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BMC Public Health
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Diurnal profiles of pedometer-determined physical activity in chronically ill and mobility-limited older adults: a cross-sectional study

Authors: Anna Mai, Alexander Bloch, Renate Klaaßen-Mielke, Petra Platen, Timo Hinrichs

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

The aim of this study was to analyze diurnal profiles of physical activity for community-dwelling adults aged 70 years and over, and to explore the moderating effect of sex, age, morbidity, mobility limitation, and season on physical activity throughout the day.

Methods

A sample of 149 primary health care patients (mean age 79.5 ± 5.2 years, 74.5% females) was included in the analyses. Participants’ physical activity was measured on up to six consecutive days via Omron Walking Style Pro HJ-720IT-E2 pedometer. Step count per day and per hour, and pedometer wear time were descriptively analyzed. A repeated measures ANOVA with physical activity per hour as dependent variable was performed to analyze the moderating effect of sex, age, morbidity, mobility limitation, and season on diurnal profiles of physical activity. The diurnal profile for the total sample and adjusted diurnal profiles for subgroups are presented.

Results

Participants’ daily step count averaged 3280 ± 1873 steps/day. They wore the pedometer for 14.2 ± 1.7 hours per day and walked on average 234 ± 139 steps per hour. With respect to diurnal profiles, there were two peaks at 10–11 AM (mean [95%-confidence interval]: 382 [329–435] steps) and at 3–4 pm (313 [261–365] steps) interrupted by a period of lower activity with a low point at 1–2 pm (229 [190–268] steps). A mobility limitation, defined by use of a cane or a rollator, had a significant moderating effect (p = 0.0237) on diurnal physical activity.

