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      Fatigue, patient reported outcomes, and objective measurement of physical activity in systemic lupus erythematosus

      Author(s): , , , , , , , , ,
      Publication date Created:
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      Journal: Lupus
      Publisher: SAGE Publications

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          Abstract

          Fatigue is a common symptom in systemic lupus erythematosus (SLE), and engaging in physical activity may reduce fatigue. We aimed to characterize relationships between fatigue, other health status measures assessed with the Patient Reported Outcomes Measurement Information System (PROMIS) instruments, and accelerometer-based physical activity measurements in patients with SLE. The internal consistency of each PROMIS measure in our SLE sample was also evaluated.

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          Combined oral contraceptives in women with systemic lupus erythematosus.

          Michelle Petri, Mimi Y. Kim, Kenneth Kalunian … (2005)
          Oral contraceptives are rarely prescribed for women with systemic lupus erythematosus, because of concern about potential negative side effects. In this double-blind, randomized, noninferiority trial, we prospectively evaluated the effect of oral contraceptives on lupus activity in premenopausal women with systemic lupus erythematosus. A total of 183 women with inactive (76 percent) or stable active (24 percent) systemic lupus erythematosus at 15 U.S. sites were randomly assigned to receive either oral contraceptives (triphasic ethinyl estradiol at a dose of 35 microg plus norethindrone at a dose of 0.5 to 1 mg for 12 cycles of 28 days each; 91 women) or placebo (92 women) and were evaluated at months 1, 2, 3, 6, 9, and 12. Subjects were excluded if they had moderate or high levels of anticardiolipin antibodies, lupus anticoagulant, or a history of thrombosis. The primary end point, a severe lupus flare, occurred in 7 of 91 subjects receiving oral contraceptives (7.7 percent) as compared with 7 of 92 subjects receiving placebo (7.6 percent). The 12-month rates of severe flare were similar: 0.084 for the group receiving oral contraceptives and 0.087 for the placebo group (P=0.95; upper limit of the one-sided 95 percent confidence interval for this difference, 0.069, which is within the prespecified 9 percent margin for noninferiority). Rates of mild or moderate flares were 1.40 flares per person-year for subjects receiving oral contraceptives and 1.44 flares per person-year for subjects receiving placebo (relative risk, 0.98; P=0.86). In the group that was randomized to receive oral contraceptives, there was one deep venous thrombosis and one clotted graft; in the placebo group, there was one deep venous thrombosis, one ocular thrombosis, one superficial thrombophlebitis, and one death (after cessation of the trial). Our study indicates that oral contraceptives do not increase the risk of flare among women with systemic lupus erythematosus whose disease is stable. Copyright 2005 Massachusetts Medical Society.
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            ActiGraph GT3X+ cut-points for identifying sedentary behaviour in older adults in free-living environments.

            Donald W. Brown, G. Peeters, N A da R Farias … (2014)
            To determine the ActiGraph GT3X+ cut-points with the highest accuracy for estimating time spent in sedentary behaviour in older adults in free-living environments. ActivPAL(3)™ was used as the reference standard. Cross-sectional study. 37 participants (13 males and 24 females, 73.5 ± 7.3 years old) wore an ActiGraph GT3X+ and an ActivPAL(3)™ for 7 consecutive days. For ActivPAL(3)™, variables were created based on posture. For ActiGraph GT3X+, sedentary behaviour was defined as (1) vector magnitude and (2) vertical axis counts for 1-s, 15-s and 1-min epochs, with cut-points for 1-s epochs of <1 to <10 counts, for 15-s epochs of <1 to <100 counts and for 1-min epochs of <1 to <400 counts. For each of the ActiGraph GT3X+ cut-points, area under the receiver operating characteristic curve (area under the curve), sensitivity, specificity, and percentage correctly classified were calculated. Bias and 95% limits of agreement were calculated using the Bland-Altman method. The highest areas under the curve were obtained for the vector magnitude cut-points: <1 count/s, <70 counts/15-s, and <200 counts/min; and for the vertical axis cut-points: <1 count/s, <10 counts/15-s and <25 counts/min. Mean biases ranged from -4.29 to 124.28 min/day. The 95% limits of agreement for these cut-points were ± 2 h suggesting great inter-individual variation. The results suggest that cut-points are dependent on unit of analyses (i.e. epoch length and axes); cut-points for a given epoch length and axis cannot simply be extrapolated to other epoch lengths. Limitations regarding inter-individual variability and misclassification of standing activity as sitting/lying must be considered. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
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              Occupation correlates of adults' participation in leisure-time physical activity: a systematic review.

              Megan Kirk, Ryan Rhodes (2011)
              The rapid changes to the labor force (e.g., advances in technology, overtime hours) have increased obesogenic behaviors (e.g., lack of physical activity, sedentariness on the job). The purpose of this review was to unite and appraise the existing research examining occupation correlates of adults' participation in leisure-time physical activity (LTPA) to establish direction for future research targeting habitual inactivity. Eligible studies were searched from January 2009 to July 2010 in English peer-reviewed journals. A total of 62 studies passed the inclusion criteria. Major findings were summarized based on common subtopics of occupation category/status, occupational physical activity (OPA), work hours, psychological work demands, and LTPA. Included articles were published between 1984 and 2010, with sample sizes ranging from 158 to 203,120. Occupation factors correlated with LTPA, but the magnitude of the effect was difficult to determine because of heterogeneous measures. Occupation category/status was directly associated with LTPA, with white-collar/professionals showing the highest LTPA compared to blue-collar workers. When OPA was measured, a positive association with LTPA was found. Work hours appeared to have a negative threshold effect on LTPA. Some preliminary evidence found psychosocial work demands (e.g., job strain) to be negatively correlated with LTPA levels. Convincing evidence supports the premise that those employed in occupations demanding long work hours and low OPA are at risk of inactivity. Existing research has focused heavily on cross-sectional data and study-created self-report measures. Longitudinal evaluations using robust research measures (e.g., accelerometry, National occupation classification tool) are a priority for future research. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Title: Lupus
                Abbreviated Title: Lupus
                Publisher: SAGE Publications
                ISSN (Print): 0961-2033
                ISSN (Electronic): 1477-0962
                Publication date Created: July 11 2016
                Publication date (Print): July 11 2016
                Volume: 25
                Issue: 11
                Pages: 1190-1199
                Article
                DOI: 10.1177/0961203316631632
                PMC ID: 4980272
                PubMed ID: 26869353
                SO-VID: c070d6e0-ef21-4364-bdd4-9bd3711e3c5c
                Copyright © © 2016
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