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Leutwyler H, Hubbard E, Cooper B. A Group Videogame-Based Physical Activity Program Improves Walking Speed in Older Adults Living With a Serious Mental Illness. Innov Aging 2022; 6:igac049. [DOI: 10.1093/geroni/igac049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Indexed: 11/27/2022] Open
Abstract
Abstract
Background and Objectives
One of the most overlooked populations in our society and in health care are middle-aged and older adults living with a serious mental illness (SMI) despite the growing numbers of this population. Health care communities, including both inpatient and outpatient mental health programs, have a responsibility to provide care that nurtures clients’ mental as well as physical health needs. Providing accessible and engaging physical activity programs is an excellent way to provide this type of holistic care. The purpose of this article is to describe the impact of a pilot videogame-based physical activity program on walking speed in older adults with SMI.
Research Design and Methods
A one-group pretest post-test pilot study was conducted with a sample of 52 older adults with SMI recruited from community-based mental health programs. Participants played an active videogame (using the Kinect for Xbox 360 game system; Microsoft, Redmond, WA) for 50-minute group sessions 3 times a week for 10 weeks. Walking speed was assessed with the timed 3-m walk from the Short Physical Performance Battery at enrollment, 5 weeks, and 10 weeks.
Results
Participants achieved statistically significant improvement in walking speed (0.10 m/s, bias-corrected confidence interval Lower Limit (LL) 0.04, Upper Limit (UL) 0.15) over a 10-week period. This change represents a clinically and statistically (p ≤ .05) significant improvement in walking speed. Best estimates for clinically meaningful changes in walking speed are 0.05 m/s for a small change and 0.10 m/s for a substantial change.
Discussion and Implications
Results suggest that engagement in a group videogame-based physical activity program has the potential to improve walking speed in older adults with SMI. In turn, walking speed is an important indicator of premature mortality and cardiorespiratory fitness.
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Affiliation(s)
- Heather Leutwyler
- Department of Physiological Nursing, University of California , San Francisco, San Francisco, California , USA
| | - Erin Hubbard
- Department of Physiological Nursing, University of California , San Francisco, San Francisco, California , USA
| | - Bruce Cooper
- Department of Physiological Nursing, University of California , San Francisco, San Francisco, California , USA
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Matthews EW, Cowman M, Brannigan M, Rosenbaum S, Sloan D, Ward PB, Denieffe S. Implementing experience-based co-design to develop a physical activity programme in recovery-focused outpatient mental health services. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims As mental health services focus on recovery orientated service delivery, there is a need to adopt recovery orientated approaches in interventions that promote physical activity. This article presents a process of using and modifying an experience-based co-design approach to develop an intervention that can be used to promote physical activity in mental health services: the ‘Move with Recovery’ programme. Methods A facilitated experience-based co-design approach was undertaken over four sessions. This approach included the use of a trigger film of touchpoints and sample physical activity experiences of service users, in addition to the use of a storyboard for emotional mapping and prioritising exercises. The final two co-design sessions involved programme prototyping and development using the TIDieR framework. Results The outcome of this process, the Move with Recovery programme, was a peer-developed and peer-led, community-focused programme structured around nine action points. It is made up of a combination of motivation, education and support sessions, together with light intensity aerobic activity sessions that is structured using the TIDieR framework, and intended for implementation in the recovery college. In this regard, the developed programme is inherently recovery orientated in its design and its aim. Conclusions The developed programme can be embedded into existing mental health services that lack integrated exercise resources. This articles details the experience-based co-design process undertaken here and offers future learning for using experience-based co-design to promote physical activity in mental health.
