Sedentary behavior and physical function: objective evidence from the Osteoarthritis Initiative.

Relationship of pase to moderate/vigorous physical activity measured by accelerometry in the osteoarthritis initiative

Background: Physical activity has been shown to be of great benefit to people with an inflammatory arthritis (IA), however people with an IA have been shown to be very inactive compared to the general population. The aims of this study were therefore to 1) identify barriers and facilitators to sustaining healthy physically active behaviour in people with inflammatory arthritis; 2) assess whether people with inflammatory arthritis sustain physical activity levels through recreational exercise in the first 12 months following completion of an NHS exercise therapy program, and which factors affect physical activity levels; 3) describe the course of health and health-related quality of life outcomes from the start of a supervised and NHS-delivered exercise therapy programme through to 12-months post-program completion in people with inflammatory arthritis; and 4) determine whether the course of health and health-related quality of life depend upon physical activity levels in people with inflammatory arthritis. Method: The study was an embedded mixed methods approach with the main component being a prospective cohort study with an embedded qualitative component through focus groups. 137 participants were recruited from referrals into the inflammatory arthritis exercise programme from across NHS Greater Glasgow & Clyde Health Board. Results: At baseline, 29% of people with an IA met current physical activity guidelines and on average spent 10 hours a day in sedentary behaviour (SB). Ninety per cent of the cohort self-reported that they successfully transitioned from a NHS-run Inflammatory Arthritis Exercise Programme onto exercising in the community. However, this was not supported by objective physical activity data as there was no reduction in SB nor an increase in physical activity. A specific barrier to physical activity in people with an IA was found to be the unpredictable nature of their condition. However, no disease specific characteristics were found to be predictors of physical activity. A specific facilitator was having access to physiotherapy led exercise classes however, a predictor of physical activity was that of attending an exercise facility in the community. Other barriers and facilitators were found to be similar to those in the general population such as availability, accessibility and affordability of exercise and recreational facilities linked to locations, transport options and cost. Other facilitators were similar to those found in people living with other chronic long-term conditions such as the importance of peer support. Over the course of the 15-month cohort study, there was little change in physical activity and health-related quality of life within individual participants. Therefore, the majority of variance for time spent in moderate-to-vigorous physical activity (MVPA) and SB over time is between participants as opposed to within participants. A value of 22.4 % of the between participant variance for time spent in MVPA can be explained by BMI, pain, fatigue, HADs, 6-minute walk test and attending a community exercise facility variables; with BMI, the 6-minute walk test and attending a community exercise facility being significant predictors. The higher the BMI, the less time spent in MVPA; the more distance covered in the 6-minute walk test, the more time spent in MVPA; and by attending an exercise facility in the community, the more time spent in MVPA a week. A value of 6.1 % of the between participant variance for time spent in SB can be explained by gender, pain, ASES, HADs, 6-minute walk test and attending a community exercise facility; with gender being a significant predictor. Males spend more time in SB a week. A value of 61.6% of the variance for the physical function domain of the SF-36 can be explained by time spent in MVPA, age, disease duration, DAS-28, fatigue, ASES, SIMD and 6-minute walk test. A value of 43.4% of the variance for the role limitations due to emotional problems domain of the SF-36 can be explained by SB, age, diagnosis, ASES and HADs. Conclusions: Patients with IA are inactive and spent a lot of time in SB. People with an IA have similar barriers and facilitators to exercise as the general population and those living with other chronic long-term conditions. A barrier which appears to be unique to this population group is that of the unpredictable nature of their condition. Predictors of time spent in MVPA are BMI, the 6-minute walk test and attending a community exercise facility. A predictor of SB is gender, with males spending more time in SB. Physical activity and SB appear to determine aspects of health-related quality of life in people with an IA.

