Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Prediction equation for physical activity energy expenditure in 11-13-year-old Sri Lankan children(MDPI Publishing, 2023) Dabare, P.; Wickramasinghe, P.; Waidyatilaka, I.; Devi, S.; Kurpad, A.V.; Samaranayake, D.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Hills, A.P.; Lanerolle, P.This study aimed to develop a regression equation to predict physical activity energy expenditure (PAEE) using accelerometry. Children aged 11-13 years were recruited and randomly assigned to validation (n = 54) and cross-validation (n = 25) groups. The doubly labelled water (DLW) technique was used to assess energy expenditure and accelerometers were worn by participants across the same period. A preliminary equation was developed using stepwise multiple regression analysis with sex, height, weight, body mass index, fat-free mass, fat mass and counts per minute (CPM) as independent variables. Goodness-of-fit statistics were used to select the best prediction variables. The PRESS (predicted residual error sum of squares) statistical method was used to validate the final prediction equation. The preliminary equation was cross-validated on an independent group and no significant (p > 0.05) difference was observed in the PAEE estimated from the two methods. Independent variables of the final prediction equation (PAEE = [0.001CPM] - 0.112) accounted for 70.6% of the variance. The new equation developed to predict PAEE from accelerometry was found to be valid for use in Sri Lankan children.Item Is being barefoot, wearing shoes and physical activity associated with knee osteoarthritis pain flares? Data from a usually barefoot Sri Lankan cohort(Oxford, 2021) Atukorala, I.; Pathmeswaran, A.; Batuwita, N.; Rajapaksha, N.; Ratnasiri, V.; Wijayaratne, L.; de Silva, M.; Chang, T.; Zhang, Y.; Hunter, D.J.AIM: To identify the association between hours of being barefoot/wearing footwear, physical activity (PA) and knee osteoarthritis pain flares (KOAF). METHODS: Persons with a diagnosis of knee osteoarthritis, who reported previous KOAF, were followed up in a 3 months long telephone-based case-crossover study. Exposures to risk factors were assessed every 10 days and whenever the participants experienced a KOAF. Conditional logistic regression examined associations of KOAF with following: hours of being barefoot/using footwear and PA performed (P < .05). RESULTS: There were 260 persons recruited, of whom 183 continued longitudinal follow up. Of them, 120 persons had at least one valid KOAF and control period. Participants were female (90%) with mean (SD) age and body mass index of 59.9 (7.0) years, 28.0 (5.0) kg/m2 respectively. Participants were barefoot for a mean duration of 12.7 hours (SD 4.6) and used footwear for 5.1 (SD 4.7) hours daily; 99% wore heel heights <2.5 cm. Duration of being barefoot, 1 and 2 days before, demonstrated reduced multivariate odds of KOAF (odds ratio [OR] = 0.85; 95% CI 0.80-0.90). Moderate PA performed 1, 2 days prior was associated with a significantly increased risk of KOAF (multivariate OR 4.29; 2.52-7.30 and OR 3.36; 2.01-5.61). Similarly, hours of using footwear 1 and 2 days before flare demonstrated increased odds of KOAF (OR 1.15; 1.07-1.23 and 1.10; 1.03-1.18). CONCLUSIONS: Increased duration of being barefoot 1 to 2 days before is associated with reduced risk of KOAF. Performing moderate PA 1 to 2 days before was associated with an increased risk of KOAF. KEYWORDS: knee osteoarthritis pain.Item Translation, cultural adaptation and validity of the Adolescent Sedentary Activity Questionnaire among school children aged 14-15 years(College of Community Physicians of Sri Lanka, 2020) Godakanda, I.; Abeysena, C.; Lokubalasooriya, A.INTRODUCTION: Sedentary behaviour is a risk factor for several diseases. Validation of questionnaires on sedentary activity is a great challenge. OBJECTIVES: To translate, culturally adapt and validate the Adolescent Sedentary Activity Questionnaire (ASAQ) among school children. METHODS: Back translation method was used to translate ASAQ into Sinhala language (ASAQ-S). Cultural adaptation and judgmental validity were ensured using a panel of experts. Criterion validity was assessed by comparing ASAQ-S data with the reference standard, which was the ActiGraph GT1M accelerometer worn on the waist. The study population consisted of 42 school children aged 14-15 years. Sedentary activity time was taken from the accelerometer recorded data as total hours per day. The ASAQ-S has 14 items and then total sedentary time was calculated by summing up the activities of all seven