeared to be optimal in improving gait and balance. CONCLUSION This scoping review identified and summarised the evidence on telerehabilitation interventions used for gait and balance in MS. The evidence is showing that telerehabilitation could be used as an alternative to conventional rehabilitation methods for improving gait and balance. More robust trials with larger sample sizes are needed to build on the current evidence to enable telerehabilitation to be integrated into care pathways in the future.
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Affiliation(s)
- Fiona Doherty
- Department of Health and Nutritional Science, Atlantic Technical University, Sligo, Ireland; The Health & Biomedical Research Centre (HEAL), Atlantic Technological University Sligo, Ireland; Neuroplasticity Research Group (NRG), Atlantic Technological University, Sligo, Ireland; Neurology Support Centre, Molloway House, Sligo, Ireland.
| | - Paul Powell
- Neuroplasticity Research Group (NRG), Atlantic Technological University, Sligo, Ireland; Faculty of Engineering, Atlantic Technical University, Sligo, Ireland; Neurology Support Centre, Molloway House, Sligo, Ireland
| | - Ciara McBride
- Department of Health and Nutritional Science, Atlantic Technical University, Sligo, Ireland; The Health & Biomedical Research Centre (HEAL), Atlantic Technological University Sligo, Ireland; Neuroplasticity Research Group (NRG), Atlantic Technological University, Sligo, Ireland
| | - Kenneth Monaghan
- Department of Health and Nutritional Science, Atlantic Technical University, Sligo, Ireland; The Health & Biomedical Research Centre (HEAL), Atlantic Technological University Sligo, Ireland; Neuroplasticity Research Group (NRG), Atlantic Technological University, Sligo, Ireland; Neurology Support Centre, Molloway House, Sligo, Ireland
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11
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Lewis A, Turner LA, Fryer S, Smith R, Dillarstone H, Patrick YW, Bevan-Smith E. The acceptability, practicality, implementation and efficacy of a physical and social activity intervention 'BreatheHappy' for people with long-term respiratory conditions: A feasibility study. Chron Respir Dis 2024; 21:14799731241238435. [PMID: 38553857 PMCID: PMC10981237 DOI: 10.1177/14799731241238435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 02/24/2024] [Accepted: 02/19/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES This study aimed to determine the feasibility of a group-based pilot programme of low-to-moderate physical activity training, education and social activities, by investigating acceptability, practicality, implementation and efficacy testing. We offer suggestions on programme adaptions for future study. METHODS People with a range of chronic respiratory diseases were invited to participate in a pilot 12 week group activity programme. Activities included outdoor walking, tai-chi, education and a range of social activities. Acceptability was determined by participant experiences determined during interviews. Practicality was determined by programme and outcome measure completion, cost and adverse events. Implementation was determined according to whether the programme ran as planned. Efficacy was determined by statistical analyses of outcomes including hand grip strength, timed up and go test, COPD Helplessness Index, COPD Assessment Test, and measures of physical activity via accelerometry. RESULTS Thematic analysis indicated that the "BreatheHappy" programme was acceptable. Seven of nine participants completed eight out of 10 sessions and the majority completed all outcome measures. "BreatheHappy" was therefore considered practical. The programme was not implemented as planned, with only 10 sessions running rather than the 12 intended. There was a significant increase in daily step counts (MD: 1284 95% CI: 240-2329 p: 0.024 effect size: 0.988), stepping time (MD: 16 min 95% CI: 5-27 min p: 0.011 effect size: 1.36) and daily minutes completing light physical activity (MD: 23 95% CI: 6-38 p: 0.006 effect size: 1.6). However, time spent sitting for ≥30 min but ≤60 min significantly increased (MD: 26 95% CI: 0.2-52 min p: 0.049 effect size: 0.931), showing signs of efficacy and changing physical activity behaviour patterns. DISCUSSION A 10-week programme of low-moderate physical activity training, education and social activities shows signs of feasibility for future research. Suggested adaptions for future study include using physical activity measures such as daily step count or light physical activity for a primary outcome, and mental health and social health related outcome measures relatable to participant's beneficial experiences of the programme. Recruitment in future studies will try and reach both those less socially active and possibly those who have completed pulmonary rehabilitation (PR). Venues should be close to efficient transport links whilst different frequencies and durations of programme delivery should be trialled. Adequate funding should be provided for both staff running the programme and blinded research staff for outcome measurement.
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Affiliation(s)
- A Lewis
- Department of Health Sciences, Brunel University London, Uxbridge, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - LA Turner
- School of Education and Science, University of Gloucestershire, Cheltenham, UK
| | - S Fryer
- School of Education and Science, University of Gloucestershire, Cheltenham, UK
| | - R Smith
- Department of Geography, University College London, London, UK
| | - H Dillarstone
- Institute for Global Health, University College London, London, UK
| | - YW Patrick
- Department of Health and Social Care, University of Gloucestershire, Cheltenham, UK
| | - E Bevan-Smith
- Department of Health and Social Care, University of Gloucestershire, Cheltenham, UK
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12
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Kirk AG, Kimmel LA, Behm KJ, Peiris CL, Ekegren CL. Validity of the activPAL and ActiGraph for measuring sitting time and steps in hospitalised orthopaedic patients with altered weight bearing. Disabil Rehabil 2024; 46:378-386. [PMID: 36541196 DOI: 10.1080/09638288.2022.2157896] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To determine the criterion validity of the activPAL and ActiGraph for measuring steps and sitting/sedentary time, compared to observation, in people hospitalised following orthopaedic lower limb injury who were weight bearing (WB) (i.e., walking) or non-weight bearing (NWB) (i.e., hopping). MATERIALS AND METHODS Participants wore an activPAL and ActiGraph on the hip/thigh/unaffected (UA)/affected ankle (AA) while completing bouts of walking and sitting. Lin's concordance correlation coefficient, Bland-Altman methods, and ratio of agreement were used to compare device-measured to observed (videoed) step count, sitting/sedentary time. RESULTS In 42 participants, the ActiGraph demonstrated excellent concordance with the observed step count when worn on the ankle (LCC 0.91-0.92) compared to the hip (LCC 0.56) in participants that were WB. The ActiGraph AA achieved the highest concordance (LCC 0.71) with observed steps in participants NWB. The activPAL had poor concordance with observed steps, particularly at slow gait speeds, in participants that were WB (LCC 0.38-0.46), however was less influenced by gait speed and had good concordance in NWB participants (LCC 0.52-0.69). The activPAL (LCC 0.79-0.88) and ActiGraph UA (LCC 0.94) showed excellent concordance with observed sitting and sedentary time, respectively. CONCLUSIONS The ActiGraph worn at the ankle provided the most valid measure of steps in people who are WB and NWB following orthopaedic injury, while the activPAL was best for measuring sitting time.Implications for rehabilitationTo accurately measure both steps and sitting time in people with lower limb orthopaedic injuries, a combination of activity monitors should be used (i.e., ActiGraph for steps, activPAL for sitting time).The ActiGraph device when worn on the ankle demonstrated the strongest agreement with observed step count in people who were weight bearing and non-weight bearing.Caution is needed when using thigh- or hip-worn devices in people who walk slowly.
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Affiliation(s)
- Asher G Kirk
- Department of Physiotherapy, Alfred Health, Prahran, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lara A Kimmel
- Department of Physiotherapy, Alfred Health, Prahran, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kate J Behm
- Department of Physiotherapy, Alfred Health, Prahran, Australia
| | - Casey L Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Christina L Ekegren
- Department of Physiotherapy, Alfred Health, Prahran, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Frankston, Australia
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13
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Paul L, McDonald MT, McConnachie A, Siebert S, Coulter EH. Online physiotherapy for people with axial spondyloarthritis: quantitative and qualitative data from a cohort study. Rheumatol Int 2024; 44:145-156. [PMID: 37733042 PMCID: PMC10766789 DOI: 10.1007/s00296-023-05456-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/01/2023] [Indexed: 09/22/2023]
Abstract
Life-long exercise is essential in axial spondyloarthritis (axSpA) management; however, long-term adherence is challenging. Online exercise programmes are an alternative to face-to-face physiotherapy. (1) To measure adherence to a 12-month, individualised, online physiotherapy programme for people with axSpA, and investigate the effects on disease activity, spinal mobility, work ability, quality of life and function. (2) To investigate associations between programme adherence and outcomes. (3) To explore participants' views of the programme and factors affecting adherence. Participants were 'non-exercisers' recruited from rheumatology outpatient services. Adherence was measured using online diary entries. Outcomes included the BATH indices, health status (EQ5D), Ankylosing Spondylitis Quality of Life (ASQOL), exercise capacity (6MWT), Work, Productivity and Activity Impairment in AS (WPAI), Exercise Attitude Questionnaire (EAQ) and Exercise Motivations Inventory-2 (EMI-2) at baseline, 6 and 12 months. Interviews determined views on the intervention and factors affecting adherence. Fifty participants were recruited. Over the 52-week intervention, adherence (five times/week) ranged from 19% (± 30%) to 44% (± 35%). Significant improvements were found in disease activity (BASDAI), spinal mobility (BASMI), 6MWT, AsQoL and EQ5D-VAS at 6 and 12 months. There were no associations between adherence and baseline variables or demographics. Interviews suggested support from others, routine, and feeling the benefit positively affected adherence. Conversely, lack of motivation, life events and symptoms negatively affected adherence. A 12-month online physiotherapy programme significantly improved symptoms in people with axSpA who were not regular exercisers. Adherence reduced over the intervention period. Online exercise programmes may benefit people with axSpA; however, strategies to improve adherence are required.
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Affiliation(s)
- L Paul
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, UK
| | - M T McDonald
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, UK
| | - A McConnachie
- Robertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - S Siebert
- School of Infection and Immunity, University of Glasgow, Glasgow, UK
| | - E H Coulter
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, UK.
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14
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Tam RM, Zablocki RW, Liu C, Narayan HK, Natarajan L, LaCroix AZ, Dillon L, Sakoulas E, Hartman SJ. Feasibility of a Health Coach Intervention to Reduce Sitting Time and Improve Physical Functioning Among Breast Cancer Survivors: Pilot Intervention Study. JMIR Cancer 2023; 9:e49934. [PMID: 38113082 PMCID: PMC10762618 DOI: 10.2196/49934] [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: 06/30/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Sedentary behavior among breast cancer survivors is associated with increased risk of poor physical function and worse quality of life. While moderate to vigorous physical activity can improve outcomes for cancer survivors, many are unable to engage in that intensity of physical activity. Decreasing sitting time may be a more feasible behavioral target to potentially mitigate the impact of cancer and its treatments. OBJECTIVE The purpose of this study was to investigate the feasibility and preliminary impact of an intervention to reduce sitting time on changes to physical function and quality of life in breast cancer survivors, from baseline to a 3-month follow-up. METHODS Female breast cancer survivors with self-reported difficulties with physical function received one-on-one, in-person personalized health coaching sessions aimed at reducing sitting time. At baseline and follow-up, participants wore the activPAL (thigh-worn accelerometer; PAL Technologies) for 3 months and completed physical function tests (4-Meter Walk Test, Timed Up and Go, and 30-Second Chair Stand) and Patient-Reported Outcomes Measurement Information System (PROMIS) self-reported outcomes. Changes in physical function and sedentary behavior outcomes were assessed by linear mixed models. RESULTS On average, participants (n=20) were aged 64.5 (SD 9.4) years; had a BMI of 30.4 (SD 4.5) kg/m2; and identified as Black or African American (n=3, 15%), Hispanic or Latina (n=4, 20%), and non-Hispanic White (n=14, 55%). Average time since diagnosis was 5.8 (SD 2.2) years with participants receiving chemotherapy (n=8, 40%), radiotherapy (n=18, 90%), or endocrine therapy (n=17, 85%). The intervention led to significant reductions in sitting time: activPAL average daily sitting time decreased from 645.7 (SD 72.4) to 532.7 (SD 142.1; β=-112.9; P=.001) minutes and average daily long sitting bouts (bout length ≥20 min) decreased from 468.3 (SD 94.9) to 366.9 (SD 150.4; β=-101.4; P=.002) minutes. All physical function tests had significant improvements: on average, 4-Meter Walk Test performance decreased from 4.23 (SD 0.95) to 3.61 (SD 2.53; β=-.63; P=.002) seconds, Timed Up and Go performance decreased from 10.30 (SD 3.32) to 8.84 (SD 1.58; β=-1.46; P=.003) seconds, and 30-Second Chair Stand performance increased from 9.75 (SD 2.81) to 13.20 completions (SD 2.53; β=3.45; P<.001). PROMIS self-reported physical function score improved from 44.59 (SD 4.40) to 47.12 (SD 5.68; β=2.53; P=.05) and average fatigue decreased from 52.51 (SD 10.38) to 47.73 (SD 8.43; β=-4.78; P=.02). CONCLUSIONS This 3-month pilot study suggests that decreasing time spent sitting may be helpful for breast cancer survivors experiencing difficulties with physical function and fatigue. Reducing sitting time is a novel and potentially more feasible approach to improving health and quality of life in cancer survivors.