Evidence on whether nutritional supplementation affects physical activity (PA) during early childhood is limited. We examined the long-term effects of lipid-based nutrient supplements (LNS) on total PA, moderate-to-vigorous PA (MVPA) and sedentary behaviour (SB) of children at 4–6 years using an accelerometer for 1 week. Their mothers were enrolled in the International Lipid-based Nutrient Supplement-DYAD randomised controlled trial in Ghana, assigned to daily LNS or multiple micronutrients (MMN) during pregnancy through 6 months postpartum or Fe and folic acid (IFA) during pregnancy and placebo for 6 months postpartum. From 6 to 18 months, children in the LNS group received LNS; the other two groups received no supplements. Analysis was done with intention to treat comparing two groups: LNS v. non-LNS (MMN+ IFA). Of the sub-sample of 375 children fitted with accelerometers, 353 provided sufficient data. Median vector magnitude (VM) count was 1374 (interquartile range (IQR) 309), and percentages of time in MVPA and SB were 4·8 (IQR 2) and 31 (IQR 8) %, respectively. The LNS group (n 129) had lower VM (difference in mean −73 (95 % CI −20, −126), P = 0·007) and spent more time in SB (LNS v. non-LNS: 32·3 v. 30·5 %, P = 0·020) than the non-LNS group (n 224) but did not differ in MVPA (4·4 v. 4·7 %, P = 0·198). Contrary to expectations, provision of LNS in early life slightly reduced the total PA and increased the time in SB but did not affect time in MVPA. Given reduced social-emotional difficulties in the LNS group previously reported, including hyperactivity, one possible explanation is less restless movement in the LNS group.

PURPOSE: Preliminary evidence suggests osteoarthritis (OA) is a risk factor for dementia. One potential reason is 87% of adults with OA are inactive, and low moderate-to-vigorous physical activity (MVPA) and high sedentary behaviour (SB) are each risk factors for brain atrophy. While regular MVPA and low SB are thus critical for brain health, it is unclear 1) what aspects of brain structure are associated with these behaviours among adults with OA; and 2) whether the relationships of MVPA and SB with brain structure are independent of each other. Hence, we investigated the independent relationships of MVPA and SB with brain structure in adults with knee OA. METHODS: This was a secondary cross-sectional analysis of a six month, proof-of-concept randomized controlled trial (RCT) to promote MVPA and reduce SB among adults with knee OA. At study entry, we objectively measured MVPA and SB for 7 days using the SenseWear Mini. Following this observation period, participants (N= 30) underwent a 3T magnetic resonance image (MRI) scan, wherein T1-weighted structural MRIs were performed to measure cortical thickness. We performed regression analyses using a surface-based cluster size exclusion method for multiple comparisons within the FreeSurfer neuroimaging software to determine if 1) MVPA was associated with greater cortical thickness independent of SB; and 2) SB was associated with less cortical thickness independent of MVPA. RESULTS: Participants had a mean age of 61 years (SD= 9 years), and 80% were female. Higher MVPA was associated with greater cortical thickness in the temporal pole (cluster size= 855 mm2; p< 0.05) and superior frontal area (cluster size= 1204 mm2; p< 0.05) of the left hemisphere independent of SB. SB was not associated with greater cortical thickness in any region independent of MVPA. CONCLUSIONS: Higher MVPA is associated with greater cortical thickness in adults with OA, however SB does not appear to be strongly associated with brain structure. Promoting MVPA among adults with OA may thus be an important strategy for maintaining cognitive health among this population.

Introduction: Sleep, sedentary behavior, and physical activity are each independently associated with cardiovascular health (CVH). However, many studies have investigated these relationships in isolation even though a change in any one given behavior will affect the time spent in the others. It is unknown how reallocating time in sedentary behavior with sleep or physical activity effects overall CVH in a diverse cohort of men and women at risk of cardiovascular disease (CVD). Hypothesis: Reallocating 30 minutes of sedentary time with sleep, light (LIPA), or moderate to vigorous physical activity (MVPA) is associated with more favorable overall CVH due to improvements in risk factors for CVD. Methods: Data for this analysis were taken from the Multi-Ethnic Study on Atherosclerosis (MESA) Sleep Ancillary Study. Eligible participants (n= 1718) wore Actiwatch accelerometers for 24 hours a day, and had at least 3 days of valid accelerometry. Time spent in sleep, sedentary behavior, LIPA, and MVPA was determined based on an established algorithm. The American Heart Association’s life simple 7 was used to represent the CVH score after excluding the physical activity component, with higher scores indicating more favorable CVH. All components were ascertained from MESA exam 5. Isotemporal substitution modeling was conducted to examine the effect of substituting 30 minutes of sedentary time for an equivalent amount of sleep, LIPA, or MVPA. Results: The mean age of participants was 68.3, 54.0% were female and 38.6% were white. The mean CVH score was 5.9 (95%CI: 5.8-6.0). On average, participants spent 499.3 minutes/day in sedentary time, 415.3 minutes/day in LIPA, 26.0 minutes/day in MVPA, and 388.2 minutes/day sleeping. Reallocating 30 minutes of sedentary time to sleep, LIPA, and MVPA was associated with a significantly higher CVH score [β(SE): 0.077(0.023), 0.039(0.017), and 0.485(0.065) respectively]. Reallocating 30 minutes of sedentary time to sleep was associated with lower BMI. Reallocating 30 minutes of sedentary time to LIPA was associated with higher diastolic blood pressure and total cholesterol, and lower BMI. Reallocating 30 minutes of sedentary time to MVPA was associated with lower systolic and diastolic blood pressure, and lower BMI. Conclusions: Our study demonstrates that sleep, LIPA, and MVPA are all positively associated with more favorable overall CVH and several key CVD risk factors. These findings underscore the importance of lifestyle modifications in improving CVH.

