1
|
Jess MA, Ryan C, Wellburn S, Atkinson G, Greenough C, Peat G, Coxon A, Roper H, Fatoye F, Ferguson D, Dickson A, Ridley H, Martin D. Does pain duration and other variables measured at baseline predict re-referral of low back pain patients managed on an evidence-based pathway? A cohort study. Physiotherapy 2023; 121:5-12. [PMID: 37591028 DOI: 10.1016/j.physio.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 04/02/2023] [Accepted: 07/26/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE To explore the association between baseline pain duration and the likelihood of re-referral of patients with low back pain (LBP) managed on the evidence-based North East of England Regional Back Pain and Radicular Pain Pathway (NERBPP). STUDY DESIGN Longitudinal, observational cohort study. METHODS In all, 12,509 adults with LBP were identified as having been discharged from the pathway, between May 2015 and December 2019. To quantify any association between baseline pain duration and the likelihood of re-referral, two statistical modelling approaches, were used: logistic regression models for odds ratios and generalised linear models with a binomial link function in order to quantify risk differences. RESULTS Twenty-five percent of patients with LBP, who were discharged, re-referred for management over a 4.5-year period. A large difference in pain duration of 2 SD days was statistically associated with re-referral, with an odds ratio of 1.22 (95% CI: 1.03, 1.44) and a risk difference of 3.6% (95% CI: 0.6, 6.6). Nevertheless, the predictive value of an individual's pain duration was found to be weak for re-referral. Higher baseline disability [odds ratio of 1.40 (95% CI: 1.07, 1.83)] and a younger age at baseline [odds ratio of 0.73 (95% CI 0.61, 0.86)] were also associated with an increased risk of re-referral. CONCLUSIONS Baseline pain duration, disability and younger age are statistically associated with re-referral onto the NERBPP. However, the value of these variables for predicting an individual's risk of re-referral is weak. CONTRIBUTION OF PAPER.
Collapse
Affiliation(s)
- Mary-Anne Jess
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK.
| | - Cormac Ryan
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Shaun Wellburn
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Greg Atkinson
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Glynis Peat
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Andrew Coxon
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Helena Roper
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Francis Fatoye
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, UK
| | - Diarmaid Ferguson
- Northumbria Healthcare NHS Trust, North Tyneside General Hospital, North Shields, UK; Primary Care Rheumatology & Musculoskeletal Medicine Society, York, UK
| | - Alastair Dickson
- Primary Care Rheumatology & Musculoskeletal Medicine Society, York, UK; The North of England Low Back Pain Pathway, NIHR Applied Research Collaboration (ARC) North East and North Cumbria, St Nicolas' Hospital, Newcastle Upon Tyne, UK; AD Outcomes Ltd, York, UK
| | - Helen Ridley
- Getting It Right First Time (GIRFT): Clinically led improvement programme delivered in partnership with the Royal National Orthopaedic Hospitals NHS Trust, NHS England and NHS Improvement, UK
| | - Denis Martin
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK; NIHR Applied Research Collaboration for the North East and North Cumbria, UK
| |
Collapse
|
2
|
Loughran KJ, Tough D, Ryan CG, Wellburn S, Martin D, Dixon J, Harrison SL. The Association of Pain with Incident Falls in People with Chronic Obstructive Pulmonary Disease: Evidence from the English Longitudinal Study of Ageing. Int J Environ Res Public Health 2023; 20:6236. [PMID: 37444084 PMCID: PMC10341239 DOI: 10.3390/ijerph20136236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/28/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023]
Abstract
People with chronic obstructive pulmonary disease (COPD) have a higher prevalence of pain and a greater risk of falls than their healthy peers. As pain has been associated with an increased risk of falls in older adults, this study investigated the association between pain and falls in people with COPD compared to healthy controls. Data from the English Longitudinal Study of Ageing were used to establish an association between pain and falls when modelled with a generalised ordinal logistic regression and adjusted for sex, age, wealth, and education (complete case analysis only; n = 806 COPD, n = 3898 healthy controls). The odds were then converted to the predicted probabilities of falling. The predicted probability of falling for people with COPD was greater across all pain categories than for healthy controls; for COPD with (predicted probability % [95%CI]), no pain was 20% [17 to 25], with mild pain was 28% [18 to 38], with moderate pain was 28% [22 to 34] with severe pain was 39% [30 to 47] and for healthy controls with no pain was 17% [16 to 18], mild pain 22% [18 to 27], moderate pain 25% [20 to 29] and severe pain 27% [20 to 35]. The probability of falling increased across pain categories in individuals with COPD, with the most severe pain category at a nearly 40% probability of falling, indicating a potential interaction between COPD and pain.
