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Allison K, Setchell J, Egerton T, Delany C, Bennell KL. In Theory, Yes; in Practice, Uncertain: A Qualitative Study Exploring Physical Therapists' Attitudes Toward Their Roles in Weight Management for People With Knee Osteoarthritis. Phys Ther 2019; 99:601-611. [PMID: 30715519 DOI: 10.1093/ptj/pzz011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 10/23/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND Physical therapists are at the frontline of treatment for knee osteoarthritis (OA). International guidelines recommend weight loss for individuals with knee OA who are overweight, and research indicates that patients believe it is appropriate for physical therapists to address weight. OBJECTIVES The objective was to explore physical therapists' attitudes about their role in weight management for people with OA. DESIGN This was a qualitative semistructured telephone interview study. METHODS Participants included 13 purposively sampled physical therapists who had treated at least 1 patient with knee OA within the past 12 months. Each participated in a telephone interview exploring their perceptions and attitudes toward the role of physical therapists in providing weight management support for people with knee OA. Data were analyzed using a thematic approach. RESULTS Three main themes were identified, which highlighted that physical therapists: (1) believe they have a role in facilitating weight loss for people with knee OA; (2) are uncertain how to integrate weight loss into their management; and (3) are conscious of the psychosocial complexities and the need to tread cautiously around weight management. CONCLUSIONS Physical therapists are aware of the importance of weight loss in the management of knee OA, and believe weight management falls within their role and responsibilities; however, they do not feel equipped to fulfill this role. They also acknowledge the weight management conversation as potentially sensitive. This study highlights the need for training opportunities to develop physical therapists' skills and confidence in weight management for people with knee OA who are overweight, including consideration of the potential harms and benefits of this aspect of care.
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Affiliation(s)
- Kim Allison
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, 160 Barry St, Parkville, Victoria 3010, Australia
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Thorlene Egerton
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne
| | - Clare Delany
- Department of General Practice, The University of Melbourne
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne
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Community-based self-management of chronic low back pain in a rural African primary care setting: a feasibility study. Prim Health Care Res Dev 2019; 20:e45. [PMID: 32800022 PMCID: PMC6536765 DOI: 10.1017/s1463423619000070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A small pragmatic non-randomised controlled study investigated the feasibility and acceptability of a novel theory-informed community-based self-management programme targeting the biopsychosocial factors associated with chronic low back pain disability in a rural Nigerian primary care centre. Participants either received the programme, once weekly for 6 weeks, or usual care. The programme combined group exercise sessions with group/individual discussion sessions, informed by cognitive behavioural therapy and motivational interviewing. Recruitment rate, intervention delivery, proportion of planned treatment attended, retention/dropout rate, adherence to recommended self-management strategies and biopsychosocial outcomes were used to determine feasibility. Structured qualitative exit feedback interviews ascertained acceptability. Recruitment rate was 100%, treatment uptake was 83% and loss to follow-up was 8%. Greater benefits for the self-management group compared with control were observed for primary and secondary biopsychosocial outcomes. Although the programme appears promising, the exploratory design of this study warrants more rigorous intervention testing following suggested programme improvement.
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Modenutte GDS, Martins J, Hotta GH, Oliveira ASD. Confiabilidade intra e interexaminador do questionário Perfil do Estilo de Vida Individual (PEVI) em indivíduos com dor musculoesquelética. FISIOTERAPIA E PESQUISA 2019. [DOI: 10.1590/1809-2950/18007426012019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo do estudo foi testar todas as propriedades de confiabilidade do Perfil do Estilo de Vida Individual (PEVI) em pacientes com dor musculoesquelética. Participaram desse estudo 105 pacientes com dor musculoesquelética, recrutados de um serviço público de fisioterapia de nível secundário. O PEVI foi aplicado pelo Examinador 1 na avaliação inicial e pelo Examinador 2 após uma hora. Após três a sete dias da avaliação inicial, o Examinador 1 reaplicou o PEVI. O PEVI e seus componentes apresentaram consistência interna de 0,27 a 0,61 e valores de confiabilidade intra e interexaminador de moderado a excelente (CCI=0,68 a 0,90) e de moderado a quase perfeito (K=0,59 a 0,83). A porcentagem de concordância foi de 61% a 98%, o EPM do PEVI foi de 4,1 pontos e a MMD foi de 5,7 pontos. Concluímos que o PEVI é um instrumento confiável para avaliar o estilo de vida de pacientes com dor musculoesquelética.
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O'Sullivan K, O'Keeffe M, Forster BB, Qamar SR, van der Westhuizen A, O'Sullivan PB. Managing low back pain in active adolescents. Best Pract Res Clin Rheumatol 2019; 33:102-121. [PMID: 31431266 DOI: 10.1016/j.berh.2019.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Adolescent low back pain has received limited research attention despite its potentially considerable impact on quality of life. The role of diagnostic triage to identify serious or specific pathology and/or order relevant investigations is considered. An overview of contemporary pain mechanisms is provided, with specific reference to the wide range of risk factors for persistent low back pain. Education and exercise framed within a biopsychosocial framework are the cornerstones of treatment. There is a lack of data on more comprehensive personalized treatment approaches among adolescents. One such approach - Cognitive Functional Therapy - which has shown promise in adults and active adolescents with low back pain, is described and illustrated using a case study. The most promising avenues, in practice and research, may be those that view adolescent low back pain as less of a local structural spinal issue and more of an indication of the general health of the adolescent.
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Affiliation(s)
- Kieran O'Sullivan
- School of Allied Health, University of Limerick, Ireland; Sports Spine Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Qatar.
| | - Mary O'Keeffe
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Institute for Musculoskeletal Health, Sydney, Australia
| | - Bruce B Forster
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sadia Raheez Qamar
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Peter B O'Sullivan
- Health Sciences Division, School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia; Bodylogic Physiotherapy, Perth, Western Australia, Australia
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55
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Boccardi M, Boccardi V. Psychological Wellbeing and Healthy Aging: Focus on Telomeres. Geriatrics (Basel) 2019; 4:geriatrics4010025. [PMID: 31023993 PMCID: PMC6473912 DOI: 10.3390/geriatrics4010025] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/09/2019] [Accepted: 02/18/2019] [Indexed: 12/15/2022] Open
Abstract
Stress and depression are known to modulate the aging process, and might also affect telomere biology. In fact, exposure to some biochemical pathways involved in stress-related depression may contribute to an ‘‘accelerated aging” phenotype, as well as the incidence of age-related diseases, including metabolic disorders and dementia. Basic studies support the notion that the telomere and telomerase system plays a pivotal role in the aging process and disease promotion. Interestingly, short and dysfunctional telomeres are associated with reduced lifespan, as shown in animal models. In this context, telomeres are very sensitive to stress, mindset, and lifestyle, and their rescue may be sufficient to restore cell and organism viability. This mini-review discusses conceptual models of healthy and active aging and their relationship with telomere biology and mental health.
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Affiliation(s)
- Mariangela Boccardi
- Department of Psychiatry, University of Campania Luigi Vanvitelli, 80138 Naples, Italy.
| | - Virginia Boccardi
- Section of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, 60132 Perugia, Italy.
