A Scoping Review of Disability Assessment in Prospective and Cross-Sectional Studies That Included Device-Based Measurement of Physical Activity.

BACKGROUND: Evidence on the prevalence, determinants, and health outcomes of physical activity in disabled people is limited. It is possible that the limited availability of high-quality scientific evidence is due to the extent and nature of disability assessment in physical activity research. This scoping review explores how disability has been measured in epidemiological studies that included accelerometer-based measurement of physical activity. METHODS: Data sources: MEDLINE (Ovid), Embase, PsychINFO, Health Management Information Consortium, Web of Science, SPORTDiscus, and CINAHL. ELIGIBILITY CRITERIA: Prospective and cross-sectional studies that included an accelerometer measurement of physical activity. Survey instruments used in these studies were obtained, and questions relating to the International Classification of Functioning, Disability and Health domains of (1) health conditions, (2) body functions and structures, and (3) activities and participation, were extracted for analysis. RESULTS: Eighty-four studies met the inclusion criteria, from which complete information on the 3 domains was obtained for 68. Seventy-five percent of studies (n = 51) captured whether a person had at least one health condition, 63% (n = 43) had questions related to body functions and structures, and 75% (n = 51) included questions related to activities and participation. CONCLUSION: While most studies asked something about one of the 3 domains, there was substantial diversity in the focus and style of questions. This diversity indicates a lack of consensus on how these concepts should be assessed, with implications for the comparability of evidence across studies and subsequent understanding of the relationships between disability, physical activity, and health.

Community-based rehabilitation training after stroke: results of a pilot randomised controlled trial (ReTrain) investigating acceptability and feasibility.

OBJECTIVES: To assess acceptability and feasibility of trial processes and the Rehabilitation Training (ReTrain) intervention including an assessment of intervention fidelity. DESIGN: A two-group, assessor-blinded, randomised controlled trial with parallel mixed methods process and economic evaluations. SETTING: Community settings across two sites in Devon. PARTICIPANTS: Eligible participants were: 18 years old or over, with a diagnosis of stroke and with self-reported mobility issues, no contraindications to physical activity, discharged from National Health Service or any other formal rehabilitation programme at least 1 month before, willing to be randomised to either control or ReTrain and attend the training venue, possessing cognitive capacity and communication ability sufficient to participate. Participants were individually randomised (1:1) via a computer-generated randomisation sequence minimised for time since stroke and level of functional disability. Only outcome assessors independent of the research team were blinded to group allocation. INTERVENTIONS: ReTrain comprised (1) an introductory one-to-one session; (2) ten, twice-weekly group classes with up to two trainers and eight clients; (3) a closing one-to-one session, followed by three drop-in sessions over the subsequent 3 months. Participants received a bespoke home-based training programme. All participants received treatment as usual. The control group received an exercise after stroke advice booklet. OUTCOME MEASURES: Candidate primary outcomes included functional mobility and physical activity. RESULTS: Forty-five participants were randomised (ReTrain=23; Control=22); data were available from 40 participants at 6 months of follow-up (ReTrain=21; Control=19) and 41 at 9 months of follow-up (ReTrain=21; Control=20). We demonstrated ability to recruit and retain participants. Participants were not burdened by the requirements of the study. We were able to calculate sample estimates for candidate primary outcomes and test procedures for process and health economic evaluations. CONCLUSIONS: All objectives were fulfilled and indicated that a definitive trial of ReTrain is feasible and acceptable. TRIAL REGISTRATION NUMBER: NCT02429180; Results.

Socioeconomic position and childhood sedentary time: evidence from the PEACH project.

BACKGROUND: Associations between socioeconomic position (SEP) and sedentary behaviour in children are unclear. Existing studies have used aggregate measures of weekly sedentary time that could mask important differences in the relationship between SEP and sedentary time at different times of the day or between weekdays and weekend days. These studies have also employed a variety of measures of SEP which may be differentially associated with sedentary time. This paper examines associations of multiple indicators of SEP and accelerometer-measured, temporally specific, sedentary time in school children. METHODS: Between 2006 and 2007 sedentary time data (minutes spent below 100 accelerometer counts per minute) for weekdays before-school (7.00-8.59AM), during school-time (9.00AM-2.59PM) and after-school (3.00PM-11.00PM), and weekend days were recorded for 629 10-11 year old children using accelerometers. Ordinary least squares regression was used to examine associations with 5 indicators of SEP (area deprivation, annual household income, car ownership, parental education and access to a private garden). Covariates were; gender, BMI, minutes of daylight, accelerometer wear time and school travel method. Analyses were conducted in 2012. RESULTS: Following adjustments for covariates, having a parent educated to university degree level was associated with more minutes of school (5.87 [95% CI 1.72, 10.04]) and after-school (6.04 [95% CI 0.08, 12.16]) sedentary time. Quartiles of area deprivation (most to least deprived) were positively associated with after-school (Q2: 4.30 [95% CI -6.09, 14.70]; Q3: 10.77 [95% CI 0.47, 21.06]; Q4: 12.74 [95% CI 2.65, 22.84]; P(trend) = 0.04) and weekend (Q2: 26.34 [95% CI 10.16, 42.53]; Q3: 33.28 [95% CI 16.92, 49.65]; Q4: 29.90 [95% CI 14.20, 45.60]; P(trend) = 0.002) sedentary time. Having a garden was associated with less sedentary time after-school (-14.39 [95% CI -25.14, -3.64]) and at weekends (-27.44 [95% CI -43.11, -11.78]). CONCLUSIONS: Associations between SEP and children's sedentary-time varied by SEP indicator and time of day. This highlights the importance of measuring multiple indicators of SEP and examining context specific sedentary time in children in order to fully understand how SEP influences this behaviour. Further research should combine self-report and objective data to examine associations with specific sedentary behaviours in the contexts within which they occur, as well as total sedentary time.