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Wullems JA, Degens H, Verschueren SMP, Morse CI, Grant DM, Onambélé-Pearson GL. Sedentary behaviour (especially accumulation pattern) has an independent negative impact on skeletal muscle size and architecture in community-dwelling older adults. PLoS One 2024; 19:e0294555. [PMID: 38394127 PMCID: PMC10889859 DOI: 10.1371/journal.pone.0294555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 11/03/2023] [Indexed: 02/25/2024] Open
Abstract
Prolonged sedentary behaviour (SB) i.e. longer bouts, is suggested to have a range of negative health effects, independent of habitual light and medium-to-vigorous physical activity (LIPA or MVPA). Any effect on musculoskeletal size, architecture or morphology has seldom been reported in older adults. Moreover, no study has yet determined if any association would persist following adjustment for covariates. Therefore, the aim of the present study was to investigate the associations between SB, and properties of the Gastrocnemius Medialis (GM) muscle, in a cross-sectional sample of older adults using compositional data analysis. 105 healthy older adults (73±6y) wore a thigh mounted tri-axial accelerometer for seven consecutive days, and underwent ultrasound [e.g. muscle length (Lm), anatomical cross-sectional area (ACSA), muscle volume (VM), fascicle length (LF), & physiological cross-sectional area (PCSA)], body composition (e.g. DEXA) and health (e.g. medical history) assessments. In-unadjusted models, SB time was negatively associated with ACSA at 75% of Lm (R2adj = 0.085), VM (R2adj = 0.020), and PCSA (R2adj = 0.039). Standing was positively associated with pennation angle (R2adj = 0.110), which persisted following co-variate adjustment (R2adj = 0.296). In fully adjusted models, both SB & LIPA time were associated with ACSA at 75% of Lm (Both R2adj = 0.393). Standing and light activity time were also associated with LF, VM, & PCSA (R2adj 0.116-0.573). In fully adjusted models, SB pattern parameters (i.e. the manner in which sedentary behaviour is accumulated daily throughout waking hours such as the timing, duration and frequency of sedentary bouts), were associated with GM muscle properties (R2adj 0.156-0.564) including LM, LF, and VM. The pattern, rather than accumulated daily SB time, was associated with the size and architecture of the GM. Our results suggest that regardless of co-existing habitual physical activities, SB bouts should be kept short and frequently interrupted to offset some of the deleterious ageing-related muscle architecture characteristics changes.
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Affiliation(s)
- Jorgen A. Wullems
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Hans Degens
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Lithuanian Sports University, Kaunas, Lithuania
| | - Sabine M. P. Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Christopher I. Morse
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - Dale M. Grant
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - Gladys L. Onambélé-Pearson
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
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Wullems JA, Verschueren SMP, Degens H, Morse CI, Onambélé-Pearson GL. Concurrent Validity of Four Activity Monitors in Older Adults. Sensors (Basel) 2024; 24:895. [PMID: 38339613 PMCID: PMC10856911 DOI: 10.3390/s24030895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
Sedentary behaviour (SB) and physical activity (PA) have been shown to be independent modulators of healthy ageing. We thus investigated the impact of activity monitor placement on the accuracy of detecting SB and PA in older adults, as well as a novel random forest algorithm trained on data from older persons. Four monitor types (ActiGraph wGT3X-BT, ActivPAL3c VT, GENEActiv Original, and DynaPort MM+) were simultaneously worn on five anatomical sites during ten different activities by a sample of twenty older adults (70.0 (12.0) years; 10 women). The results indicated that collecting metabolic equivalent (MET) data for 60 s provided the most representative results, minimising variability. In addition, thigh-worn monitors, including ActivPAL, Random Forest, and Sedentary Sphere-Thigh, exhibited superior performance in classifying SB, with balanced accuracies ≥ 94.2%. Other monitors, such as ActiGraph, DynaPort MM+, and GENEActiv Sedentary Sphere-Wrist, demonstrated lower performance. ActivPAL and GENEActiv Random Forest outperformed other monitors in participant-specific balanced accuracies for SB classification. Only thigh-worn monitors achieved acceptable overall balanced accuracies (≥80.0%) for SB, standing, and medium-to-vigorous PA classifications. In conclusion, it is advisable to position accelerometers on the thigh, collect MET data for ≥60 s, and ideally utilise population-specific trained algorithms.
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Affiliation(s)
- Jorgen A. Wullems
- Department of Sport and Exercise Sciences, Institute of Sport, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M1 7EL, UK; (J.A.W.); (C.I.M.)
| | - Sabine M. P. Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium;
| | - Hans Degens
- Department of Life Sciences, Institute of Sport, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M1 5GD, UK;
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania
| | - Christopher I. Morse
- Department of Sport and Exercise Sciences, Institute of Sport, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M1 7EL, UK; (J.A.W.); (C.I.M.)
| | - Gladys L. Onambélé-Pearson
- Department of Sport and Exercise Sciences, Institute of Sport, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M1 7EL, UK; (J.A.W.); (C.I.M.)
