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Larsen RF, Jarden M, Minet LR, Frølund UC, Hermann AP, Breum L, Möller S, Abildgaard N. Exercise in newly diagnosed patients with multiple myeloma: A randomized controlled trial of effects on physical function, physical activity, lean body mass, bone mineral density, pain, and quality of life. Eur J Haematol 2024; 113:298-309. [PMID: 38717071 DOI: 10.1111/ejh.14215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 08/03/2024]
Abstract
Reduced physical function caused by bone destruction, pain, anemia, infections, and weight loss is common in multiple myeloma (MM). Myeloma bone disease challenges physical exercise. Knowledge on the effects and safety of physical exercise in newly diagnosed patients with MM is limited. In a randomized, controlled trial, we studied the effect of a 10-week individualized physical exercise program on physical function, physical activity, lean body mass (LBM), bone mineral density (BMD), quality of life (QoL), and pain in patients newly diagnosed with MM. Lytic bone disease was assessed, and exercise was adjusted accordingly. Primary outcome: knee extension strength. Secondary outcomes: Six-Minute-Walk-Test, 30-s Sit-to-Stand-Test (SST), grip strength, level of physical activity, LBM, BMD, QoL, and pain. Measurements were conducted pre- and post-intervention, and after 6 and 12 months. We included 100 patients, 86 were evaluable; 44 in the intervention group (IG) and 42 in the control group (CG). No statistically significant differences between groups were observed. Knee extension strength declined in the IG (p = .02). SST, aerobic capacity, and global QoL improved in both groups. Pain decreased consistently in the IG regardless of pain outcome. No significant safety concerns of physical exercise in newly diagnosed patients with MM were observed.
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Affiliation(s)
- Rikke F Larsen
- Department of Physiotherapy and Occupational Therapy, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Haematology, Odense University Hospital, Odense, Denmark
| | - Mary Jarden
- Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lisbeth R Minet
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Geriatric, Odense University Hospital, Odense, Denmark
- The Competence Centre for Rehabilitation - KCR, Odense University Hospital, Odense, Denmark
| | | | | | - Leif Breum
- Department of Medicine and Endocrinology, Zealand University Hospital, Koge, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- OPEN, Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Niels Abildgaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Haematology, Odense University Hospital, Odense, Denmark
- The Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
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Kalderon L, Kaplan A, Wolfovitz A, Levy-Tzedek S, Gimmon Y. Barriers and Facilitators of Vestibular Rehabilitation: Patients and Physiotherapists' Perspectives. J Neurol Phys Ther 2024; 48:140-150. [PMID: 38426842 PMCID: PMC11208053 DOI: 10.1097/npt.0000000000000470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND AND PURPOSE Poor adherence to vestibular rehabilitation protocols is a known barrier to optimal care. Vestibular clinicians' comprehensive understanding of the barriers and facilitators to vestibular home exercise programs (VHEP) is a key element to achieving optimal care in the context of vestibular rehabilitation. The aims of this study are as follows: (1) to identify primary barriers and facilitators to VHEP from the perspective of patients with vestibular dysfunction and vestibular physical therapists (PTs); and (2) to provide strategies for clinicians to improve adherence and outcomes of VHEP. METHODS A qualitative research with single-session focus groups conducted separately for: (1) patients with vestibular disorders and (2) vestibular PTs. Six focus groups were conducted, 3 for each population, with a total of 39 participants. An online survey was conducted to evaluate the estimates of adherence rates, followed by a structured discussion over barriers and facilitators to VHEP as perceived by patients and PTs. Thematic data analyses were performed using a mixed deductive-inductive approach. RESULTS Eighteen patients with vestibular disorders and 21 experienced vestibular PTs participated in this study. Six barrier categories and 5 facilitator categories were identified. Barriers included motivation aspects, provocation of symptoms, time management, associated impairments, missing guidance and feedback, and psychosocial factors. Facilitators included motivation aspects, time management, patient education and exercise instructions, exercise setting, and associated symptom management. DISCUSSION AND CONCLUSIONS Clinicians who prescribe home exercise to patients with vestibular disorders can use this information about common barriers and facilitators for patient education and to provide optimal care and improve rehabilitation outcomes. VIDEO ABSTRACT AVAILABLE for more insights from the authors (see the video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A467 ).
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Affiliation(s)
- Liran Kalderon
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (L.K., A.K., S.L.-T.); Department of Otolaryngology—Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel (A.W., Y.G.); Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel (S.L.-T.); Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany (S.L.-T.); Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (Y.G.)
| | - Azriel Kaplan
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (L.K., A.K., S.L.-T.); Department of Otolaryngology—Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel (A.W., Y.G.); Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel (S.L.-T.); Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany (S.L.-T.); Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (Y.G.)
| | - Amit Wolfovitz
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (L.K., A.K., S.L.-T.); Department of Otolaryngology—Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel (A.W., Y.G.); Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel (S.L.-T.); Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany (S.L.-T.); Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (Y.G.)
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Hosokawa Y, Ishii K, Shibata A, Yako-Suketomo H, Suko R, Oka K. Social role of the 'Bow-Wow Patrol' in urban areas of Japan: a qualitative study. Sci Rep 2024; 14:13119. [PMID: 38849426 PMCID: PMC11161583 DOI: 10.1038/s41598-024-64079-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 06/05/2024] [Indexed: 06/09/2024] Open
Abstract
The 'Bow-Wow Patrol (BWP)', established to avert local crime by encouraging dog walking, may help build social relationships among individuals through dog walking. However, details of its social influence remain unclear. Thus, this study aimed to elucidate the social roles of BWP in the urban areas of Japan. A total of 18 BWP organisation members from two Tokyo municipalities were recruited using snowball sampling between November 2021 and July 2022. In an interview, participants were asked about their perceptions of changes in their social relationships through the BWP. Qualitative content analysis was conducted after text mining using the KH Coder software. The mean age of the participants was 63.9 years, and 83.3% engaged in BWP 7 days a week. The content analysis revealed six social roles of the BWP: establishment of social networks with schools as the centre, establishment of loose networks inside and outside the BWP organization, enhancement of a sense of trust among neighbours, enhancement of a sense of trust in communities, norms of reciprocity among dog owners, and dog and owner characteristics. This study found that the BWP in urban Japan strengthens social cohesion and expands social networks among dog walkers, encouraging them to continue walking.
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Affiliation(s)
- Yoshino Hosokawa
- Faculty of Health and Sports Sciences, Toyo University, Tokyo, Japan.
