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Stendell L, Stubbs PW, Rivera E, Rogers K, Verhagen AP, Davis GM, Middleton JW, de Oliveira CQ. Are Middle- or Older-Aged Adults With a Spinal Cord Injury Engaging in Leisure-Time Physical Activity? A Systematic Review and Meta-Analysis. Arch Rehabil Res Clin Transl 2024; 6:100335. [PMID: 39006108 PMCID: PMC11240020 DOI: 10.1016/j.arrct.2024.100335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Objectives To investigate the amount of Leisure-Time Physical Activity (LTPA) that people over 45 years with a spinal cord injury (SCI) performed and to determine the frequency, duration, intensity, and modality of LTPA performed. Data Sources We searched 5 major electronic databases (CINAHL, SCOPUS, EMBASE, MEDLINE, and PubMed) from inception to March 2023. Study Selection Cross-sectional, longitudinal studies and control arm of controlled trials that assessed LTPA in participants over 45 years old, with a SCI. We included 19 studies in the review and 11 in the meta-analysis. Data Extraction We followed the PRISMA checklist for Systematic Reviews. Two review authors independently assessed the risk of bias and extracted data on participants' demographics, injury characteristics, and LTPA participation of the included studies. Risk of bias was assessed using the Joanne Briggs Institute critical appraisal tool for cross-sectional studies. Any conflicts were resolved by a third author. Data Synthesis We found considerable variability in LTPA participation in adults 45 years and older with SCI. An estimated 27%-64% of participants did not take part in any LTPA. A random effects meta-analysis model was completed for studies that reported total or moderate-to-heavy LTPA scores in minutes per week. Overall, participants (n=1675) engaged in 260 [205;329] (mean [95% CI]) mins/week of total LTPA. Those participating in moderate-heavy intensity LTPA (n=364) completed 173 [118; 255] (mean [95% CI]) mins/week. LTPA modalities included walking, wheeling, hand-cycling, basketball, and swimming, among others. Conclusions While many older adults with SCI seem to be meeting the recommended weekly physical activity volume, many still remain sedentary. There was significant variation in reporting of frequency, intensity, and duration of LTPA and reporting on modality was limited. Because of differences in reporting, it was challenging to compare results across studies. Data constraints prevented subgroup analysis of LTPA disparities between paraplegia and tetraplegia.
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Affiliation(s)
- Laura Stendell
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Peter W. Stubbs
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Esminio Rivera
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Kris Rogers
- Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Arianne P. Verhagen
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Glen M. Davis
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - James W. Middleton
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
- The Kolling Institute, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Camila Quel de Oliveira
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Baehr LA, Hiremath SV, Bruneau M, Chiarello LA, Kaimal G, Newton R, Finley M. Effect of Tele-exercise to Promote Empowered Movement for Individuals With Spinal Cord Injury (TEEMS) Program on Physical Activity Determinants and Behavior: A Mixed Methods Assessment. Arch Phys Med Rehabil 2024; 105:101-111. [PMID: 37678447 DOI: 10.1016/j.apmr.2023.08.019] [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: 06/02/2023] [Revised: 08/08/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To assess the effects of group tele-exercise participation on physical activity (PA) determinants and behavior as identified by social cognitive theory (SCT) in individuals with spinal cord injury (SCI). DESIGN This clinically registered non-randomized trial [NCT05360719] used a single-group parallel mixed methods design. Quantitative and qualitative primary measures were assessed at pre-program and after 8-week intervention completion (post-program), with an additional 8-week period retention to capture quantitative assessments only. SETTING Community. PARTICIPANTS Individuals with chronic SCI (N=22, injury duration 2-50 years) aged 26-68 years (10 male/12 female). INTERVENTION An 8-week group tele-exercise program for individuals with SCI consisting of biweekly 60-minute classes delivered via live Web-conferencing software. MAIN OUTCOME MEASURES Exercise self-efficacy (Exercise Self-efficacy Scale for SCI: ESES), outcome expectations for exercise (Multidimensional Outcome Expectations for Exercise: MOEES), weekly PA minutes measured through quantitative assessments (Leisure Time PA Questionnaire for SCI: LTPAQ), and parallel qualitative thematic analysis of focus group interview transcripts. RESULTS Congruence between numeric and thematic findings was present for exercise self-efficacy and self-evaluative exercise outcome expectations. Improved exercise self-efficacy was influenced by exercise knowledge gained during program participation. Increased expectations of internal exercise outcomes, such as influence on psychological state and overall mood, occurred after program participation. Participant descriptions of the portability and sustainability of the program leading to added movement in everyday life were not reflected in the numeric scores of LTPAQ assessment. CONCLUSIONS Participation in an 8-week group tele-exercise program positively affected personal determinants of PA behavior immediately after participation. Future investigations should include a control group and biophysical PA measures such as wearable digital health devices.
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Affiliation(s)
- Laura A Baehr
- Department of Health and Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, PA.
| | - Shivayogi V Hiremath
- Department of Health and Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, PA
| | - Michael Bruneau
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA
| | - Girija Kaimal
- Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA
| | - Ross Newton
- Wheelock College of Education and Human Development, Boston University, Boston, MA
| | - Margaret Finley
- Department of Physical Therapy and Rehabilitation Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA
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Baehr LA, Bruneau M, Finley M. Baseline Comparison of Exercisers and Nonexercisers With Spinal Cord Injury Enrolled in a Group Tele-Exercise Program. Top Spinal Cord Inj Rehabil 2023; 29:27-36. [PMID: 38076490 PMCID: PMC10704214 DOI: 10.46292/sci23-00027] [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] [Indexed: 12/18/2023]
Abstract
Background Individuals with SCI are 1.5 times more likely to be sedentary compared to adults without disabilities or chronic health conditions. It is therefore imperative to develop and evaluate innovative facilitation strategies for physical activity behavior in this population. Objectives As an insightful step to creating and evaluating tailored physical activity interventions for individuals with SCI, we evaluated demographic, psychosocial, and physical characteristics of those who choose to engage in physical activity by enrolling in a group exercise study. Design/Methods We conducted a cross-sectional analysis detailing demographic features and baseline outcomes of those with SCI enrolled in a group tele-exercise study who were classified as regular exercisers versus nonregular exercisers per the American College of Sports Medicine exercise guidelines. Between-group differences for psychosocial and physical outcomes were assessed with chi-square and Mann-Whitney U tests (p < .05). Results Twenty-seven adult volunteers enrolled in the study (exercisers = 14, nonexercisers = 13). Groups were comparable for biological sex, gender identity, self-reported racial group(s), and current age. Exercisers demonstrated significantly shorter duration of injury compared to nonexercisers (p = .012). Exercisers exhibited significantly higher exercise self-efficacy (p = .017) and increased reported weekly minutes in vigorous intensity leisure time physical activity (p = .029). Conclusion Nonexercisers with SCI demonstrate increased injury duration and reduced exercise self-efficacy compared to active peers. These factors should be addressed in the design and delivery of SCI-specific physical activity interventions to increase the likelihood of this critical health behavior over time.