Conclusions

This is the first study to explore pedometer-determined diurnal profiles of physical activity in chronically ill and mobility-limited older adults. Prolonging periods of elevated physical activity in the afternoon while respecting individual daily routine and commitments could be one option for facilitating the integration of physical activity and for making it a habit in older adults’ daily lives. The use of a walking aid seems to be an indicator for a quite low activity plateau during the second half of the day. People who use walking aids should be motivated to increase their physical activity during afternoon; this might help to increase the overall low physical activity level of this vulnerable subgroup of older adults.
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Literature
1.
Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C: Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007, 116 (9): 1094-1105.CrossRefPubMed
2.
Australian Institute of Health and Welfare: Australia's health 2010. Australia’s health series no. 12. Cat. no. AUS 122. 2010, Canberra
3.
Health and Social Care Information Centre: Health Survey for England 2008. Physical activity and fitness. Summary of key findings. 2009, Leeds
4.
Haley C, Andel R: Correlates of physical activity participation in community-dwelling older adults. J Aging Phys Act. 2010, 18 (4): 375-389.PubMed
5.
Jones DA, Ainsworth BE, Croft JB, Macera CA, Lloyd EE, Yusuf HR: Moderate leisure-time physical activity: who is meeting the public health recommendations? A national cross-sectional study. Arch Fam Med. 1998, 7 (3): 285-289.CrossRefPubMed
6.
Hinrichs T, Trampisch U, Burghaus I, Endres H, Klaaßen-Mielke R, Moschny A, Platen P: Correlates of sport participation among community-dwelling elderly people in Germany: a cross-sectional study. Eur Rev Aging Phys Act. 2010, 7 (2): 105-115.CrossRef
7.
Moschny A, Platen P, Klaaßen-Mielke R, Trampisch U, Hinrichs T: Physical activity patterns in older men and women in Germany: a cross-sectional study. BMC Public Health. 2011, 11: 559-CrossRefPubMedPubMedCentral
8.
Krems C, Lührmann PM, Neuhäuser-Berthold M: Physical activity in young and elderly subjects. J Sport Med Phys Fit. 2004, 44 (1): 71-76.
9.
Robert Koch-Institut: Beiträge zur Gesundheitsberichterstattung des Bundes - Daten und Fakten: Ergebnisse der Studie "Gesundheit in Deutschland aktuell 2009". [Contributions to Federal Health Reporting - Facts and figures: Study results "Health in Germany up-to-date 2009"]. 2010, Berlin
10.
Tudor-Locke C, Hart TL, Washington TL: Expected values for pedometer-determined physical activity in older populations. Int J Behav Nutr Phys Act. 2009, 6: 59-CrossRefPubMedPubMedCentral
11.
Trost SG, Owen N, Bauman AE, Sallis JF, Brown W: Correlates of adults' participation in physical activity: review and update. Med Sci Sports Exerc. 2002, 34 (12): 1996-2001.CrossRefPubMed
12.
van Stralen MM, De Vries H, Mudde A, Bolman C, Lechner L: Determinants of initiation and maintenance of physical activity among older adults: a literature review. Health Psychol Rev. 2009, 3 (2): 147-207.CrossRef
13.
Mathews AE, Laditka SB, Laditka JN, Wilcox S, Corwin SJ, Liu R, Friedman DB, Hunter R, Tseng W, Logsdon RG: Older adults' perceived physical activity enablers and barriers: a multicultural perspective. J Aging Phys Act. 2010, 18 (2): 119-140.PubMed
14.
Rasinaho M, Hirvensalo M, Leinonen R, Lintunen T, Rantanen T: Motives for and barriers to physical activity among older adults with mobility limitations. J Aging Phys Act. 2007, 15 (1): 90-102.PubMed
15.
Suzuki R, Ogawa M, Otake S, Izutsu T, Tobimatsu Y, Izumi SI, Iwaya T: Analysis of activities of daily living in elderly people living alone: single-subject feasibility study. Telemed J E-Health. 2004, 10 (2): 260-276.CrossRefPubMed
16.
Hecht A, Porszasz MS, Casaburi R: Methodology for using long-term accelerometry monitoring to describe daily activity patterns in COPD. COPD. 2009, 6 (2): 121-129.CrossRefPubMedPubMedCentral
17.
Sallis JF, Cervero RB, Ascher W, Henderson KA, Kraft MK, Kerr J: An ecological approach to creating active living communities. Annu Rev Public Health. 2006, 27: 297-322.CrossRefPubMed
18.