days. Intra-class correlation coefficient (ICC) and 95% confidence interval (CI) were calculated. RESULTS: The average sedentary time was 11.7 (SD=3.4) hours per day recorded by an accelerometer and from the ASAQ-S 9.0 (SD=2.3) hours per day. An ICC for total sedentary activity time between the accelerometer and ASAQ-S was 0.52 (95% CI=0.08, 0.78) and Pearson correlation coefficient was 0.55 (p<0.01). CONCLUSIONS: The validity of ASAQ-S was satisfactory and can be used as a tool to assess adolescent sedentary behaviour. KEYWORDS: Adolescence, Cultural, Questionnaire, Reliability, Sedentary, ValidityItem Pattern of physical activity among school children aged 14-15 years in the district of Kalutara(College of Community Physicians of Sri Lanka, 2018) Godakanda, I.; Abeysena, C.; Lokubalasooriya, A.BACKGROUND: Physical inactivity is a major risk factor for NCD related global mortality. Sri Lanka is on the verge of an epidemic of NCDs. It is imperative that the pattern of physical activity is assessed among adolescents.OBJECTIVE: To describe the pattern of physical activity among school children aged 14-15 years in the district of KalutaraMETHODS: A cross-sectional survey was carried out in a sample of 1795 children in government schools in the district of Kalutara. The sample was selected using a multistage cluster sampling method with probability proportionate- to the size. A total of 90 class rooms (clusters) were included and the average cluster size was 20. The pattern of physical activity was assessed using the validated Physical Activity Questionnaire-S. Moderate to vigorous physical activities for at least 60 minutes per day for ≥5 days per week were categorized as ‘sufficiently active’. Chi-squared test was applied to compare the physical activity level with selected factors.RESULTS: Only 33.1% (n=595) of the adolescents were sufficiently active. Of them, 30.6% (246/805) females and 35.1% (349/990) males were sufficiently active (p=0.04). Of the overweight adolescents, 26.7% (48/176) were sufficiently active, which was significantly different from the normal (35.1%, 412/1175) and underweight (30.4%, 135/144) groups (p=0.04). Only 13.9% (n=249) adolescents participated on three or more days a week in sport clubs, aerobics, dancing or martial art during out-of-school hours; and 66.4% (n=1195) in one or more sport clubs during the previous year. Only 4.8% (n=86) adolescents were active on three or more days during school physical exercise period and 46.8% (n=842) traveling by bicycle to school and back during the previous week. Almost 80% (n=1407) of the adolescents learnt about benefits of physical exercise; 66.2% (n=1187) to develop a plan of physical exercise to improve it; and 80% (n=1434) on injury prevention of physical exercise during the previous year from the schools.CONCLUSIONS: Only 33.1% of the adolescents were sufficiently active. Males were more active than females. Participation of physical exercise activities within school and out-of-school hours was low.Item Sedentary behavior during leisure time, physical activity and dietary habits as risk factors of overweight among school children aged 14-15 years: case control study(Biomed Central, 2018) Godakanda, I.; Abeysena, C.; Lokubalasooriya, A.OBJECTIVE: To determine the risk of sedentary behavior during leisure time, physical activity and dietary habits on overweight among school children aged 14-15 years in Kalutara District, Sri Lanka. RESULTS: School based case-control study was conducted during September to November 2013 including 176 overweight children as cases and 704 children with normal weight as controls. Cases were defined as body mass index for age and sex of ≥ +1SD and controls as those in the range of -2SD to +1SD. Validated instruments were used for data collection. Multiple logistic regression was applied and results were expressed with adjusted odds ratios (OR) and 95% confidence intervals (CI). Risk factors for overweight were insufficient physical activity (OR 1.6, 95% CI 1.1-2.4), watching video/DVD ≥ 2 h (OR 3.1, 95% CI 1.8-5.3), watching television ≥ 2 h (OR 2.6, 95% CI 1.7-3.8) and doing homework ≥ 2 h, (OR 1.8, 95% CI 1.2-2.7). Consuming meat (OR 1.9, 95% CI 1.2-3.1), fish or other sea foods (OR 1.6, 95% CI 1.1-2.8), fast food/fried rice/oily foods (OR 1.9, 95% CI 1.2-2.9), carbonated drinks or sugary drinks (OR 1.9, 95% CI 1.2-2.8), sweets, cookies or ice cream (OR 1.8, 95% CI 1.2-2.9) were dietary risk factors for overweight. Consuming legumes and seeds (OR 0.50, 95% CI 0.3-0.7), vegetables and fruits (OR 0.6, 95% CI 0.4-0.9) were protective factors for overweight.