1
|
Singh B, Olds T, Curtis R, Dumuid D, Virgara R, Watson A, Szeto K, O'Connor E, Ferguson T, Eglitis E, Miatke A, Simpson CE, Maher C. Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. Br J Sports Med 2023; 57:1203-1209. [PMID: 36796860 PMCID: PMC10579187 DOI: 10.1136/bjsports-2022-106195] [Citation(s) in RCA: 106] [Impact Index Per Article: 106.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE To synthesise the evidence on the effects of physical activity on symptoms of depression, anxiety and psychological distress in adult populations. DESIGN Umbrella review. DATA SOURCES Twelve electronic databases were searched for eligible studies published from inception to 1 January 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Systematic reviews with meta-analyses of randomised controlled trials designed to increase physical activity in an adult population and that assessed depression, anxiety or psychological distress were eligible. Study selection was undertaken in duplicate by two independent reviewers. RESULTS Ninety-seven reviews (1039 trials and 128 119 participants) were included. Populations included healthy adults, people with mental health disorders and people with various chronic diseases. Most reviews (n=77) had a critically low A MeaSurement Tool to Assess systematic Reviews score. Physical activity had medium effects on depression (median effect size=-0.43, IQR=-0.66 to -0.27), anxiety (median effect size=-0.42, IQR=-0.66 to -0.26) and psychological distress (effect size=-0.60, 95% CI -0.78 to -0.42), compared with usual care across all populations. The largest benefits were seen in people with depression, HIV and kidney disease, in pregnant and postpartum women, and in healthy individuals. Higher intensity physical activity was associated with greater improvements in symptoms. Effectiveness of physical activity interventions diminished with longer duration interventions. CONCLUSION AND RELEVANCE Physical activity is highly beneficial for improving symptoms of depression, anxiety and distress across a wide range of adult populations, including the general population, people with diagnosed mental health disorders and people with chronic disease. Physical activity should be a mainstay approach in the management of depression, anxiety and psychological distress. PROSPERO REGISTRATION NUMBER CRD42021292710.
Collapse
Affiliation(s)
- Ben Singh
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Timothy Olds
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Rachel Curtis
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Dorothea Dumuid
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Rosa Virgara
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Amanda Watson
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Kimberley Szeto
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Edward O'Connor
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Ty Ferguson
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Emily Eglitis
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Aaron Miatke
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Catherine Em Simpson
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Carol Maher
- Health and Use of Time (HUT) Group, University of South Australia, Adelaide, South Australia, Australia
| |
Collapse
|
2
|
Wilson N, Liu J, Adamjee Q, Di Giorgio S, Steer S, Hutton J, Lempp H. Exploring the emotional impact of axial Spondyloarthritis: a systematic review and thematic synthesis of qualitative studies and a review of social media. BMC Rheumatol 2023; 7:26. [PMID: 37608395 PMCID: PMC10464274 DOI: 10.1186/s41927-023-00351-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The psychological burden in people with inflammatory arthritis is substantial, yet little is known about the disease-related affect experienced by individuals with axial Spondyloarthritis (axial SpA). The aim of this study was to conduct a qualitative evidence synthesis and a review of social media to explore the emotional impact of living with axial SpA. METHODS We searched nine databases for studies reporting qualitative data about participants' emotional experience of living with axial SpA. In addition, we searched social media platforms for posts from people with axial SpA based in the UK that offered insights into emotional responses to living with the condition. We employed a thematic approach to synthesise the data. RESULTS We included 27 studies (1314 participants; 72% men) in our qualitative evidence synthesis and developed seven descriptive themes from the data: 1) delayed diagnosis: a barrier to emotional wellbeing; 2) disruptive symptoms: a source of mood swings; 3) work disability: a loss of self-esteem; 4) obstacles in interpersonal relationships: a trigger of distress; 5) taking up exercise: personal pride or unwelcomed reminders; 6) anti-TNF therapy: hope reignited despite concerns and 7) a journey of acceptance: worry mixed with hope. Posts extracted from social media fora (537; 48% from women) for the most part supported the seven themes. One additional theme-COVID-19, uncertainty and anxiety during the pandemic, was developed, reflecting common emotions expressed during the UK's first wave of the coronavirus pandemic. CONCLUSION This study highlights a preponderance of negative affect experienced by people living with axial SpA, conditioned through existing and anticipated symptoms, failed expectations, and lost sense of self. Given the bidirectional relationships between negative emotions and inflammation, negative emotions and perceptions of pain, and the influence of affect in self-care behaviours, this finding has important implications for treatment and management of people with axial SpA.
Collapse
Affiliation(s)
- Nicky Wilson
- Department of Rheumatology, King's College Hospital NHS Foundation Trust, London, UK.
