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Barrett JS, Crozier A, Cuthbertson DJ, Strauss JA, Wagenmakers AJM, Shepherd SO. A free-living, walking-based, exercise programme, with exercise timed relative to breakfast, to improve metabolic health in people living with overweight and obesity: A feasibility study. PLoS One 2024; 19:e0307582. [PMID: 39570874 PMCID: PMC11581328 DOI: 10.1371/journal.pone.0307582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 07/08/2024] [Indexed: 11/24/2024] Open
Abstract
Optimising the timing of food intake relative to exercise may maximise the effectiveness of free-living exercise programmes on improvements in glycaemic control and cardio-metabolic health. This study aimed to assess the feasibility of a free-living, walking-based exercise programme and determine whether undertaking each exercise session before or after breakfast would most benefit longer-term metabolic health. Thirty-four people living with obesity (43±12 y, BMI 35.1±5.1 kg.m-2) undertook a 12-week walking-based programme, consisting of two continuous (30-60 min at 50% HRmax) and two interval exercise sessions per week (30-60 min, alternating 3 min at 85% HRmax and 3 min at 50% HRmax). Participants were allocated to exercise before (FASTED) or after (FED) breakfast (n = 17 per group). Feasibility (acceptability, adherence and compliance) to the exercise intervention were assessed, as well as changes in anthropometric variables, 24-hour continuous glucose monitoring, serum biochemistry including HbA1c, lipid profile and liver transaminases. Exercise adherence (FASTED: 93±4%, FED: 95±5%) and compliance (FASTED: 85±10%, FED: 88±10%) was high in both groups, and participants described exercise monitoring, programme structure and support as facilitators to this. Body mass, BMI, waist-to-hip ratio and HbA1c decreased similarly between groups (all P<0.01). However, serum ALT concentrations decreased after FASTED (-16± -14%; P = 0.001), but not FED training (-2 ± -4%; P = 0.720). We demonstrate that a free-living walking-based exercise programme, with exercise timed relative to breakfast can achieve high adherence and compliance and improve some anthropometric variables and HbA1c. Whether FASTED exercise can elicit greater improvements in liver health requires further investigation.
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Affiliation(s)
- Jennifer S. Barrett
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Anthony Crozier
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Daniel J. Cuthbertson
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, United Kingdom
- Metabolism & Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, United Kingdom
| | - Juliette A. Strauss
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Anton J. M. Wagenmakers
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Sam O. Shepherd
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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Russon CL, Allen MJ, Pulsford RM, Saunby M, Vaughan N, Cocks M, Hesketh KL, Low J, Andrews RC. A User-Friendly Web Tool for Custom Analysis of Continuous Glucose Monitoring Data. J Diabetes Sci Technol 2024; 18:1511-1513. [PMID: 39287195 PMCID: PMC11529048 DOI: 10.1177/19322968241274322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Affiliation(s)
| | | | | | - Michael Saunby
- Research Software Engineering, University of Exeter, Exeter, UK
| | | | - Matthew Cocks
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Katie L. Hesketh
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Jonathan Low
- School of Health and Exercise Science, The University of British Columbia–Okanagan, Kelowna, BC, Canada
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Crozier A, Cocks M, Hesketh K, Miller G, Mcgregor G, Thomas L, Jones H. Mobile heal th biometrics to prescribe immediate remote physical acti vity for enh ancing up tak e to cardiac rehabilitation (MOTIVATE-CR+): protocol for a randomised controlled feasibility trial. BMJ Open 2024; 14:e076734. [PMID: 38346877 PMCID: PMC10862308 DOI: 10.1136/bmjopen-2023-076734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/17/2023] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION Cardiac rehabilitation (CR) can reduce cardiovascular mortality and improve health-related quality of life. In the United Kingdom, patient uptake of CR remains low (52%), falling well short of the target in the 2019 National Health Service long-term plan (85%). Mobile health (mHealth) technologies, offering biometric data to patients and healthcare professionals, may bridge the gap between supervised exercise and physical activity advice, enabling patients to engage in regular long-term physically active lifestyles. This randomised controlled trial (RCT) will evaluate the feasibility of mHealth technology when incorporated into a structured home-based walking intervention, in people with recent myocardial infarction. METHODS AND ANALYSIS This is a feasibility, assessor blinded, parallel group RCT. Participants will be allocated to either CR standard care (control group) or CR standard care+mHealth supported exercise counselling (mHealth intervention group). Feasibility outcomes will include the number of patients approached, screened and eligible; the percentage of patients who decline CR (including reasons for declining), agree to CR and consent to being part of the study; the percentage of patients who enrol in standard CR and reasons for drop out; and the percentage of participants who complete clinical, physical and psychosocial outcomes to identify a suitable primary outcome for a future definitive trial. ETHICS AND DISSEMINATION The trial was approved in the UK by the Northwest-Greater Manchester East Research Ethics Committee (22/NW/0301) and is being conducted in accordance with the Declaration of Helsinki and Good Clinical Practice. Results will be published in peer-reviewed journals and presented at national and international scientific meetings. TRIAL REGISTRATION NUMBERS NCT05774587.