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Hiroko Yako-Suketomo
- Faculty of Physical Education, Japan Women's College of Physical Education, Tokyo, Japan
| | - Riki Suko
- Faculty of Physical Education, Japan Women's College of Physical Education, Tokyo, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Joaquim A, Amarelo A, Antunes P, Garcia C, Leão I, Vilela E, Teixeira M, Duarte B, Vieira M, Afreixo V, Capela A, Viamonte S, Costa H, Helguero LA, Alves A. Effects of a Physical Exercise Program on Quality of Life and Physical Fitness of Breast Cancer Survivors: the MAMA_MOVE Gaia After Treatment Trial. PSYCHOL HEALTH MED 2024; 29:964-987. [PMID: 37644639 DOI: 10.1080/13548506.2023.2240074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/18/2023] [Indexed: 08/31/2023]
Abstract
To assess the effects of a group class physical exercise program on health-related quality of life (HRQOL), physical fitness and activity, and safety in early breast cancer women after treatment, a double-phase trial [16-week control phase (CP) followed by a 16-week intervention phase (IP)] was designed. Outcomes were evaluated at baseline (T1), 8 (T2) and 16 (T3) weeks (CP), and 24 (T4) and 32 (T5) weeks (IP). The primary endpoint was global health status. Out of 82 enrolled patients, 37 completed the IP. Global health status decreased (-10,1; 95% CI -19.8 to -0.4; p = 0.040) during the CP and stabilized during the IP. Physical and sexual functioning increased during the IP (p = 0.008; p = 0.017), while cardiorespiratory fitness increased in the CP (p = 0.004). Upper limb strength and lower limb functionality increased during both phases [CP: p < 0.0001, p = 0.001 (surgical and nonsurgical arm), p = 0.028; IP: p < 0.0001, p = 0.002, p = 0.009]. Body mass index decreased in the IP (p = 0.026). Waist circumference increased in the CP (p = 0.001) and decreased in the IP (p = 0.010); sedentary behaviours and moderate and vigorous physical activity did not change. Adherence to 70% of the sessions was reported in 54% of patients. No serious adverse events related to the intervention were reported. In conclusion, the physical exercise program was able to prevent the decline in global health status and to improve other domains of HRQOL and physical fitness. As physical exercise is not the standard of care in many countries, the implementation of group class programs might be an option.
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Affiliation(s)
- Ana Joaquim
- Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
- Medical Oncology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Anabela Amarelo
- Medical Oncology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Pedro Antunes
- Research Center in Sport Sciences, Health, and Human Development (CIDESD), University of Beira Interior, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Catarina Garcia
- Research Center in Sport Sciences, Health, and Human Development (CIDESD), University of Maia, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Inês Leão
- Medical Oncology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Eduardo Vilela
- Cardiology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Madalena Teixeira
- Cardiology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Bárbara Duarte
- ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Micael Vieira
- Solinca Classic, SA, SC Fitness, SA, Lisbon, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Vera Afreixo
- Department of Mathematics; University of Aveiro, Center for Research & Development in Mathematics and Applications (CIDMA), University of Aveiro
| | - Andreia Capela
- Medical Oncology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Sofia Viamonte
- Department of Medical Sciences, University of Aveiro Centro de Reabilitação Do Norte, Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO), Portugal
| | - Horácio Costa
- Department of Plastic Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Department of Medical Sciences, University of Aveiro, Portugal
| | - Luisa A Helguero
- Department of Medical Sciences, University of Aveiro, Institute of Biomedicine of Aveiro (IBIMED), University of Aveiro, Aveiro, Portugal
| | - Alberto Alves
- Research Center in Sport Sciences, Health, and Human Development (CIDESD), University of Maia, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
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Lin YJ, Chung CY, Chen CPC, Hsieh YW, Wang CF, Chen CC. The Feasibility and Efficacy of Remote App-Guided Home Exercises for Frozen Shoulder: A Pilot Study. Healthcare (Basel) 2024; 12:1095. [PMID: 38891171 PMCID: PMC11171612 DOI: 10.3390/healthcare12111095] [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: 04/16/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Home exercise programs are beneficial in managing frozen shoulder (FS), yet adherence remains challenging. This pilot study introduces the remote app, Defrozen, designed for home exercises and assesses its feasibility and clinical outcomes in FS patients undergoing intra-articular and sub-acromial corticosteroid treatment. Over a four-week period, patients used the Defrozen-app, engaging in guided exercises. The feasibility of the intervention was assessed through several measurement scales, including adherence, the Technology Acceptance Model 2 (TAM2), the System Usability Scale (SUS), and User Satisfaction and Engagement (USE). Clinical outcomes included pain scale, Oxford Shoulder Score (OSS), Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) Score, and passive range of motion. The TAM2 results indicated high perceived usefulness (4.5/5), ease of use (4.8/5), and intention to use (4.4/5); the SUS score was high at 81.7/100, complemented by USE scores reflecting ease of learning (4.9/5) and satisfaction (4.3/5). Clinical outcomes showed significant pain reduction, improved shoulder function, reduced shoulder-related disability, and increased shoulder range of motion. These findings suggest the Defrozen-app as a promising solution for FS, significantly improving adherence and showing potential to enhance clinical outcomes. However, these clinical outcome results are preliminary and necessitate further validation through a large-scale randomized controlled trial to definitively confirm efficacy and assess long-term benefits.
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Affiliation(s)
- Yi-Jun Lin
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333423, Taiwan; (Y.-J.L.); (C.-Y.C.); (C.P.C.C.)
| | - Chia-Ying Chung
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333423, Taiwan; (Y.-J.L.); (C.-Y.C.); (C.P.C.C.)
| | - Carl P. C. Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333423, Taiwan; (Y.-J.L.); (C.-Y.C.); (C.P.C.C.)
| | - Yu-Wei Hsieh
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
| | - Ching-Fu Wang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
- Biomedical Engineering Research and Development Center, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Chih-Chi Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333423, Taiwan; (Y.-J.L.); (C.-Y.C.); (C.P.C.C.)
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Ley C, Putz P. Efficacy of interventions and techniques on adherence to physiotherapy in adults: an overview of systematic reviews and panoramic meta-analysis. Syst Rev 2024; 13:137. [PMID: 38773659 PMCID: PMC11106864 DOI: 10.1186/s13643-024-02538-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/17/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Adherence to physiotherapeutic treatment and recommendations is crucial to achieving planned goals and desired health outcomes. This overview of systematic reviews synthesises the wide range of additional interventions and behaviour change techniques used in physiotherapy, exercise therapy and physical therapy to promote adherence and summarises the evidence of their efficacy. METHODS Seven databases (PEDro, PubMed, Cochrane Library, Web of Science, Scopus, PsycINFO and CINAHL) were systematically searched with terms related to physiotherapy, motivation, behaviour change, adherence and efficacy (last searched on January 31, 2023). Only systematic reviews of randomised control trials with adults were included. The screening process and quality assessment with AMSTAR-2 were conducted independently by the two authors. The extracted data was synthesised narratively. In addition, four meta-analyses were pooled in a panoramic meta-analysis. RESULTS Of 187 reviews identified in the search, 19 were included, comprising 205 unique trials. Four meta-analyses on the effects of booster sessions, behaviour change techniques, goal setting and motivational interventions showed a significantly small overall effect (SMD 0.24, 95% CI 0.13, 0.34) and no statistical heterogeneity (I2 = 0%) in the panoramic meta-analysis. Narrative synthesis revealed substantial clinical and methodological diversity. In total, the certainty of evidence is low regarding the efficacy of the investigated interventions and techniques on adherence, due to various methodological flaws. Most of the RCTs that were included in the reviews analysed cognitive and behavioural interventions in patients with musculoskeletal diseases, indicating moderate evidence for the efficacy of some techniques, particularly, booster sessions, supervision and graded exercise. The reviews provided less evidence for the efficacy of educational and psychosocial interventions and partly inconsistent findings. Most of the available evidence refers to short to medium-term efficacy. The combination of a higher number of behaviour change techniques was more efficacious. CONCLUSIONS The overview of reviews synthesised various potentially efficacious techniques that may be combined for a holistic and patient-centred approach and may support tailoring complex interventions to the patient's needs and dispositions. It also identifies various research gaps and calls for a more holistic approach to define and measure adherence in physiotherapy. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021267355.
