Sedentary Behavior in Adults with Visual

ImpairmentsAER Conference on: Vision Loss in Older Adults and Veterans,

November, 2015

Dr. Lauren J. Lieberman

The College at Brockport

Kinesiology, Sport Studies, and Physical Education

Outline

What are the current physical activity and sedentary behavior habits in adults with visual impairments (VI)?

How did we become so sedentary? How can sedentary behavior impact me? Ways to sit less and move more

Physical Activity

Physical Activity Can Manage Our Health Prevention, improvement, or maintenance of the following:

Cardiovascular disease

Stroke

Type II Diabetes

Hypertension

Osteoporosis

Obesity

Breast & Prostate Cancer

Mental Health – well being, self esteem, self-efficacy, less depression

Maintenance of physical functioning

Falling and injury

Physical Activity

• = any bodily movement that results in a substantial increase in energy expenditure (i.e. burns calories)!!!

• e.g. walking, cleaning, dancing, playing with your children

Type of Physical Activity

ExerciseOccupational

Leisure Time PA

Transportation Household

Physical Activity

How Much Should We Be Doing?

30 minutes of moderate physical activity on 5 or more days per weekThis can be broken down into segments

10 mins in the morning, afternoon, and evening (to total 30 mins)

How Much Are We Doing?

Still being investigated

Low in children – trend through adulthood

Smaller proportion of individuals with disabilities are physically active compared to able-bodied

Those with VI spend less than 7% of their total active time participating in moderate to vigorous physical activity (MVPA) the intensity needed to prevent, improve, and maintain our health

Self-Reported Physical Activity Levels of Adults with Visual Impairments

Percent of Day Spent in Physical Activity and Sedentary Behavior

Walking Moderate Physical Activity Vigorous Physical Activity Sitting

9.8% in Health PromotingCombined Moderate &Vigorous Physical Activity

Barrier to Participation in Physical Activity in Individuals with VI & Sighted Peers

Accessibility

Income

Knowledge

Experience

Confidence

Motivation

Awareness of needs

Previous Injury

Environment

Social Support – friends, family, co-workers

If we are not being physically active

what are we doing with our time?

What is Sedentary Behavior

Latin word, “sedere” means “to sit” Activities that involve sitting/reclining or laying

down while awake Low energy expending tasks

Humans are made to move however we sit for long periods of time, day after day Technology Jobs Changes in our built environment Access to be active

Sedentary Behavior in Sighted Individuals

Sedentary Behavior in Individuals with Disabilities

More likely to engage in sedentary lifestyle compared to able bodied

Rimmer et al. (1999):

African American women with disabilities

86% spent more than 10 hours inside home during the week

Women reported sitting, laying down and/or sleeping - 18 hours/day = 75% of waking time

Sedentary Behavior in Individuals with VI

Majority of sedentary time watching TV, transportation, computer/paperwork

Hours spent with sedentary behavior:

Differences between acuity level:

B1 more time reading vs. B4

B4 more time watching TV on weekends vs. B1

Weekdays Weekends

Men 48.8 hrs/wk 16.2 hrs/wk

Women 51.2 hrs/wk 18.0 hrs/wk

How Does this Behavior Impact Me?

Lack of Physical Activity in Individuals with Visual Impairment

Insufficient PA exposes individuals with VI to more health risks compared to sighted peers:

stroke

osteoporosis

depression

hypertension

heart disease

diabetes

falls

obesity

Think before you sit Once you take a seat

Your muscles are no longer engaged

Your body does not expend many calories, almost nothing!

The ability to utilize stored energy (triglycerides or fat) diminishes therefore increasing the likelihood of storing fat in the body

2 hours later A 20% reduction in the function of High-Density Cholesterol

(Good Cholesterol)

Increasing likelihood of cholesterol build-up in the arteries

24 hours later Risk of type II diabetes increases – insulin is 24% less

effective

Too Much of A Good Thing

Blood pressure Triglycerides Blood sugar (glucose) Waist size Body fat Clustering of these

health markers Risk for developing

cardiovascular disease and/or metabolic syndrome

TV Time and Obesity

Obesity 1 in 3 adults are obese Obese individuals sit 2.5 times more than healthy weight

individuals

Positive relationship between watching TV and obesity in adults with VI Those watching 2 or more hours during the week – 2.89x

more likely to be obese Greater TV time in higher acuity levels

Lenz et al 2015 (JBIR)

What does all of this mean?