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Affiliation(s)
- Laura A. Baehr
- Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, Pennsylvania
| | - Michael Bruneau
- Department of Health Sciences, Drexel University, Philadelphia, Pennsylvania
| | - Margaret Finley
- Department of Physical Therapy and Rehabilitation Sciences, Philadelphia, Pennsylvania
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Wong MYC, Ou KL, Man Leung K. Investigating and promoting health behaviors reactivity among Hong Kong older adults in the post-COVID-19 Era: An exploratory network analysis. PLoS One 2023; 18:e0293512. [PMID: 37917757 PMCID: PMC10621926 DOI: 10.1371/journal.pone.0293512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/14/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Physical distance has increased the risk of developing a variety of health problems, especially among older people. During the COVID-19 lockdown period, physical activity decreased, screen time increased, food consumption increased, as well as exposure to unhealthy behaviour, leading to poorer sleep quality and more negative emotions, which ultimately led to poorer physical health, mental health, and subjective vitality among older adults. Although there were numerous research studies on changes in health behaviours during COVID-19, only a few were targeted at older adults, and none were conducted in Asian countries. METHOD The current study is aiming to identify the changes in health behaviours, as well as their associations with older adults' mental health as a result of the COVID-19 pandemic among Hong Kong older adults, using exploratory network analysis. In this study, a random tele-survey was conducted among older adults. RESULTS A total of 664 participants have been involved in the telephone survey, with 213 males and 451 females, of which mean age was 74.37. The explored network showed strong centrality and edge stability, thus enabling to reveal an overview of the associations between health behaviours and mental well-being of older adults. The lavaan model has also demonstrated the casual paths within the explored network, which indicated the significant impact of sleeping quality, eating habits and social networking on resilience. CONCLUSION The outcomes of the study were able to identify the lifestyle changes of Hong Kong older adults due to COVID-19. Although the present study is not regarded as novel internationally, it may be representative of the Hong Kong community. In order to facilitate active aging during the pandemic, a user-friendly electronic platform for healthy living should include older adults in the future.
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Affiliation(s)
| | - Kai-ling Ou
- Hong Kong Baptist University, Hong Kong, China
| | - Ka Man Leung
- The Education University of Hong Kong, Hong Kong, China
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Morgan KA, Heeb R, Flynn A, Sukow K, Tormey E, Tucker S, Walker K, Hollingsworth H. An observational study of personal and environmental factors associated with attendance at a community-based adaptive fitness center for adults with physical disabilities. Disabil Health J 2022; 15:101342. [PMID: 35710900 DOI: 10.1016/j.dhjo.2022.101342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Regular exercise has many benefits for adults with physical disabilities (AwPD). Despite these benefits, significant barriers to participating in exercise exist for AwPD. Community-based adaptive fitness centers promote exercise for AwPD by minimizing barriers. Research has yet to clearly examine the personal and environmental factors associated with enrollment and attendance rates of AwPD in community-based adaptive fitness centers. OBJECTIVE The purpose of our study was to explore personal and environmental factors associated with AwPD and their attendance at a community-based adaptive fitness center once enrolled. METHODS Individuals aged 18-85 with a physical disability interested in exercising were referred to a community-based adaptive fitness center. At initial assessment, participants completed demographics, health, barriers to exercise, and exercise self-efficacy (ESE) surveys. Following initial assessment, participant visits to the fitness center were tracked for six months. RESULTS Of 106 participants, 27 never visited the facility after initial assessment, and the remaining participants with six months of attendance data (n = 67) averaged 14.9 (SD = 14.2) visits. Correlation results showed a negative curvilinear relationship between number of visits and years living with disability (rs = -0.24, p < 0.05), with higher attendance associated with more recent diagnosis. Logistic and stepwise regressions showed that ESE score (β = 0.107, p = 0.026) was the only significant predictor of attending the fitness center once enrolled. CONCLUSIONS This study demonstrates the importance of understanding personal and environmental factors and assessing ESE for AwPD who are newly enrolled in a community-based adaptive fitness center.
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Affiliation(s)
- Kerri A Morgan
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States.
| | - Rachel Heeb
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States
| | - Ashley Flynn
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States
| | - Kayleigh Sukow
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States
| | - Erin Tormey
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States
| | - Susan Tucker
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States
| | - Kim Walker
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States
| | - Holly Hollingsworth
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, United States
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Farkas GJ, Burton AM, McMillan DW, Sneij A, Gater DR. The Diagnosis and Management of Cardiometabolic Risk and Cardiometabolic Syndrome after Spinal Cord Injury. J Pers Med 2022; 12:1088. [PMID: 35887592 PMCID: PMC9320035 DOI: 10.3390/jpm12071088] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022] Open
Abstract
Individuals with spinal cord injuries (SCI) commonly present with component risk factors for cardiometabolic risk and combined risk factors for cardiometabolic syndrome (CMS). These primary risk factors include obesity, dyslipidemia, dysglycemia/insulin resistance, and hypertension. Commonly referred to as "silent killers", cardiometabolic risk and CMS increase the threat of cardiovascular disease, a leading cause of death after SCI. This narrative review will examine current data and the etiopathogenesis of cardiometabolic risk, CMS, and cardiovascular disease associated with SCI, focusing on pivotal research on cardiometabolic sequelae from the last five years. The review will also provide current diagnosis and surveillance criteria for cardiometabolic disorders after SCI, a novel obesity classification system based on percent total body fat, and lifestyle management strategies to improve cardiometabolic health.
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Affiliation(s)
- Gary J. Farkas
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Miami Miller, Miami, FL 33136, USA; (A.S.); (D.R.G.J.)
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33136, USA;
| | - Adam M. Burton
- School of Medicine, University of Miami Miller, Miami, FL 33136, USA;
| | - David W. McMillan
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33136, USA;
- The Miami Project to Cure Paralysis, School of Medicine, University of Miami Miller, Miami, FL 33136, USA
| | - Alicia Sneij
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Miami Miller, Miami, FL 33136, USA; (A.S.); (D.R.G.J.)
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33136, USA;
| | - David R. Gater
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Miami Miller, Miami, FL 33136, USA; (A.S.); (D.R.G.J.)