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Affiliation(s)
- Evan W Matthews
- School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
- Nursing and Midwifery Planning and Development Unit, South-East, The Health Service Executive, Ireland
| | - Mary Cowman
- School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Michele Brannigan
- The Health Service Executive, Mental Health Services, South-East, Ireland
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Darina Sloan
- The Health Service Executive, Mental Health Services, South-East, Ireland
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Suzanne Denieffe
- School of Humanities, Waterford Institute of Technology, Waterford, Ireland
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3
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Hui TT, Garvey L, Olasoji M. Improving the physical health of young people with early psychosis with lifestyle interventions: Scoping review. Int J Ment Health Nurs 2021; 30:1498-1524. [PMID: 34390119 DOI: 10.1111/inm.12922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/20/2021] [Accepted: 07/29/2021] [Indexed: 12/01/2022]
Abstract
People with mental illness experience a shorter life expectancy compared to the general population. Poor physical health trajectory emerges following the onset of psychosis and is further compounded by the initiation of antipsychotic treatment. Young people are particularly at risk as the onset of mental illness mostly occurs between the age of 12 and 25 years. This represents a crucial period for early intervention to prevent a physical ill health trajectory. Furthermore, those who are at ultra-high risk for psychosis should also be targeted for early intervention. Lifestyle interventions have been identified as the first-line physical health promotion practice for improving the physical health of people with severe mental illness. The aim of this study was to conduct a scoping review following the JBI methodological guidance on scoping reviews to explore the current literature on lifestyle intervention trialled for early psychosis, including first-episode psychosis and those who are at ultra-high risk for psychosis. This review also explores the extent of literature examining physical health literacy in this specific population. The literature search was conducted on Medline, Embase, PsycINFO and Scopus. Twenty-two studies were included for the purpose of this scoping review, 21 of which examined the effects of lifestyle interventions and one of which reported on physical health literacy. This scoping review indicates the need for co-designed lifestyle interventions with the involvement of service users, families and carers and a focus on promoting physical health literacy, social support, and an incorporation of a health behaviour change model focus on promoting autonomous motivation. The findings of this study can inform future development of a novel co-designed lifestyle intervention for the targeted population.
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Affiliation(s)
- Ting Ting Hui
- Department of Nursing & Allied Health, School of Health Sciences, Swinburne University of Technology Australia, Hawthorn, Victoria, Australia
| | - Loretta Garvey
- Department of Nursing & Allied Health, School of Health Sciences, Swinburne University of Technology Australia, Hawthorn, Victoria, Australia
| | - Michael Olasoji
- Department of Nursing & Allied Health, School of Health Sciences, Swinburne University of Technology Australia, Hawthorn, Victoria, Australia.,School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
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4
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Browne J, Battaglini C, Jarskog LF, Sheeran P, Abrantes AM, McDermott J, Elliott T, Gonzalez O, Penn DL. Targeting Physical Health in Schizophrenia: Results from the Physical Activity Can Enhance Life (PACE-Life) 24-Week Open Trial. Ment Health Phys Act 2021; 20:100393. [PMID: 34178113 PMCID: PMC8224902 DOI: 10.1016/j.mhpa.2021.100393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Poor health and low cardiorespiratory fitness (CRF) contribute substantially to the shortened lifespan of individuals with schizophrenia spectrum disorders (SSDs). Increasing physical activity has demonstrated value; however, there are limited interventions that are accessible and adequately address motivational challenges. This paper reports on an open trial of Physical Activity Can Enhance Life (PACE-Life), a motivational theory-based manualized multicomponent walking intervention. The primary aim was to examine the feasibility of implementing PACE-Life through meeting the recruitment target (n=14), attendance and adherence rates, and participant feedback. The secondary aim was to assess the impact of PACE-Life on intermediate targets (autonomous motivation and satisfaction of autonomy, relatedness, and competence needs), proximal outcomes (Fitbit steps/day and minutes spent walking), the primary outcome (CRF), and secondary outcomes (loneliness, symptoms, resting heart rate, blood pressure, weight, body mass index, and hip and waist circumference). Seventeen participants with SSDs enrolled in a 24-week open trial. Assessments occurred at baseline, midpoint, post-test, and one-month follow-up. The recruitment target was exceeded, the group attendance rate was 34%, Fitbit adherence rate was 54%, and participant feedback indicated satisfaction with the intervention as well as a positive group environment. There was a large improvement in the primary outcome of CRF with 77% of participants achieving clinically significant improvement at post-test. Small and medium effect size increases were observed in autonomous motivation and satisfaction of autonomy, relatedness, and competence needs. Fitbit data and secondary outcomes generally remained unchanged or worsened during the intervention. Results from this open trial indicate that PACE-Life leads to meaningful changes in CRF among people with SSDs.
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Affiliation(s)
- Julia Browne
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA
| | - Claudio Battaglini
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - L. Fredrik Jarskog
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ana M. Abrantes
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Jessica McDermott
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tonya Elliott
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Oscar Gonzalez
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David L. Penn
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
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"Looking Forward": a qualitative evaluation of a physical activity program for middle-aged and older adults with serious mental illness. Int Psychogeriatr 2020; 32:1449-1456. [PMID: 31455434 PMCID: PMC7047554 DOI: 10.1017/s1041610218002004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Older adults with serious mental illness (SMI) often have poor physical health in addition to serious mental health issues. Sustained engagement in a group physical activity program may provide necessary physical and mental health benefits. The purpose of this report is to describe participants' feedback about a video game-based group physical activity program using the Kinect for Xbox 360 game system (Microsoft, Redmond, WA). In particular, we wanted to understand what worked about the program, what was not ideal, and how it impacted their lives. DESIGN Semi-structured interviews were collected and analyzed with grounded theory methodology. SETTING Mental health facility. PARTICIPANTS Sixteen older adults with SMI. MEASUREMENTS Participants played an active video game for 50-minute sessions, three times a week for 10 weeks. Qualitative interviews were conducted with 16 participants upon completion of the program. RESULTS Participants expressed enthusiasm for the physical activity program, indicating it was an activity that they looked forward to doing. The results of the study provide insight into how the program may be implemented into practice at mental health facilities. Three implementation to practice categories were identified: (1) programmatic considerations, such as when to hold the groups and where; (2) the critical importance of staff involvement; and (3) harnessing patients' interest in the program. CONCLUSION Our results suggest that engagement in an intense video game-based group physical activity program has a positive impact on participants' overall health. The group atmosphere, staff involvement, availability of the program at a mental health facility, and health benefits were critical.