Greater Risk of Type II Diabetes

Greater Risk of Cardiovascular Disease

Greater Risk of All-Cause Mortality

2X

90%

49%

Walking and Health Benefits

The Spectrum

Vigorous Physical Activity

Moderate

Physical Activity

Light Physical Activity

Sedentary

Behavior

Lowest Energy Expenditure

Highest Energy Expenditure

Health Promoting Physical Activity

Say “NO” to Watching TV Shows Back to Back

Each 1 hour increment in TV time 11% increased risk of all-cause mortality 18% increased risk of cardiovascular disease

mortality

When those watching 4+ hours of TV/d compared to those watching <2hrs/d TV 46% increased risk of all-cause mortality 80% increased risk of cardiovascular disease

mortality Independent of smoking, blood pressure,

cholesterol and diet, waist circumference, as well as leisure-time physical activity**

Sit Less Move More

Sit Less Move More:Household Wash dishes by hand instead of

using the dishwasher

Fold laundry while standing instead of sitting

Volunteer to do the more “active” chores: mowing the lawn, washing windows, vacuuming/mopping the floor, raking leaves

Use the stairs as an exercise platform – walk briskly up the stairs rather than slowly; take each item up the stairs one at a time instead of an armful

Cook your meals instead of ordering out

Transportation Walk/bike with your

children/grandchildren to school or the park instead of drive

Get off a stop or two earlier than your final destination if taking public transportation

Bike/walk to church, dinner, Wegman’s

If you go out for dinner walk into the restaurant instead of using the drive through

Sit Less Move More:Screen Time Do not use a remote stand up

and change the channel

Activity breaks during commercials

Stand up, do a lap around the house, march in place, resistance train

Multi task & perform a household chore while the television is on

Iron, do dishes, clean

Set a time limit for screen time

60 mins. max

Games Stand around the table instead

of sit

Take sitting breaks during the game

Choose more active games like charades rather than sedentary games

Choose active video games over sedentary ones

Wii Fit Games/Xbox Kinect - not just for the children/grandchildren

Sit Less Move More:

Socializing Invite your friends over for

a walk and catch up while enjoying the outdoors

Walk around the house while chatting on the telephone

“Active” volunteering Dog walking at a local shelter

Babysit

Start a neighborhood garden

Don’t Be A Couch Potato – Break it Up!

The Good News

Break it UP! The more breaks you

take from sitting the better health outcomes you will have Improved

Blood sugar (glucose)Waist circumference Triglycerides Blood pressure

Resources and Useful Tools to Stay Active

Where can I go to be active?

Indoor Outdoor

Tools to help me Move More Sit Less

Fitness Tracking bands Fitbit, Jump bands, Nike Fuelbands, Pedometers

Websites/Smartphone Apps www.mapmyfitness.com www.myfitnesspal.com

Paper & PencilLog your physical activity

& sedentary behaviors

Review

Sit less move more to prevent onset of chronic disease

Participate in regular physical activity in addition to breaking up your sedentary behaviors

Use your resources and tools to help you become the most active you can be

References

1. American College of Sports Medicine. Reducing sedentary behaviors: sitting less and moving more.

2. Campbell, V., & Crews, J. (2001). Health conditions, activity limitations, and participation restrictions among older people with visual impairments. Journal of Visual Impairment & Blindness (JVIB), 95(08).

3.  Jaarsma, E., Dijkstra, P., Geertzen, J., & Dekker, R. (2014). Barriers to and facilitators of sports participation for people with physical disabilities: A systematic review. Scandinavian Journal of Medicine and Science in Sports.

4. Holbrook, E. A., Caputo, J. L., Perry, T. L., Fuller, D. K., & Morgan, D. W. (2009). Physical activity, body composition, and perceived quality of life of adults with visual impairments. Journal of Visual Impairment & Blindness, 103(1), 17-29.

5. N. Owen, GN Healy, CE Matthews, DW Dunstan. Too much sitting: The population health-science of sedentary behavior. ESSR 2010. 38(3). 105-113.

6. BE Starkoff, EK Lenz. Break it up: Improving health by breaking up continuous bouts of sedentary behavior. ACSM Health & Fitness Journal (In Press 2015).

7. EK Lenz Do sedentary behaviors impact the health of older adults. IJKSS (2014).