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Mathew J, Adhia DB, Hall M, De Ridder D, Mani R. EEG-Based Cortical Alterations in Individuals With Chronic Knee Pain Secondary to Osteoarthritis: A Cross-sectional Investigation. THE JOURNAL OF PAIN 2024; 25:104429. [PMID: 37989404 DOI: 10.1016/j.jpain.2023.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 11/05/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
Chronic painful knee osteoarthritis (OA) is a disabling physical health condition. Alterations in brain responses to arthritic changes in the knee may explain persistent pain. This study investigated source localized, resting-state electroencephalography activity and functional connectivity in people with knee OA, compared to healthy controls. Adults aged 44 to 85 years with knee OA (n = 37) and healthy control (n = 39) were recruited. Resting-state electroencephalography was collected for 10 minutes and decomposed into infraslow frequency (ISF) to gamma frequency bands. Standard low-resolution electromagnetic brain tomography statistical nonparametric maps were conducted, current densities of regions of interest were compared between groups and correlation analyses were performed between electroencephalography (EEG) measures and clinical pain and functional outcomes in the knee OA group. Standard low-resolution electromagnetic brain tomography nonparametric maps revealed higher (P = .006) gamma band activity over the right insula (RIns) in the knee OA group. A significant (P < .0001) reduction in ISF band activity at the pregenual anterior cingulate cortex, whereas higher theta, alpha, beta, and gamma band activity at the dorsal anterior cingulate cortex, pregenual anterior cingulate cortex, the somatosensory cortex, and RIns in the knee OA group were identified. ISF activity of the dorsal anterior cingulate cortex was positively correlated with pain measures and psychological distress scores. Theta and alpha activity of RIns were negatively correlated with pain interference. In conclusion, aberrations in infraslow and faster frequency EEG oscillations at sensory discriminative, motivational-affective, and descending inhibitory cortical regions were demonstrated in people with chronic painful knee OA. Moreover, EEG oscillations were correlated with pain and functional outcome measures. PERSPECTIVE: This study confirms alterations in the rsEEG oscillations and its relationship with pain experience in people with knee OA. The study provides potential cortical targets and the EEG frequency bands for neuromodulatory interventions for managing chronic pain experience in knee OA.
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Affiliation(s)
- Jerin Mathew
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand; Department of Anatomy, School of Biomedical Sciences, University of Otago, New Zealand; Pain@Otago Research Theme, University of Otago, New Zealand
| | - Divya B Adhia
- Pain@Otago Research Theme, University of Otago, New Zealand; Division of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
| | - Matthew Hall
- Division of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
| | - Dirk De Ridder
- Pain@Otago Research Theme, University of Otago, New Zealand; Division of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
| | - Ramakrishnan Mani
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand; Pain@Otago Research Theme, University of Otago, New Zealand
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Wingood M, Criss MG, Irwin KE, Bamonti PM, Harris R, Phillips EL, Vincenzo JL, Chui KK. Examining physical activity participation barriers among adults 50 years and older: a scoping review. PHYSICAL THERAPY REVIEWS 2023; 28:195-210. [PMID: 38348467 PMCID: PMC10859686 DOI: 10.1080/10833196.2023.2265767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 09/12/2023] [Indexed: 02/15/2024]
Abstract
Background Addressing physical activity (PA) barriers is essential for increasing PA levels in middle-aged and older adults. However, there are no recommendations on selecting PA barrier assessment tools. Objectives Thus, we aimed to identify and provide clinimetric properties on PA barrier assessment tools that healthcare providers, exercise experts, and public health officials can use to examine potential barriers faced by community-dwelling adults 50 years and older. Methods We performed a systematic search of the following databases: PubMed, PsycINFO, CINAHL, and Web of Science. Articles were included if they presented clinimetric data on a PA participation barrier assessment tool for community-dwelling participants with a mean age of 50 years and older. The 561 identified articles underwent multiple rounds of blinded reviews. Included articles underwent data extraction for participant characteristics, scoring, constructs, reference tests, and clinimetric properties. Results The 35 included articles reported on 33 different PA participation barrier assessment tools. Eighteen articles reported on participants with cardiovascular, musculoskeletal, or neurological diagnoses, diabetes, hemodialysis, history of cancer, or mobility limitations. Tools with two or more supporting publications included the Exercise Benefits/Barrier Scale (EBBS), Episode-Specific Interpretations of Exercise Inventory (ESIE), and Inventory of Physical Activity and Barriers (IPAB). Due to differences in methodologies, across-tool comparison was not possible. Conclusion The EBBS, ESIE, and IPAB are promising tools for community-dwelling adults 50 years and older. However, additional research is warranted to identify the best PA barrier assessment tool among adults 50 years and older.