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Watkins A, Denney-Wilson E, Curtis J, Teasdale S, Rosenbaum S, Ward PB, Stein-Parbury J. Keeping the body in mind: A qualitative analysis of the experiences of people experiencing first-episode psychosis participating in a lifestyle intervention programme. Int J Ment Health Nurs 2020; 29:278-289. [PMID: 31840386 DOI: 10.1111/inm.12683] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2019] [Indexed: 12/14/2022]
Abstract
The life expectancy gap experienced by people living with severe mental illness is primarily a result of cardiometabolic disease that is often exacerbated by side effects of antipsychotic medication. Commencement of atypical antipsychotic medication is commonly associated with weight gain. The Keeping the Body in Mind programme has demonstrated that early intervention with lifestyle activities can attenuate this weight gain and potentially improve long-term health outcomes. The aim of this study was to explore the experiences of young people who participated in the Keeping the Body in Mind programme, a targeted lifestyle intervention programme. A qualitative approach was used employing a semi-structured interview format. The interview schedule included questions related to four topics: aspects of the programmes that were useful, attributes of staff members that influenced the programme, changes in attitudes towards their own physical health, and suggestions for programme improvements. Interviews were recorded with duration ranging from 40 to 65 min. Thematic analysis was used to detect and assemble codes. These were then synthesized and classified into themes. Eleven participants were interviewed (seven males), aged between 18 and 25 years. Thematic analysis revealed four main themes: the role of physical health in mental health recovery; the importance of staff interactions; the value of peer interaction; and graduation to a sustainable healthy lifestyle. Study participants reported that they valued the programme for both their physical health and mental health recovery.
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Affiliation(s)
- Andrew Watkins
- Keeping the Body in Mind Program, The Bondi Centre, South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia.,Faculty of Health, University of Technology, Sydney, Sydney, New South Wales, Australia
| | - Elizabeth Denney-Wilson
- Faculty of Medicine and Health, University of Sydney, Sydney, Sydney, New South Wales, Australia
| | - Jackie Curtis
- Keeping the Body in Mind Program, The Bondi Centre, South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia.,School of Psychiatry, University of New South Wales, Sydney, Sydney, New South Wales, Australia
| | - Scott Teasdale
- Keeping the Body in Mind Program, The Bondi Centre, South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia.,School of Psychiatry, University of New South Wales, Sydney, Sydney, New South Wales, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Sydney, New South Wales, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Sydney, New South Wales, Australia.,Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, Liverpool Hospital, South Western Sydney Local Health District, Bondi Junction, New South Wales, Australia
| | - Jane Stein-Parbury
- Faculty of Health, University of Technology, Sydney, Sydney, New South Wales, Australia
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7
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Abdul Rashid NA, Nurjono M, Lee J. Clinical determinants of physical activity and sedentary behaviour in individuals with schizophrenia. Asian J Psychiatr 2019; 46:62-67. [PMID: 31627166 DOI: 10.1016/j.ajp.2019.10.004] [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] [Received: 07/01/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Modifiable lifestyle factors such as physical activity (PA) have ameliorative effects on commonly reported health conditions in schizophrenia like cardiovascular diseases and diabetes. Similarly, reduction in sedentary behaviour (SB) promotes better physical health. However, engaging individuals with schizophrenia in PA and less SB can be challenging because of symptoms of schizophrenia. The aims of the present study are (i) to examine the profiles of PA and SB in individuals with schizophrenia; and (ii) to identify their respective clinical determinants. METHOD 157 individuals with schizophrenia were recruited. PA and SB were examined via the Global Physical Activity Questionnaire (GPAQ). Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Potential clinical predictors of PA and SB were identified via univariate regression analyses and subsequently included in the final multiple regression models for PA and SB respectively. RESULTS 63.7% met the WHO PA guidelines. Work-related activity was the largest domain specific contribution towards PA. Mean duration of SB was approximately 9 h and about 57.3% reported at least 8 h or more of SB daily. Positive symptom was associated with engagement in PA and reduced duration of SB. Negative symptom was associated with greater SB. CONCLUSION With emerging evidence of deleterious health effects of SB independent of PA, it is important to monitor SB in individuals with schizophrenia, particularly those presenting with negative symptoms. While the lack of treatment response for negative symptoms remains a challenge, effort should be made to reduce duration of SB.
