Characteristics of control group participants who increased their physical activity in a cluster-randomized lifestyle intervention trial

Effectiveness of muscle strengthening exercises on the clinical outcomes of patients with knee osteoarthritis: A randomized four-arm controlled trial

Background

Knee osteoarthritis (OA) is one of the major causes of dysfunction that reduces patients' quality of life. The aim of current study was to investigate the effectiveness of muscle strengthening exercises on the clinical outcomes of patients with knee OA.

Methods

We conducted a single-blind clinical trial on 96 patients with mild to moderate knee osteoarthritis. Patients were randomly assigned to 4 groups with 24 patients and followed-up for 8 weeks. Quadriceps, hamstring and both hamstring and quadriceps strengthening exercises were received by the first (G1), second (G2) and third (G3) groups, respectively. The fourth group (G4) was the control group and did not receive any intervention. The main outcome variables were pain, physical function and morning stiffness. This study was retrospectively registered at irct.ir (Iranian Registry of Clinical Trials) with the code IRCT20220206053950N2, 2022-09-07.

Results

Our findings demonstrated a significant impact of interventions on VAS score, pain, and stiffness (All, p < 0.001). Nonetheless, the effect of interventions was not significant for physical function (P = 0.78). After adjusting for the potential confounders, similar results were observed. Besides, the results of Dunnett post hoc test showed that either G1 or G3 had the most decrease in VAS and WOMAC-morning stiffness scores compared to G2 and G4.

Conclusion

Based on the evidence from the present study, we can recommend a combination of quadriceps and hamstring strengthening exercises as the most effective intervention to reduce pain and morning stiffness in patients with OA.

Merging Yoga and Occupational Therapy for Parkinson's Disease: A Feasibility and Pilot Program

The purpose of this study was to assess feasibility and changes in outcome measures following the Merging Yoga and Occupational Therapy for Parkinson's Disease (MY-OT for PD) program: a 14-session program which combined community-based yoga for PD, and fall-risk focused group occupational therapy sessions. Seventeen participants completed an 8-week control period consisting of their normal participation, and an 8-week intervention period (14 MY-OT for PD sessions). There were fewer self-reported falls in the intervention (6) vs. control periods (10). One fall risk factor management scale (the Fall Prevention and Management Questionnaire, p=.02), and balance (p<.01) showed significant improvement between the control and intervention. The MY-OT for PD program is an encouraging occupational therapist-led program, which may improve balance and reduce self-reported falls.

Health-related quality of life changes after the merging yoga and occupational therapy for Parkinson's disease program: A mixed-methods study

BACKGROUND

To understand changes in health-related quality of life (HRQoL) after the Merging Yoga and Occupational Therapy for Parkinson's Disease (MY-OT for PD) program.

MATERIALS AND METHODS

We used a mixed-methods convergent design and administered the Parkinson's Disease Questionnaire-8 (PDQ-8), a measure of HRQoL, with 17 participants. We considered scores 8 weeks before MY-OT for PD, just before, and upon completion. Additionally, we completed two focus groups following the program with 16 participants to assess qualitative changes in HRQoL.

RESULTS

There were no significant differences in PDQ-8 scores between time points, F(2,32) = 1.60, p = 0.22, partial η² = 0.09. Participants did discuss improvements in all 8 HRQoL domains, frequently regarding mobility and activities of daily living.

CONCLUSION

Results diverged, with quantitative results showing no significant improvement in HRQoL and qualitative results indicating participant perceived improvements in all domains of the PDQ-8. The program should be explored further, and longitudinal follow-up completed.

Studies About Physical Activity Interventions Including Follow-Up Analysis: A Systematic Review

BACKGROUND

Some studies have used the follow-up method to analyze real behavioral changes in research involving physical activity (PA) interventions. This has great scientific value; however, it is hard to apply without satisfactory resources and research funding. Little is known about how many studies have used this method to analyze PA interventions in low-income and middle-income countries, especially Brazil.

PURPOSE

To describe Brazilian studies using follow-up analysis after PA interventions.

