Insights on physical behavior while working from home: An ecological momentary assessment study.

Ever since the COVID-19 pandemic, working from home (WFH) has emerged as a common alternative work environment, but the possible influence on daily physical behavior (PB) (i.e., physical activity (PA), sedentary behavior (SB)) remains unclear. This study aimed to examine daily associations between PB and the work environment (i.e., WFH, working at the office (WAO)), as well as to explore and identify patterns of PB within each work environment. An observational study using a dual-accelerometer system to continuously assess PB for at least 5 days was conducted. The sample consisted of 55 participants providing 276 days of assessment. Additional demographic, contextual, and psychological variables were measured via baseline questionnaire and several smartphone prompts per day. To analyze the effects of the work environment on PB, multilevel analyses were conducted. For the identification of patterns within each work environment, latent class trajectory modelling was applied. Associations between the work environment and various PA parameters were found, indicating that WFH has a negative effect on MVPA time, steps, and physical activity intensity (MET), but a positive effect on short PA bouts (≤5 min). No associations between the work environment and any SB parameter (i.e., SB time, SB breaks, SB bouts) were found. Latent class trajectory modelling revealed three MVPA patterns for days WFH, and two patterns for days WAO. Given the growing prevalence of WFH and the positive health effects associated with MVPA, daily-tailored solutions to enhance MPVA while WFH are urgently needed.

Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry study.

BACKGROUND: Fatigue is one of the most commonly reported symptoms after subarachnoid hemorrhage (SAH) and is indirectly associated with physical activity (PA). Associations between fatigue and PA are primarily examined based on conventional measures (i.e. a single fatigue score or average PA levels), thereby assuming that fatigue and PA do not fluctuate over time. However, levels of fatigue and PA may not be stable and may interrelate dynamically in daily life. Insight in direct relationships between fatigue and PA in daily life, could add to the development of personalized rehabilitation strategies. Therefore we aimed to examine bidirectional relationships between momentary fatigue and PA in people with SAH. METHODS: People (n = 38) with SAH who suffer from chronic fatigue were included in an observational study using Ecological Momentary Assessment (EMA) and accelerometry. Momentary fatigue was assessed on a scale from 1 to 7 (no to extreme fatigue), assessed with 10-11 prompts per day for 7 consecutive days using EMA with a mobile phone. PA was continuously measured during this 7-day period with a thigh-worn Activ8 accelerometer and expressed as total minutes of standing, walking, running and cycling in a period of 45 min before and after a momentary fatigue prompt. Multilevel mixed model analyses including random effects were conducted. RESULTS: Mean age was 53.2 years (SD = 13.4), 58% female, and mean time post SAH onset was 9.5 months (SD = 2.1). Multilevel analyses with only time effects to predict fatigue and PA revealed that fatigue significantly (p < 0.001) increased over the day and PA significantly (p < 0.001) decreased. In addition, more PA was significantly associated with higher subsequent fatigue (ß = 0.004, p < 0.05) and higher fatigue was significantly associated with less subsequent PA (ß=-0.736, p < 0.05). Moreover, these associations significantly differed between participants (p < 0.001). CONCLUSIONS: By combining EMA measures of fatigue with accelerometer-based PA we found that fatigue and PA are bidirectionally associated. In addition, these associations differ among participants. Given these different bidirectional associations, rehabilitation aimed at reducing fatigue should comprise personalized strategies to improve both fatigue and PA simultaneously, for example by combining exercise therapy with cognitive behavioral and/or energy management therapy.

Daily patterns of fatigue after subarachnoid haemorrhage: an ecological momentary assessment study.