Physical activity is associated with improved pain, functional status, and less disability in persons with knee osteoarthritis (KOA). Because polypharmacy is related to several adverse health outcomes in older persons, we hypothesized that it might also be associated with decreased physical activity in those with KOA. This study evaluates the relationship between the number of prescription medications and weekly moderate to vigorous physical activity (MVPA). We used hierarchical median quantile regression analysis to examine the cross-sectional association between the number of prescription medications taken in the past 30 days and the median objectively measured MVPA minutes controlling for demographic and clinical variables. Four Osteoarthritis Initiative (OAI) recruitment centers in Providence, Rhode Island; Columbus, Ohio; Baltimore, Maryland; and Pittsburgh, Pennsylvania. Accelerometer monitoring occurred in 2,127 OAI participants. Of these, 1,889 participants had 4 or more days of valid physical activity monitoring data and complete medication/covariate data. Data were collected at the 48-month OAI follow-up visit (2008-2010). The outcome was weekly minutes of MVPA measured with an accelerometer. Number/type of prescribed medications and covariate data (age, sex, race/ethnicity, body mass index, presence of comorbidities, pain, depressive symptoms, and radiographic KOA severity) were taken from the public OAI database. Polypharmacy was defined as taking five or more prescribed medications. The prevalence of polypharmacy in the study population was 28.2%. Each additional prescription medication was related to a decrease of 3.6 minutes (95% confidence interval [CI] = -4.8 to -2.1) in median weekly MVPA minutes. Participants meeting the polypharmacy criterion exhibited a decrease of 12.6 minutes (95% CI = -21.2 to -4.7) in median weekly MVPA minutes compared with those not meeting the criterion. An increased number of prescription medications and polypharmacy are associated cross-sectionally with decreased MVPA in adults with KOA. Further study is necessary to establish the causal nature of this association.

The association between obesity and sedentary behavior or daily physical activity among children with Down's syndrome aged 7–12 years in Japan: A cross-sectional study

Functional limitations, sedentary time and light physical activity on 24-month clinical outcomes in patients with knee osteoarthritis

Resistance training leads to large improvements in strength and moderate improvements in physical function in adults who are overweight or obese: asystematic review.

BackgroundFor people with prediabetes and type 2 diabetes it is important to be regularly physical active. Increasing and maintaining physical activity (PA) can be challenging. The aim of this study was to evaluate the effects of a pedometer-based intervention on PA, with a compositional data analysis (CoDA) approach, in individuals with prediabetes or type 2 diabetes.MethodsLongitudinal data on 188 participants with prediabetes and type 2 diabetes (40% female, mean age = 64.1 years) from a three-armed randomized controlled trail, the Sophia Step Study, was used. The three groups were a multi?component group (self?monitoring of steps with a pedometer, together with group (12 occasions) and individual counselling (10 occasions)), a single?component group (self?monitoring of steps with a pedometer, without counselling) and a standard care group. PA (moderate-to-vigorous PA (MVPA), light-intensity PA (LIPA) and sedentary behaviour (SB)) during the awake time were measured with ActiGraph GT1M accelerometer at baseline, 6, 12, 18 and 24 months. Relative time in MVPA, LIPA and SB for each participant at each measurement point was calculated by using the CoDA approach. Linear mixed models were used to evaluate the intervention effect between the three groups on the relative time in MVPA, LIPA and SB over the two-year period.ResultsIn total, 41% had ≤30 min MVPA at baseline. Significant group by time interactions were found for the multi-component group and the standard care group for the relative time in MVPA, at 6, 18 and 24 months. Differences in predicted group means between the groups were 1.2% at 6 months, 1.3% at 18 months and 0.9% at 24 months. Significant group by time interactions were also found for the single-component group and the standard care group for the relative time in MVPA at 24 months, with a difference in predicted group means of 0.8%. No significant interactions for LIPA or SB were found.ConclusionsThe multi-component group and the single-component component group maintained their relative time in MVPA, while the standard care group decreased their relative time in MVPA over the two-year period. This indicate that the Sophia Step Study intervention can prevent a decrease in MVPA in people with prediabetes and type 2 diabetes.

