Malcolm Granat

Malcolm Granat
University of Salford · School of Health Sciences

PhD

About

209
Publications
174,426
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Introduction
Malcolm Granat is Professor of Health and Rehabilitation Sciences at the University of Salford. He is engaged in research looking at the quantification of free-living physical behaviour using body-worn monitors. The main focus of his research is the development of new outcomes, based on physical behaviour patterns, to quantify the effectiveness of interventions in a range of populations and clinical groups (e.g. stroke, OA, intermittent claudication, heart failure, the older person etc.).
Additional affiliations
March 2013 - December 2015
University of Salford
Position
  • Professor of Rehabilitation and Health Sciences

Publications

Publications (209)
Article
Full-text available
This study investigated the relationship between stepping-defined daily activity levels, time spent in different postures, and the patterns and intensities of stepping behaviour. Using a thigh-mounted triaxial accelerometer, physical activity data from 3547 participants with seven days of valid data were analysed. We classified days based on step c...
Article
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Background/Objectives: The Star Excursion Balance Test (SEBT) is a simple and feasible tool for assessing dynamic balance in individuals with knee osteoarthritis (KOA). It has an advantage as it replicates dynamic balance better than other static balance tools. This study aims to determine how reliable SEBT is among people with end-stage KOA, as we...
Article
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Introduction Tailoring physical activity interventions to individual chronotypes and preferences by time of day could promote more effective and sustainable behavior change; however, our understanding of circadian physical behavior patterns is very limited. Objective To characterize and compare 24‐h physical behavior patterns expressed relative to...
Article
Purpose: Throughout the world, mobility devices are usually distributed using product-based business models, where a device is provided to a user, and serviced or replaced when the user returns to the clinic with an issue. Moving to a service-based business model can provide continuous and customised support for the user, and provide the clinician...
Article
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Background A cluster randomised controlled trial demonstrated the effectiveness of the SMART Work & Life (SWAL) behaviour change intervention, with and without a height-adjustable desk, for reducing sitting time in desk-based workers. Staff within organisations volunteered to be trained to facilitate delivery of the SWAL intervention and act as wor...
Article
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Background Office workers spend 70–85% of their time at work sitting. High levels of sitting have been linked to poor physiological and psychological health. Evidence shows the need for fully powered randomised controlled trials, with long-term follow-up, to test the effectiveness of interventions to reduce sitting time. Objective Our objective wa...
Article
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Measures of physical performance captured within a clinical setting are commonly used as a surrogate for underlying health or disease risk within an individual. By measuring physical behaviour within a free-living setting, we may be able to better quantify physical performance. In our study, we outline an approach to measure maximum free-living ste...
Article
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Individuals with intermittent claudication (IC) are less physically active than their peers, but how this varies with location is unclear. Individuals with IC and matched controls [sex, age ±5 years, home < 5 miles] wore an activity monitor (activPAL) and carried a GPS device (AMOD-AGL3080) for 7 days. GPS data categorised walking events as occurri...
Article
Introduction : The COVID-19 lockdown introduced restrictions to free-living activities. Changes to these activities can be accurately quantified using combined measurement. Using activPAL3 and self-reports to collect activity data, the study aimed to quantify changes that occurred in physical activity and sedentary behavior between prelockdown and...
Article
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Sedentary behaviours continue to increase and are associated with heightened risks of morbidity and mortality. We assessed the cost-effectiveness of SMART Work & Life (SWAL), an intervention designed to reduce sitting time inside and outside of work, both with (SWAL-desk) and without (SWAL-only) a height-adjustable workstation compared to usual pra...
Article
Background: Self-efficacy is an important psychological construct associated with patient adherence with healthy lifestyle choices. Few studies have focused on the impacts of the type of acute myocardial infarction (AMI), non-ST-elevation myocardial infarction (STEMI) and STEMI, and the different treatment modalities of AMI on changes in cardiac s...
Article
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Objectives To evaluate the effectiveness of an intervention, with and without a height adjustable desk, on daily sitting time, and to investigate the relative effectiveness of the two interventions, and the effectiveness of both interventions on physical behaviours and physical, biochemical, psychological, and work related health and performance ou...
Article
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Background After amputation, many people become less active, feel lonely and lose independence. Understanding the factors associated with low physical activity levels and participation could contribute to defining key interventions which can support prosthesis users so they can live a more active and socially included lifestyle. This longitudinal o...
