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Brady K, Kiernan D, McConkey E, O'Gorman E, Kerr C, McDonough S, Ryan J, Malone A. Participation in physical activity by adolescents with physical disability: cross-sectional snapshot and future priorities ("Youth Experience Matters" protocol). HRB Open Res 2024; 6:38. [PMID: 39091985 PMCID: PMC11292183 DOI: 10.12688/hrbopenres.13741.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 08/04/2024] Open
Abstract
Young people with physical disability experience challenges to being physically active. To attain the health benefits of physical activity (PA) and sustain engagement, it is essential that participation is meaningful and enjoyable. This study aims to describe current participation in PA by adolescents with physical disability in Ireland, and to establish consensus on their priorities for enhancing physical activity participation. A parallel convergent mixed methods study will be undertaken, comprising a national cross-sectional quantitative assessment of PA participation ("Participation Snapshot") and Delphi consensus study ("Delphi"). Adolescents (n=100) aged 13-17 years with a physical disability will be invited to take part. The Participation Snapshot primary outcome is the Children's Assessment of Participation and Enjoyment (CAPE). Contextual factors including underlying medical diagnosis, demographics, mobility (Functional Mobility Scale), hand function (Manual Ability Classification System) and health related quality of life (Child Health Utility 9D) will also be collected. The Delphi will comprise two to four survey rounds, until consensus is reached. Round 1 consists of a bespoke survey, designed and piloted with a public and patient involvement (PPI) panel, with open-ended questions and Likert scales inviting contributions from adolescents on their prior experience and ideas to enhance participation. Responses will be analysed using inductive thematic analysis to construct items and themes, which will then be deductively mapped to the "F-words" and the family of Participation-Related Constructs frameworks. These items will be presented back to participants in subsequent rounds for selection and ranking, until consensus is achieved on the "top 10 priorities" for enhancing PA participation. The project team and PPI panel will then co-design dissemination material and identify targets for dissemination to relevant stakeholder or policy groups. The findings will provide a basis for developing interventions aiming to enhance future PA participation for adolescents with physical disability.
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Affiliation(s)
- Karen Brady
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Central Remedial Clinic, Dublin, Ireland
| | | | | | | | - Claire Kerr
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Suzanne McDonough
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Jennifer Ryan
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Ailish Malone
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
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Kilgour G, Stott NS, Steele M, Adair B, Hogan A, Imms C. More than just having fun! Understanding the experience of involvement in physical activity of adolescents living with cerebral palsy. Disabil Rehabil 2024; 46:3396-3407. [PMID: 37675880 DOI: 10.1080/09638288.2023.2251395] [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: 01/16/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023]
Abstract
Purpose: To explore the experiences of involvement of adolescents living with cerebral palsy, and their parents, while participating in physical activity. Understanding involvement in physical activity may be used to guide future participation.Methods: Eight adolescents (mean age 13 years 11 months, SD 1 year 6 months) with cerebral palsy participated in a New Zealand-based high-level mobility programme (HLMP) focused on running skills, twice per week for 12 weeks. The adolescents and 12 parents were interviewed before, after the 12 weeks and 9-months following the HLMP. Guided by interpretative description, 38 interviews were coded, analysed, and interpreted.Results: Four themes were: "Turning up is not enough" ("There's no point being there if you're not involved"); "In it all the way", "Changes on a dime", and "What works for me." Perceptions of involvement varied between adolescents and parents. Being "very involved" related to high levels of focus, concentration, effort; but not always enjoyment.Conclusions: Focusing on enjoyment as the key experience of involvement understates the complexity and dynamic nature of involvement. "Being involved" is not always easy and may not mean the absence of discomfort or effort. Optimising the individuals' involvement continuum during physical activity may be essential to promote lifelong participation.IMPLICATIONS FOR REHABILITATIONAdolescents living with cerebral palsy and their parents have differing perspective of involvement and utilise different strategies to encourage being and staying active.Teaching adolescents living with cerebral palsy about their involvement continuum and optimal level of involvement for each activity, context and environment could promote sustained participation.To ensure adolescents are "being involved" in physical activity, opportunities for engagement, motivation and persistence are important; enjoyment is a possible, but not essential attribute of involvement.Encouraging involvement in physical activity can be a source of family conflict from a young age therefore clinicians have a role as an essential supporter, motivator and educator.
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Affiliation(s)
- Gaela Kilgour
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Ngaire Susan Stott
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Michael Steele
- Department of Biostatistics, Australian Catholic University, Brisbane, Australia
| | | | | | - Christine Imms
- Department of Paediatrics, The University of Melbourne, Murdoch Children's Research Institute, Melbourne, Australia
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Brady K, Cleary R, O'Gorman E, McDonough S, Kerr C, Kiernan D, McConkey E, Ryan J, Malone A. Identifying the top 10 priorities of adolescents with a physical disability regarding participation in physical activity: A Delphi study. Dev Med Child Neurol 2024. [PMID: 38815177 DOI: 10.1111/dmcn.15986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 06/01/2024]
Abstract
AIM To establish consensus among adolescents with a physical disability regarding their priorities for enhancing participation in physical activity and help inform the design of future interventions for participation in physical activity. METHOD We conducted a national multi-round Delphi study involving adolescents with a physical disability aged 13 to 17 years. Round 1 of the initial survey consisted of open-ended questions. Free-text responses were then analysed thematically, creating items categorized according to the family of participation-related constructs (fPRC). In round 2, participants rated the perceived importance of these items using a 5-point Likert scale. The top 10 priorities were constructed from the highest-ranked items. RESULTS One hundred and sixteen participants (mean age = 14 years 7 months, range = 13-17 years; 66 males; 58 with cerebral palsy; 43 wheelchair users) completed round 1; 108 items were included in round 2. Fifty-eight items were rated as either 'important' or 'really important' by 70% of participants. The top 10 priorities were rated as important or really important by 82% to 94% of participants with a mean Likert score of 4.40 (range = 4.25-4.63). Seven of the top 10 priorities were related to the environmental context of the fPRC. The other three were related to involvement and the related concept of preference. INTERPRETATION The priorities identified will help inform future physical activity interventions for adolescents with a physical disability.
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Affiliation(s)
- Karen Brady
- Central Remedial Clinic, Dublin, Ireland
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Ronan Cleary
- School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Suzanne McDonough
- School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Kerr
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | | | - Jennifer Ryan
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Ailish Malone
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
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Ruksakulpiwat S, Schiltz NK, Irani E, Josephson RA, Adams J, Still CH. Medication Adherence of Older Adults with Hypertension: A Systematic Review. Patient Prefer Adherence 2024; 18:957-975. [PMID: 38737487 PMCID: PMC11088410 DOI: 10.2147/ppa.s459678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/16/2024] [Indexed: 05/14/2024] Open
Abstract
Objective Hypertension (HTN) significantly increases the risk of stroke and heart disease, which are the leading causes of death and disability globally, particularly among older adults. Antihypertensive medication is a proven treatment for blood pressure control and preventing complications. However, medication adherence rates in older adults with HTN are low. In this review, we systematically identified factors influencing medication adherence in older adults with HTN. Methods We applied the PRISMA guidelines and conducted systematic searches on PubMed, MEDLINE, and Google Scholar in July 2022 to identify preliminary studies reporting factors influencing medication adherence among older adults with HTN. The convergent integrated analysis framework suggested by the Joanna Briggs Institute for systematic reviews was adopted for data synthesis. Results Initially, 448 articles were identified, and after title and abstract screening, 16 articles qualified for full-text review. During this phase, three articles were excluded for reporting on irrelevant populations or focusing on issues beyond the review's aim, leaving thirteen studies in the final review. After data synthesis, fifteen themes were extracted from the key findings of the included studies. The most prevalent themes included the number of medications used (53.9%, n=7 studies), financial status (38.5%, n=5), sex (38.5%, n=5), age (30.1%, n=4), duration of disease (23.1%, n=3), comorbidities (23.1%, n=3), and health compliance (23.1%, n=3). Other themes, such as education, health literacy, health belief, medication belief, perception of illness, patient-physician relationship, self-efficacy, and social support, were also identified. Conclusion The findings of this review highlight critical areas for developing innovative, evidence-based programs to improve medication adherence in hypertensive older adults. Insights from this review can contribute to improving medication adherence and preventing future health complications.