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Maximizing the Functional Performance Outcomes of Patients Undergoing Rehabilitation by Maximizing Their Overall Health and Wellbeing. J Hum Kinet 2019; 65:57-68. [PMID: 30687419 PMCID: PMC6341960 DOI: 10.2478/hukin-2018-0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
To maximize the performance of an athlete, a team of experts work together to ensure each athlete achieves the maximal benefit from their prescribed exercise conditioning programs. In addition to the exercise specialists, the athlete’s team frequently includes psychologists (who address performance anxiety, stress, and depression), counselors (who address smoking cessation, reduction or elimination of alcohol consumption if necessary, weight optimization, and optimal sleep), and nutritionists (who address optimal nutrition and body mass attributes). Such a collaborative approach has become standard practice for athletes aiming to excel in their sports. Despite unequivocal and compelling evidence, this paradigm has only weakly been transferred to the needs of patients participating in rehabilitation programs. These individuals, like the athlete, also need to achieve their highest level of functional performance and recovery for carrying out their activities of daily living, managing the needs of their families, and often returning to work. This article reviews the evidence-based literature and the implications of this multifaceted approach in rehabilitation programs. The augmented benefits to exercise training and conditioning (prescriptive activity/exercise and less sitting) along with their ‘effect sizes’ are described in the rehabilitation context, in conjunction with smoking cessation, reduced harmful alcohol consumption, optimal nutrition, optimal body mass, manageable stress, and optimal sleep. These factors can be viewed as physical performance enhancers both in individuals participating in rehabilitation whose aim is maximal performance and recovery and in athletes aiming for maximal performance in their sports. Thus, without targeted attention to these lifestyle factors, rehabilitation outcomes cannot be maximized. The evidence presented in this article has implications for health professionals including physical therapists and others who are practicing in rehabilitation settings and those working with individuals in need in the community.
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57
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Igwesi-Chidobe CN, Kengne AP, Sorinola IO, Godfrey EL. Physical activity containing behavioural interventions for adults living with modifiable chronic non-communicable diseases in Africa: a systematic mixed-studies review. Int Health 2019; 10:137-148. [PMID: 29554307 DOI: 10.1093/inthealth/ihy013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 02/06/2018] [Indexed: 12/28/2022] Open
Abstract
Background Physical activity improves physiological, cognitive and psychosocial functioning in chronic non-communicable diseases (NCDs). This study reviewed papers on the effects and patients' experiences of physical activity interventions for chronic NCDs in Africa. Methods We conducted a systematic review of clinical and qualitative studies by searching eight bibliographic databases and grey literature until 19 April 2017. The mixed-methods appraisal and Cochrane Collaboration's tools were used for quality and risk of bias assessments. Three-stage sequential explanatory syntheses were done. Results One randomized controlled trial (RCT), two non-controlled before and after studies and two qualitative studies of diabetic South African and Reunion patients were included. Exercise and sports unrelated to home and occupational activities were increased in the long term (1 year, moderate quality evidence) and short term immediately after a 4-week intervention (low quality evidence). There was conflicting evidence of intervention effects on home and occupational physical activities. Behaviour-change techniques improving chronic disease knowledge, addressing environmental barriers and stimulating/supporting physical activity were important to patients. Procedure-related components-health professional training and adequate health facilities-were important to patients, but were not addressed. Conclusion High quality RCTs are needed to confirm the intervention components for improving physical activity for chronic NCD management in Africa.
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Affiliation(s)
- Chinonso N Igwesi-Chidobe
- University of Nigeria, Department of Medical Rehabilitation, Faculty of Health sciences and Technology, College of Medicine, Enugu Campus, Nigeria.,King's College London, Department of Physiotherapy, School of Population Health Sciences, Faculty of Life Sciences and Medicine, London, UK
| | - Andre P Kengne
- South African Medical Research Council, Non-Communicable Diseases Research Unit, Cape Town, South Africa.,University of Cape Town, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa
| | - Isaac O Sorinola
- King's College London, Department of Physiotherapy, School of Population Health Sciences, Faculty of Life Sciences and Medicine, London, UK
| | - Emma L Godfrey
- King's College London, Department of Physiotherapy, School of Population Health Sciences, Faculty of Life Sciences and Medicine, London, UK.,King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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58
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Lebleu J, Mahaudens P, Pitance L, Roclat A, Briffaut JB, Detrembleur C, Hidalgo B. Effects of ankle dorsiflexion limitation on lower limb kinematic patterns during a forward step-down test: A reliability and comparative study. J Back Musculoskelet Rehabil 2019; 31:1085-1096. [PMID: 29991123 DOI: 10.3233/bmr-171063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Altered lower limb movement patterns (LLMP) during the forward step down (FSD) test have been studied in people suffering from knee instability. However, ankle dorsiflexion range of motion (ADROM) seems to be related to LLMP but no causal inference has been defined between those variables. OBJECTIVE Our goals were to evaluate (1) psychometric quality of the FSD test in healthy people and (2) the influence of experimental restricted ADROM on LLMP. METHODS Kinematics were measured by a motion capture system. Angular displacement and speed were calculated as well as center of mass (COM) and knee linear displacement. Forty-two healthy participants; firstly, performed the test three times to assess reliability, and secondly the same test in an experimental condition limiting the ADROM. RESULTS Reliability was excellent for all parameters (ICC: 0.75-0.99, SEM%: 2.0-34.0%). ADROM limitation significantly decreased Knee flexion range of motion (ROM) (-3.8∘), increased Hip flexion ROM (6∘), Hip adduction ROM (6.1∘), Pelvis drop ROM (3.5∘), Pelvic rotation ROM (3.1∘). No significant effect was found for Hip rotation ROM. CONCLUSIONS LLMP was affected by this experimental ADROM limitation in healthy people. As this limitation is often encountered in post-traumatic ankle sprain patients, clinicians should consider this point during FSD assessment test.
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Affiliation(s)
- Julien Lebleu
- Université Catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab, B-1200 Brussels, Belgium
| | - Philippe Mahaudens
- Université Catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab, B-1200 Brussels, Belgium.,Cliniques Universitaires Saint-Luc, Service D'orthopédie et de Traumatologie de L'appareil Locomoteur, B-1200 Brussels, Belgium
| | - Laurent Pitance
- Université Catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab, B-1200 Brussels, Belgium.,Cliniques Universitaires Saint-Luc, Service de Stomatologie et Chirurgie Maxillo-Faciale, B-1200 Brussels, Belgium
| | - Aurélien Roclat
- Université Catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab, B-1200 Brussels, Belgium
| | - Jean-Baptiste Briffaut
- Université Catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab, B-1200 Brussels, Belgium
| | - Christine Detrembleur
- Université Catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab, B-1200 Brussels, Belgium
| | - Benjamin Hidalgo
- Université Catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab, B-1200 Brussels, Belgium
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Bach-Rojecky L, Vađunec D, Žunić K, Kurija J, Šipicki S, Gregg R, Mikula I, Primorac D. Continuing war on pain: a personalized approach to the therapy with nonsteroidal anti-inflammatory drugs and opioids. Per Med 2018; 16:171-184. [PMID: 30484741 DOI: 10.2217/pme-2018-0116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Successful pain management requires the delivery of analgesia with minimal risk of adverse drug reactions. Nonsteroidal anti-inflammatory drugs and opioids remain the mainstay of treatment for the majority of patients. Unfortunately, almost 50% of all patients experience inadequate pain relief and serious side effects. Allelic variants in genes coding for target proteins, transporters and enzymes, which govern analgesic drugs action and their fate in the organism, might explain inter-individual variability in pain severity and in drug-induced pain relief and toxicities. Additionally, it seems that epigenetic changes contribute to the highly variable response to pain treatment. Therefore, pharmacogenomic testing might be a valuable tool for personalization of pain treatment, with a multidisciplinary team approach involved.
