Comparison of Subjective and Objective Measures of Sedentary Behavior Using the Yale Physical Activity Survey and Accelerometry in Patients With Rheumatoid Arthritis

in Journal of Physical Activity and Health

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Abigail L. Gilbert
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Jungwha Lee
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Madeleine Ma
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Pamela A. Semanik
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Loretta DiPietro
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Dorothy D. Dunlop
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Rowland W. Chang
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Background:

Sedentary behavior is associated with increased risk of functional decline and disability. Individuals with rheumatoid arthritis (RA) spend more time sedentary than healthy adults. Self-reported assessment of sedentary behavior has not been well-developed in this patient population.

Methods:

172 adults with RA wore an accelerometer for 7 days and completed a modified version of the Yale Physical Activity Survey (YPAS). YPAS-derived sedentary estimates included 1) daily sitting categories (<3, 3 to 6, 6 to 8, >8 hours/day), 2) continuous daily sedentary time calculated by subtracting hours spent sleeping or in physical activity from a 24-hour day, and 3) rank order of YPAS-derived continuous daily sedentary time. Each estimate was compared with objective accelerometer-derived sedentary time using linear regression and Bland-Altman analysis.

Results:

A significant relationship was observed between accelerometer-derived sedentary time and all 3 estimates. Bland-Altman plot demonstrated systematic bias, however Bland-Altman plot of rank-order demonstrated that the ranked YPAS-derived continuous estimate was an unbiased predictor of ranked accelerometer sedentary time though limits of agreement were wide.

Conclusions:

This patient-reported approach using the YPAS shows promise to be a useful tool to identify the most sedentary patients. Providing a practical and accurate tool may increase the frequency sedentary behavior is assessed by clinicians.

Gilbert (abigail.gilbert@northwestern.edu) is with the Division of Rheumatology; Lee, Ma, and Chang are with the Dept of Preventive Medicine; Semanik is with the Dept of Physical Medicine and Rehabilitation; Northwestern University Feinberg School of Medicine, Chicago, IL. DiPietro is with the Dept of Exercise Science, George Washington University School of Public Health and Health Services, Washington, DC. Dunlop is with the Center for Healthcare Studies, Northwestern University, Chicago, IL.

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