Article
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The recommended treatment for idiopathic congenital clubfoot deformity involves a series of weekly castings, surgery, and a period of bracing using a foot abduction brace (FAB). Depending on the age of the child, the orthotic should be worn for periods that reduce in duration as the child develops. Compliance is vital to achieve optimal functional...
Article
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In free-living environments, continuous walking can be challenging to achieve without encountering interruptions, making it difficult to define a continuous walking event. While limited research has been conducted to define a continuous walking event that accounts for interruptions, no method has considered the intensity change caused by these inte...
Preprint
Full-text available
Background: After amputation, many people become less active, feel lonely and lose independence. Understanding the factors associated with low physical activity levels and participation could contribute to defining key interventions which can support prosthesis-users so they can live a more active and socially inclusive lifestyle. This longitudinal...
Article
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There are currently limited data on how prosthetic devices are used to support lower-limb prosthesis users in their free-living environment. Possessing the ability to monitor a patient’s physical behaviour while using these devices would enhance our understanding of the impact of different prosthetic products. The current approaches for monitoring...
Article
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To contain the recent COVID‐19 outbreak restrictions have been imposed, which has limited outdoor activity. These physical behaviour changes can have serious health implications, but there is little objective information quantifying these changes. This study aimed to estimate the change in physical behaviour levels during full lockdown conditions u...
Article
Background: Gamification has become increasingly popular in rehabilitation and is viewed as a tool to improve patient activation, motivation and engagement. The aim of this study was to compare the efficacy of validated Exergames played through a system using 'depth sensor' and bespoke software against standard physiotherapy in patients treated wi...
Article
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Introduction The Prospective Physical Activity Sitting and Sleep consortium (ProPASS) is an international collaboration platform committed to harmonise thigh-worn accelerometry data. The aim of this paper is to (1) outline observational thigh-worn accelerometry studies and (2) summarise key strategic directions arising from the inaugural ProPASS me...
Article
Background : Actively commuting to and from work can increase moderate-to-vigorous physical activity (MVPA) and increase adherence to physical activity (PA) guidelines; however, there is a lack of evidence on the contribution of mixed-mode commutes and continuous stepping bouts to PA. Many commuting studies employ the use of self-reported PA measur...
Article
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Background: Understanding how prostheses are used in everyday life is central to the design, provision and evaluation of prosthetic devices and associated services. This paper reviews the scientific literature on methodologies and technologies that have been used to assess the daily use of both upper- and lower-limb prostheses. It discusses the ty...
Article
Background: The Oxford Knee Score (OKS) is a reliable, valid, and sensitive assessment tool for individuals undergoing a total knee arthroplasty (TKA). The published psychometric assessment of the Arabic version of the OKS (OKS-Ar) is limited to male patients and has not been assessed for responsiveness following TKA. The aim of this study was to...
Article
Objective To date, no study has explored patients' experiences, outcome expectations and satisfaction 1‐year post‐total knee arthroplasty (TKA) using focus‐group discussion (FGD). The exploration of patients' expectations, functional recovery and limitations may support future modifications and thus improve outcomes post‐TKA. Methods An FGD was co...
Article
Full-text available
Objective Total knee arthroplasty (TKA) is the gold-standard treatment for end-stage knee osteoarthritis, and the primary expectations are reduced pain and improved function. However, there is conflicting evidence regarding functional changes post-TKA. Commonly, functional changes are measured using Oxford Knee Score (OKS). No previous study has in...
Preprint
Full-text available
Background Understanding how prostheses are used in everyday life is central to the design, provision and evaluation of prosthetic devices and associated services. This paper reviews the scientific literature on methodologies and technologies that have been used to assess the daily use of both upper- and lower-limb prostheses. It discusses the type...
Article
Full-text available
Background: Walking aids are issued to older adults to prevent falls, however, paradoxically their use has been identified as a risk factor for falling. To prevent falls, walking aids must be used in a stable manner, but it remains unknown to what extent associated clinical guidance is adhered to at home, and whether following guidance facilitates...
Article
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Aim The aim of this study is to cross‐culturally translate and adapt the Cardiac Self‐Efficacy Questionnaire into Arabic and subsequently evaluate the psychometric properties of that translation in a population of Arabic patients. Method The original English version of the Cardiac Self‐Efficacy Questionnaire was translated into Arabic following a...
Preprint
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ABSTRACT Background: Regular physical activity is important for patients with established coronary heart disease as it favorably influences their coronary risk profile. General self-efficacy is a powerful predictor of health behavior change that involves increases in physical activity levels. Few studies have simultaneously measured physical activi...