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Affiliation(s)
- Suebsarn Ruksakulpiwat
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Nicholas K Schiltz
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | | | - Jon Adams
- School of Public Health, The University of Technology Sydney, Sydney, Australia
| | - Carolyn Harmon Still
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
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McConnell K, McFeeters C, Marley J, Crawford A, Pedlow K. A co-designed mixed methods study on community-based gym exercise for non-ambulant adults with childhood onset disability. Disabil Rehabil 2024:1-9. [PMID: 38702917 DOI: 10.1080/09638288.2024.2346628] [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: 08/01/2023] [Accepted: 04/19/2024] [Indexed: 05/06/2024]
Abstract
PURPOSE Explore community-based gym exercise for non-ambulant adults with childhood-onset disability. MATERIALS AND METHODS Non-ambulant adults with childhood-onset disability participated in four, weekly gym sessions co-facilitated by physiotherapists and exercise professionals. Practicalities of participating in the sessions were recorded via uptake and attrition, weekly surveys, and focus groups. Perspectives of those who designed/delivered the study were gathered via weekly debrief meetings. Quantitative data were analysed descriptively, qualitative data were analysed thematically. RESULTS Ten non-ambulant adults with childhood-onset disability participated; 70% completed all exercise sessions. Focus groups identified three themes. "I wouldn't be able to exercise…there's no option for a community-based setting" described the lack of opportunities for exercise in gyms. "You don't realise the benefit of coming here" highlighted benefits of exercise. "We can do better" had two sub-themes: problem solving and ingredients for community-based gym exercise. Weekly feedback and debrief meetings identified practicalities related to equipment, exercises, and collaborative working between facilitators. CONCLUSIONS Whilst there is an interest in community-based gym exercise for non-ambulant adults with childhood-onset disability, there remains a lack of inclusive gyms. Co-design of inclusive gym guidelines and condition-specific physical activity referral scheme may enhance opportunities for participation in gym exercise for adults with childhood-onset disability.
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Affiliation(s)
- Karen McConnell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Joanne Marley
- School of Health Sciences, Ulster University, Londonderry, UK
| | | | - Katy Pedlow
- School of Health Sciences, Ulster University, Londonderry, UK
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Ryan JM, Kilbride C, Noorkoiv M, Theis N, Shortland A, Levin W, Lavelle G. Acceptability of a progressive resistance training programme for ambulatory adolescents with spastic cerebral palsy in England: a qualitative study. Disabil Rehabil 2024; 46:1832-1840. [PMID: 37154619 DOI: 10.1080/09638288.2023.2208377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE The aim of this study was to explore the acceptability of a 10-week progressive resistance training programme from the perspective of ambulatory adolescents with CP and physiotherapists. MATERIAL AND METHODS Semi-structured interviews were conducted with 32 adolescents with spastic CP, aged 10-19 years in Gross Motor Function Classification System (GMFCS) levels I-III, and 13 physiotherapists. Adolescents had completed a 10-week progressive resistance training programme and physiotherapists had delivered the programme. The Framework Method was used to analyse data. RESULTS The analysis identified four themes. "It's do-able" described the acceptability of the programme structure, including the frequency of sessions and the duration of the programme. "They were difficult but I did it" described the acceptability of the exercises. "It is completely different," explored the experience of using equipment to progress the programme and "I wish I could do it on a permanent basis" discussed continuing to participate in resistance training. CONCLUSIONS Findings suggest that resistance training is largely acceptable to adolescents and physiotherapists. Acceptability was enhanced by having a weekly supervised session and being able to adapt and progress the exercises to meet the individual's ability. However, there are challenges to implementing progressive resistance training as part of routine practice.Clinical trial registration number: ISRCTN90378161.
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Affiliation(s)
- Jennifer M Ryan
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- College of Health, Medicine and Life Sciences, Brunel University London, United Kingdom
| | - Cherry Kilbride
- College of Health, Medicine and Life Sciences, Brunel University London, United Kingdom
| | - Marika Noorkoiv
- College of Health, Medicine and Life Sciences, Brunel University London, United Kingdom
| | - Nicola Theis
- School of Sport and Exercise, University of Gloucestershire, Gloucester, United Kingdom
| | - Adam Shortland
- One Small Step Gait Laboratory, Guy's Hospital, London, United Kingdom
| | - Wendy Levin
- Department of Physiotherapy, Swiss Cottage School and Development and Research Centre, London, United Kingdom
| | - Grace Lavelle
- College of Health, Medicine and Life Sciences, Brunel University London, United Kingdom
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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McKenzie G, Willis C, Yao A, Munzel F, Kennedy R, Shields N. Identifying and prioritising strategies to optimise community gym participation for young adults with cerebral palsy: an e-Delphi study. Disabil Rehabil 2024; 46:1309-1317. [PMID: 37021370 DOI: 10.1080/09638288.2023.2193431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE Identify and prioritise strategies to optimise physical activity participation in the community gym setting for young adults with cerebral palsy. METHODS An e-Delphi method was implemented over three rounds with four stakeholder groups (young adults with cerebral palsy, their families, gym staff or exercise professionals, and health professionals). Strategies for change were identified by the stakeholders in round 1. In rounds 2 and 3, strategies for change were rated on the importance for implementation using a 7-point Likert scale (1 being lowest importance, 7 being highest). The consensus was achieved if ≥70% of participants identified a strategy as high importance. RESULTS Seventy participants (20 young adults 10 family members, 21 health professionals, and 19 exercise professionals) identified 83 strategies for improving gym participation. Of these, 44 strategies met the consensus criteria. The highest priority strategies related to changing the physical environment, addressing cost barriers, gym staff training, and developing partnerships between sectors. CONCLUSIONS Addressing physical accessibility, cost of attendance and the skills of gym staff were agreed upon by the stakeholder groups as priority areas for future resource allocation and research translation. Clinicians and community leisure facilities must work with consumers to implement strategies in their local contexts.
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Affiliation(s)
- Georgia McKenzie
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, VIC, Australia
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Claire Willis
- School of Allied Health, Human Services and Sport, La Trobe University, VIC, Australia
| | - Alexa Yao
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Freya Munzel
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Rachel Kennedy
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, VIC, Australia
| | - Nora Shields
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, VIC, Australia
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
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Hassett L, McKay MJ, Cole J, Moseley AM, Chagpar S, Geerts M, Kwok WS, Jensen C, Sherrington C, Shields N. Effects of sport or physical recreation for adults with physical or intellectual disabilities: a systematic review with meta-analysis. Br J Sports Med 2024; 58:269-277. [PMID: 38129104 DOI: 10.1136/bjsports-2023-107123] [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] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES To evaluate the effects of sport or physical recreation on participation, mobility and quality of life for adults living with disabilities. DESIGN Systematic review with meta-analysis. DATA SOURCES Six databases searched from inception to May 2022. ELIGIBILITY CRITERIA Randomised controlled trials including adults living with a physical or intellectual disability, comparing sport or physical recreation to non-active control. RESULTS Seventy-four trials (n=2954; mean age 55 years) were included. Most (70) trials included people with physical disabilities, none evaluated sport and the most common physical recreation activities tested were traditional Chinese exercise (35%), yoga (27%) and dance (18%). Mean frequency and duration was 65 min/session, two times per week for 13 weeks. Most (86%) interventions were led by people with experience and/or training in the recreation activity, and only 37% reported leader experience and/or training working with people with disabilities. Participation was measured as attendance (mean 81%, 30 intervention groups). Physical recreation improved mobility (standardised mean difference (SMD) 0.38, 95% CI 0.07 to 0.69, n=469) and walking endurance (mean difference (MD) 40.3 m, 95% CI 19.5 to 61.1, n=801) with low certainty evidence and balance (Berg Balance Scale, range 0-56 points; MD 3.4 points, 95% CI 2.3 to 4.4, n=906) and quality of life (physical health; SMD 0.37, 95% CI 0.02 to 0.72, n=468) with very low certainty evidence, but not walking speed (MD 0.03 m/s, 95% CI -0.05 to 0.11, n=486). CONCLUSION Physical recreation may confer multiple benefits for people living with disabilities regardless of the activity chosen, thus offering a potentially enjoyable and scalable strategy to increase physical activity. PROSPERO REGISTRATION NUMBER CRD42018104379.