METHODS

A systematic review was performed including Brazilian studies with follow-up analysis after PA interventions; the analyzed papers were from the previous 10 years. The search was carried out in Portuguese, English, and Spanish in the following databases: SciELO, Latin American and Caribbean Health Science Literature, PubMed, and Scopus. The Preferred Reporting Items for Systematic Review and Meta-Analysis method was used.

RESULTS

In total, 6 of the 7 studies analyzed were from the southeast region, with the intervention time ranging from 2 to 12 months, carrying out follow-up every 5.3 months with 2.2 observations on average. The interventions had a behavioral approach and were generally carried out in universities, hospitals, and ambulatory care.

CONCLUSION

Studies on PA interventions using follow-up analysis are scarce. Considering the relevance of follow-up studies to measure behavior changes, the results suggest that more studies about this topic are essential in Brazil.

Interventions to Promote Fundamental Movement Skills in Childcare and Kindergarten: A Systematic Review and Meta-Analysis

BACKGROUND

Proficiency in fundamental movement skills (FMS) lays the foundation for being physically active and developing more complex motor skills. Improving these motor skills may provide enhanced opportunities for the development of a variety of perceptual, social, and cognitive skills.

OBJECTIVE

The objective of this systematic review and meta-analysis was to assess the effects of FMS interventions on actual FMS, targeting typically developing young children.

METHOD

Searches in seven databases (CINAHL, Embase, MEDLINE, PsycINFO, PubMed, Scopus, Web of Science) up to August 2015 were completed. Trials with children (aged 2-6 years) in childcare or kindergarten settings that applied FMS-enhancing intervention programs of at least 4 weeks and meeting the inclusion criteria were included. Standardized data extraction forms were used. Risk of bias was assessed using a standard scoring scheme (Effective Public Health Practice Project-Quality Assessment Tool for Quantitative Studies [EPHPP]). We calculated effects on overall FMS, object control and locomotor subscales (OCS and LMS) by weighted standardized mean differences (SMDbetween) using random-effects models. Certainty in training effects was evaluated using GRADE (Grading of Recommendations Assessment, Development, and Evaluation System).

RESULTS

Thirty trials (15 randomized controlled trials and 15 controlled trials) involving 6126 preschoolers (aged 3.3-5.5 years) revealed significant differences among groups in favor of the intervention group (INT) with small-to-large effects on overall FMS (SMDbetween 0.46), OCS (SMDbetween 1.36), and LMS (SMDbetween 0.94). Our certainty in the treatment estimates based on GRADE is very low.

CONCLUSIONS

Although there is relevant effectiveness of programs to improve FMS proficiency in healthy young children, they need to be interpreted with care as they are based on low-quality evidence and immediate post-intervention effects without long-term follow-up.

Impact of a nutrition and physical activity intervention (ENRICH: Exercise and Nutrition Routine Improving Cancer Health) on health behaviors of cancer survivors and carers: a pragmatic randomized controlled trial

Background

Physical activity and consuming a healthy diet have clear benefits to the physical and psychosocial health of cancer survivors, with guidelines recognising the importance of these behaviors for cancer survivors. Interventions to promote physical activity and improve dietary behaviors among cancer survivors and carers are needed. The aim of this study was to determine the effects of a group-based, face-to-face multiple health behavior change intervention on behavioral outcomes among cancer survivors of mixed diagnoses and carers.

Methods

The Exercise and Nutrition Routine Improving Cancer Health (ENRICH) intervention was evaluated using a two-group pragmatic randomized controlled trial. Cancer survivors and carers (n = 174) were randomly allocated to the face-to-face, group-based intervention (six, theory-based two-hour sessions delivered over 8 weeks targeting healthy eating and physical activity [PA]) or wait-list control (after completion of 20-week data collection). Assessment of the primary outcome (pedometer-assessed mean daily step counts) and secondary outcomes (diet and alcohol intake [Food Frequency Questionnaire], self-reported PA, weight, body mass index, and waist circumference) were assessed at baseline, 8-and 20-weeks.