Cohen-Mansfield J, Marx MS, Guralnik JM: Motivators and barriers to exercise in an older community-dwelling population. J Aging Phys Act. 2003, 11 (2): 242-253.
19.
Tucker P, Gilliland J: The effect of season and weather on physical activity: a systematic review. Public Health. 2007, 121 (12): 909-922.CrossRefPubMed
20.
Sumukadas D, Witham M, Struthers A, McMurdo M: Day length and weather conditions profoundly affect physical activity levels in older functionally impaired people. J Epidemiol Community Health. 2009, 63 (4): 305-309.CrossRefPubMed
21.
Hinrichs T, Moschny A, Brach M, Wilm S, Klaaßen-Mielke R, Trampisch M, Platen P: Effects of an exercise programme for chronically ill and mobility-restricted elderly with structured support by the general practitioner's practice (HOMEfit) – study protocol of a randomised controlled trial. Trials. 2011, 12: 263-CrossRefPubMedPubMedCentral
22.
Brach M, Moschny A, Bücker B, Klaaßen-Mielke R, Trampisch M, Wilm S, Platen P, Hinrichs T: Recruiting hard-to-reach subjects for exercise interventions: a multi-centre and multi-stage approach targeting general practitioners and their community-dwelling and mobility-limited patients. Int J Env Res Public Health. 2013, 10 (12): 6611-6629.CrossRef
23.
24.
Hinrichs T, Platte K, Moschny A, Platen P: Validity and accuracy of the Omron Walking Style Pro pedometer – comparison of different wearing locations. Book of Abstracts of the 17th Annual Congress of the European College of Sport Science – 4th-7th July 2012 – Bruges/Belgium. Edited by: Meeusen R, Duchateau J, Roelands B, Klass M, De Geus B, Baudry S, Tsolakidis E. 2012, Bruges: European College of Sport Science, 539-540.
25.
Jöckel K-H, Babitsch B, Bellach B-M, Bloomfield K, Hoffmeyer-Zlotnik J, Winkler J, Wolf C: Messung und Quantifizierung soziographischer Merkmale in epidemiologischen Studien [Measuring and quantifying sociodemographic characteristics in epidemiological studies]. Messung soziodemographischer Merkmale in der Epidemiologie [Measuring sociodemographic characteristics in epidemiology]. Edited by: Ahrens W, Bellach B-M, Jöckel K-H. 1998, München: MMV Medizin, 7-38.
26.
Rowe DA, Kemble CD, Robinson TS, Mahar MT: Daily walking in older adults: day-to-day variability and criterion-referenced validity of total daily step counts. J Phys Act Health. 2007, 4 (4): 434-446.PubMed
27.
Bloch A, Hinrichs T, Platen P, Moschny A: Diurnal profiles of pedometer-determined physical activity in older primary health care patients. Book of Abstracts of the 18th Annual Congress of the European College of Sports Science – 26th-29th June 2013 – Barcelona/Spain. Edited by: Balagué N, Torrents C, Vilanova A, Cadefau J, Tarragó R, Tsolakidis E. 2013, Barcelona: European College of Sports Science, 383-
28.
Tudor-Locke C, Craig CL, Aoyagi Y, Bell RC, Croteau KA, De Bourdeaudhuij I, Ewald B, Gardner AW, Hatano Y, Lutes LD, Matsudo SM, Ramirez-Marrero FA, Rogers LQ, Rowe DA, Schmidt MD, Tully MA, Blair SN: How many steps/day are enough? For older adults and special populations. Int J Behav Nutr Phys Act. 2011, 8: 80-CrossRefPubMedPubMedCentral
29.
Buysse D, Browman K, Monk T, Reynolds C, Fasiczka A, Kupfer D: Napping and 24-hour sleep/wake patterns in healthy elderly and young adults. J Am Geriatr Soc. 1992, 40 (8): 779-786.CrossRefPubMed
30.
Foley DJ, Vitiello MV, Bliwise DL, Ancoli-Israel S, Monjan AA, Walsh JK: Frequent napping is associated with excessive daytime sleepiness, depression, pain, and nocturia in older adults: findings from the National Sleep Foundation '2003 Sleep in America' Poll. Am J Geriatr Psychiatry. 2007, 15 (4): 344-350.CrossRefPubMed
31.
Asplund R: Daytime sleepiness and napping amongst the elderly in relation to somatic health and medical treatment. J Intern Med. 1996, 239 (3): 261-267.CrossRefPubMed
32.
Clark F, Azen SP, Carlson M, Mandel D, LaBree L, Hay J, Zemke R, Jackson J, Lipson L: Embedding health-promoting changes into the daily lives of independent-living older adults: long-term follow-up of occupational therapy intervention. J Gerontol Ser B –Psychol Sci Soc Sci. 2001, 56 (1): P60-P63.CrossRef
33.
Clark F, Azen SP, Zemke R, Jackson J, Carlson M, Mandel D, Hay J, Josephson K, Cherry B, Hessel C, Palmer J, Lipson L: Occupational therapy for independent-living older adults: a randomized controlled trial. JAMA. 1997, 278 (16): 1321-1326.CrossRefPubMed