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Ryan DJ, Wullems JA, Stebbings GK, Morse CI, Stewart CE, Onambele-Pearson GL. Reliability and validity of the international physical activity questionnaire compared to calibrated accelerometer cut-off points in the quantification of sedentary behaviour and physical activity in older adults. PLoS One 2018; 13:e0195712. [PMID: 29672534 PMCID: PMC5908192 DOI: 10.1371/journal.pone.0195712] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/28/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The aim was to determine the reliability and validity of IPAQ measured sedentary behaviour (SB) and moderate-vigorous physical activity (MVPA) in older persons whilst examining any sex differences in reliability and validity results. METHOD 89 participants (73.7 ± 6.3 years, 54% female) completed the IPAQ. Participants were fitted with a thigh mounted triaxial accelerometer (GeneActiv Original) for seven consecutive days and subsequently completed a second IPAQ. RESULTS IPAQ showed weak reliability qualities for Total SB (h·week-1) and 10 minute MVPA (accumulated in bouts ≥ 10 continuous minutes, h·week-1). IPAQ had poor concurrent validity qualities for Total SB, 10 minute MVPA, but not Sporadic MVPA (accumulated in bouts < 10 continuous minutes, h·week-1). IPAQ only categorised participant physical behaviour classification correctly 2% of the time. Sex differences were only present for the correlation slope of IPAQ 10 minute MVPA reliability measures. CONCLUSION Our data suggests that the IPAQ is not suitable for assessing older adults habitual physical behaviour.
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Affiliation(s)
- Declan J. Ryan
- Health Exercise & Active Living Research Centre, Department of Exercise & Sport Science, Manchester Metropolitan University, Cheshire, United Kingdom
| | - Jorgen A. Wullems
- Health Exercise & Active Living Research Centre, Department of Exercise & Sport Science, Manchester Metropolitan University, Cheshire, United Kingdom
| | - Georgina K. Stebbings
- Health Exercise & Active Living Research Centre, Department of Exercise & Sport Science, Manchester Metropolitan University, Cheshire, United Kingdom
| | - Christopher I. Morse
- Health Exercise & Active Living Research Centre, Department of Exercise & Sport Science, Manchester Metropolitan University, Cheshire, United Kingdom
| | - Claire E. Stewart
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Gladys L. Onambele-Pearson
- Health Exercise & Active Living Research Centre, Department of Exercise & Sport Science, Manchester Metropolitan University, Cheshire, United Kingdom
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Wullems JA, Verschueren SMP, Degens H, Morse CI, Onambélé GL. A review of the assessment and prevalence of sedentarism in older adults, its physiology/health impact and non-exercise mobility counter-measures. Biogerontology 2016; 17:547-65. [PMID: 26972899 PMCID: PMC4889631 DOI: 10.1007/s10522-016-9640-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 02/19/2016] [Indexed: 12/19/2022]
Abstract
This literature review focuses on aspects of sedentary behaviour (SB) in elderly. Since it has been identified as a distinct health risk, independent of physical activity, SB is a significant issue. This is particularly true for an ageing population as evidence shows that older adults (aged ≥65 years) are the most sedentary age group (on average 8.5–9.6 h daily sitting time). Accurate SB assessment is important for understanding this habitual behaviour and its impact. However, SB measurement is challenging, regardless of the method used. Although negative associations of SB in elderly have been reported for several health outcomes, evidence is inconclusive, apart from the evidence on the adverse SB effect on the all-cause mortality rate. Generally, strategies have been proposed to counteract SB, of which breaking prolonged sedentary bouts with at least light-intensity physical activity seems to be the most promising. Overall, further research in elderly is required to increase the evidence and to either support or refute the current findings. Moreover, further research will help to develop informed SB guidelines for an optimal strategy to counteract SB and its health effects in older adults.
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Affiliation(s)
- Jorgen A Wullems
- Department of Exercise and Sport Science, Institute for Performance Research, Manchester Metropolitan University, Crewe Green Road, Crewe, CW1 5DU, UK
| | - Sabine M P Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Louvain, Belgium
| | - Hans Degens
- School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
- Lithuanian Sports University, Kaunas, Lithuania
| | - Christopher I Morse
- Department of Exercise and Sport Science, Institute for Performance Research, Manchester Metropolitan University, Crewe Green Road, Crewe, CW1 5DU, UK
| | - Gladys L Onambélé
- Department of Exercise and Sport Science, Institute for Performance Research, Manchester Metropolitan University, Crewe Green Road, Crewe, CW1 5DU, UK.