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Affiliation(s)
| | | | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; North Region & Department of Psychosis, Institute of Mental Health, Singapore.
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Effects of depression and cognitive impairment on quality of life in older adults with schizophrenia spectrum disorder: Results from a multicenter study. J Affect Disord 2019; 256:164-175. [PMID: 31176189 DOI: 10.1016/j.jad.2019.05.063] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/14/2019] [Accepted: 05/27/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Little is known about the respective effects of depression and cognitive impairment on quality of life among older adults with schizophrenia spectrum disorder. METHODS We used data from the Cohort of individuals with Schizophrenia Aged 55-years or more (CSA) study, a large multicenter sample of older adults with schizophrenia or schizoaffective disorder (N = 353). Quality of life (QoL), depression and cognitive impairment were assessed using the Quality of Life Scale (QLS), the Center of Epidemiologic Studies Depression scale and the Mini-Mental State Examination, respectively. We used structural equation modeling to examine the shared and specific effects of depression and cognitive impairment on QoL, while adjusting for sociodemographic characteristics, general medical conditions, psychotropic medications and the duration of the disorder. RESULTS Depression and cognitive impairment were positively associated (r = 0.24, p < 0.01) and both independently and negatively impacted on QoL (standardized β = -0.41 and β = -0.32, both p < 0.01) and on each QLS quality-of-life domains, except for depression on instrumental role and cognitive impairment on interpersonal relations in the sensitivity analyses excluding respondents with any missing data. Effects of depression and cognitive impairment on QoL were not due to specific depressive symptoms or specific cognitive domains, but rather mediated through two broad dimensions representing the shared effects across all depressive symptoms and all cognitive deficits, respectively. LIMITATIONS Because of the cross-sectional design of this study, measures of association do not imply causal associations. CONCLUSIONS Mechanisms underlying these two broad dimensions should be considered as important potential targets to improve quality of life of this vulnerable population.
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9
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Walker VG. The Life Course Paradigm as a Lens for Holistic Nursing Research in Older Adults Diagnosed With Schizophrenia. J Holist Nurs 2019; 37:366-380. [DOI: 10.1177/0898010119867169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Older adults diagnosed with schizophrenia (OADWS) have unique needs for care and live longer today than their forebears who were diagnosed with schizophrenia. As a result, nurses need to be prepared for the specific care of individuals who live with schizophrenia as they age. Together, Life Course Theory and holistic nursing suggest a good fit in the quest for successful solutions and/or outcomes for the unique problems that OADWS face. Holistic nursing views the patient as a whole person, considering all aspects of the patient’s experiences within life’s broader environment. The life course paradigm offers an effective way for nurses to understand issues that patients face throughout their lives, thus enhancing holistic nursing with a historical perspective. This is especially important for the care of OADWS, who face unique disparities as well as physical and psychological comorbidities over their life course. This article is intended to initiate a discussion of OADWS, focused with Life Course Theory as a holistic lens. Literature pertinent to the life course of OADWS is reviewed, followed by an analysis of the life course paradigm in relation to OADWS’ unique experiences. Conclusions support the holistic use of Life Course Theory in research and interventions for OADWS.
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Nau T, Nolan G, Smith BJ. Enhancing Engagement With Socially Disadvantaged Older People in Organized Physical Activity Programs. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 39:257-267. [PMID: 30638424 DOI: 10.1177/0272684x18821301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Participation in physical activity (PA) is low among older adults in developed nations and even lower among several socially disadvantaged groups. This study aimed to identify the actions that can be taken in the promotion, design, and implementation of organized PA programs to improve engagement with socially disadvantaged and underrepresented older people. Research design and methods: Semistructured interviews were conducted with 30 community service providers and 5 focus groups with 42 older participants in existing PA programs. Data were analyzed thematically, and the PRECEDE-PROCEED model for program planning was used to broadly categorize themes. Results: Helpful strategies for addressing predisposing factors such as social anxiety and lack of confidence included user-centered program design and sensitive, informative messaging and promotion. Key enabling strategies were transport assistance and minimizing fees. Facilitating gentle entry to groups and fostering inclusion and safety were identified as valuable reinforcing strategies. Providers regarded organizational networks as beneficial for facilitating referral and addressing resource constraints. Discussion and implications: A multifactorial approach addressing a range of predisposing, reinforcing, and enabling factors is likely to be necessary to enhance engagement in organized PA by socially disadvantaged and underrepresented older people. Key factors relate to creating a positive sociocultural environment, identifying activities of interest, and enhancing ease of access.