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Affiliation(s)
- Clemens Ley
- Department Health Sciences, Physiotherapy, FH Campus Wien University of Applied Sciences, Favoritenstrasse 226, 1100, Vienna, Austria.
| | - Peter Putz
- Department Health Sciences, Competence Center INDICATION, FH Campus Wien, University of Applied Sciences, Favoritenstrasse 226, 1100, Vienna, Austria
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Shawahna R, Jaber M, Zmiro A, Kashkoush S. Factors associated with physical inactivity among Palestinians with type 2 diabetes mellitus treated in resource-limited settings. Sci Rep 2024; 14:11256. [PMID: 38755152 PMCID: PMC11099123 DOI: 10.1038/s41598-024-60876-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 04/29/2024] [Indexed: 05/18/2024] Open
Abstract
This study determined the prevalence and the associated factors with meeting the recommended amount of physical activity among type 2 diabetes mellitus (T2DM) patients receiving care in resource-limited settings of the West Bank of Palestine. Physical activity was assessed using the World Health Organization's Global Physical Activity Questionnaire. Associations were examined using multivariate logistic regression. Of the 302 patients included, 117 (38.7%) met the recommended amount of physical activity. Being younger than 58 years [aOR = 2.1 (95% CI 1.0-4.3], were employed [aOR = 2.3 (95% CI 1.1-4.9)], had high income [aOR = 3.9 (95% CI 1.3-11.9)], had thought that physical activity was crucial for T2DM patients [aOR = 32.7 (95% CI 3.9-275.5)], did not have comorbidities [aOR = 2.2 (95% CI 1.1-4.4)], had normal weight [aOR = 2.8 (95% CI 1.3-6.0)], and those who were overweight [aOR = 2.6 (95% CI 1.1-6.0)] were more likely to meet the recommended amount of physical activity compared to the patients who were 58 years or older, had low income, did not think that physical activity was crucial for T2DM patients, had comorbidities, and were obese, respectively. There is a need to increase physical activity among T2DM patients in resource limited settings.
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Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building: 19, Office: 1340, Nablus, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
| | - Mohammad Jaber
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Arob Zmiro
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sewar Kashkoush
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Sañudo B, Sánchez-Oliver AJ, Fernández-Gavira J, Gaser D, Stöcker N, Peralta M, Marques A, Papakonstantinou S, Nicolini C, Sitzberger C. Physical and Psychosocial Benefits of Sports Participation Among Children and Adolescents with Chronic Diseases: A Systematic Review. SPORTS MEDICINE - OPEN 2024; 10:54. [PMID: 38750266 PMCID: PMC11096140 DOI: 10.1186/s40798-024-00722-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 05/01/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND This study aims to identify sports interventions for children and adolescents (CaA) with chronic diseases and evaluate their impact on physical, psychological, and social well-being. The findings of this study will contribute to our understanding of the potential benefits of sports interventions for CaA with chronic diseases and inform future interventions to promote their overall health and well-being. METHODS A systematic review was conducted in eight databases. This systematic review followed PRISMA guidelines and utilized a comprehensive search strategy to identify studies on sport-based interventions for CaA with chronic diseases. The review included randomized controlled trials and observational studies that focused on physical and psychosocial outcomes. RESULTS We screened 10,123 titles and abstracts, reviewed the full text of 622 records, and included 52 primary studies. A total of 2352 participants were assessed with an average of 45 ± 37 participants per study. Among the included studies involving CaA with chronic diseases with an age range from 3 to 18 years, 30% (n = 15) autism spectrum disorders, 21% (n = 11) cerebral palsy, 19% (n = 10) were attention deficit hyperactivity disorder, and 17% (n = 9) obesity. Other diseases included were cancer (n = 5), asthma (n = 1) and cystic fibrosis (n = 1). Interventions involved various sports and physical activities tailored to each chronic disease. The duration and frequency of interventions varied across studies. Most studies assessed physical outcomes, including motor performance and physical fitness measures. Psychosocial outcomes were also evaluated, focusing on behavioural problems, social competencies, and health-related quality of life. CONCLUSION Overall, sport-based interventions effectively improved physical and psychosocial outcomes in CaA with chronic diseases. Interventions are generally safe, and participants adhere to the prescribed protocols favorably. Despite that, there is little evidence that interventions are being implemented. Future studies should include interventions tailored to meet the common issues experienced by CaA with chronic conditions, providing a comprehensive understanding of the impact of sports interventions on those affected. REGISTRATION The methodology for this review was pre-determined and registered in the PROSPERO database (registration number: CRD42023397172).
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Affiliation(s)
- Borja Sañudo
- Department of Physical Education and Sport, University of Seville, Seville, Spain
| | | | | | - Dominik Gaser
- Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Nicola Stöcker
- CRETHIDEV. Creative Thinking Development, Attiki, Greece
| | - Miguel Peralta
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | | | - Chiara Nicolini
- CEIPES. Centro Internazionale per la Promozione dell'Educazione e lo Sviluppo, Palermo, Italy
| | - Christina Sitzberger
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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McCarthy MM, Szerencsy A, Taza-Rocano L, Hopkins S, Mann D, D'Eramo Melkus G, Vorderstrasse A, Katz SD. Implementing a Clinical Decision Support Tool to Improve Physical Activity. Nurs Res 2024; 73:216-223. [PMID: 38207172 PMCID: PMC11039363 DOI: 10.1097/nnr.0000000000000714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND Currently, only about half of U.S. adults achieve current physical activity guidelines. Routine physical activity is not regularly assessed, nor are patients routinely counseled by their healthcare provider on achieving recommended levels. The three-question physical activity vital sign (PAVS) was developed to assess physical activity duration and intensity and identify adults not meeting physical activity guidelines. Clinical decision support provided via a best practice advisory in an electronic health record (EHR) system can be triggered as a prompt, reminding healthcare providers to implement the best practice intervention when appropriate. Remote patient monitoring of physical activity can provide objective data in the EHR. OBJECTIVES This study aimed to evaluate the feasibility and clinical utility of embedding the PAVS and a triggered best practice advisor into the EHR in an ambulatory preventive cardiology practice setting to alert providers to patients reporting low physical activity and prompt healthcare providers to counsel these patients as needed. METHODS Three components based in the EHR were integrated for the purpose of this study: Patients completed the PAVS through their electronic patient portal prior to an office visit, a best practice advisory was created to prompt providers to counsel patients who reported low levels of physical activity, and remote patient monitoring via Fitbit synced to the EHR provided objective physical activity data. The intervention was pilot-tested in the Epic EHR for 1 year (July 1, 2021 to June 30, 2022). Qualitative feedback on the intervention from both providers and patients was obtained at the completion of the study. RESULTS Monthly assessments of the use of the PAVS and best practice advisory and remote patient monitoring were completed. Patients' completion of the PAVS varied from 35% to 48% per month. The best practice advisory was signed by providers between 2% and 65% and was acknowledged by 2%-22% per month. The majority (58%) of patients were able to sync a Fitbit device to their EHR for remote monitoring. DISCUSSION Although uptake of each component needs improvement, this pilot demonstrated the feasibility of incorporating a physical activity promotion intervention into the EHR. Qualitative feedback provided guidance for future implementation.
