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Level of agreement between methods for measuring moderate-to-vigorous physical activity and sedentary time in people with obstructive sleep apnea and obesity
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. (Beteendemedicin och sjukgymnastik)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. (Beteendemedicin och sjukgymnastik)
2013 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 93, no 1, 50-59 p.Article in journal (Refereed) Published
Abstract [en]

Background

There is ambiguity about what measures to use to best identify physical activity and sedentary behavior, and agreement between methods for measuring physical activity and sedentary behavior in people with obstructive sleep apnea syndrome (OSAS) and obesity has not been evaluated.

Objective

The objective of this study was to examine the level of agreement between an accelerometer and a self-report questionnaire (International Physical Activity Questionnaire [IPAQ]) or a logbook for measuring time spent on moderate to vigorous physical activity and time spent sedentary in people with OSAS and obesity.

Design

This prospective study was a psychometric evaluation of agreement between measurement methods.

Methods

Thirty-nine people who were obese (mean body mass index 36.1 kg/m2, SD=4.35) and had moderate to severe OSAS (apnea-hypopnea index of ≥15) were consecutively recruited from a sleep clinic in Sweden. All were treated with continuous positive airway pressure and were waiting for a follow-up sleep evaluation.

Results

Agreement between the measurement methods was limited. For physical activity, the mean difference between the accelerometer and the IPAQ was 47 minutes, and the mean difference between the accelerometer and the logbook was 32 minutes. Agreement was limited for sedentary time as well; the mean difference between the accelerometer and the IPAQ was 114 minutes, and the mean difference between the accelerometer and the logbook was 86 minutes.

Limitations

The small sample size may affect the interpretation and generalizability of the results.

Conclusions

The results imply that the methods cannot be used interchangeably. A combination of an accelerometer and a daily logbook seems to provide a detailed description of physical activity and sedentary behavior.

Place, publisher, year, edition, pages
2013. Vol. 93, no 1, 50-59 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-181011DOI: 10.2522/ptj.20120123ISI: 000313320400006OAI: oai:DiVA.org:uu-181011DiVA: diva2:552657
Available from: 2012-09-14 Created: 2012-09-14 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Physical Activity and Eating Behaviour Changes in Patients with Obstructive Sleep Apnea Syndrome
Open this publication in new window or tab >>Physical Activity and Eating Behaviour Changes in Patients with Obstructive Sleep Apnea Syndrome
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis aimed at developing and evaluating a tailored behavioural sleep medicine intervention for enhanced physical activity and healthy eating in patients with obstructive sleep apnea syndrome (OSAS) and overweight.

Participants with moderate or severe OSAS (apnea-hypopnea index ≥15) and obesity (Studies I-II) or overweight (Studies III-IV), treated with continuous positive airway pressure (CPAP) (Studies I-II) or admitted to CPAP treatment (Studies III-IV), were recruited from the sleep clinic at Uppsala University Hospital, Sweden. Semi-structured individual interviews were analysed using qualitative content analysis (Study I). Data on moderate-to-vigorous physical activity (MVPA) and sedentary time were collected with three measurement methods and analysed regarding the level of measurement agreement (Study II). Potential disease-related and psychological correlates for the amount of MVPA, daily steps and sedentary time were explored using multiple linear regression (Study III). Physical activity and eating behaviour changes were examined after a six month behaviour change trial (Study IV). A tailored behavioural sleep medicine intervention targeting physical activity and healthy eating in combination with first- time CPAP treatment was compared with CPAP treatment and advice on the association between weight and OSAS.

According to participants’ conceptions, a strong incentive is needed for a change in physical activity and bodily symptoms, external circumstances and thoughts and feelings influence physical activity engagement (Study I). Compared with accelerometry, the participants overestimated the level of MVPA and underestimated sedentary time when using self-reports (Study II). The participants spent 11 hours 45 minutes (71.6% of waking hours) while sedentary. Fear of movement contributed to the variation in steps and sedentary time. Body mass index was positively correlated to MVPA (Study III). The experimental group increased intake of fruit and fish and reduced more weight and waist circumference compared with controls. There were no changes in physical activity (Study IV).

The novel tailored behavioural sleep medicine intervention combined with first-time CPAP facilitated eating behaviour change, with subsequent effects on anthropometrics, but it had no effects on physical activity and sedentary time. Fear of movement may be a salient determinant of sedentary time, which has to be further explored in this population. The results confirm sedentary being a construct necessary to separate from the lower end of a physical activity continuum and highlight the need of developing interventions targeting sedentary behaviours specifically.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 64 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 885
Keyword
Obstructive sleep apnea, physical activity, eating behaviour, sedentary time, health behaviour change
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-197595 (URN)978-91-554-8638-9 (ISBN)
Public defence
2013-05-17, Universitetshuset, sal IX, Övre Slottsgatan 2, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2013-04-24 Created: 2013-03-29 Last updated: 2013-08-30Bibliographically approved

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Igelström, HelenaEmtner, MargaretaLindberg, EvaÅsenlöf, Pernilla

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