Collapse
Affiliation(s)
- Kirsti J. Loughran
- Centre for Rehabilitation, School of Health & Life Science, Teesside University, Middlesbrough TS1 3BX, UK
| | | | | | | | | | | | | |
Collapse
|
3
|
Jess MA, Hamilton S, Ryan C, Wellburn S, Alexanders J, Spence D, Martin D. Exploring the origin of pain subclassification, with emphasis on low back pain: a scoping review. JBI Evid Synth 2021; 19:308-340. [PMID: 32881730 DOI: 10.11124/jbisrir-d-19-00383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This scoping review aimed to explore the different working definitions for the duration of acute, subacute, and chronic pain, with emphasis on low back pain, and to establish where these definitions originated and the rationale provided for the time frames used. INTRODUCTION From a global perspective, low back pain is a major social and economic problem. One of the most commonly used methods to stratify and manage low back pain is the traditional duration-based classification (acute, subacute, and chronic). Where these time points lie to differentiate these transitions continues to be debated within the scientific community, which may engender a degree of heterogeneity in study findings. Therefore, applying these findings to clinical practice may be somewhat challenging. This review encapsulates the historical origins of the different duration categories to provide an understanding of how these variations were derived. INCLUSION CRITERIA Studies that included participants with low back pain were the focus of this review. Sources that included children or other specific pain pathologies, such as cancer pain, were excluded. The main concept of interest was that the publication proposed an original definition of the duration of acute, subacute, or chronic low back pain. All study designs were included provided they gave a rationale for the duration that they used. METHODS The following databases were searched: MEDLINE, Embase, CINAHL, and PsycINFO, from the inception of each database until September 18, 2019. This review was limited to studies published in English. Two independent reviewers screened the retrieved articles against the eligibility criteria. Additional studies were searched from the reference lists of studies to find the original source. Some original sources overlapped with general pain duration literature. This led to a deviation from the scoping review protocol, which originally intended to focus on definitions of low back pain duration only. Data extraction was undertaken using a charting table developed specifically for the review objectives. The findings were presented using narrative synthesis. RESULTS Nineteen records were included in this review, and comprised three book chapters, four review articles, four articles that arose following pain expert group discussions, seven primary research studies, and a spinal guideline. Data were extracted from the included studies and categorized into four themes based on the origin of the classification of the duration. The themes included i) work/employment setting, ii) empirical studies, iii) expert reasoning, and iv) pathophysiological explanation. CONCLUSIONS This scoping review compiled the existing literature on the working definitions of the duration of acute, subacute, and chronic low back pain and found a wide variation. These ranged from seven days, 14 days, and seven weeks for the acute and subacute transition points, and seven weeks to three years for chronic low back pain. The duration definitions specifically referring to the general pain literature focused on three and/or six months for the transition to chronic. Better integration of reasoning between the identified themes could facilitate the establishment of more ideal duration definitions in the future. Although inconclusive, the definition most commonly cited, with most consensus, was three months for the transition to chronic low back pain.