| | - Jia Liu
- Centre for Education, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Qainat Adamjee
- GKT School of Medical Education, King's College London, London, UK
| | - Sonya Di Giorgio
- King's College London Libraries & Collections, King's College London, London, UK
| | - Sophia Steer
- Department of Rheumatology, King's College Hospital NHS Foundation Trust, London, UK
| | - Jane Hutton
- Department of Clinical Health Psychology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Heidi Lempp
- Department of Inflammation Biology, Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| |
Collapse
|
3
|
Safi A, Khawaja I, Collins P, Myers T. A Cross-Sectional Study Exploring the Physical Activity Levels of Afghans and Other South Asian Youth in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1087. [PMID: 36673843 PMCID: PMC9858935 DOI: 10.3390/ijerph20021087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/01/2023]
Abstract
Introduction: Participating in regular physical activity (PA) has numerous benefits, such as reducing obesity, chronic degenerative conditions, and depression. Despite many health-related benefits, physical inactivity is increasing in young people worldwide, especially in ethnic minority groups, such as British South Asians (BSAs). The aim of this study was to explore the PA levels of BSAs, specifically focusing on youth from Afghan, Pakistani, Bangladeshi, and Indian groups. Methods: A total of 191 (Afghans N = 44; Bangladeshi N = 39; Indian N = 56, Pakistani N = 52) youth from the West Midlands (UK) participated in this study (mean age 15.4 ± 0.5). The International Physical Activity Questionnaire—Short Form was used to measure PA levels. Data were modelled using a Bayesian approach to determine differences in PA levels. Results: The results indicated that 88.5% Afghans, 80% Bangladeshi, 78.6% Indians and 63% Pakistani reported engaging in <30 min of PA per day. Additionally, boys were more active than girls across all ethnic groups. Discussion: This study highlighted an alarmingly low proportion of young people from each BSA ethnic group meeting the PA guidelines. To the authors’ knowledge, this is the first study to explore and compare PA levels of the young British Afghan population, thus contributing novel findings to the area of BSA PA. Conclusion: Overall, the vast majority of BSA young people failed to meet the recommended PA guidelines of 60 min per day. Future research could utilise objective methods, such as Global Positioning System, pedometers and accelerometery to track and monitor PA levels, and could adopt an ecological approach to explore determinants of PA within each ethnic and gender group.
Collapse
Affiliation(s)
- Ayazullah Safi
- Centre for Nutraceuticals, School of Life Sciences, University of Westminster, London W1W 6UW, UK
| | - Irfan Khawaja
- Department of Sport and Exercise, School of Health Sciences, Birmingham City University, Birmingham B15 3TN, UK
| | - Peter Collins
- Faculty of Education Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK
| | - Tony Myers
- Department of Social Science, Sport and Business, Newman University, Birmingham B32 3NT, UK
| |
Collapse
|
4
|
Al-Nuaim A, Safi A. The Correlation of Built Environment on Hypertension, and Weight Status amongst Adolescence in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416763. [PMID: 36554642 PMCID: PMC9779449 DOI: 10.3390/ijerph192416763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 06/01/2023]
Abstract
The prevalence of hypertension is becoming more common in children and adolescents than ever before. Thus, the aim of this study was to evaluate the associations between the built environment on physical activity, sedentary behaviour, waist circumference, and health amongst adolescents in Saudi Arabia. A systolic and diastolic blood pressure, resting heart rate and waist circumference of 380 boys and girls aged between 15-19 years old (male = 199 and females = 181) were measured. The International physical activity Questionnaire Short Form was used to assess the physical activity levels and time spent sitting. The statistical analysis conducted were means and standard deviation, 2-way and 3-way of variance (ANOVA), Bonferroni post hoc tests, Chi-squared distribution and Pearson's correlations. Among males, 16.75% were classified as hypertensive, 12.69% as pre-hypertensive, and 70.56% as normal whereas, females, 23.20% were classified as hypertensive, 12.15% as pre-hypertensive and 64.64% as normal. There were significant differences (F1,379 = 16.50, p < 0.001) between males and females waist circumference. Pearson's correlation also revealed significant positive relationships in sedentary time (r = 0.123, p < 0.016), WC (r = 0.104, p < 0.043), and systolic blood pressure (r = 0.110, p < 0.032). The results revealed that systolic and diastolic blood pressure are significantly related to multiple measures of weight status, and sedentary behaviour. The results also highlight that active youth had lower resting heart rate compared to inactive peers. The present findings provide a foundation of knowledge for future research and highlight the major need for research and policy interventions, to address the concerning health habits of Al-Ahsa youth and broader Kingdom of Saudi Arabia.
Collapse
Affiliation(s)
- Anwar Al-Nuaim
- Physical Education Department, Education College, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Ayazullah Safi
- Centre for Nutraceuticals, School of Life Sciences, University of Westminster, London W1W 6UW, UK
| |
Collapse
|
5
|
Shavazipour B, Afsar B, Multanen J, Miettinen K, Kujala UM. Interactive multiobjective optimization for finding the most preferred exercise therapy modality in knee osteoarthritis. Ann Med 2022; 54:181-194. [PMID: 35023426 PMCID: PMC8759734 DOI: 10.1080/07853890.2021.2024876] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND There are no explicit guidelines or tools available to support clinicians in selecting exercise therapy modalities according to the characteristics of individual patients despite the apparent need. OBJECTIVE This study develops a methodology based on a novel multiobjective optimization model and examines its feasibility as a decision support tool to support healthcare professionals in comparing different modalities and identifying the most preferred one based on a patient's needs. METHODS Thirty-one exercise therapy modalities were considered from 21 randomized controlled trials. A novel interactive multiobjective optimization model was designed to characterize the efficacy of an exercise therapy modality based on five objectives: minimizing cost, maximizing pain reduction, maximizing disability improvement, minimizing the number of supervised sessions, and minimizing the length of the treatment period. An interactive model incorporates clinicians' preferences in finding the most preferred exercise therapy modality for each need. Multiobjective optimization methods are mathematical algorithms designed to identify the optimal balance between multiple conflicting objectives among available solutions/alternatives. They explicitly evaluate the conflicting objectives and support decision-makers in identifying the best balance. An experienced research-oriented physiotherapist was involved as a decision-maker in the interactive solution process testing the proposed decision support tool. RESULTS The proposed methodology design and interactive process of the tool, including preference information, graphs, and exercise suggestions following the preferences, can help clinicians to find the most preferred exercise therapy modality based on a patient's needs and health status; paving the way to individualize recommendations. CONCLUSIONS We examined the feasibility of our decision support tool using an interactive multiobjective optimization method designed to help clinicians balance between conflicting objectives to find the most preferred exercise therapy modality for patients with knee osteoarthritis. The proposed methodology is generic enough to be applied in any field of medical and healthcare settings, where several alternative treatment options exist.KEY MESSAGESWe demonstrate the potential of applying Interactive multiobjective optimization methods in a decision support tool to help clinicians compare different exercise therapy modalities and identify the most preferred one based on a patient's needs.The usability of the proposed decision support tool is tested and demonstrated in prescribing exercise therapy modalities to treat knee osteoarthritis patients.
