Impact of replacing sedentary behaviour with other movement behaviours on depression and anxiety symptoms: a prospective cohort study in the UK Biobank.

BACKGROUND: Sedentary behaviour is potentially a modifiable risk factor for depression and anxiety disorders, but findings have been inconsistent. To assess the associations of sedentary behaviour with depression and anxiety symptoms and estimate the impact of replacing daily time spent in sedentary behaviours with sleep, light, or moderate to vigorous physical activity, using compositional data analysis methods. METHODS: We conducted a prospective cohort study in 60,235 UK Biobank participants (mean age: 56; 56% female). Exposure was baseline daily movement behaviours (accelerometer-assessed sedentary behaviour and physical activity, and self-reported total sleep). Outcomes were depression and anxiety symptoms (Patient Health Questionnaire-9 and Generalised Anxiety Disorders-7) at follow-up. RESULTS: Replacing 60 min of sedentary behaviour with light activity, moderate-to-vigorous activity, and sleep was associated with lower depression symptom scores by 1.3% (95% CI, 0.4-2.1%), 12.5% (95% CI, 11.4-13.5%), and 7.6% (95% CI, 6.9-8.4%), and lower odds of possible depression by 0.95 (95% CI, 0.94-0.96), 0.75 (95% CI, 0.74-0.76), and 0.90 (95% CI, 0.90-0.91) at follow-up. Replacing 60 min of sedentary behaviour with moderate-to-vigorous activity and sleep was associated with lower anxiety symptom scores by 6.6% (95% CI, 5.5-7.6%) and 4.5% (95% CI, 3.7-5.2%), and lower odds of meeting the threshold for a possible anxiety disorder by 0.90 (95% CI, 0.89-0.90) and 0.97 (95%CI, 0.96-0.97) at follow-up. However, replacing 60 min of sedentary behaviour with light activity was associated with higher anxiety symptom scores by 4.5% (95% CI, 3.7-5.3%) and higher odds of a possible anxiety disorder by 1.07 (95% CI, 1.06-1.08). CONCLUSIONS: Sedentary behaviour is a risk factor for increased depression and anxiety symptoms in adults. Replacing sedentary behaviour with moderate-to-vigorous activity may reduce mental health risks, but more work is necessary to clarify the role of light activity.

Does fitness attenuate the relationship between changes in sitting time and health-related quality of life over time in community-dwelling older adults? Evidence from the EXERNET multicenter longitudinal study.

OBJECTIVE: To assess the relationship between fitness levels and components, sitting time and health-related quality of life (HRQoL), over time among community-dwelling older adults. METHODS: Three different sitting trajectories were calculated: (i) no change; (ii) decrease; and (iii) increase in ST, between baseline and follow-up. Fitness was assessed using the aerobic capacity, upper and lower limb strength, and total fitness. Participants were classified into higher (75th percentile or above) or lower (below 75th percentile) fitness levels, using the fitness tests. HRQoL scores at follow-up were compared to the three different sitting time trajectories within and across both the higher and the lower fitness groups for each of the three fitness indexes. RESULTS: Greater HRQoL scores were observed in those participants that decreased their ST as compared with those increasing their sitting time over time for participants classified in the lower end of their aerobic capacity or total fitness index. No differences were detected in HRQoL scores in people classified in the higher fitness level group for any of the fitness indexes. Participants that increased or did not change their sitting time and who were classified in the higher fitness end of aerobic capacity and total fitness index self-reported higher HRQoL scores when compared with those in the lower fitness end. CONCLUSION: Increased sitting time over time is associated with poorer HRQoL in older adults. Higher fitness levels could help attenuate the negative impact of sitting over time.

Reallocating sedentary time to moderate-to-vigorous physical activity but not to light-intensity physical activity is effective to reduce adiposity among youths: a systematic review and meta-analysis.

