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Kraaijkamp JJM, Stijntjes M, De Groot JH, Chavannes NH, Achterberg WP, van Dam van Isselt EF. Movement Patterns in Older Adults Recovering From Hip Fracture. J Aging Phys Act 2024; 32:312-320. [PMID: 38215728 DOI: 10.1123/japa.2023-0090] [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: 03/27/2023] [Revised: 09/05/2023] [Accepted: 10/30/2023] [Indexed: 01/14/2024]
Abstract
The aim of this study was to quantify physical activity and sedentary behavior in older adults recovering from hip fracture and to identify groups based on movement patterns. In this cross-sectional cohort study, older adults (≥70 years) were included 3 months after surgery for proximal femoral fracture. Patients received an accelerometer for 7 days. Demographics and outcomes related to physical function, mobility, cognitive functions, quality of life, and hip fracture were assessed. In total, 43 patients with sufficient accelerometer wear time were included. Across all groups, participants engaged in very low levels of physical activity, spending an average of 11 hr/day in prolonged sedentary behavior. Based on the extracted components from a principal component analysis, three groups with substantial differences in levels of physical activity and sedentary behavior could be distinguished.
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Affiliation(s)
- Jules J M Kraaijkamp
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- ZZG Zorggroep, Nijmegen, the Netherlands
| | - Marjon Stijntjes
- Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, the Netherlands
- BioMechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - Jurriaan H De Groot
- Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
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Harding S, Richardson A, Glynn A, Hodgson L. Influencing factors of sedentary behaviour in people with chronic obstructive pulmonary disease: a systematic review. BMJ Open Respir Res 2024; 11:e002261. [PMID: 38789283 PMCID: PMC11129033 DOI: 10.1136/bmjresp-2023-002261] [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: 12/18/2023] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND People with chronic obstructive pulmonary disease (COPD) are more likely to adopt a sedentary lifestyle. Increased sedentary behaviour is associated with adverse health consequences and reduced life expectancy. AIM This mixed-methods systematic review aimed to report the factors contributing to sedentary behaviour in people with COPD. METHODS A systematic search of electronic databases (Medline, CINAHL, PsycINFO and Cochrane Library) was conducted and supported by a clinician librarian in March 2023. Papers were identified and screened by two independent researchers against the inclusion and exclusion criteria, followed by data extraction and analysis of quality. Quantitative and qualitative data synthesis was performed. RESULTS 1037 records were identified, 29 studies were included (26 quantitative and 3 qualitative studies) and most studies were conducted in high-income countries. The most common influencers of sedentary behaviour were associated with disease severity, dyspnoea, comorbidities, exercise capacity, use of supplemental oxygen and walking aids, and environmental factors. In-depth findings from qualitative studies included a lack of knowledge, self-perception and motivation. However, sedentarism in some was also a conscious approach, enabling enjoyment when participating in hobbies or activities. CONCLUSIONS Influencers of sedentary behaviour in people living with COPD are multifactorial. Identifying and understanding these factors should inform the design of future interventions and guidelines. A tailored, multimodal approach could have the potential to address sedentary behaviour. PROSPERO REGISTRATION NUMBER CRD42023387335.
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Affiliation(s)
| | | | | | - Luke Hodgson
- University Hospitals Sussex NHS Foundation Trust, Worthing, UK
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Kringle EA, Kersey J, Lewis MA, Gibbs BB, Skidmore ER. Similarities and differences in factors associated with high and low sedentary behavior after stroke: a mixed methods study. Disabil Rehabil 2024:1-9. [PMID: 38632899 DOI: 10.1080/09638288.2024.2341867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To identify similarities and differences in factors affecting activity engagement between adults with stroke who are more and less sedentary. MATERIALS AND METHODS Data were pooled from two studies of adults with stroke (N = 36). Sedentary time was measured activPAL micro3. Participants completed activPAL interviews, which were analyzed using framework analysis. Participants were stratified into more and less sedentary groups based on activPAL data. Between-group similarities and differences were identified. RESULTS Adults with stroke (mean [SD] age = 65.8 [13.6] years, stroke chronicity = 40.5 [SD = 38.3] months, 36.1% female) were more sedentary (785.5 [64.7] sedentary minutes/day) and less sedentary (583.6 [87.4] sedentary minutes/day). Those who were more sedentary: engaged in basic activities of daily living, avoided activities, received assistance from other people, and did not use strategies to overcome barriers. Those who were less sedentary: engaged in instrumental and community activities, embraced new strategies, did activities with other people, and used strategies to overcome environmental barriers. CONCLUSIONS Factors affecting activity engagement differed between people who are more and less sedentary. Interventions that aim to reduce post-stroke sedentary behavior should consider the: (1) types of activities, (2) role of other people, and (2) application of strategies to overcome activity and environment-related barriers.