Collapse
Affiliation(s)
| | - Bekir Afsar
- Faculty of Information Technology, University of Jyvaskyla, Jyvaskyla, Finland
| | - Juhani Multanen
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyvaskyla, Finland
| | - Kaisa Miettinen
- Faculty of Information Technology, University of Jyvaskyla, Jyvaskyla, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| |
Collapse
|
6
|
Saxena-Beem S, Dickson TA, Englund TR, Cleveland RJ, McCormick EM, Santana AE, Walker JA, Allen KD, Sheikh SZ. Perceived Impact of the COVID-19 Pandemic on Physical Activity Among Adult Patients With Rheumatologic Disease. ACR Open Rheumatol 2022; 4:1042-1049. [PMID: 36314195 DOI: 10.1002/acr2.11507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/24/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The objective of this cross-sectional study was to investigate the impact of the COVID-19 pandemic on physical activity (PA) levels of patients with rheumatic and musculoskeletal diseases (RMDs) and to examine factors associated with decreased PA. METHODS A sample of adult patients with RMDs (n = 7,776) was identified through electronic medical records from an academic health care system in North Carolina. Invitations to participate in an online survey were sent between July 2020 and September 2020 to assess self-reported changes in PA during the COVID-19 pandemic. Descriptive statistics, age-adjusted prevalence odds ratios (PORs), and 95% confidence intervals (CIs) were computed to examine patient characteristics associated with decreased PA. RESULTS A total of 893 eligible participants completed the survey (mean age 57.8 ± 14.9 years, 75.8% female). The most common primary diagnoses reported among participants included rheumatoid arthritis (27.3%), osteoarthritis (16.0%), and systemic lupus erythematosus (SLE) (13.0%). More than half of participants (56.8%) reported engaging in less PA since the pandemic began. Factors associated with engaging in less PA included lower self-reported general health (POR, 2.21; CI, 1.64-2.97) and a diagnosis of SLE (POR, 1.57; CI, 1.03-2.38). Comorbidities associated with decreased PA included chronic pain (POR, 1.38; CI, 1.04-1.82), depression (POR, 1.48; CI, 1.09-2.01), and hypertension (POR, 1.44; CI, 1.10-1.90). CONCLUSION The COVID-19 pandemic has exacerbated barriers to PA in patients with RMDs. There is a critical need to provide resources, support, and multifaceted programs to encourage PA in patients with RMDs during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Shruti Saxena-Beem
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Teresa A Dickson
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Tessa R Englund
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Rebecca J Cleveland
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Emily M McCormick
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Andres E Santana
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Julie A Walker
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Kelli D Allen
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA.,Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, North Carolina, Durham, USA
| | - Saira Z Sheikh
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA.,Division of Rheumatology, Allergy, and Immunology, University of North Carolina at Chapel Hill Department of Medicine, North Carolina, Chapel Hill, USA
| |
Collapse
|
7
|
Kelley GA, Kelley KS, Callahan LF. Are There Interindividual Differences in Anxiety as a Result of Aerobic Exercise Training in Adults With Fibromyalgia? An Ancillary Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2022; 103:1858-1865. [PMID: 35051402 PMCID: PMC9288562 DOI: 10.1016/j.apmr.2021.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/12/2021] [Accepted: 12/23/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To determine whether true interindividual response differences (IIRD) exist with respect to changes in anxiety because of aerobic exercise training in adults with fibromyalgia (FM). DATA SOURCES Data from a previous meta-analytical database of randomized controlled trials of exercise in adults with arthritis and other rheumatic diseases. STUDY SELECTION Randomized controlled trials limited to aerobic exercise training on anxiety in adults 18 years or older with FM were included. DATA EXTRACTION Change outcome SDs treated as point estimates for anxiety were used to calculate true IIRD from each study. In addition, treatment effect data were extracted. DATA SYNTHESIS The inverse variance heterogeneity model was used to pool all results. For the 5 studies and 321 participants in which results were pooled, statistically significant treatment effect reductions in anxiety were observed (mean, -0.77 points, 95% CI, -1.25 to -0.77). However, no significant IIRD were found (mean, 0.6 points, 95% CI, -1.2 to 1.5). The 95% prediction interval for true IIRD in a future study was -1.7 to 0.8. The percent chance, ie, probability, of a clinically meaningful difference in variability, was 61.5% (only possibly clinically important). CONCLUSIONS The results of the current study suggest that aerobic exercise is associated with reductions in anxiety among adults with fibromyalgia. However, there is currently a lack of convincing evidence to support the notion that true IIRD exist. Therefore, a search for potential mediators and moderators associated with aerobic exercise and changes in anxiety among adults with FM may not be warranted. However, additional research is needed before any true level of certainty can be established. This includes (1) the assessment of IIRD in future randomized controlled trials, (2) randomized controlled trials of longer duration, and (3) an increase in the proportion of men included in randomized controlled trials.