The aim of the study was to summarize the evidence of the effects of reallocating time spent in sedentary behaviours in different activity intensities on youth's adiposity. Five databases were searched. Studies that reported the effects of replacing sedentary behaviour with light-intensity physical activity (LIPA) and/or moderate-to-vigorous physical activity (MVPA) on at least one adiposity parameter. The estimated regression coefficients (ß) and 95% CIs were combined and meta-analysed. Data from 7,351 youths and five studies were analysed. Pooled analysis from cross-sectional studies shows that replacing sedentary time with LIPA showed no significant associations with any adiposity-related outcomes. Replacing sedentary time with MVPA was statistically associated with total body fat percentage (ß = -2.512; p = 0.003), but not with body mass index or waist circumference. In subgroup analysis, the greatest magnitude of association was observed from studies where 60 min of sedentary behaviour was reallocated to 60 min of MVPA (ß = -4.535; p < 0.001). Our results highlight the importance of promoting MVPA, which may improve body composition phenotypes in young people. This information can be used to develop more effective lifestyle interventions.

VALIDATION AND COMPARISON OF EQ-5D-3L AND SF-6D INSTRUMENTS IN A SPANISH PARKINSON´S DISEASE POPULATION SAMPLE.

INTRODUCTION: generic, preference-based Health- Related Quality of Life instruments are receiving growing attention in health-care decision-making process. In spite of this, to our knowledge, EQ-5D and SF-6D have never been compared in a Parkinson´s disease population sample. OBJECTIVE: the aim of this paper was to assess the psychometric properties of both instruments in a Spanish PD population sample. METHODS: a total sample of 133 patients were interviewed using EQ-5D-3L and SF-6D. The validity, level of agreement and sensitivity of both instruments were computed and then compared. The Spanish tariff has been used in both instruments. RESULTS: utilities of EQ-5D-3L and SF-6D have shown a strong correlation (r >0.50 and p<0.001) with the summary score of the PDQ-8 and the EQ-VAS score. Significant differences were observed in the stages III-IV of the Hoehn & Yahr stage. SF-6D had 51% higher efficiency than EQ-5D at detecting differences in symptoms severity. DISCUSSION: both EQ-5D-3L and SF-6D seem to be adequate generic Health-Related Quality of Life measures in terms of validity and sensitivity. CONCLUSION: EQ-5D-3L presents greater ceiling and floor effects than the SF-6D instrument in this sample. Besides, the instrument SF-6D was better at detecting changes in symptoms severity compared with EQ-5D-3L.

Introducción: el uso de cuestionarios de calidad de vida basados en preferencias poblacionales están recibiendo cada vez más atención en el proceso de toma de decisiones en el ámbito sanitario. Sin embargo, a nuestro entender, EQ-5D y SF-6D nunca han sido comparados en una muestra de población con la enfermedad de Parkinson. Objetivo: el objetivo de este trabajo fue evaluar las propiedades psicométricas de ambos instrumentos en una muestra de población española con enfermos de Parkinson. Métodos: un total de 133 pacientes fueron entrevistados utilizando EQ-5D y SF-6D. La validez, el grado de acuerdo y la sensibilidad de ambos instrumentos fueron calculados para su posterior comparación. Las preferencias de la población española fueron utilizadas en ambos instrumentos. Resultados: las utilidades de EQ-5D y SF-6D han mostrado una fuerte correlación (r> 0,50 y p.

A web-based intervention to improve and prevent low back pain among office workers: a randomized controlled trial.

OBJECTIVES: To test the feasibility, safety, and efficacy of a web-based multidisciplinary intervention for office workers with subacute, nonspecific low back pain. METHODS: The randomized controlled trial included 100 office workers with subacute low back pain. The intervention group had access to both the study intervention and standard care. The control group had access to standard care only. Standard care was defined as all existing non-web-based interventions offered by the University of Extremadura's Preventive Medicine Service. The web-based program was offered via the Preventive Medicine Service website. The participants in the intervention group were asked to engage in the web-based program at their work site for 11 minutes each day, 5 days a week. Primary outcomes were functional disability, as measured by the Roland-Morris Disability Questionnarie, and health-related quality of life, as measured by the European Quality of Life-5 Dimensions-3 Levels. Secondary outcomes were the number of episodes of low back pain and trunk muscles endurance. Outcomes were measured before and after the 9-month intervention period. RESULTS: Over the 9-month study, the score on the Roland-Morris Disability Questionnaire for the participants in the web-based intervention group improved by a mean of -7.36 points (95% confidence interval [CI]:-8.41, -6.31) compared to a worsening of 1.89 points (95% CI: 0.71, 2.65) in the control group. The between-group difference in change on the Roland-Morris Disability Questionnarie over the study period was -9.25 points (95% CI:-10.57, -7.89). Similarly, over the compared to the control group. CONCLUSIONS: A 9 month web-based intervention is feasible and effective to improve function and health-related quality of life and to decrease episodes of low back pain among office workers with a history of subacute, nonspecific low back pain.