Collapse
Affiliation(s)
- Mary-Anne Jess
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Sharon Hamilton
- School of Health and Social Care, Teesside University, Middlesbrough, UK.,Teesside Centre for Evidence-Informed Practice: A JBI Affiliated Group, Middlesbrough, UK
| | - Cormac Ryan
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Shaun Wellburn
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Jenny Alexanders
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Daniel Spence
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Denis Martin
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| |
Collapse
|
4
|
Wellburn S, Ryan CG, Coxon A, Dickson AJ, Dickson DJ, Fatoye F, Ferguson D, Green PW, Greenhough C, Hamilton S, Jess MA, Jones A, Peat G, Martin DJ. Long-term improvements following a residential combined physical and psychological programme for chronic low back pain. BMJ Open Qual 2021; 10:e001068. [PMID: 33972364 PMCID: PMC8112434 DOI: 10.1136/bmjoq-2020-001068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 03/24/2021] [Accepted: 04/11/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Evaluate the outcomes and explore experiences of patients undergoing a residential combined physical and psychological programme (CPPP) for chronic low back pain. DESIGN A longitudinal observational cohort design, with a parallel qualitative design using semistructured interviews. SETTING Residential, multimodal rehabilitation. PARTICIPANTS 136 adults (62 male/74 female) referred to the CPPP, 100 (44 male/56 female) of whom completed the programme, during the term of the study. Ten (2 male/8 female) participated in the qualitative evaluation. INTERVENTION A 3-week residential CPPP. OUTCOME MEASURES Primary outcome measures were the STarT Back screening tool score; pain intensity-11-point Numerical Rating Scale; function-Oswestry Disability Index (ODI); health status/quality of life-EQ-5D-5L EuroQol five-Dimension-five level; anxiety-Generalised Anxiety Disorder-7; depression-Patient Health Questionnaire-9. Secondary outcome measures were the Global Subjective Outcome Scale; National Health Service Friends and Family Test;. RESULTS At discharge, 6 and 12 months follow ups, there were improvements from baseline that were greater than minimum clinically important differences in each of the outcomes (with the sole exception of ODI at discharge). At 12 months, the majority of people considered themselves a lot better (57%) and were extremely likely (86%) to recommend the programme to a friend. The qualitative data showed praise for the residential nature of the intervention and the opportunities for interaction with peers and peer support. There were testimonies of improvements in understanding of pain and how to manage it better. Some participants said they had reduced, or stopped, medication they had been taking to manage their pain. CONCLUSIONS Participants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting.
Collapse
Affiliation(s)
- Shaun Wellburn
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Cormac G Ryan
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Andrew Coxon
- James Cook University Hospital, Middlesbrough, Middlesbrough, UK
| | - Alastair J Dickson
- Primary Care Rheumatology & Musculoskeletal Medicine Society, Northallerton, UK
| | - D John Dickson
- Primary Care Rheumatology & Musculoskeletal Medicine Society, Northallerton, UK
| | - Francis Fatoye
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, Greater Manchester, UK
| | | | - Paul W Green
- James Cook University Hospital, Middlesbrough, Middlesbrough, UK
| | | | - Sharon Hamilton
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | | | - Andrea Jones
- Darlington and Hartlepool and Stockton Clinical Commisioning Group, Darlington, UK
| | - Glynis Peat
- James Cook University Hospital, Middlesbrough, Middlesbrough, UK
| | - Denis J Martin
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| |
Collapse
|
5
|
Jess MA, Ryan C, Hamilton S, Wellburn S, Atkinson G, Greenough C, Peat G, Coxon A, Fatoye F, Ferguson D, Dickson A, Ridley H, Martin D. Does Duration of Pain at Baseline Influence Longer-term Clinical Outcomes of Low Back Pain Patients Managed on an Evidence-Based Pathway? Spine (Phila Pa 1976) 2021; 46:191-197. [PMID: 33079915 DOI: 10.1097/brs.0000000000003760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Nonrandomized longitudinal observational study. OBJECTIVE The aim of this study was to evaluate the association between baseline pain duration and medium-to-long term clinical outcomes, in low back pain (LBP) patients enrolled on the North East of England Regional Back Pain and Radicular Pain Pathway (NERBPP). SUMMARY OF BACKGROUND DATA The NERBPP is based upon National Institute for Health and Care Excellence (NICE) guidelines. These guidelines no longer differentiate management of LBP patients based on pain duration. Medium-to-long term data from the NERBPP is lacking. METHODS Between May 2015 and December 2019, 786 and 552 LBP patients from the NERBPP returned 6-month and 12-month follow-up outcome measures, respectively. Outcomes included pain (Numerical rating scale), function (Oswestry Disability Index) and quality-of-life (EuroQol five-dimension, five-level questionnaire), analyzed using a series of covariate-adjusted models. Patients were categorized into four groups based upon baseline pain duration: <3 months, ≥3 to <6 months, ≥6 months to <12 months, ≥12 months. RESULTS Patients with <3 months duration demonstrated clinically important improvements on all outcomes, at both follow-ups. The improvements in outcomes from this group were larger than those in the ≥12 month's duration group (P < 0.05), these group differences in change, in some cases surpassed our threshold for clinical relevance. Functional improvements in those with ≥12 month's duration were not clinically relevant at either follow-up. All patients, regardless of baseline pain duration, reported similar levels of readiness to self-manage at the 12-month follow-up. CONCLUSION Baseline pain duration would appear to be of clinical importance. Patients with shorter baseline pain duration demonstrated better outcomes. Those with ≥12 month's duration of pain may need additional support during their management to achieve clinically relevant functional improvements in the medium-to-long term. These findings raise questions about the decision by NICE to move away from duration of pain to differentiate management of LBP patients.Level of Evidence: 3.