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Affiliation(s)
- Mariana Wingood
- Department of Implementation Science, Wake Forest
University School of Medicine, Winston-Salem, NC, USA
- Sticht Center for Healthy Aging and Alzheimer’s
Prevention, Internal Medicine, Gerontology and Geriatric Medicine, Wake Forest
University School of Medicine, Winston-Salem, NC, USA
| | - Michelle G. Criss
- Doctor of Physical Therapy Program, Chatham University,
Pittsburgh, PA, USA
| | - Kent E. Irwin
- Department of Physical Therapy, Midwestern University,
Downers Grove, IL, USA
| | - Patricia M. Bamonti
- Research & Development, Veterans Affairs Boston
Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston,
MA, USA
| | - Rebekah Harris
- New England Geriatric Education and Clinical Center,
Veterans Affairs Boston Healthcare System, Boston, MA, USA
- Physical Medicine and Rehabilitation, Harvard Medical
School, Boston, MA, USA
| | | | - Jennifer L. Vincenzo
- Department of Implementation Science, University of
Arkansas for Medical Sciences, Fayetteville, AR, USA
| | - Kevin K. Chui
- Department of Physical Therapy, Radford University,
Roanoke, VA, USA
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Lorbeer N, Knoll N, Keller J, Domke A, Di Maio S, Armbrecht G, Börst H, Martus P, Ertel W, Schwarzer R. Enhancing physical activity and reducing symptoms of patients with osteoarthritis of the knee: a randomized controlled trial of the PrevOP-Psychological Adherence Program. BMC Musculoskelet Disord 2023; 24:550. [PMID: 37403119 DOI: 10.1186/s12891-023-06661-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/23/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND This primary analysis evaluated the "PREVenting the impairment of primary Osteoarthritis by high-impact long-term Physical exercise regimen-Psychological Adherence Program" (PrevOP-PAP), designed to support patients with osteoarthritis of the knee (OAK) to engage in regular moderate-to-vigorous physical activity (MVPA) to reduce OAK symptoms (WOMAC scores). Theory-based on the health action process approach (HAPA), the intervention targeted volitional precursors of MVPA change: action and coping planning, maintenance and recovery self-efficacy, action control, and social network formation. We hypothesized that compared to an active control condition, increases in MVPA at the end of the 12-month intervention would translate into lower WOMAC scores at 24 months in the intervention condition. METHODS Participants with radiographically verified moderate OAK (N = 241; 62.66% female; M(SD) = 65.60(7.61) years) were randomly assigned to the intervention (51%) or the active control condition. WOMAC scores (24 months) were the primary -, accelerometer-assessed MVPA (12 months) the key secondary outcomes. The PrevOP-PAP was a 12-month intervention with computer-assisted face-to-face and phone-based sessions designed to increase HAPA-proposed volitional precursors of MVPA change (up to 24 months; secondary outcomes). Intent-to-treat analyses included multiple regression and manifest path models. RESULTS MVPA (12 months) did not mediate effects of the PrevOP-PAP on WOMAC scores (24 months). Compared to the active control condition, WOMAC scores (24 months) were lower in the intervention condition, but this effect did not remain stable in sensitivity analyses (b(SE) = -8.41(4.66), 95%-CI [-17.53; 0.71]). However, exploratory analyses revealed significantly stronger reductions in WOMAC-pain (24 months) in the intervention condition (b(SE) = -2.99(1.18), 95%-CI [-5.36; -0.63]). Groups did not differ in MVPA at 12 months (b(SE) = -3.78(3.42), 95%-CI [-10.80; 2.58]). Of the proposed precursors of MVPA change, action planning was higher in the intervention than in the control condition (24 months; b(SE) = 0.64(0.26), 95%-CI [0.14; 1.15]). CONCLUSIONS Compared to an active control condition, the PrevOP-PAP did not produce reliable effects on WOMAC scores and none on preceding MVPA. Of the HAPA-proposed volitional precursors, only action planning was sustainably increased. Future interventions should use m-health applications to digitally support long-term changes in proposed volitional precursors of MVPA change. TRIAL REGISTRATION German Clinical Trials Register; https://drks.de/search/de/trial/DRKS00009677 ; also available at http://apps.who.int/trialsearch/ ; registration number: DRKS00009677; date of registration: 26/01/2016.