Collapse
Affiliation(s)
- George A Kelley
- Department of Epidemiology and Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV.
| | - Kristi S Kelley
- Department of Epidemiology and Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV
| | - Leigh F Callahan
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC; Department of Orthopedics, University of North Carolina, Chapel Hill, NC; Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| |
Collapse
|
8
|
Workplace Physical Activity Barriers and Facilitators: A Qualitative Study Based on Employees Physical Activity Levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159442. [PMID: 35954798 PMCID: PMC9367711 DOI: 10.3390/ijerph19159442] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 11/20/2022]
Abstract
Introduction: Lack of time, management support, insufficient facilitates, workload balance, and culture are often reported as common barriers to physical activity (PA) participation in the workplace. In comparison, identifying facilitators of PA in the workplace are scarce. A ‘one-size-fits-all’ approach to overcoming the barriers may also be unsuccessful within university settings where multidisciplinary workforce exists due to the heterogeneity nature of job roles. Thus, the aim of this study was to understand the perceived barriers and facilitators of PA of university employees who were classified as active or inactive based on their job roles. Methods: Forty-one employees (female = 17; male = 24) participated in focus groups to discuss their perceived barriers and facilitators to PA in the workplace. Participants were categorised based on their PA levels as active and inactive prior analysing the semi-structured focus groups data via using thematic analysis. Results and Discussion: The results showed that a lack of time was reported by 80% of the participants as a barrier to PA, including 63% inactive and 17% of the active participants. This included 27% administrators’ staff, 23% academics, 19% senior management, and 11% professional service staff. Over 75% participants reported a lack of management support as one of the perceived barriers to their PA engagement in the workplace. Approximately 58% also reported workplace culture as a barrier to PA participation. Open access to a gym on campus was perceived to be the main facilitator to engaging in PA in the future. Similarly, increased management support for engaging in PA and having flexibility during working days were perceived as facilitators for PA engagement and a way to reduced sedentary behaviour in the workplace. Conclusions: These findings contribute to the limited literature in terms of evaluating obstacles and facilitators of university employees to encourage engagement with PA in the workplace. These findings can be applied to form PA, health, and wellbeing-related interventions specifically targeting these identified barriers that are experienced in the workplace and thereby potentially reducing absenteeism and increasing productivity.
Collapse
|
9
|
Trends in Meeting the Aerobic Physical Activity Guideline Among Adults With and Without Select Chronic Health Conditions, United States, 1998-2018. J Phys Act Health 2021; 18:S53-S63. [PMID: 34465653 DOI: 10.1123/jpah.2021-0178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Physical activity is central to the management and control of many chronic health conditions. The authors examined trends during the past 2 decades in the prevalence of US adults with and without select chronic health conditions who met the minimal aerobic physical activity guideline. METHODS The 1998-2018 National Health Interview Survey data were analyzed. Prevalence of meeting the minimal aerobic physical activity guideline among adults with and without 6 chronic health conditions was estimated across 3-year intervals. Linear and higher-order trends were assessed overall and by age group. RESULTS During the past 2 decades, prevalence of meeting the aerobic guideline increased among adults with diabetes, hypertension, coronary heart disease, stroke, cancer, and arthritis. However, the absolute increase in prevalence was lower among adults with hypertension, coronary heart disease, and arthritis compared to counterparts without each condition, respectively. Prevalence was persistently lower among those with most chronic health conditions, except cancer, and among older adults compared to their counterparts. CONCLUSIONS Although rising trends in physical activity levels among adults with chronic health conditions are encouraging for improving chronic disease management, current prevalence remains low, particularly among older adults. Increasing physical activity should remain a priority for chronic disease management and control.
Collapse
|
10
|
Inauen J, Contzen N, Frick V, Kadel P, Keller J, Kollmann J, Mata J, van Valkengoed AM. Environmental Issues Are Health Issues. EUROPEAN PSYCHOLOGIST 2021. [DOI: 10.1027/1016-9040/a000438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abstract. Increasing demands on ecosystems, decreasing biodiversity, and climate change are among the most pressing environmental issues of our time. As changing weather conditions are leading to increased vector-borne diseases and heat- and flood-related deaths, it is entering collective consciousness: environmental issues are human health issues. In public health, the field addressing these issues is known as environmental health. This field addresses both the effects people have on their environment as well as the effects of the environment on people. Psychology, as a discipline concerned with explaining, predicting, and changing behavior has much to contribute to these issues because human behavior is key in promoting environmental health. To date, however, an integrative view of environmental health in psychology is lacking, hampering urgently needed progress. In this paper, we review how the environment and human health are intertwined, and that much can be gained through a systemic view of environmental health in psychology. Based on a review of the literature, we suggest that psychologists unite efforts to promote an integrative science and practice of environmental health psychology, and jointly address environmental-health related behavior. The research agenda for this field will include integrating behavior change theory and intervention approaches. Thereby, psychology can potentially make an important contribution to sustained environmental health for generations to come.