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Affiliation(s)
- Leanne Hassett
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Marnee J McKay
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jenni Cole
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Anne M Moseley
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Sakina Chagpar
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Minke Geerts
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- Department of Health Sciences, Groningen University, Groningen, Groningen, The Netherlands
| | - Wing S Kwok
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Connie Jensen
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Nora Shields
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
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Breij LM, van de Ven RAH, Hulst RY, Smorenburg ARP, Gorter JW, Verschuren OW. Body mass index is not suitable for assessing body composition in children with spastic cerebral palsy. Disabil Rehabil 2024; 46:509-514. [PMID: 36650975 DOI: 10.1080/09638288.2023.2167007] [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: 04/26/2022] [Accepted: 01/06/2023] [Indexed: 01/19/2023]
Abstract
PURPOSE To measure body composition by using bioelectrical impedance analysis (BIA) and body mass index (BMI) and to investigate the correlation and agreement between BMI and fat mass percentage in children with spastic Cerebral Palsy. MATERIALS AND METHODS BIA was used to assess fat mass percentage and BMI was determined from body weight and height. BMI and fat mass percentage were both categorized into five categories. The association between fat mass percentage and BMI was assessed using Pearson's correlation coefficient. Agreement between BMI and fat mass percentage was investigated with weighted Cohen's kappa coefficient. RESULTS One hundred and three children with CP across all Gross Motor Function Classification Levels (61% boys, mean age 9 years) were included. Mean BMI was 18.3 kg/m2 and mean fat mass was 24.9%. A large inter-subject variability was found with a weak correlation between BMI and fat mass percentage in children with a BMI < 20 kg/m2. Little agreement (k = 0.299, CI 0.16-0.44) between the categorization of children based on BMI and based on fat mass percentage was found. INTERPRETATION The large inter-subject variability in fat mass percentage combined with little agreement between the BMI and BIA categories suggests that BMI is not a suitable measure of fat mass in children with CP.IMPLICATIONS FOR REHABILITATIONUsing body mass index (BMI) and instead of fat mass percentage increases the risk of misclassifying body composition in children with spastic Cerebral Palsy.Children with a BMI < 20 kg/m2 are more at risk to be misclassified for body composition.
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Affiliation(s)
- Laura M Breij
- Rehabilitation Centre 'De Hoogstraat', Utrecht, Netherlands
| | - Rick A H van de Ven
- Rehabilitation Center Tolbrug, Jeroen Bosch Hospital, 's-Hertogenbosch, Netherlands
| | - Raquel Y Hulst
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | | | - Jan Willem Gorter
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Olaf W Verschuren
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
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Goodwin MV, Hogervorst E, Maidment DW. A qualitative study assessing the barriers and facilitators to physical activity in adults with hearing loss. Br J Health Psychol 2024; 29:95-111. [PMID: 37658583 DOI: 10.1111/bjhp.12689] [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: 11/11/2022] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVES Growing epidemiological evidence has shown hearing loss is associated with physical inactivity. Currently, there is a dearth in evidence investigating why this occurs. This study aimed to investigate the barriers and facilitators to physical activity in middle-aged and older adults with hearing loss. DESIGN Individual semi-structured qualitative interviews. METHODS A phenomenological approach was taken. Ten adults (≥40 years) were interviewed via videoconferencing. The interview schedule was underpinned by the capability, opportunity, motivation and behaviour (COM-B) model. Reflexive thematic analysis was used to generate themes, which were subsequently mapped onto the COM-B model and behaviour change wheel. RESULTS Nine hearing loss specific themes were generated, which included the following barriers to physical activity: mental fatigue, interaction with the environment (acoustically challenging environments, difficulties with hearing aids when physically active) and social interactions (perceived stigma). Environmental modifications (digital capabilities of hearing aids), social support (hearing loss-only groups) and hearing loss self-efficacy were reported to facilitate physical activity. CONCLUSIONS Middle-aged and older adults with hearing loss experience hearing-specific barriers to physical activity, which has a deleterious impact on their overall health and well-being. Interventions and public health programmes need to be tailored to account for these additional barriers. Further research is necessary to test potential behaviour change techniques.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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11
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Kennedy W, Curtin C, Bowling A. Access to physical activity promotion for people with neurological conditions: Are physical therapists leading the way? Disabil Health J 2024; 17:101517. [PMID: 37673784 DOI: 10.1016/j.dhjo.2023.101517] [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: 05/11/2023] [Revised: 07/26/2023] [Accepted: 08/05/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND People with neurological conditions (NCs) engage in physical activity (PA) at a lower rate than those without disabilities. Physical therapists (PTs) are positioned to provide PA promotion; however, less is known about the consistency of promoting PA for their patients with NC. OBJECTIVE The objective of this study was to investigate the frequency of PA promotion of PTs who treat patients with NC, the factors associated with PA promotion, and the types of PA promotion used. METHODS An online survey that assessed the aspects of PA promotion frequency and behaviors was delivered to a sample of licensed PTs recruited in the United States between February and April of 2022. Descriptive statistics and the equality of proportions test were used to analyze the data. RESULTS Out of 76 participants who reported working with patients with NC, 34 (45%) reported always promoting PA. Of the 38 participants reporting a caseload of over 50% NC, 17 (45%) reported always promoting PA. Seven factors had a significant correlation with the frequency of PA promotion, and participants reported providing education about PA with their patients (99%). CONCLUSIONS PTs who work with patients with NC are not consistently promoting PA for their patients. There are opportunities for PTs to learn and apply PA promotion in practice for people with disabilities. The lack of PA promotion by PT may be contributing to the health disparities experienced by people with disabilities particularly those with NC.
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Affiliation(s)
- Winston Kennedy
- Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA; Merrimack College, 315 Turnpike St, North Andover, MA 01845, USA; University of Massachusetts Chan Medical School, 55 N Lake Ave, Worcester, MA 01655, USA.
| | - Carol Curtin
- University of Massachusetts Chan Medical School, 55 N Lake Ave, Worcester, MA 01655, USA.
| | - April Bowling
- Merrimack College, 315 Turnpike St, North Andover, MA 01845, USA.
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12
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Morgan P, Cleary S, Dutia I, Bow K, Shields N. Community-based physical activity interventions for adolescents and adults with complex cerebral palsy: A scoping review. Dev Med Child Neurol 2023; 65:1451-1463. [PMID: 37032538 PMCID: PMC10952332 DOI: 10.1111/dmcn.15611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/08/2023] [Accepted: 03/16/2023] [Indexed: 04/11/2023]
Abstract
AIM To identify implementation strategies and safety outcomes (adverse events) of community-based physical activity interventions for adolescents and adults with complex cerebral palsy (CP). METHOD Five electronic databases were systematically searched to April 2022. Data were extracted on the implementation and safety of physical activity interventions for adolescents and adults with CP, classified in Gross Motor Function Classification System (GMFCS) levels IV and V, delivered in a community setting. RESULTS Seventeen studies with 262 participants (160 participants classified in GMFCS levels IV or V) were included. Community settings included schools (n = 4), participants' homes (n = 3), gymnasia (n = 2), swimming pools (n = 2), and other settings (n = 4). Most studies specified medical or safety exclusion criteria. Implementation strategies included pre-exercise screening, use of adapted equipment, familiarization sessions, supervision, physical assistance, and physiological monitoring. Attendance was high and attrition low. Nine studies reported non-serious, expected, and related events. Four studies reported minor soreness and four studies reported minor fatigue post-exercise. Serious adverse events related to exercise were infrequent (reported for 4 of 160 participants [<2%]: three participants withdrew from an exercise programme and one participant ceased exercise for a short period). Most frequently reported was pain, requiring temporary exercise cessation or programme change, or study withdrawal (three participants). INTERPRETATION For most adolescents and adults with CP classified in GMFCS levels IV and V, physical activity interventions can be safely performed in a community setting, without post-exercise pain or fatigue, or serious adverse events. WHAT THIS PAPER ADDS Supervised community-based physical activity interventions can be safely performed by people with complex cerebral palsy. Post-exercise pain or fatigue was not common among those classified in Gross Motor Function Classification System levels IV or V. Serious adverse events are infrequent when exercising in community settings, with safety strategies.
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Affiliation(s)
- Prue Morgan
- Department of PhysiotherapyMonash UniversityMelbourneAustralia
| | - Stacey Cleary
- Neurodisability and RehabilitationMurdoch Children's Research InstituteParkvilleAustralia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia
| | - Iain Dutia
- Physiotherapy, Faculty of Health SciencesAustralian Catholic UniversityBrisbaneAustralia
- School of Human Movement and Nutrition SciencesThe University of QueenslandBrisbaneAustralia
| | - Keegan Bow
- Physiotherapy, Klint NeuroForest HillAustralia
| | - Nora Shields
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
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13
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Ruksakulpiwat S, Zhou W, Niyomyart A, Wang T, Kudlowitz A. How does the COVID-19 pandemic impact medication adherence of patients with chronic disease?: A systematic review. Chronic Illn 2023; 19:495-513. [PMID: 35971949 PMCID: PMC9382573 DOI: 10.1177/17423953221110151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine how the COVID-19 pandemic impacts patients with chronic disease medication adherence. METHODS Four electronic databases, PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text, were searched for literature between 2019 and 2021. Abstracts and later full texts were independently screened by the authors of this review using inclusion and exclusion criteria to determine relevance to our study. Joanna Briggs Institute (JBI) critical appraisal tools were used to assess the quality of included texts. Relevant information and data from the included texts were extracted into tables for data synthesis and analysis. RESULTS Ten studies met the study criteria, the most popular study design was cross-sectional design (n = 9, 90.0%), others were case series (n = 1, 10.0%). Barriers to medication adherence and facilitators of medication adherence were the major two themes that participants reported regarding the impact of COVID-19 on medication adherence. Moreover, these two main themes have been organized in sub-themes that are dealt with in-depth. DISCUSSION Our results could heighten healthcare providers, stakeholders, and policy leaders' awareness of providing appropriate support for chronic disease patients, especially regarding medication adherence. Future research incorporating programs that support patients' needs is recommended.