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Affiliation(s)
- Emily A Kringle
- School of Kinesiology, University of MN, Minneapolis, MN, USA
| | - Jessica Kersey
- Program in Occupational Therapy, School of Medicine, WA University, St. Louis, MO, USA
| | | | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West VA University, Morgantown, WV, USA
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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Bertoche MP, Furlanetto KC, Hirata RP, Sartori L, Schneider LP, Mantoani LC, Brito I, Dala Pola DC, Hernandes NA, Pitta F. Assessment of sedentary behaviour in individuals with COPD: how many days are necessary? ERJ Open Res 2023; 9:00732-2022. [PMID: 37650084 PMCID: PMC10463027 DOI: 10.1183/23120541.00732-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/09/2023] [Indexed: 09/01/2023] Open
Abstract
Objective The objective of the present study was to define the minimum number of monitoring days required for the adequate cross-sectional assessment of sedentary behaviour in individuals with chronic obstructive pulmonary disease (COPD). Methods In this cross-sectional study, the sedentary behaviour of individuals with COPD was assessed using two physical activity monitors during awake time for seven consecutive days. Time spent per day in activities requiring ≤1.5 metabolic equivalents (METs) and in sitting, lying and sitting+lying positions was calculated taking into account the average of 7 days (as a reference in all analyses) and of all 119 possible combinations of 2---6 days. Intraclass correlation coefficients (ICCs) and linear regression analyses were performed for all combinations. Results 91 individuals were analysed (47 female, 66±9 years, forced expiratory volume in 1 s 50±15% predicted). For the variables time spent per day in activities ≤1.5METs and sitting, the average of any combination of at least four assessment days was sufficient to adequately reflect the average of 7 days (adjusted R2≥0.929, ICC≥0.962, p<0.0001 for all). For time spent per day lying and sitting+lying, only two assessment days were enough (adjusted R2≥0.937, ICC≥0.968, p<0.0001 for all). Results were maintained independently of patient sex, disease severity, day of the week, daylight time or daytime naps. Conclusions The average of 4 days of objective monitoring was sufficient to adequately reflect the results of a 1-week assessment of the main outcomes related to sedentary behaviour in individuals with moderate to very severe COPD, regardless of sex, disease severity, day of the week, daylight time and occurrence of daytime naps.