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Affiliation(s)
- Lidija Bach-Rojecky
- Department of Pharmacology, University of Zagreb Faculty of Pharmacy & Biochemistry, A Kovačića 1, 10000 Zagreb, Croatia
| | - Dalia Vađunec
- Department of Pharmacology, University of Zagreb Faculty of Pharmacy & Biochemistry, A Kovačića 1, 10000 Zagreb, Croatia
| | - Katarina Žunić
- Department of Pharmacology, University of Zagreb Faculty of Pharmacy & Biochemistry, A Kovačića 1, 10000 Zagreb, Croatia
| | - Jelena Kurija
- Department of Pharmacology, University of Zagreb Faculty of Pharmacy & Biochemistry, A Kovačića 1, 10000 Zagreb, Croatia
| | - Sara Šipicki
- Department of Pharmacology, University of Zagreb Faculty of Pharmacy & Biochemistry, A Kovačića 1, 10000 Zagreb, Croatia
| | - Ryan Gregg
- OneOme LLC, 807 Broadway St NE #100, Minneapolis, MN 55413, USA
| | - Ivan Mikula
- St Catherine Specialty Hospital, 10000 Zagreb & 49210 Zabok, Croatia
| | - Dragan Primorac
- St Catherine Specialty Hospital, 10000 Zagreb & 49210 Zabok, Croatia.,Department of Forensic Sciences, Eberly College of Science, 517 Thomas St, State College, Penn State University, PA 16803, USA.,Department of Pediatrics, School of Medicine, University of Split, Soltanska 2, 21000 Split, Croatia.,Department of Pediatrics, School of Medicine, University of Osijek, Ulica Cara Hadrijana 10, 31000 Osijek, Croatia.,Department of Pediatrics, Faculty of Dental Medicine and Health, University ofOsijek, Crkvena 21, 31000 Osijek, Croatia.,Children's Hospital Srebrnjak, Srebrnjak 100, 10000 Zagreb, Croatia
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60
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Amorim AB, Ferreira PH, Ferreira ML, Lier R, Simic M, Pappas E, Zadro JR, Mork PJ, Nilsen TI. Influence of family history on prognosis of spinal pain and the role of leisure time physical activity and body mass index: a prospective study using family-linkage data from the Norwegian HUNT study. BMJ Open 2018; 8:e022785. [PMID: 30341129 PMCID: PMC6196861 DOI: 10.1136/bmjopen-2018-022785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To investigate the influence of parental chronic spinal pain on prognosis of chronic spinal pain in adult offspring, and whether offspring physical activity level and body mass index (BMI) modified this association. DESIGN Prospective cohort study. SETTING We used family-linked longitudinal data from the Norwegian HUNT study collected in HUNT2 (1995-1997) and HUNT3 (2006-2008). PARTICIPANTS A total of 1529 offspring who reported spinal pain in HUNT2 were linked with parental data and followed up in HUNT3. OUTCOMES We estimated relative risk (RR) with 95% CI for recovery from chronic spinal pain, and also from activity limiting spinal pain, in offspring related to chronic spinal pain in parents. We also investigated whether offspring leisure time physical activity and BMI modified these intergenerational associations in spinal pain. RESULTS A total of 540 (35%) offspring were defined as recovered after approximately 11 years of follow-up. Offspring with both parents reporting chronic spinal pain were less likely to recover from chronic spinal pain (RR 0.83, 95% CI 0.69 to 0.99) and activity limiting spinal pain (RR 0.71, 95% CI 0.54 to 0.94), compared with offspring of parents without chronic spinal pain. Analyses stratified by BMI and physical activity showed no strong evidence of effect modification on these associations. However, offspring who were overweight/obese and with both parents reporting chronic spinal pain had particularly low probability of recovery from activity limiting spinal pain, compared with those who were normal weight and had parents without chronic spinal pain (RR 0.57, 95% CI 0.39 to 0.84). CONCLUSION Offspring with chronic spinal pain are less likely to recover if they have parents with chronic spinal pain, particularly if offspring are overweight/obese.
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Affiliation(s)
- Anita B Amorim
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Paulo H Ferreira
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, Sydney, New South Wales, Australia
| | - Ragnhild Lier
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Milena Simic
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Evangelos Pappas
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Joshua R Zadro
- Faculty of Health Sciences, The University of Sydney, Discipline of Physiotherapy, Sydney, New South Wales, Australia
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tom Il Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Towery P, Guffey JS, Doerflein C, Stroup K, Saucedo S, Taylor J. Chronic musculoskeletal pain and function improve with a plant-based diet. Complement Ther Med 2018; 40:64-69. [PMID: 30219471 DOI: 10.1016/j.ctim.2018.08.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chronic musculoskeletal pain, often debilitating, affects all genders, ethnicities, and age groups. Research suggests consumption of a plant-based diet may improve the status of persons with chronic pain. A diet rich in fruits, vegetables and whole grains has been shown to reduce chronic pain and disability associated with musculoskeletal conditions. OBJECTIVE The purpose of this study was to examine the value of a plant-based diet in the management of chronic musculoskeletal pain and functional limitations. METHOD Fourteen subjects participated in the eight-week study. Baseline evaluation included anthropometric measurements and completion of two self-reported outcome measures: Numeric Pain Rating Scale (NPRS) and the Short Form Health Survey (SF-36). A registered dietitian nutritionist provided a sample menu cycle and education on a plant-based diet. Subjects utilized a phone app to log food intake and receive support from the dietitian. Post data collection included a repeat of the baseline measures and the Patient Global Impression of Change Scale. The sample was small. Twenty subjects began, 14 completed. No comparison group was used. Results should be considered with caution. RESULTS The diet intervention resulted in decreased pain and improvement in quality of life. Diet adherence by ten of fourteen subjects was 89% based on completion of food intake records and adherence to allowed foods. CONCLUSION Consumption of a plant-based diet produced positive improvements in chronic pain and function. Interprofessional collaboration between physical therapists and registered dietitian nutritionists, along with other healthcare practitioners, can encourage and promote diet interventions that positively affect chronic pain.