OBJECTIVE: To examine the daily course of, and factors associated with, momentary fatigue after subarachnoid haemorrhage, and to explore subgroups of patients with distinct diurnal patterns of fatigue. DESIGN: Observational study using ecological momentary assessment. SUBJECTS: A total of 41 participants with subarachnoid haemorrhage. METHODS: Patients with fatigue were included within one year post-onset. Momentary fatigue (scale 1-7) was assessed with repeated measurements (10-11 times/day) during 7 consecutive days. Multilevel-mixed-model analyses and latent-class trajectory modelling were conducted. RESULTS: Mean (standard deviation; SD) age of the group was 53.9 (13.0) years, 56% female, and mean (SD) time post-subarachnoid haemorrhage onset was 9.3 (3.2) months. Mean (SD) momentary fatigue over all days was 3.22 (1.47). Fatigue increased significantly (p < 0.001) over the day, and experiencing more burden of fatigue and day type (working day vs weekend day) were significantly (p < 0.05) associated with higher momentary fatigue. Three subgroups could be distinguished based on diurnal patterns of fatigue. The largest group (n = 17, 41.5%) showed an increasing daily pattern of fatigue. CONCLUSION: Momentary fatigue in patients with subarachnoid haemorrhage increases over the day, and diurnal patterns of fatigue differ between  participants. In addition to conventional measures, momentary measures of fatigue might provide valuable information for physicians to optimize personalized management of fatigue after subarachnoid haemorrhage.

Fatigue is Associated with Reduced Participation and Health-Related Quality of Life Five Years After Perimesencephalic Subarachnoid Haemorrhage: A Multicentre Cross-Sectional Study.

OBJECTIVE: To determine whether fatigue is associated with participation and health-related quality of life 5 years after perimesencephalic subarachnoid haemorrhage. DESIGN: Multicentre cross-sectional study. SUBJECTS: Forty-six patients with perimesencephalic subarachnoid haemorrhage. METHODS: Fatigue was assessed with the Fatigue Severity Scale, participation (frequency, restrictions, satisfaction) with the Utrecht Scale for Evaluation of Rehabilitation-Participation, healthrelated quality of life with the Stroke-Specific Quality of Life Scale-12, symptoms of depression and anxiety with the Hospital Anxiety and Depression Scale, and coping with the Coping Inventory for Stressful Situations. RESULTS: A total of 46 patients were included (63% men, mean age 50.4 ± 9.4 years), with a mean time of 4.7 ± 1.6 years after perimesencephalic subarachnoid haemorrhage onset. Fatigued patients (33%) had worse participation (p < 0.01) and health-related quality of life (p < 0.001) than non-fatigued patients, and more often had hypertension, depression, anxiety and emotion-oriented coping (p < 0.05). Fatigue severity was inversely and independently (p < 0.005) associated with participation frequency (B = -3.62), satisfaction (B = -4.54), having restrictions (odds ratio = 2.48, 95% confidence interval 1.079-5.685), and health-related quality of life (B = -0.19), adjusted for depression, anxiety, and/or hypertension. CONCLUSION: Five years after perimesencephalic subarachnoid haemorrhage, one-third of patients still reported fatigue, which was associated with worse participation and health-related quality of life. Future studies should examine whether these patients may benefit from rehabilitation aimed at fatigue.

Differences between young and older adults in the control of weight shifting within the surface of support.

An important reason for falling in elderly is incorrect weight-shifting. In many daily life activities quick and accurate weight-shifting is needed to maintain balance and to prevent from falling. The present study aims to gain more insight in age-related differences in the control of weight-shifting. Nine healthy older adults (70.3 ± 6.9 years) and twelve young adults (20.9 ± 0.5 years) participated in the study. They performed a weight shifting task by moving the body's center of pressure, represented by a red dot on a screen, in different directions, towards targets of different sizes and at different distances projected on a screen. Movement time, fluency and accuracy of the movement were determined. Accuracy was quantified by the number of times the cursor hit the goal target before a target switch was realized (counts on goal) and by the time required to realize a target switch after the goal target was hit by the cursor for the first time (dwelling time). Fluency was expressed by the maximal deviation of the performed path with respect to the ideal path and the number of peaks, or inflections in the performed path. Significant main effects of target size, target distance and age on all outcome measures were found. With decreasing target size, increasing target distance and increasing age, movement time significantly increased and fluency and accuracy significantly decreased (i.e. increased number of peaks, maximal deviation, number of times on the goal target and longer dwelling time around the goal target). In addition, significant interaction effects of size*age and distance*age were found. Older adults needed more time to perform the weight-shifting task and their movements were less fluent and accurate compared to younger adults, especially with increasing task difficulty. This indicates that elderly might have difficulties with executing an adequate adaptation to a perturbation in daily life.