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33136, USA;
- School of Medicine, University of Miami Miller, Miami, FL 33136, USA;
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7
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Valentino SE, Hutchinson MJ, Goosey-Tolfrey VL, MacDonald MJ. The effects of perceptually regulated exercise training on cardiorespiratory fitness and peak power output in adults with spinal cord injury: a systematic review and meta-analysis. Arch Phys Med Rehabil 2022; 103:1398-1409. [DOI: 10.1016/j.apmr.2022.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/22/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022]
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Pebdani RN, Leon J, Won DS, deLeon RD, Dy CJ, Forsyth R, Keslacy S. "It Helps Me With Everything": A Qualitative Study of the Importance of Exercise for Individuals With Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2022; 28:176-184. [PMID: 35521059 PMCID: PMC9009197 DOI: 10.46292/sci21-00049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background The influence of exercise after spinal cord injury (SCI) is a topic important to both clinicians and researchers. The impact of exercise for individuals with SCI is often studied quantitively, with a large focus on the physiological adaptations to exercise intervention. Objectives This study explores individualized experiences of exercise for people with SCI. Methods A phenomenological approach was utilized to qualitatively study the experiences of exercise for 16 individuals with SCI. Results Participants described multiple benefits of exercise, including increased independence, improved mental health, and increased engagement in social activity. Conclusion This study provides novel information about attitudes toward exercise held by individuals with SCI and a more thorough understanding of concepts that are well researched.
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Affiliation(s)
- Roxanna N. Pebdani
- The University of Sydney, Centre for Disability Research and Policy, School of Health Sciences, Faculty of Medicine and Health, Sydney, Australia
| | - Jesus Leon
- Division of Special Education and Counseling, California State University, Los Angeles
| | - Deborah S. Won
- Department of Electrical and Computer Engineering, California State University, Los Angeles
| | - Ray D. deLeon
- School of Kinesiology, California State University, Los Angeles
| | - Christine J. Dy
- School of Kinesiology, California State University, Los Angeles
| | - Rowena Forsyth
- The University of Sydney, Biomedical Informatics and Digital Health, School of Medical Sciences, Sydney, Australia
| | - Stefan Keslacy
- School of Kinesiology, California State University, Los Angeles
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Hansen RK, Samani A, Laessoe U, Larsen RG, Cowan RE. Sociodemographic characteristics associated with physical activity barrier perception among manual wheelchair users. Disabil Health J 2021; 14:101119. [PMID: 34099418 DOI: 10.1016/j.dhjo.2021.101119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/19/2021] [Accepted: 05/14/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Individuals with disabilities are sub-optimally active and at increased risk for chronic diseases. Limited knowledge exists about how differences among wheelchair-dependent individuals may affect their perception of physical activity barriers. OBJECTIVE We examined whether the perception of physical activity barriers are associated with wheelchair user sociodemographic characteristics. METHODS Danish manual wheelchair users (MWCUs) (N = 181; 52.5% females, mean ± SD: age 48 ± 14 yrs) completed the 'Barriers to Physical Activity Questionnaire for People with Mobility Impairments' (BPAQ-MI) online. The BPAQ-MI queries physical activity barriers in four domains (intrapersonal, interpersonal, organizational, and community) and eight subdomains. Participant characteristics evaluated as potentially associated with physical activity barriers included age, sex, years in chair, body mass index (BMI), spinal cord injury (SCI) (if any), education, employment, and resident city size. Simple linear regression (step 1) and multiple regression models (step 2) were created to assess associations between MWCU characteristics and barriers. RESULTS Multiple regression models revealed that MWCUs who were obese, who did not complete high school, or were unemployed rated physical activity barriers higher across several subdomains (all r2≤0.226, p<0.05). Resident city size was associated with safety subdomain barrier impact (r2=0.039, p<0.05). Sex, age, years in chair and SCI were not associated with any barrier domains (all p ≥ 0.064). CONCLUSIONS Our results provide new evidence that MWCUs with BMI ≥30; who are not employed; or who only have completed high school, may need special consideration and resources to overcome distinct physical activity barriers. Behavioral strategies and interventions focusing on reducing physical activity barriers should be tailored to the individuals above.
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Affiliation(s)
- Rasmus K Hansen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; Department of Research and Development, University College of Northern Jutland (UCN), Aalborg, Denmark.
| | - Afshin Samani
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Uffe Laessoe
- Department of Research and Development, University College of Northern Jutland (UCN), Aalborg, Denmark; Physical Therapy Department, University College of Northern Jutland (UCN), Aalborg, Denmark
| | - Ryan G Larsen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Rachel E Cowan
- Department of Physical Medicine and Rehabilitation, The University of Alabama at Birmingham, Birmingham, AL, USA
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FARROW MATTHEWT, MAHER JENNIFERL, NIGHTINGALE TOME, THOMPSON DYLAN, BILZON JAMESLJ. A Single Bout of Upper-Body Exercise Has No Effect on Postprandial Metabolism in Persons with Chronic Paraplegia. Med Sci Sports Exerc 2021; 53:1041-1049. [PMID: 33560775 PMCID: PMC8048731 DOI: 10.1249/mss.0000000000002561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The acute effects of a single bout of upper-body exercise on postprandial metabolism in persons with spinal cord injury are currently not well understood. The primary aim of this study was to evaluate the effects of a single bout of upper-body high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) in comparison with a no-exercise control (REST) condition on postprandial metabolic responses in persons with chronic paraplegia. METHODS Ten participants (eight males, two females; age, 49 ± 10 yr; time since injury, 22 ± 13 yr) with chronic paraplegia took part in a randomized crossover study, consisting of three trials: HIIE (8 × 60 s at 70% peak power output [PPEAK]), MICE (25 min at 45% PPEAK), and REST, at least 3 d apart. Exercise was performed in the fasted state, and participants consumed a mixed-macronutrient liquid meal 1-h postexercise. Venous blood and expired gas samples were collected at regular intervals for 6-h postmeal consumption. RESULTS There were no significant differences in postprandial incremental area under the curve for triglycerides (P = 0.59) or glucose (P = 0.56) between conditions. Insulin incremental area under the curve tended to be lower after MICE (135 ± 85 nmol·L-1 per 360 min) compared with REST (162 ± 93 nmol·L-1 per 360 min), but this did not reach statistical significance (P = 0.06, d = 0.30). Participants reported a greater fondness (P = 0.04) and preference for HIIE over MICE. CONCLUSIONS After an overnight fast, a single bout of upper-body exercise before eating has no effect on postprandial metabolism in persons with chronic paraplegia, irrespective of exercise intensity. This suggests that alternative exercise strategies may be required to stimulate postprandial substrate oxidation for this population.