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Affiliation(s)
- Pam Towery
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States.
| | - J Stephen Guffey
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States
| | - Cody Doerflein
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States
| | - Kyle Stroup
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States
| | - Sara Saucedo
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States
| | - Jennifer Taylor
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States
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62
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Montes Chañi EM, Pacheco SOS, Martínez GA, Freitas MR, Ivona JG, Ivona JA, Craig WJ, Pacheco FJ. Long-Term Dietary Intake of Chia Seed Is Associated with Increased Bone Mineral Content and Improved Hepatic and Intestinal Morphology in Sprague-Dawley Rats. Nutrients 2018; 10:nu10070922. [PMID: 30029467 PMCID: PMC6073254 DOI: 10.3390/nu10070922] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/12/2018] [Accepted: 07/18/2018] [Indexed: 12/14/2022] Open
Abstract
Chia seeds (Salvia hispanica) provide an unusually high content of α-linolenic acid with several potential health benefits, but few studies have examined the long-term intake of n-3 fatty acid-rich plant foods such as chia. In this work, we investigated some of the effects of a diet containing 10% chia seeds versus a conventional isocaloric diet for 10 and 13 months on body measurements, musculoskeletal system, the liver, and the intestines of 20 male Sprague-Dawley rats assigned into two groups. The n-6/n-3 ratios for the control and chia diets were 7.46 and 1.07, respectively. For the first 10 months of the diet, the body parameters and weights were similar, but at 13 months, the bone mineral content (BMC) of the chia-fed rats was significantly higher than that of the controls whether in total or proximal areas of the left tibia. Also, significant positive correlations were found between the age of the chia group and the bone mineral density, BMC, weight of the musculoskeletal system, final body weight, and skin weight. Liver and intestinal examinations showed improved morphology associated with lower lipid deposit in hepatocytes and increased intestinal muscle layers and crypt size in the chia group. This study provides new data suggesting the potential benefits associated with the long-term intake of chia seeds.
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Affiliation(s)
- Evelyn M Montes Chañi
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
| | - Sandaly O S Pacheco
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
| | - Gustavo A Martínez
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
| | - Maykon R Freitas
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
| | - Joaquin G Ivona
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
| | - Javier A Ivona
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
| | - Winston J Craig
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
- Department of Public Health, Nutrition and Wellness, School of Health Professions, Andrews University, Berrien Springs, MI 49104, USA.
| | - Fabio J Pacheco
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos 3103, Argentina.
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Schweier R, Grande G, Richter C, Riedel-Heller SG, Romppel M. In-depth statistical analysis of the use of a website providing patients' narratives on lifestyle change when living with chronic back pain or coronary heart disease. PATIENT EDUCATION AND COUNSELING 2018; 101:1283-1290. [PMID: 29506876 DOI: 10.1016/j.pec.2018.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 02/05/2018] [Accepted: 02/25/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate the use of lebensstil-aendern.de ("lifestyle change"), a website providing peer narratives of experiences with successful lifestyle change, and to analyze whether peer model characteristics, clip content, and media type have an influence on the number of visitors, dwell time, and exit rates. METHODS An in-depth statistical analysis of website use with multilevel regression analyses. RESULTS In two years, lebensstil-aendern.de attracted 12,844 visitors. The in-depth statistical analysis of usage rates demonstrated that audio clips were less popular than video or text-only clips, longer clips attracted more visitors, and clips by younger and female interviewees were preferred. User preferences for clip content categories differed between heart and back pain patients. Clips about stress management drew the smallest numbers of visitors in both indication modules. CONCLUSIONS Patients are interested in the experiences of others. Because the quality of information for user-generated content is generally low, healthcare providers should include quality-assured patient narratives in their interventions. User preferences for content, medium, and peer characteristics need to be taken into account. PRACTICE IMPLICATIONS If healthcare providers decide to include patient experiences in their websites, they should plan their intervention according to the different needs and preferences of users.
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Affiliation(s)
- Rebecca Schweier
- Research Group "Social Issues & Health", Leipzig University of Applied Sciences (HTWK Leipzig), Leipzig, Germany; Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.
| | - Gesine Grande
- Research Group "Social Issues & Health", Leipzig University of Applied Sciences (HTWK Leipzig), Leipzig, Germany.
| | - Cynthia Richter
- Research Group "Social Issues & Health", Leipzig University of Applied Sciences (HTWK Leipzig), Leipzig, Germany.
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.
| | - Matthias Romppel
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.
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Lewis J, O’Sullivan P. Is it time to reframe how we care for people with non-traumatic musculoskeletal pain? Br J Sports Med 2018; 52:1543-1544. [DOI: 10.1136/bjsports-2018-099198] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2018] [Indexed: 12/31/2022]
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Sandborgh M, Dean E, Denison E, Elvén M, Fritz J, Wågert PVH, Moberg J, Overmeer T, Snöljung Å, Johansson AC, Söderlund A. Integration of behavioral medicine competencies into physiotherapy curriculum in an exemplary Swedish program: rationale, process, and review. Physiother Theory Pract 2018; 36:365-377. [DOI: 10.1080/09593985.2018.1488192] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Maria Sandborgh
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
| | - Elizabeth Dean
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Eva Denison
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
- Division of health sciences, Norwegian Institute of Public Health, Nydalen, Oslo, Norway
| | - Maria Elvén
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
| | - Johanna Fritz
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
| | - Petra von Heideken Wågert
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
| | - Johan Moberg
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
| | - Thomas Overmeer
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
- Centre for Health and Medical Psychology, Örebro University, Örebro, Sweden
| | - Åsa Snöljung
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
| | - Ann-Christin Johansson
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Division of Physiotherapy, Mälardalen University, Västerås, Sweden
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Clement I, Lorenz A, Ulm B, Plidschun A, Huber S. Implementing Systematically Collected User Feedback to Increase User Retention in a Mobile App for Self-Management of Low Back Pain: Retrospective Cohort Study. JMIR Mhealth Uhealth 2018; 6:e10422. [PMID: 29875088 PMCID: PMC6010841 DOI: 10.2196/10422] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/19/2018] [Accepted: 05/08/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Promising first results for Kaia, a mobile app digitalizing multidisciplinary rehabilitation for low back pain, were recently published. It remains unclear whether the implementation of user feedback in an updated version of this app leads to desired effects in terms of increased app usage and clinical outcomes. OBJECTIVE The aim is to elucidate the effect on user retention and clinical outcomes of an updated version of the Kaia app where user feedback was included during development. METHODS User feedback of the initial app versions (0.x) was collected in a quality management system and systematically analyzed to define requirements of a new version. For this study, the anonymized data of Kaia users was analyzed retrospectively and users were grouped depending on the available version at the time of the sign-up (0.x vs 1.x). The effect on the duration of activity of users in the app, the number of completed exercises of each type, and user-reported pain levels were compared. RESULTS Overall, data of 1251 users fulfilled the inclusion criteria, of which 196 users signed up using version 0.x and 1055 users signed up with version 1.x. There were significant differences in the demographic parameters for both groups. A log-rank test showed no significant differences for the duration of activity in the app between groups (P=.31). Users signing up during availability of the 1.x version completed significantly more exercises of each type in the app (physical exercises: 0.x mean 1.99, SD 1.61 units/week vs 1.x mean 3.15, SD1.72 units/week; P<.001; mindfulness exercises: 0.x mean 1.36, SD 1.43 units/week vs 1.x mean 2.42, SD 1.82 units/week; P<.001; educational content: 0.x mean 1.51, SD 1.42 units/week vs 1.x mean 2.71, SD 1.89 units/week; P<.001). This translated into a stronger decrease in user-reported pain levels in versions 1.x (F1,1233=7.084, P=.008). CONCLUSIONS Despite the limitations of retrospective cohort studies, this study indicates that the implementation of systematically collected user feedback during development of updated versions can contribute to improvements in terms of frequency of use and potentially even clinical endpoints such as pain level. The clinical efficiency of the Kaia app needs to be validated in prospective controlled trials to exclude bias.