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Affiliation(s)
- Mariana Pereira Bertoche
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Karina Couto Furlanetto
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
- Biological and Health Sciences Research Center, Stricto Sensu Graduate Program in Rehabilitation Sciences, Universidade Pitagoras – UNOPAR, Londrina, Paraná, Brazil
| | - Raquel Pastrello Hirata
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Larissa Sartori
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Lorena Paltanin Schneider
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Leandro Cruz Mantoani
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Igor Brito
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Daniele Caroline Dala Pola
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Nidia Aparecida Hernandes
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
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Minakata Y, Azuma Y, Sasaki S, Murakami Y. Objective Measurement of Physical Activity and Sedentary Behavior in Patients with Chronic Obstructive Pulmonary Disease: Points to Keep in Mind during Evaluations. J Clin Med 2023; 12:jcm12093254. [PMID: 37176694 PMCID: PMC10179547 DOI: 10.3390/jcm12093254] [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: 03/31/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Objective measurement methods using accelerometers have become the mainstream approach for evaluating physical activity (PA) and sedentary behavior (SB). However, several problems face the objective evaluation of PA and SB in patients with chronic obstructive pulmonary disease (COPD). For example, indicators of PA differ depending on whether the accelerometer detects the kind of activity on the one hand, or its intensity on the other. Measured data are also strongly influenced by environmental factors (weather, season, employment status, etc.) and methodological factors (days with uncommon activities, non-wearing time, minimum required wearing time per day, minimum number of valid days required, etc.). Therefore, adjusting for these factors is required when evaluating PA or SB, especially when evaluating the effects of intervention. The exclusion of sleeping time, unification of total measurement time, and minimization of the required wearing time per day might be more important for the evaluation of ST than for evaluating PA. The lying-down-time-to-sitting-time ratio was shown to be larger in COPD patients than in healthy subjects. In this review, we clarified the problems encountered during objective evaluations of PA and SB in patients with COPD and encouraged investigators to recognize the presence of these problems and the importance of adjusting for them.
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Affiliation(s)
- Yoshiaki Minakata
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
| | - Yuichiro Azuma
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
| | - Seigo Sasaki
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
| | - Yusuke Murakami
- National Hospital Organization Wakayama Hospital, 1138 Wada, Mihama-Cho, Hidaka-gun, Wakayama 644-0044, Japan
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Lynch L, McCarron M, Eustace-Cook J, Burke É, McCallion P. Physical health effects of sedentary behaviour on adults with an intellectual disability: A scoping review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022:17446295221107281. [PMID: 35695076 DOI: 10.1177/17446295221107281] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This literature review was designed to establish the effects of sedentary behaviour on the physical health of adults with an intellectual disability. Sedentary behaviour is defined as any waking behaviour characterized by an energy expenditure of ≤1.5 METs while in a sitting, lying or reclining posture. An extensive search was executed in six databases: EMBASE, Medline, CINAHL, PsycINFO, ASSIA and Web of Science. Following screening, 18 articles remained for inclusion in the review. A thematic analysis using the Braun and Clarke six step process resulted in the identification of seven broad health areas. Studies showed a prevalence of obesity, multimorbidity and metabolic syndrome as well as elevated levels of sedentary behaviour in adults with an intellectual disability. This literature review demonstrated that sedentary behaviour could be a contributor to the poor health which is common in adults with an intellectual disability. However to date the body of evidence does not confirm a cause-and-effect relationship.
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Affiliation(s)
- Louise Lynch
- IDS-TILDA, School of Nursing and Midwifery, 8809Trinity College, Dublin, Ireland
| | - Mary McCarron
- IDS-TILDA, School of Nursing and Midwifery, 8809Trinity College, Dublin, Ireland
| | - Jessica Eustace-Cook
- IDS-TILDA, School of Nursing and Midwifery, 8809Trinity College, Dublin, Ireland
| | - Éilish Burke
- IDS-TILDA, School of Nursing and Midwifery, 8809Trinity College, Dublin, Ireland
| | - Phillip McCallion
- School of Social Work, College of Public Health, Temple University, Philadelphia, PA, USA
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Coll F, Cavalheri V, Gucciardi DF, Wulff S, Hill K. Quantifying the Effect of Monitor Wear Time and Monitor Type on the Estimate of Sedentary Time in People with COPD: Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11071980. [PMID: 35407588 PMCID: PMC8999633 DOI: 10.3390/jcm11071980] [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: 01/26/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 01/25/2023] Open
Abstract
In studies that have reported device-based measures of sedentary time (ST) in people with chronic obstructive pulmonary disease (COPD), we explored if the monitor type and monitor wear time moderated the estimate of this measure. Five electronic databases were searched in January 2021. Studies were included if >70% of participants had stable COPD, and measures of ST (min/day) were collected using wearable technology. Meta-regression was used to examine the influence of moderators on ST, monitor type, and wear time. The studies identified were a total of 1153, and 36 had usable data for meta-analyses. The overall pooled estimate of ST (mean [95% CI]) was 524 min/day [482 to 566] with moderate heterogeneity among effect sizes (I2 = 42%). Monitor wear time, as well as the interaction of monitor wear time and monitor type, were moderators of ST (p < 0.001). The largest difference (−318 min; 95% CI [−212 to −424]) was seen between studies where participants wore a device without a thigh inclinometer for 24 h (and removed sleep during analysis) (675 min, 95% CI [589 to 752]) and studies where participants wore a device with a thigh inclinometer for 12 h only (356 min; 95% CI [284 to 430]). In people with COPD, the monitor wear time and the interaction of the monitor wear time and the monitor type moderated the estimate of ST.