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McNeely ML, Chan KM, Spychka RA, Nedeljak J, Debenham B, Jha N, Seikaly H. Building a Bridge to Community: A Pragmatic Randomized Trial Examining a Combined Physical Therapy and Resistance Exercise Intervention for People after Head and Neck Cancer. Cancers (Basel) 2024; 16:1758. [PMID: 38730710 PMCID: PMC11083025 DOI: 10.3390/cancers16091758] [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: 04/01/2024] [Revised: 04/25/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Established barriers to general exercise and physical activity among individuals with head and neck cancer include dry mouth, difficulty eating, weight loss, fear of injury, comorbidities, and treatment-related symptoms of pain and fatigue. METHODS/DESIGN A 12-week pragmatic randomized controlled trial was conducted followed by an optional supported exercise transition phase. Eligible participants were individuals with head and neck cancers who had undergone surgery and/or radiation therapy to lymph node regions in the neck. Participants were randomized to a comparison group involving a shoulder and neck physiotherapeutic exercise protocol, or to a combined experimental group comprising the shoulder and neck physiotherapeutic exercise protocol and lower-body resistance exercise training. The primary outcome of this study was fatigue-related quality of life. RESULTS Sixty-one participants enrolled, 59 (97%) completed the randomized trial phase, 55 (90%) completed the 24-week follow-up, and 52 (85%) completed the one-year follow-up. Statistically significant between-group differences were found in favor of the combined experimental group for the fatigue-related quality of life, fitness outcomes, and overall physical activity. Paired comparisons confirmed significant within-group improvements for both groups from baseline to one-year follow-up across most outcomes. DISCUSSION A group-based combined physiotherapeutic and lower-body resistance exercise program was feasible and effective. Findings are limited to individuals who had undergone a surgical neck dissection procedure. Given the complexity of head and neck cancer, further pragmatic interdisciplinary research is warranted.
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Affiliation(s)
- Margaret L. McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (R.A.S.); (J.N.)
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 1Z2, Canada; (B.D.); (N.J.)
| | - K. Ming Chan
- Department of Physical Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2E1, Canada;
| | - Ryan A. Spychka
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (R.A.S.); (J.N.)
- Department of Radiology & Diagnostic Imaging, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Joni Nedeljak
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (R.A.S.); (J.N.)
| | - Brock Debenham
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 1Z2, Canada; (B.D.); (N.J.)
- Department of Radiation Oncology, Cross Cancer Institute, Alberta Health Services, Edmonton, AB T6G 1Z2, Canada
| | - Naresh Jha
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 1Z2, Canada; (B.D.); (N.J.)
- Department of Radiation Oncology, Cross Cancer Institute, Alberta Health Services, Edmonton, AB T6G 1Z2, Canada
| | - Hadi Seikaly
- Division of Otolaryngology-Head & Neck Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada;
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Jones MD, Clifford BK, Stamatakis E, Gibbs MT. Exercise Snacks and Other Forms of Intermittent Physical Activity for Improving Health in Adults and Older Adults: A Scoping Review of Epidemiological, Experimental and Qualitative Studies. Sports Med 2024; 54:813-835. [PMID: 38190022 DOI: 10.1007/s40279-023-01983-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/09/2024]
Abstract
Exercise snacks, including other variants of brief intermittent bouts, are an emerging approach for increasing physical activity, although their operationalisation is unstandardised and their health benefits remain unclear. This scoping review aimed to explore characterisations of exercise snacks and summarise their effects on health in adults and older adults. Clinical trial registers (clinicaltrials.gov and ANZCTR) and electronic databases (PubMed, CINAHL, CENTRAL, PsycINFO) were searched from inception to 1 June 2023, for ongoing and published studies of exercise snacks. Backwards and forwards citation tracking was also conducted to identify additional eligible studies. Studies were included if they investigated exercise snacks-brief intermittent bouts of physical activity spread across the day-in adults or older adults. We included epidemiological, experimental, quasi-experimental and qualitative studies that examined the effect of exercise snacks on any health outcomes or described barriers to and enablers of these approaches. Thirty-two studies were included (7 trial registers, 1 published protocol, 3 epidemiological studies and 20 trials reported across 21 studies). Three main terms were used to describe exercise snacks: exercise snack(ing), snacktivity and vigorous intermittent lifestyle physical activity (VILPA). Participants were predominantly physically inactive but otherwise healthy adults or older adults. Exercise snacks were feasible and appeared safe. Epidemiological studies showed steep, near-linear associations of VILPA with reduced all-cause, cardiovascular and cancer mortality as well as reduced incidence of major adverse cardiovascular events and cancer. The limited trial evidence showed exercise snacks had modest effects on improving cardiorespiratory fitness, whereas effects on physical function, mood, quality of life and other health outcomes were equivocal. In conclusion, exercise snacks appear feasible and safe for adults and older adults and may have promising health benefits, but this is mostly based on findings from a limited number of small quasi-experimental studies, small randomised trials or qualitative studies. More studies are needed in individuals with chronic disease. This emerging physical activity approach may have appeal for individuals who find structured exercise unfeasible.Registration https://osf.io/qhu24/.
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Affiliation(s)
- Matthew D Jones
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia.
| | - Briana K Clifford
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Emmanuel Stamatakis
- Mackenzie Wearables Research Hub, Charles Perkins Centre, University of Sydney, Sydney, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Mitchell T Gibbs
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
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Perry AE, Baker H, Aboaja A, Wilson L, Morris S. Co-production and adaptation of a prison-based problem-solving workbook to support the mental health of patients housed within a medium- and low-secure forensic service. Health Expect 2024; 27:e13997. [PMID: 38400622 PMCID: PMC10891435 DOI: 10.1111/hex.13997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/19/2023] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION Problem-solving skills (PSS) help to provide a systematic approach to dealing with and managing complex problems. The overall aim of this study was to assess the acceptability and feasibility of developing and adapting a prison-based PSS workbook for adults within a medium- and low-secure hospital. METHOD We used the Medical Research Council framework in our participatory mixed methods study incorporating an adapted survey (to identify what types of problems people experience in secure hospitals), a series of three interactive workshops (to co-produce two case study examples for a workbook) and we gathered feedback from patients and hospital staff on the acceptability and feasibility of the workbook. Data from the survey were used to inform the case study examples, and the feedback from patients and hospital staff was descriptively summarised and the results consolidated. RESULTS In total, 82 (51%) patients took part in the survey; 22 patients and 49 hospital staff provided feedback on the workbook. The survey results indicated that patients regularly experience problems while in the hospital. Patients reported problems relating to restrictions of freedom and boredom. The workshops produced two case studies for the workbooks, with mainly positive patient and staff feedback. More work is required to improve the visual representation of the characters in the case studies, the amount and content of the language and the mechanism of the intervention delivery. CONCLUSION The adaptation process proved acceptable and feasible to both patients and staff. The co-production methodology for the workbook and feedback from patients and staff was an effective way of iteratively refining the materials to ensure that they were both meaningful and acceptable to staff and patients. Subsequent work is required to develop the workbook and evaluate the feasibility of the intervention delivery, recruitment rates, uptake and adherence to the PSS using a randomised controlled trial. PATIENT OR PUBLIC CONTRIBUTION At each stage of the project consultation with patients and/or hospital staff was involved.