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Affiliation(s)
- MATTHEW T. FARROW
- Department for Health, Centre for Clinical Rehabilitation and Exercise Medicine (CREM), University of Bath, Bath, UNITED KINGDOM
- Department for Health, Centre for Nutrition and Exercise Metabolism (CNEM), University of Bath, Bath, UNITED KINGDOM
- Centre for the Analysis of Motion, Entertainment Research and Applications (CAMERA), University of Bath, Bath, UNITED KINGDOM
| | - JENNIFER L. MAHER
- Department for Health, Centre for Clinical Rehabilitation and Exercise Medicine (CREM), University of Bath, Bath, UNITED KINGDOM
- Department for Health, Centre for Nutrition and Exercise Metabolism (CNEM), University of Bath, Bath, UNITED KINGDOM
| | - TOM E. NIGHTINGALE
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UNITED KINGDOM
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, CANADA
| | - DYLAN THOMPSON
- Department for Health, Centre for Clinical Rehabilitation and Exercise Medicine (CREM), University of Bath, Bath, UNITED KINGDOM
- Department for Health, Centre for Nutrition and Exercise Metabolism (CNEM), University of Bath, Bath, UNITED KINGDOM
| | - JAMES L. J. BILZON
- Department for Health, Centre for Clinical Rehabilitation and Exercise Medicine (CREM), University of Bath, Bath, UNITED KINGDOM
- Department for Health, Centre for Nutrition and Exercise Metabolism (CNEM), University of Bath, Bath, UNITED KINGDOM
- Centre for the Analysis of Motion, Entertainment Research and Applications (CAMERA), University of Bath, Bath, UNITED KINGDOM
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Impact of Flexible Work Arrangements, Self-Efficacy, and Barriers on Daily Physical Activity Among University Staff. J Phys Act Health 2021; 18:594-602. [PMID: 33811186 DOI: 10.1123/jpah.2020-0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little is known about the link between flexible work arrangements and health behaviors, such as physical activity. This study aimed to explore how self-efficacy and daily barriers to physical activity influence daily levels of physical activity on workdays when university staff members used a flexible work arrangement (flextime or telework). METHODS Full-time university staff employees (N = 61, mean age = 41; 89% female) participated in this daily diary study. Participants completed an initial survey followed by daily surveys over the course of one workweek, resulting in 281 diary days. RESULTS The most frequently reported barriers to physical activity were as follows: lack of time, feeling tired, and not enough motivation. Multilevel models revealed that as the number of barriers increased, minutes of physical activity significantly decreased. Self-efficacy was not significantly related to daily physical activity. Participants reported fewer minutes of physical activity on flextime workdays compared to days when a flexible work arrangement was not used (ie, traditional workday). Daily use of a flexible work arrangement did not moderate the association between barriers and physical activity. CONCLUSIONS This study illustrated the influence of daily barriers and flextime workdays on physical activity levels, which can inform workplace health programs for university staff.
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12
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Nash MS, Gater DR. Cardiometabolic Disease and Dysfunction Following Spinal Cord Injury. Phys Med Rehabil Clin N Am 2020; 31:415-436. [DOI: 10.1016/j.pmr.2020.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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13
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Predicting physical activity in university students with disabilities: The role of social ecological barriers in the theory of planned behaviour. Disabil Health J 2019; 12:574-580. [PMID: 31266729 DOI: 10.1016/j.dhjo.2019.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 05/29/2019] [Accepted: 06/18/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Even though university students with disabilities are less active than their peers without disabilities, there is scarce knowledge on the predictors of physical activity (PA) in this population. OBJECTIVES To predict PA in Spanish university students with disabilities using the Theory of Planned Behaviour (TPB) and to examine the role of social ecological barriers within this theoretical framework. METHODS Participants (N = 1079; Mean age = 40.12) for this cross-sectional study were recruited through the disability care services of 55 Spanish universities. The TPB constructs were assessed using a questionnaire. The Spanish short form of the International Physical Activity Questionnaire was used to measure PA and the reduced Spanish version of the Barriers to Physical Activity for People with Mobility Impairments was used to measure social ecological barriers. RESULTS Two different models were computed through path analysis. Model 1 included the traditional TPB constructs and model 2 added a social ecological barriers variable. In both models, attitudes (β = 0.152; β = 0.152), subjective norms (β = 0.114; β = 0.115) and self-efficacy (β = 0.657; β = 0.659) each predicted PA intentions. PA intentions (β = 0.118; β = 0.122), self-efficacy (β = 0.225; β = 0.207) and controllability (β = 0.098; β = 0.075) predicted PA. In model 2, social ecological barriers predicted PA (β = 0.099). Regression analyses revealed intrapersonal barriers as a significant predictor of self-efficacy (β = -0.441). Controllability was predicted by intrapersonal barriers (β = -0.265), community barriers (β = -0.100) and organizational barriers (β = -0.095). CONCLUSIONS Future PA behaviour change interventions should target intentions, self-efficacy and controllability, since they directly predicted PA. These interventions would benefit from considering social ecological barriers to PA.
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Kooijmans H, Post M, Motazedi E, Spijkerman D, Bongers-Janssen H, Stam H, Bussman H. Exercise self-efficacy is weakly related to engagement in physical activity in persons with long-standing spinal cord injury. Disabil Rehabil 2019; 42:2903-2909. [PMID: 30907149 DOI: 10.1080/09638288.2019.1574914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aims: Many people with a long-standing spinal cord injury have an inactive lifestyle. Although exercise self-efficacy is considered a key determinant of engaging in exercise, the relationship between exercise self-efficacy and physical activity remains unclear. Therefore, this study examines the relationship between exercise self-efficacy and the amount of physical activity in persons with long-standing spinal cord injury.Methods: This cross-sectional study included 268 individuals (aged 28-65 years) with spinal cord injury ≥ 10 years and using a wheelchair. Physical activity was measured with the Physical Activity Scale for Individuals with Physical Disabilities. Exercise self-efficacy was assessed with the Spinal cord injury Exercise Self-Efficacy Scale. Univariate and multivariable regression analyses were performed to test for the association between exercise self-efficacy and physical activity, controlling for supposed confounders.Results: Univariate regression analysis revealed that exercise self-efficacy was significantly related to the level of daily physical activity (β = 0.05; 95% CI 0.04-0.07; 15% explained variance; p < 0.001). In multivariable regression analysis exercise self-efficacy remained, explaining a significant additional amount of the variance (2%; p < 0.001) of physical activity.Conclusion: Exercise-self efficacy is a weak but independent explanatory factor of the level of physical activity among persons with long-standing spinal cord injury. Longitudinal trials are needed to study the impact of interventions targeting an increase of exercise self-efficacy on the amount of physical activity performed.Implications for rehabilitationPre-intervention levels of exercise-self-efficacy might mediate the effectiveness of interventions that aim at increasing physical activities in people with a long-standing spinal cord injury.Enhancing exercise-self efficacy may improve levels of physical activity, even in people with a long-standing spinal cord injury.When it comes to enhancing physical activity, efforts to enhance non-structured daily physical activities such as household activities and gardening might be as important as efforts to enhance sports and other physical exercise.