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Affiliation(s)
- Fiona Coll
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Physiotherapy Department, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
- Allied Health, South Metropolitan Health Service, Perth, WA 6150, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA 6027, Australia
| | - Daniel F. Gucciardi
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
| | - Sheldon Wulff
- Physiotherapy Department, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Kylie Hill
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia; (F.C.); (V.C.); (D.F.G.)
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
- Institute for Respiratory Health, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
- Correspondence: ; Tel.: +61-8-9226-2774
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Takahashi K, Tashiro H, Tajiri R, Takamori A, Uchida M, Kato G, Kurihara Y, Sadamatsu H, Kinoshita T, Yoshida M, Kawaguchi A, Kimura S, Sueoka-Aragane N, Kawayama T. Factors Associated with Reduction of Sedentary Time Following Tiotropium/Olodaterol Therapy in Treatment-Naïve Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2021; 16:3297-3307. [PMID: 34908832 PMCID: PMC8664652 DOI: 10.2147/copd.s338560] [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: 09/13/2021] [Accepted: 11/23/2021] [Indexed: 11/23/2022] Open
Abstract
Background Prolonged sedentary behavior is associated with worse prognosis in patients with chronic obstructive pulmonary disease (COPD). Our previous study found that first-line dual therapy with tiotropium/olodaterol significantly reduces sedentary time compared to tiotropium monotherapy in Japanese patients with treatment-naïve COPD, although the characteristics of responders to dual-therapy versus monotherapy for COPD are still unclear. Methods Patients with treatment-naïve COPD were randomized to receive either tiotropium or tiotropium/olodaterol treatment for 12 weeks. Physical activity was assessed using a triaxle accelerometer for 2 weeks before and after treatment. This analysis focused on the change in sedentary time, indicated by physical activity of 1.0–1.5 metabolic equivalents (METs), with stratification for the following factors: age, body mass index (BMI), pulmonary function, COPD assessment test (CAT), the 6-minute walk distance (6MWD), and physical activity level at study entry. Results Thirty-five patients received tiotropium/olodaterol and 34 patients received tiotropium. In patients with lower inspiratory capacity at study entry, a significant reduction in sedentary time was observed in the tiotropium/olodaterol group compared with the tiotropium group (Tio: −12.8 ± 13.5 min, Tio/Olo: −65.1 ± 21.0 min, mean difference, −52.2 min, 95% CI −103.6 to 0.88, p = 0.046). In patients with a shorter duration of physical activity of ≥2 METs at study entry, a significant reduction of sedentary time was observed in the tiotropium/olodaterol group compared with the tiotropium group (Tio: −3.3 ± 17.5 min, Tio/Olo: −72.9 ± 23.1 min, mean difference, −69.7 min, 95% CI −128.7 to −10.6, p = 0.02). There were no differences in terms of age, BMI, CAT score, 6MWD, FEV1, FVC, VC, and physical activity of 1.0–1.5 METs and ≥3.0 METs. Conclusion This study showed that COPD patients with lower inspiratory capacity or shorter active time of ≥2.0 METs at study entry are likely to exhibit significantly greater reduction in sedentary time with tiotropium/olodaterol treatment.