The relationship between nutritional status, functional capacity, and health-related quality of life in older adults with type 2 diabetes: a pilot explanatory study.

OBJECTIVE: To explore the relationship between nutritional status, functional capacity and health-related quality of life (HRQoL) in older adults with type 2 diabetes (T2DM). DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Forty two non-insulin dependent older adults from a primary care center in Seville, Spain. MEASUREMENTS: Function was assessed with a battery of standardized physical fitness tests. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) and the European Quality of Life Questionnaire (EQ-5D-3L) was used to assess HRQoL. RESULTS: There was an association between MNA-nutritional status and lower body strength as assessed by the chair sit-stand test (rho= .451; p= .037) and between MNA-nutritional status and EQ-5D-3L-HRQoL (EQ-5D-3Lutility, rho= .553; p<.001 and EQ-5D-3LVAS rho= .402; p<.001). An MNA item by item correlation analysis with HRQoL and lower limb strength demonstrated that HRQoL appears to be related to functional capacity (principally lower body strength, motor agility and cardiorespiratory fitness) among participants. These results were maintained when correlations were adjusted for co-morbidity. CONCLUSION: Our results demonstrated that nutritional status is moderately associated with HRQoL and lower limb strength in patients with T2DM. Our data suggest that more emphasis should be placed on interventions to encourage a correct diet and stress the needed to improve lower body strength to reinforce better mobility in T2DM population.

Musculoskeletal fitness and health-related quality of life characteristics among sedentary office workers affected by sub-acute, non-specific low back pain: a cross-sectional study.

OBJECTIVES: To establish the level of musculoskeletal fitness and health-related quality of life (HRQoL) in sedentary office workers with sub-acute, non-specific low back pain, and compare the results with reference data for healthy sedentary office workers. DESIGN: Cross-sectional study. SETTING: Occupational secondary prevention setting. PARTICIPANTS: One-hundred and ninety sedentary office workers: 118 suffering from sub-acute, non-specific low back pain (47 men and 71 women) and 72 age-matched healthy controls (30 men and 42 women). MAIN OUTCOME MEASURES: Participants were assessed using a musculoskeletal fitness battery (sit-and-reach test, hand grip strength, lumbar and abdominal trunk muscle endurance, and back scratch test), the EuroQol-5D-3L, Oswestry Disability Questionnaire, and Roland Morris Disability Questionnaire. Data for both genders and conditions were compared. RESULTS: Subjects with low back pain achieved lower scores in most of the fitness tests compared with healthy, age-matched controls. Trunk flexor and extensor endurance demonstrated the greatest difference in both men {flexion: median difference 59 [95% confidence interval (CI) 26 to 90]seconds; extension: median difference 24 [95% CI 20 to 68]} and women [flexion: median difference 59 (95% CI 5 to 85.50)seconds; extension: median difference 41 (95% CI 30 to 55)seconds]. Differences in HRQoL were also demonstrated between groups for both men and women, with the exception of the pain/discomfort dimension in women. CONCLUSIONS: Sedentary office workers with sub-acute, non-specific low back pain had lower musculoskeletal fitness than healthy, age-matched controls, with the main difference found in endurance of the trunk muscles. HRQoL was also lower in workers with low back pain.

