The role of resilience: Physical activity continuation after falling in adults with multiple sclerosis

The moderating role of psychological resilience in the relationship between falls, anxiety and depressive symptoms

BACKGROUND

There is a greater likelihood of anxiety and depression among older adults who suffer falls. This study examined the relationships of falls and severe falls with anxiety and depressive symptoms, and the moderating role of psychological resilience on these associations.

METHODS

Our study recruited participants from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative cohort study. A total of 11,857 participants included in the analysis. We used a linear regression model to investigate the relationship between falls/severe falls and anxiety/depressive symptoms, adjusting for a range of potential covariates and a bootstrapping sample test to examine the potential moderating role of psychological resilience in these relationships.

RESULTS

Older adults who suffered the falls have higher anxiety/depressive symptoms (β = 0.28 [0.23, 0.32] for anxiety symptoms, p < 0.001; β = 0.21 [0.16, 0.25] for depressive symptoms, p < 0.001), and those who suffered the severe falls have higher anxiety/depressive symptoms (β = 0.30 [0.24, 0.37] for anxiety symptoms, p < 0.001; β = 0.21 [0.15, 0.27] for depressive symptoms, p < 0.001), in the fully adjusted model. The relationship between falls/severe falls and anxiety/depressive symptoms was mitigated in participants with higher levels of psychological resilience.

LIMITATIONS

The present study is based on cross-sectional data, which limits the ability to infer causal relationships.

CONCLUSIONS

Falls/severe falls were positively associated with anxiety and depression, and that psychological resilience could moderate this association. Our findings suggest that psychological resilience may be an effective target for intervention and prevention of fall-related symptoms of anxiety and depression.

Exploring the Role of Resilience and Optimism during the COVID-19 Pandemic in Older European Adults

This study examined how resilience and optimism were related to psychological well-being among older European adults during the early pandemic. The study used data sampled from the Eurofound COVID-19 survey conducted in 27 European countries during the first lockdown (April 2020). The study sample included 10,674 older adults (mean age = 69.71 ± 5.15, 68.6% women, 87.3% retired). Using structural equation modeling, the relationship between pandemic adversities, resilience, optimism, and well-being was investigated. Results indicated that resilience and optimism in part mediated the association between adversities and psychological well-being. Resilience and optimism have the potential to help older adults cope with stressful life events and other adversities. Future studies should more precisely explore the role of resilience and optimism, its formation, and the protective mechanisms that promote the psychological well-being of older adults.

Experiences of integrating and sustaining physical activity in life with multiple sclerosis, Alzheimer's disease, and ischaemic heart disease: a scoping review

PURPOSE

The effects of physical activity on health are well-established for chronic diseases such as multiple sclerosis (MS), Alzheimer's disease (AD), and ischaemic heart disease (IHD). However, sustaining physical activity in everyday life is difficult. Lifeworld knowledge can help qualify interventions aimed at resolving this public health issue, but there is a gap in regard to synthesized research on peoples' experiences with integrating and sustaining physical activity. Hence, the purpose of this review is to explore and present the available evidence on experiences with integrating and sustaining physical activity in a lived life with MS, AD, and IHD.

METHODS

We conducted a scoping review with qualitative analysis and narrative syntheses in accordance with PRISMA-ScR. Based on SPIDER we ran a systematic search in Cinahl, Embase, Medline, and PsychInfo for primary qualitative research papers published until December 2022.

RESULTS

43 papers were included. A thematic content analysis found that individuals who have MS, AD or IHD find integrating and sustaining physical activity in everyday life meaningful on several levels: Physical activity can facilitate meaningful movement with outcomes of physical, psychosocial, and existential importance.

CONCLUSION

The research literature presents a meaning to physical activity that extends the idea of physical fitness to one of existential movement and personal growth. In addition, our review finds that people are more likely to integrate and sustain physical activity if they feel acknowledged, supported and believe that physical activity has a meaningful purpose reflecting their sense of self. Taking a more person-centred approach in rehabilitative care might help qualify the content of physical activity in terms of integration into everyday life, but more research is needed on how to implement a person-centred approach in practice.IMPLICATIONS FOR REHABILITATIONThe research literature presents an experiential meaning to physical activity that extends the idea of physical fitness to one of more existential movement and personal growth.To ensure the integration of physical activity in people's everyday life, future rehabilitation interventions might benefit from adapting a more person-centred approach.People are more likely to sustain physical activity when they feel acknowledged, supported through social relationships, can access activities adapted to their specific needs and preferences, and believe that physical activity has a meaningful purpose reflecting their sense of self.

Predictors of resilience for people with spinal cord injury over two periods of COVID-19 social distancing restrictions: a 12-month longitudinal study using structural equation modelling

BACKGROUND

The novel coronavirus (COVID-19) pandemic is disproportionately impacting the health of people with disability. Resilience has remained an important health promoting characteristic during periods of social distancing restrictions. Factors promoting resilience for people with disability under the context of the pandemic remains poorly understood. Studies have yet to investigate evidence-based factors that promote resilience over multiple periods of restrictions for people with disability.

METHODS

A longitudinal study developed via a collaborative partnership between peer-support workers with lived experience of spinal cord injury (SCI) and university researchers was undertaken to fill knowledge gaps around factors promoting resilience for people with SCI during two periods of stringent social distancing restrictions within Victoria, Australia. Over 12-months, participants with SCI completed two surveys, towards the end of two lockdown periods. Evidence-based factors associated with resilience were measured. The Impact on Participation and Autonomy Questionnaire, the International SCI Quality of Life scale, and the 10-item Conor Davidson Resilience Scale, respectively measured autonomy and participation limitations, life satisfaction and psychological health, and resilience. A structural equation modelling (SEM) approach established factors directly and indirectly associated with resilience.