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Affiliation(s)
- Koichiro Takahashi
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hiroki Tashiro
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Ryo Tajiri
- Clinical Research Center, Saga University Hospital, Faculty of Medicine, Saga University, Saga, Japan
| | - Ayako Takamori
- Clinical Research Center, Saga University Hospital, Faculty of Medicine, Saga University, Saga, Japan
| | - Masaru Uchida
- Division of Internal Medicine, Japan Community Health Care Organization Saga Central Hospital, Saga, Japan
| | - Go Kato
- Division of Respiratory Medicine, Saga Prefectural Medical Center Koseikan, Saga, Japan
| | - Yuki Kurihara
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hironori Sadamatsu
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Takashi Kinoshita
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Makoto Yoshida
- Division of Respiratory Medicine, National Hospital Organization Fukuoka Hospital, Fukuoka, Japan
| | - Atsushi Kawaguchi
- Clinical Research Center, Saga University Hospital, Faculty of Medicine, Saga University, Saga, Japan.,Education and Research Center for Community Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Shinya Kimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Naoko Sueoka-Aragane
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
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Flury D, Massé F, Paraschiv-Ionescu A, Aminian K, Luft AR, Gonzenbach R. Clinical value of assessing motor performance in postacute stroke patients. J Neuroeng Rehabil 2021; 18:102. [PMID: 34167546 PMCID: PMC8223372 DOI: 10.1186/s12984-021-00898-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/14/2021] [Indexed: 01/28/2023] Open
Abstract
Background Rehabilitative treatment plans after stroke are based on clinical examinations of functional capacity and patient-reported outcomes. Objective information about daily life performance is usually not available, but it may improve therapy personalization. Objective To show that sensor-derived information about daily life performance is clinically valuable for counseling and the planning of rehabilitation programs for individual stroke patients who live at home. Performance information is clinically valuable if it can be used as a decision aid for the therapeutic management or counseling of individual patients. Methods This was an observational, cross-sectional case series including 15 ambulatory stroke patients. Motor performance in daily life was assessed with body-worn inertial sensors attached to the wrists, shanks and trunk that estimated basic physical activity and various measures of walking and arm activity in daily life. Stroke severity, motor function and activity, and degree of independence were quantified clinically by standard assessments and patient-reported outcomes. Motor performance was recorded for an average of 5.03 ± 1.1 h on the same day as the clinical assessment. The clinical value of performance information is explored in a narrative style by considering individual patient performance and capacity information. Results The patients were aged 59.9 ± 9.8 years (mean ± SD), were 6.5 ± 7.2 years post stroke, and had a National Institutes of Health Stroke Score of 4.0 ± 2.6. Capacity and performance measures showed high variability. There were substantial discrepancies between performance and capacity measures in some patients. Conclusions This case series shows that information about motor performance in daily life can be valuable for tailoring rehabilitative therapy plans and counseling according to the needs of individual stroke patients. Although the short recording time (average of 5.03 h) limited the scope of the conclusions, this study highlights the usefulness of objective measures of daily life performance for the planning of rehabilitative therapies. Further research is required to investigate whether information about performance in daily life leads to improved rehabilitative therapy results.
