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The Daily Movement Pattern and Fulfilment of Physical Activity Recommendations in Swedish Middle-Aged Adults: The SCAPIS Pilot Study.
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.ORCID iD: 0000-0002-3901-7833
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.ORCID iD: 0000-0003-3591-5123
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.ORCID iD: 0000-0001-6058-4982
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.ORCID iD: 0000-0002-4030-5437
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2015 (English)In: PLoS ONE, ISSN 1932-6203, Vol. 10, no 5, e0126336Article in journal (Refereed) Published
Abstract [en]

Different aspects of the daily movement pattern-sitting, light intensity physical activity, and moderate- and vigorous intensity physical activity-have each independently been associated with health and longevity. Previous knowledge of the amount and distribution of these aspects in the general Swedish population, as well as the fulfilment rate of physical activity recommendations, mainly relies on self-reported data. More detailed data assessed with objective methods is needed. The aim of the study was to present descriptive data on the daily movement pattern in a middle-aged Swedish population assessed by hip-worn accelerometers. The cohort consisted of 948 participants (51% women), aged 50 to 64 years, from the Swedish CArdioPulmonary bioImage pilot Study. In the total sample, 60.5% of accelerometer wear time was spent sitting, 35.2% in light physical activity and 3.9% in moderate- and vigorous physical activity. Men and participants with high educational level spent a larger proportion of time sitting, compared to women and participants with low educational level. Men and participants with a high educational level spent more time, and the oldest age-group spent less time, in moderate- and vigorous physical activity. Only 7.1% of the study population met the current national physical activity recommendations, with no gender, age or education level differences. Assessment of all three components of the daily movement pattern is of high clinical relevance and should be included in future research. As the fulfilment of national physical activity recommendations is very low and sitting time is very high in our middle-aged population, the great challenge remains to enhance the implementation of methods to increase the level of physical activity in this population.

Place, publisher, year, edition, pages
2015. Vol. 10, no 5, e0126336
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
URN: urn:nbn:se:gih:diva-3822DOI: 10.1371/journal.pone.0126336PubMedID: 25970580OAI: oai:DiVA.org:gih-3822DiVA: diva2:813039
Available from: 2015-05-21 Created: 2015-05-21 Last updated: 2017-03-31
In thesis
1. Studies of physical activity in the Swedish population
Open this publication in new window or tab >>Studies of physical activity in the Swedish population
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Cheap and effective tools for measuring patients’ physical activity (PA) level are needed. The first aim in this thesis was therefore to assess the validity of two PA -questions, and their three associated answer modes, that are used within the Swedish health care system. Sitting, light intensity PA (LIPA), and moderate and vigorous intensity PA (MVPA), are associated with health and longevity, but detailed population data assessed with objective methods is needed. The second aim was thus to assess the above with motion sensor technology, in a middle-aged Swedish sample. Low self-perceived health is a strong predictor of morbidity and mortality, but this association may vary over time with changes in the society and our lifestyle. The third aim was to assess secular trends in the interrelations between self-perceived health, physical fitness, and selected covariates. The effects of PA on prescription (PAP) on health-related quality of life (HRQoL) in overweight adults are unclear, thus the fourth aim was to explore this.

Methods: All data was collected in the Swedish population. Data from the PA -questions and accelerometers, aerobic fitness, counter movement jump, and balance tests, blood samples, and self-rated general health were collected in 365 participants, 21–66 yrs. The PA pattern was assessed in 948 individuals, 50‒64 yrs, from the SCAPIS pilot study. Self-perceived physical health, and measured aerobic fitness, counter movement jump height, and balance, and demographic and lifestyle data, was assessed in three independent samples from 1990, 2000 and 2013, including 3564 adults, 20‒65 yrs. The effects of Swedish PAP on HRQoL was assessed in a randomized controlled trial including 101 men and women, 67‒68 yrs, that were inactive, overweight (BMI>25 kg/m2), and had a waist circumference ≥102 cm (men) or ≥88 cm (women), who were randomized to an intervention group or a control group. The 36-item Short Form Health Survey (SF-36) was used to assess HRQoL.

Results: The multiple choice answer mode of the two PA -questions was found to have the strongest validity, compared with the two other (an open mode, and one where PA minutes is specified per weekday). The validity is in line with many other established PA-questionnaires, but the open mode has limitations. The assessment of PA pattern showed that 61% of motion sensor wear time represented sitting, 35% LIPA, and 4% MVPA. Only 7% of the sample met the PA recommendations. The odds for describing perceived health as good was found to increase by 5% per each increment of 1 ml/kg/min in VO2max. This was stable across genders and all three LIV-samples (i.e. over time). Waist circumference, chronic disease, sleep problems, and level of satisfaction with one’s life, were also important correlates. The Swedish PAP group improved significantly more, and more participants displayed clinically relevant improvements (OR 2.43), in mental aspects of HRQoL, compared to the controls. Physical aspects of HRQoL improved in the PAP group, but not in the control group.

Conclusions: The multiple choice answer mode has the strongest validity and Open mode the weakest. The PA -questions may be used in populations, or in individuals to determine appropriateness for treatment. The questions’ advantages and limitations must be considered and further reliability and validity studies are needed. The results regarding sitting, LIPA, MVPA and fulfillment of PA recommendations, are of high clinical relevance. A great challenge remains to further implement methods to increase the level of PA in the Swedish population. Physical fitness is related to self-perceived health independently of changes in society and lifestyle over time, and simple questions may be useful for the clinical assessment of physical fitness. Swedish PAP has a positive effect on mental aspects of HRQoL, measured by the SF-36. This finding supports the clinical use of the Swedish PAP model.

Place, publisher, year, edition, pages
Stockholm: Gymnastik- och idrottshögskolan, GIH, 2016. 71 p.
Series
Avhandlingsserie för Gymnastik- och idrottshögskolan, 05
Keyword
physical activity, physical fitness, sedentary, questionnaire, validity, self-rated health, sensitivity, specificity, physical activity on prescription, accelerometry, the Ekblom-Bak test, answer modes, movement pattern, health-related quality of life, physical health
National Category
Health Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-4309 (URN)978-91-980862-5-6 (ISBN)
Public defence
2016-02-19, Aulan, Lidingövägen 1, Stockholm, 09:00 (Swedish)
Opponent
Supervisors
Projects
LIV 2013
Available from: 2016-01-28 Created: 2016-01-27 Last updated: 2016-02-17Bibliographically approved

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