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Affiliation(s)
- Suebsarn Ruksakulpiwat
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Wendie Zhou
- School of Nursing, Peking University, Beijing, China
| | - Atsadaporn Niyomyart
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tongyao Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Aaron Kudlowitz
- The College of Arts and Sciences, Case Western Reserve University, Cleveland, USA
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14
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Tucker S, Heneghan NR, Gardner A, Rushton A, Alamrani S, Soundy A. Factors Influencing Participation in Physical Activity, Sports, and Exercise in Children and Adolescents with Spinal Pain or Spinal Conditions: A Systematic Review and Meta-Ethnography. Behav Sci (Basel) 2023; 13:486. [PMID: 37366738 DOI: 10.3390/bs13060486] [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: 03/23/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Physical activity is an effective treatment for paediatric spinal pain. However, participation rates remain low and review evidence is needed to establish why. This review identifies factors influencing participation in sports, exercise, and physical activity in those aged 18 or under with spinal pain or spinal conditions. Trends or differences between discrete sub-populations are identified. METHODS A meta-ethnographic review was undertaken. Qualitative papers were identified and appraised using the JBI checklist. Thematic trends were mapped onto the biopsychosocial model and subthemes identified. Uniqueness was calculated and the confidence in the evidence was evaluated using the GRADE-CERQual tool. RESULTS Data were gathered from nine qualitative papers (384 participants). Three themes were identified: (1) biological: physical challenges and bladder and bowel care; (2) psychological: perceptions of differences to peers, struggle, anger, sadness, adjustment, and acceptance; and (3) sociological: influence of friends, social acceptance, negative attitudes from others, and the influence of their disability on family routine. CONCLUSIONS Sociological factors were most influential on exercise participation alongside related psychological and biological factors. Adolescents over 14 years offered greater critical insight compared to the younger children. Results are best applied to neuromuscular conditions with further robust evidence required in paediatric musculoskeletal spinal pain.
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Affiliation(s)
- Susanna Tucker
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Nicola R Heneghan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Adrian Gardner
- Spinal Surgery, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham B31 2AP, UK
| | - Alison Rushton
- School of Physical Therapy, Western University Canada, London, ON N6A 3K7, Canada
| | - Samia Alamrani
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
- Physical Therapy Department, University of Tabuk, Tabuk 47512, Saudi Arabia
| | - Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
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15
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Bhowon Y, Prendergast LA, Taylor NF, Shields N. Using Geospatial Analysis to Determine the Proximity of Community Gyms for a Population-based Cohort of Young People with Cerebral Palsy. Physiother Can 2023. [DOI: 10.3138/ptc-2022-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
Purpose: To quantify a perceived barrier to physical activity participation (proximity to exercise facilities) by investigating the distance a population-based cohort of young people with cerebral palsy aged 13–30 years lived from community gyms. Method: We developed a web-based application using open-access software that could be used to complete a geospatial analysis by simultaneously visualising, describing, and estimating the location of young people with cerebral palsy, using deidentified data from a cerebral palsy register, in terms of distance and travel time to all available community gyms in one metropolitan city. The suitability of facilities for individuals was not investigated. Distance to the closest gym for participants was measured using the “as the crow flies” and “street network” methods. The proportion of the cohort living 5, 7, and 9 km from a community gym was calculated using the “as the crow flies” method. Distances and travel times to the closest gym for each person were calculated using the “street network” method. Data analysis used one-dimensional (median, quartiles) and two-dimensional (spatial median, bagplot) dispersion measures. Results: Of 568 young people with cerebral palsy, 97% lived within 7 km of a community gym, with a median absolute distance to their closest gym of 3.6 km (1st and 3rd quartiles 2.4, 5.1) and median travel time of 6.6 minutes (1st and 3rd quartiles 4.4, 8.8) by car. For the two-dimensional analysis, the spatial medians were 3.7 km and 6.5 minutes. Conclusions: The open-access, web-based application that was developed can be used by physiotherapists and others to study proximity of clinical and community infrastructure for other populations in other cities and regions. In this study, most young people with cerebral palsy living in one metropolitan city had reasonable access by car to a community gym.
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Affiliation(s)
- Yeshna Bhowon
- From the: Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Luke A Prendergast
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Nicholas F Taylor
- From the: Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia
- Allied Health Clinical Research Office, Eastern Health, Melbourne, Australia
| | - Nora Shields
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
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16
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Tucker S, Heneghan NR, Alamrani S, Rushton A, Gardner A, Soundy A. Barriers and facilitators of physical function, activity, sports and exercise in children and adolescents with spinal pain: a protocol for a systematic review and meta-ethnography. BMJ Open 2023; 13:e063946. [PMID: 36927588 PMCID: PMC10030483 DOI: 10.1136/bmjopen-2022-063946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Spinal pain is one of the leading causes of disability, with the incidence of adolescent back pain estimated at 20%. Multiple barriers influence exercise participation in adolescents. However, there remains a lack of literature surrounding patients' choice to exercise, perceived barriers and facilitators of exercise, and their relationship to participant demographics. The aim of this systematic review with meta-ethnography will be to identify the barriers and facilitators of exercise participation among adolescents with thoracic or lower back pain (LBP). The secondary aim will be to identify any trends in barriers and facilitators of exercise between different demographic groups within children or adolescents under 18 years. METHODS AND ANALYSIS The seven-phase process identified by Noblit and Hare's meta-ethnography approach will be used. A comprehensive electronic search of databases (AMED, CINAHLplus, EMBASE, MEDLINE, SCOPUS, Nursing & Allied Health, PubMed, PsycINFO, SPORTDiscus, Social Science Database) will be completed during April 2022. Grey literature using reference lists, websites and search engines will also be searched in accordance with Peer Review of Electronic Search Strategies (PRESS) guidelines. Inclusion criteria include: (A) qualitative studies, (B) participants under 18 years experiencing thoracic or LBP, (C) identification of barriers and facilitators of exercise participation in exercise, sports or physical activity and (D) primary research. This systematic review with meta-ethnography review aims to generate theories of behaviours and interpret significance across multiple studies. This process aims to develop future physiotherapeutic behavioural interventions, inform service provision and identify possible future research questions. ETHICS AND DISSEMINATION No ethical approval was required due to the nature of using previously published work to form a systematic review paper. This systematic review and meta-ethnography will be disseminated through both conference presentations and journal publications. No funding was received for this review. PROSPERO REGISTRATION NUMBER CRD42022314796.
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Affiliation(s)
- Susanna Tucker
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Nicola R Heneghan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Samia Alamrani
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Alison Rushton
- School of Physical Therapy, Western University Faculty of Health Sciences, London, Ontario, Canada
| | - Adrian Gardner
- Spinal Surgery, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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17
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Divecha AA, Bialek A, Kumar DS, Garn RM, Currie LEJ, Campos T, Friel KM. Effects of a 12-week, seated, virtual, home-based tele-exercise programme compared with a prerecorded video-based exercise programme in people with chronic neurological impairments: protocol for a randomised controlled trial. BMJ Open 2023; 13:e065032. [PMID: 36693691 PMCID: PMC9884574 DOI: 10.1136/bmjopen-2022-065032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Exercise is vital to staying well and preventing secondary complications in people with chronic neurological impairments (CNI). Appropriate exercise is often inaccessible to this population. The purpose of the study is to investigate the effects of a seated, virtual exercise programme on heart rate, recovery, fatigue, pain, motivation, enjoyment and quality of life in people with CNI. METHODS AND ANALYSIS Individuals with CNI will be screened for eligibility, and 60 participants will be randomised 1:1 into either a live or prerecorded group. There is no geographical limitation to where participants reside, since participation is virtual. The study will be coordinated by one site in White Plains, New York, USA. The live group will exercise with an instructor via Zoom while the prerecorded group will exercise at their chosen time using prerecorded videos, 3×/week for 12 weeks. PRIMARY OUTCOME MEASURES change in heart rate during exercise/recovery. SECONDARY OUTCOME MEASURES fatigue, motivation, level of pain and exertion, physical well-being, enjoyment of physical activity, motivation and quality of life. Outcomes will be assessed at baseline, midpoint, end of study and 1-month poststudy. Adverse events, medication changes and physical activity will be tracked throughout. Within-group and between-group comparisons will be performed by using analysis of covariance and regression. ETHICS AND DISSEMINATION BRANY IRB approval: 22 September 2020, protocol #20-08-388-512. All participants will provide written informed consent. Results will be disseminated through presentations, publications and ClinicalTrials.gov. TRIAL REGISTRATION NUMBER NCT04564495.