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Affiliation(s)
| | - Marcel Post
- De Hoogstraat Center of Excellence in Rehabilitation Medicine, Utrecht, Netherlands
| | - Ehsan Motazedi
- Plant Sciences Group, Wageningen University and Research, Wageningen, Netherlands
| | | | | | - Henk Stam
- Erasmus MC, Rehabilitation Medicine, Rotterdam, Netherlands
| | - Hans Bussman
- Erasmus MC, Rehabilitation Medicine, Rotterdam, Netherlands
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Tai PA, Hsu YJ, Huang WC, Chang CH, Chen YH, Huang CC, Wei L. Congenital exercise ability ameliorates muscle atrophy but not spinal cord recovery in spinal cord injury mouse model. Int J Med Sci 2019; 16:1549-1556. [PMID: 31839742 PMCID: PMC6909809 DOI: 10.7150/ijms.37442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 09/11/2019] [Indexed: 12/24/2022] Open
Abstract
Spinal cord injury (SCI) can cause loss of mobility in the limbs, and no drugs, surgical procedures, or rehabilitation strategies provide a complete cure. Exercise capacity is thought to be associated with the causes of many diseases. However, no studies to date have assessed whether congenital exercise ability is related to the recovery of spinal cord injury. High congenital exercise ability (HE) and low congenital exercise ability (LE) mice were artificially bred from the same founder ICR mice. The HE and LE groups still exhibited differences in exercise ability after 13 generations of breeding. Histological staining and immunohistochemistry staining indicated no significant differences between the HE and LE groups on recovery of the spinal cord. In contrast, after SCI, the HE group exhibited better mobility in gait analysis and longer endurance times in the exhaustive swimming test than the LE group. In addition, after SCI, the HE group also exhibited less atrophy than the LE group, and no inflammatory cells appeared. In conclusion, we found that high congenital exercise ability may reduce the rate of muscle atrophy. This result can be applied to sports science and rehabilitation science as a reference for preventive medicine research.
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Affiliation(s)
- Po-An Tai
- Division of Neurosurgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan.,Department of Surgery, School of Medicine, Buddhist Tzu Chi University, Hualien County 97004, Taiwan
| | - Yi-Ju Hsu
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Wen-Ching Huang
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan
| | - Chun-Hao Chang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Yi-Hsun Chen
- Graduate Institute of Veterinary Pathobiology, National Chung Hsin University, Taichung, 402, Taiwan
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Li Wei
- Division of Neurosurgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan.,Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
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Nash MS, Bilzon JLJ. Guideline Approaches for Cardioendocrine Disease Surveillance and Treatment Following Spinal Cord Injury. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2018; 6:264-276. [PMID: 30546969 PMCID: PMC6267529 DOI: 10.1007/s40141-018-0203-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW Persons with spinal cord injuries (SCI) commonly experience individual risks and coalesced health hazards of the cardiometabolic syndrome (CMS). This review will examinethe role of exercise and nutritional intervention as countermeasures to these disease risks. RECENT FINDINGS The CMS hazards of overweight/obesity, insulin resistance, hypertension, and dyslipidemia are strongly associated with physical deconditioning and are common after SCI. Both the CMS diagnosis and physical deconditioning worsen the prognosis for all-cause cardiovascular disease occurring early after SCI. Evidence supports a therapeutic role for physical activity after SCI as an effective countermeasure to these risks and often represents the first-line approach to CMS abatement. This evidence is supported by authoritative systematic reviews and associated guidelines that recommend specific activities, frequencies, and activities of work. In many cases, the most effective exercise programming uses more intense periods of work with limited rest. As SCI is also associated with poor dietary habits, including excessive energy intake and saturated fat consumption, more comprehensive lifestyle management incorporating both exercise and nutrition represents a preferred approach for overall health management. SUMMARY Irrespective of the interventional strategy, improved surveillance of the population for CMS risks and encouraged incorporation of exercise and nutritional management according to recent population-specific guidelines will most likely play an important role in the preservation of activity, optimal health, and independence throughout the lifespan.
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Affiliation(s)
- Mark S. Nash
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL USA
- Departments of Neurological Surgery and Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, FL USA
| | - James L. J. Bilzon
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL USA
- Department for Health, University of Bath, Bath, Somerset UK
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Nightingale TE, Rouse PC, Walhin JP, Thompson D, Bilzon JL. Home-Based Exercise Enhances Health-Related Quality of Life in Persons With Spinal Cord Injury: A Randomized Controlled Trial. Arch Phys Med Rehabil 2018; 99:1998-2006.e1. [DOI: 10.1016/j.apmr.2018.05.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 10/14/2022]
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Norris M, Poltawski L, Calitri R, Shepherd AI, Dean SG. Acceptability and experience of a functional training programme (ReTrain) in community-dwelling stroke survivors in South West England: a qualitative study. BMJ Open 2018; 8:e022175. [PMID: 30049699 PMCID: PMC6067351 DOI: 10.1136/bmjopen-2018-022175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/18/2018] [Accepted: 06/11/2018] [Indexed: 11/10/2022] Open
Abstract
Rehabilitation Training (ReTrain) is a group-based approach to functional training post stroke. ReTrain has recently been evaluated through a pilot randomised controlled trial. OBJECTIVE This article reports on the acceptability of the intervention as described by trial participants. DESIGN A qualitative approach was undertaken. Of the 45 participants recruited into the trial, 23 were randomised to receive ReTrain. Following a sampling strategy, 10 participants undertook 1:1 semistructured audio-recorded interviews. Transcripts were analysed following a modified Framework Approach. RESULTS Six themes were developed including exploration of: the physical and psychological impacts of training,the perceived mechanisms of change, the interaction of the group and approach of the trainer. A further theme considered the reported longer term impact of participation. Overall, the results indicated the acceptability of the intervention, but also key areas for potential modification in the definitive trial. These include a need to consider potential impact on both physical and psychological function, careful consideration of dosing and fatigue and the interpersonal factors that facilitate appropriate level of delivery, the trainer to participant ratio, and enhancing features that support continuation of activity postintervention. CONCLUSION Overall, this study supports the acceptability of ReTrain and the development of a definitive trial evaluation of this intervention to full. TRIAL REGISTRATION NUMBER NCT02429180.
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Affiliation(s)
| | | | | | - Anthony I Shepherd
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
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19
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Hug K, Stumm C, Debecker I, Fellinghauer CS, Peter C, Hund-Georgiadis M. Self-Efficacy and Pressure Ulcer Prevention After Spinal Cord Injury-Results From a Nationwide Community Survey in Switzerland (SwiSCI). PM R 2017; 10:573-586. [DOI: 10.1016/j.pmrj.2017.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/30/2017] [Accepted: 11/29/2017] [Indexed: 11/17/2022]
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Bisson T, Newsam CJ. Short-duration, high-intensity bouts of physical therapy to increase self-efficacy, confidence, and function in an individual with incomplete spinal cord injury: A case report. Physiother Theory Pract 2017; 33:888-895. [PMID: 28792298 DOI: 10.1080/09593985.2017.1357155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
High intensity and frequency of task-specific practice is required to produce functional change in individuals with neurologic conditions. Self-efficacy is an important predictor of engagement in physical activity in individuals with spinal cord injury. Combining these two rehabilitation concepts has the potential for lasting functional improvement. The purpose of this case report is to describe the management of a patient with incomplete spinal cord injury (iSCI) using a model of concentrated bouts of physical therapy with an emphasis on techniques to increase self-efficacy. The patient is a 70-yr old female who sustained C5/C6 vertebral fractures in a fall, resulting in incomplete tetraplegia. She participated in a pilot program of 1 week of intensive physical therapy every 10-12 weeks over the course of 5.5 months. Interventions included functional activities important to the patient, therapeutic exercise, and home exercise program. Confidence and self-efficacy were shaped using patient-directed discussions and active problem solving. The patient improved on all measures of gait, balance, and participation, and also reported increased confidence and self-management of her condition. A high-intensity, periodic model of care delivery combined with a capacity-building approach may be an effective method to improve confidence, motivation, and function in persons with iSCI.