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Affiliation(s)
- Tracy Nau
- 1 Sydney School of Public Health, University of Sydney, Australia
| | | | - Ben J Smith
- 1 Sydney School of Public Health, University of Sydney, Australia.,3 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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11
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Çelik Ince S, Partlak Günüşen N. The views and habits of the individuals with mental illness about physical activity and nutrition. Perspect Psychiatr Care 2018; 54:586-595. [PMID: 29733428 DOI: 10.1111/ppc.12289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 04/04/2018] [Accepted: 04/14/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study is to determine the views and habits of the individuals with mental illness on physical activities and nutrition behaviors. DESIGN AND METHODS This study was carried out descriptive qualitative method. The sample of the study consisted of 15 individuals with mental illness. The data were collected with Socio-Demographic Information Form and Semi-Structured Interview Form and analyzed by content analysis. FINDINGS Four main themes emerged as the result of the analysis of the data. These themes are the barriers, facilitators, habits, and the needs. PRACTICE IMPLICATIONS Mental health nurses should be aware of the barriers of individuals with mental illness. It is recommended that mental health nurses make interventions to encourage patients to have physical activity and healthy eating.
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Affiliation(s)
- Sevecen Çelik Ince
- Faculty of Nursing, Psychiatric Nursing Department, Dokuz Eylul University, Izmir, Turkey
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12
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Impact of a Pilot Videogame-Based Physical Activity Program on Walking Speed in Adults with Schizophrenia. Community Ment Health J 2018; 54:735-739. [PMID: 29127562 DOI: 10.1007/s10597-017-0208-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/06/2017] [Indexed: 10/18/2022]
Abstract
The purpose of this report is to describe the impact of a videogame-based physical activity program using the Kinect for Xbox 360 game system (Microsoft, Redmond, WA) on walking speed in adults with schizophrenia. In this randomized controlled trial, 28 participants played either an active videogame for 30 min (intervention group) or played a sedentary videogame for 30 min (control group), once a week for 6 weeks. Walking speed was measured objectively with the Short Physical Performance Battery at enrollment and at the end of the 6-week program. The intervention group (n = 13) showed an average improvement in walking speed of 0.08 m/s and the control group (n = 15) showed an average improvement in walking speed of 0.03 m/s. Although the change in walking speed was not statistically significant, the intervention group had between a small and substantial clinically meaningful change. The results suggest a videogame based physical activity program provides clinically meaningful improvement in walking speed, an important indicator of health status.
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13
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Blomqvist M, Sandgren A, Carlsson IM, Jormfeldt H. Enabling healthy living: Experiences of people with severe mental illness in psychiatric outpatient services. Int J Ment Health Nurs 2018; 27:236-246. [PMID: 28160392 DOI: 10.1111/inm.12313] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 12/11/2022]
Abstract
It is well known that people with severe mental illness have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as metabolic syndrome, cardiovascular disease and type 2 diabetes. There are still, however, only a few published studies focusing on what enables healthy living for this group. This study thus aimed to describe what enables healthy living among people with severe mental illness in psychiatric outpatient services. The data were collected in qualitative interviews (n = 16) and content analysis was used to analyze the data. The interviews resulted in an overall theme "Being regarded as a whole human being by self and others", which showed the multidimensional nature of health and the issues that enable healthy living among people with severe mental illness. Three categories emerged: (i) everyday structure (ii), motivating life events and (iii) support from significant others. The results indicate that a person with severe mental illness needs to be encountered as a whole person if healthy living is to be enabled. Attaining healthy living requires collaboration between the providers of care, help and support. Health care organizations need to work together to develop and provide interventions to enable healthy living and to reduce poor physical health among people with severe mental illness.
