Different Relationships Between Steps and Movements and Healthy Biomarkers in People With and Without Disability

in Journal of Physical Activity and Health
Restricted access

Purchase article

USD  $24.95

Student 1 year online subscription

USD  $117.00

1 year online subscription

USD  $156.00

Student 2 year online subscription

USD  $222.00

2 year online subscription

USD  $296.00

Background: Physical activity benefits have been extensively studied. However, the public health guidelines seem unclear about the relationships between steps and movements with healthy biomarkers for people with (PWD) and without disabilities (PWOD), respectively. While public health guidelines illustrate types of exercise (eg, running, swimming), it is equally important to provide data-driven recommended amounts of daily steps or movements to achieve health biomarkers and further promote a physically active lifestyle. Methods: Data from the National Health and Nutrition Examination Survey 2003–2006 were used. The authors conducted sensitivity, specificity, and receiver-operating-characteristic curve analyses regarding cut points from ActiGraph 7164 of daily steps and movements for health biomarkers (eg, body mass index, cholesterol) in PWD (2178 participants) and PWOD (4414 participants). The authors also examined the dose relationships of steps, movements, and healthy biomarkers in each group. Results: The authors found significant differences in the cut points of daily steps and movement for health biomarkers in PWD and PWOD. For daily steps, cut points of PWD were ranged from 3222 to 8311 (area under the receiver-operating-characteristic curve [AUC] range = 0.52–0.93) significantly lower than PWOD’s daily steps (range = 5455–14,272; AUC = 0.58–0.87). For daily movement, cut points of PWD were ranged from 115,451 to 430,324 (AUC = 0.53–0.91) significantly lower than the PWOD’s daily movements (range = 215,288–282,307; AUC = 0.60–0.88). The authors found strong but different dose relationships of many biomarkers in each group. Conclusions: PWD need fewer daily steps or movement counts to achieve health biomarkers than PWOD. The authors provided data-driven, condition-specific recommendations on promoting a physically active lifestyle.

Chiu, Covello-Jones, and Shen are with the Health Promotion and Rehabilitation Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA. Montenegro is with the UC Davis Alzheimer’s Disease Center, Sacramento, CA, USA. Brooks is with the Department of Psychiatry, UW School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.

Chiu (chiucy@illinois.edu) is the corresponding author.
  • 1.

    Rezende LFM, Rey-Lopez JP, Mtsudo VKR, do Carmo Luiz O. Sedentary behavior and health outcomes among older adults: a systematic review. BMC Public Health. 2014;14:333. PubMed ID: 24712381 doi:10.1186/1471-2458-14-333

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Centers for Disease Control and Prevention. Press Release. 2013. https://www.cdc.gov/media/releases/2013/p0502-physical-activity.html. Accessed February 16, 2021.

    • Search Google Scholar
    • Export Citation
  • 3.

    Thorp AA, Owen N, Neuhaus M, Dunstan DW. Sedentary behaviors and subsequent health outcomes in adults: a systematic review of longitudinal studies 1996–2011. Am J Prev Med. 2011;41(2):207215. PubMed ID: 21767729 doi:10.1016/j.amepre.2011.05.004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Canning KL, Brown RE, Jamnik VK, Salmon A, Ardern CI, Kuk JL. Individuals underestimate moderate and vigorous intensity physical activity. PLoS One. 2014;9(5):e97927. PubMed ID: 24835105 doi:10.1371/journal.pone.0097927

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Johnson I, Tillgren P, Hagstromer M. Understanding and interpreting the concept of physical activity—a focus group study among Swedish women. Scand J Public Health. 2009;37(1):207. PubMed ID: 19141551 doi:10.1177/1403494808099963

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Tudor-Locke C, Henderson KA, Wilcox S, Cooper RS, Durstine JL, Ainsworth BE. In their own voices: definitions and interpretations of physical activity. Womens Health Issues. 2003;13(5):194199. doi:10.1016/s1049-3867(03)00038-0

