Sedentary Behavior in People with and without a Chronic Health Condition: How Much, What and When?

Lucy K Lewis,Toby Hunt,Coralie English,Marie T Williams,Tim S Olds

doi:10.3934/publichealth.2016.3.503

Abstract

PurposeTo describe sedentary behaviors (duration, bouts and context) in people with and without a chronic health condition.MethodsDesign: Secondary analysis of two cross-sectional studies. Participants: People with stable chronic obstructive pulmonary disease (COPD) (n = 24, male:female 18:6) and their spousal carers (n = 24, 6:18); stroke survivors (n = 24, 16:8) and age- and sex-matched healthy adults (n = 19, 11:8). Level of physiological impairment was measured with post-bronchodilator spirometry (FEV1 %predicted) for people with COPD, and walking speed for people with stroke. Outcomes: Participants were monitored over seven days (triaxial accelerometer, Sensewear armband) to obtain objective data on daily sedentary time, and prolonged sedentary bouts (≥ 30 min). During the monitoring period, a 24-hour use of time recall instrument was administered by telephone interview to explore the context of sedentary activities (e.g. television, computer or reading). Sedentary time was quantified using accelerometry and recall data, and group differences were explored. Linear regression examined associations between physiological impairment and sedentary time.ResultsParticipant groups were similar in terms of age (COPD 75 ± 8, carers 70 ± 11, stroke 69 ± 10, healthy 73 ± 7 years) and body mass index (COPD 28 ± 4, carers 27 ± 4, stroke 31 ± 4, healthy 26 ± 4 kg.m−2). The healthy group had the lowest sedentary time (45% of waking hours), followed by the carer (54%), stroke (60%) and COPD (62%) groups (p < 0.0001). Level of physiological impairment was an independent predictor of waking sedentary time (p = 0.001).ConclusionsPeople with a chronic health condition spent more time sedentary than those without a chronic condition, and there were small but clear differences between groups in the types of activities undertaken during sedentary periods. The study findings may aid in the design of targeted interventions to decrease sedentary time in people with chronic health conditions.

Highlights

The term “sedentary” was used to indicate a lack of moderate-to-vigorous physical activity (MVPA)
A quarter of the stroke group (n = 6) were identified as having some cognitive impairment (MoCA ≤ 21) and spirometry data revealed nearly 20 percent (n = 5) of carers met chronic obstructive pulmonary disease (COPD) diagnosis according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2016) criteria despite not identifying themselves as having COPD
The key findings of this analysis of sedentary behaviors observed in aged people with either COPD or stroke, or without chronic conditions were: (1) percentage of waking time spent in sedentary behaviors differed significantly between groups across a continuum; (2) people with COPD or stroke spent significantly more time engaged in sedentary behaviors than otherwise healthy people; (3) people with COPD and stroke spent similar amounts of their waking days in sedentary behaviors; (4) groups did not differ for the percent of waking day spent sitting in bouts of > 30 minutes; and (5) there were small but clear differences between groups in the types of activities undertaken during sedentary periods

Summary

Introduction

The term “sedentary” was used to indicate a lack of moderate-to-vigorous physical activity (MVPA). Sedentary behavior has been associated with a number of chronic health conditions including cardiovascular disease, type 2 diabetes, obesity, breast and colon cancer, as well as with cardiovascular and all-cause mortality [2,3,4]. Both the total sedentary time and the pattern in which the time is accumulated appear to be important. While accelerometry has been shown to provide a valid measure of sedentary behavior [9], these devices do not provide information regarding the context or types of sedentary behaviors people are engaging in (e.g. using the computer, watching TV or driving in the car)

Methods

Results

Discussion

Conclusion