Collapse
Affiliation(s)
- Mary-Anne Jess
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Cormac Ryan
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Sharon Hamilton
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Shaun Wellburn
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Greg Atkinson
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | | | - Glynis Peat
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Andrew Coxon
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Francis Fatoye
- Department of Health Professions, Faculty of Health Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Diarmaid Ferguson
- Northumbria Healthcare NHS Trust, North Tyneside General Hospital, North Shields, UK
- Primary Care Rheumatology & Musculoskeletal Medicine (PCRMM) Society, York, North Yorkshire, UK
| | - Alastair Dickson
- Primary Care Rheumatology & Musculoskeletal Medicine (PCRMM) Society, York, North Yorkshire, UK
- GP Lead for the North of England Back and Radicular Pain Pathway, UK
| | - Helen Ridley
- Getting It Right First Time (GIRFT): Clinically-led improvement programme delivered in partnership with the Royal National Orthopedic Hospitals NHS Trust, NHS England and NHS Improvement, UK
| | - Denis Martin
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| |
Collapse
|
6
|
|
7
|
Ryan C, Vijayaraman A, Denny V, Ogier A, Ells L, Wellburn S, Cooper L, Martin D, Atkinson G. The association between musculoskeletal pain and weight change in patients attending a specialist weight management service. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
8
|
Ryan CG, Vijayaraman A, Denny V, Ogier A, Ells L, Wellburn S, Cooper L, Martin DJ, Atkinson G. The association between baseline persistent pain and weight change in patients attending a specialist weight management service. PLoS One 2017; 12:e0179227. [PMID: 28604789 PMCID: PMC5467875 DOI: 10.1371/journal.pone.0179227] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 05/25/2017] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To quantify the influence of baseline pain levels on weight change at one-year follow-up in patients attending a National Health Service specialist weight management programme. METHODS We compared one-year follow-up weight (body mass) change between patient sub-groups of none-to-mild, moderate, and severe pain at baseline. A mean sub-group difference in weight change of ≥5kg was considered clinically relevant. RESULTS Of the 141 complete cases, n = 43 (30.5%) reported none-to-mild pain, n = 44 (31.2%) reported moderate pain, and n = 54 (38.3%) reported severe pain. Covariate-adjusted mean weight loss (95%CI) was similar for those with none-to-mild (8.1kg (4.2 to 12.0kg)) and moderate pain (8.3kg (4.9 to 11.7kg). The mean weight loss of 3.0kg (-0.4 to 6.4kg) for the severe pain group was 5.1kg (-0.6 to 10.7, p = 0.08) lower than the none-to-mild pain group and 5.3kg (0.4 to 10.2kg, p = 0.03) lower than the moderate pain group. CONCLUSIONS Patients with severe pain upon entry to a specialist weight management service in England achieve a smaller mean weight loss at one-year follow-up than those with none-to-moderate pain. The magnitude of the difference in mean weight loss was clinically relevant, highlighting the importance of addressing severe persistent pain in obese patients undertaking weight management programmes.
Collapse
Affiliation(s)
- Cormac G. Ryan
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom
- * E-mail:
| | - Arutchelvam Vijayaraman
- Specialist Weight Management Service, South Tees Hospitals NHS Foundation Trust, NHS, Middlesbrough, United Kingdom
| | - Victoria Denny
- Specialist Weight Management Service, South Tees Hospitals NHS Foundation Trust, NHS, Middlesbrough, United Kingdom
| | - Alison Ogier
- Specialist Weight Management Service, South Tees Hospitals NHS Foundation Trust, NHS, Middlesbrough, United Kingdom
| | - Louisa Ells
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom
| | - Shaun Wellburn
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom
| | - Lesley Cooper
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom
| | - Denis J. Martin
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom
| | - Greg Atkinson
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom
| |
Collapse
|
9
|
Ryan CG, Wellburn S, McDonough S, Martin DJ, Batterham AM. The association between displacement of sedentary time and chronic musculoskeletal pain: an isotemporal substitution analysis. Physiotherapy 2017; 103:471-477. [PMID: 28818451 DOI: 10.1016/j.physio.2017.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 01/19/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Physical activity is an effective intervention for the prevention and management of chronic musculoskeletal pain (CMP). However, there is a lack of research to inform the intensity of physical activity that should be recommended. The aim of this study was to investigate the association between substituting 10minutes of sedentary time with either 10minutes of light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) and the CMP prevalence ratio. DESIGN Secondary Analysis (November 2015) of data from the Health Survey for England (2008). PARTICIPANTS 2313 adults (≥16years). MAIN OUTCOME MEASURES Sedentary time, LPA and MVPA were measured using accelerometry. We used isotemporal models to quantify the prevalence ratio for CMP of replacing 10minutes of sedentary time with 10minutes of LPA or MVPA. RESULTS The prevalence of CMP in this sample was 17%. The unadjusted prevalence ratio was 0.99 (95% CI: 0.97 to 1.01) for LPA and 0.76 (0.70 to 0.84) for MVPA. The fully adjusted prevalence ratio was 1.01 (95% CI: 0.99 to 1.02) for LPA and 0.89 (0.82 to 0.96) for MVPA. CONCLUSIONS Substituting 10minutes of sedentary time with an equivalent period of LPA was not associated with a reduction in the prevalence ratio for CMP, whereas the equivalent replacement with MVPA showed a small protective relationship. Regarding CMP prevalence, physical activity intensity appears to be important, with MVPA rather than LPA showing a protective relationship. Prospective studies are needed to investigate causality.
