Self‐Reported and Objectively Measured Physical Activity in Adults With Systemic Lupus Erythematosus

Abstract

Objective Most estimates of physical activity (PA) patterns in systemic lupus erythematosus (SLE) are based on subjective self-report measures prone to error. The aims of this study were to obtain objective measurements of PA using an accelerometer and estimates of energy expenditure based on the self-reported International Physical Activity Questionnaire (IPAQ), and to describe their relationship. Methods The “Activity in Lupus To Energize and Renew” (ALTER) study, a cross-sectional study of PA, included 129 persons with SLE. Accelerometer measures over 7 days included total daily activity counts and minutes of moderate-vigorous physical activity (MVPA). Each person completed the IPAQ via telephone interview. Spearman correlations (r) and 95% confidence intervals (CIs) assessed associations between accelerometer and IPAQ. Results Daily PA means (SD) from accelerometer measures were total daily activity counts, 502,910 (118,755) and MVPA, 40 (30) minutes. The median (interquartile range) MET-min per day for IPAQ intensities were: total 400 (159–693); walking, 83 (26–184); and moderate-vigorous, 231 (77–514), and domains were: work 0 (0–73); active transportation 28 (0–85); domestic and garden 77 (26–231); and leisure 57 (0–213). Associations between accelerometer measures and IPAQ were: 1) total daily count vs. IPAQ total, r=0.21, 95% CI: (0.03, 0.37); and 2) MVPA vs. IPAQ moderate-vigorous, r=0.16, 95% CI: (-0.02, 0.33). Conclusion Accelerometer measures and IPAQ energy expenditure estimates were moderately correlated. IPAQ provided descriptive PA data whereas accelerometers captured all daily activities and can help assess guideline attainment. The choice of IPAQ versus accelerometer measure should consider the purpose for which PA is measured.

Physical activity and sedentary behavior in patients with systemic lupus erythematosus and rheumatoid arthritis

“…The literature investigating PA behavior in SLE patients using accelerometry is limited. A study by Ahn et al 29 used accelerometry to measure MVPA in 129 SLE patients. As in our study, low levels of MVPA were demonstrated among SLE patients, with mean total MVPA of 39.6 minutes/day.…”

“…As in our study, low levels of MVPA were demonstrated among SLE patients, with mean total MVPA of 39.6 minutes/day. 29 A recent study by Pinto et al 31 compared accelerometry-derived MVPA estimates between physically inactive SLE patients and physically inactive non-SLE participants. Not surprisingly, MVPA levels were very low in both groups.…”

“… 25 Several studies have assessed moderate–vigorous PA (MVPA) among RA patients using accelerometry and have found lower levels of MVPA compared to healthy non-RA participants. 26 – 28 To date, relatively little work has been performed using accelerometry to measure MVPA in SLE patients 29 – 31 and, to our knowledge, no prior studies have directly compared MVPA levels between RA and SLE patients.…”

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

“…Accelerometers are able to objectively determine quantitative changes in PA. For example, self-reported time spent in moderate/vigorous PA (using the IPAQ) was higher than measurements obtained from accelerometers in one study. 16 Detailing both PA duration and intensity continuously throughout the day allows a more comprehensive description of the relationships between PA and fatigue. Finally, accelerometer responsiveness to change in PA over time has been established in rheumatic disease populations.…”

Reduced Aerobic Capacity and Quality of Life in Physically Inactive Patients With Systemic Lupus Erythematosus With Mild or Inactive Disease

“…Evidence on the physical activity levels in SLE patients is scarce. However, a few studies have suggested that rheumatic patients may experience insufficient levels of physical activity , which could account for the reduced aerobic capacity and health‐related quality of life (HRQOL) in these patients . However, despite the notion that a physically inactive lifestyle could be detrimental in general and for rheumatic populations, there is no study assessing physical fitness and HRQOL in physically inactive SLE patients and controls.…”