Background While it is well known that patients with ankylosing spondyltis (AS) experience restrictions in worker participation, information regarding participation in other social roles is lacking. ...Objectives To assess and understand social role participation in patients with AS in comparison with a healthy control group using the social role participation questionnaire (SRPQ). Methods In a cross-sectional study, subjects completed the SRPQ, which assesses the influence of health on the perceived importance of 11 diverse social roles (e.g., hobbies, traveling, relationships, employment) and one global participation question, as well as the satisfaction with the role performance. All items were rated on a 5 point likert scale ranging from 1= not important /not at all satisfied to 5= very important/very satisfied. From these scores the importance satsifaction gap was calculated (importance minus satisfaction with the role performance), indicating the discordance between role salience and role performance. Results A total of 246 AS patients (mean age 51 ± 12 years; 62% males; mean disease duration of 17 ± 12 years) and 510 healthy controls (mean age 42 ± 15 years; 70% males) were included. The mean scores of importance and satisfaction with the role performance of the global participation question were 4.3 ± 0.8 and 3.0 ± 1.0, respectively for patients and 4.0 ± 0.9 and 3.6 ± 0.9, respectively for controls and were significantly different between groups for both measures P< 0.001. The difference of the importance-satisfaction gaps between patients and controls accros social roles varied between 0 and 1.1. Figure 1 illustrates the gaps for patients and controls for all social roles seperately. Image/graph Conclusions In comparison with a healthy population, patients with AS report larger importance-satisfaction gaps except for the social role of paid work. Future studies should explore the reasons for the difference in the gap between patients and controls as well as the contribution of the concept of the importance-satisfaction gap on the satisfaction with life. Disclosure of Interest S. van Genderen: None Declared, G. Plasqui: None Declared, P. Jacobs: None Declared, L. Heuft: None Declared, J. Luime: None Declared, A. Spoorenberg: None Declared, S. Arends: None Declared, M. Gignac: None Declared, D. Lacaille: None Declared, D. van der Heijde: None Declared, R. Landewe: None Declared, A. Boonen Grant/research support from: MSD, Pfizer, Amgen, Abbott, Consultant for: Pfizer, Speakers bureau: Pfizer, UCB
Background Ankylosing spondylitis (AS) is a rheumatic inflammatory disease that mainly affects the axial skeleton. Important symptoms comprise pain, (morning) stiffness, fatigue, reduced mobility and ...limitations in the physical function. Likely this will lead to a decrease of physical activity (PA) compared to a healthy population. Objectives The aim of this study was to compare patients with AS and healthy controls regarding their PA, using a tri-axial accelerometer. Methods In this cross-sectional study, PA was measured using a tri-axial accelerometer (Actigraph GT3X+) attached to the lower back by means of an elastic belt. Subjects wore the accelerometer for 7 consecutive days, during waking hours. From accelerometer output, total activity counts per day was calculated, as well as the average minutes per day subjects spent in light i.e. <3.00 Metabolic Equivalent of Task (MET), moderate (3.00-5.99 MET) vigorous (6.00-8.99 MET) or very vigorous activity (>8.99 MET). Subjects also completed an online questionnaire including the BASDAI (disease activity, 0 no symptoms to 10 worst symptoms), BASFI (limitations in physical function, 0 no limitations to 10 most limitations), disease duration in years (patients only), height and weight. Results A total of 135 AS patients (mean age 51 ± 13 y; 60% males; disease duration of 17 ± 12 y) and 100 healthy controls (mean age 44 ± 12 years; 66% males) were included. Patients with AS were significantly older, P <0.001 and had a mean ± SD body mass index (BMI) in kg/m2 of 26.0 ± 4.3, compared to 24.8 ± 5.0 in controls (NS). Patients showed the same total amount of PA as well as time spent in low and moderate activity as controls (Table 1). Controls spent slightly more time in vigorous and very vigorous PA. Patients reported significantly higher on the BASDAI 4.3 ± 2.2 and BASFI 4.1 ± 2.6 opposed to controls 1.3 ± 1.2 and 0.38 ± 0.7 respectively, (both P <0.001). Conclusions Despite experiencing more limitations and disease activity, patients with AS scored a similar amount of total PA as controls and spent equal time in light and moderate PA, except for vigorous and very vigorous PA even though the patients were older. This study indicates the importance of including objective measures of physical functioning in patients with AS. Disclosure of Interest S. van Genderen: None Declared, A. Boonen Grant/research support from: MSD, Pfizer, Amgen, Abbott, Consultant for: Pfizer, Speakers bureau: Pfizer, UCB, P. Jacobs: None Declared, L. Heuft: None Declared, J. Luime: None Declared, A. Spoorenberg: None Declared, S. Arends: None Declared, D. van der Heijde: None Declared, R. Landewe: None Declared, G. Plasqui: None Declared
The present study investigated the use of a tri-axial accelerometer, Tracmor2, for the measurement of physical activity in children. Eleven children age 6.9 (2.2) years, body mass 19.5 (5.3) kg and ...height 112.3 (14.4) cm were studied. Total daily energy expenditure (TDEE) was measured using the doubly labeled water method over a 2-week period. In addition, basal metabolic rate (BMR) was determined by the ventilated hood system. Physical activity level (PAL) was defined as TDEE/BMR. Tracmor2 was worn during the same 2-week period throughout waking hours after which average counts per day were calculated. The average counts per day were shown to be highly correlated to PAL values measured by doubly labeled water: PAL = 1.156 x 10(-5) x Tracmor2 average counts day(-1) + 0.978 (r=0.79, P<0.01). In conclusion, Tracmor2 is a valid instrument to measure physical activity in children under free-living conditions.
