The longitudinal relationship of sedentary behavior with health outcomes in a community-based cohort: The Johnston County Health Study

项目摘要/摘要 患有慢性肌肉骨骼疾病的成年人，如膝骨性关节炎(OA)或背部疼痛，迫切需要 有效干预以减少久坐行为，如久坐不动。从历史上看，干预 通过有监督的锻炼来有针对性地进行体育活动，但在很大程度上忽视了久坐的行为。是这样的 久坐不动的行为以独立于运动的方式影响健康，包括增加患心脏病的风险 死亡率、糖尿病和肥胖症。这与患有慢性肌肉骨骼疾病的成年人有关，他们在 每天久坐的时间比健康的人多3.5个小时，而且干预的目标是 久坐的行为还有待测试。然而，在我们可以计划和实施临床试验之前，一个关键的 必须首先填补的知识空白是需要减少多少久坐行为才能拥有 在临床上有意义的健康改善。令人惊讶的是，没有既定的标准来定义 久坐过多的行为，也没有关于应该减少多少的建议。 因此，我们看不到应该针对多少久坐的行为进行改变，而 在我们首先确定这一点之前，临床试验将是浪费时间和资源。为了填补这一空白，我们建议 检查久坐行为减少与临床上有意义的疼痛、生理变化的关系。 以社区为基础的大型、多样化队列中两年多的功能和健康相关生活质量(HRQOL) 目前正在该领域学习。这项研究的目的是使用一种最先进的监测设备， 评估来自约翰斯顿县健康研究的1500名成年人的久坐行为 (JoCoHS)。我们的提案将首次为久坐不动的人设定急需的门槛 将克服当前领域中设计和实施有效临床的限制的行为 针对过度久坐行为的干预措施。我们特别感兴趣的是了解如何 久坐行为会影响常见但代价高昂的肌肉骨骼结果，如疼痛、力量、体力 功能和HRQOL。这项提案产生的结果将提供必要的数据， 美国计划未来的临床试验，然后广泛告知更广泛的科学界如何 解决患有慢性肌肉骨骼疾病的成年人的久坐行为。

Project Summary/Abstract Adults with chronic musculoskeletal disease, such as knee osteoarthritis (OA) or back pain, are in urgent need of an effective intervention to reduce sedentary behaviors, such as excessive sitting. Historically, interventions have targeted physical activity via supervised exercise, but have largely ignored sedentary behaviors. Such sedentary behaviors impact health in ways that are independent of exercise, including increased risk of mortality, diabetes, and obesity. This is relevant to adults with chronic musculoskeletal disease who spend up to 3.5 hours/day more in sedentary behaviors than their healthy counterparts, and where intervention targeting sedentary behaviors has yet to be tested. However, before we can plan and implement a clinical trial, a critical gap in knowledge that must first be filled is how much sedentary behaviors need to be reduced to have clinically meaningful improvements in health. Surprisingly, there are no established standards to define excessive levels of sedentary behavior, nor recommendations for how much they should be reduced. Consequently, we are blind to what amount of sedentary behaviors should be targeted for change, and a clinical trial would be a waste of time and resources until we first establish this. To fill this gap, we propose to examine the relation of reduced sedentary behavior with clinically meaningful changes in pain, physical function, and Health Related Quality of Life (HRQoL) over 2 years in a large, diverse community-based cohort study currently in the field. The objective of this study is to use a state-of-the-art monitoring device, the activPAL, to evaluate sedentary behaviors within 1,500 adults from the Johnston County Health Study (JoCoHS). Our proposal will establish for the first time much-needed thresholds for targeting sedentary behaviors that will overcome current limitations in the field for designing and implementing effective clinical interventions that address excessive sedentary behaviors. We are specifically interested in understanding how sedentary behavior impacts common, yet costly, musculoskeletal outcomes such as pain, strength, physical function, and HRQoL. The results stemming from this proposal will provide essential data that is necessary for us to plan for a future clinical trial which would then broadly inform the wider scientific community of how to address sedentary behaviors in adults with chronic musculoskeletal disease.