RESULTS

A model with excellent fit was produced. During two extended lockdowns over the 12-month period, increased family role limitations and favourable psychological health were respectively, negatively (Lockdown 1 [n = 127]: β = -.251, p < .01, Lockdown 2: β = -.400, p < .01) and positively (Lockdown 1: β = .601, p < .01, Lockdown 2 [n = 65]: β = .430, p < .01) associated with resilience. Indirect negative associations between resilience and increased outdoor autonomy limitations (Lockdown 1: β = -.195, p < .01, Lockdown 2: β = -.255, p < .01) and social life limitations (Lockdown 1: β = -.217, p < .01, Lockdown 2: β = -.142, p < .05) existed, and these relationships were moderated by psychological health.

CONCLUSIONS

Psychological health, and participation and autonomy are determinants of resilience during periods of crisis. Health and social care providers and public health departments should prioritise programs promoting these domains, to counter the negative impact of social distancing.

Cross-Lagged Associations Between Physical Activity, Self-Rated Health, and Psychological Resilience Among Older American Adults: A 3-Wave Study

The current study examined the reciprocal association between psychological resilience, physical activity, and self-rated health in older America adults. A 3-wave cross-lagged panel design was employed using data sampled from the Health and Retirement Study 2010, 2014, and 2018. In total, 8380 older adults, age ranged between 56 and 95 years at the baseline (mean age = 68.06, SD = 7.77), were analyzed. Using structural equation modeling, standardized path coefficients were estimated to determine the relationship between physical activity, self-rated health, and psychological resilience across 2 follow-up points. Cross-lagged analysis revealed that higher levels of physical activity at T1 and T2 were significantly associated with higher levels of self-rated health at T2 and T3, respectively. Self-rated health at T1 and T2 were significantly associated with physical activity at T2 and T3, respectively. Self-rated health and psychological resilience were positively related to one another at each time point. However, relationship between physical activity and psychological resilience was complex across time. Study findings support reciprocal prospective relationship between physical activity and self-rated health and the relationship between self-rated health and psychological resilience.

Resilience is associated with physical activity and sedentary behaviour recommendations attainment in Chinese university students

PURPOSE

To determine the associations of resilience with physical activity (PA) and sedentary behaviour (SB) recommendations attainment among university students by considering the sex of the participants.

METHODS

This cross-sectional study recruited 352 Chinese university students (131 males, 20.8 ± 2.18 years). PA and SB were assessed using the International Physical Activity Questionnaire-Short Form. Resilience was measured using the Chinese version of the Connor-Davidson Resilience Scale with 25 items (CD-RISC-25). Attainment of PA and SB recommendations with different patterns was determined by referring to the global recommendations for adults. Mann-Whitney U tests and generalized linear models (GLMs) were used to determine sex differences in all outcomes and the contribution of resilience to the attainment of PA and SB recommendations, respectively.

RESULTS

The percentage of males who attained all patterns related to vigorous PA (VPA), moderate-to-vigorous PA (MVPA), and SB recommendations was significantly higher than that of females. Males also scored significantly higher than females in the CD-RISC-25 final score (p < .01). GLMs results showed that, after adjusting for key confounders, resilience was a significant predictor of PA recommendations attainment in terms of minimum moderate PA (MPA), minimum MVPA, and adequate MVPA (all p < .05).

CONCLUSION

PA (at more intense levels), SB, and resilience among university students vary by sex, with males outperforming females. Regardless of sex, resilience is an important predictor for the attainment of PA and SB recommendations. Sex-specific resilience-building interventions should be developed to foster a physically active lifestyle among this population group.

Impact of Social Support on Physical Activity in Adults With Heart Failure: The Mediating Effect of Resilience

This study aimed to evaluate the impact of resilience and social support on physical activity in adults with heart failure (HF) and to explore the mediating effect of resilience on the relationship between social support and physical activity. A cross-sectional study was conducted with 197 adults with HF (n = 197) from two outpatient departments for cardiovascular diseases. Resilience was assessed using the Connor-Davidson Resilience Scale, social support using the Social Support Rating Scale, and physical activity using the short form of the International Physical Activity Questionnaire. Social support and resilience were significantly associated with physical activity in adults with HF. Resilience partially mediated the relationship between social support and physical activity, and the mediating effect accounted for 25.93% of the total effect of social support on physical activity. These findings contribute to the development of tailored interventions by targeting these two factors to increase physical activity levels in adults with HF.

Physical Activity and Health of Koreans with Spinal Cord Injury during COVID-19

Objectives: The primary purpose of this study was to explore the mediating roles of resilience and physical activity (PA) levels on the subjective health of people with spinal cord injury(SCI) during the COVID-19 pandemic.Methods: A total of 201 Koreans with SCI completed a survey between February and April 2021. The questionnaire measured participants' PA levels before and during the COVID-19 pandemic, resilience, and subjective health assessment. The data were analyzed using SPSS, and PROCESS macro (Model 6) was used to determine the dual mediation effects. Results: PA levels before COVID-19 positively affected resilience and PA levels during COVID-19, and resilience positively affected PA levels during COVID-19 and subjective health. PA levels during COVID-19 had a positive influence on subjective health. Moreover, resilience and PA levels during COVID-19 were independent mediators of the relationship between PA levels before COVID-19 and subjective health. PA levels before COVID-19 indirectly affected subjective health through a dual-mediated pathway of resilience and PA levels during COVID-19. Conclusion: We suggest that it is necessary to promote regular PA for people with physical disabilities to enhance resilience, and thus, maintain a healthy life even during a public health crisis.