Article
Objective: Global positioning system (GPS) data can add context to physical activity data and have previously been integrated with epoch-based physical activity data. The current study aimed to develop a framework for integrating GPS data and event-based physical activity data (suitable for assessing patterns of behavior). Methods: A convenience da...
Article
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The upper limb activity of twenty unilateral upper limb myoelectric prosthesis users and twenty anatomically intact adults were recorded over a 7-day period using two wrist worn accelerometers (Actigraph, LLC). This dataset reflects the real-world activities of the participants during their normal day-to-day routines. Participants included students...
Article
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Obesity can negatively influence walking cadence, reducing the overall intensity of daily activities and increasing the risk of weight gain. Purpose Objectively describe the walking cadence of individuals’ long-term post-bariatric surgery. Methods Fifty-eight participants, 51.2 ± 8.9 years old, with a BMI of 34.6 ± 10.1 kg/m², 10.0 ± 3.1 years po...
Article
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This paper presents the story behind developing the Cambodia-UK prosthetics and orthotics (P&O) project ‘LMIC Limbs’. We describe the methods employed in identifying and iterating the project scope, the principles underpinning our collaboration, and our reflections on the process. In the context of growing digital technology possibilities for P&O s...
Article
Purpose: Standing up, sitting down and walking require considerable effort and coordination, which are crucial indicators to rehabilitation (e.g. stroke), and in older populations may indicate the onset of frailty and physical and cognitive decline. Currently, there are few reports robustly quantifying sit-to-stand and stand-to-sit transitions in...
Article
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Galileo Galilei’s quote ‘measure what is measurable, and make measurable what is not so’ has particular relevance to health behaviours, such as physical activity (PA), sitting and sleep, whose measurement during free living is notoriously difficult. To date, much of what we know about how these behaviours affect our health is based on self-report b...
Article
Prolonged standing at work is required by an estimated 60% of the employed population and is associated with a high prevalence of musculoskeletal disorders. ‘Standing’ is expected to encompass a range of activities of varying intensity. This study aimed to define a range of ‘standing’ work-based activities; and objectively explore differences betwe...
Article
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Introduction: Current UK guidance for the treatment of intermittent claudication (IC) states that supervised exercise programmes (SEPs) should be offered as first-line treatment [1], prior to surgical interventions. However, there is currently a national shortage of dedicated SEPs. It has been suggested that the established network of UK Cardiac R...
Article
Full-text available
Background: Office-based workers typically spend 70-85% of working hours, and a large proportion of leisure time, sitting. High levels of sitting have been linked to poor health. There is a need for fully powered randomised controlled trials (RCTs) with long-term follow-up to test the effectiveness of interventions to reduce sitting. This paper de...
Article
Full-text available
Studies of the effectiveness of prosthetic hands involve assessing user performance on functional tasks, typically collected in the lab, sometimes combined with self-report of real-world use. In this paper we compare real-world upper limb activity between a group of 20 myoelectric prosthesis users and 20 anatomically intact adults. Activity was mea...
Article
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Falls in older adults present a major growing healthcare challenge and reliable detection of falls is crucial to minimise their consequences. The majority of development and testing has used laboratory simulations. As simulations do not cover the wide range of real-world scenarios performance is poor when retested using real-world data. There has b...
Article
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The Seniors USP study measured sedentary behaviour (activPAL3, 9 day wear) in older adults. The measurement protocol had three key characteristics: enabling 24-hour wear (monitor location, waterproofing); minimising data loss (reducing monitor failure, staff training, communication); and quality assurance (removal by researcher, confidence about we...
Article
High levels of sedentary time have been detrimentally linked to health outcomes. Differentiating sitting from lying may help to further understand the mechanisms associated with these health impacts. This study compares the inter‐method agreement between the ‘single‐monitor’ method (thigh‐worn activPAL³TM) and a more robustly validated ‘dual‐monito...
Article
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The study examined the influence of dog ownership on physical activity (PA) in community dwelling older adults using a longitudinal design and an objective measure of PA (activPAL monitor). Eighty six participants (aged 65–81 years) were matched on gender, age, and socio-economic status into dog owner (DO) and non-dog owner (NDO) pairs. Each partic...
Article
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Background: Current outcome measures used in upper limb myoelectric prosthesis studies include clinical tests of function and self-report questionnaires on real-world prosthesis use. Research in other cohorts has questioned both the validity of self-report as an activity assessment tool and the relationship between clinical functionality and real-...