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Fuzeki E, Engeroff T, Banzer W. Health benefit of light-intensity physical activity: a systematic review of accelerometer data of the National Health and Nutrition Examination Survey (NHANES). Sports Med. 2017;47(9):17691793. doi:10.1007/s40279-017-0724-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Chastin SFM, De Craemer M, De Cocker K, et al. How does light-intensity physical activity associate with adult cardiometabolic health and mortality? Systematic review with meta-analysis of experimental and observational studies. Br J Sports Med. 2019;53(6):370376. doi:10.1136/bjsports-2017-097563

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Tweedy SM, Trost SG. Validity of accelerometry for measurement of activity in people with brain injury. Med Sci Sports Exerc. 2005;37(9):14741480. doi:10.1249/01.mss.0000177584.43330.ae

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Sandroff BM, Riskin BJ, Agiovlasitis S, Motl RW. Accelerometer cut-points derived during over-ground walking in persons with mild, moderate, and severe multiple sclerosis. J Neurol Sci. 2014;340(1-2):5057. doi:10.1016/j.jns.2014.02.024

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Rimmer JH, Riley B, Wang E, Rauworth A, Jurkowski J. Physical activity participation among persons with disabilities: barriers and facilitators. Am J Prev Med. 2004;26(5):419425. doi:10.1016/j.amepre.2004.02.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Stubbs B, Firth J, Berry A, et al. How much physical activity do people with schizophrenia engage in? A systematic review, comparative meta-analysis and meta-regression. Schizophr Res. 2016;176(2–3):431440. doi:10.1016/j.schres.2016.05.017

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Stubbs B, Williams J, Gaughran F, Craig T. How sedentary are people with psychosis? A systematic review and meta-analysis. Schizophr Res. 2016;171(1–3):103109. doi:10.1016/j.schres.2016.01.034

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Schuch F, Vancampfort D, Firth J, et al. Physical activity and sedentary behavior in people with major depressive disorder: a systematic review and meta-analysis. J Affect Disord. 2017;210:139150. doi:10.1016/j.jad.2016.10.050

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Carroll DD, Courtney-Long EA, Stevens AC, et al. Vital signs: disability and physical activity—United States, 2009–2012. Morb Mortal Wkly Rep. 2014;63:17.

    • Search Google Scholar
    • Export Citation
  • 16.

    Loprinzi PD, Smit E, Mahoney S. Physical activity and dietary behavior in US adults and their combined influence on health. Mayo Clin Proc. 2014;89(2):190198. doi:10.1016/j.mayocp.2013.09.018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Tudor-Locke C, Washington TL, Hart TL. Expected values for steps/day in special populations. Prev Med. 2009;49(1):311. doi:10.1016/j.ypmed.2009.04.012

  • 18.

    Center for Disease Control and Prevention. Common Barriers to Participation Experienced by People with Disabilities. 2018. https://www.cdc.gov/ncbddd/disabilityandhealth/disability-barriers.html. Accessed February 16, 2021.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    McDaniels BW, Harley DA, Beach DT. Transportation, accessibility, and accommodation in rural communities. In: Harley D, Ysasi N, Bishop M, Fleming A, eds. Disability and Vocational Rehabilitation in Rural Settings. Cham, Switzerland: Springer; 2018;43–57.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Shor R, Shalev A. Barriers to involvement in physical activities of persons with mental illness. Health Promot Int. 2016;31(1):116123. doi:10.1093/heapro/dau078

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Calder A, Sole G, Mulligan H. The accessibility of fitness center for people with disabilities: a systematic review. Disability and Health Journal. 2018;11(4):525536. doi:10.1016/j.dhjo.2018.04.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Centers for Disease Control and Prevention. Disability impacts all of us infographic. 2019. https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html. Accessed February 16, 2021.

    • Search Google Scholar
    • Export Citation
  • 23.

    Koene RJ, Prizment AE, Blaes A, Konety SH. Shared risk factors in cardiovascular disease and cancer. Rev Cardiovasc Med. 2016;133:11041114. doi:10.1161/CIRCULATIONAHA.115.020406

    • Search Google Scholar
    • Export Citation
  • 24.