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Affiliation(s)
- Teresa Bisson
- a Department of Physical Therapy , Rancho Los Amigos National Rehabilitation Center , Downey , CA , USA.,b Program in Physical Therapy, University of Minnesota , Minneapolis , MN , USA
| | - Craig J Newsam
- c Doctor of Physical Therapy, Mount Saint Mary's University , Los Angeles , CA , USA
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21
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What do patients value about spinal manipulation and home exercise for back-related leg pain? A qualitative study within a controlled clinical trial. ACTA ACUST UNITED AC 2016; 26:183-191. [PMID: 27705840 DOI: 10.1016/j.math.2016.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/15/2016] [Accepted: 09/20/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patient perceptions may influence the effectiveness and utilization of healthcare interventions, particularly for complex health conditions such as sciatica or back-related leg pain (BRLP). OBJECTIVES To explore BRLP patients' perceptions of spinal manipulative therapy (SMT) and home exercise with advice (HEA). DESIGN Qualitative study in a controlled clinical trial. METHOD Semi-structured interviews conducted after 12 weeks of treatment asked participants about satisfaction with care and whether treatment was worthwhile. An interdisciplinary research team conducted content analysis using qualitative data analysis software to identify and summarize themes. RESULTS Of 192 trial participants, 174 (91%) completed interviews (66% female, age 57.0 ± 11.5 years). Participants identified interactions with providers and staff, perceived treatment effects, and information as key contributors to both their satisfaction and the worthwhile nature of treatment. HEA was liked for its convenience and ability to foster an exercise habit. SMT was liked for specific aspects of the modality (e.g. manipulation, stretching) and provider competency. Most participants reported no dislikes for SMT or HEA, but some noted the dose/time commitment for SMT and discipline of HEA as least liked aspects of the interventions. CONCLUSIONS The quality of patient-provider interactions, perceived treatment effects, and information sharing influenced BRLP patients' satisfaction with care. Qualitative research describing patients' preferences can facilitate translation of study findings into practice and allow clinicians to tailor treatments to facilitate compliance and satisfaction with care.
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Zbogar D, Eng JJ, Miller WC, Krassioukov AV, Verrier MC. Reliability and validity of daily physical activity measures during inpatient spinal cord injury rehabilitation. SAGE Open Med 2016; 4:2050312116666941. [PMID: 27635252 PMCID: PMC5011392 DOI: 10.1177/2050312116666941] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/03/2016] [Indexed: 11/22/2022] Open
Abstract
Objectives: To assess the test–retest reliability and convergent validity of daily physical activity measures during inpatient spinal cord injury rehabilitation. Design: Observational study. Setting: Two inpatient spinal cord injury rehabilitation centres. Subjects: Participants (n = 106) were recruited from consecutive admissions to rehabilitation. Methods: Physical activity during inpatient spinal cord injury rehabilitation stay was recorded on two days via (1) wrist accelerometer, (2) hip accelerometer if ambulatory, and (3) self-report (Physical Activity Recall Assessment for People with Spinal Cord Injury questionnaire). Spearman’s correlations and Bland–Altman plots were utilized for test–retest reliability. Correlations between physical activity measures and clinical measures (functional independence, hand function, and ambulation) were performed. Results: Correlations for physical activity measures between Day 1 and Day 2 were moderate to high (ρ = 0.53–0.89). Bland–Altman plots showed minimal bias and more within-subject differences in more active individuals and wide limits of agreement. None of these three physical activity measures correlated with one another. A moderate correlation was found between wrist accelerometry counts and grip strength (ρ = 0.58) and between step counts and measures of ambulation (ρ = 0.62). Functional independence was related to wrist accelerometry (ρ = 0.70) and step counts (ρ = 0.56), but not with self-report. Conclusion: The test–retest reliability and convergent validity of the instrumented measures suggest that wrist and hip accelerometers are appropriate tools for use in research studies of daily physical activity in the spinal cord injury rehabilitation setting but are too variable for individual use.
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Affiliation(s)
- Dominik Zbogar
- Rehabilitation Research Lab, GF Strong Rehabilitation Centre, The University of British Columbia, Vancouver, BC, Canada
| | - Janice J Eng
- Rehabilitation Research Lab, GF Strong Rehabilitation Centre, The University of British Columbia, Vancouver, BC, Canada
| | | | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries, The University of British Columbia, Vancouver, BC, Canada
| | - Mary C Verrier
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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Associations with being physically active and the achievement of WHO recommendations on physical activity in people with spinal cord injury. Spinal Cord 2016; 55:235-243. [DOI: 10.1038/sc.2016.126] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/12/2016] [Accepted: 07/14/2016] [Indexed: 11/09/2022]
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Kljajić D, Eminović F, Dopsaj M, Pavlović D, Arsić S, Otašević J. The Impact Of Sports Activities On Quality Of Life Of Persons With A Spinal Cord Injury: VPLIV ŠPORTNIH AKTIVNOSTI NA KAKOVOST ŽIVLJENJA OSEB S POŠKODBO HRBTENJAČE. Zdr Varst 2016; 55:94-101. [PMID: 27284378 PMCID: PMC4845769 DOI: 10.1515/sjph-2016-0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 11/13/2015] [Indexed: 11/29/2022] Open
Abstract
Objectives Studying the quality of life of people with a spinal cord injury is of great importance as it allows the monitoring of both functioning and adaptation to disability. The aim of this study was to determine the difference between persons with a spinal cord injury involved in sports activities and those not involved in sports activities in relation to their quality of life and the presence of secondary health conditions (pressure ulcers, urinary infections, muscle spasms, osteoporosis, pain, kidney problems-infections, calculosis and poor circulation). Methods The study included a total of 44 participants with spinal cord injury-paraplegia of both genders; 26 of them were athletes and 18 were not athletes. The athletes were training actively for the last two years, minimally 2-3 times per week. A specially designed questionnaire, medical documentation and the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23) were used for research purposes. Chi-square test was used to analyze the differences between the groups, while multiple analysis of variance (MANOVA) was used to determine the differences between the sets of variables. Results Among the participants, the athletes perceived higher quality of life than the non-athletes (male gender p<0.001 and female gender p<0.05). Regarding secondary health conditions, the athletes reported the presence of less pain (p=0.034) and a subjective feeling of better circulation (p=0.023). Conclusion The implementation of sports activities significantly improves quality of life in the population of people with spinal cord injury-paraplegia. However, sports activities only partially affect secondary health conditions.
