Physical activity assessment in patients with axial spondyloarthritis compared to healthy controls: a technology-based approach.

INTRODUCTION: Traditionally, assessment in axial Spondyloarthritis (aSpA) includes the evaluation of the capacity to execute tasks, conceptualized as physical function. The role of physical activity, defined as movement-related energy expenditure, is largely unknown and almost exclusively studied using patient-reported outcome measures. The aims of this observational cross-sectional study are to compare physical activity between patients with aSpA and healthy controls (HC) and to evaluate the contribution of disease activity to physical activity differences between groups. METHODS: Forty patients with aSpA were matched by age, gender, period of data acquisition in terms of days and season to 40 HC. Physical activity was measured during five consecutive days (three weekdays and two weekend days) using ambulatory monitoring (SenseWear Armband). Self-reported disease activity was measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Differences in physical activity between patients with aSpA and HC were examined with Wilcoxon signed-rank tests and a mixed linear model. Difference scores between patients and HC were correlated with disease activity. RESULTS: Average weekly physical activity level (Med(IQR); HC:1.54(1.41-1.73); aSpA:1.45(1.31-1.67),MET) and energy expenditure (HC:36.40(33.43-41.01); aSpA:34.55(31.08-39.41),MET.hrs/day) were significantly lower in patients with aSpA. Analyses across intensity levels revealed no significant differences between groups for inactivity and time spent at light or moderate physical activities. In contrast, weekly averages of vigorous (HC:4.02(1.20-12.60); aSpA:0.00(0.00-1.20),min/d), very vigorous physical activities (HC0.00(0.00-1.08); aSpA:0.00(0.00-0.00),mind/d) and moderate/(very)vigorous combined (HC2.41(1.62-3.48); aSpA:1.63(1.20-2.82),hrs/d) were significantly lower in patients with aSpA. Disease activity did not interact with differences in physical activity between patients with aSpA and HC, evidenced by non-significant and very low correlations (range: -0.06-0.17) between BASDAI and HC-aSpA patients' difference scores. CONCLUSIONS: Patients with aSpA exhibit lower physical activity compared to HC and these differences are independent of self-reported disease activity. Further research on PA in patients with aSpA should be prioritized.

Objectively-determined intensity- and domain-specific physical activity and sedentary behavior in relation to percent body fat.

BACKGROUND & AIMS: This study examined the independent and joint associations of overall, intensity-specific and domain-specific physical activity and sedentary behavior with bioelectrical impedance-determined percent body fat. METHODS: Physical activity was measured in 442 Flemish adults (41.4 ± 9.8 years) using the SenseWear Armband and an electronic diary. Two-way analyses of covariance investigated the interaction of physical activity and sedentary behavior with percent body fat. Multiple linear regression analyses, adjusted for potential confounders, examined the associations of intensity-specific and domain-specific physical activity and sedentary behavior with percent body fat. RESULTS: Results showed a significant main effect for physical activity in both genders and for sedentary behavior in women, but no interaction effects. Light activity was positively (ß = 0.41 for men and 0.43 for women) and moderate (ß = -0.64 and -0.41), vigorous (ß = -0.21 and -0.24) and moderate-to-vigorous physical activity (MVPA) inversely associated with percent body fat, independent of sedentary time. Regarding domain-specific physical activity, significant associations were present for occupation, leisure time and household chores, irrespective of sedentary time. The positive associations between body fat and total and domain-specific sedentary behavior diminished after MVPA was controlled for. CONCLUSIONS: MVPA during leisure time, occupation and household chores may be essential to prevent fat gain.

Compliance with different physical activity recommendations and its association with socio-demographic characteristics using an objective measure.

BACKGROUND: In the past decades, several public health guidelines concerning physical activity have been published. This study evaluated compliance with various physical activity guidelines and examined the associations between meeting the guidelines and socio-demographic characteristics. METHODS: Data were obtained from 357 Flemish men and women (41.9 ± 9.6 years). Physical activity was assessed for seven consecutive days using the SenseWear Armband. The prevalence of sufficient physical activity was calculated according to various public health guidelines. Logistic regressions examined the associations between socio-demographic characteristics and the odds of meeting the different guidelines. RESULTS: 87.2% of men and 68.1% of women achieved ≥150 min/week of moderate-to-vigorous physical activity (MVPA), but only 57.6% and 37.3% accumulated this amount as ≥30 min/day on ≥5 days/week. With regard to vigorous physical activity, 27.9% of men and 15.7% of women achieved ≥75 min/week and 12.8% and 7.0% achieved ≥20 min/day on ≥3 days/week. In addition, 34.9% of men and 21.6% of women attained an average physical activity level (PAL) of 1.75 MET and thus met the criteria for weight maintenance. Only 16.3% of men and 14.1% of women took 10000 steps/day on 7 days/week. Women had a lower probability of achieving 30 min/day MVPA on 5 days/week (OR: 0.40), or a weekly total of 150 min or 500 MET.min MVPA or 75 min of vigorous activity compared to men (OR: 0.27-0.46). In addition, they were 50% less likely to meet the guidelines for weight maintenance. The odds of engaging in 150 min/week MVPA or attaining a PAL of 1.75 was lower with higher age. Educational level was positively related with accumulating 75 min/week of vigorous activity, but negatively with taking 10000 steps/day. Smokers were 60% less likely to participate weekly in 150 min of MVPA compared to non-smokers. CONCLUSIONS: The prevalence of sufficient physical activity differed greatly depending on the definition used. Women and subjects older than 35 were less likely to meet the guidelines than men and younger subjects and thus are important groups to target in future interventions.