Collapse
Affiliation(s)
- Jennifer Inauen
- Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern, Switzerland
| | - Nadja Contzen
- Eawag: Swiss Federal Institute of Aquatic Science & Technology, Duebendorf, Switzerland
- Faculty of Behavioural and Social Sciences, University of Groningen, The Netherlands
| | - Vivan Frick
- Institute for Ecological Economy Research (IÖW), Center for Technology and Society, TU Berlin, Germany
| | - Philipp Kadel
- School of Social Sciences, Chair of Health Psychology, University of Mannheim, Germany
| | - Jan Keller
- Department of Education and Psychology, Freie Universität Berlin, Germany
| | | | - Jutta Mata
- School of Social Sciences, Chair of Health Psychology, University of Mannheim, Germany
- Mannheim Center for Data Science, University of Mannheim, Germany
| | | |
Collapse
|
11
|
Guglielmo D, Murphy LB, Theis KA, Helmick CG, Omura JD, Odom EL, Croft JB. Physical Activity Assessment and Recommendation for Adults With Arthritis by Primary Care Providers-DocStyles, 2018. Am J Health Promot 2021; 35:559-570. [PMID: 33356415 PMCID: PMC10479947 DOI: 10.1177/0890117120981371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To examine primary care providers' (PCPs) physical activity assessment and recommendation behaviors for adults with arthritis. DESIGN Cross-sectional. SETTING 2018 DocStyles online national market research survey of US physicians and nurse practitioners. SAMPLE 1,389 PCPs seeing adults with arthritis. MEASURES 2 independent behaviors (assessment and recommendation) as 3 non-mutually exclusive groups: "always assesses," "always recommends," and "both" ("always assesses and recommends"). ANALYSIS Calculated percentages of each group (overall and by PCP characteristics), and multivariable-adjusted prevalence ratios (PRs) using binary logistic regression. RESULTS Among PCPs, 49.2% always assessed and 57.7% always recommended physical activity; 39.7% did both. Across all 3 groups, percentages were highest for seeing ≥20 adults with arthritis weekly ("both": 56.4%; "always assesses": 66.7%; "always recommends": 71.3%) and lowest among obstetrician/gynecologists ("both": 26.9%; "always assesses": 36.8%; "always recommends": 40.7%). Multivariable-adjusted associations were strongest for seeing ≥20 adults with arthritis weekly (referent: 1-9 adults) and each of "always assesses" (PR = 1.5 [95% confidence interval (CI): 1.3-1.8] and "both" (PR = 1.6 [95% CI: 1.4-1.9]). CONCLUSIONS Approximately 40% of PCPs sampled always engaged in both behaviors (assessing and recommending physical activity) with adults with arthritis; seeing a high volume of adults with arthritis was consistently related to engaging in each behavior. Evidence-based approaches to support PCP counseling include offering provider education and training, raising awareness of available resources, and using health system supports.
Collapse
Affiliation(s)
- Dana Guglielmo
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Louise B. Murphy
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristina A. Theis
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Charles G. Helmick
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John D. Omura
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erica L. Odom
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Janet B. Croft
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
12
|
van Zanten JJCSV, Fenton SAM, Brady S, Metsios GS, Duda JL, Kitas GD. Mental Health and Psychological Wellbeing in Rheumatoid Arthritis during COVID-19 - Can Physical Activity Help? Mediterr J Rheumatol 2020; 31:284-287. [PMID: 33196006 PMCID: PMC7656132 DOI: 10.31138/mjr.31.3.284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 11/17/2022] Open
Abstract
In response to the COVID-19 pandemic, many countries have adopted community containment to manage COVID-19. These measures to reduce human contact, such as social distancing, are deemed necessary to contain the spread of the virus and protect those at increased risk of developing complications following infection with COVID-19. People with rheumatoid arthritis (RA) are advised to adhere to even more stringent restrictions compared to the general population, and avoid any social contact with people outside their household. This social isolation combined with the anxiety and stress associated with the pandemic, is likely to particularly have an impact on mental health and psychological wellbeing in people with RA. Increasing physical activity and reducing sedentary behaviour can improve mental health and psychological wellbeing in RA. However, COVID-19 restrictions make it more difficult for people with RA to be physically active and facilitate a more sedentary lifestyle. Therefore, guidance is necessary for people with RA to adopt a healthy lifestyle within the constraints of COVID-19 restrictions to support their mental health and psychological wellbeing during and after the COVID-19 pandemic.