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Affiliation(s)
- Dragana Kljajić
- Higher Education School of Professional Health Studies, Cara Dušana 254, 11000 Belgrade, Serbia
| | - Fadilj Eminović
- University of Belgrade, Faculty of Special Education and Rehabilitation, Visokog Stevana 2, 11000 Belgrade, Serbia
| | - Milivoj Dopsaj
- University of Belgrade, Faculty of Sport and Physical Education, Blagoja Parovića 156, 11000 Belgrade, Serbia Received: Nov 6, 2014
| | - Dragan Pavlović
- University of Belgrade, Faculty of Special Education and Rehabilitation, Visokog Stevana 2, 11000 Belgrade, Serbia
| | - Sladjana Arsić
- University of Belgrade, Faculty of Special Education and Rehabilitation, Visokog Stevana 2, 11000 Belgrade, Serbia
| | - Jadranka Otašević
- University of Belgrade, Faculty of Special Education and Rehabilitation, Visokog Stevana 2, 11000 Belgrade, Serbia
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Nooijen CFJ, Post MWM, Spooren AL, Valent LJ, Broeksteeg R, Sluis TA, Stam HJ, van den Berg-Emons RJG. Exercise self-efficacy and the relation with physical behavior and physical capacity in wheelchair-dependent persons with subacute spinal cord injury. J Neuroeng Rehabil 2015; 12:103. [PMID: 26586130 PMCID: PMC4653935 DOI: 10.1186/s12984-015-0099-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 11/16/2015] [Indexed: 11/30/2022] Open
Abstract
Background Since physical activity and exercise levels are known to be generally low in persons with spinal cord injury (SCI), there seems to be a need for intervention. Exercise self-efficacy (ESE), the confidence persons have in their ability to be physically active and exercise, is an important and modifiable predictor of physical behavior. The goal of this study was to 1) describe ESE in persons with subacute SCI, 2) to assess ESE in subgroups based on demographic and lesion characteristics, and 3) to explore the relation between ESE and physical behavior and physical capacity. Methods Thirthy-seven persons with subacute SCI who are wheelchair dependent participated. Participants completed the Exercise Self-Efficacy Scale. We recorded age and lesion characteristics, measured physical behavior (physical activity, motility and sedentary day time, n = 35) with an accelerometer-based activity monitor and measured physical capacity (peak power output, n = 28 and peak oxygen uptake, n = 24) during a maximal hand-cycling test. Measurements were performed 2 months prior to discharge from inpatient rehabilitation. Mann-Whitney tests were used to test for differences between subgroups based on age and lesion characteristics and spearman correlations were used to assess the relation between ESE and physical activity and physical capacity. Results Persons with tetraplegia had lower ESE compared to persons with paraplegia (Z = −1.93, p = 0.05). No differences in ESE were found between subgroups based on age and motor completeness of the lesion. In persons with paraplegia, ESE was positively related to peak power output (ρ = 0.58, p = 0.02). The relation of ESE with wheeled physical activity was ρ = 0.36, p = 0.09. Conclusions In persons with SCI who are dependent on a manual wheelchair, lesion level when categorized as paraplegic and tetraplegic affected ESE whereas age categories and completeness categories did not. Persons with tetraplegia were found to have lower confidence with regard to physical activity and exercise indicating that this subgroup can benefit from extra attention in the promotion of physical activity and exercise. In persons with paraplegia, ESE seemed to be lower in persons with less peak power output and less daily physical activity.
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Affiliation(s)
- Carla F J Nooijen
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Marcel W M Post
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands. .,Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, Groningen, The Netherlands. .,University Medical Center Groningen, Groningen, The Netherlands.
| | - Annemie L Spooren
- Adelante Center of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands. .,CAPHRI School for Public Health and Primary Care, Department of Rehabilitation Medicine, Maastricht University, Maastricht, Netherlands.
| | - Linda J Valent
- Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands.
| | | | - Tebbe A Sluis
- Rijndam Rehabilitation Institute, Rotterdam, The Netherlands.
| | - Henk J Stam
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | | | - Rita J G van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
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Kratz AL, Chadd E, Jensen MP, Kehn M, Kroll T. An examination of the psychometric properties of the community integration questionnaire (CIQ) in spinal cord injury. J Spinal Cord Med 2015; 38:446-55. [PMID: 24621050 PMCID: PMC4612200 DOI: 10.1179/2045772313y.0000000182] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To examine the psychometric properties of the Community Integration Questionnaire (CIQ) in large samples of individuals with spinal cord injury (SCI). DESIGN Longitudinal 12-month survey study. SETTING Nation-wide, community dwelling. PARTICIPANTS Adults with SCI: 627 at Time 1, 494 at Time 2. INTERVENTIONS Not applicable. OUTCOME MEASURES The CIQ is a 15-item measure developed to measure three domains of community integration in individuals with traumatic brain injury: home integration, social integration, and productive activity. SCI consumer input suggested the need for two additional items assessing socializing at home and internet/email activity. RESULTS Exploratory factor analyses at Time 1 indicated three factors. Time 2 confirmatory factor analysis did not show a good fit of the 3-factor model. CIQ scores were normally distributed and only the Productive subscale demonstrated problems with high (25%) ceiling effects. Internal reliability was acceptable for the Total and Home scales, but low for the Social and Productive activity scales. Validity of the CIQ is suggested by significant differences by sex, age, and wheelchair use. CONCLUSIONS The factor structure of the CIQ was not stable over time. The CIQ may be most useful for assessing home integration, as this is the subscale with the most scale stability and internal reliability. The CIQ may be improved for use in SCI by including items that reflect higher levels of productive functioning, integration across the life span, and home- and internet-based social functioning.
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Affiliation(s)
- Anna L. Kratz
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA,Correspondence to: Anna L. Kratz, Department of Physical Medicine & Rehabilitation, University of Michigan, 325 E. Eisenhower Parkway, Suite 300, Ann Arbor, MI 48108, USA.
| | - Edmund Chadd
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | | | - Matthew Kehn
- Mathematica Policy Research, Washington, DC, USA
| | - Thilo Kroll
- Social Dimensions of Health Institute (SDHI), Universities of Dundee & St Andrews, Dundee, UK
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Guicciardi M, Lecis R, Anziani C, Corgiolu L, Porru A, Pusceddu M, Spanu F. Type 2 diabetes mellitus, physical activity, exercise self-efficacy, and body satisfaction. An application of the transtheoretical model in older adults. Health Psychol Behav Med 2014; 2:748-758. [PMID: 25750816 PMCID: PMC4346010 DOI: 10.1080/21642850.2014.924858] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 04/08/2014] [Indexed: 11/08/2022] Open
Abstract
Physical activity (PA) is a relevant component of the treatment of Type 2 diabetes mellitus (T2DM). However, to prevent its related morbidities, PA requires an immediate and lasting change of lifestyle. Exercise self-efficacy and body satisfaction were used in a sample of older adults with T2DM, classified in different stages of change, to predict levels of PA. Results show that exercise self-efficacy increases linearly from precontemplation to maintenance stage, while body satisfaction shows an inverted U shape. However, only stages of change, other than exercise self-efficacy, add a significant and noticeable contribution to prediction of levels of PA. This evidence claims a tailored approach to PA in older adults with T2DM and advises behavioural health interventions based on exercise self-efficacy.