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Affiliation(s)
- Rowena M Tam
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Rong W Zablocki
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Chenyu Liu
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Hari K Narayan
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States
- UC San Diego Moores Cancer Center, University of California San Diego, La Jolla, CA, United States
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
- UC San Diego Moores Cancer Center, University of California San Diego, La Jolla, CA, United States
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Lindsay Dillon
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Eleanna Sakoulas
- UC San Diego Moores Cancer Center, University of California San Diego, La Jolla, CA, United States
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
- UC San Diego Moores Cancer Center, University of California San Diego, La Jolla, CA, United States
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15
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Pavlovic N, Brady B, Boland R, Harris IA, Flood VM, Genel F, Gao M, Naylor JM. A mixed methods approach to investigating physical activity in people with obesity participating in a chronic care programme awaiting total knee or hip arthroplasty. Musculoskeletal Care 2023; 21:1447-1462. [PMID: 37772968 DOI: 10.1002/msc.1825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/09/2023] [Accepted: 09/14/2023] [Indexed: 09/30/2023]
Abstract
AIMS To describe patient-reported physical activity and step count trajectory and explore perceived barriers and enablers to physical activity amongst people with obesity participating in a chronic care programme whilst awaiting arthroplasty. DESIGN Convergent parallel mixed-method study. METHOD A patient cohort derived from a longitudinal sample of adults with end-stage osteoarthritis and obesity from a chronic care programme whilst awaiting primary total knee or hip arthroplasty (n = 97) was studied. Physical activity was measured at baseline (entry to the wait list) and before surgery (9-12 months waiting time) using the Lower Extremity Activity Scale (LEAS) and activity monitors (activPAL™). A subset of participants completed in-depth semi-structured interviews 6 months after being waitlisted to explore perceived barriers and enablers to physical activity. Themes were inductively derived and then interpreted through the COM-B model. RESULTS Baseline LEAS and activPAL™ data were available from 97 and 63 participants, respectively. The proportion of community ambulant individuals reduced from 43% (95% CI 33%-53%) at baseline to 17% (95% CI 9%-28%) pre-surgery. Paired activPAL™ data (n = 31) for step count, upright time, and stepping time remained unchanged. Twenty-five participants were interviewed. Five themes underpinning physical activity were mapped to the COM-B model components of capability (physical capability), opportunity (accessibility and social norms), and motivation (self-efficacy and beliefs and physical activity). CONCLUSIONS Participation in a chronic care programme did not improve physical activity levels for people with obesity awaiting arthroplasty. Programs cognisant of the COM-B model components may be required to address the natural trajectory of declining physical activity levels while awaiting arthroplasty.
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Affiliation(s)
- Natalie Pavlovic
- South Western Sydney Clinical School, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Fairfield Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Bernadette Brady
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Robert Boland
- Fairfield Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ian A Harris
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Victoria M Flood
- University Centre for Rural Health, Northern Rivers, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Furkan Genel
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- St George and Sutherland Clinical School, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Manxin Gao
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Justine M Naylor
- South Western Sydney Clinical School, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
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Burahmah E, Shanmugam S, Williams D, Stansfield B. Agreement of Two Physical Behaviour Monitors for Characterising Posture and Stepping in Children Aged 6-12 Years. SENSORS (BASEL, SWITZERLAND) 2023; 23:8970. [PMID: 37960669 PMCID: PMC10648043 DOI: 10.3390/s23218970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/19/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023]
Abstract
All new physical behaviour measurement devices should be assessed for compatibility with previous devices. Agreement was assessed between the activPAL4TM and activPAL3TM physical behavior monitors within a laboratory and a multi-day free-living context. Healthy children aged 6-12 years performed standardised (sitting, standing, stepping) (12 min) and non-standardised (6 min) activities in a laboratory and a multi-day (median 3 days) free-living assessment whilst wearing both monitors. Agreement was assessed using Bland-Altman plots, sensitivity, and the positive predictive value (PPV). There were 15 children (7M/8F, 8.4 ± 1.8 years old) recruited. For the laboratory-based standardised activities, sitting time, stepping time, and fast walking/jogging step count were all within ±5% agreement. However, the activPAL4TM standing time was lower (-6.4%) and normal speed walking step count higher (+7.8%) than those of the activPAL3TM. For non-standardised activities, a higher step count was recorded by the activPAL4TM (+4.9%). The standardised activity sensitivity and PPV were all >90%, but the non-standardised activity values were lower. For free-living agreement, the standing time was lower (-7.6%) and step count higher (all steps + 2.2%, steps with cadence >100 step/min + 6.6%) for the activPAL4TM than the activPAL3TM. This study highlights differences in outcomes as determined by the activPAL4TM and activPAL3TM, which should be considered when comparing outcomes between studies.
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Affiliation(s)
- Esraa Burahmah
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK; (S.S.); (D.W.); (B.S.)
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Perks J, Mcbride P, Rayt H, Payne T, Edwardson C, Rowlands AV, Messeder SJ, Yates T, Sayers R. Efficacy of a personalised activity plan for BREAKing UP sitting time in patients with intermittent claudication (the BREAK UP study). Diabetes Res Clin Pract 2023; 204:110925. [PMID: 37774979 DOI: 10.1016/j.diabres.2023.110925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/11/2023] [Accepted: 09/27/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION The aim of this study was to investigate the concept of an 8-week personalised activity plan, using short periods of physical activity to break up sitting time in people with Intermittent Claudication (IC), to improve walking ability, and reduce time spent sitting. METHODS The study was designed as a single centre, single arm, before and after study and is registered with clinicaltrials.gov (NCT04572737). The co-primary outcomes are time spent sitting and walking ability measured via the walking impairment questionnaire. Normally distributed data was analysed using paired samples T-tests; non-normally distributed data was analysed using related-samples Wilcoxon signed rank tests. RESULTS There was a significant improvement in both co-primary outcomes: walking ability and time spent sitting, as well as the following secondary outcomes: total bouts and time spent in prolonged sitting, time spent standing and stepping, anxiety, depression, and activity levels reported on the vascular quality of life questionnaire. CONCLUSION An 8-week personalised activity plan to break up sitting time shows promise as a treatment for people with IC, improving walking ability and reducing time spent sitting. This study supports the use of large randomised controlled trials to further develop this treatment in people with IC.
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Affiliation(s)
- Jemma Perks
- Department of Cardiovascular Sciences, University of Leicester, On-Call Suite OC9, Glenfield General Hospital, Groby Road, Leicester LE3 9QP, UK.
| | - Philip Mcbride
- Leicester Diabetes Centre, University of Leicester, Leicester LE5 4PW, UK
| | - Harjeet Rayt
- Department of Cardiovascular Sciences, University of Leicester, On-Call Suite OC9, Glenfield General Hospital, Groby Road, Leicester LE3 9QP, UK
| | - Tanya Payne
- Department of Cardiovascular Sciences, University of Leicester, On-Call Suite OC9, Glenfield General Hospital, Groby Road, Leicester LE3 9QP, UK
| | | | - Alex V Rowlands
- Leicester Diabetes Centre, University of Leicester, Leicester LE5 4PW, UK
| | - Sarah Jane Messeder
- Department of Cardiovascular Sciences, University of Leicester, On-Call Suite OC9, Glenfield General Hospital, Groby Road, Leicester LE3 9QP, UK
| | - Thomas Yates
- Leicester Diabetes Centre, University of Leicester, Leicester LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, UK
| | - Robert Sayers
- Department of Cardiovascular Sciences, University of Leicester, On-Call Suite OC9, Glenfield General Hospital, Groby Road, Leicester LE3 9QP, UK
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Fuchita M, Ridgeway KJ, Sandridge B, Kimzey C, Abraham A, Melanson EL, Fernandez-Bustamante A. Comparison of postoperative mobilization measurements by activPAL versus Johns Hopkins Highest Level of Mobility scale after major abdominal surgery. Surgery 2023; 174:851-857. [PMID: 37580218 PMCID: PMC10530478 DOI: 10.1016/j.surg.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/22/2023] [Accepted: 07/08/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND The Johns Hopkins Highest Level of Mobility scale is a validated tool for assessing patient mobility in the hospital. It has excellent inter-rater and test-retest reliabilities, but it is unknown how accurately Johns Hopkins Highest Level of Mobility documentation reflects the patients' mobility performance in the immediate postoperative period compared to objective measures such as accelerometers. METHODS In this single-center observational study, consented adults undergoing open abdominal surgery wore a research-grade accelerometer, activPAL, starting immediately postoperatively until hospital discharge or up to 7 days. We collected the Johns Hopkins Highest Level of Mobility scores documented by hospital staff via retrospective chart review and evaluated their accuracy in describing the type, frequency, and volume of postoperative out-of-bed mobilization using the activPAL as the criterion. RESULTS We analyzed data from 56 participants. The activPAL showed that participants spent 97.7% of their time lying in bed or sitting in a chair. Meanwhile, the Johns Hopkins Highest Level of Mobility documentation of preambulatory activities (scores 1-5) was rare. The activPAL detected 4 times more out-of-bed mobilization than routine Johns Hopkins Highest Level of Mobility documentation. Whereas the frequency of activPAL-measured out-of-bed mobilization increased steadily to a median of 9 sessions by postoperative day 6, the number of Johns Hopkins Highest Level of Mobility documentation remained around twice daily. ActivPAL measurements demonstrated that Johns Hopkins Highest Level of Mobility documentation of ambulatory sessions (scores 6-8) was accurate. CONCLUSIONS We found that routine Johns Hopkins Highest Level of Mobility documentation did not accurately detect preambulatory activities or the overall frequency of out-of-bed mobility sessions, poorly reflecting the highly sedentary behaviors of the acute postoperative inpatients and highlighting the need to improve clinical documentation or use alternative methods to track postoperative mobilization.
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Affiliation(s)
- Mikita Fuchita
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Kyle J Ridgeway
- Inpatient Rehabilitation Therapy Department, University of Colorado Hospital, University of Colorado Health, Aurora, CO; Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO. http://www.twitter.com/Dr_Ridge_DPT
| | | | | | - Alison Abraham
- Department of Epidemiology, University of Colorado School of Public Health, Aurora, CO
| | - Edward L Melanson
- Division of Endocrinology and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO; Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO; Rocky Mountain Regional VA Medical Center, Aurora, CO
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19
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Edwardson CL, Maylor BD, Biddle SJ, Clemes SA, Cox E, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Hadjiconstantinou M, Healy GN, Jaicim NB, Lawton S, Mandalia P, Munir F, Richardson G, Walker S, Yates T, Clarke-Cornwell AM. A multicomponent intervention to reduce daily sitting time in office workers: the SMART Work & Life three-arm cluster RCT. PUBLIC HEALTH RESEARCH 2023; 11:1-229. [PMID: 37786938 DOI: 10.3310/dnyc2141] [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] [Indexed: 10/04/2023] Open
Abstract
Background Office workers spend 70-85% of their time at work sitting. High levels of sitting have been linked to poor physiological and psychological health. Evidence shows the need for fully powered randomised controlled trials, with long-term follow-up, to test the effectiveness of interventions to reduce sitting time. Objective Our objective was to test the clinical effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable workstation, compared with usual practice at 12-month follow-up. Design A three-arm cluster randomised controlled trial. Setting Councils in England. Participants Office workers. Intervention SMART Work & Life is a multicomponent intervention that includes behaviour change strategies, delivered by workplace champions. Clusters were randomised to (1) the SMART Work & Life intervention, (2) the SMART Work & Life intervention with a height-adjustable workstation (i.e. SMART Work & Life plus desk) or (3) a control group (i.e. usual practice). Outcome measures were assessed at baseline and at 3 and 12 months. Main outcome measures The primary outcome was device-assessed daily sitting time compared with usual practice at 12 months. Secondary outcomes included sitting, standing, stepping time, physical activity, adiposity, blood pressure, biochemical measures, musculoskeletal issues, psychosocial variables, work-related health, diet and sleep. Cost-effectiveness and process evaluation data were collected. Results A total of 78 clusters (756 participants) were randomised [control, 26 clusters (n = 267); SMART Work & Life only, 27 clusters (n = 249); SMART Work & Life plus desk, 25 clusters (n = 240)]. At 12 months, significant differences between groups were found in daily sitting time, with participants in the SMART Work & Life-only and SMART Work & Life plus desk arms sitting 22.2 minutes per day (97.5% confidence interval -38.8 to -5.7 minutes/day; p = 0.003) and 63.7 minutes per day (97.5% confidence interval -80.0 to -47.4 minutes/day; p < 0.001), respectively, less than the control group. Participants in the SMART Work & Life plus desk arm sat 41.7 minutes per day (95% confidence interval -56.3 to -27.0 minutes/day; p < 0.001) less than participants in the SMART Work & Life-only arm. Sitting time was largely replaced by standing time, and changes in daily behaviour were driven by changes during work hours on workdays. Behaviour changes observed at 12 months were similar to 3 months. At 12 months, small improvements were seen for stress, well-being and vigour in both intervention groups, and for pain in the lower extremity and social norms in the SMART Work & Life plus desk group. Results from the process evaluation supported these findings, with participants reporting feeling more energised, alert, focused and productive. The process evaluation also showed that participants viewed the intervention positively; however, the extent of engagement varied across clusters. The average cost of SMART Work & Life only and SMART Work & Life plus desk was £80.59 and £228.31 per participant, respectively. Within trial, SMART Work & Life only had an incremental cost-effectiveness ratio of £12,091 per quality-adjusted life-year, with SMART Work & Life plus desk being dominated. Over a lifetime, SMART Work & Life only and SMART Work & Life plus desk had incremental cost-effectiveness ratios of £4985 and £13,378 per quality-adjusted life-year, respectively. Limitations The study was carried out in one sector, limiting generalisability. Conclusions The SMART Work & Life intervention, provided with and without a height-adjustable workstation, was successful in changing sitting time. Future work There is a need for longer-term follow-up, as well as follow-up within different organisations. Trial registration Current Controlled Trials ISRCTN11618007.
