Sedentary Behaviour In People Research Articles

A study protocol for a randomised controlled feasibility trial of an intervention to increase activity and reduce sedentary behaviour in people with severe mental illness: Walking fOR Health (WORtH) Study

BackgroundPeople with severe mental illness (SMI) are less physically active and more sedentary than healthy controls, contributing to poorer physical health outcomes in this population. There is a need to understand the feasibility and acceptability, and explore the effective components, of health behaviour change interventions targeting physical activity and sedentary behaviour in this population in rural and semi-rural settings.MethodsThis 13-week randomised controlled feasibility trial compares the Walking fOR Health (WORtH) multi-component behaviour change intervention, which includes education, goal-setting and self-monitoring, with a one-off education session. It aims to recruit 60 inactive adults with SMI via three community mental health teams in Ireland and Northern Ireland. Primary outcomes are related to feasibility and acceptability, including recruitment, retention and adherence rates, adverse events and qualitative feedback from participants and clinicians. Secondary outcome measures include self-reported and accelerometer-measured physical activity and sedentary behaviour, anthropometry measures, physical function and mental wellbeing. A mixed-methods process evaluation will be undertaken. This study protocol outlines changes to the study in response to the COVID-19 pandemic.DiscussionThis study will address the challenges and implications of remote delivery of the WORtH intervention due to the COVID-19 pandemic and inform the design of a future definitive randomised controlled trial if it is shown to be feasible.Trial registrationThe trial was registered on clinicaltrials.gov (NCT04134871) on 22 October 2019.

Smartphone applications for physical activity and sedentary behaviour change in people with cardiovascular disease: A systematic review and meta-analysis.

BackgroundSmartphone applications provide new opportunities for secondary prevention healthcare. This systematic review and meta-analysis aimed to determine if smartphone applications are effective at changing physical activity and sedentary behaviour in people with cardiovascular disease.MethodsSix electronic databases (Medline, CINAHL Plus, Cochrane Library, SCOPUS, Sports Discus and EMBASE) were searched from 2007 to October 2020. Cardiovascular disease secondary prevention physical activity or sedentary behaviour interventions were included where the primary element was a smartphone or tablet computer application (excluding SMS-only text-messaging). Study quality was assessed using validated tools appropriate for each study design. Random effects model was used and the pooled mean difference between post scores were calculated. Subgroup analyses were conducted to examine differences based on diagnosis, sample size, age, intervention duration, activity tracker use, target behaviour, and self-report versus device-measured outcome.ResultsNineteen studies with a total of 1,543 participants were included (coronary heart disease, n = 10; hypertension, n = 4; stroke, n = 3; heart failure, n = 1; peripheral artery disease, n = 1). Risk of bias was rated as high. Thirteen studies were included in the meta-analysis. Only two controlled studies reported on sedentary behaviour. Smartphone applications produced a significant increase of 40.35 minutes of moderate-to-vigorous intensity physical activity per week (7 studies; p = 0.04; 95% CI 1.03 to 79.67) and 2,390 steps per day (3 studies; p = 0.0007; 95% CI 1,006.9 to 3,791.2). Subgroup analyses found no difference when comparing diagnoses, sample size, activity tracker use, target behaviour and self-report versus device-measured outcome. Larger improvements in physical activity were noted in intervention durations of ≤3-months and participants ≥60yrs (95.35 mins.week-1; p = 0.05).ConclusionsSmartphone applications were effective in increasing physical activity in people with cardiovascular disease. Caution is warranted for the low-quality evidence, small sample and larger coronary heart disease representation. More rigorous research is needed to investigate the effect of smartphone applications across diagnoses and in sedentary behaviour.

Physical activity and sedentary behavior in people with spinal cord injury: Mitigation strategies during COVID-19 on behalf of ACSM-EIM and HL-PIVOT.