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Affiliation(s)
| | - Amy Bialek
- Burke Neurological Institute, White Plains, New York, USA
| | - Devina S Kumar
- Burke Neurological Institute, White Plains, New York, USA
| | - Rachel M Garn
- Burke Neurological Institute, White Plains, New York, USA
- School of Medicine, State of New York Upstate Medical University, Syracuse, NY, USA
| | | | - Talita Campos
- Burke Neurological Institute, White Plains, New York, USA
- School of Nursing, Columbia University Irving Medical Center, New York, NY, USA
| | - Kathleen M Friel
- Burke Neurological Institute, White Plains, New York, USA
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
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18
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Kennedy RA, McKenzie G, Holmes C, Shields N. Social Support Initiatives That Facilitate Exercise Participation in Community Gyms for People with Disability: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:699. [PMID: 36613019 PMCID: PMC9819822 DOI: 10.3390/ijerph20010699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
People with disability report social support facilitates participation in physical activity. A scoping review explored social support strategies used to facilitate exercise participation for people with disability (aged ≥ 15 years) in community gym settings. Seven electronic databases were searched. Studies were screened for eligibility based on title and abstract followed by full-text review. Data were analysed using content analysis and narrative synthesis. Forty-two articles reporting data from 35 studies were included. Eight types of social support were identified: supervision (n = 30), peer support (n = 21), specialist support (n = 19), orientation (n = 15), education (n = 7), logistical support (n = 6), motivational support (n = 5) and organised social activities (n = 4). Direct supervision was typically provided 1:1 or in small groups by staff experienced working with people with disability. Peer support typically involved support from exercise group participants or a peer mentor. Specialist support was usually provided by a health or exercise professional either directly to people with disability or to the people providing support to them (e.g., trainer). Orientation to the gym environment, equipment and exercise program was usually provided over 1 or 2 sessions. Gym staff may use these strategies to guide the implementation of social supports within their facilities to promote social connectedness and participation for people with disability.
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Affiliation(s)
- Rachel A. Kennedy
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora 3086, Australia
| | - Georgia McKenzie
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora 3086, Australia
| | - Carlee Holmes
- CP Achieve Centre of Research Excellence, Neurodisability and Rehabilitation, Murdoch Children’s Research Institute, Parkville 3052, Australia
| | - Nora Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora 3086, Australia
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19
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Pérez-Rodríguez M, Gutiérrez-Suárez A, Arias JÁR, Andreu-Caravaca L, Pérez-Tejero J. Effects of Exercise Programs on Functional Capacity and Quality of Life in People With Acquired Brain Injury: A Systematic Review and Meta-Analysis. Phys Ther 2022; 103:pzac153. [PMID: 36336977 DOI: 10.1093/ptj/pzac153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 05/14/2022] [Accepted: 08/29/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aims of this systematic review and meta-analyses were to evaluate the effects of exercise on the functional capacity and quality of life (QoL) of people with acquired brain injury (ABI) and to analyze the influence of training variables. METHODS Five electronic databases (MEDLINE, Cochrane Library, CINAHL, SportDiscus, and Web of Science) were searched until October 2021 for clinical trials or experimental studies examining the effects of exercise on the functional capacity and QoL in adults with ABI and comparing exercise interventions with non-exercise (usual care). RESULTS Thirty-eight studies were evaluated. A total sample of 2219 people with ABI (exercise, n = 1572; control, n = 647) were included in the quantitative analysis. A greater improvement was observed in walking endurance (z score = 2.84), gait speed (z score = 2.01), QoL physical subscale (z score = 3.42), and QoL mental subscale (z score = 3.00) was observed in the experimental group than in the control group. In addition, an improvement was also observed in the experimental group in the "Timed Up and Go" Test scores and balance without differences from the control group. Significant interactions were also observed between the rehabilitation phases, type, frequency and volume of training, and overall effects. CONCLUSION The results suggest that exercise improves functional capacity and QoL regardless of model training, highlighting the effectiveness of long-term exercise that includes short sessions with components such as strength, balance, and aerobic exercise. IMPACT The results shown in this systematic review with meta-analysis will allow physical therapists to better understand the effects of training on people with ABI.
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Affiliation(s)
- Marta Pérez-Rodríguez
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Andrea Gutiérrez-Suárez
- Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, Universidad de A Coruña, A Coruña, Spain
| | - Jacobo Ángel Rubio Arias
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid, Spain
- Health Research Centre, Department of Education, Faculty of Educational Sciences, University of Almería, Almería, Spain
| | - Luis Andreu-Caravaca
- International Chair of Sports Medicine, Faculty of Medicine, UCAM, Universidad Catolica de Murcia, Murcia, Spain
- Facultad de Deporte, UCAM, Universidad Católica de Murcia, Murcia, Spain
| | - Javier Pérez-Tejero
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid, Spain
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20
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Buckley N, Stahlhut M, Elefant C, Leonard H, Lotan M, Downs J. Parent and therapist perspectives on "uptime" activities and participation in Rett syndrome. Disabil Rehabil 2022; 44:7420-7427. [PMID: 34689665 DOI: 10.1080/09638288.2021.1992026] [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: 01/18/2023]
Abstract
PURPOSE People with a disability may spend more time sitting and lying ("downtime") and less time standing and walking ("uptime"). Caregivers and therapists supporting individuals with Rett syndrome were surveyed, aiming to gather insights on how to support participation in "uptime" activities. METHOD An anonymous online survey including open ended questions about the enablers and barriers to "uptime" was administered to parent/caregivers and therapists/health professionals in an international sample. Responses were coded to the International Classification of Functioning, Health and Disability (ICF) framework identifying barriers, enablers, and strategies for increasing uptime activities. RESULTS Parents (N = 115) and therapists (N = 49) completed the survey. Barriers and enablers to "uptime" were identified for all ICF domains and additional data coded to enabling access to the physical environment. Strategies to promote "uptime" activities and participation particularly related to the individual's physical capacity and personal factors as well as social and physical environmental factors. CONCLUSIONS Findings can inform the design of interventions aiming to increase "uptime" in individuals with Rett syndrome. Strategies should create individualised support by considering how to build fitness using activities that are motivating, at the same time creating opportunities for social interactions within a range of environments.IMPLICATIONS FOR REHABILITATION"Uptime" participation comprised a dynamic interaction of "doing" the standing or walking activity, with a sense of self-engagement with the activities and interaction with others.Strategies to promote "uptime" participation should consider how to create support for person-related attributes, including building physical capacity for a greater volume of "uptime" in activities that are enjoyable and motivating.Strategies to promote "uptime participation should also include creating a supportive environment, comprising opportunities for social interaction within a range of environments".
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Affiliation(s)
- Nicholas Buckley
- Telethon Kids Institute, The University of Western Australia, Nedlands, Australia
| | - Michelle Stahlhut
- Department of Paediatrics and Adolescent Medicine, Center for Rett Syndrome, Copenhagen, Denmark
| | | | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Nedlands, Australia
| | - Meir Lotan
- Ariel University, Ariel, Israel.,Israeli Rett syndrome National evaluation team
| | - Jenny Downs
- Telethon Kids Institute, The University of Western Australia, Nedlands, Australia.,Curtin School of Allied Health, Curtin University, Perth, Australia
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21
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Reedman SE, Jayan L, Boyd RN, Ziviani J, Elliott C, Sakzewski L. Descriptive contents analysis of ParticiPAte CP: a participation-focused intervention to promote physical activity participation in children with cerebral palsy. Disabil Rehabil 2022; 44:7167-7177. [PMID: 34624202 DOI: 10.1080/09638288.2021.1985636] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE ParticiPAte CP is a participation-focused therapy intervention that is effective to increase perceived performance of physical activity (PA) participation goals in children with cerebral palsy (CP). We aimed to characterise the contents of ParticiPAte CP using validated behaviour change frameworks. MATERIALS AND METHODS Data came from physiotherapist treatment notes and were used to specify: (1) physiotherapist-perceived barriers to behaviour change (using the International Classification of Functioning, Disability and Health Framework [ICF] and Theoretical Domains Framework), intervention content (Behaviour Change Technique Taxonomy v1), intervention functions (Behaviour Change Wheel) and mechanisms of action (Capability, Opportunity, Motivation - Behaviour model). RESULTS Physiotherapist-perceived barriers to participation were identified in all ICF and Theoretical Domains Framework domains. ParticiPAte CP consisted of 32 behaviour change techniques, delivered via six intervention functions of the Behaviour Change Wheel, especially enablement. All six possible mechanisms of action were identified according to the Capability, Opportunity, Motivation - Behaviour model. These were targeted most frequently through Theoretical Domains Framework domains social influences, environmental context and resources, intentions, skills, knowledge, and beliefs about capabilities. CONCLUSIONS The content of a PA intervention for children with CP can be specified according to behaviour change frameworks. ParticiPAte CP was complex, with multiple targets, constituent behaviour change techniques and mechanisms of action. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12615001064594.Implications for rehabilitationProviding social support to families through practical actions such as motivating conversation, providing information, linking families to community services and participating in activities with children to support their self-efficacy may be a defining feature of effective participation-focused therapies.If children with cerebral palsy (CP) and their families nominate goals for increased frequency of attendance or improved involvement in physical activities (PAs), therapists must identify all important barriers to participation, including behavioural barriers that may be thought of less often (e.g. emotions, beliefs, optimism etc.).Promoting PA participation in children with CP may require a complex or multi-faceted therapy intervention that supports not only physical capability, but also enhances the social and physical opportunity for participation to take place and promotes the psychological capability and motivation for PA of children and families.Therapists or researchers may consider using the Behaviour Change Wheel to prospectively design their own health behaviour intervention for children with CP.