SenseWear-determined physical activity and sedentary behavior and metabolic syndrome.

PURPOSE: The aim of this study was to examine the associations of multiple, objectively measured parameters of physical activity and sedentary behavior with metabolic syndrome (MetS) and its individual components. METHODS: Physical activity was measured in 370 Flemish adults (age = 41.7 ± 9.8 yr; mean ± SD) for 7 d using a SenseWear Armband. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III guidelines. Logistic regressions examined the associations between the subcomponents of physical activity and sedentary behavior and the odds of having MetS or individual risk factors. RESULTS: MetS was observed in 10.2% of men and 5.2% of women. Adults who spent ≥60 min·d-1 in moderate-to-vigorous physical activity (MVPA) were 68%-81% less likely to have abdominal obesity, hypertriglyceridemia, and low HDL cholesterol compared with those with <30 min·d MVPA, independent of sex, age, education, smoking, alcohol consumption, and total sedentary time. The total sedentary time and the average duration of a sedentary bout were positively associated with MetS and most of its individual risk factors (odds ratio [OR] = 1.07-1.47). Breaks in sedentary time were inversely associated with abdominal obesity (OR = 0.71, 95% confidence interval [CI] = 0.55-0.91) and hypertriglyceridemia (OR = 0.79, 95% CI 0.63-0.99). These associations were no longer significant after adjustment for MVPA (and total sedentary time). Light physical activity was not associated with MetS or any of the individual risk factors. Time spent in moderate, vigorous, total MVPA, and bouts of MVPA were associated with a reduced likelihood of abdominal obesity (OR = <0.01-0.48), hypertriglyceridemia (OR = 0.14-0.63), and low HDL cholesterol (OR = 0.02-0.43), independent of potential confounders and total sedentary time. CONCLUSIONS: Engagement in MVPA may be essential to prevent MetS and individual risk factors.

Assessment of physical activity and inactivity in multiple domains of daily life: a comparison between a computerized questionnaire and the SenseWear Armband complemented with an electronic diary.

BACKGROUND: Although differences between paper-and-pencil questionnaires and accelerometers have been reported for overall physical activity and time spent in moderate and vigorous activity, few studies have looked at domain-specific behavior. This study compared estimates of domain-specific physical (in)activity obtained with the Flemish physical activity computerized questionnaire (FPACQ) with those obtained from a combination of the SenseWear Armband and an electronic diary. Furthermore, it was investigated whether the correspondence between the two methods varied with gender and age. METHODS: Data were obtained from 442 Flemish adults (41.4 ± 9.8 years). Physical activity was questioned with the FPACQ and measured for seven consecutive days using the SenseWear Armband together with an electronic activity diary (SWD). Analogous variables were calculated from the FPACQ and SWD. Mean differences and associations between FPACQ and SWD outcomes were examined with paired t-tests and Pearson correlations. The Bland-Altman method was used to assess the level of agreement between the two methods. Main effects and interaction of gender and age groups (20-34; 35-49; 50-64 years) on differences between FPACQ and SWD outcomes were analyzed using two-way ANOVAs. RESULTS: All parameters of the FPACQ were significantly correlated with SWD assessments (r = 0.21 to 0.65). Reported activity was significantly different from SWD-obtained values for all parameters, except screen time. Physical activity level, total energy expenditure and time spent in vigorous activities were significantly higher (+0.14 MET, +25.09 METhours·week(-1) and +1.66 hours·week(-1), respectively), and moderate activities and sedentary behavior significantly lower (-5.20 and -25.01 hours·week(-1), respectively) with the FPACQ compared to SWD. Time and energy expenditure of job activities and active transport were significantly higher, while household chores, motorized transport, eating and sleeping were significantly lower with the FPACQ. Time spent in sports was lower (-0.54 hours·week(-1)), but energy expenditure higher (+4.18 METhours·week(-1)) with the FPACQ. The correspondence between methods varied with gender and age, but results differed according to the intensity and domain of activity. CONCLUSIONS: Despite the moderate correlations, significant differences between the two methods were found. In general, physical activity was higher and sedentary behavior lower as calculated from the FPACQ compared to SWD.