BackgroundLocomotive syndrome (LS) is a condition of reduced mobility due to a disorder of the locomotive system. Increasing moderate to vigorous physical activity (MVPA) has been recommended to prevent LS. However, to increase daily MVPA is difficult for older people with LS. The MVPA consists of not only locomotive activities such as walking but also non-locomotive activities such as household activities. The aim of this study was to examine the associations between locomotive/non-locomotive MVPA and physical performance in older females with and without LS.MethodsParticipants of this cross-sectional study were 143 older community-dwelling Japanese females. The participants were divided into two groups based on the results of the stand-up test: the normal group (NL) (n = 86) and the LS group (n = 57). Both the locomotive and non-locomotive PA seperately measured with its intensity. The intensity of physical activity (PA) was calculated as METs and classified as sedentary behavior (SB 1–1.5 metabolic equivalent tasks (METs)), low-intensity physical activity (LPA 1.6–2.9 METs), and MVPA (≥ 3 METs). For example, locomotive LPA is slow walking speed of 54 m/min, and locomotive MVPA is walking speed of 67 m/min. While non-locomotive LPA is office work and cooking, non-locomotive MVPA is housecleaning. Physical function was evaluated by handgrip strength, walking speed, and 2-step test.ResultsWalking speed, hand-grip strength, 2-step test, daily step counts, and all PA measurements were not significantly different between two groups. In the LS, locomotive MVPA (r = 0.293, p < 0.05) and total MVPA (r = 0.299, p < 0.05) was significantly correlated with walking speed, but not in the NL.ConclusionsWalking speed was positively correlated with locomotive MVPA and total MVPA in the LS group, but not in NL group. This result suggests that slow walking speed in older people with LS occur in connection with lower locomotive MVPA and total MVPA.

BackgroundOlder adults have low physical activity(PA) and high sedentary behaviour(SB) levels. We investigate how total volume and specific patterns of moderate to vigorous PA(MVPA), light PA(LPA) and SB are related to adiposity and metabolic syndrome (MS). Then, with reference to physical activity guidelines which encourage MVPA in bouts > =10 min and avoiding “long” sedentary bouts, we investigate whether accumulating PA and SB in bouts of different defined durations are differently associated with these outcomes.MethodsCross-sectional study of men (71–91 years) recruited in UK primary care centres. Nurses made physical measures (weight, height, bio-impedance, blood pressure) and took fasting blood samples. 1528/3137 (49 %) surviving men had ≥3 valid days (≥600 min) accelerometer data. 450 men with pre-existing chronic disease were excluded. 1009/1078 (93.6 %) had complete covariate data.ResultsMen (n = 1009, mean age 78.5(SD 4.7) years) spent 612(SD 83), 202(SD 64) and 42(SD 33) minutes in SB, LIPA and MVPA respectively. Each additional 30 min/day of SB and MVPA were associated with 0.32 (95 % CI 0.23, 0.40)Kg/m2 higher Body Mass Index (BMI) and −0.72(−0.93, −0.51) lower BMI Kg/m2 respectively. Patterns for waist circumference (WC), fat mass index (FMI), fasting insulin and MS were similar. MVPA in bouts lasting <10 min or ≥10 min duration were not associated differently with outcomes. In models adjusted for total MVPA, each minute accumulated in SB bouts lasting 1–15 min was associated with lower BMI −0.012 kg/m2, WC −0.029 cm, and OR 0.989 for MS (all p < 0.05), and coefficients for LPA bouts 1–9 min were very similar in separate models adjusted for total MVPA. Minutes accumulated in SB bouts 1–15 min and LPA bouts 1–9 min were correlated, r = 0.62.ConclusionsObjectively measured MVPA, LPA and SB were all associated with lower adiposity and metabolic risk. The beneficial associations of LPA are encouraging for older adults for whom initiating MVPA and maintaining bouts lasting ≥10 min may be particularly challenging. Findings that short bouts of LPA (1–9 min) and SB (1–15 min), but that all MVPA, not just MVPA accumulated in bouts ≥10 min were associated with lower adiposity and better metabolic health could help refine older adult PA guidelines.