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Affiliation(s)
- Anthony Crozier
- Sport and Exercise Science, Liverpool John Moores University, Faculty of Science, Liverpool, UK
| | - Matthew Cocks
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, Merseyside, UK
| | | | | | - Gordon Mcgregor
- University of Warwick Warwick Clinical Trials Unit, Coventry, UK
| | | | - Helen Jones
- Liverpool John Moores University, Liverpool, UK
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Piras A, Raffi M. A Narrative Literature Review on the Role of Exercise Training in Managing Type 1 and Type 2 Diabetes Mellitus. Healthcare (Basel) 2023; 11:2947. [PMID: 37998439 PMCID: PMC10671220 DOI: 10.3390/healthcare11222947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
Diabetes mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia associated with impaired carbohydrate, lipid, and protein metabolism, with concomitant absence of insulin secretion or reduced sensitivity to its metabolic effects. Patients with diabetes mellitus have a 30% more risk of developing heart failure and cardiovascular disease compared to healthy people. Heart and cardiovascular problems are the first cause of death worldwide and the main complications which lead to high healthcare costs. Such complications can be delayed or avoided by taking prescribed medications in conjunction with a healthy lifestyle (i.e., diet and physical activity). The American College of Sports Medicine and the American Diabetes Association recommend that diabetic people reduce total sedentary time by incorporating physical activity into their weekly routine. This narrative literature review aims to summarize and present the main guidelines, pre-exercise cardiovascular screening recommendations, and considerations for patients with diabetes and comorbidities who are planning to participate in physical activity programs.
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Affiliation(s)
- Alessandro Piras
- Department of Life Quality Studies, University of Bologna, 40126 Bologna, Italy
| | - Milena Raffi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
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Jadotte Y, Buchholz B, Carroll W, Frum-Vassallo D, MacPherson J, Cole S. Brief Action Planning in Health and Health Care: A Scoping Review. Med Clin North Am 2023; 107:1047-1096. [PMID: 37806724 DOI: 10.1016/j.mcna.2023.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Achieving maximal health outcomes via health promotion and disease prevention requires the adoption of healthy behaviors. Brief action planning (BAP) is a method for patient self-management, health behavior change, and health coaching with potentially broad implications for and clinical applications in health and health care contexts. This scoping review presents 5 major findings about the literature on BAP: the principal geographic locations and the clinical contexts of its application, the types of research evaluations that it has undergone to date, the theoretic frameworks in which it is grounded, and the fidelity of its use in clinical practice.
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Affiliation(s)
- Yuri Jadotte
- Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA; Northeast Institute for Evidence Synthesis and Translation, Division of Nursing Science, School of Nursing, Rutgers University, Newark NJ, USA.