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Affiliation(s)
- Marjut Blomqvist
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Anna Sandgren
- Department of Health and Caring Sciences, Linneaus University, Växjö, Sweden
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14
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Jormfeldt H, Doyle L, Ellilä H, Lahti M, Higgins A, Keogh B, Meade O, Stickley T, Sitvast J, Skärsäter I, Kilkku N. Master's level mental health nursing competencies, a prerequisite for equal health among service users in mental health care. Int J Qual Stud Health Well-being 2018; 13:1502013. [PMID: 30067476 PMCID: PMC6084491 DOI: 10.1080/17482631.2018.1502013] [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] [Accepted: 07/11/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE This discussion paper aims to explore the need of a clarified definition of master's level mental health nursing competencies in terms of knowledge, skills and attitudes in a European context. Mental health service users have, in spite of their right to equal overall health, higher rates of physical illness and are more likely to experience premature death than the general population. Implementation of a holistic concept of health comprising mental, physical and social aspects of health in mental health services has previously proved to be challenging. METHODS Master's level mental health nursing competencies in recent literature are discussed and illuminated in terms of knowledge, skills and attitudes in order to enable the promotion of equal overall health among service users in mental health services. RESULTS The discussion show contents, values and utility of master's level mental health nursing competencies in mental health services and contribute to reduced role ambiguity by distinguishing master's level responsibilities from undergraduate nursing tasks and obligations of other professionals in mental health care. CONCLUSION This discussion paper shapes implications for developments in master's level mental health nursing education curricula.
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Affiliation(s)
- Henrika Jormfeldt
- School of Health and Wellfare, Halmstad University, Halmstad, Sweden
| | - Louise Doyle
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Heikki Ellilä
- Health and Well-being, Turku University of Applied Science, Turku, Finland
| | - Mari Lahti
- Health and Well-being, Turku University of Applied Science, Turku, Finland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Brian Keogh
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Oonagh Meade
- School of Health Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Theodore Stickley
- School of Health Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Jan Sitvast
- Advanced Nursing Practice, University of Applied Sciences HU, Utrecht, The Netherlands
| | - Ingela Skärsäter
- School of Health and Wellfare, Halmstad University, Halmstad, Sweden
| | - Nina Kilkku
- Tampere University of Applied Sciences, Tampere, Finland
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15
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Vazin R, McGinty EE, Dickerson F, Dalcin A, Goldsholl S, Oefinger Enriquez M, Jerome GJ, Gennusa JV, Daumit GL. Perceptions of strategies for successful weight loss in persons with serious mental illness participating in a behavioral weight loss intervention: A qualitative study. Psychiatr Rehabil J 2016; 39:137-46. [PMID: 27054900 PMCID: PMC4900940 DOI: 10.1037/prj0000182] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of this study was to describe perceptions of weight loss strategies, benefits, and barriers among persons with serious mental illness who lost weight in the ACHIEVE behavioral weight loss intervention. METHODS Semistructured interviews with 20 ACHIEVE participants were conducted and analyzed using an inductive coding approach. RESULTS Participants perceived tailored exercise sessions, social support, and dietary strategies taught in ACHIEVE-such as reducing portion sizes and avoiding sugar-sweetened beverages-as useful weight loss strategies. Health benefits, improved physical appearance, self-efficacy, and enhanced ability to perform activities of daily living were commonly cited benefits of intervention participation and weight loss. Some participants reported challenges with giving up snack food and reducing portion sizes, and barriers to exercise related to medical conditions. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE There is emerging evidence that behavioral weight loss interventions can lead to clinically meaningful reductions in body weight among persons with serious mental illness. The perspective of persons with serious mental illness regarding strategies for, benefits of, and barriers to weight loss during participation in behavioral weight loss programs provide insight into which elements of multicomponent interventions such as ACHIEVE are most effective. The results of this study suggest that tailored exercise programs, social support, and emphasis on nonclinical benefits of intervention participation, such as improvements in self-efficacy and the ability to participate more actively in family and community activities, are promising facilitators of engagement and success in behavioral weight loss interventions for the population with serious mental illness. (PsycINFO Database Record
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Affiliation(s)
- Roza Vazin
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
| | - Emma E McGinty
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
| | | | - Arlene Dalcin
- Department of Medicine, Johns Hopkins University School of Medicine
| | - Stacy Goldsholl
- Department of Medicine, Johns Hopkins University School of Medicine
| | | | - Gerald J Jerome
- Department of Medicine, Johns Hopkins University School of Medicine
| | - Joseph V Gennusa
- Department of Medicine, Johns Hopkins University School of Medicine
| | - Gail L Daumit
- Center for Prevention, Epidemiology, and Clinical Research, Division of General Internal Medicine, Johns Hopkins Medical Institutions
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16
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Cohen CI, Meesters PD, Zhao J. New perspectives on schizophrenia in later life: implications for treatment, policy, and research. Lancet Psychiatry 2015; 2:340-50. [PMID: 26360087 DOI: 10.1016/s2215-0366(15)00003-6] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 01/06/2015] [Indexed: 11/17/2022]
Abstract
Worldwide, in the past few decades, the demographics of older people (ie, people 55 years and over) with schizophrenia have changed completely with respect to absolute numbers of people affected, the proportion of all people with the disorder, life expectancy, and residential status. The ageing schizophrenia population has created vast health-care needs and their medical comorbidity contributes to higher mortality than in the general population. Proposals to classify schizophrenia into early-onset, late-onset, and very-late-onset subtypes now should be tempered by the recognition that comorbid medical and neurological disorders can contribute to psychotic symptoms in later life. The concept of outcome has become more nuanced with an appreciation that various outcomes can occur, largely independent of each other, that need different treatment approaches. Data show that schizophrenia in later life is not a stable end-state but one of fluctuation in symptoms and level of functioning, and show that pathways to improvement and recovery exist. Several novel non-pharmacological treatment strategies have been devised that can augment the clinical options used to address the specific needs of older adults with schizophrenia.
