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      Physical activity and sedentary behavior in patients with systemic lupus erythematosus and rheumatoid arthritis

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          Abstract

          Objective

          Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are at increased risk of cardiovascular disease (CVD). As sedentary behavior and lack of physical activity are known cardiovascular risk factors, we compared habitual activity between SLE patients, RA patients, and healthy control participants.

          Patients and methods

          For this cross-sectional study, RA and SLE patients were recruited from rheumatology clinics at an academic medical center from April 2013 to December 2014. Healthy control participants were recruited through local advertising during the same time period. Habitual activity was measured using a triaxial accelerometer worn during waking hours for 7 consecutive days. Minutes per day of sedentary, light, and moderate–vigorous physical activity (MVPA) were recorded and compared between SLE, RA, and healthy participants using ANOVA.

          Results

          There were 59 participants included in the analysis: 20 SLE patients, 19 RA patients, and 20 healthy controls. Disease activity was quiescent in both the SLE and RA groups. All three groups demonstrated high sedentary behavior (mean ± SD sedentary time for all participants: 10.1±1.3 hours/day; 76.4% total wear time). There were no significant differences between SLE, RA, and healthy participants in time spent in sedentary behavior ( p=0.80) or light activity ( p=0.17). Total MVPA (mean ± SD, minutes/day) was significantly lower in SLE (34.5±22.7; p<0.001) and RA (41.5±21.3; p=0.005) patients compared to controls (64.9±22.4).

          Conclusion

          SLE and RA patients demonstrate suboptimal MVPA despite well-controlled disease. Given their increased CVD risk, effective interventions are required to improve habitual physical activity levels in both populations.

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          Most cited references39

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          Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.

          M Hochberg (1997)
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            A systematic review of the evidence for Canada's Physical Activity Guidelines for Adults

            This systematic review examines critically the scientific basis for Canada's Physical Activity Guide for Healthy Active Living for adults. Particular reference is given to the dose-response relationship between physical activity and premature all-cause mortality and seven chronic diseases (cardiovascular disease, stroke, hypertension, colon cancer, breast cancer, type 2 diabetes (diabetes mellitus) and osteoporosis). The strength of the relationship between physical activity and specific health outcomes is evaluated critically. Literature was obtained through searching electronic databases (e.g., MEDLINE, EMBASE), cross-referencing, and through the authors' knowledge of the area. For inclusion in our systematic review articles must have at least 3 levels of physical activity and the concomitant risk for each chronic disease. The quality of included studies was appraised using a modified Downs and Black tool. Through this search we identified a total of 254 articles that met the eligibility criteria related to premature all-cause mortality (N = 70), cardiovascular disease (N = 49), stroke (N = 25), hypertension (N = 12), colon cancer (N = 33), breast cancer (N = 43), type 2 diabetes (N = 20), and osteoporosis (N = 2). Overall, the current literature supports clearly the dose-response relationship between physical activity and the seven chronic conditions identified. Moreover, higher levels of physical activity reduce the risk for premature all-cause mortality. The current Canadian guidelines appear to be appropriate to reduce the risk for the seven chronic conditions identified above and all-cause mortality.
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              Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey.

              Rising obesity rates and declining fitness levels have increased interest in understanding what underlies these trends. This article presents the first directly measured data on physical activity and sedentary behaviour on a nationally representative sample of Canadians aged 20 to 79 years. Data are from the 2007 to 2009 Canadian Health Measures Survey (CHMS). Physical activity was measured using accelerometry. Data are presented as time spent in sedentary, light, moderate and vigorous intensity movement as well as steps accumulated per day. An estimated 15% of Canadian adults accumulate 150 minutes of moderate-to-vigorous physical activity (MVPA) per week; 5% accumulate 150 minutes per week as at least 30 minutes of MVPA on 5 or more days a week. Men are more active than women and MVPA declines with increasing age and adiposity. Canadian adults are sedentary for approximately 9.5 hours per day (69% of waking hours). Men accumulate an average of 9,500 steps per day and women, 8,400 steps per day. The 10,000-steps-per-day target is achieved by 35% of adults. Before the CHMS, objective measures of physical activity and sedentary behaviour were not available for a representative sample of Canadians. The findings indicate that 85% of adults are not active enough to meet Canada's new physical activity recommendation.
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                Author and article information

                Journal
                Open Access Rheumatol
                Open Access Rheumatol
                Open Access Rheumatology: Research and Reviews
                Open Access Rheumatology : Research and Reviews
                Dove Medical Press
                1179-156X
                2017
                08 November 2017
                : 9
                : 191-200
                Affiliations
                [1 ]Department of Medicine
                [2 ]Division of Rheumatology, Department of Medicine
                [3 ]Department of Pathology, Dalhousie University and Queen Elizabeth II Health Sciences Center, Halifax, NS, Canada
                Author notes
                Correspondence: John G Hanly, Division of Rheumatology, Nova Scotia Rehabilitation Centre, 1341 Summer Street – Suite 245, Halifax, NS B3H 4K4, Canada, Email john.hanly@ 123456nshealth.ca
                Article
                oarrr-9-191
                10.2147/OARRR.S148376
                5687492
                29184453
                cba8f651-593e-4a31-8f81-9315186983ed
                © 2017 Legge et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                systemic lupus erythematosus,rheumatoid arthritis,physical activity,sedentary behavior,accelerometry

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