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Affiliation(s)
| | - Andreas Lorenz
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Campus Grosshadern, Munich, Germany
| | - Bernhard Ulm
- Unabhängige statistische Beratung Bernhard Ulm, Munich, Germany
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O’Sullivan PB, Caneiro JP, O’Keeffe M, Smith A, Dankaerts W, Fersum K, O’Sullivan K. Cognitive Functional Therapy: An Integrated Behavioral Approach for the Targeted Management of Disabling Low Back Pain. Phys Ther 2018; 98:408-423. [PMID: 29669082 PMCID: PMC6037069 DOI: 10.1093/ptj/pzy022] [Citation(s) in RCA: 185] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 02/12/2018] [Indexed: 12/18/2022]
Abstract
Biomedical approaches for diagnosing and managing disabling low back pain (LBP) have failed to arrest the exponential increase in health care costs, with a concurrent increase in disability and chronicity. Health messages regarding the vulnerability of the spine and a failure to target the interplay among multiple factors that contribute to pain and disability may partly explain this situation. Although many approaches and subgrouping systems for disabling LBP have been proposed in an attempt to deal with this complexity, they have been criticized for being unidimensional and reductionist and for not improving outcomes. Cognitive functional therapy was developed as a flexible integrated behavioral approach for individualizing the management of disabling LBP. This approach has evolved from an integration of foundational behavioral psychology and neuroscience within physical therapist practice. It is underpinned by a multidimensional clinical reasoning framework in order to identify the modifiable and nonmodifiable factors associated with an individual's disabling LBP. This article illustrates the application of cognitive functional therapy to provide care that can be adapted to an individual with disabling LBP.
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Affiliation(s)
- Peter B O’Sullivan
- School of Physiotherapy, Curtin University, Shenton Park, Western Australia,Bodylogic Physiotherapy, Private Practice, Perth, Australia,Address all correspondence to Prof O’Sullivan at:
| | - J P Caneiro
- School of Physiotherapy, Curtin University, Shenton Park, Western Australia,Bodylogic Physiotherapy, Private Practice, Perth, Australia
| | - Mary O’Keeffe
- Sydney School of Public Health, University of Sydney, Australia,Department of Allied Health, University of Limerick, Limerick, Ireland
| | - Anne Smith
- School of Physiotherapy, Curtin University, Shenton Park, Western Australia
| | - Wim Dankaerts
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Kjartan Fersum
- Department of Global Public Health and Primary Care, Universitetet i Bergen Institutt for indremedisin, Bergen, Norway
| | - Kieran O’Sullivan
- Department of Allied Health, University of Limerick, Limerick, Ireland,Sports Spine Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Abstract
An estimated 116 million Americans suffer from chronic pain, at a cost of over $600 billion per year, or roughly $2000 per person per year. In this Viewpoint, the authors highlight the challenges of the current opioid epidemic and outline strategies that the physical therapy profession may adopt to be part of the solution. These strategies include facilitating and providing patient education, early access to physical therapy services, and the promotion of health, wellness, and prevention. J Orthop Sports Phys Ther 2018;48(5):349-353. doi:10.2519/jospt.2018.0606.
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Horne J, Madill J, O'Connor C, Shelley J, Gilliland J. A Systematic Review of Genetic Testing and Lifestyle Behaviour Change: Are We Using High-Quality Genetic Interventions and Considering Behaviour Change Theory? Lifestyle Genom 2018; 11:49-63. [PMID: 29635250 DOI: 10.1159/000488086] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/26/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studying the impact of genetic testing interventions on lifestyle behaviour change has been a priority area of research in recent years. Substantial heterogeneity exists in the results and conclusions of this literature, which has yet to be explained using validated behaviour change theory and an assessment of the quality of genetic interventions. The theory of planned behaviour (TPB) helps to explain key contributors to behaviour change. It has been hypothesized that personalization could be added to this theory to help predict changes in health behaviours. PURPOSE This systematic review provides a detailed, comprehensive identification, assessment, and summary of primary research articles pertaining to lifestyle behaviour change (nutrition, physical activity, sleep, and smoking) resulting from genetic testing interventions. The present review further aims to provide in-depth analyses of studies conducted to date within the context of the TPB and the quality of genetic interventions provided to participants while aiming to determine whether or not genetic testing facilitates changes in lifestyle habits. This review is timely in light of a recently published "call-to-action" paper, highlighting the need to incorporate the TPB into personalized healthcare behaviour change research. METHODS Three bibliographic databases, one key website, and article reference lists were searched for relevant primary research articles. The PRISMA Flow Diagram and PRISMA Checklist were used to guide the search strategy and manuscript preparation. Out of 32,783 titles retrieved, 26 studies met the inclusion criteria. Three quality assessments were conducted and included: (1) risk of bias, (2) quality of genetic interventions, and (3) consideration of theoretical underpinnings - primarily the TPB. RESULTS Risk of bias in studies was overall rated to be "fair." Consideration of the TPB was "poor," with no study making reference to this validated theory. While some studies (n = 11; 42%) made reference to other behaviour change theories, these theories were generally mentioned briefly, and were not thoroughly incorporated into the study design or analyses. The genetic interventions provided to participants were overall of "poor" quality. However, a separate analysis of studies using controlled intervention research methods demonstrated the use of higher-quality genetic interventions (overall rated to be "fair"). The provision of actionable recommendations informed by genetic testing was more likely to facilitate behaviour change than the provision of genetic information without actionable lifestyle recommendations. Several studies of good quality demonstrated changes in lifestyle habits arising from the provision of genetic interventions. The most promising lifestyle changes were changes in nutrition. CONCLUSIONS It is possible to facilitate behaviour change using genetic testing as the catalyst. Future research should ensure that high-quality genetic interventions are provided to participants, and should consider validated theories such as the TPB in their study design and analyses. Further recommendations for future research are provided.