    Goyal R, Jialal I. Diabetes Mellitus Type 2. Treasure Island, FL: StatPearls Publishing; 2019.

  • 25.

    Durstine JL, Painter P, Franklin BA, Morgan D, Pitetti KH, Roberts SO. Physical activity for the chronically ill and disabled. Sports Med. 2000;30(3):207219. doi:10.2165/00007256-200030030-00005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Tudor-Locke C, Hatano Y, Pangrazi RP, Kang M. How many steps/day are enough? For adults. Int J Behav Nutr Phys Act. 2008;8(79):117. doi:10.1186/1479-5868-8-79

    • Search Google Scholar
    • Export Citation
  • 27.

    National Institutes of Health. Classification of overweight and obesity by BMI, waist circumference, and associated disease risks. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi_dis. Accessed February 16, 2021.

    • Search Google Scholar
    • Export Citation
  • 28.

    American College of Cardiology. New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension. 2017. https://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017. Accessed February 16, 2021.

    • Search Google Scholar
    • Export Citation
  • 29.

    Nehring SM, Goyal A, Bansal P, et al. C reactive protein (CRP). In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2020. https://www.ncbi.nlm.nih.gov/books/NBK441843/. Accessed February 16, 2021.

    • Search Google Scholar
    • Export Citation
  • 30.

    Centers for Disease Control and Prevention. Diabetes Basics. 2019. https://www.cdc.gov/diabetes/basics/getting-tested.html#:∼:text=This%20measures%20your%20blood%20sugar,higher%20indicates%20you%20have%20diabetes. Accessed February 16, 2021.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Clemes SA, Hamilton SL, Lindley MR. Four-week pedometer-determined activity patterns in normal-weight, overweight, and obese adults. Prev Med. 2008;46(4):325330. PubMed ID: 18199475 doi:10.1016/j.ypmed.2007.11.013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Chang CB, Ryan DAJ, Tudor-Locke C. Health benefits of a pedometer-based physical activity intervention in sedentary workers. Prev Med. 2004;39(6):12151222. doi:10.1016/j.ypmed.2004.04.053

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Verbrugge LM, Jette AM. The disablement process. Soc Sci Med. 1994;38(1):114. doi:10.1016/0277-9536(94)90294-1. Accessed February 16, 2021.

  • 34.

    Ginis KAM, van der Scheer JW, Latimer-Cheung AE, et al. Evidence-based scientific exercise guidelines for adults with spinal cord injury: An update and a new guideline. Spinal Cord. 2018;56:308321.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Tudor-Locke C, Aguiar EJ, Han H, et al. Walking cadence (steps/min) and intensity in 21-40 year olds: CADENCE-adults. Int J Behav Nutr Phys Act. 2019;16(8):111.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    O’Brien MW, Kivell MJ, Wojcik WR, et al. Step rate thresholds associated with moderate and vigorous physical activity in adults. Int J Environ Res Public Health. 2018;15(11):2454. doi:10.3390/ijerph15112454

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37.

    Kenyon A, McEvoy M, Sprod J, Maher C. Validity of pedometers in people with physical disabilities: A systematic review. Arch Phys Med Rehabil. 2013;94:11611170. doi:10.1016/j.apmr.2012.11.030

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    American College of Cardiology. New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension. 2017. Retrieved from www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017.

    • Search Google Scholar
    • Export Citation
  • 39.

    Obesity Prevention Source. Examples of Moderate and Vigorous Physical Activity. 2017. Retrieved from http://www.hsph.harvard.edu/obesity-prevention-source/moderate-and-vigorous-physical-activity/. Accessed February 16, 2021.

    • Search Google Scholar
    • Export Citation
  • 40.

    Centers for Disease Control and Prevention. Disability and Health Overview. 2019. ∼https://www.cdc.gov/ncbddd/disabilityandhealth/disability.html#:∼:text=A%20disability%20is%20any%20condition,around%20them%20(participation%20restrictions.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 95 95 67
Full Text Views 9 9 5
PDF Downloads 9 9 6