Physical Activity and Sedentary Behaviour Subsequent to Serious - - PowerPoint PPT Presentation

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Aug 10, 2023 384 likes •622 views

MONASH PUBLIC HEALTH & PREVENTIVE MEDICINE Physical Activity and Sedentary Behaviour Subsequent to Serious Orthopaedic Injury: A Systematic Review Dr Christina Ekegren NHMRC Early Career Fellow, Deputy head Pre-hospital, Emergency and

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MONASH PUBLIC HEALTH & PREVENTIVE MEDICINE

Physical Activity and Sedentary Behaviour Subsequent to Serious Orthopaedic Injury: A Systematic Review

Dr Christina Ekegren

NHMRC Early Career Fellow, Deputy head Pre-hospital, Emergency and Trauma Research

Co-authors: Dr Ben Beck, Dr Rachel Climie, Prof Neville Owen, Prof David Dunstan, Prof Belinda Gabbe

@CLEkegren @Physios4PA

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@CLEkegren @Physios4PA

Background

▪ Orthopaedic patients:

– Largest group of injury hospitalisations in Australia – Hip fractures expected to dramatically increase

▪ Australian Guidelines:

– 150 mins moderate intensity exercise/week & minimise prolonged sitting

▪ Potential for increased risk of inactivity-related chronic disease in orthopaedic patients What is the extent of the problem?

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@CLEkegren @Physios4PA

Study aim

▪ To systematically review and synthesise the evidence on physical activity and sedentary behaviour following serious orthopaedic injury

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@CLEkegren @Physios4PA

Methods

▪ Search strategy:

– 8 electronic databases + reference lists of relevant articles: inception to March 2016

▪ Inclusion criteria:

– Observational studies only – Serious orthopaedic injury = acute bone or soft-tissue injury requiring emergency hospital admission and/or non-elective surgery – Objective measurement only

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@CLEkegren @Physios4PA

Search results

▪ 6 out of 31 studies included:

– Hip fractures (n=4) – Other orthopaedic injuries (n=2)

▪ Moderate risk of bias:

– Small, non representative samples (5 / 6 studies: n<50) – High attrition

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@CLEkegren @Physios4PA

Results 1: Sedentary behaviour: hip fracture

Authors Device Months post-injury Mean (95% CI)  /Median (IQR)  Davenport et al 2015 ActivPAL <0.5 Fleig et al 2016 Accelerometer 6.7

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@CLEkegren @Physios4PA

Results 1: Sedentary behaviour: hip fracture

Authors Device Months post-injury Mean (95% CI)  /Median (IQR)  Davenport et al 2015 ActivPAL <0.5 Fleig et al 2016 Accelerometer 6.7

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@CLEkegren @Physios4PA

Results 1: Sedentary behaviour: hip fracture

Authors Device Months post-injury Mean (95% CI)  /Median (IQR)  Davenport et al 2015 ActivPAL <0.5

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Fleig et al 2016 Accelerometer 6.7 

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@CLEkegren @Physios4PA

Results 1: Sedentary behaviour: hip fracture

Authors Device Months post-injury Mean (95% CI)  /Median (IQR)  Davenport et al 2015 ActivPAL <0.5

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Fleig et al 2016 Accelerometer 6.7  Davenport et al 2015 ActivPAL <0.5 Bernhardt et al 2005 Uptimer 1 Bernhardt et al 2005 Uptimer 1.2 Bernhardt et al 2005 Uptimer 1.5

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@CLEkegren @Physios4PA

Results 1: Sedentary behaviour: hip fracture

Authors Device Months post-injury Mean (95% CI)  /Median (IQR)  Davenport et al 2015 ActivPAL <0.5

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Fleig et al 2016 Accelerometer 6.7  Davenport et al 2015 ActivPAL <0.5  Bernhardt et al 2005 Uptimer 1  Bernhardt et al 2005 Uptimer 1.2  Bernhardt et al 2005 Uptimer 1.5 

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@CLEkegren @Physios4PA

Results 2: Physical activity: hip fracture

Authors Device Months post-injury Mean (95% CI)  /Median (IQR)  Davenport et al 2015 ActivPAL <0.5 Resnick et al 2011 Accelerometer 2.0 Fleig et al 2016 Accelerometer 6.7

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@CLEkegren @Physios4PA

Results 2: Physical activity: hip fracture

Authors Device Months post-injury Mean (95% CI)  /Median (IQR)  Davenport et al 2015 ActivPAL <0.5

