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1.
J Stroke Cerebrovasc Dis ; 30(1): 105449, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33166768

RESUMO

OBJECTIVES: Sitting ability during the acute phase after stroke is a useful indicator of functional outcomes; however, factors that affect this ability have not been evaluated. Therefore, this study aimed to identify and evaluate factors that affect sitting ability in the acute phase after stroke. MATERIALS AND METHODS: This multicenter prospective cohort study included hemispheric stroke patients who underwent an inpatient rehabilitation program after acute stroke from five acute care hospitals. The effect of age, sex, lesion side, etiology, consciousness disorder, stroke and dementia history, stroke-related complications, National Institutes of Health Stroke Scale score, hemiparalysis, turn-over movement from the supine position and sit-up movement, and Scale for Contraversive Pushing on the "remain sitting" item in the revised version of the Ability of Basic Movement Scale at the time of acute hospital discharge were investigated. Factors affecting sitting ability were identified using binomial logistic regression analysis. RESULTS: We included 293 stroke patients. Age (odds ratio: 0.943, 95% confidence interval: 0.910-0.977, p=0.001), National Institutes of Health Stroke Scale score (odds ratio: 0.862, 95% confidence interval: 0.811-0.916, p<0.001), and Scale for Contraversive Pushing score (odds ratio: 0.543, 95% confidence interval: 0.419-0.705, p<0.001) were identified as independent predictors of sitting ability at the time of hospital discharge (median; 23.0 days). CONCLUSIONS: Older patients and those with high Scale for Contraversive Pushing and National Institutes of Health Stroke Scale scores experienced difficulties in regaining sitting ability. These results may guide physical therapy for patients with impaired sitting ability due to hemispheric stroke.


Assuntos
Equilíbrio Postural , Postura Sentada , Acidente Vascular Cerebral/fisiopatologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral
2.
Artigo em Inglês | MEDLINE | ID: mdl-33327556

RESUMO

We examine the impact of the COVID-19 outbreak and concomitant restrictions (i.e., lockdown) on 24-hour movement behaviors (i.e., physical activity, sitting, sleep) in a purposive sample of people (n = 3230) reporting change recruited online. Participants' self-reported time spent in moderate-to-vigorous physical activity (MVPA), walking, sitting and sleep prior to lockdown (T1), during the first national lockdown (T2) and as restrictions initially started to ease (T3). For each 24-hour movement behavior, category-shifts are reported (positive, negative or did not change), as well as the percentage of participants recording positive/negative changes across clusters of behaviors and the percentage of participants recording improvement or maintenance of change across time. From T1 to T2 walking decreased, whereas MVPA, sitting and sleep increased, from T2 to T3 levels returned to pre-lockdown for all but MVPA. Participants who changed one behavior positively were more likely to report a positive change in another and 50% of those who reported positive changes from T1 to T2 maintained or improved further when restrictions started to ease. The current study showed that a large proportion of the sample reported positive changes, most notably those displaying initially poor levels of each behavior. These findings will inform salutogenic intervention development.


Assuntos
Exercício Físico , Pandemias , Comportamento Sedentário , Sono , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escócia , Postura Sentada , Adulto Jovem
3.
PLoS One ; 15(11): e0242854, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33253292

RESUMO

Today's office chairs are not known to promote active sitting or to activate the lumbar trunk muscles, both of which functions are ergonomically recommended. This study investigated a newly developed dynamic office chair with a moveable seat, specifically designed to promote trunk muscle controlled active sitting. The study aimed to determine the means by which the seat movement was controlled during active sitting. This was accomplished by quantifying trunk and thigh muscular activity and body kinematics. Additionally, the effect of increased spinal motion on muscular activity and body kinematics was analysed. Ten subjects were equipped with reflective body markers and surface electromyography on three lumbar back muscles (multifidus, iliocostalis, longissimus) and two thigh muscles (vastus lateralis and medialis). Subjects performed a reading task during static and active sitting in spontaneous and maximum ranges of motion in a simulated office laboratory setting. The temporal muscle activation pattern, average muscle activity and body segment kinematics were analysed and compared using Friedman and post-hoc Wilcoxon tests (p≤0.05). Active sitting on the new chair significantly affected the lumbar trunk muscles, with characteristic cyclic unloading/loading in response to the seat movement. Neither thigh muscle activity nor lateral body weight shift were substantially affected by active sitting. When participants increased their range of motion, the lumbar back muscles were activated for longer and relaxation times were shorter. The characteristic activity pattern of the lumbar trunk muscles was shown to be the most likely dominant factor in controlling seat movement during active sitting. Consequently, the new chair may have a potential positive impact on back health during prolonged sitting. Further studies are necessary to analyse the frequency and intensity of active sitting during daily office work.


