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Zhu D, Zhao J, Wang M, Cao B, Zhang W, Li Y, Zhang C, Han T. Rehabilitation Applications Based on Behavioral Therapy for People With Knee Osteoarthritis: Systematic Review. JMIR Mhealth Uhealth 2024; 12:e53798. [PMID: 38696250 PMCID: PMC11099817 DOI: 10.2196/53798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/07/2024] [Accepted: 03/14/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND The development of digital applications based on behavioral therapies to support patients with knee osteoarthritis (KOA) has attracted increasing attention in the field of rehabilitation. This paper presents a systematic review of research on digital applications based on behavioral therapies for people with KOA. OBJECTIVE This review aims to describe the characteristics of relevant digital applications, with a special focus on the current state of behavioral therapies, digital interaction technologies, and user participation in design. The secondary aim is to summarize intervention outcomes and user evaluations of digital applications. METHODS A systematic literature search was conducted using the keywords "Knee Osteoarthritis," "Behavior Therapy," and "Digitization" in the following databases (from January 2013 to July 2023): Web of Science, Embase, Science Direct, Ovid, and PubMed. The Mixed Methods Assessment Tool (MMAT) was used to assess the quality of evidence. Two researchers independently screened and extracted the data. RESULTS A total of 36 studies met the inclusion criteria and were further analyzed. Behavioral change techniques (BCTs) and cognitive behavioral therapy (CBT) were frequently combined when developing digital applications. The most prevalent areas were goals and planning (n=31) and repetition and substitution (n=27), which were frequently used to develop physical activity (PA) goals and adherence. The most prevalent combination strategy was app/website plus SMS text message/telephone/email (n=12), which has tremendous potential. This area of application design offers notable advantages, primarily manifesting in pain mitigation (n=24), reduction of physical dysfunction (n=21), and augmentation of PA levels (n=12). Additionally, when formulating design strategies, it is imperative to consider the perspectives of stakeholders, especially in response to the identified shortcomings in application design elucidated within the study. CONCLUSIONS The results demonstrate that "goals and planning" and "repetition and substitution" are frequently used to develop PA goals and PA behavior adherence. The most prevalent combination strategy was app/website plus SMS text message/telephone/email, which has tremendous potential. Moreover, incorporating several stakeholders in the design and development stages might enhance user experience, considering the distinct variations in their requirements. To improve the efficacy and availability of digital applications, we have several proposals. First, comprehensive care for patients should be ensured by integrating multiple behavioral therapies that encompass various aspects of the rehabilitation process, such as rehabilitation exercises and status monitoring. Second, therapists could benefit from more precise recommendations by incorporating additional intelligent algorithms to analyze patient data. Third, the implementation scope should be expanded from the home environment to a broader social community rehabilitation setting.
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Affiliation(s)
- Dian Zhu
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Jianan Zhao
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Mingxuan Wang
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Bochen Cao
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Wenhui Zhang
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Yunlong Li
- Department of Design, Jiangxi Science and Technology Normal University, Shanghai, China
| | - Chenqi Zhang
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Ting Han
- School of Design, Shanghai Jiao Tong University, Shanghai, China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China
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Arredondo EM, Haughton J, Ayala GX, Slymen D, Sallis JF, Perez LG, Serrano N, Ryan S, Valdivia R, Lopez NV, Elder JP. Two-year outcomes of Faith in Action/Fe en Acción: a randomized controlled trial of physical activity promotion in Latinas. Int J Behav Nutr Phys Act 2022; 19:97. [PMID: 35907867 PMCID: PMC9338625 DOI: 10.1186/s12966-022-01329-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 07/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Latina women are less likely to report engaging in leisure-time physical activity (PA) than non-Latina white women. This study evaluated the 24-month impact of a faith-based PA intervention targeting Latinas. Methods The study is a cluster randomized controlled trial of a PA intervention or cancer screening comparison condition, with churches as the randomization unit. A total of 436 Latinas (aged 18-65 years) from 16 churches who engaged in low levels of self-report and accelerometer-based PA were enrolled. The experimental condition was a 24-month PA intervention, with in-person classes, social support, and environmental changes, led by community health workers (i.e., promotoras). At baseline, 12-, and 24 months, we assessed changes in accelerometer-based and self-reported moderate to vigorous physical activity (MVPA; primary outcomes). Secondary outcomes were light intensity activity, sedentary time, body mass index (BMI), and waist circumference. Results After adjusting for sociodemographic factors, a mixed effects analysis found significant increases in self-reported leisure time MVPA (p < 0.005) and marginal increases in accelerometer-assessed MVPA (p < 0.08) 24 months post-baseline in the intervention compared to the attention-control condition. Data showed significant associations between PA class attendance and engaging in MVPA as assessed by self-report and accelerometry. No significant changes were found for light activity, sedentary time, BMI, or waist circumference. Conclusions Participants who attended the PA classes at least once a month engaged in significantly higher MVPA compared to those who did not. Maximizing engagement and maintenance strategies to enhance PA maintenance could contribute to important long-term health benefits. Trial registration NCT01776632, Registered March 18, 2011. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01329-6.
