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Brakenridge CJ, Koster A, de Galan BE, Carver A, Dumuid D, Dzakpasu FQS, Eussen SJPM, Savelberg HHCM, Bosma H, Owen N, Schaper NC, Healy GN, Dunstan DW. Associations of 24 h time-use compositions of sitting, standing, physical activity and sleeping with optimal cardiometabolic risk and glycaemic control: The Maastricht Study. Diabetologia 2024; 67:1356-1367. [PMID: 38656371 PMCID: PMC11153304 DOI: 10.1007/s00125-024-06145-0] [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: 11/30/2023] [Accepted: 02/28/2024] [Indexed: 04/26/2024]
Abstract
AIMS/HYPOTHESIS The associations of sitting, standing, physical activity and sleep with cardiometabolic health and glycaemic control markers are interrelated. We aimed to identify 24 h time-use compositions associated with optimal metabolic and glycaemic control and determine whether these varied by diabetes status. METHODS Thigh-worn activPAL data from 2388 participants aged 40-75 years (48.7% female; mean age 60.1 [SD = 8.1] years; n=684 with type 2 diabetes) in The Maastricht Study were examined. Compositional isometric log ratios were generated from mean 24 h time use (sitting, standing, light-intensity physical activity [LPA], moderate-to-vigorous physical activity [MVPA] and sleeping) and regressed with outcomes of waist circumference, fasting plasma glucose (FPG), 2 h plasma glucose, HbA1c, the Matsuda index expressed as z scores, and with a clustered cardiometabolic risk score. Overall analyses were adjusted for demographics, smoking, dietary intake and diabetes status, and interaction by diabetes status was examined separately. The estimated difference when substituting 30 min of one behaviour with another was determined with isotemporal substitution. To identify optimal time use, all combinations of 24 h compositions possible within the study footprint (1st-99th percentile of each behaviour) were investigated to determine those cross-sectionally associated with the most-optimal outcome (top 5%) for each outcome measure. RESULTS Compositions lower in sitting time and with greater standing time, physical activity and sleeping had the most beneficial associations with outcomes. Associations were stronger in participants with type 2 diabetes (p<0.05 for interactions), with larger estimated benefits for waist circumference, FPG and HbA1c when sitting was replaced by LPA or MVPA in those with type 2 diabetes vs the overall sample. The mean (range) optimal compositions of 24 h time use, considering all outcomes, were 6 h (range 5 h 40 min-7 h 10 min) for sitting, 5 h 10 min (4 h 10 min-6 h 10 min) for standing, 2 h 10 min (2 h-2 h 20 min) for LPA, 2 h 10 min (1 h 40 min-2 h 20 min) for MVPA and 8 h 20 min (7 h 30 min-9 h) for sleeping. CONCLUSIONS/INTERPRETATION Shorter sitting time and more time spent standing, undergoing physical activity and sleeping are associated with preferable cardiometabolic health. The substitutions of behavioural time use were significantly stronger in their associations with glycaemic control in those with type 2 diabetes compared with those with normoglycaemic metabolism, especially when sitting time was balanced with greater physical activity.
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Affiliation(s)
- Christian J Brakenridge
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland.
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia.
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Bastiaan E de Galan
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Alison Carver
- National Centre for Healthy Ageing, The School of Translational Medicine, Monash University, Melbourne, VIC, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, SA, Australia
| | - Francis Q S Dzakpasu
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Simone J P M Eussen
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Hans H C M Savelberg
- Department of Nutrition and Movement Science, Maastricht University, Maastricht, the Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Nicolaas C Schaper
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Genevieve N Healy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
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Ahmadi MN, Blodgett JM, Atkin AJ, Chan HW, Del Pozo Cruz B, Suorsa K, Bakker EA, Pulsford RM, Mielke GI, Johansson PJ, Hettiarachchi P, Thijssen DHJ, Stenholm S, Mishra GD, Teixeira-Pinot A, Rangul V, Sherar LB, Ekelund U, Hughes AD, Lee IM, Holtermann A, Koster A, Hamer M, Stamatakis E. Relationship of device measured physical activity type and posture with cardiometabolic health markers: pooled dose-response associations from the Prospective Physical Activity, Sitting and Sleep Consortium. Diabetologia 2024; 67:1051-1065. [PMID: 38478050 PMCID: PMC11058050 DOI: 10.1007/s00125-024-06090-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 12/04/2023] [Indexed: 04/30/2024]
Abstract
AIMS/HYPOTHESIS The aim of this study was to examine the dose-response associations of device-measured physical activity types and postures (sitting and standing time) with cardiometabolic health. METHODS We conducted an individual participant harmonised meta-analysis of 12,095 adults (mean ± SD age 54.5±9.6 years; female participants 54.8%) from six cohorts with thigh-worn accelerometry data from the Prospective Physical Activity, Sitting and Sleep (ProPASS) Consortium. Associations of daily walking, stair climbing, running, standing and sitting time with a composite cardiometabolic health score (based on standardised z scores) and individual cardiometabolic markers (BMI, waist circumference, triglycerides, HDL-cholesterol, HbA1c and total cholesterol) were examined cross-sectionally using generalised linear modelling and cubic splines. RESULTS We observed more favourable composite cardiometabolic health (i.e. z score <0) with approximately 