34.
Zisberg A, Gur-Yaish N, Shochat T: Contribution of routine to sleep quality in community elderly. Sleep. 2010, 33 (4): 509-514.PubMedPubMedCentral
35.
Kressig RW, Wolf SL, Sattin RW, O'Grady M, Greenspan A, Curns A, Kutner M: Associations of demographic, functional, and behavioral characteristics with activity-related fear of falling among older adults transitioning to frailty. J Am Geriatr Soc. 2001, 49 (11): 1456-1462.CrossRefPubMed
36.
Lachman ME, Howland J, Tennstedt S, Jette A, Assmann S, Peterson EW: Fear of falling and activity restriction: the survey of activities and fear of falling in the elderly (SAFE). J Gerontol Series B – Psychol Sci Social Sci. 1998, 53 (1): P43-P50.CrossRef
37.
Bruce DG, Devine A, Prince RL: Recreational physical activity levels in healthy older women: the importance of fear of falling. J Am Geriatr Soc. 2002, 50 (1): 84-89.CrossRefPubMed
38.
Lees FD, Clark PG, Nigg CR, Newman P: Barriers to exercise behavior among older adults: a focus-group study. J Aging Phys Act. 2005, 13 (1): 23-33.PubMed
39.
Deshpande N, Metter EJ, Lauretani F, Bandinelli S, Guralnik J, Ferrucci L: Activity restriction induced by fear of falling and objective and subjective measures of physical function: a prospective cohort study. J Am Geriatr Soc. 2008, 56 (4): 615-620.CrossRefPubMedPubMedCentral
40.
Mahoney JE, Sager MA, Jalaluddin M: Use of an ambulation assistive device predicts functional decline associated with hospitalization. J Gerontol Ser A – Biol Sci Med Sci. 1999, 54 (2): M83-M88.CrossRef
41.
Schofield G, Croteau K, McLean G: Trust levels of physical activity information sources: a population study. Health Promot J Aust. 2005, 16 (3): 221-224.
42.
Hinrichs T, Brach M: The general practitioner's role in promoting physical activity to older adults: a review based on program theory. Curr Aging Sci. 2012, 5 (1): 41-CrossRefPubMed
43.
Lindesay J, Thompson C: Housebound elderly people-definition, prevalence and characteristics. Int J Geriatr Psychiatry. 1993, 8 (3): 231-237.CrossRef
44.
Hildebrand M, Neufeld P: Recruiting older adults into a physical activity promotion program: active living every day offered in a naturally occurring retirement community. Gerontologist. 2009, 49 (5): 702-710.CrossRefPubMed
45.
Holbrook EA, Barreira TV, Kang M: Validity and reliability of Omron pedometers for prescribed and self-paced walking. Med Sci Sports Exerc. 2009, 41 (3): 669-673.CrossRef
46.
Bassett DR, Ainsworth BE, Leggett SR, Mathien CA, Main JA, Hunter DC, Duncan GE: Accuracy of five electronic pedometers for measuring distance walked. Med Sci Sports Exerc. 1996, 28 (8): 1071-1077.CrossRefPubMed
47.
Jehn M, Schmidt-Trucksaess A, Schuster T, Hanssen H, Weis M, Halle M, Koehler F: Accelerometer-based quantification of 6-minute walk test performance in patients with chronic heart failure: applicability in telemedicine. J Card Fail. 2009, 15 (4): 334-340.CrossRefPubMed
48.
Motl RW, McAuley E, Snook EM, Scott JA: Accuracy of two electronic pedometers for measuring steps taken under controlled conditions among ambulatory individuals with multiple sclerosis. Mult Scler. 2005, 11 (3): 343-345.CrossRefPubMed
49.
Melanson EL, Knoll JR, Bell ML, Donahoo WT, Hill JO, Nysse LJ, Lanningham-Foster L, Peters JC, Levine JA: Commercially available pedometers: considerations for accurate step counting. Prev Med. 2004, 39 (2): 361-368.CrossRefPubMed
50.
Jorgensen T, Andersen LB, Froberg K, Maeder U, Von Huth SL, Aadahl M: Position statement: testing physical condition in a population – how good are the methods?. Eur J Sports Sci. 2009, 9 (5): 257-267.CrossRef
51.
Ainsworth BE: How do I measure physical activity in my patients? Questionnaires and objective methods. Br J Sports Med. 2009, 43 (1): 6-9.CrossRefPubMed
Metadata
Title
Diurnal profiles of pedometer-determined physical activity in chronically ill and mobility-limited older adults: a cross-sectional study
Authors
Anna Mai
Alexander Bloch
Renate Klaaßen-Mielke
Petra Platen
Timo Hinrichs
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-1268

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