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Affiliation(s)
| | | | - Stuart Jh Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Stacy A Clemes
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Edward Cox
- Centre for Health Economics, University of York, York, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | | | | | - Sarah Lawton
- School of Health & Society, University of Salford, Salford, UK
| | - Panna Mandalia
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Simon Walker
- Centre for Health Economics, University of York, York, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
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20
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Karlsson P, Nygren-Bonnier M, Henningsohn L, Rydwik E, Hagströmer M. The feasibility of using a digital tool to enhance mobilisation following abdominal cancer surgery-a non-randomised controlled trial. Pilot Feasibility Stud 2023; 9:147. [PMID: 37612761 PMCID: PMC10463628 DOI: 10.1186/s40814-023-01377-0] [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: 03/06/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Early mobilisation is strongly recommended following abdominal cancer surgery, but evidence on how to structure early mobilisation to improve outcomes and support patient adherence is lacking. Pedatim® (Phystec) is a novel digital tool designed to support mobilisation in hospital settings using prescribed activities and goals on a tablet. The aim of this study was to evaluate the feasibility of the Pedatim tablet to enhance mobilisation following abdominal cancer surgery. METHODS In a non-randomised feasibility trial design, participants were recruited between January and May 2022 at Karolinska University Hospital, Sweden. Participants used a Pedatim tablet from postoperative day 1 (POD 1) until hospital discharge. The primary objective was to evaluate process feasibility, regarding recruitment, compliance, and acceptability. Recruitment was measured by percentage of available patients included, eligibility criteria sufficiency, and number of dropouts. Compliance was measured by number of patients using versus not using the board. Acceptability was measured using the System Usability Scale. The secondary objective was to evaluate scientific feasibility, defined as an indication of treatment effects where physical activity was assessed using an activPAL accelerometer. Unforeseen events relating to the tablet were also registered. RESULTS Based on predetermined feasibility criteria, the overall study design was determined to be feasible regarding recruitment as 69% accepted participation (n = 20), compliance was 95%, and the acceptability mean score was high (77/100). Eligibility criteria were not feasible as 79% (n = 108) of available patients were excluded. The intervention was determined to be scientifically feasible, mean steps per day increased from 623 (SD 766) to 1823 (SD 1446), and mean sit-to-stand transitions per day increased from 11 (SD 8) to 29 (SD 12) POD 1-4. Technical issues emerged, highlighting the need for available technical support and "user champions" among healthcare professionals on the ward. CONCLUSIONS Using the Pedatim tablet to enhance mobilisation following abdominal cancer surgery was deemed feasible, but a randomised controlled trial is needed to determine the tool's effectiveness. The study process was determined to be feasible with revisions of the eligibility criteria needed before a future trial. Involving healthcare professionals and providing available technical support are important for future implementation.
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Affiliation(s)
- Patrik Karlsson
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
| | - Malin Nygren-Bonnier
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Henningsohn
- Department of Clinical Science, Intervention and Technology, Division of Urology, Karolinska Institutet, Stockholm, Sweden
| | - Elisabeth Rydwik
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
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Maher JP, Hevel DJ, Bittel KM, Hudgins BL, Labban JD, Kennedy-Malone L. Studying Movement-Related Behavioral Maintenance and Adoption in Real Time: Protocol for an Intensive Ecological Momentary Assessment Study Among Older Adults. JMIR Res Protoc 2023; 12:e47320. [PMID: 37505805 PMCID: PMC10422169 DOI: 10.2196/47320] [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: 03/15/2023] [Revised: 05/10/2023] [Accepted: 05/23/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Older adults struggle to maintain newly initiated levels of physical activity (PA) or sedentary behavior (SB) and often regress to baseline levels over time. This is partly because health behavior theories that inform interventions rarely address how the changing contexts of daily life influence the processes regulating PA and SB or how those processes differ across the behavior change continuum. Few studies have focused on motivational processes that regulate the dynamic nature of PA and SB adoption and maintenance on microtimescales (ie, across minutes, hours, or days). OBJECTIVE The overarching goal of Project Studying Maintenance and Adoption in Real Time (SMART) is to determine the motivational processes that regulate behavioral adoption versus maintenance over microtimescales, using a dual process framework combined with ecological momentary assessment and sensor-based monitoring of behavior. This paper describes the recruitment, enrollment, data collection, and analytics protocols for Project SMART. METHODS In Project SMART, older adults engaging in at least 30 minutes of moderate-to-vigorous intensity PA per week complete 3 data collection periods over 1 year, with each data collection period lasting 14 days. Across each data collection period, participants wear an ActiGraph GT3X accelerometer (ActiGraph, LLC) on their nondominant waist and an ActivPAL micro4 accelerometer (PAL Technologies, Ltd) on their anterior thigh to measure PA and SB, respectively. Ecological momentary assessment questionnaires are randomly delivered via smartphone 10 times per day on 4 selected days in each data collection period and assess reflective processes (eg, evaluating one's efficacy and exerting self-control) and reactive processes (eg, contextual cues) within the dual process framework. At the beginning and end of each data collection period, participants complete a computer-based questionnaire to learn more about their typical motivation for PA and SB, physical and mental health, and life events over the course of the study. RESULTS Recruitment and enrollment began in January 2021; enrollment in the first data collection period was completed by February 2022; and all participants completed their second and third data collection by July 2022 and December 2022, respectively. Data were collected from 202 older adults during the first data collection period, with approximate retention rates of 90.1% (n=182) during the second data collection period and 88.1% (n=178) during the third data collection period. Multilevel models and mixed-effects location scale modeling will be used to evaluate the study aims. CONCLUSIONS Project SMART seeks to predict and model the adoption and maintenance of optimal levels of PA and SB among older adults. In turn, this will inform the future delivery of personalized intervention content under conditions where the content will be most effective to promote sustained behavior change among older adults. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47320.
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Affiliation(s)
- Jaclyn P Maher
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, United States
| | - Derek J Hevel
- Henry M Goldman School of Dental Medicine, Boston University, Boston, MA, United States
| | - Kelsey M Bittel
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, United States
| | - Brynn L Hudgins
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, United States
| | - Jeffery D Labban
- School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC, United States
| | - Laurie Kennedy-Malone
- School of Nursing, University of North Carolina Greensboro, Greensboro, NC, United States
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22
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Iveson AMJ, Abaraogu UO, Dall PM, Granat MH, Ellis BM. Walking Behaviour of Individuals with Intermittent Claudication Compared to Matched Controls in Different Locations: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105816. [PMID: 37239542 DOI: 10.3390/ijerph20105816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
Individuals with intermittent claudication (IC) are less physically active than their peers, but how this varies with location is unclear. Individuals with IC and matched controls [sex, age ±5 years, home < 5 miles] wore an activity monitor (activPAL) and carried a GPS device (AMOD-AGL3080) for 7 days. GPS data categorised walking events as occurring at home (<=50 m from home co-ordinates) or away from home, and indoors (signal to noise ratio <= 212 dB) or outdoors. Number of walking events, walking duration, steps and cadence were compared between groups and each location pair using mixed model ANOVAs. In addition, the locus of activity (distance from home) at which walking was conducted was compared between groups. Participants (n = 56) were mostly male (64%) and aged 54-89 years. Individuals with IC spent significantly less time walking and took fewer steps than their matched controls at all locations, including at home. Participants spent more time and took more steps away from home than at home, but were similar when walking indoors and outdoors. The locus of activity was significantly smaller for individuals with IC, suggesting that it is not just physical capacity that influences walking behaviour, and other factors (e.g., social isolation) may play a role.
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Affiliation(s)
- Anna M J Iveson
- Research Centre for Health, Glasgow Caledonian University, Glasgow G4 0BA, UK
| | | | - Philippa M Dall
- Research Centre for Health, Glasgow Caledonian University, Glasgow G4 0BA, UK
| | - Malcolm H Granat
- School of Health Sciences, Salford University, Salford M5 4WT, UK
| | - Brian M Ellis
- Research Centre for Health, Glasgow Caledonian University, Glasgow G4 0BA, UK
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23
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Burahmah E, Shanmugam S, Williams D, Stansfield B. Validity and Reliability of the activPAL4 TM for Measurement of Body Postures and Stepping Activity in 6-12-Year-Old Children. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094555. [PMID: 37177759 PMCID: PMC10181769 DOI: 10.3390/s23094555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 04/28/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Abstract
A link between inappropriate physical behaviour patterns (low physical activity and high sedentary behaviour) and poor health outcomes has been observed. To provide evidence to quantify this link, it is important to have valid and reliable assessment tools. This study aimed to assess the validity and reliability of the activPAL4TM monitor for distinguishing postures and measuring stepping activity of 6-12-year-old children. Thirteen children (8.5 ± 1.8 years) engaged in pre-determined standardised (12 min) and non-standardised (6 min) activities. Agreement, specificity and positive predictive value were assessed between the activPAL4TM and direct observation (DO) (nearest 0.1 s). Between-activPAL4TM (inter-device) and between-observer (inter-rater) reliability were determined. Detection of sitting and stepping time and forward purposeful step count were all within 5% of DO. Standing time was slightly overestimated (+10%) and fast walking/jogging steps underestimated (-20%). For non-standardised activities, activPAL4TM step count matched most closely to combined backward and forward purposeful steps; however, agreement varied widely. The activPAL4TM demonstrated high levels of reliability (ICC(1, 1) > 0.976), which were higher in some instances than could be achieved through direct observation (ICC(2, 1) > 0.851 for non-standardised activities). Overall, the activPAL4TM recorded standardised activities well. However, further work is required to establish the exact nature of steps counted by the activPAL4TM.
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Affiliation(s)
- Esraa Burahmah
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
| | - Sivaramkumar Shanmugam
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
| | - Daniel Williams
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
| | - Ben Stansfield
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
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Jardine IR, Christie HE, Oetsch K, Sabag A, Kennedy M, Meyer BJ, Francois ME. Physical Activity, but Not Glycaemic Load, Is Associated with Lower Real-Time Glycaemic Control in Free-Living Women with Gestational Diabetes Mellitus. Nutrients 2023; 15:nu15081974. [PMID: 37111193 PMCID: PMC10142701 DOI: 10.3390/nu15081974] [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: 02/27/2023] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Maintaining blood glucose within the target range is the primary treatment goal for women with gestational diabetes mellitus (GDM). Foods with low glycaemic loads are recommended in clinical practice; however, the relative importance of other key lifestyle variables is unexplored. This pilot study explored the associations of glycaemic load, carbohydrates and physical activity parameters on blood glucose concentrations in free-living women with GDM. Twenty-nine women (28-30 weeks gestation, 34 ± 4 years) with GDM were enrolled. Continuous glucose monitoring, physical activity (ActivPAL inclinometer) and dietary intake and dietary quality were measured concurrently for 3 days. Pearson correlation analyses determined the association between glucose levels and lifestyle variables. Despite all receiving the same nutrition education, only 55% of women were following a low glycaemic load diet with a large range of carbohydrate intakes (97-267 g/day). However, the glycaemic load did not correlate with 3-hr postprandial glucose (r2 = 0.021, p = 0.56) or 24-h glucose iAUC (r2 = 0.021, p = 0.58). A significant relationship between total stepping time and lower 24-h glucose iAUC (r2 = 0.308, p = 0.02) and nocturnal glucose (r2 = 0.224, p = 0.05) was found. In free-living women with diet-controlled GDM, more physical activity, i.e., steps accumulated across the day, may be a simple and effective strategy for improving maternal blood glucose concentrations.