Assuntos
Ergonomia , Postura/fisiologia , Postura Sentada , Coluna Vertebral/fisiologia , Adulto , Músculos do Dorso/fisiologia , Fenômenos Biomecânicos , Eletromiografia , Feminino , Humanos , Decoração de Interiores e Mobiliário , Dor Lombar/fisiopatologia , Região Lombossacral/fisiologia , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Adulto Jovem
4.
PLoS One ; 15(11): e0242365, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33196674

RESUMO

BACKGROUND: Few studies have reported on the clustering pattern of CVD risk factors, including sedentary behavior, systemic inflammation, and cadiometabolic components in the general population. OBJECTIVE: We aimed to explore the clustering pattern of CVD risk factors using exploratory factor analysis to investigate the underlying relationships between various CVD risk factors. METHODS: A total of 5606 subjects (3157 male, 51.5±11.7 y/o) were enrolled, and 14 cardiovascular risk factors were analyzed in an exploratory group (n = 3926) and a validation group (n = 1676), including sedentary behaviors. RESULTS: Five factor clusters were identified to explain 69.4% of the total variance, including adiposity (BMI, TG, HDL, UA, and HsCRP; 21.3%), lipids (total cholesterol and LDL-cholesterol; 14.0%), blood pressure (SBP and DBP; 13.3%), glucose (HbA1C, fasting glucose; 12.9%), and sedentary behavior (MET and sitting time; 8.0%). The inflammation biomarker HsCRP was clustered with only adiposity factors and not with other cardiometabolic risk factors, and the clustering pattern was verified in the validation group. CONCLUSION: This study confirmed the clustering structure of cardiometabolic risk factors in the general population, including sedentary behavior. HsCRP was clustered with adiposity factors, while physical inactivity and sedentary behavior were clustered with each other.


Assuntos
Doenças Cardiovasculares/epidemiologia , Estudos Transversais/métodos , Adiposidade , Adulto , Biomarcadores/sangue , Glicemia , Pressão Sanguínea , Índice de Massa Corporal , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Análise por Conglomerados , Análise Fatorial , Feminino , Humanos , Inflamação/metabolismo , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Comportamento Sedentário , Postura Sentada , Taiwan/epidemiologia , Triglicerídeos/sangue , Circunferência da Cintura
5.
PLoS One ; 15(11): e0242580, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33211765

RESUMO

OBJECTIVES: We investigated the incidence and characteristics of pseudo-spontaneous nystagmus (PSN) in benign paroxysmal positional vertigo involving the lateral semicircular canal (LC-BPPV) and evaluated the correlation between PSN and the bow and lean test. METHODS: We examined nystagmus in the sitting position using video-oculography goggles in 131 LC-BPPV patients. The positioning test and bow and lean test were also performed. Patients were divided into canalolithiasis and cupulolithiasis groups according to the character of nystagmus. In each group, the incidence and direction of PSN, correlation with the bow and lean test, and treatment outcome were analyzed. RESULTS: PSN was observed in 25 cases (19.1%) in LC-BPPV patients, 7 of which were canalolithiasis and 18 of which were cupulolithiasis (p = 0.098). Of the 25 patients with PSN, 21 (84%) exhibited nystagmus consistent with the lean test whereas 4 (16%) exhibited nystagmus consistent with the bow test. In patients with PSN, nystagmus was observed in the bow and lean test in all cases (23/23), but in patients without PSN, no nystagmus was observed in 13 cases (13/87) in the bow and lean test (p = 0.048). The number of barbecue maneuvers performed until the end of treatment was 1.4 ± 0.7 in patients with PSN and 1.4 ± 0.9 in those without PSN (p = 0.976). CONCLUSION: We identified PSN in patients with LC-BPPV irrelevant of subtype. Moreover, all patients with PSN showed nystagmus in the bow and lean test. The direction of PSN was mostly consistent with that of the lean test (21/25, 84%). The presence of PSN was not related to the treatment outcome in this study.