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Affiliation(s)
- D Flury
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
| | - F Massé
- Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - A Paraschiv-Ionescu
- Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - K Aminian
- Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - A R Luft
- Department of Neurology, University Hospital of Zurich, Zurich, Switzerland.,Center for Neurology and Rehabilitation, Cereneo, Vitznau, Switzerland
| | - R Gonzenbach
- Department of Neurology, University Hospital of Zurich, Zurich, Switzerland
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10
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Kringle EA, Skidmore ER, Terhorst L, Hammel J, Barone Gibbs B. Sedentary behavior patterns over 6 weeks among ambulatory people with stroke. Top Stroke Rehabil 2020; 28:537-544. [PMID: 33176623 DOI: 10.1080/10749357.2020.1846934] [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: 10/23/2022]
Abstract
Objective: To describe patterns of sedentary behavior over 6 weeks among ambulatory people with subacute and chronic stroke.Design: Observational longitudinal study with assessments at baseline (T0) and week 6 (T1).Methods: Community-dwelling people with stroke (n = 39) pooled from two studies who were ≥18 years of age were assessed for sedentary behavior at 2 timepoints (T0, T1). Sedentary behavior was measured with the activPAL micro3 following a 7-day wear protocol to obtain mean daily: total sitting time, sitting time accumulated in bouts ≥30 minutes, number of sit-to-stand transitions, and fragmentation index (sit-to-stand transitions/total sitting hours). Paired samples t-tests were used to calculate mean group differences in sedentary behavior metrics between T0 and T1 (α =.05). Cohen's d was calculated to describe the magnitude of within-person change between T0 and T1.Results: There were no statistically significant within-person differences between T0 and T1 on mean daily sitting time (Cohen's d= -0.21, p=.19), sitting time accumulated in bouts ≥30 minutes (d= -0.27, p=.11), number of sit-to-stand transitions (d= -0.02, p=.53), or the fragmentation index (d= -0.11, p=.92).Conclusions: Sedentary behavior metrics were stable for over 6 weeks. The number of sit-to-stand transitions per day and the fragmentation index appeared to be the most stable indicators over 6 weeks. Future research should confirm these findings and identify correlates of sedentary behavior among people with stroke.
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Affiliation(s)
- Emily A Kringle
- Division of Academic Internal Medicine and Geriatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Joy Hammel
- Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Bethany Barone Gibbs
- Department of Health and Human Development, School of Education, University of Pittsburgh, Pittsburgh, PA, USA
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11
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Wondergem R, Pisters MF, Heijmans MW, Wouters EJM, de Bie RA, Veenhof C, Visser-Meily JMA. Movement behavior remains stable in stroke survivors within the first two months after returning home. PLoS One 2020; 15:e0229587. [PMID: 32214319 PMCID: PMC7098564 DOI: 10.1371/journal.pone.0229587] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/11/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND PURPOSE The aim of this study is to investigate changes in movement behaviors, sedentary behavior and physical activity, and to identify potential movement behavior trajectory subgroups within the first two months after discharge from the hospital to the home setting in first-time stroke patients. METHODS A total of 140 participants were included. Within three weeks after discharge, participants received an accelerometer, which they wore continuously for five weeks to objectively measure movement behavior outcomes. The movement behavior outcomes of interest were the mean time spent in sedentary behavior (SB), light physical activity (LPA) and moderate to vigorous physical activity (MVPA); the mean time spent in MVPA bouts ≥ 10 minutes; and the weighted median sedentary bout. Generalized estimation equation analyses were performed to investigate overall changes in movement behavior outcomes. Latent class growth analyses were performed to identify patient subgroups of movement behavior outcome trajectories. RESULTS In the first week, the participants spent an average, of 9.22 hours (67.03%) per day in SB, 3.87 hours (27.95%) per day in LPA and 0.70 hours (5.02%) per day in MVPA. Within the entire sample, a small but significant decrease in SB and increase in LPA were found in the first weeks in the home setting. For each movement behavior outcome variable, two or three distinctive subgroup trajectories were found. Although subgroup trajectories for each movement behavior outcome were identified, no relevant changes over time were found. CONCLUSION Overall, the majority of stroke survivors are highly sedentary and a substantial part is inactive in the period immediately after discharge from hospital care. Movement behavior outcomes remain fairly stable during this period, although distinctive subgroup trajectories were found for each movement behavior outcome. Future research should investigate whether movement behavior outcomes cluster in patterns.