Collapse
Affiliation(s)
- Jet J C S Veldhuijzen van Zanten
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.,Rheumatology Department, Dudley Group NHS Foundation Trust, Dudley, United Kingdom
| | - Sally A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.,Rheumatology Department, Dudley Group NHS Foundation Trust, Dudley, United Kingdom
| | - Sophia Brady
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.,Rheumatology Department, Dudley Group NHS Foundation Trust, Dudley, United Kingdom
| | - George S Metsios
- Rheumatology Department, Dudley Group NHS Foundation Trust, Dudley, United Kingdom.,Faculty of Education, Health and Wellbeing, University of Wolverhampton, United Kingdom
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - George D Kitas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.,Rheumatology Department, Dudley Group NHS Foundation Trust, Dudley, United Kingdom
| |
Collapse
|
13
|
Murphy LB, Cisternas MG, Theis KA, Brady TJ, Bohm MK, Guglielmo D, Hootman JM, Barbour KE, Boring MA, Helmick CG. All-Cause Opioid Prescriptions Dispensed: The Outsized Role of Adults With Arthritis. Am J Prev Med 2020; 59:355-366. [PMID: 32763134 DOI: 10.1016/j.amepre.2020.03.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/28/2020] [Accepted: 03/16/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Limited estimates of prescribed opioid use among adults with arthritis exist. All-cause (i.e., for any condition) prescribed opioid dispensed (referred to as opioid prescription in the remainder of this abstract) in the past 12 months among U.S. adults aged ≥18 years (n=35,427) were studied, focusing on adults with arthritis (n=12,875). METHODS In 2018-2019, estimates were generated using Medical Expenditure Panel Survey data: (1) 2015 prevalence of 1 or more opioid prescriptions to U.S. adults overall and by arthritis status and (2) in 2014-2015, among adults with arthritis, multivariable-adjusted associations between 1 or more opioid prescriptions and sociodemographic characteristics, health status, and healthcare utilization characteristics. RESULTS In 2015, the age-standardized prevalence of 1 or more opioid prescriptions among adults with arthritis (29.6%) was almost double of that for all adults (15.4%). Adults with arthritis represented more than half of all adults (55.3%) with at least 1 opioid prescription; among those with 1 or more prescriptions, 43.2% adults had 4 or more prescriptions. The strongest multivariable-adjusted associations with 1 or more opioid prescriptions were ambulatory care visits (1-4: prevalence ratios=1.9-2.0, 5-8: prevalence ratios=2.5-2.7, 9 or more: prevalence ratios=3.4-3.7) and emergency room visits (1: prevalence ratios=1.6, 2-3: prevalence ratios=1.9-2.0, 4 or more: prevalence ratios=2.4); Ref for both: no visits. CONCLUSIONS Adults with arthritis are a high-need target group for improving pain management, representing more than half of all U.S. adults with 1 or more opioid prescriptions. The association with ambulatory care visits suggests that providers have routine opportunities to discuss comprehensive and integrative pain management strategies, including low-cost evidence-based self-management approaches (e.g., physical activity, self-management education programs, cognitive behavioral therapy). Those with multiple opioid prescriptions may need extra support if transitioning to nonopioid and nonpharmacologic pain management strategies.
Collapse
Affiliation(s)
- Louise B Murphy
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | | | - Kristina A Theis
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Teresa J Brady
- Retired, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Clarity Consulting and Communications, Atlanta, Georgia
| | - Michele K Bohm
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dana Guglielmo
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Jennifer M Hootman
- Retired, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kamil E Barbour
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Charles G Helmick
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
14
|
Marks R. Anxiety and Osteoarthritis Disability: Updated Overview and Commentary. Open Orthop J 2020. [DOI: 10.2174/1874325002014010046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Introduction:
Osteoarthritis, a widespread highly painful often incapacitating joint disease continues to impose immense personal and societal challenges among adults of all ages, especially among older adults. In the absence of any effective cure or treatment, it has become essential to explore all correlates of this chronic disabling disease, especially those that might be preventable or modifiable. Anxiety, a potentially remediable state of mental distress - found linked to chronically disabling forms of arthritis, in various imperceptible ways, and which may have an immense bearing on the outcomes of osteoarthritis, has not received as much attention in the related literature as other topics, such as surgery.
Objective:
In line with previous promising work, this narrative review elected to explore the extent to which current researchers in the field are pursuing this topic, and if so, the degree to which prevailing peer-reviewed data sources support an important role for continued research in this realm, and in what regard.
Methods:
Primarily explored were the key databases housing relevant publications that emerged over Aug 1, 2018-Feb 26, 2020 using the keywords Osteoarthritis and Anxiety. Using a descriptive approach, the relative progress made over the past five previous years in this regard was assessed, in addition to what joints have been studied and with what frequency, and how the degree of interest compares to other currently researched osteoarthritis themes. The potential for intervening in the osteoarthritis pain cycle by addressing anxiety was also examined.
Results:
Findings show a high level of current interest in this topic, and that despite the paucity of prospective studies, studies on joints other than the knee and hip joints, some equivocal conclusions, small numbers of anxiety-related studies compared to other topics, and substantive design limitations, it appears that future research in this realm is strongly indicated.
Conclusion:
This topic if examined further is likely to produce highly advantageous results at all stages of the osteoarthritic disease process and in the context of primary, secondary, as well as tertiary measures to ameliorate osteoarthritis pain and disability.