Assuntos
Vertigem Posicional Paroxística Benigna/complicações , Nistagmo Patológico/etiologia , Canais Semicirculares/fisiopatologia , Postura Sentada , Adulto , Idoso , Vertigem Posicional Paroxística Benigna/fisiopatologia , Feminino , Movimentos da Cabeça/fisiologia , Humanos , Doenças do Labirinto/complicações , Doenças do Labirinto/fisiopatologia , Litíase/complicações , Litíase/fisiopatologia , Masculino , Pessoa de Meia-Idade , Nistagmo Patológico/fisiopatologia , Postura/fisiologia
6.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(6): 847-852, 2020 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-33236611

RESUMO

Objective: To investigate the effect of trunk control training on trunk function, balance, mobility and functional independence in hemiplegia patients after acute stroke, and to compare the therapeutic effects with conventional stroke rehabilitation. Methods: The study was designed as a randomized controlled trial. The subjects and evaluators were blinded and the therapist was unblinded. Subjects were randomly assigned to either the experimental group or the control group using a computer-generated random number table, the experimental group ( n=15) received30 min of high-intensity trunk control training plus 15 min of low-intensity conventional stroke rehabilitation (45 min, once1 d for 5 d). The control group ( n=15) received only 45 min low-intensity conventional stroke rehabilitation, once 1 d for 5 d. Trunk function was the primary outcome, which was evaluated by the Trunk Impairment Scale (TIS). The secondary outcome included balance, mobility and functional independence, which were assessed by the Brunel Balance Assessment (BBA), the Modified Rivermead Mobility Index (MRMI) and the modified Barthel Index (MBI). Subjects were assessed before and after the intervention. Results: After 5 d of treatment, the scores of TIS general table, TIS static sitting balance sub table, TIS coordination sub table, BBA, MRMI and MBI were increased, but there was no statistically significant difference between the two groups (all P>0.05). The trunk control training group improved dynamic sitting balance more significantly, the score of TIS dynamic sitting balance sub table increased more than that in the control group, with a statistically significant difference ( P<0.05). Conclusion: The results of this study indicate that trunk control training has improved trunk function, balance, mobility, and activities of daily living in hemiplegia patients after acute stroke, and trunk control training improves dynamic sitting balance more effectively than conventional stroke rehabilitation.


Assuntos
Terapia por Exercício , Hemiplegia , Acidente Vascular Cerebral , Atividades Cotidianas , Humanos , Equilíbrio Postural , Postura Sentada , Acidente Vascular Cerebral/complicações
7.
Sci Rep ; 10(1): 16203, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004894

RESUMO

Currently, no clinical studies have compared the inspiratory and expiratory volumes of unilateral lung or of each lobe among supine, standing, and sitting positions. In this prospective study, 100 asymptomatic volunteers underwent both low-radiation-dose conventional (supine position, with arms raised) and upright computed tomography (CT) (standing and sitting positions, with arms down) during inspiration and expiration breath-holds and pulmonary function test (PFT) on the same day. We compared the inspiratory/expiratory lung/lobe volumes on CT in the three positions. The inspiratory and expiratory bilateral upper and lower lobe and lung volumes were significantly higher in the standing/sitting positions than in the supine position (5.3-14.7% increases, all P < 0.001). However, the inspiratory right middle lobe volume remained similar in the three positions (all P > 0.15); the expiratory right middle lobe volume was significantly lower in the standing/sitting positions (16.3/14.1% decrease) than in the supine position (both P < 0.0001). The Pearson's correlation coefficients (r) used to compare the total lung volumes on inspiratory CT in the supine/standing/sitting positions and the total lung capacity on PFT were 0.83/0.93/0.95, respectively. The r values comparing the total lung volumes on expiratory CT in the supine/standing/sitting positions and the functional residual capacity on PFT were 0.83/0.85/0.82, respectively. The r values comparing the total lung volume changes from expiration to inspiration on CT in the supine/standing/sitting positions and the inspiratory capacity on PFT were 0.53/0.62/0.65, respectively. The study results could impact preoperative CT volumetry of the lung in lung cancer patients (before lobectomy) for the prediction of postoperative residual pulmonary function, and could be used as the basis for elucidating undetermined pathological mechanisms. Furthermore, in addition to morphological evaluation of the chest, inspiratory and expiratory upright CT may be used as an alternative tool to predict lung volumes such as total lung capacity, functional residual capacity, and inspiratory capacity in situation in which PFT cannot be performed such as during an infectious disease pandemic, with relatively more accurate predictability compared with conventional supine CT.