Collapse
Affiliation(s)
- Cormac G Ryan
- Health and Social Care Institute, Teesside University, Middlesbrough, TS1 3BA, UK.
| | - Shaun Wellburn
- Health and Social Care Institute, Teesside University, Middlesbrough, TS1 3BA, UK
| | - Suzanne McDonough
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown, UK
| | - Denis J Martin
- Health and Social Care Institute, Teesside University, Middlesbrough, TS1 3BA, UK
| | - Alan M Batterham
- Health and Social Care Institute, Teesside University, Middlesbrough, TS1 3BA, UK
| |
Collapse
|
10
|
Wellburn S, Ryan CG, Azevedo LB, Ells L, Martin DJ, Atkinson G, Batterham AM. Displacing Sedentary Time: Association with Cardiovascular Disease Prevalence. Med Sci Sports Exerc 2016; 48:641-7. [PMID: 26559454 DOI: 10.1249/mss.0000000000000816] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Isotemporal substitution analysis offers new insights for public health but has only recently been applied to sedentary behavior research. We aimed to quantify associations between the substitution of 10 min of sedentary behavior with 10 min of light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) and the prevalence of cardiovascular disease (CVD). Age was also explored as a potential effect modifier. METHODS We completed a secondary analysis of data from 1477 adults from the Health Survey for England (2008). Sedentary time, LPA, and MVPA were measured using accelerometry. We applied isotemporal models to quantify the relationship with CVD prevalence of replacing 10 min of sedentary time with equivalent amounts of LPA or MVPA. Prevalence risk ratios (RR) with 95% confidence intervals (CI) are presented, adjusted for covariates. The role of age as an effect modifier was explored via age-MVPA and age-LPA interactions. CVD was defined as per the International Classification of Diseases. RESULTS The prevalence of CVD was 24%. The RR was 0.97 (95% CI, 0.96-0.99) for LPA and 0.88 (0.81-0.96) for MVPA. Substitution of approximately 50 min of LPA would be required for an association equivalent to 10 min of MVPA. The beneficial association of MVPA was attenuated with age, with a decrease in the relative risk reduction of approximately 7% per decade. CONCLUSIONS Isotemporal substitution of sedentary time with LPA was associated with a trivial relative risk reduction for CVD, whereas the equivalent replacement with MVPA had a small beneficial relationship. With respect to CVD prevalence, MVPA might become decreasingly important in older individuals. Prospective studies are needed to investigate causality.
Collapse
Affiliation(s)
- Shaun Wellburn
- Health and Social Care Institute, Teesside University, Middlesbrough, UNITED KINGDOM
| | | | | | | | | | | | | |
Collapse
|
11
|
Ryan C, Wellburn S, Mcdonough S, Martin D, Batterham A. The association between displacement of sedentary time and chronic musculoskeletal pain: an isotemporal substitution analysis. Physiotherapy 2016. [DOI: 10.1016/j.physio.2016.10.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
12
|
Wellburn S, Bettany-Saltikov J, Martin D, Van Schaik P. Websites recommended to patients with adolescent idiopathic scoliosis at first point of diagnosis: a content analysis. Scoliosis 2012. [PMCID: PMC3304783 DOI: 10.1186/1748-7161-7-s1-o35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|