People with spinal cord injury (SCI) face unique challenges during the COVID-19 pandemic, including greater risk of poor COVID-19-related outcomes, increased social isolation, and restricted access to important services. Furthermore, COVID-19 related restrictions have decreased already low levels of physical activity (PA) in this population. Therefore, the purpose of this commentary is to: 1) address the impact of COVID-19 on PA and sedentary behavior (SB) in people with SCI; 2) provide potential SB reduction strategies to guide future research; and 3) provide recommendations to increase PA and reduce SB on behalf of the American College of Sports Medicine Exercise is Medicine (ACSM-EIM) and Healthy Living for Pandemic Event Protection (HL-PIVOT) using a social-ecological model targeting the individual-, social environment-, physical environment-, and policy-level determinants of behavior in people with SCI.

Six-week behaviour change intervention to reduce sedentary behaviour in people with chronic obstructive pulmonary disease: a randomised controlled trial

IntroductionThis study aimed to determine whether a 6-week behaviour change intervention was more effective than a sham intervention for reducing sedentary behaviour (SB) in people with chronic obstructive pulmonary disease...

The association between sleep deficits and sedentary behavior in people with mild Parkinson disease

Purpose: Sleep deficits are a common nonmotor symptom of Parkinson disease (PD). People with mild PD also achieve less physical activity (PA) than healthy older adults (HOA), but the relationship between sleep and PA in PD is unclear. This study examined associations between sleep and PA in participants with PD and HOA. Materials and Methods: Secondary analysis of a prospective observational study. Participants wore a commercially available activity monitor for two weeks. Wilcoxon Rank-Sum tests compared nighttime sleep, wakenings after sleep onset, number of wakenings, naps, step count, and PA intensity between PD and HOA groups. Age-adjusted regression models calculated associations between nighttime sleep and PA. Results: Per day, participants with PD slept 75 fewer minutes (p < 0.01), took 5,792 fewer steps (p < 0.001), achieved less PA at all intensities, and had 32% more sedentary time (p < 0.001) compared to HOA. Thirty minutes more sleep was associated with 26 fewer sedentary minutes for HOA (p = 0.01) and 25 fewer sedentary minutes for the PD group (p < 0.001). Conclusions: Sleep and PA are reduced in mild PD compared to HOA. Both groups demonstrated similar associations between reduced sleep and increased sedentary behavior. Results may encourage providers to screen for sleep deficits when promoting PA. IMPLICATIONS FOR REHABILITATION The use of a wrist-worn commercial activity and sleep monitor was well tolerated by both healthy older adults and people with mild Parkinson Disease in this study. People with mild Parkinson Disease slept less and were less active than a group of healthy older adults. Less sleep was associated with more sedentary behavior in both groups. The relationship between poor sleep and sedentary behavior in mild Parkinson Disease suggests that rehabilitation interventions may be optimized by targeting both physical activity and sleep deficits.

Interventions for reducing sedentary behaviour in people with stroke.