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Affiliation(s)
- Marco Guicciardi
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari , Via Is Mirrionis, 1, 09123 Cagliari , Italy
| | - Romina Lecis
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari , Via Is Mirrionis, 1, 09123 Cagliari , Italy
| | - Chiara Anziani
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari , Via Is Mirrionis, 1, 09123 Cagliari , Italy
| | - Lucina Corgiolu
- Group Physical Activity Project, Centre of Diabetology, San Giovanni University Hospital , Via Ospedale 46, 09124 Cagliari , Italy
| | - Adele Porru
- Group Physical Activity Project, Centre of Diabetology, San Giovanni University Hospital , Via Ospedale 46, 09124 Cagliari , Italy
| | - Matteo Pusceddu
- Group Physical Activity Project, Centre of Diabetology, San Giovanni University Hospital , Via Ospedale 46, 09124 Cagliari , Italy
| | - Francesca Spanu
- Group Physical Activity Project, Centre of Diabetology, San Giovanni University Hospital , Via Ospedale 46, 09124 Cagliari , Italy
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Direct referral and physical activity counselling upon discharge from spinal cord injury rehabilitation. Spinal Cord 2014; 52:392-5. [PMID: 24534780 DOI: 10.1038/sc.2014.16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/15/2014] [Accepted: 01/20/2014] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Sixteen-week follow-up study. OBJECTIVE To evaluate the efficacy of referral from a health-care provider to regular exercise combined with 16 weeks of counselling support following discharge from inpatient or outpatient spinal cord injury (SCI) rehabilitation. SETTING Two rehabilitation centres in Canada. METHODS Seventeen participants (age 42.1±10.6 years, C3-T12, ASIA impairment score A-C) were recruited at discharge from inpatient (n=9; 5.2±1.3 months post-injury) or outpatient (n=8; 14.2±3.8 months post-injury) rehabilitation and were given a referral for regular exercise. Telephone counselling support was provided and adherence to the prescribed program was monitored for 16 weeks. RESULTS There was a nonsignificant difference in exercise adherence rates (percentage of available sessions attended) between participants discharged from inpatient (71.4±44.9%) and those from outpatient (39.5±27.2%) rehabilitation programs. The most common barriers to participation were physical health problems (50%) and transportation (36%). An exercise beliefs questionnaire revealed that participants value exercise at discharge from rehabilitation, despite the common report of a relative lack of confidence in their ability to perform or adapt aerobic and resistance exercises to their specific capabilities. CONCLUSION A system of direct referral and ongoing counselling support following discharge from either inpatient or outpatient SCI rehabilitation appears to encourage sustained participation, although future health promotion strategies should continue to provide specific information about how to adapt and complete aerobic and resistance exercises. SPONSORSHIP Rick Hansen Institute and Ontario Neurotrauma Foundation.
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Yang SO, Jeong GH, Kim SJ, Lee SH. Correlates of self-care behaviors among low-income elderly women with hypertension in South Korea. J Obstet Gynecol Neonatal Nurs 2013; 43:97-106. [PMID: 24354464 DOI: 10.1111/1552-6909.12265] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To identify correlates of self-care behaviors among elderly, low-income Korean women with hypertension. RESEARCH DESIGN A secondary analysis of data from a community-based intervention trial for hypertension control. SETTING Three community health posts in the Gangwon province, South Korea. PARTICIPANTS Two hundred thirty-four (234) low-income elderly women (age 60-93) who had previously participated in a community-based intervention trial for hypertension control. METHODS The researchers collected data that included patient background characteristics, hypertension self-care behavior, self-efficacy of hypertension control, general knowledge of hypertension, and social support. The data were analyzed using descriptive and inferential statistics, including hierarchical regression analysis. RESULTS The model explained 41.1% of the total variance in hypertension self-care behavior scores. Among elderly, low-income Korean women, the significant factors of their hypertension self-care behavior included: (a) self-efficacy of hypertension control (β = .62), (b) social support (β = .16), and (c) age (β = -.14). Hierarchical regression analysis showed that elderly Korean women that had higher self-efficacy of hypertension control, higher social support, and were younger were more likely to have higher hypertension self-care behavior scores. CONCLUSIONS The results highlight the need for interventions that focus on improving an individual's self-efficacy and social support to enhance hypertension self-care. The findings of this study can help nurses better understand hypertension self-care behavior in elderly, low-income Korean women.
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Aerobic Capacity, Orthostatic Tolerance, and Exercise Perceptions at Discharge From Inpatient Spinal Cord Injury Rehabilitation. Arch Phys Med Rehabil 2013; 94:2013-9. [DOI: 10.1016/j.apmr.2013.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 05/11/2013] [Accepted: 05/15/2013] [Indexed: 11/22/2022]
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Postpartum Exercise among Nigerian Women: Issues Relating to Exercise Performance and Self-Efficacy. ISRN OBSTETRICS AND GYNECOLOGY 2013; 2013:294518. [PMID: 23844290 PMCID: PMC3697309 DOI: 10.1155/2013/294518] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 06/04/2013] [Indexed: 11/18/2022]
Abstract
Physical exercise during postpartum period is beneficial to mothers, and the health gains are abundantly reported. This study characterises the postpartum exercise profile of a group of Nigerian women and reports how their exercise self-efficacies are influenced by sociodemographic characteristics. Participants were women attending the two largest postnatal clinics in Ibadan, south-western Nigeria. A self-developed questionnaire assessed the socio-demographic and exercise profile of participants, while the Exercise Self-Efficacy Scale assessed their exercise self-efficacy. About two-third (61.0%) of the participants were not aware that they could undertake physical exercise to enhance postpartum health, and 109 (47.8%) were not engaged in any exercise. Those who exercised did so for less than three days/week, and 89% of the women did not belong to any exercise support group. Exercise self-efficacy was significantly (P < 0.05) associated with being in an exercise programme, age, employment, work hours/week, monthly income, and number of pregnancies. Most of the women were not aware they could engage in postpartum exercise, and about half were not undertaking it. More women with high compared to moderate exercise self-efficacy undertook the exercise. Efforts at increasing awareness, improving exercise self-efficacy and adoption of postpartum exercise are desirable among the Nigerian women.
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