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Affiliation(s)
- Amanda E. Perry
- Department of Health SciencesUniversity of YorkYorkFulfordUK
| | - Heather Baker
- Tees Esk and Wear Valleys NHS Foundation TrustDarlingtonWest ParkUK
| | - Anne Aboaja
- Tees Esk and Wear Valleys NHS Foundation TrustDarlingtonWest ParkUK
| | - Lindsey Wilson
- Tees Esk and Wear Valleys NHS Foundation TrustDarlingtonWest ParkUK
| | - Sarah Morris
- Tees Esk and Wear Valleys NHS Foundation TrustDarlingtonWest ParkUK
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Dugunchi F, Mudgal SK, Marznaki ZH, Shirafkan H, Abrotan S, Jafarian F, Pourkia R. Levels of adherence to treatment, illness perception and acceptance of illness in patients with coronary artery disease - descriptive and correlational study. BMC Cardiovasc Disord 2024; 24:171. [PMID: 38509506 PMCID: PMC10953129 DOI: 10.1186/s12872-024-03827-w] [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: 12/22/2023] [Accepted: 03/04/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Understanding the disease and its acceptance significantly influence adherence to prescribed medications, a critical aspect in managing coronary artery disease (CAD). This study is designed to explore the multifaceted factors influencing medication adherence specifically in CAD patients. Of particular interest is investigating the interconnectedness between medication adherence, the perception of illness, and the level of acceptance of the illness itself among these individuals. METHODS This cross-sectional study involved 280 confirmed CAD patients who were selected through a convenience sampling method adhering to predefined inclusion criteria. The study was conducted between March and September 2023. Three primary parameters-medication adherence, illness perception, and acceptance of illness-were evaluated using standardized tools: The Morisky Medication Adherence Scale-8, Illness Perception Questionnaire-Brief, and Acceptance of Illness Scale. Statistical analyses using SPSS (version 25) were used to analyze the data. RESULTS Patients had moderate illness perception (51.82 ± 7.58) and low acceptance to illness (16.98 ± 4.75), and 61.8 of them adhered to their medication regimen. A positive relationship between acceptance of illness and medication adherence (r = 0.435, p-value < 0.01) was found. Level of education, type of drug and marital status had significantly impact on medication adherence, and gender, level of education, intention to stop drug and marital status were associated with acceptance of illness (p < 0.05). CONCLUSION These results underscore the pivotal role of medication adherence in CAD management. Future interventions should target improving illness perception and acceptance of illness among CAD patients to enhance their overall adherence to prescribed medications and ultimately improve disease management.
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Affiliation(s)
- Farzad Dugunchi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Shiv Kumar Mudgal
- College of Nursing, All India Institute of Medical Sciences, Deoghar, India
| | - Zohreh Hosseini Marznaki
- Imam Ali Hospital, Amol, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
| | - Hoda Shirafkan
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Saeed Abrotan
- Department of Cardiology, Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Fateme Jafarian
- Department of Cardiology, Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Roghayeh Pourkia
- Department of Cardiology, Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
- Department of Cardiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
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14
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Nokes KM, Sokhela DG, Orton PM, Samuels WE, Phillips JC, Tufts KA, Perazzo JD, Chaiphibalsarisdi P, Portillo C, Schnall R, Hamilton MJ, Dawson-Rose C, Webel AR. Exploring the Interrelationships Between Physical Function, Functional Exercise Capacity, and Exercise Self-Efficacy in Persons Living with HIV. Clin Nurs Res 2024; 33:165-175. [PMID: 38362890 PMCID: PMC11144462 DOI: 10.1177/10547738241231626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE To determine if there were differences between the subjective and objective assessments of physical activity while controlling for sociodemographic, anthropometric, and clinical characteristics. SETTING/SAMPLE A total of 810 participants across eight sites located in three countries. MEASURES Subjective instruments were the two subscales of Self-efficacy for Exercise Behaviors Scale: Making Time for Exercise and Resisting Relapse and Patient-Reported Outcomes Measurement Information System, which measured physical function. The objective measure of functional exercise capacity was the 6-minute Walk Test. ANALYSIS Both univariate and multivariant analyses were used. RESULTS Physical function was significantly associated with Making Time for Exercise (β = 1.76, p = .039) but not with Resisting Relapse (β = 1.16, p = .168). Age (β = -1.88, p = .001), being employed (β = 16.19, p < .001) and race (βs = 13.84-31.98, p < .001), hip-waist ratio (β = -2.18, p < .001), and comorbidities (β = 7.31, p < .001) were significant predictors of physical functioning. The model predicting physical function accounted for a large amount of variance (adjusted R2 = .938). The patterns of results predicting functional exercise capacity were similar. Making Time for Exercise self-efficacy scores significantly predicted functional exercise capacity (β = 0.14, p = .029), and Resisting Relapse scores again did not (β = -0.10, p = .120). Among the covariates, age (β = -0.16, p < .001), gender (β = -0.43, p < .001), education (β = 0.08, p = .026), and hip-waist ratio (β = 0.09, p = .034) were significant. This model did not account for much of the overall variance in the data (adjusted R2 = .081). We found a modest significant relationship between physical function and functional exercise capacity (r = 0.27). CONCLUSIONS Making Time for Exercise Self-efficacy was more significant than Resisting Relapse for both physical function and functional exercise capacity. Interventions to promote achievement of physical activity need to use multiple measurement strategies.
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Affiliation(s)
- Kathleen M Nokes
- International Nursing Network for HIV Research, Durban University of Technology, South Africa
| | - Dudu G Sokhela
- Department of Nursing, Durban University of Technology, South Africa
| | | | | | - J Craig Phillips
- Faculty of Health Sciences, School of Nursing, University of Ottawa, ON, Canada
| | | | | | | | | | | | - Mary Jane Hamilton
- College of Nursing and Health Sciences, Texas A&M University-Corpus Christi, USA
| | | | - Allison R Webel
- Department of Child, Family and Population Health Nursing, University of Washington, Seattle, USA
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15
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Noriega de la Colina A, Morris TP, Kramer AF, Kaushal N, Geddes MR. Your move: A precision medicine framework for physical activity in aging. NPJ AGING 2024; 10:16. [PMID: 38413658 PMCID: PMC10899613 DOI: 10.1038/s41514-024-00141-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/31/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Adrián Noriega de la Colina
- The Montreal Neurological Institute-Hospital, McGill University, 3801 Rue University, Montréal, QC, Canada.