Patterns of physical activity and sedentary behavior in normal-weight, overweight and obese adults, as measured with a portable armband device and an electronic diary.

BACKGROUND & AIMS: Accurate data on domain-specific physical activity and sedentary behavior among normal-weight, overweight and obese adults are scarce. This study described a comprehensive physical (in)activity profile and examined variations in activity across the week. METHODS: Physical activity was measured in 442 Flemish adults (41.4 ± 9.8 years) for 7 days using the SenseWear Armband and an electronic diary. Differences in (in)activity between BMI subgroups were examined using one-way analyses of variance. RESULTS: Physical activity level decreased with increasing BMI in men (1.77-1.46 MET) and women (1.67-1.31 MET). Sedentary time was higher in obese than normal-weight men (+1.09 h/day) and overweight and obese than normal-weight women (+1.04 and +1.88 h/day). Total hours of moderate-to-vigorous activity and bouts of moderate-to-vigorous activity were lower in overweight and obese than normal-weight subjects. The average duration of a sedentary bout and the number of breaks in sedentary time were only different between female BMI groups. The intensity of domain-specific activities decreased with increasing BMI. Activity patterns across the week differed between subgroups, with the difference most pronounced on Saturday for the male BMI groups. CONCLUSIONS: This study described activity patterns among normal-weight, overweight and obese adults. The results should be used to design obesity prevention strategies.

Variability in physical activity patterns as measured by the SenseWear Armband: how many days are needed?

To examine sources of variance in objectively measured physical activity and to determine the number of monitoring days needed to quantify physical activity patterns reliably, 394 Flemish adults (41.1 ± 9.9 years) were monitored during 7 days, using the SenseWear Armband. Differences between weekdays, Saturday and Sunday were examined with repeated measures ANOVA's. Variance components were estimated for subject, weekday and residual error using data from Mondays through Fridays and used to calculate the reliability of 1-5 monitoring weekdays. Saturday was more and Sunday less active than an average weekday. Inter-individual variability was the largest source of variance (54.4-67.9%) for physical activity level (PAL), energy expenditure, inactivity, light, moderate and total physical activity. Intra-individual variability accounted for 31.8-44.8% and weekday for 0.1-1.1% of total variance. Intra-individual variability was the largest source of variance for vigorous activity in both sexes and steps in women. At least, 3 monitoring weekdays were required to achieve a reliability of 0.80 for PAL, energy expenditure, inactivity, light, moderate and total physical activity. All 5 weekdays should be monitored to reach acceptable reliability for steps. Five weekdays resulted in a reliability of 0.58-0.60 for vigorous activity. Both Saturday and Sunday and at least 3 weekdays need to be monitored to obtain reliable measures of habitual physical activity.

Lipid profile in men and women with different levels of sports participation and physical activity.

OBJECTIVE: The purpose of the present study was to analyse the lipid profile in men and women differentiated according to energy expenditure during sports participation (EE(SPORT)), energy expenditure during active leisure time (EE(ALT)) and overall energy expenditure (EE(TOTAL)). DESIGN: The subjects were grouped by sex, age, EE(SPORT), EE(ALT) and EE(TOTAL). Group differences were analysed using analyses of covariance with BMI and alcohol consumption as covariates. SETTING: Physical activity was assessed using the Flemish Physical Activity Computerised Questionnaire. Fasting blood samples were taken to measure total cholesterol (TC), TAG, HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and the ratio TC:HDL-C. SUBJECTS: The study sample consisted of 1170 Flemish men and women between 18 and 75 years of age. RESULTS: Differences in lipid profile were observed in the younger age group (<45 years), all in favour of the most active group. More specifically, when differentiating by EE(ALT) and EE(TOTAL), men had a healthier lipid profile for TAG, HDL-C and TC:HDL-C. Differentiation according to EE(SPORT) revealed the same significant results except for TAG. In women significant results for HDL-C, LDL-C and TC:HDL-C were found when differentiated by EE(SPORT). CONCLUSIONS: Men and women <45 years of age with higher levels of energy expenditure due to sport show a better lipid profile than their sedentary counterparts. When differentiating subjects according to energy expenditure during active leisure time or overall energy expenditure, only in men was a healthier lipid profile observed in favour of the most active subjects.