BackgroundGiven that limited research has examined the relationships between lifestyle activities of varying intensities, including moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and sedentary behavior (SB), and dynapenia, which refers to an age-related decline in muscle function, this study aimed to investigate the longitudinal associations between MVPA, LPA, and SB and the risk of dynapenia among older adults in Taiwan.MethodsThis longitudinal study included older adults aged ≥ 65 years with independent mobility, recruited from the National Taiwan University Hospital. Baseline data were collected from September 2020 to December 2021 and follow-up data were collected until December 2022. Participants wore a tri-axial accelerometer (GT3X + ActiGraph) on the hip for seven consecutive days to evaluate baseline time spent of MVPA (≥ 2020 counts/min), LPA (100–2019 counts/min), and SB (< 100 counts/min). To confirm the dynapenia classification at baseline and follow-up, participants underwent standard assessments, including handgrip dynamometry for muscle strength, bioelectrical impedance analysis for muscle mass, and a 6-m walk test for physical performance. Adjusted binary logistic regression analyses were conducted to examine the association between lifestyle activities and dynapenia risks.ResultsAmong 154 participants (mean age 80.3 ± 7.2 years; 53.9% women), 53.9% were classified as having dynapenia at baseline, compared to 55.2% at follow-up. Participants spent an average of 16.9 (± 26.6) min in MVPA, 249.5 (± 85.7) min in LPA, and 604.5 (± 76.4) min in SB daily. The longitudinal analysis results indicated that higher MVPA time was significantly associated with lower odds of dynapenia in both the unadjusted (odds ratio [OR] = 0.625, 95% confidence interval [CI]: 0.466–0.837) and fully adjusted models (OR = 0.578, 95% CI: 0.406–0.823). Each additional 10 min/day of MVPA was associated with 42.2% lower odds of dynapenia in the adjusted model. No significant prospective associations were observed between the LPA or SB time and dynapenia.ConclusionThis study provides longitudinal evidence that higher MVPA levels are significantly associated with a reduced dynapenia risks among community-dwelling older adults in Taiwan. These findings underscore the importance of promoting MVPA as a part of lifestyle interventions aimed at preserving muscle function and preventing dynapenia in older populations.

The clinical relevance of Tai Chi on pain, stiffness, and physical function in adults with knee osteoarthritis (KOA) has not been established. Therefore, the purpose of the current study was to address this gap. Eight randomized controlled trials from a recent meta-analysis representing 407 participants (216 Tai Chi, 191 control) in adults ≥18 years of age with KOA and included the assessment of pain, stiffness, and physical function using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were assessed. The inverse variance heterogeneity model (IVhet) was first used to pool standardized mean difference effect sizes (ES) for each outcome. Clinical relevance, i.e., number-needed-to treat (NNT) ≤10 and relative risk reduction (RRR) ≥25% was calculated across assumed controlled risks (ACR) ranging from 0.01 to 0.99. Statistically significant improvements were found for pain (ES, −0.75, 95% CI, −0.99, −0.51; Q = 8.9, p = 0.26; I2 = 21%), stiffness (ES, −0.70, 95% CI, −0.95, −0.46; Q = 9.6, p = 0.21; I2 = 27%), and physical function (ES, −0.91, 95% CI, −1.12, −0.70; Q = 7.2, p = 0.40; I2 = 3%). The intersection of results for a NNT ≤10 and RRR ≥25% yielded high evidence and clinically relevant improvements across a wide range of ACR for pain (0.15 to 0.88), stiffness (0.15 to 0.87), and physical function (0.13 to 0.97). These findings suggest that Tai Chi results in statistically significant as well as clinically important improvements in pain, stiffness, and physical function across a wide range of ACR in adults with KOA.

Physical activity (PA) and sedentary behavior (SB) are key determinants of health outcomes in individuals living with type 1 diabetes (T1D). However, the influence of sociodemographic and clinical factors on engagement in these behaviors is not yet well understood. This study aimed to analyze the associations of sociodemographic factors, body mass index, and both the duration and age at diagnosis of diabetes with SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) in Brazilian adults. A cross-sectional study was conducted at the Diabetes and Metabolism Service of a public secondary care unit in Rio de Janeiro. One hundred adults diagnosed with T1D had their daily awake time spent in SB, LPA, and MVPA measured using triaxial accelerometers. Sociodemographic and clinical factors were assessed using questionnaires. Generalized Linear Models were used to analyze the relationships of these factors with SB, LPA, and MVPA. Significant associations were found between age, education level, and employment status with SB and LPA, but not with MVPA. On average, each additional year of age was associated with decreased time in SB and increased time in LPA. Higher education levels and unemployment were linked to more SB and less time in LPA. Age, education level, and employment status emerged as key sociodemographic predictors of SB and LPA in Brazilian adults living with T1D. These findings contribute to a better understanding of the sociodemographic determinants associated with SB and PA in individuals diagnosed with T1D.