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Affiliation(s)
- Sarah E Reedman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Lakshmi Jayan
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Catherine Elliott
- School of Allied Health, Curtin University, Perth, Australia.,Telethon Kids Institute, Perth, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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22
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Vernerova A, Marova I, Chmelik F. The Role of Volunteers in a Swimming Organization for Persons with Disabilities. Healthcare (Basel) 2022; 10:2149. [PMID: 36360493 PMCID: PMC9690843 DOI: 10.3390/healthcare10112149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/16/2022] [Accepted: 10/24/2022] [Indexed: 08/13/2023] Open
Abstract
Participation in leisure time physical activity (LTPA) has considerable health-related, psychological, and social benefits. However, the involvement of individuals with disabilities is considerably less than that of their peers without disabilities. A higher rate of participation of individuals with disabilities in LTPA may be achieved by the active involvement of volunteers. This study aimed to describe the importance of volunteer involvement in a swimming organization focused on individuals with disabilities, as perceived by all participants, including swimmers with disabilities, their parents, volunteers, and coaches. The organization uses volunteers as swimming instructors who work individually with swimmers with disabilities. The data were obtained through 11 semi-structured interviews with swimmers with disabilities and their parents, volunteers, and coaches. The interviews were transcribed verbatim and analyzed using a five-step inductive thematic analysis. As a result of the cooperation with the volunteer swimming instructors, swimmers with disabilities felt an improved range of movement, greater independence, and higher self-esteem than before they started using the services of the swimming organization. Consequently, even individuals with severe disabilities can participate in LTPA. Membership to the organization also provided space for the establishment of new social relations, and the instructors described them accepting persons with disabilities as their equals. More importantly, the involvement of volunteers enables organizations to provide respite care for parents.
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Affiliation(s)
- Alena Vernerova
- Faculty of Physical Culture, Palacký University Olomouc, 779 00 Olomouc, Czech Republic
| | - Ivana Marova
- Faculty of Education, Masaryk University, 601 77 Brno, Czech Republic
| | - Frantisek Chmelik
- Faculty of Physical Culture, Palacký University Olomouc, 779 00 Olomouc, Czech Republic
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Ruksakulpiwat S, Zhou W, Phianhasin L, Benjasirisan C, Fan Y, Su T, Chiaranai C. The experience of caregivers of chronically ill patients during the COVID-19: A Systematic Review. Chronic Illn 2022; 18:488-502. [PMID: 34898282 PMCID: PMC9396735 DOI: 10.1177/17423953211064854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aimed to identify the difficulties that caregivers of chronically ill patients experienced during the COVID-19 pandemic and to provide directions for future studies. METHODS Five electronic databases, including PubMed, Web of Science, CINAHL Plus Full Text, EMBASE, and Scopus, were systematically searched from January 2019 to February 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were employed for the literature screening, inclusion, and exclusion. The Mixed Methods Appraisal Tool was adopted for qualifying appraisal. RESULTS Six studies met the study criteria, including three quantitative studies, two qualitative studies, and one mixed-method study. Mental health, personal experience, financial problems, physical health, and improvement approaches were the major five themes that participants reported regarding the impact of COVID-19 they encountered during the pandemic. DISCUSSION The results could heighten healthcare providers, stakeholders, and policy leaders' awareness of providing appropriate support for caregivers. Future research incorporating programs that support caregivers' needs is recommended.
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Affiliation(s)
- Suebsarn Ruksakulpiwat
- Department of Medical Nursing, Faculty of Nursing, 26685Mahidol University, 2 Prannok Road, Siriraj, Wanglang, Bangkoknoi, Bangkok, Thailand
| | - Wendie Zhou
- 105821The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Lalipat Phianhasin
- Department of Medical Nursing, Faculty of Nursing, 26685Mahidol University, 2 Prannok Road, Siriraj, Wanglang, Bangkoknoi, Bangkok, Thailand
| | - Chitchanok Benjasirisan
- Department of Medical Nursing, Faculty of Nursing, 26685Mahidol University, 2 Prannok Road, Siriraj, Wanglang, Bangkoknoi, Bangkok, Thailand
| | - Yuying Fan
- 105821The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tingyu Su
- The Faculty of Medicine and Health, 522555The University of Sydney, Australia
| | - Chantira Chiaranai
- 506978Suranaree University of Technology Institute of Nursing, 111 University Avenue, Muang District, Nakhonratchasima, Thailand
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Ryan J, Kerr C, Kilbride C, Norris M. Editorial: Exploring physical activity and sedentary behaviour in physical disability. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1006039. [PMID: 36188969 PMCID: PMC9397993 DOI: 10.3389/fresc.2022.1006039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Jennifer Ryan
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, County Dublin, Ireland
| | - Claire Kerr
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
- Correspondence: Claire Kerr
| | - Cherry Kilbride
- College of Health, Brunel University London, Uxbridge, London, United Kingdom
| | - Meriel Norris
- College of Health, Brunel University London, Uxbridge, London, United Kingdom
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Kable TJ, Leahy AA, Smith JJ, Eather N, Shields N, Noetel M, Lonsdale C, Hillman CH, Reeves P, Oldmeadow C, Kennedy SG, Boyer J, Stimpson L, Comis P, Roche L, Lubans DR. Time-efficient physical activity intervention for older adolescents with disability: rationale and study protocol for the Burn 2 Learn adapted (B2La) cluster randomised controlled trial. BMJ Open 2022; 12:e065321. [PMID: 35948376 PMCID: PMC9379534 DOI: 10.1136/bmjopen-2022-065321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Physical activity declines during adolescence, with the lowest levels of activity observed among those with disability. Schools are ideal settings to address this issue; however, few school-based interventions have been specifically designed for older adolescents with disability. Our aim is to investigate the effects of a school-based physical activity programme, involving high-intensity interval training (HIIT), on physical, mental and cognitive health in older adolescents with disability. METHODS AND ANALYSIS We will evaluate the Burn 2 Learn adapted (B2La) intervention using a two-arm, parallel group, cluster randomised controlled trial with allocation occurring at the school level (treatment or waitlist control). Secondary schools will be recruited in two cohorts from New South Wales, Australia. We will aim to recruit 300 older adolescents (aged 15-19 years) with disability from 30 secondary schools (10 in cohort 1 and 20 in cohort 2). Schools allocated to the intervention group will deliver two HIIT sessions per week during scheduled specialist support classes. The sessions will include foundational aerobic and muscle strengthening exercises tailored to meet student needs. We will provide teachers with training, resources, and support to facilitate the delivery of the B2La programme. Study outcomes will be assessed at baseline, 6 months (primary endpoint), and 9 months. Our primary outcome is functional capacity assessed using the 6 min walk/push test. Secondary outcomes include physical activity, muscular fitness, body composition, cognitive function, quality of life, physical literacy, and on-task behaviour in the classroom. We will also conduct economic and process evaluations to determine cost-effectiveness, programme acceptability, implementation, adaptability, and sustainability in schools. ETHICS AND DISSEMINATION This study has received approval from the University of Newcastle (H-2021-0262) and the New South Wales Department of Education (SERAP: 2021257) human research ethics committees. Findings will be published in peer-reviewed journals, and key stakeholders will be provided with a detailed report following the study. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry Number: ACTRN12621000884808.