Assuntos
Capacidade Residual Funcional/fisiologia , Pulmão/fisiologia , Postura Sentada , Posição Ortostática , Decúbito Dorsal , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Expiração , Feminino , Humanos , Pulmão/diagnóstico por imagem , Medidas de Volume Pulmonar , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Testes de Função Respiratória
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 710-713, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018086

RESUMO

Recent developments of detrended fluctuation analysis (DFA) provide multifractal/multiscale (MFMS) descriptions of the heart rate self-similarity, a promising approach to cardiovascular complexity. However, it is unclear whether the MFMS DFA may also describe the nonlinear components of heart rate variability. Our aim is to define MFMS DFA indices for quantifying the short-term and long-term degree of the heart-rate nonlinearity and to apply these indices to detect possible sex-related differences.We recorded the inter-beat-interval (IBI) series in 42 male and in 42 female healthy participants sitting at rest for about 2 hours. For each series j, we generated 100 phase-randomized surrogate series. We applied the MFMS DFA to estimate the self-similarity coefficients α over scales τ between 8 and 512 s and moment orders q between -5 and +5, obtaining coefficients for the original series, αO,j (q, τ), and for each surrogate, αi,j (q, τ) with 1≤i≤100. We first evaluated πj(q, τ), percentile of αi,j (q, τ) distribution in which was αO,j (q, τ). Then we calculated the percentages of scales where πj(q, τ) was <5% for 8≤τ≤16 s (short-term nonlinearity index NL1(q)) and for 16≤τ≤512 s (long-term nonlinearity index NL2(q)). We found that NL1(q) was generally greater than 50% at all q≥0 but q=2 (i.e., moment order of the monofractal DFA), while at q<0 it was high in males only, with significant sex differences at q=-1 and q=-2. Results indicate that the multifractal DFA may highlight nonlinear heart-rate components at the short scales that are not revealed by the traditional monofractal DFA and that appear related to gender differences.Clinical Relevance- This supports the use of MFMS DFA to integrate the linear information from traditional spectral methods of heart rate variability in clinical studies aimed at improving the stratification of the cardiovascular risk.


Assuntos
Sistema Cardiovascular , Caracteres Sexuais , Algoritmos , Feminino , Frequência Cardíaca , Humanos , Masculino , Postura Sentada
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3940-3944, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018862

RESUMO

Energy expenditure (EE) estimation is an important factor in tracking personal activity and preventing chronic diseases, such as obesity and diabetes. The challenge is to provide accurate EE estimations in free-living environment through portable and unobtrusive devices. In this paper, we present an experimental study to estimate energy expenditure during sitting, standing and treadmill walking using a smartwatch. We introduce a novel methodology, which aims to improve the EE estimation by first separating sedentary (sitting and standing) and non-sedentary (walking) activities, followed by estimating the walking speeds and then calculating the energy expenditure using advanced machine learning based regression models. Ten young adults participated in the experimental trials. Our results showed that combining activity type and walking speed information with the acceleration counts substantially improved the accuracy of regression models for estimating EE. On average, the activity-based models provided 7% better EE estimation than the traditional acceleration-based models.


Assuntos
Metabolismo Energético , Velocidade de Caminhada , Aceleração , Humanos , Postura Sentada , Caminhada , Adulto Jovem
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4042-4045, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018886

RESUMO

The millennial age group (18 to 30 years) spend at least 6 hours sitting, either in college or at their workspace. High screen time as a routine, is the major cause for numerous spinal problems. Despite the wide research carried out on postural abnormalities, there exists numerous unrequited queries with regards to lumbar lordosis estimations, due to indeterminate parameters such as age, gender, lifestyle and diet. This work emphasizes the proficient method by observing the posture of a person for early detection of obliteration in Lumbar Lordosis. This further contributes to efficient diagnosis and treatment of spine ailments. With a novel approach to hardware using the myRIO hardware coupled with LabVIEW for interactive interface, the calibration is enhanced using machine learning (ML) - kNN Classifier. The use of machine learning accounts for the variations in the ideal angles of segmented sagittal measures with respect to different subjects. The device is developed to be a non-invasive, user friendly instrument to analyse the casual seated posture trends of the subject. The male subjects are expected to show the tilt angles in the range of -16.3 to -17.2 degrees and similar threshold for females are -15.8 to -16.8 degrees. Out of 120 subjects taken into consideration, the device could accurately classify subjects with obliterated or normal lumbar lordosis). An accuracy and f1- score of 94% and 90% respectively was achieved by the ML model.


Assuntos
Lordose , Animais , Feminino , Estilo de Vida , Lordose/diagnóstico , Masculino , Postura , Postura Sentada , Coluna Vertebral
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4265-4268, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018938

RESUMO

Automatic monitoring of daily living activities can greatly improve the possibility of living autonomously for frail individuals. Pose recognition based on skeleton tracking data is promising for identifying dangerous situations and trigger external intervention or other alarms, while avoiding privacy issues and the need for patient compliance. Here we present the benefits of pre-processing Kinect-recorded skeleton data to limit the several errors produced by the system when the subject is not in ideal tracking conditions. The accuracy of our two hidden layers MLP classifier improved from about 82% to over 92% in recognizing actors in four different poses: standing, sitting, lying and dangerous sitting.