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Affiliation(s)
- Carl I Cohen
- SUNY Downstate Medical Center, Brooklyn, NY, USA.
| | - Paul D Meesters
- Department of Psychiatry, VU University Medical Center, GGZ inGeest and EMGO+, Institute for Health and Care Research, Amsterdam, Netherlands
| | - Jingna Zhao
- SUNY Downstate Medical Center, Brooklyn, NY, USA
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17
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Soundy A, Freeman P, Stubbs B, Probst M, Coffee P, Vancampfort D. The transcending benefits of physical activity for individuals with schizophrenia: a systematic review and meta-ethnography. Psychiatry Res 2014; 220:11-9. [PMID: 25149128 DOI: 10.1016/j.psychres.2014.07.083] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 07/28/2014] [Accepted: 07/31/2014] [Indexed: 10/24/2022]
Abstract
A systematic review and meta-ethnographic synthesis exploring the experiences of people with schizophrenia and healthcare professionals (HCPs) towards physical activity was undertaken. Major electronic databases were searched from inception until January 2014. Studies were eligible if they considered the experiences and perceptions of people with schizophrenia or the perceptions of HCPs towards physical activity. All included studies were synthesised within a meta-ethnographic approach, including completing a methodological quality assessment. The search strategy identified 106 articles, 11 of which were included in the final analysis. Eight articles considered patients׳ experiences and perceptions, and three articles considered the experiences and perceptions of HCPs. A total of 108 patients and 65 HCPs were included. Three main themes were identified: (1) the influence of identity, culture and the environment on physical activity engagement, (2) access and barriers to participation in physical activity, and (3) the benefits of engaging in physical activity. Aspects within the built, social and political environment as well as aspects of social cognition and perceptual biases influence participation in physical activity for individuals with schizophrenia. Specific recommendations for HCPs are given to help promote physical activity in this population group.
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Affiliation(s)
- Andy Soundy
- Department of Physiotherapy, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2 TT UK.
| | - Paul Freeman
- Department of Sport and Health Sciences, University of Exeter, Exeter, Devon, UK
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, Southwood Site Avery Hill Road Eltham, London SE9 2UG, UK
| | - Michel Probst
- University Psychiatric Centre, KU Leuven, Kortenberg, Department of Neurosciences, KU Leuven, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
| | - Pete Coffee
- School of Sport, University of Stirling, Stirling, Scotland, UK
| | - Davy Vancampfort
- University Psychiatric Centre, KU Leuven, Kortenberg, Department of Neurosciences, KU Leuven, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium; Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
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18
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Leutwyler H, Hubbard EM, Jeste DV, Miller BL, Vinogradov S. Association between schizophrenia symptoms and neurocognition on mobility in older adults with schizophrenia. Aging Ment Health 2014; 18:1006-12. [PMID: 24697281 PMCID: PMC4177266 DOI: 10.1080/13607863.2014.903467] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Older persons with schizophrenia develop problems associated with aging, such as poor mobility, at more rapid rates than people without serious mental illness. Decrements in mobility contribute to poor health outcomes. Impaired neurocognitive function and psychiatric symptoms are central aspects of schizophrenia. The purpose of this study was to determine the association between neurocognitive impairment and schizophrenia symptoms to mobility in older adults with schizophrenia. METHODS A cross-sectional study with 46 older adults with schizophrenia. Participants were assessed on neurocognitive function (MATRICS Consensus Cognitive Battery), psychiatric symptoms (Positive and Negative Syndrome Scale or PANSS), and mobility (Timed Get Up and Go or TGUG test). Pearson's bivariate correlations (two-tailed) and a simultaneous regression model were used. RESULTS Lower severity of negative symptoms and faster speed of processing tests were associated with faster TGUG time in bivariate correlations and multivariate regression analyses (p < .05). CONCLUSION Our data suggest that lower negative symptoms and faster speed of processing positively impact mobility in older patients with schizophrenia. Mobility interventions for this population need to target neurocognitive impairment and schizophrenia symptoms for optimal results.