| | - Benjamin Buchholz
- Sickle Cell Center of Excellence, College of Medicine, Howard University, Washington, DC, USA
| | - William Carroll
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles CA, USA
| | - Deirdra Frum-Vassallo
- Health Promotion Disease Prevention, Northport VA Medical Center, Northport, NY, USA
| | | | - Steven Cole
- BAP Professional Network, US; Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA; Department of Scientific Education, Zucker SOM at Hofstra/Northwell, Hempstead, NY, USA; Department of Psychiatry, Zucker SOM at Hofstra/Northwell, Hempstead, NY, USA
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Bannell DJ, France-Ratcliffe M, Buckley BJR, Crozier A, Davies AP, Hesketh KL, Jones H, Cocks M, Sprung VS. Adherence to unsupervised exercise in sedentary individuals: A randomised feasibility trial of two mobile health interventions. Digit Health 2023; 9:20552076231183552. [PMID: 37426588 PMCID: PMC10328121 DOI: 10.1177/20552076231183552] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Adherence to unsupervised exercise is poor, yet unsupervised exercise interventions are utilised in most healthcare settings. Thus, investigating novel ways to enhance adherence to unsupervised exercise is essential. This study aimed to examine the feasibility of two mobile health (mHealth) technology-supported exercise and physical activity (PA) interventions to increase adherence to unsupervised exercise. Methods Eighty-six participants were randomised to online resources (n = 44, females n = 29) or MOTIVATE (n = 42, females n = 28). The online resources group had access to booklets and videos to assist in performing a progressive exercise programme. MOTIVATE participants received exercise counselling sessions supported via mHealth biometrics which allowed instant participant feedback on exercise intensity, and communication with an exercise specialist. Heart rate (HR) monitoring, survey-reported exercise behaviour and accelerometer-derived PA were used to quantify adherence. Remote measurement techniques were used to assess anthropometrics, blood pressure, HbA1c and lipid profiles. Results HR-derived adherence rates were 22 ± 34% and 113 ± 68% in the online resources and MOTIVATE groups, respectively. Self-reported exercise behaviour demonstrated moderate (Cohen's d = 0.63, CI = 0.27 to 0.99) and large effects (Cohen's d = 0.88, CI = 0.49 to 1.26) in favour of online resources and MOTIVATE groups, respectively. When dropouts were included, 84% of remotely gathered data were available, with dropouts removed data availability was 94%. Conclusion Data suggest both interventions have a positive impact on adherence to unsupervised exercise but MOTIVATE enables participants to meet recommended exercise guidelines. Nevertheless, to maximise adherence to unsupervised exercise, future appropriately powered trials should explore the effectiveness of the MOTIVATE intervention.
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Affiliation(s)
- Daniel J Bannell
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Benjamin James Roy Buckley
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Anthony Crozier
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Andrew P Davies
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Katie L. Hesketh
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Helen Jones
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
| | - Matthew Cocks
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
| | | | - on behalf of the MOTIVATE Team
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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Sittig S, Hauff C, Williams SG, Graves RJ, Fruh S. A Qualitative Exploration of Desired mHealth App Mechanisms Related to Daily Life Influences for College Nursing Students. RESEARCH DIRECTS IN HEALTH SCIENCES 2022; 2:7. [PMID: 36569223 PMCID: PMC9782965 DOI: 10.53520/rdhs2022.10441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction Mobile health (mHealth) apps are digital health tools that allow for the delivery and access to vital health information, support, and encouragement needed to foster positive behavior change. Designing and developing mHealth solutions based on daily life influences for nursing students is imperative to establishing healthier physical and mental health habits. Methods Multiple focus groups (n=10) were conducted, and a questionnaire (n=11) was administered to undergraduate students in the professional nursing component. Themed analysis of focus-group data was conducted along with descriptive analysis of the questionnaire. Results All participants stated it has been more difficult to maintain a healthy lifestyle since beginning the nursing program. This deterioration can be attributed to three key areas: mental health needs/support, rigor of nursing school, and decline in positive health choices. Participants stated they would use an mHealth app designed specifically for nursing students to combat deterioration of their health. Conclusions The results of this study (100% positive response rate) reveal mHealth applications might be a powerful tool in helping nursing students transform their physical and mental health. It appears that if an mHealth application is created with the specific "must-haves" of nursing students then we might experience a positive shift in health behaviors for nursing students, which will hopefully transcend into their careers as nurses.
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Affiliation(s)
- Scott Sittig
- Department of Health Science, University of Louisiana at Lafayette, Lafayette, Louisiana
| | - Caitlyn Hauff
- Departemnt of Health, Kinesiology and Sport, University of South Alabama, Mobile, Alabama
| | | | - Rebecca J Graves
- College of Nursing, University of South Alabama, Mobile, Alabama
| | - Sharon Fruh
- College of Nursing, University of South Alabama, Mobile, Alabama
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