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Affiliation(s)
- Elva M Arredondo
- Department of Psychology, San Diego State University and the Institute for Behavioral and Community Health, 9245 Sky Park Ct, San Diego, CA, 92123, USA.
| | - Jessica Haughton
- Institute for Behavioral and Community Health, San Diego State University, San Diego, USA
| | - Guadalupe X Ayala
- School of Public Health, San Diego State University and the Institute for Behavioral and Community Health, San Diego, USA
| | - Donald Slymen
- School of Public Health, San Diego State University, San Diego, USA
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, USA.,Australian Catholic University, Melbourne, Australia
| | - Lilian G Perez
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, USA
| | - Natalicio Serrano
- School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Sherry Ryan
- School of Public Affairs, San Diego State University, San Diego, USA
| | | | - Nanette V Lopez
- Health Sciences, Northern Arizona University, Flagstaff, USA
| | - John P Elder
- School of Public Health, San Diego State University, San Diego, USA
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Mendoza-Vasconez AS, Arredondo EM, Larsen B, Crespo N, Hurst S, Marcus BH. Lapse, Relapse, and Recovery in Physical Activity Interventions for Latinas: a Survival Analysis. Int J Behav Med 2021; 28:540-551. [PMID: 33415695 DOI: 10.1007/s12529-020-09943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Physical activity (PA) research extensively focuses on initiation of PA, yet lapse and relapse among PA intervention participants are less well understood, particularly among minority populations such as Latinas in the USA. This study aimed to (1) determine the probability of lapse during two PA interventions for Latinas; (2) assess demographic, psychosocial, and environmental predictors of the amount of time until first lapse; and (3) identify factors predictive of lapse recovery. METHODS Data from 176 Latina intervention participants were pooled. Survival functions and Kaplan-Meier curves were used to illustrate probability of lapse. Cox proportional hazard models assessed predictors of time to lapse. Logistic regressions identified predictors of lapse recovery. RESULTS The probability of lapse after 1 month of starting to exercise was 18%, escalating to 34% after 4 months. Predictors of earlier lapse included various psychosocial constructs (i.e., self-efficacy and various processes of change), but none of the measured environmental factors, and only one demographic factor (≥ 2 children under 18). Increased use of consciousness raising at 2 months was associated with lower likelihood of lapse recovery, yet use of behavioral processes of change at 6 months was associated with higher likelihood of recovery. CONCLUSIONS Lapsing may not be pre-determined by demographic and environmental characteristics. On the other hand, skills that can be learned through interventions, such as skills to improve self-efficacy, seem important in the delay or prevention of lapses. Results pertaining to lapse recovery are less clear.
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Affiliation(s)
- Andrea S Mendoza-Vasconez
- Stanford Prevention Research Center, Stanford University, 1265 Welch Rd, Palo Alto, CA, 94305, USA. .,School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA. .,Department of Family Medicine & Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA.
| | - Elva M Arredondo
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA
| | - Britta Larsen
- Department of Family Medicine & Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Noe Crespo
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA
| | - Samantha Hurst
- Department of Family Medicine & Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121, South Main Street, Providence, Rhode Island, 02903, USA
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Bouma AJ, van Wilgen P, Lemmink KAPM, Stewart R, Dijkstra A, Diercks RL. Barrier-belief lifestyle counseling in primary care: A randomized controlled trial of efficacy. PATIENT EDUCATION AND COUNSELING 2018; 101:2134-2144. [PMID: 30072044 DOI: 10.1016/j.pec.2018.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 07/14/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Intervening on barrier beliefs (BBs) may inhibit the role of barriers as mediating factors in lifestyle behavior. The aim of this study was to analyze the effects of a barrier-belief counseling intervention (BBCI) on physical activity (PA) and healthy food intake. METHODS An RCT was conducted in a primary care setting among adults (aged 18-70), with two interventions: a BBCI (n = 123) and a standardized lifestyle group intervention (SLI) (n = 122). A non-treated hanging control group (n = 36) received no intervention. Outcomes on PA (accelerometer and SQUASH) and fruit and vegetable intake (self-report) were measured with follow-ups at 6, 12 and 18 months, and analyzed using multiple regression. RESULTS The BBCI was more effective on PA compared with the SLI (p < .01): in the short term all PA outcomes improved (p < .05), in the long term moderate-to-vigorous PA outcomes improved (p < .05), all with small effect sizes. No differences between interventions were found on fruit and vegetable intake. None of the outcomes in the control group changed over time. CONCLUSIONS BBCI in primary care improves PA compared with SLI. PRACTICE IMPLICATIONS The customized BB approach seems promising for implementation in healthcare practice to stimulate PA.