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Affiliation(s)
- Isabelle R Jardine
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health University of Wollongong, Wollongong, NSW 2522, Australia
| | - Hannah E Christie
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia
| | - Kate Oetsch
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia
| | - Angelo Sabag
- NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia
| | - Meredith Kennedy
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Shoalhaven Local Health District, Diabetes Service, Wollongong, NSW 2500, Australia
| | - Barbara J Meyer
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia
- Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Monique E Francois
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia
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Cheng SWM, Alison JA, Stamatakis E, Dennis SM, McKeough ZJ. Validity and Accuracy of Step Count as an Indicator of a Sedentary Lifestyle in People With Chronic Obstructive Pulmonary Disease. Arch Phys Med Rehabil 2023:S0003-9993(23)00097-7. [PMID: 36775005 DOI: 10.1016/j.apmr.2023.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/04/2023] [Accepted: 01/25/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE To determine the validity and accuracy of <5000 steps/day as a sedentary lifestyle indicator, and the optimal step count cut point value for indicating a sedentary lifestyle in people with chronic obstructive pulmonary disease (COPD). DESIGN Analysis of baseline data from a randomized clinical trial. SETTING Sydney, Australia. PARTICIPANTS Stable COPD on the waitlist for pulmonary rehabilitation. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Step count and time in sedentary behavior (SB) were assessed using thigh-worn accelerometry. A sedentary lifestyle was defined as <5000 steps/day. Pearson correlation coefficients were analyzed between step count and time spent in SB. Sensitivity, specificity, and accuracy were calculated for the <5000 steps/day threshold. Receiver operating characteristic curves with the area under the curve were computed for step count in identifying a sedentary lifestyle. RESULTS 69 people with COPD (mean age=74 years, SD=9; forced expiratory volume in 1 second, mean=55%, SD=19 predicted) had sufficient wear data for analysis. There was a moderate inverse correlation between step count and time spent in SB (r=-0.58, P<.001). Step count had a fair discriminative ability for identifying a sedentary lifestyle (area under the curve=0.80, 95% confidence interval [CI], 0.68-0.91). The <5000 steps/day threshold had a sensitivity, specificity, and accuracy of 82% (95% CI, 70-94), 70% (95% CI, 54-86), and 78%, respectively. A lower threshold of <4300 steps/day was more accurate for ruling in a sedentary lifestyle. CONCLUSIONS Compared with thigh-worn accelerometry, <5000 steps/day is a valid and reasonably accurate indicator of a sedentary lifestyle in this population.
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Affiliation(s)
- Sonia W M Cheng
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Jennifer A Alison
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Allied Health Professorial Unit, Sydney Local Health District, Sydney, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sarah M Dennis
- Allied Health Professorial Unit, Sydney Local Health District, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia; Allied Health Professorial Unit, South Western Sydney Local Health District, Sydney, Australia
| | - Zoe J McKeough
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Objective Activity Levels and Patient-Reported Outcomes After Total Hip Arthroplasty and Periacetabular Osteotomy: Retrospective Matched Cohort Study at Mean 12-Year Follow-Up. J Arthroplasty 2023; 38:323-328. [PMID: 36038071 DOI: 10.1016/j.arth.2022.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND There is increasing interest in improving activity after total hip arthroplasty (THA) and periacetabular osteotomy (PAO). The present study evaluated whether there were differences in the subjective and objective activity levels of THA and PAO patients at mean 12-year follow-up (range 4-20) and what factors influence the objective activity levels. METHODS THA and PAO patients (30 patients each; mean age: 66 and 63 years, respectively), who had undergone surgery for osteoarthritis due to acetabular dysplasia, were included. Patients were retrospectively matched based on age, gender, body mass index, follow-up duration, and preoperative University of California, Los Angeles activity score (UCLA score). Patients were surveyed for the subjective activity levels using the Oxford Hip Score and UCLA score. Objective activity levels (the number of steps, upright time, and the number of sit-to-stand transitions) were made using an accelerometer. RESULTS There was no significant difference in subjective activity level between THA and PAO patients. The number of steps was significantly higher in PAO than in THA patients. Multivariable analyses revealed that THA and low Oxford Hip Score activities of daily living were negatively associated with the number of steps, that men and high UCLA score were negatively associated with upright time, and that high body mass index was negatively associated with sit-to-stand transitions in THA and PAO patients. CONCLUSION This study suggested that although there was no difference in postoperative subjective activity level between THA and PAO patients, there was a difference in objective activity level. Providing guidance to these patients based on objective activity may lead to higher activity levels.
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Buchan DS, Baker JS. Development and Evaluation of Sedentary Time Cut-Points for the activPAL in Adults Using the GGIR R-Package. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2293. [PMID: 36767662 PMCID: PMC9915298 DOI: 10.3390/ijerph20032293] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to develop sedentary cut-points for the activPAL and evaluate their performance against a criterion measure (i.e., activPAL processed by PALbatch). Part 1: Thirty-five adults (23.4 ± 3.6 years) completed 12 laboratory activities (6 sedentary and 6 non-sedentary activities). Receiver operator characteristic (ROC) curves proposed optimal Euclidean Norm Minus One (ENMO) and Mean Amplitude Deviation (MAD) cut-points of 26.4 mg (ENMO) and 30.1 mg (MAD). Part 2: Thirty-eight adults (22.6 ± 4.1 years) wore an activPAL during free-living. Estimates from PALbatch and MAD revealed a mean percent error (MPE) of 2.2%, mean absolute percent error (MAPE) of 6.5%, limits of agreement (LoA) of 19% with absolute and relative equivalence zones of 5% and 0.3 SD. Estimates from PALbatch and ENMO revealed an MPE of -10.6%, MAPE of 14.4%, LoA of 31% and 16% and 1 SD equivalence zones. After standing was isolated from sedentary behaviours, ROC analysis proposed an optimal cut-off of 21.9 mg (herein ENMOs). Estimates from PALbatch and ENMOs revealed an MPE of 3.1%, MAPE of 7.5%, LoA of 25% and 9% and 0.5 SD equivalence zones. The MAD and ENMOs cut-points performed best in discriminating between sedentary and non-sedentary activity during free-living.
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Affiliation(s)
- Duncan S. Buchan
- Division of Sport and Exercise, School of Health and Life Sciences, University of the West of Scotland, Lanarkshire Campus, Glasgow G72 0LH, Scotland, UK
| | - Julien S. Baker
- Research Centre for Population Health and Medical Informatics, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
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Bailey DP, Kilbride C, Harper JH, Victor C, Brierley ML, Hewson DJ, Chater AM. The Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention to improve sarcopenia and maintain independent living via reductions in prolonged sitting: a randomised controlled feasibility trial protocol. Pilot Feasibility Stud 2023; 9:1. [PMID: 36609363 PMCID: PMC9823257 DOI: 10.1186/s40814-022-01225-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/01/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Sarcopenia is a progressive and generalised loss of muscle mass and function with advancing age and is a major contributor to frailty. These conditions lead to functional disability, loss of independence, and lower quality of life. Sedentary behaviour is adversely associated with sarcopenia and frailty. Reducing and breaking up sitting should thus be explored as an intervention target for their management. The primary aim of this study, therefore, is to examine the feasibility, safety, and acceptability of conducting a randomised controlled trial (RCT) that evaluates a remotely delivered intervention to improve sarcopenia and independent living via reducing and breaking up sitting in frail older adults. METHODS This mixed-methods randomised controlled feasibility trial will recruit 60 community-dwelling older adults aged ≥ 65 years with very mild or mild frailty. After baseline measures, participants will be randomised to receive the Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention or serve as controls (usual care) for 6 months. Frail-LESS is a remotely delivered intervention comprising of tailored feedback on sitting, information on the health risks of excess sitting, supported goal setting and action planning, a wearable device that tracks inactive time and provides alerts to move, health coaching, and peer support. Feasibility will be assessed in terms of recruitment, retention and data completion rates. A process evaluation will assess intervention acceptability, safety, and fidelity of the trial. The following measures will be taken at baseline, 3 months, and 6 months: sitting, standing, and stepping using a thigh-worn activPAL4 device, sarcopenia (via hand grip strength, muscle mass, and physical function), mood, wellbeing, and quality of life. DISCUSSION This study will determine the feasibility, safety, and acceptability of evaluating a remote intervention to reduce and break up sitting to support improvements in sarcopenia and independent living in frail older adults. A future definitive RCT to determine intervention effectiveness will be informed by the study findings. TRIAL REGISTRATION ISRCTN, ISRCTN17158017; Registered 6 August 2021, https://www.isrctn.com/ISRCTN17158017.
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Affiliation(s)
- Daniel P. Bailey
- grid.7728.a0000 0001 0724 6933Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH UK ,grid.7728.a0000 0001 0724 6933Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH UK
| | - Cherry Kilbride
- grid.7728.a0000 0001 0724 6933Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH UK ,grid.7728.a0000 0001 0724 6933Division of Physiotherapy and Physician Associates, Department of Health Sciences, Brunel University London, Uxbridge, UB8 3PH UK
| | - Jamie H. Harper
- grid.7728.a0000 0001 0724 6933Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH UK ,grid.7728.a0000 0001 0724 6933Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH UK
| | - Christina Victor
- grid.7728.a0000 0001 0724 6933Division of Global Public Health, Brunel University London, Uxbridge, UB8 3PH UK
| | - Marsha L. Brierley
- grid.7728.a0000 0001 0724 6933Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH UK
| | - David J. Hewson
- grid.15034.330000 0000 9882 7057Institute for Health Research, University of Bedfordshire, Luton, LU1 3JU UK
| | - Angel M. Chater
- grid.15034.330000 0000 9882 7057Institute for Sport and Physical Activity Research, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA UK ,grid.83440.3b0000000121901201Centre for Behaviour Change, University College London, London, WC1E 7HB UK
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Tsutsui T, Tsutsui Y, Tsukamoto M, Nakamura E. Validation of foot plantar pressure sensor data used to estimate standing, sitting, and moving durations in one working day. J Orthop Sci 2023; 28:217-221. [PMID: 34763976 DOI: 10.1016/j.jos.2021.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 08/15/2021] [Accepted: 09/24/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Maintaining immovable postures for long durations might be a cause of low back pain. However, the relation between low back pain and the maintenance of postures for long durations has been unclear. Therefore, the durations of several postures in one working day should be measured to evaluate the risk of low back pain, although the available measuring methods are limited. To the best of our knowledge, no study has reported the development and investigation of a foot plantar pressure sensor for measurement of standing, sitting, and moving durations in daily work routines. Thus, in this study, we aimed to develop a foot plantar pressure sensor that could withstand long-term loads in the workplace. Furthermore, we aimed to evaluate the estimated results of standing, sitting, and moving durations among factory workers using the developed foot plantar pressure sensor. METHODS The developed foot plantar pressure sensor obtained a percentage difference within ±5% to estimate standing, sitting, and moving durations in the laboratory. We measured foot plantar pressures of 20 factory workers to estimate standing, sitting, and moving activity in one working day using data obtained by the foot plantar pressure sensor. The estimated standing, sitting, and moving durations were compared with the human estimation of photo data obtained by a wearable camera. RESULTS The agreement rate (Cohen's kappa coefficient) was 0.75 between the evaluation using the foot plantar pressure sensor data and human estimation using a wearable camera. Cohen's kappa coefficient was 0.81 in subjects who sat for ≥30% during daily work and 0.68 in subjects who sat for <30%. CONCLUSION Our foot plantar pressure sensor effectively measured the standing, sitting, and moving durations in daily work that requires various movements and assumption of postures.