64 min/day walking (z score [95% CI] -0.14 [-0.25, -0.02]) and 5 min/day stair climbing (-0.14 [-0.24, -0.03]). We observed an equivalent magnitude of association at 2.6 h/day standing. Any amount of running was associated with better composite cardiometabolic health. We did not observe an upper limit to the magnitude of the dose-response associations for any activity type or standing. There was an inverse dose-response association between sitting time and composite cardiometabolic health that became markedly less favourable when daily durations exceeded 12.1 h/day. Associations for sitting time were no longer significant after excluding participants with prevalent CVD or medication use. The dose-response pattern was generally consistent between activity and posture types and individual cardiometabolic health markers. CONCLUSIONS/INTERPRETATION In this first activity type-specific analysis of device-based physical activity, ~64 min/day of walking and ~5.0 min/day of stair climbing were associated with a favourable cardiometabolic risk profile. The deleterious associations of sitting time were fully attenuated after exclusion of participants with prevalent CVD and medication use. Our findings on cardiometabolic health and durations of different activities of daily living and posture may guide future interventions involving lifestyle modification.
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Affiliation(s)
- Matthew N Ahmadi
- Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Joanna M Blodgett
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Sciences, UCL, London, UK
| | - Andrew J Atkin
- School of Health Sciences and Norwich Epidemiology Centre, University of East Anglia, Norwich, UK
| | - Hsiu-Wen Chan
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Borja Del Pozo Cruz
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz, Cádiz, Spain
- Faculty of Education, University of Cádiz, Cádiz, Spain
| | - Kristin Suorsa
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Esmee A Bakker
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | | | - Gregore I Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Peter J Johansson
- Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Pasan Hettiarachchi
- Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Dick H J Thijssen
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Armando Teixeira-Pinot
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Vegar Rangul
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases, Norwegian Public Health Institute, Oslo, Norway
| | - Alun D Hughes
- MRC Unit for Lifelong Health and Ageing, UCL Institute of Cardiovascular Science, UCL, London, UK
- UCL BHF Research Accelerator, University College London, London, UK
- University College London Hospitals NIHR Biomedical Research Centre, London, UK
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Annemarie Koster
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Mark Hamer
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Sciences, UCL, London, UK
| | - Emmanuel Stamatakis
- Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Yerrakalva D, Hajna S, Khaw KT, Griffin SJ, Brage S. Prospective associations between changes in physical activity and sedentary time and subsequent lean muscle mass in older English adults: the EPIC-Norfolk cohort study. Int J Behav Nutr Phys Act 2024; 21:10. [PMID: 38279174 PMCID: PMC10811887 DOI: 10.1186/s12966-023-01547-6] [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: 03/23/2023] [Accepted: 12/05/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND The longitudinal associations between physical behaviours and lean muscle mass indices need to be better understood to aid healthy ageing intervention development. METHODS We assessed physical behaviours (total physical activity, moderate-to-vigorous physical activity (MVPA), light physical activity, total sedentary time and prolonged sedentary bout time) for 7 days using hip-worn accelerometers. We also assessed domain-specific physical behaviours (walking, cycling, gardening and housework time) with self-report questionnaires at baseline (2006-2011) and follow-up (2012-2016) in the European Prospective Investigation into Cancer (EPIC)-Norfolk study. We assessed body composition using dual-energy X-ray absorptiometry (DEXA) at follow-up in 1535 participants (≥ 60 years at baseline). From this, we derived appendicular lean muscle mass (ALM) indices (% relative ALM = (ALM/total body weight)*100), body mass index (BMI)-scaled ALM (ALM/BMI, kg/kg/m2) and height-scaled ALM (ALM/height2, kg/m2)). We evaluated the prospective associations of both baseline and change in physical behaviours with follow-up muscle mass indices using multivariable linear regression. RESULTS Over 5.5 years (SD 14.8) follow-up, higher baseline accelerometer-measured physical activity and lower sedentary time were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.02% higher subsequent relative ALM per minute/day of baseline MVPA for men). Greater increases in physical activity and greater declines in sedentary time variables were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.001 kg/kg/m2 subsequent BMI-scaled ALM and 0.04% subsequent relative ALM per min/day/year increases in LPA over follow-up; 0.001 kg/kg/m2 subsequent BMI-scaled ALM and -0.03% subsequent relative ALM per min/day/year less of total sedentary time over follow-up). Greater increases in women's cycling and gardening over follow-up were associated with greater subsequent relative ALM (cycling 0.9% per hour/week/year; gardening 0.2% per hour/week/year) and BMI-scaled ALM (cycling 0.03 kg/kg/m2 per hour/week/year; gardening 0.004 kg/kg/m2 per hour/week/year). CONCLUSION Physical behaviours across all intensities, and in women more specifically cycling and gardening, may help prevent age-related declines in muscle mass.