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Affiliation(s)
- Adrie J Bouma
- Hanze University of Applied Sciences Groningen, Institute of Sports Studies, Zernikeplein 17, 9766 AS Groningen, The Netherlands.
| | - Paul van Wilgen
- Transcare, Transdisciplinary Pain Management Centre, Barkmolenstraat 196, 9723 DM Groningen, The Netherlands.
| | - Koen A P M Lemmink
- Center for Human Movement Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - Roy Stewart
- Faculty of Medical Sciences, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - Arie Dijkstra
- Faculty of Behavioral and Society Sciences, Grote Kruisstraat 2/1, 9712 TS, University of Groningen, Groningen, The Netherlands.
| | - Ron L Diercks
- Department of Sports Medicine and Orthopedic Surgery, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
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Using formative research with older adults to inform a community physical activity programme: Get Healthy, Get Active. Prim Health Care Res Dev 2018; 20:e60. [PMID: 29976266 PMCID: PMC8512642 DOI: 10.1017/s1463423618000373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim The purpose of this formative study was to explore current knowledge and attitudes towards physical activity, as well as perceived barriers, facilitators and opportunities for physical activity participation among older adults living in the community. The findings have subsequently informed the design, delivery and recruitment strategies of a local community physical activity intervention programme which forms part of Sport England’s national Get Healthy, Get Active initiative. Background There is a growing public health concern regarding the amount of time spent in sedentary and physical activity behaviours within the older adult population. Methods Between March and June 2016, 34 participants took part in one of six focus groups as part of a descriptive formative study. A homogenous purposive sample of 28 community dwelling white, British older adults (six male), aged 65–90 years (M=78, SD=7 years) participated in one of five focus group sessions. An additional convenience pragmatic sub-sample of six participants (three male), aged 65–90 years (M=75, SD=4 years), recruited from an assisted living retirement home participated in a sixth focus group. Questions for focus groups were structured around the PRECEDE stage of the PRECEDE–PROCEDE model of health programme design, implementation and evaluation. Questions addressed knowledge, attitudes and beliefs towards physical activity, as well as views on barriers and opportunities for physical activity participation. All data were transcribed verbatim. Thematic analysis was then conducted with outcomes represented as pen profiles. Findings Consistent views regarding both the potential physical and psychosocial benefits of physical activity were noted regardless of living status. The themes of, opportunities and awareness for physical activity participation, cost, transport, location and season/weather varied between participants living in an assisted living retirement home and community dwelling older adults. Further comparative research on the physical activity requirements of older adults living in assisted living versus community settings are warranted.
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Stadnyk AMJ, Rehrer NJ, Handcock PJ, Meredith-Jones KA, Cotter JD. No clear benefit of muscle heating on hypertrophy and strength with resistance training. Temperature (Austin) 2017; 5:175-183. [PMID: 30393753 DOI: 10.1080/23328940.2017.1391366] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 12/15/2022] Open
Abstract
Heat is a major stressor during exercise, though its value in driving adaptation is not well understood. Muscle heating can upregulate pathways facilitating protein synthesis and could thereby enhance effects of exercise training, however, few studies have investigated this possibility. We examined whether heating active muscle during resistance training differentially affected physical and functional adaptations. Within a randomised contralateral-limb control study, ten healthy, resistance-untrained individuals (21 ± 3 y; 5 female) completed 30 sessions of progressive resistance training (12 weeks), performing 4 × 8 unilateral knee extensions at 70% of 1RM. One randomly-allocated thigh was heated during, and for 20 min after, each session using an electric pad eliciting muscle temperatures of >38 °C (HOT); the contralateral limb remained unheated (CON). Training intensity was progressed using 4-weekly strength assessments. Quadricep lean mass (measured using DXA) increased by 15 ± 7% in HOT (p = 0.00) and 15 ± 6% in CON (p = 0.00); the difference being trivial (p = 0.94). Peak isokinetic torque at 90°.s-1 increased by 30 ± 25% (HOT; p = 0.00) and 34 ± 33% (CON; p = 0.01), with no difference (p = 0.84) between limbs. Rate of torque development increased ∼40%, with no difference between limbs (p = 0.73). The increase in 3-RM strength was also similar in HOT (75 ± 16%) and CON (71 ± 14%; p = 0.80 for difference). No differences in mass or strength changes were evident between sexes. In conclusion, supplemental heating of active muscle during and after each bout of resistance training showed no clear positive (or negative) effect on training-induced hypertrophy or function.