Collapse
|
15
|
Kelley GA, Kelley KS, Callahan LF. Brief Report: State-Level Number of Physically Inactive US Adults With Arthritis Who can Improve Their Anxiety and Depression by Exercising. ACR Open Rheumatol 2020; 2:92-96. [PMID: 32043829 PMCID: PMC7011451 DOI: 10.1002/acr2.11110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/01/2019] [Indexed: 11/21/2022] Open
Abstract
Objective Provide state‐level estimates of the number of physically inactive adults in the United States with arthritis and other rheumatic and musculoskeletal diseases (RMDs) who could improve their anxiety and depression by exercising. Methods Utilizing 1) number‐needed‐to treat (NNT) data from two prior meta‐analyses of randomized controlled trials addressing the effects of exercise on anxiety and depression in adults with arthritis and other RMDs, 2) recent state‐level prevalence estimates on arthritis and physical inactivity in adults with arthritis and other RMDs, and 3) state‐level 2010 US Census population data, the number of physically inactive adults with arthritis and other RMDs who could improve their anxiety and depression by exercising was estimated. Results Across all states and the District of Columbia, the number of adults with arthritis and other RMDs who could improve their anxiety and depression by starting an exercise program was estimated at 3 433 167 (95% confidence interval [CI] = 3 171 000‐3 703 522) for anxiety and 2 942 706 (95% CI = 2 718 000‐3 174 438) for depression. For anxiety, numbers ranged from 3677 (95% CI = 3235‐4154) in the District of Columbia to 271 253 (95% CI = 243 998‐298 508) in Texas. For depression, numbers ranged from 3151 (95% CI = 2773‐3561) in the District of Columbia to 232 502 (95% CI = 209 140‐255 863) in Texas. Conclusion These state‐specific data suggest that a large number of physically inactive US adults with arthritis and other RMDs could improve their anxiety and depression by starting and maintaining a regular exercise program.
Collapse
|
16
|
Borisovskaya A, Chmelik E, Karnik A. Exercise and Chronic Pain. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:233-253. [PMID: 32342462 DOI: 10.1007/978-981-15-1792-1_16] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this chapter, we describe the impact and etiology of chronic pain, the associated changes in the nervous system, and the mechanisms by which exercise may be able to affect and reverse these changes. Evidence for efficacy of exercise in different conditions associated with chronic pain is presented, with focus on chronic low back pain, fibromyalgia, osteoarthritis, rheumatoid arthritis, and migraines. While the efficacy of exercise and level of evidence supporting it vary in different diseases, exercise has direct and indirect benefits for most patients suffering from chronic pain. Effective exercise regimens include education and cognitive restructuring to promote behavioral activation and reconceptualization of what pain means, with the goal of gradually reversing the vicious cycle of pain, inertia, sedentary behavior, and worsening disability. Long-term, consistent, individualized exercise-based treatment approaches are most likely to result in improvements in pain and function.
Collapse
Affiliation(s)
- Anna Borisovskaya
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
- Veterans Administration Medical Center, Seattle, WA, USA.
| | - Elizabeth Chmelik
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Veterans Administration Medical Center, Seattle, WA, USA
| | - Ashwin Karnik
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| |
Collapse
|
17
|
Macfarlane GJ, Rotariu O, Jones GT, Pathan E, Dean LE. Determining factors related to poor quality of life in patients with axial spondyloarthritis: results from the British Society for Rheumatology Biologics Register (BSRBR-AS). Ann Rheum Dis 2019; 79:202-208. [PMID: 31662321 DOI: 10.1136/annrheumdis-2019-216143] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine modifiable factors associated with poor quality of life (QoL) in patients with axial spondyloarthritis (axSpA). METHODS Analysis of data from the British Society for Rheumatology Biologics Register in Ankylosing Spondylitis (BSRBR-AS) and validation of a previous model using data from 1810 patients with axSpA recruited during 2012-2017. Data collected included clinical and patient-reported measures. QoL was assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) measure. Linear regression models predicting ASQoL scores were used first to validate a previous model from a national study, to extend this with additional information available in BSRBR-AS and finally to identify a 'de novo' model from BSRBR-AS of which factors impact on poor QoL. RESULTS Four out of five factors included in a previous model of poor QoL in patients with axSpA were confirmed: Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index, fatigue and widespread pain, although the performance of the model was improved by the addition of measures of mood and sleep disturbance. In a de novo model in BSRBR-AS, there were six factors (other than disease activity and function) that predicted ASQoL: depression (β=0.16), sleep disturbance (β=0.08), activity impairment (β=0.04), fibromyalgia (Symptom Severity Scale (β=0.24) and Widespread Pain Index (β=0.10)) and tobacco smoking (β=0.66). CONCLUSION This study confirms that poor QoL in patients with axSpA, in addition to high disease activity and poor function, is independently influenced by sleep disturbance, mood and widespread pain. These additional factors are not considered targets for treatment in current European League Against Rheumatism (EULAR) guidelines for managing the condition.
Collapse
Affiliation(s)
| | - Ovidiu Rotariu
- Epidemiology Group, University of Aberdeen, Aberdeen, Scotland, UK
| | - Gareth T Jones
- Epidemiology Group, University of Aberdeen, Aberdeen, Scotland, UK
| | - Ejaz Pathan
- Spondylitis Program, University Hospital Network, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Linda E Dean
- Epidemiology Group, University of Aberdeen, Aberdeen, Scotland, UK
| |
Collapse
|
18
|
Golla A, Mattukat K, Mau W. [Promotion of physical activity for older patients with rheumatism : Characteristics of inflammatory rheumatic diseases against the background of physical activity recommendations]. Z Rheumatol 2019; 78:127-135. [PMID: 30694360 DOI: 10.1007/s00393-019-0592-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Due to the wide range of positive effects and the clear evidence of effectiveness, physical activity is one of the most important treatments for inflammatory rheumatic diseases. Because of the frequent overlap of disease and age-related aspects in older patients, the implementation of the German national physical activity recommendations has to be checked and accompanied by physicians. To get the older patients in motion, a patient-centered approach is required that takes the individual health problem(s) and the current context of life into account. This article provides an overview of the activity-related characteristics of older patients with inflammatory rheumatic diseases. Against this background a simple strategy is provided for promoting physical activity during medical consultation, which takes the characteristics of older patients with rheumatism into consideration. In this way, physicians can integrate a targeted, resource and time-saving economic strategy into consultations that is in concordance with the national physical activity recommendations.