- Department of Neurology and Neurosurgery, Faculty of Medicine and Human Sciences, McGill University, 3801 Rue University, Montréal, QC, Canada.
| | - Timothy P Morris
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, USA
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, USA
| | - Navin Kaushal
- School of Health & Human Sciences, Indiana University, Indiana, USA
| | - Maiya R Geddes
- The Montreal Neurological Institute-Hospital, McGill University, 3801 Rue University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine and Human Sciences, McGill University, 3801 Rue University, Montréal, QC, Canada
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16
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Flammer F, Paraschiv-Ionescu A, Marques-Vidal P. It needs more than a myocardial infarction to start exercising: the CoLaus|PsyCoLaus prospective study. BMC Cardiovasc Disord 2024; 24:102. [PMID: 38347464 PMCID: PMC10863136 DOI: 10.1186/s12872-024-03755-9] [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: 07/31/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Increased physical activity (PA) is recommended after an acute coronary event to prevent recurrences. Whether patients with acute coronary event actually increase their PA has not been assessed using objective methods such as accelerometer. We aimed to assess the subjectively and objectively measured physical activity (PA) levels of patients before and after an acute coronary event. METHODS Data from the three follow-up surveys of a prospective study conducted in Lausanne, Switzerland. Self-reported PA was assessed by questionnaire in the first (2009-2012) and second (2014-2017) follow-ups. Objective PA was assessed by a wrist-worn accelerometer in the second and third (2018-2021) follow-ups. Participants who developed an acute coronary event between each survey period were considered as eligible. PA levels were compared before and after the event, and changes in PA levels were also compared between participants who developed an acute event with three gender and age-matched healthy controls. RESULTS For self-reported PA, data from 43 patients (12 women, 64 ± 9 years) were used. No differences were found for all PA levels expressed in minutes/day before and after the event: moderate PA, median and [interquartile range] 167 [104-250] vs. 153 [109-240]; light PA: 151 [77-259] vs. 166 [126-222], and sedentary behaviour: 513 [450-635] vs. 535 [465-642] minutes/day. Comparison with gender- and age-matched healthy controls showed no differences regarding trends in reported PA. For accelerometer-assessed PA, data from 32 patients (16 women, 66 ± 9 years) were used. No differences were found for all PA levels expressed in minutes/day before and after the event: moderate PA: 159 [113-189] vs. 141 [111-189]; light PA: 95.8 [79-113] vs. 95.9 [79-117], and sedentary behaviour: 610 [545-659] vs. 602 [540-624]. Regarding the comparison with gender- and age-matched healthy controls, controls had an increase in accelerometer-assessed sedentary behaviour as % of day: multivariable adjusted average standard error 2.7 ± 0.6, while no increase was found for cases: 0.1 ± 1.1; no differences were found for the other PA levels. CONCLUSION Patients do not seem to change their PA levels after a first coronary event. Our results should be confirmed in larger samples.
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Affiliation(s)
- François Flammer
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 46 rue du Bugnon, Lausanne, 1011, Switzerland
| | - Anisoara Paraschiv-Ionescu
- Laboratory of Movement Analysis and Measurement (LMAM), Ecole Polytechnique Federale de Lausanne (EPFL), Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 46 rue du Bugnon, Lausanne, 1011, Switzerland.
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Hormazábal-Aguayo I, Muñoz-Pardeza J, López-Gil JF, Huerta-Uribe N, Chueca-Guindulain MJ, Berrade-Zubiri S, Burillo Sánchez E, Izquierdo M, Ezzatvar Y, García-Hermoso A. Comprehensive management of children and adolescents with type 1 diabetes mellitus through personalized physical exercise and education using an mHealth system: The Diactive-1 study protocol. Front Endocrinol (Lausanne) 2024; 15:1354734. [PMID: 38379866 PMCID: PMC10877052 DOI: 10.3389/fendo.2024.1354734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
Introduction The use of new technologies presents an opportunity to promote physical activity, especially among young people with type 1 diabetes (T1DM), who tend to be less active compared to their healthy counterparts. The aim of this study is to investigate the impact of a personalized resistance exercise program, facilitated by the Diactive-1 App, on insulin requirements among children and adolescents diagnosed with T1DM. Methods and analysis A minimum of 52 children and adolescents aged 8-18 years, who were diagnosed with T1DM at least 6 months ago, will be randomly assigned to either a group engaging in an individualized resistance exercise program at least 3 times per week over a 24-week period or a waiting-list control group. The primary outcome will be the daily insulin dose requirement. The secondary outcomes will include glycemic control, cardiometabolic profile, body composition, vascular function, physical fitness, 24-hour movement behaviors, diet, and psychological parameters. The usability of the app will also be assessed. Ethics and dissemination Ethical approval to conduct this study has been granted by the University Hospital of Navarra Research Board (PI_2020/140). Parents or legal guardians of minors participating in the study will provide written consent, while children and adolescents will sign an assent form to indicate their voluntary agreement. The trial's main findings will be shared through conference presentations, peer-reviewed publications, and communication directly with participating families. This study aims to offer valuable insights into the holistic management of children and adolescents with T1DM by utilizing personalized exercise interventions through an mHealth system. Trial registration NCT06048757.
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Affiliation(s)
- Ignacio Hormazábal-Aguayo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Jacinto Muñoz-Pardeza
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | | | - Nidia Huerta-Uribe
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | | | - Sara Berrade-Zubiri
- Pediatric Endocrinology Unit, Hospital Universitario de Navarra (HUN), IdiSNA, Pamplona, Spain
| | | | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
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Lee J, Kim J, Ju HJ, An SJ, Woo B. A Longitudinal Dose-Response Curve Between Leisure-Time Physical Activity and the Prevalence of Diabetes Based on the Different Levels of Cognitive Function Among Older Adults. Am J Alzheimers Dis Other Demen 2024; 39:15333175241241891. [PMID: 38549562 PMCID: PMC11072067 DOI: 10.1177/15333175241241891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
This study investigated a dose-response relationship between Leisure-Time Physical Activity participation (LTPA) and the risk of diabetes and a comparison of the risk across different cognitive function groups among older adults. The Health and Retirement Study data were used from 2012 to 2020 (n = 18 746). This study conducted a Cox Proportional Hazard Regression to investigate the Dose-Response Curve between the prevalence of diabetes and the covariates following a level of LTPA participation. The result presented that the Odds Ratio continuously decreased as the level of LTPA participation increased. Among the three cognitive function groups, the high group (OR = .43, P < .05) and the mid group (OR = .71, P < .05) had a larger negative slope coefficient than the low group. This study found that LTPA participation reduces the risk of diabetes and gives evidence for the importance of cognitive function in reducing the prevalence of diabetes.
