Correlates of sedentary behaviour and light physical activity in people living with rheumatoid arthritis: protocol for a longitudinal study

O’Brien, Ciara; Duda, Joan L.; Kitas, George D.; Zanten, Jet J.C.S. Veldhuijzen van; Metsios, George S.; Fenton, Sally A. M.

doi:10.31138/mjr.29.2.106

Cited by 10 publications

(12 citation statements)

References 93 publications

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“…As such, in developing interventions to reduce sedentary behaviour in RA, we must work not only work to understand patterns of sedentary time accumulation (ie, identify ‘sedentary windows’ of opportunity) but also to identify salient RA-related and non-RA-related determinants of sedentary behaviour that can be targeted by such interventions, in order to effectively encourage behavioural change. 33…”

Section: Discussionmentioning

confidence: 99%

Diurnal patterns of sedentary time in rheumatoid arthritis: associations with cardiovascular disease risk

et al. 2020

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ObjectivesResearch demonstrates that sedentary behaviour may contribute towards cardiovascular disease (CVD) risk in rheumatoid arthritis (RA). This study explored diurnal patterns of sedentary time and physical activity (PA) in RA and examined associations with long-term CVD risk.Methods97 RA patients wore an accelerometer for 7 days to assess sedentary time, light-intensity and moderate-to-vigorous-intensity PA. Estimated 10-year CVD risk was determined via QRISK score. Hourly estimates of sedentary time and PA (min/hour) were computed for valid-wear hours (ie, valid-wear = 60 min/hour of activity data, ≥3 days). Hourly data were averaged across time periods to represent morning (08:00–11:59), afternoon (12:00–17:59) and evening (18:00–22:59) behaviour. Participants providing data for ≥2 complete time periods/day (eg, morning/evening, or morning/afternoon) were used in the main analysis (n = 41). Mixed linear modelling explored the associations between 10-year CVD risk and within-person (time: morning, afternoon, evening) changes in sedentary time and PA.ResultsSedentary time was higher, and light-intensity and moderate-to-vigorous-intensity PA lower in the evening, compared to morning and afternoon. Significant interactions revealed individuals with higher CVD risk were more sedentary and did less light-intensity PA during the afternoon and evening. Findings remained significant after adjustment for disease duration, functional ability and erythrocyte sedimentation rate.ConclusionResults suggest that the evening time period may offer a significant window of opportunity for interventions to reduce sedentary behaviour in RA and contribute to associated improvements in CVD risk. Due to inverse patterns of engagement, replacing sedentary time with light-intensity PA may offer an effective approach for intervention.

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Section: Discussionmentioning

confidence: 99%

Diurnal patterns of sedentary time in rheumatoid arthritis: associations with cardiovascular disease risk

et al. 2020

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“…The study methodology is described in detail elsewhere [ 17 ]. Briefly, participants visited the hospital at two time points, 6 months apart; time point 1 (T1, baseline) and time point 2 (T2, 6-month follow-up).…”

Section: Methodsmentioning

confidence: 99%

“…The protocol of this study has been published previously (O’Brien et al 2018 [ 17 ]). As a result, some of the text included herein may duplicate information reported in the prior publication.…”

Section: Acknowledgementsmentioning

confidence: 99%

Pain and fatigue are longitudinally and bi-directionally associated with more sedentary time and less standing time in rheumatoid arthritis