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Affiliation(s)
- Justine Horne
- Health and Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada.,School of Food and Nutritional Sciences, Brescia University College at The University of Western Ontario, London, Ontario, Canada
| | - Janet Madill
- School of Food and Nutritional Sciences, Brescia University College at The University of Western Ontario, London, Ontario, Canada
| | - Colleen O'Connor
- School of Food and Nutritional Sciences, Brescia University College at The University of Western Ontario, London, Ontario, Canada
| | - Jacob Shelley
- Faculty of Law, The University of Western Ontario, London, Ontario, Canada.,School of Health Studies, The University of Western Ontario, London, Ontario, Canada.,Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Jason Gilliland
- School of Health Studies, The University of Western Ontario, London, Ontario, Canada.,Department of Geography, The University of Western Ontario, London, Ontario, Canada.,Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
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Effectiveness of a healthy lifestyle intervention for chronic low back pain: a randomised controlled trial. Pain 2018. [DOI: 10.1097/j.pain.0000000000001198] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Use of Pain Neuroscience Education, Tactile Discrimination, and Graded Motor Imagery in an Individual With Frozen Shoulder. J Orthop Sports Phys Ther 2018; 48:174-184. [PMID: 29257926 DOI: 10.2519/jospt.2018.7716] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Case report. Background Aggressive physical therapy in the freezing stage of frozen shoulder may prolong the course of recovery. Central sensitization may play a role in the early stages of frozen shoulder. Pain neuroscience education, tactile discrimination, and graded motor imagery have been used in a number of conditions with central sensitization. The purpose of this case report was to describe the examination and treatment of a patient in the freezing stage of frozen shoulder using pain neuroscience education, tactile discrimination, and graded motor imagery. Case Description A 54-year-old woman with a diagnosis of frozen shoulder was referred by an orthopaedic surgeon following lack of progress after 4 weeks of intensive daily physical therapy. Pain at rest was 7/10, and her Shoulder Pain and Disability Index score was 64%. She had painful and limited active range of motion and elevated fear-avoidance beliefs. Tactile discrimination and limb laterality were impaired, with signs of central sensitization. A "top-down" approach using pain neuroscience education, tactile discrimination, and graded motor imagery was used for the first 6 weeks, followed by a "bottom-up" impairment-based approach. Outcomes The patient was seen for 20 sessions over 12 weeks. At discharge, her Shoulder Pain and Disability Index score was 22%, resting pain was 0/10, and fear-avoidance beliefs improved. Improvements in active range of motion, laterality, and tactile discrimination were also noted. Discussion Intensive physical therapy in the freezing stage of frozen shoulder may be detrimental to long-term outcomes. This case report suggests that a top-down approach may allow a quicker transition through the freezing stage of frozen shoulder. Level of Evidence Therapy, level 5. J Orthop Sports Phys Ther 2018;48(3):174-184. Epub 19 Dec 2017. doi:10.2519/jospt.2018.7716.
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Lein DH, Clark D, Graham C, Perez P, Morris D. A Model to Integrate Health Promotion and Wellness in Physical Therapist Practice: Development and Validation. Phys Ther 2017; 97:1169-1181. [PMID: 29186634 DOI: 10.1093/ptj/pzx090] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 08/30/2017] [Indexed: 02/09/2023]
Abstract
BACKGROUND Globally, physical therapy professional organizations have called for physical therapists to perform lifestyle behavior management during customary care, or health-focused care, due to increasing morbidity and mortality related to noncommunicable diseases. Given the potential for health-focused care to improve health outcomes, physical therapists should integrate health promotion into their daily clinical practice. A clinical model that illustrates necessary steps to deliver health-focused care would be helpful to educate present and future physical therapists. OBJECTIVE The purpose of the study was to develop and validate the Health-Focused Physical Therapy Model (HFPTM) for physical inactivity and smoking. METHODS The authors used a mixed method approach. The preliminary model was informed by previous research and the investigators' shared experience in health promotion and physical therapy. An interdisciplinary group of health professionals provided input into the preliminary model by way of a World Café format. Eight physical therapists with health promotion and education expertise then engaged in a Delphi process to establish content validity. RESULTS World Café participants indicated that: (1) physical therapists are well positioned to engage in health promotion and wellness, and (2) the model facilitates interdisciplinary collaboration and consultation. Delphi process participants reached majority consensus in 1 round. The average model content validity index (CVI) was .915 for physical inactivity and .899 for smoking. Agreement concerning the model schematic was 88% for either behavior. Investigators made few editorial changes after the Delphi process. LIMITATIONS Limitations of this study include using only 2 unhealthy lifestyle behaviors for testing, and performing the testing in a nonclinical setting. CONCLUSIONS An interdisciplinary group of health professionals believes that physical therapists should practice health-focused care and that the HFPTM is a valid model. This model could help physical therapist educators when educating physical therapist students and clinicians to practice health-focused care.
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Affiliation(s)
- Donald H Lein
- D.H. Lein Jr, PT, PhD, Department of Physical Therapy, University of Alabama at Birmingham, SHPB 376, 1720 2nd Avenue South, Birmingham, AL, 35294-1212
| | - Diane Clark
- D. Clark, PT, DScPT, MBA, Department of Physical Therapy, University of Alabama at Birmingham
| | - Cecilia Graham
- C. Graham, PT, PhD, Department of Physical Therapy, University of Alabama at Birmingham
| | - Patricia Perez
- P. Perez, PT, DScPT, Department of Physical Therapy, University of Alabama at Birmingham
| | - David Morris
- D. Morris, PT, PhD, Department of Physical Therapy, University of Alabama at Birmingham
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Understanding Adolescent Low Back Pain From a Multidimensional Perspective: Implications for Management. J Orthop Sports Phys Ther 2017; 47:741-751. [PMID: 28898135 DOI: 10.2519/jospt.2017.7376] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Synopsis Low back pain (LBP) is the leading cause of disability worldwide. It often begins in adolescence, setting a course for later in life. We have tracked the course of LBP in the Raine Study cohort from the age of 14 years into early adulthood. Our work has found that LBP is already prevalent in individuals at 14 years of age and increases throughout adolescence and into early adulthood. It is often comorbid with other musculoskeletal pain. For some adolescents, LBP has little impact; for others, its impact includes care seeking, taking medication, taking time off from school and work, as well as modifying physical and functional activity. Of concern is the increasing prevalence of LBP with impact across adolescence, reaching adult rates by 22 years of age. The predictors of disabling LBP in adolescence are multidimensional. They include female sex, negative back pain beliefs, poor mental health status, somatic complaints, involvement in sports, and altered stress responses. Genetics also plays a role. Ironically, the factors that we have historically thought to be important predictors of LBP, such as "poor" spinal posture, scoliosis, carrying school bags, joint hypermobility, and poor back muscle endurance, are not strong predictors. This challenges our clinical beliefs and highlights that adolescent LBP needs a flexible and targeted multidimensional approach to assessment and management. In most cases, we recommend a cognitive functional approach that challenges negative LBP beliefs, educates adolescents regarding factors associated with their LBP, restores functional capacity where it is impaired, and encourages healthy lifestyle habits. J Orthop Sports Phys Ther 2017;47(10):741-751. Epub 12 Sep 2017. doi:10.2519/jospt.2017.7376.
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Abaraogu UO, Ogaga MO, Dean E. Practices of Nigerian physiotherapists with respect to lifestyle risk factor assessment and intervention: A national cross-sectional survey. Physiother Theory Pract 2017; 33:497-507. [PMID: 28481667 DOI: 10.1080/09593985.2017.1318421] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Resolutions of the World Health Organization and World Confederation for Physical Therapy declare health promotion a priority for health professionals including physiotherapists. OBJECTIVE To describe lifestyle-related risk factor assessment and intervention practices of Nigerian physiotherapists, their perceived barriers to such practices, and education needs. METHODS Physiotherapists (n = 650) were invited to complete a questionnaire with 23 questions about respondent demographics, lifestyle risk factor assessment, and management practices; barriers to such practices; and related education needs. Statistical analysis was descriptive. RESULTS Response rate was 69% (n = 451). Less than half of respondents indicated that they "always" advised smokers to quit or heavy drinkers to reduce alcohol consumption. Most respondents viewed diet and anthropometrics as risk factors that warrant being addressed, but few respondents did so. Physical inactivity and blood pressure were the commonest risk factors reportedly assessed. Perceived barriers to health promotion practices included time, knowledge, and access to other providers. Continuing education needs identified by respondents included methods for delivering advice regarding smoking cessation, diet, and alcohol consumption. CONCLUSIONS Nigerian physiotherapists inconsistently assess lifestyle-related risks and intervene to address them. Continuing education is needed to address barriers to health promotion practices by meeting the perceived needs of Nigerian physiotherapists.