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Affiliation(s)
- Heather Leutwyler
- Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way, N631A, Box 0610, San Francisco, California, 94143-0610
| | - Erin M. Hubbard
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA 94143-0610, Phone: 415-502-7774 Fax: 415-476-8899,
| | - Dilip V. Jeste
- Estelle and Edgar Levi Chair in Aging, Director, Sam and Rose Stein Institute for Research on Aging, Distinguished Professor of Psychiatry & Neurosciences, Director of Education, Clinical and Translational Research Institute, University of California, San Diego, President, American Psychiatric Association, 9500 Gilman Drive #0664, San Diego, California 92093, Phone: (858) 534-4020,
| | - Bruce L. Miller
- A.W. Clausen Distinguished Professor of Neurology, Director, Memory & Aging Center, University of California, San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, (415) 476-5591 Direct,
| | - Sophia Vinogradov
- Department of Psychiatry, University of California, San Francisco and San Francisco VA Medical Center, Mail Code 116C, 4150 Clement Street, San Francisco, CA 94121, tel: 1-415-221-4810 ext 3106,
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19
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Abstract
BACKGROUND Patients with schizophrenia have a substantially increased risk of cardiovascular disease and premature death compared with the general population. High prevalence of an unhealthy lifestyle contributes to the increased risk in these patients. Patients with schizophrenia are often physically inactive, and there is limited knowledge on the factors, such as barriers and incentives, that can influence physical activity in this patient group. OBJECTIVE The aim was to study the perception and experience of barriers to and incentives for physical activity in daily living in patients with schizophrenia, as reported by the patients themselves. DESIGN An explorative study applying conventional qualitative content analysis was conducted. METHODS A purposeful sample of 20 patients with schizophrenia or schizoaffective disorder (13 men, 7 women; 22-63 years of age) registered at 3 psychiatric outpatient clinics in Sweden were interviewed using semistructured interviews. RESULTS The analysis resulted in 3 main themes: (1) barriers-factors that complicate or obstruct physical activity, (2) reward-the motivation for physical activity, and (3) helpful strategies. LIMITATIONS The results may not reflect important factors related to physical activity in older patients (>65 years of age), newly diagnosed patients, or inpatients. CONCLUSIONS In accordance with patients' perceptions, there may be biopsychosocial determinants of physical activity behavior that are unique for this group of patients. Future studies should investigate whether physical activity interventions for patients with schizophrenia benefit from individual analyses of barriers and reward for physical activity in combination with the use of tailored strategies such as personal support and activity planning.
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20
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Leutwyler H, Hubbard EM, Dowling GA. Adherence to a Videogame-Based Physical Activity Program for Older Adults with Schizophrenia. Games Health J 2014; 3:227-33. [PMID: 26192371 DOI: 10.1089/g4h.2014.0006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Adults with schizophrenia are a growing segment of the older adult population. Evidence suggests that they engage in limited physical activity. Interventions are needed that are tailored around their unique limitations. An active videogame-based physical activity program that can be offered at a treatment facility can overcome these barriers and increase motivation to engage in physical activity. The purpose of this report is to describe the adherence to a videogame-based physical activity program using the Kinect(®) for Xbox(®) 360 game system (Microsoft(®), Redmond, WA) in older adults with schizophrenia. MATERIALS AND METHODS This was a descriptive longitudinal study among 34 older adults with schizophrenia to establish the adherence to an active videogame-based physical activity program. In our ongoing program, once a week for 6 weeks, participants played an active videogame, using the Kinect for Xbox 360 game system, for 30 minutes. Adherence was measured with a count of sessions attended and with the total minutes attended out of the possible total minutes of attendance (180 minutes). RESULTS Thirty-four adults with schizophrenia enrolled in the study. The mean number of groups attended was five out of six total (standard deviation=2), and the mean total minutes attended were 139 out of 180 possible (standard deviation=55). Fifty percent had perfect attendance. CONCLUSIONS Older adults with schizophrenia need effective physical activity programs. Adherence to our program suggests that videogames that use the Kinect for Xbox 360 game system are an innovative way to make physical activity accessible to this population.
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Affiliation(s)
- Heather Leutwyler
- Department of Physiological Nursing, University of California , San Francisco, San Francisco, California
| | - Erin M Hubbard
- Department of Physiological Nursing, University of California , San Francisco, San Francisco, California
| | - Glenna A Dowling
- Department of Physiological Nursing, University of California , San Francisco, San Francisco, California
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