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Resnick et al 2011 Accelerometer 2.0

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Fleig et al 2016 Accelerometer 6.7 

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@CLEkegren @Physios4PA

Results 2: Physical activity: hip fracture

Authors Device Months post-injury Mean (95% CI)  /Median (IQR)  Davenport et al 2015 ActivPAL <0.5

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Resnick et al 2011 Accelerometer 2.0

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Fleig et al 2016 Accelerometer 6.7  Resnick et al 2011 Accelerometer 2.0

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@CLEkegren @Physios4PA

Results 2: Physical activity: hip fracture

Authors Device Months post-injury Mean (95% CI)  /Median (IQR)  Davenport et al 2015 ActivPAL <0.5

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Resnick et al 2011 Accelerometer 2.0

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Fleig et al 2016 Accelerometer 6.7  Resnick et al 2011 Accelerometer 2.0

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@CLEkegren @Physios4PA

Results 2: Physical activity: hip fracture

Authors Device Months post-injury Mean (95% CI)  /Median (IQR)  Davenport et al 2015 ActivPAL <0.5



Resnick et al 2011 Accelerometer 2.0



Fleig et al 2016 Accelerometer 6.7  Resnick et al 2011 Accelerometer 2.0



Fleig et al 2016 Accelerometer 6.7 

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@CLEkegren @Physios4PA

Results 3: Sedentary behaviour and physical activity: UL & LL fracture

Authors Injury Device Months post- injury Mean (95% CI)  /Median (IQR)  Ceroni et al 2011 UL # Accelerometer 1 day Ceroni et al 2012 LL # Accelerometer 1 day Ceroni et al 2012 LL # Accelerometer 6 Ceroni et al 2012 LL # Accelerometer 18

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@CLEkegren @Physios4PA

Results 3: Sedentary behaviour and physical activity: UL & LL fracture

Authors Injury Device Months post- injury Mean (95% CI)  /Median (IQR)  Ceroni et al 2011 UL # Accelerometer 1 day

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Ceroni et al 2012 LL # Accelerometer 1 day

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Ceroni et al 2012 LL # Accelerometer 6

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Ceroni et al 2012 LL # Accelerometer 18

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@CLEkegren @Physios4PA

Results 3: Sedentary behaviour and physical activity: UL & LL fracture

Authors Injury Device Months post- injury Mean (95% CI)  /Median (IQR)  Ceroni et al 2011 UL # Accelerometer 1 day



Ceroni et al 2012 LL # Accelerometer 1 day

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Ceroni et al 2012 LL # Accelerometer 6

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Ceroni et al 2012 LL # Accelerometer 18

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Ceroni et al 2011 UL # Accelerometer 1 day Ceroni et al 2012 LL # Accelerometer 1 day Ceroni et al 2012 LL # Accelerometer 6 Ceroni et al 2012 LL # Accelerometer 18

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@CLEkegren @Physios4PA

Results 3: Sedentary behaviour and physical activity: UL & LL fracture

Authors Injury Device Months post- injury Mean (95% CI)  /Median (IQR)  Ceroni et al 2011 UL # Accelerometer 1 day



Ceroni et al 2012 LL # Accelerometer 1 day



Ceroni et al 2012 LL # Accelerometer 6



Ceroni et al 2012 LL # Accelerometer 18



Ceroni et al 2011 UL # Accelerometer 1 day



Ceroni et al 2012 LL # Accelerometer 1 day

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Ceroni et al 2012 LL # Accelerometer 6

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Ceroni et al 2012 LL # Accelerometer 18



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@CLEkegren @Physios4PA

Limitations

▪ Inconsistency of outcome reporting ▪ No pre-injury data – 3 studies compared with age-matched controls

?

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@CLEkegren @Physios4PA

Conclusions and future directions

▪ Low physical activity levels and high levels of sedentary behaviours found consistently throughout recovery

– Similarities with stroke, TBI, SCI, other chronic diseases – Only 1 study >7 month follow up – in adolescents

▪ Physios: Capacity vs Activity! ▪ Activity  Recovery?

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@CLEkegren @Physios4PA

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MONASH PUBLIC HEALTH & PREVENTIVE MEDICINE

Thank you

Dr Christina Ekegren, Department Epidemiology and Preventive Medicine

christina.ekegren@monash.edu

@CLEkegren @Physios4PA