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Affiliation(s)
- Jungjoo Lee
- School of Health Professions, College of Nursing and Health Professions, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Junhyoung Kim
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Hyo Jin Ju
- Department of Medical Humanities, The Convergence Institute of Healthcare and Medical Science, Catholic Kwandong University, Incheon, South Korea
| | - Sang Joon An
- Department of Neurology, The Convergence Institute of Healthcare and Medical Science, International St. Mary’s Hospital, Catholic Kwandong University, Incheon, South Korea
| | - Bomi Woo
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
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Levy T, Huxley K, Vuu S, Lewis LK. Physical activity for people with chronic conditions: a systematic review of toolkits to promote adherence. Disabil Rehabil 2023:1-14. [PMID: 38131330 DOI: 10.1080/09638288.2023.2296525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE The World Health Organisation (WHO) recommends that health professionals develop and implement "adherence counselling toolkits" to promote adherence to long-term therapies in people with chronic conditions. This prospectively registered review aimed to systematically identify and evaluate existing toolkits developed to promote adherence to physical activity in people with chronic conditions. MATERIALS AND METHODS Grey literature and six e-databases were searched for studies investigating the use of "toolkits" to promote adherence to physical activity or exercise recommendations in people with chronic conditions (Medline, PsycInfo, EmCare, Cochrane, CINAHL Plus, Pedro). A two-stage screening process was completed by two independent reviewers. RESULTS Five studies describing five toolkits were included. Three toolkits displayed all WHO recommended features, including information on adherence, a clinically useful way of using this information, and behavioural tools for maintaining habits. The included toolkits featured "adherence" to the intervention; however, this was not their primary aim. There were trends towards improved physical activity with some of the included toolkits. CONCLUSIONS There are a lack of rigorously developed toolkits that focus on adherence to physical activity in people with chronic conditions. Toolkits should be developed, tested, and implemented to improve adherence and outcomes for people with chronic conditions.
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Affiliation(s)
- Tamina Levy
- Caring Futures Institute, Flinders University, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Flinders Medical Centre, Rehabilitation and Palliative Services, Adelaide, Australia
| | - Kelly Huxley
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Flinders Medical Centre, Rehabilitation and Palliative Services, Adelaide, Australia
| | - Sally Vuu
- Caring Futures Institute, Flinders University, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Lucy K Lewis
- Caring Futures Institute, Flinders University, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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20
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Jeon S, Park C, Kim J, Lee JH, Joe SY, Ko YK, Gim JA. Comparing variants related to chronic diseases from genome-wide association study (GWAS) and the cancer genome atlas (TCGA). BMC Med Genomics 2023; 16:332. [PMID: 38114957 PMCID: PMC10729405 DOI: 10.1186/s12920-023-01758-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Several genome-wide association studies (GWAS) have been performed to identify variants related to chronic diseases. Somatic variants in cancer tissues are associated with cancer development and prognosis. Expression quantitative trait loci (eQTL) and methylation QTL (mQTL) analyses were performed on chronic disease-related variants in TCGA dataset. METHODS MuTect2 calling variants for 33 cancers from TCGA and 296 GWAS variants provided by LocusZoom were used. At least one mutation was found in TCGA 22 cancers and LocusZoom 23 studies. Differentially expressed genes (DEGs) and differentially methylated regions (DMRs) from the three cancers (TCGA-COAD, TCGA-STAD, and TCGA-UCEC). Variants were mapped to the world map using population locations of the 1000 Genomes Project (1GP) populations. Decision tree analysis was performed on the discovered features and survival analysis was performed according to the cluster. RESULTS Based on the DEGs and DMRs with clinical data, the decision tree model classified seven and three nodes in TCGA-COAD and TCGA-STAD, respectively. A total of 11 variants were commonly detected from TCGA and LocusZoom, and eight variants were selected from the 1GP variants, and the distribution patterns were visualized on the world map. CONCLUSIONS Variants related to tumors and chronic diseases were selected, and their geological regional 1GP-based proportions are presented. The variant distribution patterns could provide clues for regional clinical trial designs and personalized medicine.
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Affiliation(s)
- Soohyun Jeon
- Department of Brain and Cognitive Engineering, Korea University, Seoul, 02841, South Korea
| | - Chaewon Park
- School of Biomedical Engineering, Korea University, Seoul, 02841, South Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, 02841, South Korea
| | - Jineui Kim
- Department of Microbiology, Institute for Viral Diseases, College of Medicine, Korea University, Seoul, 02841, South Korea
| | - Jung Hoon Lee
- Department of Pharmacology, College of Medicine, Korea University, Seoul, 02841, South Korea
| | - Sung-Yune Joe
- School of Biomedical Engineering, Korea University, Seoul, 02841, South Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, 02841, South Korea
| | - Young Kyung Ko
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, 08308, South Korea
| | - Jeong-An Gim
- Department of Medical Science, Soonchunhyang University, Asan, 31538, South Korea.
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21
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Sierawska O, Sawczuk M. Interaction between Selected Adipokines and Musculoskeletal and Cardiovascular Systems: A Review of Current Knowledge. Int J Mol Sci 2023; 24:17287. [PMID: 38139115 PMCID: PMC10743430 DOI: 10.3390/ijms242417287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Adipokines are substances secreted by adipose tissue that are receiving increasing attention. The approach to adipose tissue has changed in recent years, and it is no longer looked at as just a storage organ but its secretion and how it influences systems in the human body are also looked at. The role of adipokine seems crucial in developing future therapies for pathologies of selected systems. In this study, we look at selected adipokines, leptin, adiponectin, chemerin, resistin, omentin-1, nesfatin, irisin-1, visfatin, apelin, vaspin, heparin-binding EGF-like growth factor (HB-EGF), and TGF-β2, and how they affect systems in the human body related to physical activity such as the musculoskeletal and cardiovascular systems.
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Affiliation(s)
- Olga Sierawska
- Institute of Physical Culture Sciences, University of Szczecin, 71-065 Szczecin, Poland;
- Doctoral School, University of Szczecin, 70-384 Szczecin, Poland
| | - Marek Sawczuk
- Institute of Physical Culture Sciences, University of Szczecin, 71-065 Szczecin, Poland;
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Brinkmann C. Road map for personalized exercise medicine in T2DM. Trends Endocrinol Metab 2023; 34:789-798. [PMID: 37730486 DOI: 10.1016/j.tem.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023]
Abstract
The number of patients with type 2 diabetes mellitus (T2DM) is rising at an alarming rate. Regular physical activity and exercise are cornerstones in the therapy of T2DM. While a one-size-fits-all approach fails to account for many between-subject differences, the use of personalized exercise medicine has the potential of optimizing health outcomes. Here, a road map for personalized exercise therapy targeted at patients with T2DM is presented. It considers secondary complications, glucose management, response heterogeneity, and other relevant factors that might influence the effectiveness of exercise as medicine, taking exercise-medication-diet interactions, as well as feasibility and acceptance into account. Furthermore, the potential of artificial intelligence and machine learning-based applications in assisting sports therapists to find appropriate exercise programs is outlined.
