Upload
fusephysicalactivitygroup
View
23
Download
0
Tags:
Embed Size (px)
Citation preview
Relationship between physical activity measured by accelerometer and by
questionnaire in pregnancy
Cath McParlinLouise Hayes
Benefits of PA in pregnancy
Potential to:• Maintain energy balance• Reduce excessive gestational weight gain• Improve pregnancy outcomes
Obese women• Poor glycaemic control, insulin resistance, metabolic
syndrome
Observational data• Predominantly self-report, contradictory/conflicting• Potential association PA and GDM
Guidelines in pregnancy
• Importance of healthy eating and appropriate exercise for all women, esp. if BMI>30
• Dispel myths• Recommend 30 mins
moderate activity per day
• Importance of not being sedentary
Intervention studies
• Various approaches• Goal setting, motivational interviewing, behaviour
change techniques
Predominantly ineffective in achieving outcomes
Often PA/behaviour change not measured
? can PA be increased
? would an increase result in improved outcomes
Measuring PA in pregnancyvalidity/reliability/acceptability
Accelerometry• Position• Cut points• Compliance• Not waterproof• Upper body• EE in pregnancy
Questionnaire• PPAQ correlations
(light -0.08 – 0.22
mod. 0.20 – 0.49)• Over estimate, multi tasking• Focus on LTPA
Advantage:
Recreational activities
EE in different domains
Measuring Activity in Pregnancy Study (MAPS)
• Pilot feasibility study• Pregnant women, (n=68, BMI>25)• PA measured at 12-14 weeks gestation for 7
days
1. Actigraph accelerometer
2. Recent Physical Activity Questionnaire
Activity (min/day) Median (IQR) Spearman’s ρ
Accelerometer
Sedentary (<100 cpm) 631 (574, 673)
Light (100-1951 cpm) 125 (97, 153)
MVPA (>1952 cpm) 35 (28, 51)
All activity 165 (127, 192)
RPAQ
Sedentary (<1.5 MET) 1197 (1058, 1318) 0.30*
Light (1.5-2.9 MET) 94 (60, 231) 0.41**
MVPA (>3.0 MET) 81 (35, 169) 0.06
All activity 243 (122, 382) 0.53**
Correlation between RPAQ and accelerometer
MAPS (n=55)
**p<0.01; *p<0.05
Bell R et al 2013 EGOG:170;90
Activity (min/day) Median (IQR) Spearman’s ρ
Accelerometer
Sedentary (<100 cpm) 1167 (1111, 1218)
Light (100-1951 cpm) 175 (140, 222)
MVPA (>1952 cpm) 39 (25, 52)
All activity 216 (168, 265)
RPAQ
Sedentary (<1.5 MET) 1007 (878,1140) 0.42**
Light (1.5-2.9 MET) 372 (233, 473) 0.05
MVPA (>3.0 MET) 26 (12, 56) 0.25**
All activity 424 (283, 532) 0.15
Correlation between RPAQ and accelerometer
UPBEAT pilot study (n=102)
**p<0.01
Time in different PA intensities by RPAQ tertile
UPBEAT pilot study (n=102)
Tertile 1 Tertile 2 Tertile 3
Sedentary (<100 cpm): min/d
1165 (110) 1168 (109) 1180 (99)
% weartime 72 (11) 73 (10) 75 (12)
Light (100-1951 cpm): min/d 184 (88) 171 (80) 172 (89)
% weartime 23 (8) 21 (9) 20 (11)
MVPA (>1952 cpm): min/d 40 (27) 41 (26) 38 (29)
% weartime 4.5 (3) 4.8 (3) 4.7 (4)
All activity: min/d 220 (101) 215 (95) 210 (96)
Counts per minute 275 (129) 288 (172) 269 (149)Figures are median (IQR)
Proportion meeting PA guidelines
UPBEAT pilot study (n=102)
0
10
20
30
40
50
60
70
Actigraph - 30 min MVPA Actigraph - 30 min MVPA ( bouts)
RPAQ - 30 min MVPA RPAQ - 500 MET/min/d
Conclusions
• Poor agreement between accelerometer and RPAQ assessed PA in pregnant women
• Choice of method affects estimates of pregnant women achieving guidelines
• Implications for understanding of relationship between PA during pregnancy and outcomes
Why does it matter?
• Need to (try to) quantify the dose-response relationship between PA and pregnancy outcomes
• Want to determine proportion of women meeting guidelines to guide public health activity and to assess effectiveness of interventions
Acknowledgements
Participants in MAPS and UPBEATLucilla Poston, Ruth Bell, Steve Robson and UPBEAT teamFunders – NIHR Programme Grant: RP-0407-10452