Stroke survivors are often physically inactive as well as sedentary,and may sit for long periods of time each day. This increases cardiometabolic risk and has impacts on physical and other functions. Interventions to reduce or interrupt periods of sedentary time, as well as to increase physical activity after stroke, could reduce the risk of secondary cardiovascular events and mortality during life after stroke. To determine whether interventions designed to reduce sedentary behaviour after stroke, or interventions with the potential to do so, can reduce the risk of death or secondary vascular events, modify cardiovascular risk, and reduce sedentary behaviour. In December 2019, we searched the Cochrane Stroke Trials Register, CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, Conference Proceedings Citation Index, and PEDro. We also searched registers of ongoing trials, screened reference lists, and contacted experts in the field. Randomised trials comparing interventions to reduce sedentary time with usual care, no intervention, or waiting-list control, attention control, sham intervention or adjunct intervention. We also included interventions intended to fragment or interrupt periods of sedentary behaviour. Two review authors independently selected studies and performed 'Risk of bias' assessments. We analyzed data using random-effects meta-analyses and assessed the certainty of the evidence with the GRADE approach. We included 10 studies with 753 people with stroke. Five studies used physical activity interventions, four studies used a multicomponent lifestyle intervention, and one study used an intervention to reduce and interrupt sedentary behaviour. In all studies, the risk of bias was high or unclear in two or more domains. Nine studies had high risk of bias in at least one domain. The interventions did not increase or reduce deaths (risk difference (RD) 0.00, 95% confidence interval (CI) -0.02 to 0.03; 10 studies, 753 participants; low-certainty evidence), the incidence of recurrent cardiovascular or cerebrovascular events (RD -0.01, 95% CI -0.04 to 0.01;10 studies, 753 participants; low-certainty evidence), the incidence of falls (and injuries) (RD 0.00, 95% CI -0.02 to 0.02; 10 studies, 753 participants; low-certainty evidence), or incidence of other adverse events (moderate-certainty evidence). Interventions did not increase or reduce the amount of sedentary behaviour time (mean difference (MD) +0.13 hours/day, 95% CI -0.42 to 0.68; 7 studies, 300 participants; very low-certainty evidence). There were too few data to examine effects on patterns of sedentary behaviour. The effect of interventions on cardiometabolic risk factors allowed very limited meta-analysis. Sedentary behaviour research in stroke seems important, yet the evidence is currently incomplete, and we found no evidence for beneficial effects. Current World Health Organization (WHO) guidelines recommend reducing the amount of sedentary time in people with disabilities, in general. The evidence is currently not strong enough to guide practice on how best to reduce sedentariness specifically in people with stroke. More high-quality randomised trials are needed, particularly involving participants with mobility limitations. Trials should include longer-term interventions specifically targeted at reducing time spent sedentary, risk factor outcomes, objective measures of sedentary behaviour (and physical activity), and long-term follow-up.

The impact of non-residential grandchild care on physical activity and sedentary behavior in people aged 50\u2009years and over: study protocol of the Healthy Grandparenting Project

BackgroundFinding effective ways to support people aged > 50 years to develop adequate levels of physical activity and sedentary behavior is necessary as these behaviors are positively related to the maintenance of functional independence and health-related quality of life. Given the widespread provision of grandparental child care, examining its impact on grandparents’ energy-expenditure related behavior in the broader context of health is imperative. Therefore, the Healthy Grandparenting Project will aim to investigate the levels of physical activity and sedentary behavior, body composition and health-related quality of life in grandparents caring for their grandchildren and to compare these outcomes with non-caregiving grandparents and older adults without grandchildren, both momentarily and over time. An additional purpose is to identify possible predictors of potential changes over time.MethodsA prospective cohort study will run over a period of 2 years, including three test occasions with a one-year time interval in between (T0 = baseline, T1 = 12 months, T2 = 24 months). A total of 276 participants will be recruited in Flanders through non-probability quota sampling (50–50% men-women), of which 92 caregiving grandparents, 92 non-caregiving grandparents and 92 non-grandparents. All three subsamples will be matched for age and sex. At each test occasion, anthropometric and body composition measurements will be determined. Participants’ levels of physical activity and sedentary behavior will be assessed both objectively and subjectively by means of accelerometry and self-report questionnaires. Information about their grandchildren and the provided grandparental care (if applicable) as well as their health-related quality of life will also be assessed using self-report questionnaires. Mixed modelling will be used to identify differences in physical activity, sedentary behavior, body composition and health-related quality of life between the subsamples at baseline, as well as to evaluate and compare changes in energy-expenditure related behavior over time between subsamples and to identify predictors of the detected changes.DiscussionThe Healthy Grandparenting Project is an innovative study examining the levels of physical activity and sedentary behavior in caregiving grandparents, non-caregiving grandparents and non-grandparents. Obtained results will help in the development of campaigns to maintain/improve health in adults at a more advanced age.Trial registrationclinicaltrials.gov, Identifier: NTC04307589. Registered March 2020.

Test-Retest Reliability of activPAL in Measuring Sedentary Behavior and Physical Activity in People With Type 2 Diabetes.