Fiabilidad relativa y absoluta del test de elevación progresiva de carga isoinercial en pacientes afectados por dolor de espalda bajo crónico no específico: un estudio test-retest de 12 semanas / Relative and absolute reliability of the progressive iso-inertial lifting test in patients affected by non-specific, chronic low back pain: a 12-week test-retest study

Introducción. El dolor de espalda bajo crónico inespecífico es una dolencia cada vez más prevalente. Esta dolencia afecta a la funcionalidad y a la calidad de vida del individuo que la padece. El objetivo de este estudio fue determinar los índices relativos y absolutos de fiabilidad test-retest del protocolo de evaluación de la capacidad isoinercial de carga progresivo, como método de evaluación de la capacidad funcional en estos pacientes. Material y métodos. La muestra se compuso de 10 pacientes con dolor de espalda baja crónico inespecífico derivados por una unidad hospitalaria especializada en pacientes con dolor a los que se aplicó el protocolo del test de evaluación de la capacidad isoinercial de carga progresivo en 2 ocasiones separadas por un período de tiempo de 12 semanas siguiendo el protocolo estandarizado de dicho test. El análisis de los datos consistió en el cálculo de los índices de fiabilidad relativos (coeficiente de correlación intraclase) y absolutos (error estándar de medida y mínima diferencia real), así como la representación de los datos mediante los correspondientes gráficos de Bland-Altman. Resultados. Los resultados obtenidos muestran coeficientes de correlación intraclase altos, así como índices de error absolutos elevados para el test usado tanto en varones como en mujeres. Conclusión. El procedimiento empleado para la determinación de la capacidad funcional mediante del test de evaluación de la capacidad isoinercial de carga progresivo muestra una consistencia temporal alta, por lo que puede ser utilizado como medio para evaluar dicha capacidad en pacientes con dolor de espalda baja crónico inespecífico, en intervenciones inferiores a 12 semanas(AU)

Introduction. Chronic non-specific low back pain is an increasingly prevalent ailment. This ailment affects functional capacity and quality of life of individuals who have this condition. The aim of this study was to determine relative and absolute test-retest reliability of the protocol for the evaluation of the progressive isoinertial lifting test as a functional capacity function method. Material and methods. The sample consisted of 10 patients with chronic non-specific low back pain referred from a hospital unit specialized in pain patients who underwent the standardized protocol of the progressive isoinertial lifting test on two occasions separated by a period of 12 weeks. The data analysis consisted of calculating relative reliability (intraclass correlation coefficients) and absolute (standard error of measurement and smallest real difference) indices and the representation of the data using the corresponding Bland-Altman plots. Results. The results obtained show high correlation coefficients and large absolute error rates for the test used both in men and women. Conclusion. The procedure used for determining the functional capacity by means of the progressive isoinertial lifting test shows high temporal consistence. Thus, it can be used as a method to assess functional capacity of patients with chronic non-specific low back pain enrolled in interventions of less than 12 weeks(AU)

Whole body vibration improves the single-leg stance static balance in women with fibromyalgia: a randomized controlled trial.

AIM: Fibromyalgia (FM) is a chronic disorder characterized by widespread pain. Fibromyalgia is associated with balance problems and increased fall frequency. Whole-body vibration therapy had been used for improve balance in special populations but not in fibromyalgia. The main objective of this study was to analyze the effects of 12 weeks of tilting whole-body vibration therapy on static balance in fibromyalgia patients. METHODS: Women with FM were randomly and sequentially assigned to either the vibration group (N.=21) or the control group (N.=20) based on a randomly generated number table, and a code number was assigned to each participant. All participants received standard care that included medical care through the public health system (hospital and outpatient clinic, including primary care) and social support through the local fibromyalgia association. Participants in the exercise group received whole-body vibration therapy (12 weeks, 12.5 Hz frequency and 3 mm amplitude). Outcome measure was determined using postural stability indices (overall, anterior-posterior and medial-lateral) assessed by the Biodex Balance System in a single dominant limb stance. RESULTS: Treatment effect after 12-weeks of tilting whole body vibration therapy were 57.1% on overall stability and 66.6% on anterior-posterior stability. CONCLUSION: Tilting whole-body vibration therapy effectively improves static balance in patients with FM.