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Affiliation(s)
| | - Mary Oguma Ogaga
- a Department of Medical Rehabilitation , University of Nigeria , Enugu , Nigeria
| | - Elizabeth Dean
- b Department of Physical Therapy , University of British Columbia , Vancouver , Canada
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Lanhers C, Pereira B, Gay C, Hérisson C, Levyckyj C, Dupeyron A, Coudeyre E. Evaluation of the efficacy of a short-course, personalized self-management and intensive spa therapy intervention as active prevention of musculoskeletal disorders of the upper extremities (Muska): a research protocol for a randomized controlled trial. BMC Musculoskelet Disord 2016; 17:497. [PMID: 27938361 PMCID: PMC5148841 DOI: 10.1186/s12891-016-1353-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 11/28/2016] [Indexed: 02/01/2023] Open
Abstract
Background Musculoskeletal disorders (MSDs) constitute a major occupational health problem in the working population, substantially impacting the quality of life of employees. They also cause considerable economic cost to the healthcare system, with, notably, the reimbursement of treatments and compensation for lost income. MSDs manifest as localized pain or functional difficulty in one or more anatomical areas, such as the cervical spine, shoulder, elbow, hand, and wrist. Although prevalence varies depending on the region considered and the method of assessment, a prevalence of 30% is found in different epidemiological studies. The disease needs to be prevented, not only for medical and economic reasons, but also for legal reasons, owing to the requirement of assessing occupational risks. The strategy envisaged may thus revolve around active, multimodal prevention that has employees fully involved at the heart of their care. Although physical exercise is widely recommended, few studies with a good level of evidence have enabled us to base a complete, well-constructed intervention on exercise that can be offered as secondary prevention in these disorders. Methods A prospective, multicenter, comparative (intervention arm vs. control arm), randomized (immediate vs. later treatment) study using Zelen’s design. This study falls under active prevention of MSDs of the upper extremities (UE-MSDs). Participants are workers aged between 18 and 65 years with latent or symptomatic MSDS, with any type of job or workstation, with or without an history of sick leave. The primary aim is to show the superiority at 3 months of a combination of spa therapy, exercise, and self-management workshops for 6 days over usual care in the management of MSDs in terms of employee functional capacity in personal and professional daily life. Secondary aims are to assess the benefit of the intervention in terms of pain, quality of life, and accumulated duration of sick leave. Discussion This randomized controlled trial is the first that will aim to evaluate multidisciplinary management of UE-MSDs using nonpharmacological treatment combining exercise, self-management, and spa therapy. The originality of this intervention lies, in its short, intensive format, which is compatible with remaining in work; and in its multidisciplinary approach. This trial has the potential to demonstrate, with a good level of evidence, the benefits of a short course of spa therapy combined with a personalized self-management program on the functional capacity, pain, and quality of life of employees in their daily life. Trial registration Clinical trial.gov NCT02702466 retrospectively registered. Protocol: Version 4 of 9/10/2015. Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-1353-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Charlotte Lanhers
- Physical Medicine and Rehabilitation, University Hospital of Clermont-Ferrand (CHU), 58, rue de Montalembert, 63000, Clermont-Ferrand, France. .,University of Clermont-Ferrand Auvergne, Auvergne University, 28, Place Henri-Dunant, 63000, Clermont-Ferrand, France. .,Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France.
| | - Bruno Pereira
- Clinical Research and Innovation Direction, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France
| | - Chloé Gay
- Physical Medicine and Rehabilitation, University Hospital of Clermont-Ferrand (CHU), 58, rue de Montalembert, 63000, Clermont-Ferrand, France
| | - Christian Hérisson
- Physical Medicine and Rehabilitation, University of Montpellier 1, Hopital of Lapeyronie, CHRU Montpellier, 371 Av. du Doyen Gaston Giraud, 34295 Cedex 5, Montpellier, France
| | - Christine Levyckyj
- Research and Development, Thermal Cure Center de Royat, 1 place Allard, CS 20053 Royat, 63408, Chamalières Cedex, France
| | - Arnaud Dupeyron
- Physical Medicine and Rehabilitation, Hospital of Caremeau, University of Montpellier 1, 30029 Cedex 09, Nîmes, France
| | - Emmanuel Coudeyre
- Physical Medicine and Rehabilitation, University Hospital of Clermont-Ferrand (CHU), 58, rue de Montalembert, 63000, Clermont-Ferrand, France.,University of Clermont-Ferrand Auvergne, Auvergne University, 28, Place Henri-Dunant, 63000, Clermont-Ferrand, France.,INRA, Unity of Human Nutrition (UNH, UMR 1019), CRNH Auvergne, Clermont-Ferrand, France
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Raising the Priority of Lifestyle-Related Noncommunicable Diseases in Physical Therapy Curricula. Phys Ther 2016; 96:940-8. [PMID: 26678448 DOI: 10.2522/ptj.20150141] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 12/06/2015] [Indexed: 02/09/2023]
Abstract
Given their enormous socioeconomic burdens, lifestyle-related noncommunicable diseases (heart disease, cancer, chronic lung disease, hypertension, stroke, type 2 diabetes mellitus, and obesity) have become priorities for the World Health Organization and health service delivery systems. Health care systems have been criticized for relative inattention to the gap between knowledge and practice, as it relates to preventing and managing noncommunicable diseases. Physical therapy is a profession that can contribute effectively to patients'/clients' lifestyle behavior changes at the upstream end of prevention and management. Efforts by entry-to-practice physical therapist education programs to align curricula with epidemiological trends toward best health care practices are varied. One explanation may be the lack of a frame of reference for reducing the knowledge translation gap. The purpose of this article is to provide a current perspective on epidemiological indicators and societal priorities to inform physical therapy curriculum content. Such content needs to include health examination/evaluation tools and health behavior change interventions that are consistent with contemporary values, directions, and practices of physical therapy. These considerations provide a frame of reference for curriculum change. Based on 5 years of experience and dialogue among curriculum stakeholders, an example of how epidemiologically informed and evidence-based best health care practices may be systematically integrated into physical therapy curricula to maximize patient/client health and conventional physical therapy outcomes is provided. This novel approach can serve as an example to other entry-to-practice physical therapist education programs of how to align their curricula with societal health priorities, specifically, noncommunicable diseases. The intentions are to stimulate dialogue about effectively integrating health-based competencies into entry-level education and advancing best practice, as opposed to simply evidence-based practice, across professions and health services and to establish accreditable, health promotion practice standards for physical therapy.