To investigate how changes in sedentary behavior relate to health outcomes, it is important to establish the test-retest reliability of activity monitors in measuring habitual sedentary behavior in people with type 2 diabetes (T2D) as a prerequisite for interpreting this information. Thus, the authors' objective was to examine the test-retest reliability of a common activity monitor (activPAL™) in measuring sedentary behavior and physical activity in people with T2D. Sedentary-time, standing-time, stepping-time, step-count, and sit-to-stand transitions were obtained from two 7-day assessment periods separated by at least 1 week. Test-retest reliability was determined with the intraclass correlation coefficient (ICC) to compare sedentary and activity measures between the 2 time points. A total of 30 participants with self-reported T2D completed the study (age 65 [6]y, 63% women, body mass index 33.3 [5] kg/m2). High test-retest reliability was found for sedentary-time (ICC = .79; 95% confidence interval [CI], .61-.89) and standing-time (ICC = .74; 95% CI, .53-.87). Very high test-retest reliability was found for stepping-time (ICC = .90; 95% CI, .81-.95), step-count (ICC = .91; 95% CI, .83-.96), and sit-to-stand transitions (ICC = .90; 95% CI, .79-.95). The activPAL™ device showed high to very high test-retest reliability in measuring all tested activity categories in people with T2D.

Validation of a Clinically Feasible Activity Monitor Which Measures Body Postures and Movements in Adults With Lower-Limb Amputation Who Wear a Prosthesis

Purpose: A simple single-unit activity monitor (Activ8), which is based on a tri-axial accelerometer, measures specific body postures and movements, and has potential for research and clinical practice to monitor and optimize physical behavior of people with chronic conditions. However, the validity of the Activ8 in people with lower-limb amputation is unknown. Studying validity in this specific group is needed because they often have postures and movements that differ from the normal population, and which might affect validity. Therefore our study aimed to validate the Activ8 to measure body postures and movements in people with a lower-limb amputation. Methods: Thirty people with a unilateral lower-limb amputation and who are able to walk with a prosthesis completed two activity protocols in a simulated home setting: one with basic activities (only one posture or movement) and one with functional activities from daily living. Outcomes of the Activ8 (used in thigh-fixed position and pocket position) were compared to outcomes of video observation (the reference method). Primary analyses focused on the agreement in duration of merged measures of physical activity (walking, running, cycling, standing) and sedentary behavior (lying/sitting) with the Activ8 used in thigh-fixed position. Additional analyses included the detection of specific types of physical activity, the effects of amputation level and cause, and the validity of the Activ8 in pocket position. Results: Overall percentage time differences between Activ8 (thigh-fixed position) and video observation for merged measures of physical activity and sedentary behavior outcomes were −2.7% and 2.3%, respectively. These percentages were −1.6% and 1.3% for the basic protocol, and −3.9% and 3.6% for the functional protocol, respectively. For specific postures and movements, differences were larger (ranging from −12.6% to 7.1%). Conclusion: The Activ8 activity monitor has acceptable validity to measure physical activity and sedentary behavior in people with a unilateral lower-limb amputation.

Is Symptomatic Fatigue Associated With Physical Activity and Sedentary Behaviors Among Persons With Multiple Sclerosis?

Background. Fatigue is a debilitating symptom in multiple sclerosis (MS) that may be associated with reduced physical activity and increased sedentary behavior. Objective. This study examined the associations among fatigue and device-measured physical activity and sedentary behavior in people with MS. Methods. The participants (n = 252) completed the Patient Determined Disease Steps (PDDS) and Fatigue Severity Scale (FSS) and wore a waist-mounted accelerometer for 7 days. Participants were divided into 2 groups based on fatigue severity as measured by the FSS scale. We compared percentage of wear time spent in sedentary, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) between the 2 groups. Results. Persons in the fatigued group (FSS score ≥ 4) spent a greater percentage of time in sedentary behavior (P = .004) and a lower percentage of time in LPA (P = .035). Persons in the fatigued group further spent a lower percentage of time in nontransformed MVPA (P < .001) and square-root-transformed MVPA (P < .001) than persons in the nonfatigued group. When controlling for PDDS scores and years of education, there were no longer significant differences between groups in sedentary behavior, LPA, or transformed MVPA values; the difference in nontransformed MVPA was still statistically significant but likely the result of nonnormally distributed data. Conclusion. The present study suggests that factors other than fatigue might be associated with physical activity and sedentary behavior in MS, and this group might benefit from focal behavioral interventions that take into account mobility status in persons with MS who have fatigue.

Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ)

BackgroundPhysical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness.MethodsThe five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments.ResultsEvidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ.ConclusionsThe SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.

Physical activity and sedentary behaviour and their associations with clinical measures in axial spondyloarthritis

Engaging in physical activity (PA) is a key aspect in the management of axial spondyloarthritis (axial SpA), however, its relationship with clinical measures is unknown. Previous research has mainly focused on subjective methods of measuring PA and sedentary behaviour (SB). The aim of this study was to explore the associations between objectively measured PA and SB with clinical measures in people with established axial SpA. Fifty participants were recruited from secondary-care rheumatology outpatient services in Glasgow, UK. Clinical measures collected included; Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life (ASQOL) and the Six Minute Walk Test (6MWT). PA and SB were measured using the activPAL3 tri-axial accelerometer. Data from forty-five participants were included (23 males, average age 49 ± 12 years). Participants accumulated an average of 93.2 ± 41.5 min/day walking with an average of 7200 ± 3397 steps/day. The majority of the day (65%) was spent sitting, accumulated in prolonged bouts. Walking time and steps taken/day were associated with better BASFI (r = − 0.395, p = 0.007 and r = − 0.404, p = 0.006), ASQOL (r = − 0.375, p = 0.011 and r = − 0.361, p = 0.015) and 6MWT (r = 0.396, p = 0.007 and r = 0.421, p = 0.004); while longer walking events were associated with better BASMI (rho = − 0.352, p = 0.018), BASFI (rho = − 0.316, p = 0.034) and 6MWT (rho = 0.404, p = 0.006). SB was associated with worse ASQOL (r = 0.380, p = 0.010) and 6MWT (6MWT, r = − 0.357, p = 0.016). In people with axial SpA PA is associated with better function, exercise capacity and spinal mobility, while SB is associated with lower exercise capacity and poor quality of life. These findings support the promotion of PA and reduction of SB in people with axial SpA.

Walking for Health: an Intervention to Increase Physical Activity and Reduce Sedentary Behaviour in People With SMI

Walking for Health: an Intervention to Increase Physical Activity and Reduce Sedentary Behaviour in People With SMI

Systematic review of sedentary behaviour in people with Down syndrome across the lifespan: A clarion call.

Individuals with Down syndrome (DS) experience health disparities possibly associated with high levels of sedentary behaviour (SB). We systematically reviewed SB measurement, levels, patterns, correlates, consequences and interventions in people with DS across the lifespan. We searched these databases: Embase; PubMed; Web of Science; Scopus; CINAHL; PsycINFO; SPORTDiscus; and Cochrane Library. We included quantitative studies published in English since 1 January 1990. We identified 17 eligible articles. Across studies, accelerometer-determined sedentary time was 552min/day (median: 542; range 392-680min/day). Sedentary time appeared higher than previously reported values in the general population, especially for youth with DS. Multivariate SB correlates were primarily familial and environmental. Sedentary behaviour consequences have not been exclusively studied. Motor skills training reduced SB in youth with DS. Sedentary behaviour research in this population is in early stages. Individuals with DS have high levels of SB that may be responsive to interventions.

Exploring adults\u2019 experiences of sedentary behaviour and participation in non-workplace interventions designed to reduce sedentary behaviour: a thematic synthesis of qualitative studies