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Affiliation(s)
- Antony M J Stadnyk
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Nancy J Rehrer
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Phil J Handcock
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | | | - James D Cotter
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
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Herazo-Beltrán Y, Pinillos Y, Vidarte J, Crissien E, Suarez D, García R. Predictors of perceived barriers to physical activity in the general adult population: a cross-sectional study. Braz J Phys Ther 2017; 21:44-50. [PMID: 28442074 PMCID: PMC5537451 DOI: 10.1016/j.bjpt.2016.04.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 02/28/2016] [Accepted: 04/08/2016] [Indexed: 11/18/2022] Open
Abstract
Our investigation has shown factors that influence physical activity. Lack of motivation, resources, social support and fear of injury are barriers. Socioeconomic level, marital status, education and others are predictors. The design not allowed to calculate a causal relationship between the variables. A representative sample of the residents of Barranquilla (Colombia), is a strength.
Background The perception of personal barriers to physical activity varies according to the sociodemographic characteristics of individuals. Objective To determine the predictors of the perception of barriers to physical activity in the adult population. Method A cross-sectional study with 1066 adult women and 1036 adult men. The sociodemographic variables (age, gender, marital status, socioeconomic level, level of education), the perception of barriers that do not allow performance of physical activity (i.e. lack of time, social support, energy, motivation, skill, resources, and fear of injury during practice); and the level of physical activity through the International Physical Activity Questionnaire in its short-form version were evaluated. Results Individuals from low socioeconomic level (1 and 2) have higher risks of perceiving barriers such as lack of motivation [OR 1.76 (95% CI (1.4–2.1))] and lack of resources [OR 1.37 (95% CI (1.1–1.6))]; individuals with partners did not perceive the lack of social support [OR 0.29 (95% CI (0.2–0.4))] and lack of motivation [OR 0.54 (95% CI (0.4–0.7))] as barriers to physical activity. Individuals with low schooling perceived lack of social support [OR 3.81 (95% CI (3–4.7))], lack of resources [OR 2.78 (95% CI (2.2–3.3))], and fear of injury [OR 2.70 (95% CI (2.2–3.3))] as barrier to physical activity. Conclusion Factors such as socioeconomic level, marital status, level of education, and self-perception of health are predictors of barriers to physical activity.
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Affiliation(s)
| | - Yisel Pinillos
- Physical Therapy Program, Universidad Simón Bolívar, Barranquilla, Colombia
| | - José Vidarte
- Physical Therapy Program, Universidad Autónoma de Manizales, Manizales, Colombia
| | - Estela Crissien
- Physical Therapy Program, Universidad Simón Bolívar, Barranquilla, Colombia
| | - Damaris Suarez
- Physical Therapy Program, Universidad Simón Bolívar, Barranquilla, Colombia
| | - Rafael García
- Physical Therapy Program, Universidad Simón Bolívar, Barranquilla, Colombia
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Ogdie A, Eder L. Improving cardiovascular health and metabolic comorbidities in patients with psoriatic arthritis. ACTA ACUST UNITED AC 2015; 10:451-459. [PMID: 27134682 DOI: 10.2217/ijr.15.45] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Numerous studies have suggested a link between psoriatic arthritis (PsA) and comorbidities, in particular cardiovascular disease and metabolic comorbidities such as diabetes. The co-existence of these comorbidities is likely the result of systemic inflammation. In order to improve the health of patients with PsA and provide optimal care, these comorbidities must be addressed. However, little is known about how to improve metabolic and cardiovascular health in patients with PsA. In this perspective, we describe the research needs in the area of improving cardiovascular disease and metabolic comorbidities among patients with PsA.
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Affiliation(s)
- Alexis Ogdie
- Perelman School of Medicine, University of Pennsylvania, White Building, Room 5024, 3400 Spruce St, Philadelphia, PA 19104, USA
| | - Lihi Eder
- Centre for Prognosis Studies in the Rheumatic Diseases, University of Toronto, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada
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