Results

There was a significant difference between the change over time in the intervention group and the control group. At 20 weeks, the intervention group had increased by 478 steps, and the control group had decreased by 1282 steps; this represented an adjusted mean difference of 1761 steps (184 to 3337; P = 0.0028). Significant intervention effects for secondary outcomes, included a half serving increase in vegetable intake (difference 39 g/day; 95 % CI: 12 to 67; P = 0.02), weight loss (kg) (difference -1.5 kg; 95 % CI, -2.6 to -0.3; P = 0.014) and change in body mass index (kg/m²) (difference -0.55 kg/m²; 95 % CI, -0.97 to -0.13; P = 0.012). No significant intervention effects were found for self-reported PA, total sitting time, waist circumference, fruit, energy, fibre, alcohol, meat, or fat consumption.

Conclusions

The ENRICH intervention was effective for improving PA, weight, body mass index, and vegetable consumption even with the inclusion of multiple cancer types and carers. As an example of successful research translation, the Cancer Council NSW has subsequently adopted ENRICH as a state-wide program.

Trial registration

Australian New Zealand Clinical Trials Register identifier: ANZCTRN1260901086257.

Can skin cancer prevention and early detection be improved via mobile phone text messaging? A randomised, attention control trial

OBJECTIVE

To test the impact of a theory-based, SMS (text message)-delivered behavioural intervention (Healthy Text) targeting sun protection or skin self-examination behaviours compared to attention control.

METHOD

Overall, 546 participants aged 18-42 years were randomised using a computer-generated number list to the skin self-examination (N=176), sun protection (N=187), or attention control (N=183) text messages group. Each group received 21 text messages about their assigned topic over 12 months (12 weekly messages for 3 months, then monthly messages for the next 9 months). Data were collected via telephone survey at baseline, 3, and 12 months across Queensland from January 2012 to August 2013.

RESULTS

One year after baseline, the sun protection (mean change 0.12; P=0.030) and skin self-examination groups (mean change 0.12; P=0.035) had significantly greater improvement in their sun protection habits (SPH) index compared to the attention control group (reference mean change 0.02). The increase in the proportion of participants who reported any skin self-examination from baseline to 12 months was significantly greater in the skin self-examination intervention group (103/163; 63%; P<0.001) than the sun protection (83/173; 48%) or attention control (65/165; 36%) groups. There was no significant effect of the intervention for participants' self-reported whole-body skin self-examination, sun tanning, or sunburn behaviours.

CONCLUSION

The Healthy Text intervention was effective in inducing significant improvements in sun protection and any type of skin self-examination behaviours.

TRIAL REGISTRATION

The Australian and New Zealand Clinical Trials register (ACTRN12612000577819).

FUNDING

Cancer Australia 1011999.

Effect of a telephone-delivered coronary heart disease secondary prevention program (proactive heart) on quality of life and health behaviours: primary outcomes of a randomised controlled trial

BACKGROUND

Participation in coronary heart disease secondary prevention programs is low. Innovative programs to meet this treatment gap are required.

PURPOSE

To aim of this study is to describe the effectiveness of a telephone-delivered secondary prevention program for myocardial infarction patients.

METHODS

Four hundred and thirty adult myocardial infarction patients in Brisbane, Australia were randomised to a 6-month secondary prevention program or usual care. Primary outcomes were health-related quality of life (Short Form-36) and physical activity (Active Australia Survey).

RESULTS

Significant intervention effects were observed for health-related quality of life on the mental component summary score (p = 0.02), and the social functioning (p = 0.04) and role-emotional (p = 0.03) subscales, compared with usual care. Intervention participants were also more likely to meet recommended levels of physical activity (p = 0.02), body mass index (p = 0.05), vegetable intake (p = 0.04) and alcohol consumption (p = 0.05).

CONCLUSIONS

Telephone-delivered secondary prevention programs can significantly improve health outcomes and could meet the treatment gap for myocardial infarction patients.