Collapse
Affiliation(s)
- A Golla
- Institut für Rehabilitationsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland.
| | - K Mattukat
- Institut für Rehabilitationsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland
| | - W Mau
- Institut für Rehabilitationsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland
| |
Collapse
|
19
|
Systematic reviews and meta-analysis in rheumatology: a gentle introduction for clinicians. Clin Rheumatol 2019; 38:2029-2038. [PMID: 31102085 DOI: 10.1007/s10067-019-04590-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/19/2022]
Abstract
Given the plethora of studies today on the same topic, clinicians in rheumatology as well as others increasingly rely on systematic reviews, with or without meta-analysis, to aid in their evidence-based decision-making. However, given time constraints, staying up-to-date on current methods for conducting systematic reviews and meta-analyses as well as interpreting the results of these reviews for application in clinical practice can be challenging. The purpose of this paper is to try and address this gap. In this paper, a description of the different types of systematic reviews and meta-analyses is provided as well as a description of the major elements, including methodology and interpretation of systematic reviews with meta-analyses. Included is a broad, five-question checklist to aid clinicians in rheumatology for making decisions about the utility of a systematic review. It is the hopes that this paper will aid clinicians in rheumatology as well as other consumers of systematic reviews and meta-analyses with the information necessary for judging the utility of systematic reviews and meta-analyses in their own work.
Collapse
|
20
|
Kelley GA. Individual Participant Data Meta-Analysis Explained. J Pediatr 2019; 207:265-266. [PMID: 30723015 DOI: 10.1016/j.jpeds.2018.12.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 12/17/2018] [Indexed: 12/31/2022]
Affiliation(s)
- George A Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV.
| |
Collapse
|
21
|
Brief Report: Exercise and Anxiety in Adults with Arthritis and Other Rheumatic Diseases: Support for Evidential Value. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2984671. [PMID: 30420959 PMCID: PMC6211156 DOI: 10.1155/2018/2984671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/01/2018] [Indexed: 11/18/2022]
Abstract
Objective Given the high prevalence of anxiety in adults with arthritis and other rheumatic diseases (AORD) and the subsequent need for interventions to reduce anxiety, this brief report sought to determine if evidential value exists to support the role of exercise for reducing anxiety in adults with AORD. Methods Utilizing data from a prior meta-analysis, a recently developed approach, P-curve, was used to determine evidential value by assessing for publication bias and p-hacking. Binomial tests as well as the more robust Stouffer's test were used to examine for evidential value. To examine the influence of selected studies on p-curve results, findings were also examined by dropping the highest and lowest p values from the analysis. Results The binomial test for evidential value was not statistically significant (p = 0.11) while the more robust Stouffer's test satisfied both conditions for evidential value (p = 0.002). Power analyses suggested a good fit for the observed p-curve. Results were generally robust when the least and most extreme values were excluded. Conclusions The results of this study provide evidential support for the benefits of exercise on anxiety in adults with AORD.
Collapse
|
22
|
Kelley GA, Kelley KS, Callahan LF. Brief communication: use of the minimal important difference for a meta-analysis on exercise and anxiety in adults with arthritis. Clin Rheumatol 2018; 37:1997-2000. [PMID: 29845416 DOI: 10.1007/s10067-018-4156-5] [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: 03/28/2018] [Accepted: 05/22/2018] [Indexed: 11/26/2022]
Abstract
A recent meta-analysis reported statistically significant improvements in anxiety as a result of exercise in adults with arthritis and other rheumatic diseases (AORD) using the traditional standardized mean difference (SMD) effect size (ES). The objective of this study was to use the more recently developed and clinically relevant minimal important difference (MID) approach to examine this association. Data from a previous meta-analysis of 14 randomized controlled trials representing 926 initially enrolled adults ≥ 18 years of age (539 exercise, 387 control) was used to calculate the ES using the MID approach. Minimal important difference data were derived from previously reported anchor-based values that represented the different instruments used to assess anxiety. Effect sizes were pooled using the inverse heterogeneity (IVhet) model. Overall, exercise resulted in a mean ES reduction in anxiety of - 0.80 (95% CI, - 1.60 to 0.001, p = 0.05; Q = 92.1, p < 0.001, I 2 = 83.7%, 95% CI, 74.9%, 89.5%), suggesting that overall, exercise may benefit an appreciable number of patients. Nonetheless, this effect spanned the range from many patients gaining important benefits to no patients improving. The clinically relevant effects of exercise on anxiety in adults with AORD are varied. However, these results should be interpreted with caution given the absence of anchor-based MID data specific to the instruments and questions used to assess anxiety in adults with AORD. A need exists for future research to establish instrument-specific, anchor-based MID values for questions assessing anxiety in adults with AORD.
Collapse
Affiliation(s)
- George A Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, PO Box 9190, Morgantown, WV, 26506-9190, USA.
| | - Kristi S Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, PO Box 9190, Morgantown, WV, 26506-9190, USA
| | - Leigh F Callahan
- Departments of Social Medicine and Orthopaedics, Department of Epidemiology, University of North Carolina, 3300 Thurston Bldg, Campus Box 7280, Chapel Hill, NC, 27599-7280, USA
| |
Collapse
|