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Affiliation(s)
- Toby J Kable
- School of Education, University of Newcastle, Callaghan, New South Wales, Australia
- Active Living Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Centre for Active Living, University of Newcastle, Callaghan, New South Wales, Australia
| | - Angus A Leahy
- School of Education, University of Newcastle, Callaghan, New South Wales, Australia
- Active Living Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Centre for Active Living, University of Newcastle, Callaghan, New South Wales, Australia
| | - Jordan J Smith
- School of Education, University of Newcastle, Callaghan, New South Wales, Australia
- Active Living Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Centre for Active Living, University of Newcastle, Callaghan, New South Wales, Australia
| | - Narelle Eather
- School of Education, University of Newcastle, Callaghan, New South Wales, Australia
- Active Living Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Centre for Active Living, University of Newcastle, Callaghan, New South Wales, Australia
| | - Nora Shields
- La Trobe University, Melbourne, Victoria, Australia
| | - Michael Noetel
- School of Behavioural and Health Sciences, Australian Catholic University - Brisbane Campus, Banyo, Queensland, Australia
| | - Chris Lonsdale
- Institute for Positive Psychology and Education, Australian Catholic University - North Sydney Campus, North Sydney, New South Wales, Australia
| | - Charles H Hillman
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Penny Reeves
- Health Research Economics, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Christopher Oldmeadow
- Clinical Research Design and Statistics, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Sarah G Kennedy
- School of Health Sciences, Western Sydney University, Kingswood, New South Wales, Australia
| | - James Boyer
- School Sport Unit, NSW Department of Education, Sydney, New South Wales, Australia
| | - Leisl Stimpson
- Special Olympics Australia, Sydney, New South Wales, Australia
| | - Pierre Comis
- Special Olympics Australia, Sydney, New South Wales, Australia
| | - Laura Roche
- School of Education, University of Newcastle, Callaghan, New South Wales, Australia
| | - David R Lubans
- School of Education, University of Newcastle, Callaghan, New South Wales, Australia
- Active Living Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Centre for Active Living, University of Newcastle, Callaghan, New South Wales, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, New South Wales, Finland
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McKenzie G, Shields N, Willis C. 'Finding what works for me' - a qualitative study of factors influencing community gym participation for young adults with cerebral palsy. Disabil Rehabil 2022:1-8. [PMID: 35694973 DOI: 10.1080/09638288.2022.2083243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To understand the factors influencing participation in community-based gym exercise for young adults with cerebral palsy (CP). METHODS A qualitative study using semi-structured interviews was conducted. Interviews were completed with 39 young adults with CP (15-30 years, GMFCS I-IV) following a peer-supported, gym-based exercise program called FitSkills. RESULTS "Finding what works for me" was the overarching theme. Through their gym experiences, young adults with CP identified four interrelated main themes that influenced whether gym participation "worked" for them, or not: (i) psychological factors, (ii) a "social" participation context, (iii) organisational and logistical support, and (iv) cost. The social context of FitSkills was perceived to positively influence psychological health outcomes and attenuate perceived barriers to participation. Organisational support facilitated their initial attendance, while logistical effort and cost affected ongoing or future gym participation. CONCLUSIONS Social involvement plays a critical role in positive participation experiences in community exercise settings for young adults with CP. Clinicians supporting exercise participation for this group should prioritise intervention strategies that promote social engagement and mental wellbeing. Collaboration between clinicians, community leisure organisations, and funding bodies may be essential to overcome logistical and financial barriers during the transition to adulthood. Implications for rehabilitationThe main factor influencing the attendance, involvement, and ongoing exercise preferences of young adults with cerebral palsy (CP) was the social context of the participation experience.Altering the social environment through peer-mentoring can facilitate participation in the gym.Young adults with CP consider mental wellbeing to be an important motivator and outcome of gym-based exercise participation.Mental wellbeing should be prioritised for health promotion for this group.Collaboration between recreation organisations, health services, clinicians, and consumers to address logistical and financial factors can facilitate positive physical activity participation experiences in community settings.
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Affiliation(s)
- Georgia McKenzie
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Nora Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Claire Willis
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
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Lizarondo L, Stern C, Apostolo J, Carrier J, de Borges K, Godfrey C, Kirkpatrick P, Pollock D, Rieger K, Salmond S, Vandyk A, Loveday H. Five common pitfalls in mixed methods systematic reviews - lessons learned. J Clin Epidemiol 2022; 148:178-183. [PMID: 35341946 DOI: 10.1016/j.jclinepi.2022.03.014] [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: 10/13/2021] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Mixed methods systematic reviews (MMSR) combine quantitative and qualitative evidence within a single review. Since the revision of the JBI Methodology for MMSRs in 2020, there has been an increasing number of reviews published that claim to follow this approach. A preliminary examination of these indicated that authors frequently deviated from the methodology. This paper outlines five common 'pitfalls' associated with undertaking MMSR and provides direction for future reviewers attempting MMSR. METHODS Forward citation tracking identified 17 reviews published since the revision of the JBI mixed methods methodological guidance. Methods used in these reviews were then examined against the JBI methodology to identify deviations. RESULTS The issues identified related to the rationale for choosing the methodological approach; incorrect synthesis and integration approach chosen to answer the review question/s posed; the exclusion of primary mixed methods studies in the review; the lack of detail regarding the process of data transformation and a lack of 'mixing' of the quantitative and qualitative components. CONCLUSION This exercise was undertaken to assist systematic reviewers considering conducting a MMSR as well as MMSR users to identify potential areas where authors tend to deviate from the methodological approach. Based on these findings a series of recommendations are provided.
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Affiliation(s)
- Lucylynn Lizarondo
- JBI, Faculty of Health and Medical Sciences, University of Adelaide, 55 Norwich House, King William Road, Adelaide, Australia.
| | - Cindy Stern
- JBI, Faculty of Health and Medical Sciences, University of Adelaide, 55 Norwich House, King William Road, Adelaide, Australia
| | - Joao Apostolo
- Health Sciences Research Unit: Nursing, Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Portugal
| | - Judith Carrier
- School of Healthcare Sciences, Cardiff University, The Wales Centre For Evidence Based Care: A JBI Centre of Excellence, Cardiff CF10 3AT, United Kingdom
| | - Kelli de Borges
- Universidade Federal de Juiz de For a, Campus Universitário, Rua José Lourenço Kelmer, s/n - São Pedro, Juiz de Fora - MG, 36036-900, Brazil
| | - Christina Godfrey
- School of Nursing, Queen's University, Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence Kingston, 99 University Ave, Kingston, Ontario K7L 3N6, Canada
| | - Pamela Kirkpatrick
- School of Nursing and Midwifery, Robert Gordon University, The Scottish Centre for Evidence-based, Multi-professional Practice: A JBI Centre of Excellence, Garthdee House, Garthdee Rd, Garthdee, Aberdeen AB10 7AQ, United Kingdom
| | - Danielle Pollock
- JBI, Faculty of Health and Medical Sciences, University of Adelaide, 55 Norwich House, King William Road, Adelaide, Australia
| | - Kendra Rieger
- School of Nursing, Trinity Western University, 22500 University Dr, Langley, British Columbia, V2Y 1Y1, Canada
| | - Susan Salmond
- School of Nursing, Rutgers, The State University of New Jersey, The Northeast Institute for Evidence Synthesis and Translation (NEST): A JBI Centre of Excellence, New Brunswick, New Jersey, USA
| | - Amanda Vandyk
- School of Nursing, University of Ottawa, 75 Laurier Ave. E, Ottawa, Ontario K1N 6N5, Canada
| | - Heather Loveday
- College of Nursing, Midwifery and Healthcare, University of West London, The University of West London Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, St Mary's Rd, London W5 5RF, United Kingdom
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Brown MC, Podmore M, Araújo-Soares V, Skinner R, Sharp L. Childhood cancer survivors' perceptions of the barriers and facilitators to physical activity: a systematic review and thematic synthesis of qualitative evidence using the Theoretical Domains Framework. Health Psychol Rev 2022; 17:277-300. [PMID: 35081866 DOI: 10.1080/17437199.2022.2032795] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AbstractDue to the potential for late adverse effects of treatment, and in particular cardiovascular problems, physical activity (PA) is recommended for childhood cancer survivors (CCSs). However, many CCSs have low levels of activity. This review aimed to systematically identify, appraise and synthesise qualitative research evidence on the barriers and facilitators to PA from the perspective of CCSs. Six databases (MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, and Scopus) were searched from inception to February 2021 to identify qualitative data on PA gathered from CCSs diagnosed ≤18 years of age, and who had completed active treatment. Two reviewers screened for eligibility and assessed methodological quality using CASP. An inductive thematic synthesis was undertaken to identify descriptive themes relating to barriers and facilitators to PA, before mapping these onto the Theoretical Domains Framework (TDF). Confidence in review findings was assessed using the GRADE-CERQual approach. Eight original studies including 126 CCSs were eligible. A total of 45 descriptive themes (29 facilitators and 16 barriers) were mapped onto nine domains of the TDF; they were most commonly mapped onto the Environmental Context and Resources (n = 13 descriptive themes) and the Social Influences (n = 13) domains. Between two and four descriptive themes were mapped onto each of the remaining seven domains. Study quality was variable and overall confidence in review findings was low. Although a range of perceived influences on PA were identified, few studies were eligible, and fewer focused specifically on identifying the barriers and facilitators to PA. These findings provide a first step required for the development of PA interventions for CCSs. However, conclusive/strong evidence for the barriers and facilitators to PA is lacking highlighting the need for further research on the perceived influences on PA in CCSs. PROSPERO Registration: CRD42019147829.