Assuntos
Atividades Cotidianas , Redes Neurais de Computação , Humanos , Postura Sentada
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4390-4393, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018968

RESUMO

It has been known that the fall of a patient in a hospital is a serious accident. In order to prevent such accidents, we have been studying the fall prevention using image processing technology. Our previous studies have detected the patient's end sitting position with high accuracy, but have problems responding to the sitting position of patients who are eating or responding to visitors. In order to solve these problems, this paper proposes a method to detect the patient's bed exit action by analyzing the posture of the patient extracted from the image of the monocular camera by long short-term memory (LSTM). Our proposed method introduces two strategies - abstraction of input information and use of relative position information for the input time-series human images, achieving a 99.2[%] detection rate of bed exit action with a 5.7[%] false detection rate. Detecting the bed exit action with high accuracy contributes to preventing the patient from falling down. The proposed solution handles only posture information that abstracts camera images for patient privacy purposes.


Assuntos
Memória de Curto Prazo , Postura , Acidentes por Quedas/prevenção & controle , Humanos , Processamento de Imagem Assistida por Computador , Postura Sentada
13.
Public Health ; 188: 1-3, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33032239

RESUMO

OBJECTIVES: Parental and peer support can foster adolescents' activity behaviours; however, little is known about how such support are linked with adolescents' active lifestyle in non-Western settings. The study aimed to explore associations of parental and peer support with an active lifestyle of adolescents in Malaysia. STUDY DESIGN: This is a cross-sectional study. METHODS: We used data from the 2012 Malaysian Global School-based Student Health Survey, which covered adolescents aged 11-17 years (51% girls). Adolescents were asked about their physical activity, sitting time, and levels of parental and peer support. Participants with ≥60 min of moderate to vigorous physical activity per day and ≤2 h of sitting time per day were categorised as having an 'active lifestyle'. Binary logistic regression was used to examine the relationships by gender and age group (11-14 and 15-17 years). RESULTS: Of the participating adolescents (n = 12,081), 15.3% reported to have an active lifestyle (boys: 22.0%; girls: 8.8%). About 31% reported to have higher levels of parental support, whereas 47% reported higher levels of peer support. Higher parental and peer support were significantly associated with an active lifestyle of boys across both age groups. Girls with higher parental support had higher odds of reporting an active lifestyle in both age groups, whereas higher peer support was significantly associated with an active lifestyle among girls aged 11-14 years. CONCLUSIONS: This study uniquely extends the current evidence by examining the associations of parental and peer support with physical activity and sitting time combined. More research is needed to understand how different types of social support can influence adolescents' active lifestyle.


Assuntos
Exercício Físico , Estilo de Vida , Pais/psicologia , Grupo Associado , Apoio Social , Adolescente , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Malásia , Masculino , Instituições Acadêmicas , Postura Sentada , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Fatores de Tempo
14.
PLoS One ; 15(10): e0236205, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33095774

RESUMO

The present research aims at quantifying the impact of practicing a new coordination pattern with an online visual feedback on the postural coordination performed on a mechanical horse. Forty-four voluntary participants were recruited in this study. They were randomly assigned to four practice groups based on i) with or without feedback (i.e., group 1, control, did not receive the feedback; group 2, 3 and 4 received an online feedback during practice) and ii) the specific trunk/horse coordination to target during practice (group 1, target coordination = 180° (without feedback); group 2, target coordination = 0°; group 3, target coordination = 90°; group 4, target coordination = 180°). All participants performed pre-, practice, post- and retention sessions. The pre-, post- and retention sessions consisted of four trials, with one trial corresponding to one specific target coordination to maintain between their own oscillations and the horse oscillations (spontaneous, 0°, 90°, and 180°). The practice phase was composed of three different sessions during which participants received an online feedback about the coordination between their own oscillations and the horse oscillations. Results showed a significant change with practice in the trunk/horse coordination patterns which persisted even after one month (retention-test). However, all the groups did not show the same nature of change, evidenced by a high postural variability during post-test for 0° and 90° target coordination groups, in opposition to the 180° and spontaneous groups who showed a decrease in coordination variability for the 180° group. The coordination in anti-phase was characterized as spontaneously adopted by participants on the mechanical horse, explaining the ease of performing this coordination (compared to the 0° and 90° target coordination). The effect of online visual feedback appeared not only on the coordination pattern itself, but most importantly on its variability during practice, including concerning initially stable coordination patterns.


