Physical Activity Levels Are Low in Free-Living Adults with Chronic Paraplegia

Background Promotion of increased physical activity is advocated for survivors of an intensive care unit (ICU) admission to improve physical function and health-related quality of life. Objective The primary aims of this study were: (1) to measure free-living physical activity levels and (2) to correlate the measurements with scores on a self-reported activity questionnaire. A secondary aim was to explore factors associated with physical activity levels. Design This was a prospective cohort study. Methods Nested within a larger randomized controlled trial, participants were block randomized to measure free-living physical activity levels. Included participants wore an accelerometer for 7 days during waking hours at 2 months after ICU discharge. At completion of the 7 days of monitoring, participants were interviewed using the Physical Activity Scale for the Elderly (PASE) questionnaire. Factors associated with physical activity were explored using regression analysis. Results The ICU survivors (median age=59 years, interquartile range=49–66; mean Acute Physiologic Chronic Health Evaluation [APACHE II] score=18, interquartile range=16–21) were inactive when quantitatively measured at 2 months after hospital discharge. Participants spent an average of 90% of the time inactive and only 3% of the time walking. Only 37% of the sample spent 30 minutes or more per day in the locomotion category (more than 20 steps in a row). Activity reported using the PASE questionnaire was lower than that reported in adults who were healthy. The PASE scores correlated only fairly with activity measured by steps per day. The presence of comorbidities explained one third of the variance in physical activity levels. Limitations Accelerometer overreading, patient heterogeneity, selection bias, and sample size not reached were limitations of the study. Conclusions Survivors of an ICU admission greater than 5 days demonstrated high levels of inactivity for prolonged periods at 2 months after ICU discharge, and the majority did not meet international recommendations regarding physical activity. Comorbidity appears to be a promising factor associated with activity levels.

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Associations of Affective Responses During Free-Living Physical Activity and Future Physical Activity Levels: an Ecological Momentary Assessment Study

International Journal of Behavioral Medicine ◽

10.1007/s12529-016-9626-z ◽

2016 ◽

Vol 24 (4) ◽

pp. 513-519 ◽

Cited By ~ 6

Author(s):

Yue Liao ◽

Chih-Ping Chou ◽

Jimi Huh ◽

Adam Leventhal ◽

Genevieve Dunton

Keyword(s):

Physical Activity ◽

Ecological Momentary Assessment ◽

Affective Responses ◽

Activity Levels ◽

Free Living ◽

Assessment Study ◽

Physical Activity Levels ◽

Ecological Momentary ◽

Momentary Assessment

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Objectively measuring children's physical activity levels in a free living environment

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2017.01.089 ◽

2017 ◽

Vol 20 ◽

pp. e104 ◽

Cited By ~ 1

Author(s):

C. Desmet ◽

R. Sutherland ◽

L. Davies ◽

L. Wolfenden ◽

P. Butler ◽

...

Keyword(s):

Physical Activity ◽

Living Environment ◽

Activity Levels ◽

Free Living ◽

Physical Activity Levels ◽

Children’S Physical Activity

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Effect of calorie restriction on the free-living physical activity levels of nonobese humans: results of three randomized trials

Journal of Applied Physiology ◽

10.1152/japplphysiol.00846.2009 ◽

2011 ◽

Vol 110 (4) ◽

pp. 956-963 ◽

Cited By ~ 42

Author(s):

Corby K. Martin ◽

Sai Krupa Das ◽

Lauren Lindblad ◽

Susan B. Racette ◽

Megan A. McCrory ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Energy Expenditure ◽

Calorie Restriction ◽

Weight Maintenance ◽

Energy Deficit ◽

Control Group ◽

Activity Levels ◽

Free Living ◽

Physical Activity Levels

The objective of this study was to evaluate the influence of calorie restriction (CR) on free-living physical activity levels among humans. Data were from three CALERIE phase I site-specific protocols. Participants were nonobese (body mass index = 23.5–29.9 kg/m2) adults randomly assigned to 25% CR, low-calorie diet (LCD, 890 kcal/day supplement diet until 15% weight loss, then weight maintenance), or control at Pennington Biomedical Research Center (PBRC); 30% or 10% CR at Tufts University; and 20% CR or control at Washington University School of Medicine (WUSM). Activity was measured at months 0, 3, and 6 (PBRC) and at months 0, 3, 6, 9, and 12 (WUSM and Tufts). Total daily energy expenditure (TEE) by doubly labeled water and resting metabolic rate (RMR) were used to compute activity energy expenditure: AEE = TEE − RMR − 0.1 * TEE. Accelerometry and 7-day recall categorized activities by intensity. At Tufts, the 10% and 30% CR groups experienced significant decreases in AEE at months 6, 9, and 12. At month 6, a larger decrease in AEE was observed in the CR than the control group at WUSM. At months 3 and 6, larger decreases in AEE were observed in the CR and LCD groups than the control group at PBRC. Accelerometry and 7-day PAR did not consistently detect changes in activity categories. CR-associated changes in AEE were variable but, generally, reduced the energy deficit, which would reduce the expected rate of weight loss. Accelerometry and recall did not consistently explain reduced AEE, suggesting that increased muscle efficiency and/or decreased fidgeting accounted for decreased AEE. Inaccuracy of accelerometry and recall also likely negatively affected sensitivity.

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