Background: Hypermetabolism and muscle wasting frequently occur in patients with severe emphysema. Improving respiratory mechanics by bronchoscopic lung volume reduction (BLVR) might contribute to ...muscle maintenance by decreasing energy requirements and alleviating eating-related dyspnoea. Objective: The goal was to assess the impact of BLVR on energy balance regulation. Design: Twenty emphysematous subjects participated in a controlled clinical experiment before and 6 months after BLVR. Energy requirements were assessed: basal metabolic rate (BMR) by ventilated hood, total daily energy expenditure (TDEE) by doubly labelled water, whole body fat-free mass (FFM) by deuterium dilution, and physical activity by accelerometry. Oxygen saturation, breathing rate, and heart rate were monitored before, during, and after a standardized meal via pulse oximetry and dyspnoea was rated. Results: Sixteen patients completed follow-up, and among those, 10 patients exceeded the minimal clinically important difference of residual volume (RV) reduction. RV was reduced with median (range) 1,285 mL (−2,430, −540). Before BLVR, 90% of patients was FFM-depleted despite a normal BMI (24.3 ± 4.3 kg/m 2 ). BMR was elevated by 130%. TDEE/BMR was 1.4 ± 0.2 despite a very low median (range) daily step count of 2,188 (739, 7,110). Following BLVR, the components of energy metabolism did not change significantly after intervention compared to before intervention, but BLVR treatment decreased meal-related dyspnoea (4.1 vs. 1.7, p = 0.019). Conclusions: Impaired respiratory mechanics in hyperinflated emphysematous patients did not explain hypermetabolism. Clinical Trial Registry Number: NCT02500004 at www.clinicaltrial.gov.
Objective: The impact of season on energy expenditure and physical activity is not well quantified. This study focused on summer‐winter differences in total energy expenditure (TEE) and physical ...activity.
Research Methods and Procedures: Twenty‐five healthy Dutch young adults, living in an urban environment, were measured in the summer season and the winter season. TEE was measured using doubly labeled water, and sleeping metabolic rate (SMR) was measured during an overnight stay in a respiration chamber. Subsequently, the physical activity level (PAL = TEE/SMR) and activity‐related energy expenditure (0.9 × TEE) − SMR were calculated. Maximal mechanical power (Wmax) was determined with an incremental test on a cycle ergometer. Body composition was measured with hydrostatic weighing and deuterium dilution using Siri's three‐compartment model.
Results: There was no difference in TEE between seasons. PAL was higher in summer than in winter (1.87 ± 0.22 vs. 1.76 ± 0.18; p < 0.001), and the difference was higher for men than for women (0.20 ± 0.14 vs. 0.05 ± 0.16; p = 0.04). The difference in PAL between seasons was dependent on the initial activity level. There was a strong linear relation (R2 = 0.48) between PAL and physical fitness (Wmax/fat‐free mass), but Wmax/fat‐free mass did not change between seasons in response to the lower PAL in winter.
Discussion: The extent of the changes in PAL is of physiological significance, and seasonality in physical activity should be taken into account when studying physical activity patterns or relationships between physical activity and health.
The aim of this study was to use a novel method to examine and compare physical activity levels in four different groups of men to investigate the impact of modernity on activity levels. Physical ...activity levels of four different groups of men were measured and compared, using a tri-axial accelerometer (Tracmor). The first group (HA = historically active) were actors in a historical theme park who play the part of Australian settlers 150 years ago, the second were sedentary modern-day office workers (MS = modern sedentary), the third men who had successfully lost weight (SWL) in a modern men's weight loss program and the last, men who were unsuccessful (UWL) in the same program. Men who had successfully lost weight in a weight loss program were active at a level similar to that of men performing activity at a level carried out historically. Both of these groups were in turn significantly more active than modern-day sedentary workers (p < 0.05) and men who had not been successful at losing weight (p < 0.01). A linear regression between weekly average activity levels and the degree of waist size loss showed a significant positive association (r = 0.52, p < 0.01). The data suggest that a higher activity level facilitates the maintenance of long-term weight loss and this level is likely to approximate activity levels in the past. For the prevention and treatment of obesity an increase in physical activity is necessary, because (long-term) weight loss or weight maintenance is unlikely to occur when people are as sedentary as most people are today.
PDF