Assuntos
Retroalimentação , Atividade Motora/fisiologia , Equilíbrio Postural , Prática Psicológica , Desempenho Psicomotor , Postura Sentada , Adolescente , Adulto , Animais , Atenção , Fenômenos Biomecânicos , Cavalos , Humanos , Sistemas On-Line , Tronco , Adulto Jovem
15.
Arthritis Care Res (Hoboken) ; 72(12): 1678-1686, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33025679

RESUMO

OBJECTIVE: To identify 24-hour activity-sleep profiles in adults with arthritis and explore factors associated with profile membership. METHODS: Our study comprised a cross-sectional cohort and used baseline data from 2 randomized trials studying activity counseling for people with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or knee osteoarthritis (OA). Participants wore activity monitors for 1 week and completed surveys for demographic information, mood (Patient Health Questionnaire 9), and sitting and walking habits (Self-Reported Habit Index). A total of 1,440 minutes/day were stratified into minutes off body (activity unknown), sleeping, resting, nonambulatory, and intermittent or purposeful ambulation. Latent class analysis determined cluster numbers; baseline-category multinomial logit regression identified factors associated with cluster membership. RESULTS: Our cohort included 172 individuals, including 51% with RA, 30% with OA, and 19% with SLE. We identified 4 activity-sleep profiles (clusters) that were characterized primarily by differences in time in nonambulatory activity: high sitters (6.9 hours sleep, 1.6 hours rest, 13.2 hours nonambulatory activity, and 1.6 hours intermittent and 0.3 hours purposeful walking), low sleepers (6.5 hours sleep, 1.2 hours rest, 12.2 hours nonambulatory activity, and 3.3 hours intermittent and 0.6 hours purposeful walking), high sleepers (8.4 hours sleep, 1.9 hours rest, 10.4 hours nonambulatory activity, and 2.5 hours intermittent and 0.3 hours purposeful walking), and balanced activity (7.4 hours sleep, 1.5 hours sleep, 9.4 hours nonambulatory activity, and 4.4 hours intermittent and 0.8 hours purposeful walking). Younger age (odds ratio [OR] 0.95 [95% confidence interval (95% CI) 0.91-0.99]), weaker occupational sitting habit (OR 0.55 [95% CI 0.41-0.76]), and stronger walking outside habit (OR 1.43 [95% CI 1.06-1.91]) were each associated with balanced activity relative to high sitters. CONCLUSION: Meaningful subgroups were identified based on 24-hour activity-sleep patterns. Tailoring interventions based on 24-hour activity-sleep profiles may be indicated, particularly in adults with stronger habitual sitting or weaker walking behaviors.


Assuntos
Ciclos de Atividade , Artrite Reumatoide/fisiopatologia , Hábitos , Lúpus Eritematoso Sistêmico/fisiopatologia , Osteoartrite do Joelho/fisiopatologia , Sono , Actigrafia , Adulto , Idoso , Artrite Reumatoide/psicologia , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Lúpus Eritematoso Sistêmico/psicologia , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Comportamento Sedentário , Postura Sentada , Inquéritos e Questionários , Fatores de Tempo , Caminhada
16.
Medicine (Baltimore) ; 99(38): e22111, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957331

RESUMO

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a lung disease with the highest incidence and high mortality in the world. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can significantly accelerate the progression of the disease. Pulmonary rehabilitation is one of the effective treatment methods in COPD patients, but few studies have focused on the effect of pulmonary rehabilitation in AECOPD patients. Liuzijue can improve the pulmonary function and relieve symptoms of COPD patients. However, due to the influence of disease and non-invasive ventilation (NIV), AECOPD patients have poor compliance with getting out of bed at the early stage. Sitting and lying Liuzijue is more suitable in AECOPD patients with NIV. Therefore, this study will evaluate the effect of sitting and lying Liuzijue for lung function, exercise endurance, and quality of life in AEOPD patients with NIV. METHODS: This study is a clinical randomized controlled trial. Sixty four AECOPD patients with NIV will be randomly divided into the experimental group and the control group. All participants will be treated with routine treatment and nursing according to their specific condition. The experimental group will be combined with sitting and lying Liuzijue on the basis of the control group. The duration of the exercise will be 3 months. The primary outcomes are the pulmonary function test and 6-minute walking test (6MWT). The secondary outcome measures include blood gas parameters, dyspnea index (the Modified Medical Research Council Dyspnea Scale [mMRC]), the body-mass, airflow obstruction, dyspnea and exercise capacity (BODE) index, anxiety, and depression (Hospital Anxiety and Depression Scale [HADS]), and quality of life (St·George Respiratory Questionnaire [SGRQ]). The measurement of outcomes will be evaluated at week 13. DISCUSSION: It's imperative to focus on pulmonary rehabilitation in AECOPD patients. The purpose of this study is to evaluate the effect of sitting and lying Liuzijue for pulmonary rehabilitation in AECOPD patients with NIV. TRIAL REGISTRATION: ChiCTR2000034530, Registered on July 8th, 2020.