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Affiliation(s)
- Dharani Yerrakalva
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Samantha Hajna
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Simon J Griffin
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK.
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Lin CY, Shibata A, Ishii K, Koohsari MJ, Hadgraft N, Dunstan DW, Owen N, Oka K. Reallocating desk workers' sitting time to standing or stepping: associations with work performance. Occup Med (Lond) 2023; 73:575-580. [PMID: 38104251 PMCID: PMC10824261 DOI: 10.1093/occmed/kqad142] [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] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Studies have suggested that sitting time at work may lead to underperformance but they may underestimate the benefits to desk workers' performance of reducing occupational sitting time without considering the relative effects of the specific activities replaced. AIMS To estimate differences in work performance (presenteeism, absenteeism and engagement) when occupational sitting time is reallocated to standing/stepping in desk workers. METHODS Data for middle-aged desk workers were from a Japan-wide online survey (n = 2228). Self-report proportion of occupational sitting and standing/stepping, work hours and work performance indicators, including absolute (ratings relating only to self) and relative (ratings of self, compared to others) presenteeism and absenteeism, and dimensions of work engagement, were collected. Partition and isotemporal substitution models were used to investigate the associations of occupational sitting and standing/stepping time with work performance, including their reallocation effects. RESULTS In partition models, longer occupational sitting time was associated with a lower absolute presenteeism score (i.e. less productivity), lower absolute absenteeism (i.e. longer-than-expected work hours), and lower engagement. Longer occupational standing/stepping time was associated with lower absolute absenteeism and more engagement. Isotemporal substitution models showed that each hour of occupational sitting reallocated to standing/stepping was favourably associated with overall work engagement (B = 0.087; 95% confidence interval 0.051, 0.122) and its dimensions (B ranged from 0.078 to 0.092), but was not associated with presenteeism or absenteeism. CONCLUSIONS These findings suggest that management support and practical initiatives to encourage desk workers to replace portions of their sitting time with standing/stepping may contribute to enhanced work engagement.
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Affiliation(s)
- C-Y Lin
- Department of Public Health, College of Public Health, China Medical University, Taichung, 406040Taiwan
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, 3122Australia
| | - A Shibata
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, 305-8577Japan
| | - K Ishii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
| | - M J Koohsari
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, 923-1292Japan
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3216Australia
| | - N Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, 3122Australia
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, 3004Australia
| | - D W Dunstan
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3216Australia
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, 3004Australia
| | - N Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, 3122Australia
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, 3004Australia
| | - K Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
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Alsamman RA, Pesola AJ, Shousha TM, Hagrass MS, Arumugam A. Effect of night-time data on sedentary and upright time and energy expenditure measured with the Fibion accelerometer in Emirati women. Diabetes Metab Syndr 2022; 16:102415. [PMID: 35104752 DOI: 10.1016/j.dsx.2022.102415] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Wearing an accelerometer during night-time could conflate sedentary behavior time and sleep hours. It is important to assess the impact of including night-time data on sedentary and upright behavior in a sedentary population. Therefore, we investigated differences in sitting and upright time and associated energy expenditure (EE), recorded by a Fibion accelerometer, with and without night-time data in Emirati women working in desk-based jobs. METHODS Thirty-one healthy Emirati women working in the government offices used the Fibion accelerometer for a week. Fibion data were included if the participants wore the device for ≥600 min per day for a minimum of three weekdays and one weekend day. Sedentary (sitting) and upright time and associated energy expenditure (EE) were recorded using the Fibion. Variables were compared with and without night-time data using the paired t tests or Wilcoxon signed-rank tests. Effect sizes were determined using Cohen's d. RESULTS Statistically significant differences for 15 out of 18 variables were observed when the night-time data were included. Except for cycling time, cycling EE, and vigorous activity time, nearly all other outcome measures showed a significant increase (moderate to large effect sizes) with night-time data compared to those without night-time data. CONCLUSIONS Cycling time/EE and vigorous activity time did not change with standard night-time data. Therefore, studies examining only cycling and/or vigorous activity time with the Fibion accelerometer do not require night-time data removal. An analysis of other variables relating to sedentary and upright time will require night-time data exclusion.
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Affiliation(s)
- Razan Adnan Alsamman
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates
| | - Arto J Pesola
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Finland
| | - Tamer Mohamed Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates; Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates; Faculty of Physical Therapy, Cairo University, Egypt
| | - Muhammad S Hagrass
- Cardiology Department, Khorfakkan Hospital, Ministry of Health and Prevention, Sharjah, United Arab Emirates
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates; Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates; Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates; Adjunct Faculty, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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