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Ekegren C1, Climie R2, Veitch W1, Owen N3, Dunstan D3, Kimmel L4, Gabbe B1
1Monash University, Department of Epidemiology and Preventive Medicine, Melbourne, Australia, 2Paris Centre de Recherche Cardiovasculaire, Paris, France, 3Baker Heart and Diabetes Institute, Melbourne, Australia, 4The Alfred, Melbourne, Australia
Background: Fractures are the most common form of hospitalised trauma and the damaging effects are long-lasting. Activity restrictions during recovery, combined with prolonged periods of time spent sitting, may add to the already-significant burden of injury by increasing patients' risk of long-term chronic conditions, including weight gain, bone density loss, and type 2 diabetes. Currently, there are no objective data capturing activity levels in working-age adults with fractures.
Purpose: To describe patterns of sedentary behaviour and physical activity in adults two weeks post-hospital discharge following an upper or lower limb fracture, and identify associated predictive factors.
Methods: From two-weeks post-hospital discharge, adults aged 18-69 years with an isolated upper (UL) or lower (LL) limb fracture wore an inclinometer (activPAL) on the anterior thigh and a tri-axial accelerometer (ActiGraph) at the hip for ten days. Multivariable linear regression models were fitted via a backwards step-wise approach to determine factors predicting three main outcomes: i) sitting time; ii) steps; and iii) moderate-intensity physical activity (MPA).
Results: 83 adults returned valid activity data. The majority of participants were men (63%), 43% were aged 18 - 34 years, and 55% sustained LL fractures, primarily to the ankle. The mean (SD) time spent sedentary was 11.07 (1.89) h/day, with participants spending up to 98% of waking hours sedentary (median 79%). Overall, participants took a median (IQR) of 1575 (618 - 3445) steps per day and spent only 5.22 (1.50 - 20.78) minutes per day engaging in MPA. 78% of participants recorded no VPA. LL fracture was associated with sedentary time (b=2.5 hours, p 0.001), while days since surgery/injury was inversely associated with sedentary time (b=-0.06 hours, p = 0.048). LL fracture was associated with fewer steps per day (Ratio of Geometric Means (RGM)=0.20, p 0.001). Older age (RGM=0.38-0.41, p=0.01) and LL fracture (RGM=0.11, p 0.001) were associated with less MPA.
Conclusion(s): In the first month following fracture, working-age adults were highly sedentary, took few steps and engaged in little physical activity. Adults with lower limb fractures were particularly sedentary and inactive. While some patients need immobilisation of the fracture site to optimise bone healing, complete rest is unnecessary and potentially harmful.
Implications: To improve health outcomes and prevent secondary conditions, more must be done to encourage patients with fractures to interrupt bouts of prolonged sitting and gradually increase activity early in the recovery period.
Keywords: Sedentary behaviour, Physical activity, Fractures
Funding acknowledgements: This project was funded by a Monash University Faculty of Medicine, Nursing and Health Sciences Strategic Grant.
Purpose: To describe patterns of sedentary behaviour and physical activity in adults two weeks post-hospital discharge following an upper or lower limb fracture, and identify associated predictive factors.
Methods: From two-weeks post-hospital discharge, adults aged 18-69 years with an isolated upper (UL) or lower (LL) limb fracture wore an inclinometer (activPAL) on the anterior thigh and a tri-axial accelerometer (ActiGraph) at the hip for ten days. Multivariable linear regression models were fitted via a backwards step-wise approach to determine factors predicting three main outcomes: i) sitting time; ii) steps; and iii) moderate-intensity physical activity (MPA).
Results: 83 adults returned valid activity data. The majority of participants were men (63%), 43% were aged 18 - 34 years, and 55% sustained LL fractures, primarily to the ankle. The mean (SD) time spent sedentary was 11.07 (1.89) h/day, with participants spending up to 98% of waking hours sedentary (median 79%). Overall, participants took a median (IQR) of 1575 (618 - 3445) steps per day and spent only 5.22 (1.50 - 20.78) minutes per day engaging in MPA. 78% of participants recorded no VPA. LL fracture was associated with sedentary time (b=2.5 hours, p 0.001), while days since surgery/injury was inversely associated with sedentary time (b=-0.06 hours, p = 0.048). LL fracture was associated with fewer steps per day (Ratio of Geometric Means (RGM)=0.20, p 0.001). Older age (RGM=0.38-0.41, p=0.01) and LL fracture (RGM=0.11, p 0.001) were associated with less MPA.
Conclusion(s): In the first month following fracture, working-age adults were highly sedentary, took few steps and engaged in little physical activity. Adults with lower limb fractures were particularly sedentary and inactive. While some patients need immobilisation of the fracture site to optimise bone healing, complete rest is unnecessary and potentially harmful.
Implications: To improve health outcomes and prevent secondary conditions, more must be done to encourage patients with fractures to interrupt bouts of prolonged sitting and gradually increase activity early in the recovery period.
Keywords: Sedentary behaviour, Physical activity, Fractures
Funding acknowledgements: This project was funded by a Monash University Faculty of Medicine, Nursing and Health Sciences Strategic Grant.
Topic: Musculoskeletal; Health promotion & wellbeing/healthy ageing; Disability & rehabilitation
Ethics approval required: Yes
Institution: Alfred Health
Ethics committee: Alfred Human Research Ethics Committee
Ethics number: 458/16
All authors, affiliations and abstracts have been published as submitted.
