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Hensman M.1, Pilutti L.2, Motl R.3, Fenton S.1, Duda J.1, Douglas M.4, Veldhuijzen van Zanten J.1
1University of Birmingham, School of Sport, Exercise and Rehabilitation Sciences, Birmingham, United Kingdom, 2University of Ottawa, Interdisciplinary School of Health Sciences, Ottawa, Canada, 3University of Alabama, Department of Physical Therapy, Alabama, United States, 4University of Birmingham, Medical School, Birmingham, United Kingdom
Background: Multiple sclerosis (MS) is a long-term neurological condition that results in disability, comorbidity, muscle weakness and spasms, fatigue, poor balance and visual problems. Those consequences likely predispose people with MS to be sedentary, but very few studies have assessed sedentary behaviour (i.e., any waking behaviour with an energy expenditure ≤1.5 METs while sitting or lying) in this population. This may be partly attributable to the lack of information on an acceptable sedentary behaviour questionnaire for people with MS. Such information is necessary for research on the prevalence, determinants, and consequences of sedentary behaviour that would inform the design of interventions.
Purpose: To compare self-reported sedentary time assessed by questionnaires in individuals with MS. Secondly, to investigate perceptions of these questionnaires by people with MS.
Methods: Participants completed six existing questionnaires measuring sedentary behaviour (the Longitudinal Ageing Study (LAS), Measure of Older Adults Sedentary Time, Marshall Sitting Questionnaire, Sedentary Behaviour Questionnaire (SBQ), International Physical Activity Questionnaire (IPAQ) and SIT-Q. Following this, participants took part in a semi-structured interview to reflect on ease of questionnaire completion and the role of sedentary behaviour in people with MS.
Results: Twelve female and three male participants with MS took part (mean age 49.7 ± 10.2 years). Mean disability measured by Patient Determined Disease Steps was 2.8 ± 2.1 (range 0-7). Mean self-reported sedentary time ranged from 442 minutes per day measured by the IPAQ to 782 minutes assessed by the LAS. Analyses of variance yielded an overall effect of questionnaire on self-reported sitting time for both weekdays and weekend days (p .01). Post hoc analyses revealed that reported sitting time on weekdays was significantly higher in the LAS and SIT-Q, compared to the other questionnaires.
A broadly similar pattern was apparent for weekend days.
The SBQ was preferred by most participants. In contrast to the other questionnaires which ask for calculated times, this questionnaire gives options ranging from 15 minutes or less to 6 hours or more allowing participants to indicate which option best represents their sedentary behaviour. This facilitated completion of the questionnaire for those with visual impairments and writing difficulties. Other feedback from participants included suggesting several sedentary activities that were absent from the questionnaires i.e.,eating, as well as the difficulty of describing a typical day due to unpredictable MS symptoms.
Conclusion(s): The SBQ was perceived as the easiest to complete, however, reported sitting time was lower than was revealed for some other questionnaires, e.g. the LAS, perhaps due to the restricted answer options. Reported sitting time varied significantly between the different questionnaires. Only the SIT-Q assessed sedentary breaks, which may be particularly relevant in MS as fatigue and stiffness can be exacerbated by prolonged sitting.
Implications: Future research should investigate which questionnaire provides the best measurement of sedentary behaviour in MS by comparing the data with estimates from objective assessments provided by accelerometry. Further information about how sedentary time is accumulated would help to develop clinical interventions to reduce sedentary behaviour.
Funding acknowledgements: Funding was provided by the Universities of Birmingham, UK and Illinois, USA in partnership with Dudley Hospitals NHS Trust.
Topic: Neurology
Ethics approval: The study was reviewed and approved by the The East of Scotland Research Ethics Service, UK.
All authors, affiliations and abstracts have been published as submitted.