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Affiliation(s)
- Morven C Brown
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Mary Podmore
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK.,Faculty of Behavioural, Management and Social Sciences, Department of Health Technology and Services Research, University of Twente, The Netherlands
| | - Roderick Skinner
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK.,Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,Department of Paediatric and Adolescent Haematology and Oncology, Great North Children's Hospital, Newcastle upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
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Bjorgaas HM, Elgen IB, Hysing M. Illness perception in children with cerebral palsy, a longitudinal cohort study. Heliyon 2021; 7:e08558. [PMID: 34917821 PMCID: PMC8666649 DOI: 10.1016/j.heliyon.2021.e08558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/18/2021] [Accepted: 12/02/2021] [Indexed: 11/24/2022] Open
Abstract
Background The perception of a disorder could be of importance both in problem solving behaviors, and in the emotional approach towards a disorder. Aims In this paper, we wanted to assess changes in illness perception in children with Cerebral Palsy (CP) over a four-year interval, to compare parental and self-ratings, and to assess illness perceptions according to co-occurring medical and psychiatric disorders. Methods Parents in a cohort of children with CP (N = 36), filled in the Illness Perception Questionnaire at age seven and again at age eleven, and self-reports were gathered at age eleven. Stability across time, informant differences and scores according to motor function, intellectual disability and the prevalence of psychiatric disorders were assessed. Results We found stable parental perceptions across a four –year interval. Parents reported significantly higher impact of CP on the child, than that reported by the child itself. In children with a more severe motor disability and/or co-occurring psychiatric disorders, parents reported significantly higher median scores for perceived impact of the CP condition on symptoms, duration of the condition, and impact on leisure activities, compared to those who had less severe motor disability and/or intellectual abilities within the normal range. Conclusions We propose that illness perception should be included in the follow-up of children with CP, as it may provide a mutual understanding between the child/family and professionals involved in follow-up services, with possible impact on treatment adherence and outcome of the condition. Parents reported significantly more negative impact of CP than their children. Parents reported stable perception of their child's CP across a four-year period. Parents and children reported significant impact of CP on leisure activities. Impact of CP was significant in children with co-occurring psychiatric disorders.
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Affiliation(s)
- Hanne Marit Bjorgaas
- Dept. of Pediatric Neurology, Habu Stavanger, Stavanger University Hospital, Stavanger HF, Pb. 8100, 4068, Stavanger, Norway
| | | | - Mari Hysing
- Dept. of Psychosocial Science, Pb. 7807, 5020, Bergen, Norway
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Imms C, Reddihough D, Shepherd DA, Kavanagh A. Social Outcomes of School Leavers With Cerebral Palsy Living in Victoria. Front Neurol 2021; 12:753921. [PMID: 34970206 PMCID: PMC8712328 DOI: 10.3389/fneur.2021.753921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: In Australia, the National Disability Strategy provides a framework to guide actions and investment to achieve equity in social inclusion and economic participation for people with disability. We investigated the social outcomes of school leavers with cerebral palsy (CP) in Victoria, Australia and explored the determinants of desirable outcomes. Methods: We used the Victorian CP Register to invite all adults with CP aged 18-25 years (n = 649). On-line and/or paper-based surveys explored participation in education, employment, community activities, living situation, relationships and life satisfaction. Functional and health status data were collected. Social outcomes were summarized descriptively and compared between individuals with CP and non-disabled peers aged 18-25 years from the Household Income and Labor Dynamics in Australia dataset. Within the CP cohort we explored whether physical and mental health and level of functioning were associated with social outcomes. In addition, a descriptive comparison was undertaken between the social outcomes of the current CP cohort with that of a previously reported 2007 cohort. Results: Ninety participants (57% male; mean age 22.4 years (SD: 2.2) in 2020; 61.1% self-reported) provided data for analyses; response rate 16.9%. CP characteristics were similar between respondents and non-respondents. In comparison to similar aged peers, 79.8% had completed secondary school (compared to 83.2%); 32.6% (compared to 75.8%) were in paid work; 87.5% (compared to 48.2%) were living in their parental home; and 3.4% (compared to 31.6%) were married or partnered. Individuals with CP and higher levels of functional capacity and better physical health were more likely to undertake post-secondary education. Higher levels of functional capacity and physical health, as well as lower mental health status were associated with being employed. Conclusions: While foundational education completion rates were similar to non-disabled peers, significant gaps in social outcomes remain, including residence in the parental home and single status. While addressing these issues is challenging, substantial efforts are needed to reduce these disparities-work that needs to be done in collaboration with people with CP and their families.
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Affiliation(s)
- Christine Imms
- Apex Australia Foundation Chair of Neurodevelopment and Disability, Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Dinah Reddihough
- Principal Research Fellow, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Daisy A. Shepherd
- Biostatistician, Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Anne Kavanagh
- Chair in Disability and Health, School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
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Salie R, Eken MM, Donald KA, Fieggen AG, Langerak NG. Physical Activity Levels of Adolescents and Adults With Cerebral Palsy in Urban South Africa. Front Neurol 2021; 12:747361. [PMID: 34777217 PMCID: PMC8581637 DOI: 10.3389/fneur.2021.747361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/28/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Research in high income countries shows that people with cerebral palsy (CP) are less physically active than typically developing (TD) peers, but less is known regarding physical activity (PA) in those with CP in low-to-middle income countries. The aim of this study was to determine daily step count and levels of PA in adolescents and adults with CP living in urban South Africa, compared to TD peers, and to determine associations with sex, Gross Motor Function Classification System (GMFCS) level, body mass index and socio-economic status. Materials and Methods: This case-control study included 26 adolescents and 22 adults with CP (GMFCS Level I-V) and matched TD peers (25 and 30, respectively). Participants wore an ActiGraph GT3X for 7 consecutive days to determine step count and time (minutes per hour) spent in PA levels, including sedentary (SED), low physical activity (LPA) and moderate to vigorous physical activity (MVPA). Results: The daily step count and PA levels for ambulant adolescents with CP (GMFCS level I-III) were similar to TD peers, while this was less for adolescents classified in GMFCS level IV-V. Daily step count, SED and MVPA were similar for adults classified in GMFCS level I-II compared to TD adults, while all parameters were lower for adults using assistive devices (GMFCS level III) and non-ambulant adults (GMFCS level IV-V) compared to TD peers. Daily step count and PA levels were inversely associated with GMFCS, while no other associations were found. Conclusion: People with CP who were more mobile dependent (higher GMFCS level) were less active. However, adolescents and adults with CP classified as GMFCS levels I-II living in urban South Africa recorded similar step count and PA levels as their TD peers. This was also the case for adolescents using assistive devices, though not for those in the adult group (GMFCS level III). Furthermore, it was apparent that even the ambulant individuals with CP and TD cohorts were relatively inactive. Intervention programs for CP and TD adolescents should be aimed at finding strategies to keep adolescents physically active well into adulthood, in order to promote physical health, social and emotional well-being and independence.
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Affiliation(s)
- Roshaan Salie
- Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Division of Neurosurgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Maaike M Eken
- Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Kirsten A Donald
- Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - A Graham Fieggen
- Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Division of Neurosurgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Nelleke G Langerak
- Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Division of Neurosurgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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32
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Frisina C. Barriers and facilitators of physical activity participation for people with disabilities: a parent's perspective. Dev Med Child Neurol 2021; 63:890. [PMID: 33864245 DOI: 10.1111/dmcn.14897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 11/30/2022]
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33
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Qi J, Cai JH, Meng X. Impact of the Paralympic Games on the Beliefs of Children with Physical Disabilities Engaging in Sports and Physical Activities: A Chinese Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7296. [PMID: 34299749 PMCID: PMC8307629 DOI: 10.3390/ijerph18147296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this qualitative study was to explore the beliefs of Chinese children with physical disabilities engaging in sports and physical activity (PA), and the impact of the Paralympic Games on these beliefs. Five Chinese children with physical disabilities (female = 2, male = 3) were recruited for participating in the workshops of the Paralympic Games and PA, and received individual semi-structured interviews before and after the workshop implementations. Interview transcripts were analysed and presented as descriptive summaries. Three themes emerged based on the analysis of the participants' interview data: (1) shocked, knowledgeable, and useful; (2) willingness to try, and (3) hope to obtain support. Results indicated that children with physical disabilities in this study acknowledged the positive outcomes of participating in the workshops of the Paralympic Games on the sports and PA engagement attitude change. However, children with disabilities also expressed that they need more related knowledge and information. The results of the study revealed that impairment and contextual factors (i.e., lack of support from family and physical education teachers, unsafe environments, and negative attitudes of peers without disabilities) were barriers to sports and PA engagement among children with physical disabilities in this study.
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Affiliation(s)
- Jing Qi
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China; (J.-H.C.); (X.M.)
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