et al. 2021

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Objectives The aims of this study were to examine the longitudinal and bi-directional associations between pain and fatigue with sedentary, standing and stepping time in Rheumatoid Arthritis (RA). Methods People living with RA undertook identical assessments at baseline (T1 [n = 104]) and 6-month follow-up (T2 [n = 54]). Participants completed physical measures (e.g. height, weight, body-mass index) and routine clinical assessments to characterise RA disease activity (Disease Activity Score-28). Participants also completed questionnaires to assess physical function (Health Assessment Questionnaire), pain (McGill Pain Questionnaire) and fatigue (Multidimensional Assessment of Fatigue Scale). Participants’ free-living sedentary, standing and stepping time (min/day) were assessed over 7 days using the activPAL3µTM. Statistical analysis: Hierarchical regression analysis was employed to inform the construction of path models, which were subsequently used to examine bi-directional associations between pain and fatigue with sedentary, standing and stepping time. Specifically, where significant associations were observed in longitudinal regression analysis, the bi-directionality of these associations was further investigated via path analysis. For regression analysis, bootstrapping was applied to regression models to account for non-normally distributed data, with significance confirmed using 95% confidence intervals. Where variables were normally distributed, parametric, non-bootstrapped statistics were also examined (significance confirmed via ß coefficients, with p < 0.05) to ensure all plausible bi-directional associations were examined in path analysis. Results Longitudinal bootstrapped regression analysis indicated that from T1 to T2, change in pain, but not fatigue, was positively associated with change in sedentary time. In addition, change in pain and fatigue were negatively related to change in standing time. Longitudinal non-bootstrapped regression analysis demonstrated a significant positive association between change in fatigue with change in sedentary time. Path analysis supported the hypothesised bi-directionality of associations between change in pain and fatigue with change in sedentary time (pain, ß = 0.38; fatigue, ß = 0.44) and standing time (pain, ß = –0.39; fatigue, ß = –0.50). Conclusion Findings suggest pain and fatigue are longitudinally and bi-directionally associated with sedentary and standing time in RA.

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“…Participants (n = 104) attended the laboratory to complete physical assessments and routine clinical evaluations, as per objective 1. Participants were asked to wear the GT3X+ and activPAL3 μ ™ for 7 days to assess free-living sedentary time and PA [23]. The GT3X+ was worn during all waking hours, removing for water-based activities.…”

Section: Objective 2 (Field-validation)mentioning

confidence: 99%

Measurement of sedentary time and physical activity in rheumatoid arthritis: an ActiGraph and activPAL™ validation study

et al. 2020

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Accurate measurement of sedentary time and physical activity (PA) is essential to establish their relationships with rheumatoid arthritis (RA) outcomes. Study objectives were to: (1) validate the GT3X+ and activPAL3 μ ™, and develop RAspecific accelerometer (count-based) cut-points for measuring sedentary time, light-intensity PA and moderate-intensity PA (laboratory-validation); (2) determine the accuracy of the RA-specific (vs. non-RA) cut-points, for estimating free-living sedentary time in RA (field-validation). Laboratory-validation: RA patients (n = 22) were fitted with a GT3X+, activPAL3 μ ™ and indirect calorimeter. Whilst being video-recorded, participants undertook 11 activities, comprising sedentary, lightintensity and moderate-intensity behaviours. Criterion standards for devices were indirect calorimetry (GT3X+) and direct observation (activPAL3 μ ™). Field-validation: RA patients (n = 100) wore a GT3X+ and activPAL3 μ ™ for 7 days. The criterion standard for sedentary time cut-points (RA-specific vs. non-RA) was the activPAL3 μ ™. Results of the laboratoryvalidation: GT3X-receiver operating characteristic curves generated RA-specific cut-points (counts/min) for: sedentary time = ≤ 244; light-intensity PA = 245-2501; moderate-intensity PA ≥ 2502 (all sensitivity ≥ 0.87 and 1-specificity ≤ 0.11). ActivPAL3 μ ™-Bland-Altman 95% limits of agreement (lower-upper [min]) were: sedentary = (− 0.1 to 0.2); standing = (− 0.7 to 1.1); stepping = (− 1.2 to 0.6). Results of the field-validation: compared to the activPAL3 μ ™, Bland-Altman 95% limits of agreement (lower-upper) for sedentary time (min/day) estimated by the RA-specific cut-point = (− 42.6 to 318.0) vs. the non-RA cut-point = (− 19.6 to 432.0). In conclusion, the activPAL3 μ ™ accurately quantifies sedentary, standing and stepping time in RA. The RA-specific cut-points offer a validated measure of sedentary time, light-intensity PA and moderate-intensity PA in these patients, and demonstrated superior accuracy for estimating free-living sedentary time, compared to non-RA cut-points.

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Correlates of sedentary behaviour and light physical activity in people living with rheumatoid arthritis: protocol for a longitudinal study

Cited by 10 publications

References 93 publications

Diurnal patterns of sedentary time in rheumatoid arthritis: associations with cardiovascular disease risk

Diurnal patterns of sedentary time in rheumatoid arthritis: associations with cardiovascular disease risk

Pain and fatigue are longitudinally and bi-directionally associated with more sedentary time and less standing time in rheumatoid arthritis

Measurement of sedentary time and physical activity in rheumatoid arthritis: an ActiGraph and activPAL™ validation study

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