Assuntos
Ventilação não Invasiva , Doença Pulmonar Obstrutiva Crônica/reabilitação , Qigong , Postura Sentada , Decúbito Dorsal , Humanos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Testes de Função Respiratória
17.
Artigo em Inglês | MEDLINE | ID: mdl-32993142

RESUMO

Traditional classroom furniture dictates that children predominantly sit during class time. This study evaluated the impact of providing standing desks within a deprived UK primary school setting over 8 months using mixed-method approaches. All children within a Year 5 class (9-10-year-olds, n = 30) received an adjustable sit-stand desk, while another Year 5 class (n = 30) in a nearby school retained traditional furniture as a control classroom. At baseline, 4 months, and 8 months, activPAL monitors (PAL Technologies, Glasgow, UK) were worn for 7 days to provide time spent sitting and standing. Behavior-related mental health, musculoskeletal discomfort surveys, and a cognitive function test battery were also completed at all three timepoints. Intervention experiences from pupils and the teacher were captured using focus groups, interviews, and classroom observations. At both 4 months and 8 months, multi-level models revealed a reduction in class time sitting in the intervention group compared to the control group ((ß (95%CI) 4 months -25.3% (-32.3, -18.4); 8 months -19.9% (-27.05, -12.9)). Qualitative data revealed challenges to teaching practicalities and a gradual decline in behavior-related mental health was observed (intervention vs. control: 4 months +5.31 (+2.55, +8.08); 8 months +7.92 (+5.18, +10.66)). Larger trials within similar high-priority settings are required to determine the feasibility and cost-effectiveness of providing standing desks to every child in the classroom.


Assuntos
Promoção da Saúde/métodos , Comportamento Sedentário , Posição Ortostática , Estudantes/estatística & dados numéricos , Criança , Feminino , Humanos , Masculino , Instituições Acadêmicas/organização & administração , Postura Sentada
18.
Phys Ther ; 100(12): 2090-2098, 2020 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-32915985

RESUMO

OBJECTIVE: Hospital in Motion is a multidimensional implementation project aiming to improve movement behavior during hospitalization. The purpose of this study was to investigate the effectiveness of Hospital in Motion on movement behavior. METHODS: This prospective study used a pre-implementation and post-implementation design. Hospital in Motion was conducted at 4 wards of an academic hospital in the Netherlands. In each ward, multidisciplinary teams followed a 10-month step-by-step approach, including the development and implementation of a ward-specific action plan with multiple interventions to improve movement behavior. Inpatient movement behavior was assessed before the start of the project and 1 year later using a behavioral mapping method in which patients were observed between 9:00 am and 4:00 pm. The primary outcome was the percentage of time spent lying down. In addition, sitting and moving, immobility-related complications, length of stay, discharge destination home, discharge destination rehabilitation setting, mortality, and 30-day readmissions were investigated. Differences between pre-implementation and post-implementation conditions were analyzed using the chi-square test for dichotomized variables, the Mann Whitney test for non-normal distributed data, or independent samples t test for normally distributed data. RESULTS: Patient observations demonstrated that the primary outcome, the time spent lying down, changed from 60.1% to 52.2%. For secondary outcomes, the time spent sitting increased from 31.6% to 38.3%, and discharges to a rehabilitation setting reduced from 6 (4.4%) to 1 (0.7%). No statistical differences were found in the other secondary outcome measures. CONCLUSION: The implementation of the multidimensional project Hospital in Motion was associated with patients who were hospitalized spending less time lying in bed and with a reduced number of discharges to a rehabilitation setting. IMPACT: Inpatient movement behavior can be influenced by multidimensional interventions. Programs implementing interventions that specifically focus on improving time spent moving, in addition to decreasing time spent lying, are recommended.