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Affiliation(s)
- Roderick Wondergem
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
- Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Martijn F. Pisters
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
- Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Martijn W. Heijmans
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Eveline J. M. Wouters
- Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Rob A. de Bie
- Department of Epidemiology and Caphri Research School, Maastricht University, Maastricht, The Netherlands
| | - Cindy Veenhof
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
- Expertise Center Healthy Urban Living, Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Johanna M. A. Visser-Meily
- Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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12
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Wshah A, Selzler AM, Hill K, Brooks D, Goldstein R. Determinants of Sedentary Behaviour in Individuals with COPD: A Qualitative Exploration Guided by the Theoretical Domains Framework. COPD 2020; 17:65-73. [PMID: 31909650 DOI: 10.1080/15412555.2019.1708883] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In people with chronic obstructive pulmonary disease (COPD), there is increasing recognition that the prolonged accumulation of sedentary time (ST) is associated with adverse cardio-metabolic health outcomes. Nevertheless, changing this lifestyle, which has evolved over several decades, is likely to be challenging. This study reports the determinants, perceived by individuals with COPD, as being important for reducing ST. An in-depth understanding of this information is essential when planning an intervention to reduce ST. Fourteen individuals with COPD completed semi-structured one-on-one interviews, which were audio recorded and transcribed verbatim. Both the interview schedule and mapping of data items extracted from the interview transcripts were informed by the Theoretical Domains Framework (TDF). A total of 867 quotes were mapped to the 14 TDF domains. Seven of the fourteen domains were identified as being important determinants for reducing ST: knowledge, beliefs about consequences, beliefs about capabilities, environmental context and resources, social influences, social/professional role and identity, and behavioural regulation. There was a lack of knowledge regarding the meaning of sedentary behaviour. Participants' desire to be educated by knowledgeable health professionals in a formal programme was a dominant theme across multiple domains. The most frequently reported barriers to reducing ST related to the domains of social/professional role and identity and environmental context and resources, while the most frequently reported enablers were related to the domains pertaining to beliefs about consequences and social influences. Potential strategies to reduce ST among people with COPD include education and other determinants identified in this research.
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Affiliation(s)
- Adnan Wshah
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | | | - Kylie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Dina Brooks
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,School of Rehabilitation Science, McMaster University, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Roger Goldstein
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
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13
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Wondergem R, Veenhof C, Wouters EMJ, de Bie RA, Visser-Meily JMA, Pisters MF. Movement Behavior Patterns in People With First-Ever Stroke. Stroke 2019; 50:3553-3560. [PMID: 31658902 PMCID: PMC7597994 DOI: 10.1161/strokeaha.119.027013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Supplemental Digital Content is available in the text. Movement behaviors, that is, both physical activity and sedentary behavior, are independently associated with health risks. Although both behaviors have been investigated separately in people after stroke, little is known about the combined movement behavior patterns, differences in these patterns between individuals, or the factors associated with these patterns. Therefore, the objectives of this study are (1) to identify movement behavior patterns in people with first-ever stroke discharged to the home setting and (2) to explore factors associated with the identified patterns.
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Affiliation(s)
- Roderick Wondergem
- From the Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands (R.W., C.V., M.F.P.).,Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, the Netherlands (R.W., C.V., J.M.A.V.-M., M.F.P.).,Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands (R.W., E.M.J.W., M.F.P.)
| | - Cindy Veenhof
- From the Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands (R.W., C.V., M.F.P.).,Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, the Netherlands (R.W., C.V., J.M.A.V.-M., M.F.P.).,Expertise Center Healthy Urban Living, Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, the Netherlands (C.V.)
| | - Eveline M J Wouters
- Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands (R.W., E.M.J.W., M.F.P.).,Tilburg University, School of Social and Behavioral Sciences, Department of Tranzo, the Netherlands (E.M.J.W.)
| | - Rob A de Bie
- Department of Epidemiology and Caphri Research School, Maastricht University, the Netherlands (R.A.d.B.)
| | - Johanna M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, the Netherlands (R.W., C.V., J.M.A.V.-M., M.F.P.).,Center of Excellence for Rehabilitation Medicine, Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands (J.M.A.V.-M)
| | - Martijn F Pisters
- From the Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands (R.W., C.V., M.F.P.).,Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, the Netherlands (R.W., C.V., J.M.A.V.-M., M.F.P.).,Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands (R.W., E.M.J.W., M.F.P.)