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Østerås B, Sigmundsson H, Haga M. Pain is prevalent among adolescents and equally related to stress across genders. Scand J Pain 2016; 12:100-107. [DOI: 10.1016/j.sjpain.2016.05.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/12/2016] [Accepted: 05/21/2016] [Indexed: 12/21/2022]
Abstract
Abstract
Background
Young people seem increasingly disabled due to pain and stress. Pain and stress are health risks with adverse long-term health effects. Traditionally, these health risks have been most prevalent and strongest associated in females, also regarding children and adolescents. Main objectives in this study were to investigate current gender differences in musculoskeletal pain and perceived stress in adolescents aged 15 and 16 years with respect to prevalence and group differences for various aspects of stress and pain, and to explore the relationship between stress and pain, specified for gender.
Methods
A cross-sectional study was conducted with 17 participating public schools. The survey was administrated by the schools in accordance with given procedures, emphasizing the volunteer and anonymous participation of the pupils. Primary study measurements were pain and stress. The pain measurements addressed different aspects of musculoskeletal pain including pain sites, pain duration and pain intensity (measured by a Visual analogue scale; VAS). The stress instrument used was the Perceived stress questionnaire (PSQ) comprising different factors of stress, i.e. worries, tension, joy and demands. The secondary study measurement was body mass index (BMI).
Results
The study sample comprised 422 adolescents aged 15 and 16 years; 218 females and 204 males. The pain reporting was high in both genders, 57.3 per cent of the females and 44.6 per cent of the males. In general, the female adolescents reported more pain and stress, although several pain measures corresponded between genders. The pain prevalence was similar across genders with respect to lower extremity pain, back pain and arm pain. Lower extremity pain was the most frequent reported pain in both genders. More females reported head pain (Pearson Chi-Square 7.11, p = .008), severe pain (VAS ≥ 7, Pearson Chi-Square 13.12, p = .004) and moderate to severe stress (PSQ ≥ 0.45, Pearson Chi-Square 29.11, p < .001). Comparison analyses of the continuous pain and stress variables revealed significant mean (95% confidence interval [CI]) differences between genders for all stress variables with the highest mean scores in females. In both genders there were significant (p < .01) correlations between all the continuous pain and stress variables. In 9 out of 15 correlations, the stress-pain associations were strongest in males (Pearson product-moment correlation (r) between 0.34 and 0.38). Only in females, the body mass index (BMI) appeared associated (weakly) to pain and stress, in terms of pain intensity (VAS, r = 0.19) and lack of joy (as a factor of stress, r = 0.16).
Conclusion
Pain and stress were prevalent in the adolescent sample, with generally higher reporting among females. Several pain measures corresponded between genders, but stress differed significantly between genders for all variables. Scrutinizing the relationship between pain and stress revealed significant stress-pain associations regarding all variables across genders, i.e. the pain complaints among the adolescents seemed equally related to stress in males and females in the sample.
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Affiliation(s)
- Berit Østerås
- Norwegian University of Science and Technology (NTNU) , Department of Physiotherapy and Department of Psychology , Trondheim , Norway
| | - Hermundur Sigmundsson
- NTNU , Department of Psychology , Trondheim , Norway
- Reykjavik University , Reykjavik , Iceland
| | - Monika Haga
- NTNU , Department of Physiotherapy , Trondheim , Norway
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Perceived stress and musculoskeletal pain are prevalent and significantly associated in adolescents: an epidemiological cross-sectional study. BMC Public Health 2015; 15:1081. [PMID: 26498498 PMCID: PMC4619092 DOI: 10.1186/s12889-015-2414-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/12/2015] [Indexed: 02/08/2023] Open
Abstract
Background Long-term musculoskeletal pain and negative stress are health risks with adverse long-term health effects, and these health risks seem to increase among young people. The mechanisms behind this are unclear. There is a need for a better understanding of perceived stress and musculoskeletal pain among adolescents, in order to improve health promotion and treatment approaches in this group. Methods Objectives were to evaluate the current prevalence of perceived stress and musculoskeletal pain in 15 and 16 year olds, to explore stress-pain associations and the probability that perceived stress (PSQ) was related to the reporting of pain and variations in pain, and to investigate possible differences in stress between different types of musculoskeletal pain in the adolescents. A cross-sectional study was conducted. Elementary schools participated. The outcomes were stress (Perceived stress questionnaire; PSQ) and musculoskeletal pain (pain/no pain, pain sites, pain duration and pain intensity (Visual analogue scale; VAS). Results Fifty-one point two percent (N = 422) reported pain, of which 70.8 % reported long-term pain. Some more girls (57.9 %) reported pain. 22.0 % of the study population reported moderate to severe stress (PSQ ≥ 0.45), of which 79.6 % were bothered by pain (Pearson Chi-square 38.47, p ≤ .001). All stress and pain variables were significantly associated (p < .01). The strongest association appeared between pain intensity (VAS) and stress (PSQ) (r = 0.40). Perceived stress (PSQ) was associated with the reporting of pain among the adolescents (Odds Ratio [OR] 1.68) and could explain some of the variation in pain intensity (VAS; β = 0.15, p < .001) and number of pain sites (β = 0.14, p < .01), according to the regression analyses. There were no mean differences in stress (PSQ) between different types of musculoskeletal pain. Conclusions There was high prevalence of musculoskeletal pain, long-term pain and moderate to severe stress (PSQ ≥ 0.45) in this study sample. Perceived stress (PSQ) was related to the reporting of musculoskeletal pain among the adolescents and could explain some of the variation in pain intensity (VAS) and number of pain sites. There were no differences in stress levels (PSQ) between different types of musculoskeletal pain in the adolescents. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2414-x) contains supplementary material, which is available to authorized users.
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Großschädl F, Stolz E, Mayerl H, Rásky É, Freidl W, Stronegger W. Educational inequality as a predictor of rising back pain prevalence in Austria—sex differences. Eur J Public Health 2015; 26:248-53. [DOI: 10.1093/eurpub/ckv163] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Duong K, Lee JSH. Perception of Exercise Lifestyle as a Valid Tool for Prevention and Treatment of Depression in Rural Communities. J Lifestyle Med 2015; 5:39-48. [PMID: 26770890 PMCID: PMC4711958 DOI: 10.15280/jlm.2015.5.2.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/19/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study examines perception of exercise lifestyle prescription as a valid treatment for depression among rural patients at a primary care clinic in Texas. METHODS The researchers created a depression and exercise survey completed by 104 patients ages 18 and up living in central, economically disadvantaged rural Texas. Logistic regression was used to analyze data obtained. RESULTS There was a significant difference (p = 0.01) in perception of exercise as a valid treatment for depression as a function of demographic variables, however not as a function of exercise duration (p = 0.12) in the rural primary care clinic's patients. Even though it was not a statistically significant finding, there was a positive correlation found between the amount of exercise engaged in per day and the likelihood to have a positive perception of exercise prescription as a tool in depression prevention and treatment. CONCLUSION Participants between ages 40 to 59 years old, female, and of Hispanic ethnicity independently are most likely to perceive exercise lifestyle as a valid treatment for depression. This is the first study to look specifically at patient perception of exercise as a valid treatment tool for depression not only in rural areas, but also in the nation. Findings from this pilot study may help healthcare service providers learn how to best incorporate exercise prescription into depression prevention and treatment in rural areas, leading to reducing depression epidemics.
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Affiliation(s)
- Karen Duong
- Medical Student, Department of Family Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107-2699,
USA
| | - Jenny Seung-Hyun Lee
- Assistant Professor, Department of Family Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107-2699,
USA
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