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Affiliation(s)
- Noemi Lorbeer
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany
| | - Nina Knoll
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany.
| | - Jan Keller
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany
| | - Antonia Domke
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany
| | - Sally Di Maio
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany
| | - Gabriele Armbrecht
- Centre for Muscle- and Bone Research, Department of Radiology, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, Berlin, 12200, Germany
| | - Hendrikje Börst
- Centre for Muscle- and Bone Research, Department of Radiology, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, Berlin, 12200, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, Universitätsklinikum Tübingen, Silcherstr. 5, Tübingen, 72076, Germany
| | - Wolfgang Ertel
- Department of Traumatology and Reconstructive Surgery, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, Berlin, 12200, Germany
| | - Ralf Schwarzer
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University, ul. Ostrowskiego 30b, Wrocław, 53-238, Poland
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Selk-Ghaffari M, Hassanmirzaei B, Nakhostin-Ansari A, Mahdaviani B, Khonji MS, Aghajani R, Gholami-Mehrabadi M, Khosravi A, Kordi R. Conceptualization and development of a questionnaire to determine physical activity barriers. Phys Act Nutr 2022; 26:17-21. [PMID: 35982625 PMCID: PMC9395253 DOI: 10.20463/pan.2022.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 06/27/2022] [Indexed: 11/22/2022] Open
Abstract
[Purpose] Considering the role of physical activity on public health and the high prevalence of physical inactivity worldwide, determining physical activity barriers is critical and will be a road map for future planning. This study aimed to develop a comprehensive questionnaire to determine physical activity barriers.[Methods] By reviewing previous studies, the main domains of the questionnaire were established. A physical activity expert interviewed 20 individuals aged 18 to 65 years. The results were evaluated by an expert panel for a content validity index. Face validity, test-retest reliability, and internal consistency were established on 204 individuals.[Results] The content validity index in all items was within the acceptable range (>0.85). Face validity was appropriate, and the misunderstanding index was < 20% in all items. Test-retest reliability in the final questionnaire in all items based on Cohen’s kappa was > 0.20, indicating fair agreement. Internal consistency with Cronbach’s alpha of 0.63 was within the acceptable range.[Conclusion] The study revealed that the newly designed survey is valid, accurate, and reliable. The use of this comprehensive tool by policymakers would help them properly identify the perceived barriers, and thus perform better physical activity interventions as promotional health programs.
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Guelmami N, Chalghaf N, Tannoubi A, Puce L, Azaiez F, Bragazzi NL. Initial Psychometric Evidence of Physical Inactivity Perceived Experience Scale (Pipes): COVID-19 Pandemic as a Pilot Study. Front Public Health 2022; 10:819052. [PMID: 35392464 PMCID: PMC8980326 DOI: 10.3389/fpubh.2022.819052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/16/2022] [Indexed: 11/29/2022] Open
Abstract
Aims Our study aimed to develop a two-factor self-administered orthogonal questionnaire to assess the experience of perceived physical inactivity, to test its psychometric properties, to confirm its relationships with fear of COVID-19, and finally, with perceived stress during the pandemic. Methods A total of 481 Tunisian subjects collected in several cities, aged from 16 to 67 years with a mean age = 32.48 ± 9.46, and of both sexes participate in our study with (male: 51.8%) and (female: 48.2%), divided according to the level of study into three categories. All subjects voluntarily answered the PIPES questionnaire, the IPAQ scale, the COVID-19 fear scale and the PSS-10 test. Results The results of the exploratory and confirmatory factor analysis supported the robustness of the tool measure. In addition, examination of configurational, metric, scalar, and strict invariance supported the equivalence of the structure by gender and educational level. Concurrent validity was established by the positive association of a negative perception of physical inactivity with scores measured by the IPAQ scale and a negative association with scores of COVID-19 fear and perceived stress. Whereas, a positive perception of physical inactivity from the COVID-19 scale was negatively associated with the IPAQ and positively associated with fear of COVID-19 and perceived stress. Conclusion The PIPES-10 scale can be used to measure the perception of physical inactivity in different situations.