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Affiliation(s)
- Takao Tsutsui
- Department of Health Policy and Management, Institute of Industrial and Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
| | - Yasuhiro Tsutsui
- Department of Work Systems and Health, Institute of Industrial and Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Manabu Tsukamoto
- Department of Orthopedic Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Eiichiro Nakamura
- Department of Orthopedic Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
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Neale CD, Christensen PE, Dall C, Ulrik CS, Godtfredsen N, Hansen H. Sleep Quality and Self-Reported Symptoms of Anxiety and Depression Are Associated with Physical Activity in Patients with Severe COPD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16804. [PMID: 36554684 PMCID: PMC9778999 DOI: 10.3390/ijerph192416804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/25/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Sleep quantity, quality and symptoms of depression or anxiety potentially affect the level of daily physical activity (PAL) and plausibly counteracts benefits from pulmonary rehabilitation programs. Their collective impact on PAL is sparsely investigated, particularly in patients with severely progressed chronic obstructive pulmonary disease (COPD). Aim: To investigate if sleep quantity, quality and symptoms from self-reported hospital anxiety and depression scores (HADS) are associated with PAL. Methods: In this exploratory cross-sectional study data were analysed from 148 participants with COPD; GOLD grade II-IV; GOLD group B to D (52% female, mean 69.7 ± SD of 8.4 years, FEV1% predicted 33.6 ± 10.9, 6MWD 327 ± 122 m, CAT 20 ± 7 points), eligible for conventional outpatient hospital-based pulmonary rehabilitation. Participants had sleep and PAL measured 24 h per day for five consecutive days with an activPAL monitor. Adjusted negative binomial regression was applied to investigate the associations with PAL. Results: Participants walked median (25th, 75th percentile) of 2358 (1325.75; 3822.25) steps per day and 14% walked >5000 steps per day on average. Time in bed (TIB) were a median (25th, 75th percentile) of 8.3 (7.1; 9.7) hours and numbers of nocturnal sleeping bouts (NSB) were 1.5 (0.8; 3), Anxiety (HADS-A) and depression (HADS-D) scores were median (25th, 75th percentile) of 5 (3; 8) points and 3 (2; 6) points, respectively, whereof 29% (HADS-A) and 15% (HADS-D) reported scores ≥8 points indicating significant symptoms. The fully adjusted rate ratio (RR) for steps per day for TIB (hours) [RR 0.97 (95% CI: 0.92; 1.02)], NSB (numbers) [RR 1.02 (95% CI: 0.97; 1.07)] were not significantly associated with number of steps per day, while there was a significantly association with number of steps per day for HADS-A [RR 1.04 (95% CI: 1.01; 1.07)] and HADS-D [RR 0.95 (95% CI: 0.91; 0.99)]. Conclusion: This exploratory cross-sectional study found a statistically significant association between HADS-A and HADS-D with numbers of steps per day in patients with severe COPD.
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Affiliation(s)
- Christopher D. Neale
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, 2400 Copenhagen, Denmark
| | | | - Christian Dall
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, 2400 Copenhagen, Denmark
- Institute for Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Charlotte Suppli Ulrik
- Institute for Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Respiratory Research Unit and Department of Respiratory Medicine, Copenhagen University Hospital, 2650 Hvidovre, Denmark
| | - Nina Godtfredsen
- Institute for Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Respiratory Research Unit and Department of Respiratory Medicine, Copenhagen University Hospital, 2650 Hvidovre, Denmark
| | - Henrik Hansen
- Respiratory Research Unit and Department of Respiratory Medicine, Copenhagen University Hospital, 2650 Hvidovre, Denmark
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Buchan DS, Ugbolue UC. Comparing the activPAL CREA and GHLA Algorithms for the Classification of Postures and Activity in Free-Living Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15962. [PMID: 36498039 PMCID: PMC9739422 DOI: 10.3390/ijerph192315962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
The activPAL accelerometer has been used extensively in research to assess sedentary behaviour (SB) and physical activity (PA) outcomes. The aim of this study was to assess the comparability of PA and SB outcomes from two automated algorithms (CREA and GHLA) applied to the activPAL accelerometer. One hundred and twenty participants aged 8−12 years wore an activPAL accelerometer on their right thigh continuously for seven days on two occasions, providing valid data from 1058 days. The PALbatch software downloaded the data after applying the CREA and GHLA (latest) algorithms. The comparability of the algorithms were assessed using the mean absolute percent error (MAPE), intra-class correlation coefficients (ICC), and equivalence testing. Comparisons for daily wear time, primary lying, sitting and standing time, sedentary and stepping time, upright time, total number of steps, sit−stand transitions and stepping time ≤ 1 min revealed mainly small MAPE (≤2%), excellent ICCs (lower bound 95% CI ≥ 0.97), and equivalent outcomes. Time spent in sitting bouts > 60 min and stepping bouts > 5 min were not equivalent with the absolute zone needed to reach equivalence (≥7%). Comparable outcomes were provided for wear time and postural outcomes using the CREA or GHLA algorithms, but not for time spent in sitting bouts > 60 min and stepping bouts > 5 min.
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O'Brien MW, Shivgulam ME, Petterson JL, Wu Y, Frayne RJ, Mekari S, Kimmerly DS. Habitual sedentary time and stationary time are inversely related to aerobic fitness. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:260-266. [PMID: 36600973 PMCID: PMC9806710 DOI: 10.1016/j.smhs.2022.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/23/2022] [Accepted: 10/06/2022] [Indexed: 01/07/2023] Open
Abstract
A one metabolic-equivalent-of-task increase in peak aerobic fitness (peak MET) is associated with a clinically relevant improvement in survival risk and all-cause mortality. The co-dependent impact of free-living physical behaviours on aerobic fitness are poorly understood. The purpose of this study was to investigate the impact of theoretically re-allocating time spent in physical behaviours on aerobic fitness. We hypothesized that substituting sedentary time with any physical activity (at any intensity) would be associated with a predicted improvement in aerobic fitness. Peak volume rate of oxygen uptake ( V ˙ O2peak) was assessed via indirect calorimetry during a progressive, maximal cycle ergometer protocol in 103 adults (52 females; [38 ± 21] years; [25.0 ± 3.8] kg/m2; V ˙ O2peak: [35.4 ± 11.5] ml·kg-1·min-1). Habitual sedentary time, standing time, light- (LPA), moderate- (MPA), and vigorous-physical activity (VPA) were assessed 24-h/day via thigh-worn inclinometry for up to one week (average: [6.3 ± 0.9] days). Isotemporal substitution modelling examined the impact of replacing one physical behaviour with another. Sedentary time (β = -0.8, 95% CI: [-1.3, -0.2]) and standing time (β = -0.9, 95%CI: [-1.6, -0.2]) were negatively associated with V ˙ O2peak, whereas VPA was positively associated with relative V ˙ O2peak (β = 9.2, 95%CI: [0.9, 17.6]). Substituting 30-min/day of VPA with any other behaviour was associated with a 2.4-3.4 higher peak MET. Higher standing time was associated with a lower aerobic fitness. As little as 10-min/day of VPA predicted a clinically relevant 0.8-1.1 peak MET increase. Theoretically, replacing any time with relatively small amounts of VPA is associated with improvements in aerobic fitness.
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Affiliation(s)
- Myles W. O'Brien
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- Corresponding author. School of Health and Human Performance, Division of Kinesiology, Dalhousie University, 6230 South Street, Halifax, Nova Scotia, B3H 4R2, Canada.
| | - Madeline E. Shivgulam
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jennifer L. Petterson
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yanlin Wu
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ryan J. Frayne
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Said Mekari
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Derek S. Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Bursais AK, Gentles JA, Albujulaya NM, Stone MH. Field based assessment of a tri-axial accelerometers validity to identify steps and reliability to quantify external load. Front Physiol 2022; 13:942954. [PMID: 36171976 PMCID: PMC9510681 DOI: 10.3389/fphys.2022.942954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background: The monitoring of accelerometry derived load has received increased attention in recent years. However, the ability of such measures to quantify training load during sport-related activities is not well established. Thus, the current study aimed to assess the validity and reliability of tri-axial accelerometers to identify step count and quantify external load during several locomotor conditions including walking, jogging, and running. Method: Thirty physically active college students (height = 176.8 ± 6.1 cm, weight = 82.3 ± 12.8 kg) participated. Acceleration data was collected via two tri-axial accelerometers (Device A and B) sampling at 100 Hz, mounted closely together at the xiphoid process. Each participant completed two trials of straight-line walking, jogging, and running on a 20 m course. Device A was used to assess accelerometer validity to identify step count and the test-retest reliability of the instrument to quantify the external load. Device A and Device B were used to assess inter-device reliability. The reliability of accelerometry-derived metrics Impulse Load (IL) and Magnitude g (MAG) were assessed. Results: The instrument demonstrated a positive predictive value (PPV) ranging between 96.98%–99.41% and an agreement ranging between 93.08%–96.29% for step detection during all conditions. Good test-retest reliability was found with a coefficient of variation (CV) <5% for IL and MAG during all locomotor conditions. Good inter-device reliability was also found for all locomotor conditions (IL and MAG CV < 5%). Conclusion: This research indicates that tri-axial accelerometers can be used to identify steps and quantify external load when movement is completed at a range of speeds.
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Affiliation(s)
- Abdulmalek K. Bursais
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
- Center of Excellence for Sport Science and Coach Education, East Tennessee State University, Johnson, TN, United States
- *Correspondence: Abdulmalek K. Bursais,
| | - Jeremy A. Gentles
- Center of Excellence for Sport Science and Coach Education, East Tennessee State University, Johnson, TN, United States
| | - Naif M. Albujulaya
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, United Kingdom
| | - Michael H. Stone
- Center of Excellence for Sport Science and Coach Education, East Tennessee State University, Johnson, TN, United States
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Jones MA, Whitaker K, Taverno Ross SE, Davis K, Libertus K, Gibbs BB. Maternal Sedentary Behavior and Physical Activity across Pregnancy and Early Childhood Growth. Child Obes 2022; 18:399-408. [PMID: 35108109 PMCID: PMC9634982 DOI: 10.1089/chi.2021.0202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Evidence suggests in utero exposures are related to lifespan health of the offspring. Whether maternal activity profile during pregnancy impacts offspring health remains unknown. Methods: This follow-up study recruited mothers with objectively measured sedentary behavior (SED) and moderate-to-vigorous intensity physical activity (MVPA) from a previous cohort study. Maternal activity was analyzed across pregnancy (trajectory groups) and continuously by trimester. Offspring anthropometrics up to 24 months were abstracted from medical records (n = 62). Outcomes included childhood growth rate (incremental rate of BMI z-score change up to 24 months) and rapid growth (increased BMI z-score >0.67 at 12 months). Associations of maternal activity with growth rate were examined using mixed linear models and rapid growth using generalized linear models. Results: Forty percent of participants were in the high SED and 20% in the high MVPA trajectories during pregnancy. Higher SED, across pregnancy [slope (95% confidence interval; CI): 0.080 (0.024-0.061) ΔBMI z-score/month] and in the first trimester [standardized beta; std β (95% CI): 0.017 (0.007-0.026)], was related to accelerated growth rate. Higher MVPA, in the second and third trimesters, was associated with accelerated growth rate [std β (95% CI): trimester 2: 0.013 (0.002-0.024) and trimester 3:0.011 (0.003-0.020)] and greater risk of rapid growth [risk ratio (95% CI): trimester 2: 1.25 (1.009-1.555) and trimester 3: 1.25 (1.056-1.475)]. Conclusions: These findings add to growing evidence on the deleterious effects of high SED during pregnancy. The increased risk for accelerated growth with higher MVPA elicits further investigation. Overall, maternal activity profile shows promise as a modifiable behavior to improve intergenerational health.
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Affiliation(s)
- Melissa A. Jones
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Kara Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Sharon E. Taverno Ross
- Department of Health and Human Development and University of Pittsburgh, Pittsburgh, PA, USA
| | - Kelliann Davis
- Department of Health and Human Development and University of Pittsburgh, Pittsburgh, PA, USA
| | - Klaus Libertus
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bethany Barone Gibbs
- Department of Health and Human Development and University of Pittsburgh, Pittsburgh, PA, USA
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MICKLESFIELD LISAK, WESTGATE KATE, SMITH ANTONIA, KUFE CLEMENTN, MENDHAM AMYE, LINDSAY TIM, WIJNDAELE KATRIEN, GOEDECKE JULIAH, BRAGE SOREN. Physical Activity Behaviors of a Middle-Age South African Cohort as Determined by Integrated Hip and Thigh Accelerometry. Med Sci Sports Exerc 2022; 54:1493-1505. [PMID: 35658390 PMCID: PMC9390235 DOI: 10.1249/mss.0000000000002940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
PURPOSE Descriptive studies of objectively measured physical activity behaviors in African populations are rare. We developed a method of combining hip and thigh accelerometery signals to quantify and describe physical behaviors in middle-age South African men and women. METHODS We integrated signals from two triaxial accelerometers worn simultaneously during free-living, in a subsample of the Middle-age Soweto Cohort ( n = 794; mean (SD) age, 53.7 (6.3) yr). Acceleration time series from the accelerometers were combined and movement-related acceleration was derived using Euclidean Norm Minus One (in milligrams), to determine total movement volume (mean Euclidean Norm Minus One) and nonmovement time (<28 m g ), light-intensity physical activity (LPA; 28-85 m g ), and moderate- to vigorous-intensity physical activity (MVPA; >85 m g ); thigh pitch angle and a sleep diary were used to divide nonmovement time (in minutes per day) into sleep, awake sitting/lying, and standing. Sociodemographic factors were self-reported, and weight and height were measured. RESULTS Mean (SD) wear time was 128 (48) h. Movement volume was 15.0 (6.5) m g for men and 12.2 (3.4) m g for women. Men spent more time in MVPA and sitting/lying, whereas women spent more time standing. Age was inversely associated with movement volume, MVPA, and LPA. When compared with their normal-weight counterparts, men who were overweight or obese spent less time in MVPA, whereas women who were overweight or obese spent less time in LPA and more time sitting/lying. Socioeconomic status was inversely associated with total movement volume, MVPA, and time spent sleeping, and positively associated with time spent sitting/lying, in both men and women. CONCLUSIONS Integrating signals from hip and thigh accelerometers enables characterization of physical behaviors that can be applied in an African population.