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van der Weegen W, Wullems JA, Bos E, Noten H, van Drumpt RAM. No difference between intra-articular injection of hyaluronic acid and placebo for mild to moderate knee osteoarthritis: a randomized, controlled, double-blind trial. J Arthroplasty 2015; 30:754-7. [PMID: 25548079 DOI: 10.1016/j.arth.2014.12.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 11/11/2014] [Accepted: 12/09/2014] [Indexed: 02/01/2023] Open
Abstract
The main goal of our study was to examine the effectiveness and safety of Fermathron plus, a specific brand of hyaluronic acid (HA), in patients with mild to moderate knee osteoarthritis. In a randomized, controlled, double-blind trial, 196 patients with symptomatic knee osteoarthritis (mean age ± SD, 59.4 ± 9.9 years, Kellgren-Lawrence grade 1-3) were given either 3 weekly intra-articular injections of HA or saline (placebo). Although pain and functional scores (WOMAC scale) improved significantly from baseline up to 6 months, HA was not superior to placebo at any follow-up (VAS pain 50 m walking from 56.4 to 38.1, P < .001, and 58.2 to 39.6, P < .001, respectively). No subgroup analysis resulted in superior outcomes. No serious adverse events were noticed.
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Affiliation(s)
| | - Jorgen A Wullems
- Department of Orthopedic Surgery, St. Anna hospital, Geldrop, The Netherlands
| | - Ellis Bos
- Department of Orthopedic Surgery, St. Anna hospital, Geldrop, The Netherlands
| | - Hub Noten
- Department of Orthopedic Surgery, Elkerliek hospital, Helmond, The Netherlands
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van der Weegen W, Brakel K, Horn RJ, Wullems JA, Das HP, Pilot P, Nelissen RG. Comparison of different pseudotumor grading systems in a single cohort of metal-on-metal hip arthroplasty patients. Skeletal Radiol 2014; 43:149-55. [PMID: 24221138 DOI: 10.1007/s00256-013-1755-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 09/26/2013] [Accepted: 10/10/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Follow-up of pseudotumors observed with metal-artefact reducing sequence (MARS)-magnetic resonance imaging (MRI) following metal-on-metal total hip arthroplasty (MoMTHA) depends on how severe these pseudotumors are graded. Several pseudotumor grading systems for MARS-MRI have emerged but little is known of their validity. We studied the intra- and interobserver reliability of three different pseudotumor grading systems in a single cohort of MoMTHA. PATIENTS AND METHODS Two experienced musculoskeletal radiologists independently used three different pseudotumor grading systems for classifying MARS-MRI results of the same cohort of 42 MoMTHA patients (49 hips, mean follow-up 5.2 years). Intraobserver and interobserver reliability for each grading system was measured using Cohen's kappa (κ). Variance in pseudotumor severity grading between systems was analyzed. RESULTS Intraobserver reliability on grading pseudotumor severity with the Anderson, Matthies, and Hauptfleisch grading system scored 0.47, 0.10, and 0.35 (observer 1), and 0.75, 0.38, and 0.42 (observer 2), respectively. Interobserver reliability scores for pseudotumor severity were 0.58, 0.23, and 0.34, respectively. CONCLUSIONS Intraobserver reliability for grading pseudotumor severity on MARS-MRI ranged from poor to good, dependent on observer and grading system used. Interobserver reliability scored best with the Anderson system. A more succinct pseudotumor severity grading system is needed for clinical use.
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Affiliation(s)
- W van der Weegen
- Department of Orthopaedic Surgery, St. Anna Hospital, Bogardeind 2, 5664 EH, Geldrop, The Netherlands,
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Wullems JA, Halim W, van der Weegen W. Current Evidence of Percutaneous Nucleoplasty for the Cervical Herniated Disk: A Systematic Review. Pain Pract 2013; 14:559-69. [DOI: 10.1111/papr.12122] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Jorgen A. Wullems
- Department of Orthopedic Surgery; St. Anna Hospital; Geldrop The Netherlands
| | - Willy Halim
- Department of Anesthesia and Pain Management; St. Anna Hospital; Geldrop The Netherlands
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Halim W, Wullems JA, Lim T, Aukes HA, van der Weegen W, Vissers KC, Gültuna I, Chua NHL. The Long-term Efficacy and Safety of Percutaneous Cervical Nucleoplasty in Patients with a Contained Herniated Disk. Pain Pract 2012; 13:364-71. [DOI: 10.1111/papr.12003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 09/04/2012] [Indexed: 01/22/2023]
Affiliation(s)
- Willy Halim
- Department of Anesthesia and Pain Management; St. Anna Hospital; Geldrop; The Netherlands
| | - Jorgen A. Wullems
- Department of Orthopedic Surgery; St. Anna Hospital; Geldrop; The Netherlands
| | - Toine Lim
- Department of Anesthesia and Pain Management; St. Anna Hospital; Geldrop; The Netherlands
| | - Hans A. Aukes
- Department of Anesthesia and Pain Management; Albert Schweitzer Hospital; Sliedrecht; The Netherlands
| | | | - Kris C. Vissers
- Department of Anesthesiology, Pain Therapy and Palliative Care; UMC St. Radboud; Nijmegen; The Netherlands
| | - Ismail Gültuna
- Department of Anesthesia and Pain Management; Albert Schweitzer Hospital; Sliedrecht; The Netherlands
| | - Nicholas H. L. Chua
- Department of Anesthesia, Surgical Intensive Care and Pain Management; Tan Tock Seng Hospital; Singapore; Singapore
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