Assuntos
Repouso em Cama/estatística & dados numéricos , Hospitalização , Movimento , Alta do Paciente/estatística & dados numéricos , Centros de Reabilitação/estatística & dados numéricos , Postura Sentada , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Participação do Paciente , Estudos Prospectivos , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de Tempo
19.
Phys Ther ; 100(12): 2134-2143, 2020 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-32936920

RESUMO

OBJECTIVE: Obesity reduces voluntary recruitment of quadriceps during single-joint exercises, but the effects of obesity on quadriceps femoris muscle activation during dynamic daily living tasks, such as sit-to-stand (STS), are largely unknown. The purpose of this study was to determine how obesity affects quadriceps muscle recruitment during STS. METHODS: In this cross-sectional study, 10 women who were lean and 17 women who were obese completed STS from a chair with arms crossed over the chest. Three-dimensional motion analysis was used to define 3 distinct phases (I-III) of the STS cycle. The electromyographic (EMG) activity of the vastus medialis, vastus lateralis, and semitendinosus was measured. RESULTS: STS duration was greater (3.02 [SD = 0.75] seconds vs 1.67 [SD = 0.28] seconds) and peak trunk flexion angle was lower (28.9 degrees [SD = 10.4 degrees] vs 35.8 degrees [SD = 10.1 degrees]) in the women who were obese than in the women who were lean. The mean EMG activity of the knee extensors increased from phase I to phase II in both groups; however, the mean EMG activities of both the vastus medialis (32.1% [SD = 16.6%] vs 47.3% [SD = 19.6%] maximal voluntary isometric contraction) and the vastus lateralis (31.8% [SD = 19.4%] vs 47.5% [SD = 19.6%] maximal voluntary isometric contraction) were significantly lower during phase II in the women who were obese. The mean EMG activity of the semitendinosus increased throughout STS but was not significantly different between the 2 groups. Coactivation of the semitendinosus and knee extensors tended to be greater in the women who were obese but failed to reach statistical significance. CONCLUSIONS: Knee extensor EMG amplitude was reduced in women who were obese during STS, despite reduced trunk flexion. IMPACT: Reduced knee extensor recruitment during STS in obesity may redistribute forces needed to complete this task to other joints. Functional movement training may help improve knee extensor recruitment during STS in people who are obese. LAY SUMMARY: People with obesity often have low quadriceps muscle strength and impaired mobility during daily activities. This study shows that women who are obese have lower voluntary recruitment of quadriceps when rising from a chair than women who are lean do, which could increase workload on hip or ankle muscles during this important daily task. Quadriceps strengthening exercises might improve the ability to rise from sitting to standing.


Assuntos
Movimento/fisiologia , Obesidade/fisiopatologia , Músculo Quadríceps/fisiologia , Postura Sentada , Posição Ortostática , Adulto , Estudos Transversais , Eletromiografia/métodos , Feminino , Humanos , Contração Isométrica/fisiologia , Extremidade Inferior/fisiopatologia , Pessoa de Meia-Idade , Recrutamento Neurofisiológico/fisiologia , Magreza/fisiopatologia , Fatores de Tempo , Adulto Jovem
20.
J Vasc Res ; 57(6): 355-366, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32937620

RESUMO

We evaluated the effects of a simulated workday of prolonged sitting on blood pressure (BP) and pulse wave velocity (PWV) and examined whether posture (seated vs. supine) affected responses. Participants (n = 25) were adults, with overweight/obesity and elevated BP, and performed seated desk work for 7.5 h. BP and PWV were measured in seated and supine postures at baseline (7:15 a.m.), midday (12:05 p.m.), and afternoon (4:45 p.m.). Generalized linear mixed models evaluated the effects of prolonged sitting on BP and PWV within each posture and interactions by posture and sex. In the recommended postures, seated BP and supine carotid-femoral pulse wave velocity (cfPWV) and carotid-ankle pulse wave velocity (caPWV), but not carotid-radial pulse wave velocity (crPWV), significantly increased over the simulated seated workday (all p < 0.05; effect sizes [d] ranged from 0.25 to 0.44). Whilst no posture-by-time interactions were observed (p > 0.05), BP, caPWV, and crPWV were higher when seated versus supine (main effects of posture p < 0.05; d ranged from 0.30 to 1.04). Exploratory analysis revealed that females had greater seated BP responses (p for interaction <0.05); seated PWV and supine BP and PWV responses were similar by sex (p for interaction >0.05). A simulated workday of prolonged sitting increased seated BP and supine cfPWV and caPWV, and posture minimally influenced these responses. These results add to the evidence suggesting a deleterious effect of prolonged sitting on cardiovascular health.


Assuntos
Determinação da Pressão Arterial , Pressão Sanguínea , Hipertensão/diagnóstico , Obesidade/diagnóstico , Posicionamento do Paciente , Análise de Onda de Pulso , Comportamento Sedentário , Postura Sentada , Decúbito Dorsal , Rigidez Vascular , Adulto , Estudos Cross-Over , Feminino , Humanos , Hipertensão/fisiopatologia , Descrição de Cargo , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Valor Preditivo dos Testes , Fatores de Tempo
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