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Affiliation(s)
- LISA K. MICKLESFIELD
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit (DPHRU), Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, SOUTH AFRICA
| | - KATE WESTGATE
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
| | - ANTONIA SMITH
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
| | - CLEMENT N. KUFE
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit (DPHRU), Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, SOUTH AFRICA
| | - AMY E. MENDHAM
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit (DPHRU), Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, SOUTH AFRICA
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, SOUTH AFRICA
| | - TIM LINDSAY
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
| | - KATRIEN WIJNDAELE
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
| | - JULIA H. GOEDECKE
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit (DPHRU), Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, SOUTH AFRICA
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, SOUTH AFRICA
| | - SOREN BRAGE
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
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Validity of the activPAL monitor to measure stepping activity and activity intensity: A systematic review. Gait Posture 2022; 97:165-173. [PMID: 35964334 DOI: 10.1016/j.gaitpost.2022.08.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/24/2022] [Accepted: 08/04/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Accumulating step counts and engaging in moderate-to-vigorous intensity physical activity is positively associated with numerous health benefits. The activPAL is a thigh-worn monitor that is frequently used to measure physical activity. RESEARCH QUESTION Can the activPAL accurately measure stepping activity and identify physical activity intensity? METHODS We systematically reviewed validation studies examining the accuracy of activPAL physical activity outcomes relative to a criterion measure in adults (>18 years). Citations were not restricted to language or date of publication. Sources were searched up to May 16, 2021 and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier. The study was pre-registered in Prospero (ID# CRD42021248240). Study quality was determined using a modified Hagströmer Bowles checklist. RESULTS Thirty-nine studies (20 laboratory arms, 17 semi-structured arms, 11 uncontrolled protocol arms; 1272 total participants) met the inclusion criteria. Most studies demonstrated a high validity of the activPAL to measure steps across laboratory (12/15 arms), semi-structured (10/13 arms) and uncontrolled conditions (5/7 arms). Studies that demonstrated low validity were generally conducted in unhealthy populations, included slower walking speeds, and/or short walking distances. Few studies indicated that the activPAL accurately measured physical activity intensity across laboratory (0/6 arms), semi-structured (0/5 arms) and uncontrolled conditions (2/5 arms). Using the default settings, the activPAL overestimates light-intensity activity but underestimates moderate-to-vigorous intensity activity. The overall study quality was 11.5 ± 2.0 out of 19. CONCLUSION Despite heterogeneous methodological and statistical approaches, the included studies generally provide supporting evidence that the activPAL can accurately detect stepping activity but not physical activity intensity. Strategies that use alternative data processing methods have been developed to better characterize physical activity intensity, but all methods still underestimate vigorous-intensity activity.
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Ostendorf DM, Caldwell AE, Zaman A, Pan Z, Bing K, Wayland LT, Creasy SA, Bessesen DH, MacLean P, Melanson EL, Catenacci VA. Comparison of weight loss induced by daily caloric restriction versus intermittent fasting (DRIFT) in individuals with obesity: study protocol for a 52-week randomized clinical trial. Trials 2022; 23:718. [PMID: 36038881 PMCID: PMC9421629 DOI: 10.1186/s13063-022-06523-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The standard of care for treating overweight and obesity is daily caloric restriction (DCR). While this approach produces modest weight loss, adherence to DCR declines over time and weight regain is common. Intermittent fasting (IMF) is an alternative dietary strategy for reducing energy intake (EI) that involves >60% energy restriction on 2-3 days per week, or on alternate days, with habitual intake on fed days. While numerous studies have evaluated IMF as a weight loss strategy, there are several limitations including lack of a standard-of-care DCR control, failure to provide guideline-based behavioral support, and failure to rigorously evaluate dietary and PA adherence using objective measures. To date, only three longer-term (52-week) trials have evaluated IMF as a weight loss strategy. None of these longer-duration studies reported significant differences between IMF and DCR in changes in weight. However, each of these studies has limitations that prohibit drawing generalizable conclusions about the relative long-term efficacy of IMF vs. DCR for obesity treatment. METHODS The Daily Caloric Restriction vs. Intermittent Fasting Trial (DRIFT) is a two-arm, 52-week block randomized (1:1) clinical weight loss trial. The two intervention arms (DCR and IMF) are designed to prescribe an equivalent average weekly energy deficit from baseline weight maintenance energy requirements. Both DCR and IMF will be provided guideline-based behavioral support and a PA prescription. The primary outcome is change in body weight at 52 weeks. Secondary outcomes include changes in body composition (dual-energy x-ray absorptiometry (DXA)), metabolic parameters, total daily energy expenditure (TDEE, doubly labeled water (DLW)), EI (DLW intake-balance method, 7-day diet diaries), and patterns of physical activity (PA, activPAL device). DISCUSSION Although DCR leads to modest weight loss success in the short-term, there is wide inter-individual variability in weight loss and poor long-term weight loss maintenance. Evidence-based dietary approaches to energy restriction that are effective long-term are needed to provide a range of evidence-based options to individuals seeking weight loss. The DRIFT study will evaluate the long-term effectiveness of IMF vs. DCR on changes in objectively measured weight, EI, and PA, when these approaches are delivered using guideline-based behavioral support and PA prescriptions.
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Affiliation(s)
- Danielle M. Ostendorf
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Ann E. Caldwell
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Adnin Zaman
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Kristen Bing
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Liza T. Wayland
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Seth A. Creasy
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Daniel H. Bessesen
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Paul MacLean
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO USA
| | - Victoria A. Catenacci
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
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Edwardson CL, Biddle SJH, Clemes SA, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Healy GN, Jaicim NB, Lawton S, Maylor BD, Munir F, Richardson G, Yates T, Clarke-Cornwell AM. Effectiveness of an intervention for reducing sitting time and improving health in office workers: three arm cluster randomised controlled trial. BMJ 2022; 378:e069288. [PMID: 35977732 PMCID: PMC9382450 DOI: 10.1136/bmj-2021-069288] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of an intervention, with and without a height adjustable desk, on daily sitting time, and to investigate the relative effectiveness of the two interventions, and the effectiveness of both interventions on physical behaviours and physical, biochemical, psychological, and work related health and performance outcomes. DESIGN Cluster three arm randomised controlled trial with follow-up at three and 12 months. SETTING Local government councils in Leicester, Liverpool, and Greater Manchester, UK. PARTICIPANTS 78 clusters including 756 desk based employees in defined offices, departments, or teams from two councils in Leicester, three in Greater Manchester, and one in Liverpool. INTERVENTIONS Clusters were randomised to one of three conditions: the SMART Work and Life (SWAL) intervention, the SWAL intervention with a height adjustable desk (SWAL plus desk), or control (usual practice). MAIN OUTCOMES MEASURES The primary outcome measure was daily sitting time, assessed by accelerometry, at 12 month follow-up. Secondary outcomes were accelerometer assessed sitting, prolonged sitting, standing and stepping time, and physical activity calculated over any valid day, work hours, workdays, and non-workdays, self-reported lifestyle behaviours, musculoskeletal problems, cardiometabolic health markers, work related health and performance, fatigue, and psychological measures. RESULTS Mean age of participants was 44.7 years, 72.4% (n=547) were women, and 74.9% (n=566) were white. Daily sitting time at 12 months was significantly lower in the intervention groups (SWAL -22.2 min/day, 95% confidence interval -38.8 to -5.7 min/day, P=0.003; SWAL plus desk -63.7 min/day, -80.1 to -47.4 min/day, P<0.001) compared with the control group. The SWAL plus desk intervention was found to be more effective than SWAL at changing sitting time (-41.7 min/day, -56.3 to -27.0 min/day, P<0.001). Favourable differences in sitting and prolonged sitting time at three and 12 month follow-ups for both intervention groups and for standing time for the SWAL plus desk group were observed during work hours and on workdays. Both intervention groups were associated with small improvements in stress, wellbeing, and vigour, and the SWAL plus desk group was associated with improvements in pain in the lower extremity, social norms for sitting and standing at work, and support. CONCLUSIONS Both SWAL and SWAL plus desk were associated with a reduction in sitting time, although the addition of a height adjustable desk was found to be threefold more effective. TRIAL REGISTRATION ISRCTN Registry ISRCTN11618007.
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Affiliation(s)
- Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Stacy A Clemes
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC, Australia
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
- Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, UK
| | - Malcolm H Granat
- School of Health and Society, University of Salford, Salford, Greater Manchester, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Genevieve N Healy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | | | - Sarah Lawton
- School of Health and Society, University of Salford, Salford, Greater Manchester, UK
| | - Benjamin D Maylor
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicester, UK
| | | | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
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Sharma H, Pankratz VS, Demark-Wahnefried W, Pestak CR, Blair CK. Association between Quality of Life and Physical Functioning in a Gardening Intervention for Cancer Survivors. Healthcare (Basel) 2022; 10:1421. [PMID: 36011078 PMCID: PMC9407773 DOI: 10.3390/healthcare10081421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose: To examine potential factors associated with maintaining or improving self-reported physical function (PF) among older cancer survivors participating in a gardening intervention impacted by the Coronavirus 2019 (COVID-19) pandemic. Methods: Thirty cancer survivors completed a home-based gardening intervention to encourage a healthier diet and a more active lifestyle. Device-based measures of physical activity (PA) and surveys to evaluate quality of life (QOL; PROMIS-57 questionnaire) were administered at baseline, mid-intervention (6 months), and post-intervention (9 months). Results: Depression, fatigue, and sleeplessness at baseline were significantly associated with worse average PF scores across follow-up (2.3 to 4.9 points lower for every decrease of 5 points in the QOL score; p-values < 0.02). Worsening of these QOL domains during the intervention was also associated with an additional decrease of 2.1 to 2.9 points in PF over follow-up (p values < 0.01). Better social participation and PA at baseline were significantly associated with better average PF scores during the intervention (2.8 to 5.2 points higher for every 5-point increase in social participation or 30 min more of PA; p values < 0.05). Every 5-point increase in pain at baseline, or increases in pain during the intervention, was associated with decreases of 4.9 and 3.0 points, respectively, in PF. Conclusions: Worse QOL scores before and during the intervention were significantly associated with worse PF over follow-up. Encouraging social participation and PA through interventions such as home-based gardening may improve long-term health among older cancer survivors.
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Affiliation(s)
- Harsh Sharma
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (V.S.P.); (C.K.B.)
| | - Vernon S. Pankratz
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (V.S.P.); (C.K.B.)
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA;
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA;
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Claire R. Pestak
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA;
| | - Cindy K. Blair
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (V.S.P.); (C.K.B.)
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA;
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Brierley ML, Smith LR, Chater AM, Bailey DP. A-REST (Activity to Reduce Excessive Sitting Time): A Feasibility Trial to Reduce Prolonged Sitting in Police Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159186. [PMID: 35954543 PMCID: PMC9368451 DOI: 10.3390/ijerph19159186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/12/2022] [Accepted: 07/23/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the acceptability and feasibility of a theory-derived sedentary workplace intervention for police office staff. Twenty-four staff participated in an 8-week intervention (single arm, pre-post design) incorporating an education session, team competition with quick response (QR) codes, team trophy, weekly leaderboard newsletters, a self-monitoring phone app, and electronic prompt tools. The intervention supported participants to reduce and break up their sitting time with three minutes of incidental movement every 30 min at work. Feasibility and acceptability were assessed using mixed methods via the RE-AIM QuEST and PRECIS-2 frameworks. The intervention was highly pragmatic in terms of eligibility, organisation, adherence, outcome, and analysis. It was slightly less pragmatic on recruitment and setting. Delivery and follow-up were more explanatory. Reach and adoption indicators demonstrated feasibility among police staff, across a range of departments, who were demographically similar to participants in previous office-based multi-component interventions. The intervention was delivered mostly as planned with minor deviations from protocol (implementation fidelity). Participants perceived the intervention components as highly acceptable. Results showed improvements in workplace sitting and standing, as well as small improvements in weight and positive affect. Evaluation of the intervention in a fully powered randomised controlled trial to assess behaviour and health outcomes is recommended.