BackgroundSedentary behaviour is any waking behaviour characterised by an energy expenditure of ≤1.5 metabolic equivalent of task while in a sitting or reclining posture. Prolonged bouts of sedentary behaviour have been associated with negative health outcomes in all age groups. We examined qualitative research investigating perceptions and experiences of sedentary behaviour and of participation in non-workplace interventions designed to reduce sedentary behaviour in adult populations.MethodA systematic search of seven databases (MEDLINE, AMED, Cochrane, PsychINFO, SPORTDiscus, CINAHL and Web of Science) was conducted in September 2017. Studies were assessed for methodological quality and a thematic synthesis was conducted. Prospero database ID: CRD42017083436.ResultsThirty individual studies capturing the experiences of 918 individuals were included. Eleven studies examined experiences and/or perceptions of sedentary behaviour in older adults (typically ≥60 years); ten studies focused on sedentary behaviour in people experiencing a clinical condition, four explored influences on sedentary behaviour in adults living in socio-economically disadvantaged communities, two examined university students’ experiences of sedentary behaviour, two on those of working-age adults, and one focused on cultural influences on sedentary behaviour. Three analytical themes were identified: 1) the impact of different life stages on sedentary behaviour 2) lifestyle factors influencing sedentary behaviour and 3) barriers and facilitators to changing sedentary behaviour.ConclusionsSedentary behaviour is multifaceted and influenced by a complex interaction between individual, environmental and socio-cultural factors. Micro and macro pressures are experienced at different life stages and in the context of illness; these shape individuals’ beliefs and behaviour related to sedentariness. Knowledge of sedentary behaviour and the associated health consequences appears limited in adult populations, therefore there is a need for provision of accessible information about ways in which sedentary behaviour reduction can be integrated in people’s daily lives. Interventions targeting a reduction in sedentary behaviour need to consider the multiple influences on sedentariness when designing and implementing interventions.

An observational study of self-reported sedentary behaviour in people with chronic obstructive pulmonary disease and bronchiectasis

BackgroundFew studies have examined sedentary behaviour in chronic respiratory disease. The limited evidence suggests that increased levels of sedentary behaviour are associated with increased mortality. ObjectivesThis study aimed to compare the level of self-reported sedentary behaviour in people with chronic obstructive pulmonary disease (COPD) and bronchiectasis as well as to identify associations between sedentary time with functional performance measures and health-related quality of life in the chronic respiratory disease group. MethodsAn observational study design was used. Participants completed the Sedentary Behaviour Questionnaire from which average sedentary time (hours/day) was determined. Functional performance was measured using the six-minute walk test, the four-metre gait speed test and the five sit-to-stand test. Health-related quality of life was measured using the St George's Respiratory Questionnaire. Sedentary time was compared between groups using an unpaired t-test. Univariate analysis explored relationships amongst variables. ResultsThe convenience sample consisted of 103 people with COPD [52% male; mean±SD age: 73±9 years, FEV1% predicted: 56±23] and 33 people with bronchiectasis [52% male; 74±8 years, FEV1% predicted: 69±25]. Average self-reported sedentary time in COPD was 7.6±2.7 hours/day and in bronchiectasis was 8.0±4.1 hours/day, with no between-group difference (−0.4, 95% CI −1.7, 0.8). No associations were found between sedentary time and any functional performance outcome or with health-related quality of life. ConclusionThere was no difference in the high sedentary time between people with COPD and bronchiectasis. Sedentary behaviour was not associated with functional performance or disease-related health-related quality of life in people with chronic respiratory disease.

Associations of the Built Environment With Physical Activity and Sedentary Time in Ugandan Outpatients With Mental Health Problems

This study investigated whether reported neighborhood variables explained variance in time spent walking, exercising, and being sedentary, in addition to mental health and demographic variables among Ugandan outpatients with mental illness. Ninety-nine outpatients (78 men; 31.1 [8.6]y) of the Butabika National Referral Hospital in Uganda completed the Neighborhood Environment Walkability Scale for Africa, the Simple Physical Activity Questionnaire, and the Brief Symptoms Inventory-18. Multiple regression analyses were performed. Seven percent of the variance in walking time was explained by the variance in anxiety/depression and an additional 13% by the variance in perceived mixed land use and the availability of roads and walking paths. Eight percent of the variance in exercise time was explained by variance in age and an additional 6% by the variance anxiety/depression. The availability of recreational space added 8%. Six percent of variance in time spent sedentary was explained by family income, while availability of roads and walking paths added another 6%. This study shows the relevance of availability of roads and walking paths and recreational space for more physical activity and less sedentary behavior in people with mental illness. This is particularly relevant in low-income countries where a rapid urbanization is taking place.