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Duran AT, Ewing Garber C, Cornelius T, Schwartz JE, Diaz KM. Patterns of Sedentary Behavior in the First Month After Acute Coronary Syndrome. J Am Heart Assoc 2019; 8:e011585. [PMID: 31364434 PMCID: PMC6761643 DOI: 10.1161/jaha.118.011585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 06/27/2019] [Indexed: 02/06/2023]
Abstract
Background Sedentary behavior is a key contributor to cardiovascular disease. Few data exist on the sedentary behavior patterns of patients with acute coronary syndrome. Methods and Results We characterized patterns of sedentary time and their correlates in 149 patients with acute coronary syndrome over the first month postdischarge, a critical period when lifestyle behaviors are formed. Sedentary time was measured by accelerometry for 28 days postdischarge. Group-based modeling at the day level was used to characterize sedentary patterns. Participants spent a mean of 9.7±2.0 hours per day sedentary during the 28 days postdischarge, with significant decreases in sedentary time observed in each consecutive week (P<0.01 for all). Three distinct sedentary patterns were identified: high (20.6% of participants), moderate (47.9%), and low (31.5%). The high and moderate sedentary groups spent a mean of 12.6±0.8 and 10.0±0.7 hours per day sedentary, respectively, and had only minimal decreases in their sedentary time (<3 minutes per day) over the 28 days. The low sedentary group spent a mean of 7.3±0.8 hours per day sedentary, with a rapid decrease in sedentary time (14 minutes per day) observed during the first week postdischarge followed by a relatively smaller decrease (≈5 minutes per day) that persisted until day 21 postdischarge. Non-Hispanic ethnicity, left ventricular ejection fraction <40%, lower physical health-related quality of life, and not having a partner were associated with an increased likelihood of being in the high sedentary group. Conclusions Survivors of acute coronary syndrome accrued high volumes of sedentary time during the first month postdischarge, with most showing little change over time. Interventions targeting reductions in sedentary time among survivors of acute coronary syndrome may be warranted, particularly for those with poor physical health and greater disease severity.
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Affiliation(s)
- Andrea T. Duran
- Department of Biobehavioral SciencesTeachers CollegeColumbia UniversityNew YorkNY
- Center for Behavioral Cardiovascular HealthColumbia University Irving Medical CenterNew YorkNY
| | - Carol Ewing Garber
- Department of Biobehavioral SciencesTeachers CollegeColumbia UniversityNew YorkNY
| | - Talea Cornelius
- Center for Behavioral Cardiovascular HealthColumbia University Irving Medical CenterNew YorkNY
| | - Joseph E. Schwartz
- Center for Behavioral Cardiovascular HealthColumbia University Irving Medical CenterNew YorkNY
- Department of PsychiatryStony Brook UniversityStony BrookNY
| | - Keith M. Diaz
- Center for Behavioral Cardiovascular HealthColumbia University Irving Medical CenterNew YorkNY
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Ellingson LD, Zaman A, Stegemöller EL. Sedentary Behavior and Quality of Life in Individuals With Parkinson's Disease. Neurorehabil Neural Repair 2019; 33:595-601. [PMID: 31208286 DOI: 10.1177/1545968319856893] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background. Sedentary behavior is a growing public health concern and may have particular relevance for the Parkinson disease (PD) population. However, the influence of sedentary time on factors associated with quality of life (QOL) in PD is unknown. The primary purpose of this study was to examine relationships between sedentary behaviors and markers of PD-specific QOL. A secondary purpose was to examine relationships between physical activity behaviors and QOL. Methods. We assessed sedentary and active behaviors using objective and interview measures and examined relationships between these behaviors and a measure of PD-specific QOL in individuals with PD. Results. Results demonstrated that sedentary time was significantly related to several aspects of QOL, including perceived deficits in the domains of mobility, cognitive processing, and communication. Additionally, results showed that time spent watching television was more strongly associated with lower levels of QOL than other more engaging sedentary activities. For physical activity, relationships between objective measures and QOL were weaker and only significantly associated with mobility. Time spent doing housework was associated with lower levels of QOL, whereas time spent in recreational activity was associated with lower levels of discomfort. Discussion. These results suggest that targeting decreases in sedentary behaviors (eg, reducing time spent watching television, breaking up prolonged bouts of sedentary time) may be effective for improving QOL in individuals with PD.
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