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Affiliation(s)
- Marsha L. Brierley
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK
| | - Lindsey R. Smith
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
| | - Angel M. Chater
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Daniel P. Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK
- Correspondence: ; Tel.: +44-(0)1895-266127
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Macena ML, Hoffman DJ, Clemente AP, Ferriolli E, Pfrimer K, Florêncio TMT, Bueno NB. The relationship between total energy expenditure and physical activity level in women living in an impoverished Brazilian urban area. Am J Hum Biol 2022; 34:e23780. [PMID: 35809076 DOI: 10.1002/ajhb.23780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/09/2022] [Accepted: 06/28/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE This study aimed to describe how strong is the relationship between TEE and PAL in women living in an impoverished Brazilian urban area. METHODS Anthropometric, hormonal (insulin, TSH, FT4 , and FT3 ), body composition (deuterium), TEE (doubly labeled water) and PAL (metabolic equivalent task [MET]-7-day triaxial accelerometer, ActivPAL®) data were collected from 55 women (mean age: 31y, mean BMI: 27.4 kg/m2 ). Adjusted-TEE models were calculated incorporating the residuals of anthropometric, hormonal, and body composition variables in the TEE, to assess the relation between MET and adjusted-TEE, through three different analyzes: linear regression, nonlinear regression and change-point regression. RESULTS Most participants (89.1%, n = 49) were classified as low-active. There was no association between crude TEE and MET.h/d (R2 = 0.05; p = 0.09). There was a positive, although weak, linear relationship between adjusted-TEE and MET.h/d (β = 2705.26 kcal; 95% CI: 436.25; 4974.27; adj-R2 = 0.08). A change point of this relationship was identified in the MET.h/d value of 1.53 (SD = 0.02; adj-R2 = 0.13). The association between adjusted-TEE and MET.h/d before the change point (β = 5101.46 kcal; 95%CI: 978.84; 9224.08; adj-R2 = 0.11) was stronger than the association in the full linear model, nevertheless, it was still weak. This association stop existing when it is assessed in individuals after the change point (β = -6609.92 kcal; 95%CI: -16773.24; 3553.40; adj-R2 = 0.08). CONCLUSIONS These results suggest that the relationship between TEE and PAL is weak and it is not completely linear in women living in an impoverished Brazilian urban area.
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Affiliation(s)
- Mateus L Macena
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | - Daniel J Hoffman
- Department of Nutritional Sciences, Program in International Nutrition, and the New Jersey Institute for Food, Nutrition, and Health, Center for Childhood Nutrition Education and Research, Rutgers University, New Brunswick, New Jersey, USA
| | - Ana Paula Clemente
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | - Eduardo Ferriolli
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Karina Pfrimer
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil.,Curso de Nutrição, Universidade de Ribeirão Preto, São Paulo, Brazil
| | | | - Nassib B Bueno
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
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Alfatafta H, Alfatafta M, Onchonga D, Hammoud S, Khatatbeh H, Zhang L, Boncz I, Lohner S, Molics B. Effect of the knee replacement surgery on activity level based on ActivPAL: a systematic review and meta-analysis study. BMC Musculoskelet Disord 2022; 23:576. [PMID: 35705950 PMCID: PMC9199222 DOI: 10.1186/s12891-022-05531-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/06/2022] [Indexed: 11/25/2022] Open
Abstract
Background The knee replacement (KR) surgery aims to restore the activity level and reduce the risk of experiencing disabilities. The outcomes of this surgery are evaluated mainly with subjective tools or low validity objective tools. However, the effect of the surgery on activity level using high validity objective accelerometer is still in question. Methods A systematic review and meta-analysis were conducted to evaluate the benefit of KR surgery alone to enhance physical activity recommendations based on high validity accelerometer. Two independent reviewers evaluated five electronic databases (Cochrane-Central-Register-of-Controlled Trials, EMBASE, PubMed, Web of Science, and Scopus) to find relative studies between January 2000 and October 2021. The quality assessments and risk of bias assessments were examined. Results Three articles were included with 202 participants (86 males, 116 females), with an average age of 64 years and an average 32 kg/m2 body mass index. The results found that the number of steps was significantly improved up to 36.35 and 45.5% after 6-months and 1-year of the surgery, respectively. However, these changes did not meet the recommended activity level guideline and could be related to the patients’ health status and their activity level before the surgery. No significant changes were seen in sedentary time, standing time, and upright time after 6-months and 1-year follow-ups. Heterogeneity among studies was low to moderate (0–63%). Conclusion Knee replacement surgery is an effective treatment for improving patients’ quality of life with severe knee injuries. However, various factors impact the success of surgical and achieving maximum benefit of the surgery. One factor, sedentary time, can be reduced by implementing pre-and post-surgery exercise or physical activity recommendations. Further studies are needed to understand the benefit of surgery with or without rehabilitation assessed using high validity monitors. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05531-2.
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Affiliation(s)
- Huda Alfatafta
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary.
| | - Mahmoud Alfatafta
- Orthotics and Prosthetics Department, Rehabilitation Sciences School, University of Jordan, Amman, Jordan
| | - David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary
| | - Sahar Hammoud
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary
| | - Haitham Khatatbeh
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary
| | - Lu Zhang
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary
| | - Imre Boncz
- Institute for Health Insurance, Faculty of Health Sciences, University of Pecs, Pécs, Hungary
| | - Szimonetta Lohner
- Cochrane Hungary, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Bálint Molics
- Institute of Physiotherapy and Sport Science, Faculty of Health Sciences, University of Pecs, Pécs, Hungary
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Jones MA, Diesel SJ, Gibbs BB, Whitaker KM. Concurrent Agreement Between ActiGraph and activPAL for Measuring Physical Activity in Pregnant Women and Office Workers. JOURNAL FOR THE MEASUREMENT OF PHYSICAL BEHAVIOUR 2022; 5:69-75. [PMID: 36340243 PMCID: PMC9635580 DOI: 10.1123/jmpb.2021-0050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Current best practice for objective measurement of sedentary behavior and moderate-to-vigorous intensity physical activity (MVPA) requires two separate devices. This study assessed concurrent agreement between the ActiGraph GT3X and the activPAL3 micro for measuring MVPA to determine if activPAL can accurately measure MVPA in addition to its known capacity to measure sedentary behavior. METHODS Forty participants from two studies, including pregnant women (n = 20) and desk workers (n = 20), provided objective measurement of MVPA from waist-worn ActiGraph GT3X and thigh-worn activPAL micro3. MVPA from the GT3X was compared with MVPA from the activPAL using metabolic equivalents of task (MET)- and step-based data across three epochs. Intraclass correlation coefficient and Bland-Altman analyses, overall and by study sample, compared MVPA minutes per day across methods. RESULTS Mean estimates of activPAL MVPA ranged from 22.7 to 35.2 (MET based) and 19.7 to 25.8 (step based) minutes per day, compared with 31.4 min/day (GT3X). MET-based MVPA had high agreement with GT3X, intraclass correlation coefficient ranging from .831 to .875. Bland-Altman analyses revealed minimal bias between 15- and 30-s MET-based MVPA and GT3X MVPA (-3.77 to 8.63 min/day, p > .10) but with wide limits of agreement (greater than ±27 min). Step-based MVPA had moderate to high agreement (intraclass correlation coefficient: .681-.810), but consistently underestimated GT3X MVPA (bias: 5.62-11.74 min/day, p < .02). For all methods, activPAL appears to better estimate GT3X at lower quantities of MVPA. Results were similar when repeated separately by pregnant women and desk workers. CONCLUSION activPAL can measure MVPA in addition to sedentary behavior, providing an option for concurrent, single device monitoring. MET-based MVPA using 30-s activPAL epochs provided the best estimate of GT3X MVPA in pregnant women and desk workers.
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Affiliation(s)
- Melissa A Jones
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Sara J Diesel
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Bethany Barone Gibbs
- Department of Health and Human Development and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kara M Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
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Validation of Two Activity Monitors in Slow and Fast Walking Hospitalized Patients. Rehabil Res Pract 2022; 2022:9230081. [PMID: 35615755 PMCID: PMC9126721 DOI: 10.1155/2022/9230081] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/25/2022] [Accepted: 04/06/2022] [Indexed: 12/30/2022] Open
Abstract
To evaluate interventions to promote physical activity, valid outcome measures are important. This study evaluated the validity and reliability of the ActivPAL3™ and the SENS motion® activity monitors with regard to the number of steps taken, walking, and sedentary behavior in hospitalized patients (
) (older medical patients (+65 years) (
), older patients (+65) with acute hip fracture (
), and patients (+18) who underwent acute high-risk abdominal surgery (
)). Both monitors showed good (≥60%) percentage agreement with direct observation for standing and no. of steps (all gait speeds) and high agreement (≥80%) for lying. For walking, ActivPAL3™ showed moderate percentage agreement, whereas SENS motion® reached high percentage agreement. The relative reliability was moderate for sedentary behavior for both monitors. The ActivPAL3™ showed poor (walking) to moderate (steps) reliability for walking and steps, whereas SENS motion® showed moderate reliability for both activities. For slow walkers, the relative reliability was moderate for SENS motion® and poor for ActivPAL3™. This trial is registered with the ClinicalTrials.gov identifier NCT04120740.
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Brakenridge CJ, Gardiner PA, Grigg RV, Winkler EAH, Fjeldsoe BS, Schaumberg MA, Owen N, Eakin EG, Biddle SJH, Moodie M, Daly RM, Green DJ, Cohen N, Gray L, Comans T, Buman MP, Goode AD, Nguyen P, Gao L, Healy GN, Dunstan DW. Sitting less and moving more for improved metabolic and brain health in type 2 diabetes: 'OPTIMISE your health' trial protocol. BMC Public Health 2022; 22:929. [PMID: 35538430 PMCID: PMC9086419 DOI: 10.1186/s12889-022-13123-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Clinical practice guidelines recommend that adults with type 2 diabetes (T2D) sit less and move more throughout the day. The 18-month OPTIMISE Your Health Clinical Trial was developed to support desk-based workers with T2D achieve these recommendations. The two-arm protocol consists of an intervention and control arms. The intervention arm receives 6 months health coaching, a sit-stand desktop workstation and an activity tracker, followed by 6 months of text message support, then 6 months maintenance. The control arm receives a delayed modified intervention after 12 months of usual care. This paper describes the methods of a randomised controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of the intervention, compared to a delayed intervention control. METHODS This is a two-arm RCT being conducted in Melbourne, Australia. Desk-based workers (≥0.8 full-time equivalent) aged 35-65 years, ambulatory, and with T2D and managed glycaemic control (6.5-10.0% HbA1c), are randomised to the multicomponent intervention (target n = 125) or delayed-intervention control (target n = 125) conditions. All intervention participants receive 6 months of tailored health coaching assisting them to "sit less" and "move more" at work and throughout the day, supported by a sit-stand desktop workstation and an activity tracker (Fitbit). Participants receive text message-based extended care for a further 6-months (6-12 months) followed by 6-months of non-contact (12-18 months: maintenance). Delayed intervention occurs at 12-18 months for the control arm. Assessments are undertaken at baseline, 3, 6, 12, 15 and 18-months. Primary outcomes are activPAL-measured sitting time (h/16 h day), glycosylated haemoglobin (HbA1c; %, mmol/mol) and, cognitive function measures (visual learning and new memory; Paired Associates Learning Total Errors [adjusted]). Secondary, exploratory, and process outcomes will also be collected throughout the trial. DISCUSSION The OPTIMISE Your Health trial will provide unique insights into the benefits of an intervention aimed at sitting less and moving more in desk-bound office workers with T2D, with outcomes relevant to glycaemic control, and to cardiometabolic and brain health. Findings will contribute new insights to add to the evidence base on initiating and maintaining behaviour change with clinical populations and inform practice in diabetes management. TRIAL REGISTRATION ANZCTRN12618001159246 .
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Affiliation(s)
- Christian J Brakenridge
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.