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Affiliation(s)
- Noomen Guelmami
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Group for the Study of Development and Social Environment (GEDES), Faculty of Human and Social Science of Tunis, Tunis, Tunisia.,Department of Human and Social Sciences, Higher Institute of Sport and Physical Education of Kef, University of Jendouba, Jendouba, Tunisia
| | - Nasr Chalghaf
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Group for the Study of Development and Social Environment (GEDES), Faculty of Human and Social Science of Tunis, Tunis, Tunisia.,Department of Human Sciences, Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Amayra Tannoubi
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Group for the Study of Development and Social Environment (GEDES), Faculty of Human and Social Science of Tunis, Tunis, Tunisia.,Department of Human and Social Sciences, Higher Institute of Sport and Physical Education of Kef, University of Jendouba, Jendouba, Tunisia.,Department of Human Sciences, Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Luca Puce
- Department of Neuroscience, University of Genoa, Genoa, Italy
| | - Fairouz Azaiez
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Group for the Study of Development and Social Environment (GEDES), Faculty of Human and Social Science of Tunis, Tunis, Tunisia.,Department of Human Sciences, Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nicola Luigi Bragazzi
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, Toronto, ON, Canada.,Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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Davergne T, Moe RH, Fautrel B, Gossec L. Development and initial validation of a questionnaire to assess facilitators and barriers to physical activity for patients with rheumatoid arthritis, axial spondyloarthritis and/or psoriatic arthritis. Rheumatol Int 2020; 40:2085-2095. [PMID: 32862307 DOI: 10.1007/s00296-020-04692-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/19/2020] [Indexed: 10/23/2022]
Abstract
To develop and validate a self-administered questionnaire to identify in people with Inflammatory arthritis (IA) Facilitators And Barriers to Physical activity (PA): the IFAB questionnaire. The development of the questionnaire included a systematic review of barriers and facilitators to PA to identify key themes, face validity assessment by 11 experts, and cognitive debriefing with 14 patients. The psychometric properties of the questionnaire were assessed by convergent validity (Spearman correlation) against the modified Health Assessment Questionnaire (mHAQ), the Fear-Avoidance Beliefs Questionnaire subscale for PA and the Tampa Scale for Kinesiophobia, internal consistency (Cronbach α) in 63 IA patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA). Reliability and feasibility were assessed in 32 IA patients. The questionnaire comprises 10 items: 4 assessing either barriers or facilitators, 3 assessing barriers, and 3 assessing facilitators. The items are related to psychological status (N = 6), social support (N = 2), disease (N = 1), environmental factors (N = 1). The validation study included 63 patients: 26 RA, 24 axSpA, 13 PsA; with mean age 52.8 (standard deviation 16.5) years, mean disease duration 12.5 (12.3) years, and 53% of women. The questionnaire was correlated (rho = 0.24) with mHAQ. Internal consistency (Cronbach α 0.69) and reliability (interclass coefficient 0.79 [95% confidence interval 0.59; 0.88]) were satisfactory, as was feasibility (missing data 12%, mean completion time < 5 min). The questionnaire allows the assessment of barriers and facilitators to PA in patients with IA. This questionnaire may guide targeted interventions to increase levels of PA in these patients.
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Affiliation(s)
- Thomas Davergne
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 47-83 Boulevard de Hôpital, 75013, Paris, France.
| | - Rikke H Moe
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Bruno Fautrel
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 47-83 Boulevard de Hôpital, 75013, Paris, France.,Rheumatology Department, Pitié Salpêtrière Hospital, APHP, 75013, Paris, France
| | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), 47-83 Boulevard de Hôpital, 75013, Paris, France.,Rheumatology Department, Pitié Salpêtrière Hospital, APHP, 75013, Paris, France
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Davergne T, Rakotozafiarison A, Servy H, Gossec L. Wearable Activity Trackers in the Management of Rheumatic Diseases: Where Are We in 2020? SENSORS (BASEL, SWITZERLAND) 2020; 20:E4797. [PMID: 32854412 PMCID: PMC7506912 DOI: 10.3390/s20174797] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/14/2020] [Accepted: 08/24/2020] [Indexed: 12/26/2022]
Abstract
In healthcare, physical activity can be monitored in two ways: self-monitoring by the patient himself or external monitoring by health professionals. Regarding self-monitoring, wearable activity trackers allow automated passive data collection that educate and motivate patients. Wearing an activity tracker can improve walking time by around 1500 steps per day. However, there are concerns about measurement accuracy (e.g., lack of a common validation protocol or measurement discrepancies between different devices). For external monitoring, many innovative electronic tools are currently used in rheumatology to help support physician time management, to reduce the burden on clinic time, and to prioritize patients who may need further attention. In inflammatory arthritis, such as rheumatoid arthritis, regular monitoring of patients to detect disease flares improves outcomes. In a pilot study applying machine learning to activity tracker steps, we showed that physical activity was strongly linked to disease flares and that patterns of physical activity could be used to predict flares with great accuracy, with a sensitivity and specificity above 95%. Thus, automatic monitoring of steps may lead to improved disease control through potential early identification of disease flares. However, activity trackers have some limitations when applied to rheumatic patients, such as tracker adherence, lack of clarity on long-term effectiveness, or the potential multiplicity of trackers.
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Affiliation(s)
- Thomas Davergne
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (UMRS 1136), 75013 Paris, France;
| | | | - Hervé Servy
- E-Health Services Sanoïa, 13420 Gémenos, France;
| | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (UMRS 1136), 75013 Paris, France;
- APHP, Rheumatology Department, Pitié Salpêtrière Hospital, 75013 Paris, France;
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