Poster
This poster contains information on a study that was carried out with the aim of investigating sedentary behaviour among university office workers and how it impacts on mental wellbeing. These office workers were established users of sit stand desks- an intervention put in place to reduce sitting. The time spent sitting was measured objectively usi...
Article
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Background There is some evidence to suggest that dog ownership may improve physical activity (PA) among older adults, but to date, studies examining this, have either depended on self-report or incomplete datasets due to the type of activity monitor used to record physical activity. Additionally, the effect of dog ownership on sedentary behaviour...
Article
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Background Physical activity has not been objectively measured in prospective cohorts with sufficiently large numbers to reliably detect associations with multiple health outcomes. Technological advances now make this possible. We describe the methods used to collect and analyse accelerometer measured physical activity in over 100,000 participants...
Article
Background: People with hip osteoarthritis are likely to limit physical activity (PA) engagement due to pain and lack of function. Total hip arthroplasty (THA) reduces pain and improves function, potentially allowing increased PA. PA of THA patients was quantified to 12 months postoperation. The hypothesis was that postoperatively levels of PA wou...
Data
Minimum wear time criterion. One challenge is to determine the minimum amount of time participants should wear an accelerometer to get a reliable measure of their physical activity status. Therefore, using 29 765 participants who had complete wear time compliance, we simulated the effect of only having 24–168 hours of data (1–7 days). Using intracl...
Article
Full-text available
Background: The relationship between metabolic risk and time spent sitting, standing and stepping has not been well established. The present study aimed to determine associations of objectively measured time spent siting, standing and stepping, with coronary heart disease (CHD) risk. Methods: A cross-sectional study of healthy non-smoking Glasgo...
Article
Understanding the contribution that attending a workplace has in accumulating physical activity (PA) may help inform strategies used to increase PA. This study explores the influence that attending work has on the total number of steps taken and the time spent in moderate to vigorous activity (MVPA). A global position system (GPS) was used to ident...
Article
Full-text available
Background: Hesitation between moving from a sedentary posture (lying/sitting) to walking is a characteristic of mobility impaired individuals, as identified from laboratory studies. Knowing the extent to which this hesitation occurs during everyday life would benefit rehabilitation research. This study aimed to quantify this transition hesitation...
Article
Sedentary behaviour (SB) is associated with a number of adverse health outcomes. Studies that have used ActiGraph monitors to define sedentary time tend to use a threshold of <100 counts per minute (cpm) for classifying SB; however, this cut-point was not empirically derived for adults. It is not known whether ActiGraph cut-points for SB differ dep...
Article
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Background This study is part of the Trondheim Hip Fracture Trial, where we compared free-living physical behavior in daily life 4 and 12 months following hip surgery for patients managed with comprehensive geriatric care (CGC) in a geriatric ward with those managed with orthopedic care (OC) in an orthopedic ward. Methods This is a single centre,...
Article
Purpose: To develop and test a classification algorithm to identify sedentary events as either lying or sitting events using a thigh-worn, tri-axial accelerometer. Methods: Seven day free-living activity from 14 sedentary workers was recorded using the activPAL3 monitor. Participants recorded when they went to bed and when they got up in a diary...
Article
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Purpose: Seasonality studies in adolescent's physical activity (PA) tend to report total PA (e.g. steps/day) rather than more specific detail such as steps/hour. This study compared the detailed changes in PA between seasons. Methods: Thirty three adolescents (baseline age 12.2 ± 0.3y) wore the activPAL activity monitor for 8 days on two occasio...
Article
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Visualization is commonly used in the interpretation of physical behavior (PB) data, either in conjunction with or as precursor to formal analysis. Effective representations of the data can enable the identification of patterns of behavior, and how they relate to the temporal context in a single day, or across multiple days. An understanding of beh...
Article
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To describe the scope of accelerometry data collected internationally in adults; and, to obtain a consensus from measurement experts regarding the optimal strategies to harmonize international accelerometry data. In March 2014 a comprehensive review was undertaken to identify studies that collected accelerometry data in adults (sample size N ≥400)....
Article
Full-text available
Introduction There is limited understanding of the type and extent of maternal postures that midwives should encourage or support during labor. The aims of this study were to identify a set of postures and movements commonly seen during labor, to develop an activity monitoring system for use during labor, and to validate this system design. Method...