- Australian Catholic University, Mary Mackillop Institute of Health Research, Melbourne, Australia.
| | - Paul A Gardiner
- University of Southern Queensland, School of Health and Medical Sciences, Ipswich, Australia
- University of Southern Queensland, Centre for Health Research, Springfield, Australia
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Ruth V Grigg
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Elisabeth A H Winkler
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
| | - Brianna S Fjeldsoe
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Mia A Schaumberg
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
- University of Sunshine Coast, School of Health and Behavioural Sciences, Sunshine Coast, Australia
- Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, Australia
| | - Neville Owen
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
- Swinburne University, School of Health Sciences, Melbourne, Australia
| | - Elizabeth G Eakin
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Stuart J H Biddle
- University of Southern Queensland, Centre for Health Research, Springfield, Australia
| | - Marjory Moodie
- Deakin University, School of Health and Social Development, Melbourne, Australia
| | - Robin M Daly
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Melbourne, Australia
| | - Daniel J Green
- University of Western Australia, School of Sport Science, Exercise & Health, Perth, Australia
| | - Neale Cohen
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Len Gray
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Tracy Comans
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Matthew P Buman
- Arizona State University, College of Health Solutions, Tempe, USA
| | - Ana D Goode
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
| | - Phuong Nguyen
- Deakin University, School of Health and Social Development, Melbourne, Australia
| | - Lan Gao
- Deakin University, School of Health and Social Development, Melbourne, Australia
| | - Genevieve N Healy
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
| | - David W Dunstan
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Melbourne, Australia
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
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Ojo SO, Bailey DP, Chater AM, Hewson DJ. Workplace Intervention for Reducing Sitting Time in Sedentary Workers: Protocol for a Pilot Study Using the Behavior Change Wheel. Front Public Health 2022; 10:832374. [PMID: 35493386 PMCID: PMC9039234 DOI: 10.3389/fpubh.2022.832374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
The workplace is a major contributor to excessive sitting in office workers. There are a wide array of adverse effects of high volumes of sitting time, including an increased risk of type 2 diabetes and depression. Active workstations can be used in effective interventions to decrease workplace sitting. However, there are a lack of interventions that have been developed using a systematic process that is informed by participant needs and a framework for identifying the most appropriate content for the intervention. Applying these methods could increase adherence and potential effectiveness of the intervention. Therefore, the purpose of this pilot study is to examine the feasibility, acceptability, and efficacy of a tailored workplace intervention to reduce and break up sitting in office workers that has been developed using the Behavior Change Wheel and the APEASE (Acceptability, Practicability, Effectiveness/cost-effectiveness, Affordability, Safety/side-effects, Equity) criteria. This article reports the protocol for this study that is currently ongoing. Participants will be cluster-randomized (by offices) to control and intervention groups. The evaluation of the intervention includes determining feasibility by assessing participant recruitment, retention and data completion rates. Adherence to the intervention will be assessed based on daily sitting and standing time relative to guidelines provided to participants as part of the intervention. Outcome measures also include productivity measured using Ecological Momentary Assessment, absenteeism, presenteeism, cardiometabolic risk markers, and wellbeing. The findings of this study will inform the effective design and implementation of interventions for reducing and breaking up sitting in office workers.
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Affiliation(s)
- Samson O Ojo
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom.,Quality Improvement, Northampton General Hospital NHS Trust, Northampton, United Kingdom
| | - Daniel P Bailey
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, United Kingdom.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom.,Centre for Physical Activity in Health and Disease, Brunel University London, Uxbridge, United Kingdom
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, United Kingdom.,Centre for Behaviour Change, University College London, London, United Kingdom
| | - David J Hewson
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom
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Validity of the ActivPAL monitor to distinguish postures: A systematic review. Gait Posture 2022; 94:107-113. [PMID: 35276456 DOI: 10.1016/j.gaitpost.2022.03.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/13/2022] [Accepted: 03/03/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Posture has been recently integrated into activity guidelines, advising people to limit their sedentary time and break up sedentary postures with standing/stepping as much as possible. The thigh-worn activPAL is a frequently used objective measure of posture, but its validity has only been investigated by individual studies and has not been systematically reviewed. RESEARCH QUESTION Can the activPAL accurately characterize different postures? METHODS A rigorous systematic review protocol was conducted, including multiple study screeners and determiners of study quality. To be included, validation studies had to examine the accuracy of an activPAL posture outcome relative to a criterion measure (e.g., direct observation) in adults (>18 years). Citations were not restricted to language or date of publication. Sources were searched on May 16, 2021 and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier. The study was pre-registered in Prospero (ID# CRD42021248240). Study quality was determined using a modified Hagströmer Bowles checklist. The results are presented narratively. RESULTS Twenty-four studies (18 semi-structured laboratory arms, 8 uncontrolled protocol arms; 476 participants) met the inclusion criteria. Some studies (5/24) incorporated dual-monitor (trunk: 4/5; shin: 1/5) configurations. While heterogenous statistical procedures were implemented, most studies (n = 22/24) demonstrated a high validity (e.g., percent agreement >90%, no fixed bias, etc.) of the activPAL to measure sedentary and/or upright postures across semi-structured (17/18 arms) and uncontrolled study designs (7/8 arms). Specific experimental protocol factors (i.e., seat height, fidgeting, non-direct observation criterion comparator) likely explain the divergent reports that observed valid versus invalid findings. The study quality was 11.3 (standard deviation: 2.3) out of 19. CONCLUSION Despite heterogeneous methodological and statistical approaches, the included studies generally provide supporting evidence that the activPAL can accurately distinguish between sedentary and standing postures. Multiple activPAL monitor configurations (e.g., thigh and torso) are needed to better characterize sitting versus lying postures.
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48
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Peiris C, Harding K, Porter J, Shields N, Gilfillan C, Taylor N. Understanding the hidden epidemic of metabolic syndrome in people accessing community rehabilitation: a cross-sectional study of physical activity, dietary intake, and health literacy. Disabil Rehabil 2022; 45:1471-1479. [PMID: 35476590 DOI: 10.1080/09638288.2022.2065540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine the prevalence of metabolic syndrome in patients attending outpatient community rehabilitation in Melbourne, Australia and to compare health literacy, physical activity, and dietary intake of people with and without metabolic syndrome. MATERIALS AND METHODS A cross-sectional, multi-centre, observational study of adults (n = 193) presenting to rehabilitation with various health complaints. Metabolic syndrome was determined according to the International Diabetes Federation joint consensus worldwide definition. Health literacy was assessed using the Rapid Estimate of Adult literacy in Medicine (REALM) and the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Physical activity was assessed using accelerometers and dietary intake was assessed using a food frequency questionnaire. RESULTS One hundred and twenty three participants (64%) had metabolic syndrome. Of these, only three (2%) knew they had it. People with metabolic syndrome scored lower on health literacy (S-TOFHLA MD -2.10, 95% confidence interval (CI) -3.98 to -0.22) and took 1311 (95%CI 375 to 2246) fewer daily steps than those without metabolic syndrome. There were no differences in dietary intake. CONCLUSIONS Metabolic syndrome is a prevalent and under-recognised condition in community rehabilitation. Community healthcare professionals and health services may need to consider a broader approach to management including lifestyle assessment and intervention of patients with various conditions. Implications for rehabilitationAlmost two-thirds of adults in community rehabilitation had underlying, undetected metabolic syndrome.Adults with metabolic syndrome completed less objectively measured physical activity and had lower health literacy levels than those without metabolic syndrome.A broader approach to management may need to be considered in community rehabilitation where patients presenting for rehabilitation of various conditions would likely benefit from lifestyle assessment and intervention.
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Affiliation(s)
- Casey Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Katherine Harding
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,Eastern Health, Allied Health Clinical Research Office, Box Hill, Australia
| | - Judi Porter
- School of Exercise and Nutrition Science, Deakin University, Burwood, Australia
| | - Nora Shields
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Chris Gilfillan
- Eastern Clinical Research Unit, Eastern Health, Box Hill, Australia
| | - Nicholas Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,Eastern Health, Allied Health Clinical Research Office, Box Hill, Australia
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Escribà-Salvans A, Jerez-Roig J, Molas-Tuneu M, Farrés-Godayol P, Moreno-Martin P, Goutan-Roura E, Güell-Masramon H, Amblàs-Novellas J, de Souza DLB, Skelton DA, Torres-Moreno M, Minobes-Molina E. Sarcopenia and associated factors according to the EWGSOP2 criteria in older people living in nursing homes: a cross-sectional study. BMC Geriatr 2022; 22:350. [PMID: 35448983 PMCID: PMC9022416 DOI: 10.1186/s12877-022-02827-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/01/2022] [Indexed: 01/11/2023] Open
Abstract
Background In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. Early diagnosis of sarcopenia in nursing home residents and the identification of contributing factors would target interventions to reduce the incidence of malnutrition, social isolation, functional decline, hospitalization and mortality. Aim Verify the prevalence and the degree of severity of sarcopenia according to the new EWSGOP2 criteria and to analyse its associated factors in residents living in nursing homes in Central Catalonia (Spain). Design A cross-sectional multicenter study was conducted in 4 nursing homes. SARC-F test was applied as the initial screening, muscle strength was measured by a dynamometer, skeletal muscle mass by bioimpedance analysis and physical performance by Gait Speed. Four categories were used: total probable sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia. Results Among the total sample of 104 nursing home residents (mean age 84.6, ± 7.8; median 86, IQR 110), 84.6% were women and 85 (81.7%) (95% confidence interval [CI] 73.0-88.0) had total probable sarcopenia, 63 (60.5%) had probable sarcopenia, 19 (18.3%) had confirmed sarcopenia and 7 (6.7%) had severe sarcopenia. In the bivariate analysis, obesity was negatively associated and total time in sedentary behavior positively associated with all sarcopenia categories. In addition, malnutrition and urinary continence were positively associated with total and probable sarcopenia. Urinary incontinence was a positive associated factor of total and probable sarcopenia. In the multivariate analysis, obesity represented a negative associated factor: OR = 0.13 (0.03 - 0.57), p = 0.007 and OR = 0.14 (0.03 - 0.60), p = 0.008 with total and probable sarcopenia, respectively, adjusted by urinary incontinence status. For confirmed sarcopenia, obesity also represented a negative associated factor OR = 0.06 (0.01 - 0.99), p = 0.049 and the total time in sedentary behavior a positive associated factor OR = 1.10 (1.00- 1.20), p = 0.040. Conclusions According the EWGSOP2 criteria, high prevalence of sarcopenia was found in institutionalized older people, ranging from 6.7 to 81.7% depending on the category. Malnutrition, urinary incontinence and total time in sedentary behavior were associated with sarcopenia, whilst obesity represented a protective factor in this population.
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Affiliation(s)
- Anna Escribà-Salvans
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain.
| | - Miriam Molas-Tuneu
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Pau Farrés-Godayol
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Pau Moreno-Martin
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Ester Goutan-Roura
- Research group on Tissue Repair and Regeneration Laboratory (TR2Lab), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Helena Güell-Masramon
- Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Jordi Amblàs-Novellas
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, VIC, 08500, Barcelona, Spain
| | - Dyego Leandro Bezerra de Souza
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain.,Department of Collective Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Miriam Torres-Moreno
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
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50
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Harding EM, Gibson AL, Kang H, Zuhl MN, Sharma H, Blair CK. Self-Selected Walking Cadence after 16-Week Light-Intensity Physical Activity Intervention for Older Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084768. [PMID: 35457633 PMCID: PMC9027651 DOI: 10.3390/ijerph19084768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 01/25/2023]
Abstract
In this secondary analysis of a light-intensity physical activity intervention, we hypothesized that older cancer survivors would self-select a faster walking cadence to meet their daily step goals. Average steps/day and free-living walking cadence were measured in 41 participants (age 69 ± 3.1 years) with an ActivPAL monitor worn 7 days pre- and post-intervention. Besides peak and average walking cadence, stepping patterns associated with ambulatory intensity were sorted in cadence bands of 20 steps/min from 40−59 (incidental movement) to ≥120 steps/min (fast locomotor movement). Compared to the waitlist Control group (n = 17), the Intervention group (n = 24) increased their peak 30-min cadence (4.3 vs. 1.9 steps/minute; p = 0.03), average 10-min cadence (4.1 vs. −6.6 steps/minute; p = 0.04), and average 30-min cadence (5.7 vs. −0.8 steps/minute, p = 0.03). Steps taken in cadence bands denoting moderate-intensity physical activity (100−119 steps/min) increased by 478 (interquartile range (IQR): −121 to 1844) compared to decreasing by 92 (IQR: −510 to 181) steps/day for the intervention and Control groups, respectively (p < 0.01). Evaluation of free-living walking cadence and patterns of ambulatory behavior can inform future interventions targeting behavior change, especially in those populations most at risk for reduced physical activity and vulnerable to mobility deficits and loss of independence.
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Affiliation(s)
- Elizabeth M. Harding
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT 05405, USA;
| | - Ann L. Gibson
- Department of Health, Exercise, and Sports Sciences, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Huining Kang
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (H.K.); (H.S.)
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM 87131, USA
| | - Micah N. Zuhl
- Exercise Science Division, School of Health Sciences, Central Michigan University, Mt Pleasant, MI 48859, USA;
| | - Harsh Sharma
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (H.K.); (H.S.)
| | - Cindy K. Blair
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (H.K.); (H.S.)
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM 87131, USA
- Correspondence: ; Tel.: +1-505-925-7907
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