Assessing Physical Activity in People with Mental Illness: 23-Country Reliability and Validity of the Simple Physical Activity Questionnaire (SIMPAQ)

Background: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. Methods: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Investigators from 43 centres in 23 countries collected reliability and validity data on the SIMPAQ from patients with DSM or ICD mental illness diagnoses. Test-retest repeatability was assessed one-week apart. Criterion SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Findings: Data were obtained from 1,010 participants. The SIMPAQ had good test-retest reliability (Spearman rho approximately 0.70). Criterion validity for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Criterion validity of the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had greater criterion validity. This alternative method is recommended for use in future studies employing the SIMPAQ. Interpretation: The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals. Funding Statement: SR is funded by an NHMRC Early Career Fellowship (APP1123336). BS is supported by Health Education England and the National Institute for Health Research HEE/ NIHR ICA Programme Clinical Lectureship (ICA-CL-2017-03-001). FG and BS are part supported by the Maudsley Charity and the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London (NIHR CLAHRC South London) at King’s College Hospital NHS Foundation Trust with support from the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. JBA was supported by the Spanish Ministry of Education (FPU13/05130). Declaration of Interests: We confirm that authors have no competing interests. Ethics Approval Statement: Approval was obtained from the Human Research Ethics Committee (HREC) of UNSW Sydney, Australia (HC15586) as the lead site. Details of individual site ethics approvals from participating sites are listed in Supplementary material.

Effect of different operationalizations of sedentary behavior in people with chronic stroke

Purpose: Sedentary behavior is common in people with stroke and has devastating impact on their health. Quantifying it is important to provide people with stroke with adequate physical behavior recommendations. Sedentary behavior can be quantified in terms of posture (sitting) or intensity (low energy expenditure). We compared the effect of different operationalizations of sedentary behavior on sedentary behavior outcomes (total time; way of accumulation) in people with stroke.Methods: Sedentary behavior was analyzed in 44 people with chronic stroke with an activity monitor that measured both body postures and movement intensity. It was operationalized as: (1) combining postural and intensity data; (2) using only postural data; (3) using only intensity data. For each operationalization, we quantified a set of outcomes. Repeated measures ANOVA and Bland–Altman plots were used to compare the operationalizations.Results: All sedentary behavior outcomes differed significantly between all operationalizations (p < 0.01). Bland–Altman plots showed large limits of agreement for all outcomes, showing large individual differences between operationalizations.Conclusions: Although it was neither possible nor our aim to investigate the validity of the two-component definition of sedentary behavior, our study shows that the type of operationalization of sedentary behavior significantly influences sedentary behavior outcomes in people with stroke.Implications for RehabilitationReliable assessment of sedentary behavior after stroke is important in order to provide adequate physical behavior recommendations for people with stroke.Sedentary behavior can be operationalized in terms of body posture (sitting time) or in terms of movement intensity (time <1.5 MET) or as a combination of both criteria; this study reveals that the type of operationalization affects the different outcome measures used to quantify sedentary behavior.Comparing sedentary behavior outcomes requires caution and should only be done when sedentary behavior is operationalized in the same way.

Correlates of sedentary behavior in middle-aged and old age people with mild cognitive impairment: a multinational study

This was a cross-sectional study. Data from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. Individuals aged ≥50 years with MCI were included. SB was assessed by the Global Physical Activity Questionnaire. Associations between SB levels and the correlates were examined using multivariable linear and logistic regressions. 4,082 individuals aged ≥50 years with MCI (64.4 ± 17.0 years; 55.1% female) were included. The prevalence of high SB (i.e., ≥8 hours/day) was 14.0% (95%CI = 12.2%-16.0%), while the time spent sedentary was 262 ± 290 minutes/day. Correlates significantly associated with being sedentary ≥8 hours/day and time spent sedentary per day were, older age, being unemployed, depression, sleep problems, obesity (vs. normal weight), diabetes, stroke, poor self-rated health, and lower levels of social cohesion. Future research exploring interventions to reduce SB in people with MCI should target the identified sociodemographic and mental and physical health correlates, while the promotion of social cohesion may have the potential to increase the efficacy of future public health initiatives.