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Affiliation(s)
- Christian Brinkmann
- Institute of Cardiovascular Research and Sport Medicine, Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany; Department of Fitness & Health, IST University of Applied Sciences, Düsseldorf, Germany.
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23
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Fakolade A, Awadia Z, Cardwell K, McKenna O, Venasse M, Hume T, Ludgate J, Freedman MS, Finlayson M, Latimer-Cheung AE, Pilutti LA. Physical Activity Together for Multiple Sclerosis (PAT-MS): A randomized controlled feasibility trial of a dyadic behaviour change intervention. Contemp Clin Trials Commun 2023; 36:101222. [PMID: 37928934 PMCID: PMC10622616 DOI: 10.1016/j.conctc.2023.101222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/08/2023] [Accepted: 10/15/2023] [Indexed: 11/07/2023] Open
Abstract
Background Many people with advanced multiple sclerosis (MS) and their care-partners do not engage in sufficient physical activity (PA) for health benefits. We developed "Physical Activity Together for MS (PAT-MS)", a 12-week dyadic behavioural intervention, to promote PA among these dyads. Herein, we evaluated the feasibility of PAT-MS before a definitive trial. Methods A randomized controlled feasibility trial, with 1:1 allocation into the intervention or wait-list control condition. Predefined progression criteria included rates of recruitment, retention, safety, participant satisfaction and adherence. Changes in self-reported and accelerometer-measured PA were assessed at baseline and post-intervention using mixed-factor ANOVAs. Effects sizes were calculated as Cohen's d. Results The recruitment rate (i.e., 20 participants in 10 months) was not acceptable. However, retention (80%) was acceptable. No serious adverse events were reported. There were high levels of participant satisfaction with the intervention (content (median = 6 out of 7), facilitator (median = 7 out of 7), and delivery (median = 5 out of 7)) and adherence (92% of the group sessions, 83% of the individual support calls, and 80% of the practice activities were completed). There were statistically significant time-by-condition interactions on self-reported PA, steps/day, and %wear time and minutes in sedentary behaviour, and moderate-to-vigorous PA from baseline to post-intervention in people with MS and their family care-partners. Conclusion PAT-MS appears feasible, safe, and efficacious for PA promotion in MS dyads. We established effect size estimates to power a future definitive trial and identified necessary methodological changes to increase the efficiency of study procedures and improve the quality of the intervention. Trial registration ClinicalTrials.gov NCT04267185; Registered February 12, 2020, https://clinicaltrials.gov/ct2/show/NCT04267185.
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Affiliation(s)
| | - Zain Awadia
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Katherine Cardwell
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Odessa McKenna
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Myriam Venasse
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Taylor Hume
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Julia Ludgate
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Mark S. Freedman
- University of Ottawa, Department of Medicine and the Ottawa Hospital Research Institute, Ottawa, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | | | - Lara A. Pilutti
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
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Trujillo-Barberá S, García-Martínez P, Sánchez-Martínez JM, Rodríguez-Herrera MÁ, Ruiz-Hontangas A, Gámez-Paya J. Predictors of physical activity in older adults 65 years and older: findings in health survey of the Valencian Community. Front Public Health 2023; 11:1294537. [PMID: 38089020 PMCID: PMC10711059 DOI: 10.3389/fpubh.2023.1294537] [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: 09/14/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Background Physical activity is part of a healthy lifestyle in the older adult and is related to multiple variables that promote this behavior. Objective To identify the relationship and predictive power of sociodemographic variables, multimorbidity, severity index, risk of poor mental health, social support, affective support and confidential support with the time devoted to physical activity in the population over 65 years of age in the Valencian Community. Methods Cross-sectional descriptive analytical study of the data collected in the Health Survey of the Valencian Community on a total of 3,199 people over 65 years of age. The study variables were age, sex, educational level, marital status, social class, multimorbidity, severity index collected with the EQ-5D-5L tool, risk of poor mental health collected with the Goldberg general health questionnaire (GHQ-12), and perceived social, affective and confidential support collected with the Duke-Unc social support scale (Duke-UNC-11). Results All variables, except affective support, are significantly related to the time of physical activity performed by people older than 65 years. The severity index has a predictive capacity of 13.7% of physical activity performed and age is able to predict 1.2% of this variable. Conclusion Sex, age, education, social class, marital status, multimorbidity, risk of poor mental health or social support and confidentiality are related to the physical activity time of the Valencian population over 65 years of age. On the other hand, the variables severity index and age have been identified as variables capable of predicting up to 14.8% of the variance of the physical activity time variable in our study population.
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Affiliation(s)
- Silvia Trujillo-Barberá
- Department of Health Sciences, Faculty of Health Sciences, Universidad Europea de Valencia, Valencia, Spain
| | - Pedro García-Martínez
- Nursing School La Fe, Adscript Centre, University of Valencia, Valencia, Spain
- Research Group GREIACC, Health Research Institute La Fe, Valencia, Spain
| | | | | | - Antonio Ruiz-Hontangas
- Department of Health Sciences, Faculty of Health Sciences, Universidad Europea de Valencia, Valencia, Spain
| | - Javier Gámez-Paya
- Department of Health Sciences, Faculty of Health Sciences, Universidad Europea de Valencia, Valencia, Spain
- Biomechanics and Physiotherapy in Sports Research Group (BIOCAPS), Valencia, Spain
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St-Cyr J, Saint-Onge K, Doré I, Gauvin L. Milestones and turning points in the experience of physical activity throughout cancer care: a qualitative study to inform physical activity promotion. Support Care Cancer 2023; 31:682. [PMID: 37943370 PMCID: PMC10635913 DOI: 10.1007/s00520-023-08093-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 09/29/2023] [Indexed: 11/10/2023]
Abstract
PURPOSE Physical activity (PA) is an important supportive care strategy to manage cancer and treatment-related side effects, yet PA participation is low among people diagnosed with cancer. This study examined patients', health professionals', and managers' perspectives on PA throughout cancer care to glean implications for PA promotion. METHODS Random selection and purposeful sampling methods allowed for the recruitment of 21 patients (76.2% women) and 20 health professionals and managers (80% women) who participated in individual semi-structured interviews. Interview questions explored facilitators and barriers to PA participation and promotion across the cancer care continuum. Interviews were audio-recorded and transcribed. Then, qualitative thematic analysis was performed. RESULTS The analysis produced five main themes describing milestones in PA participation throughout cancer care: (1) Getting Started, (2) Discovering PA Resources, (3) Taking Action, (4) Striving for Change, and (5) Returning to a "New Normal." The sub-themes underscored turning points, i.e., tasks and challenges to PA participation that had to be overcome at each milestone. Achieving milestones and successfully navigating turning points were dependent on clinical, social, and community factors. CONCLUSION Cancer patients appear to progress through a series of milestones in adopting and maintaining PA throughout cancer care. Intervention strategies aimed at promoting PA could test whether support in navigating turning points could lead to greater PA participation. These findings require replication and extension, specifically among patients who are men, younger adults, and culturally diverse.
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Affiliation(s)
- Jany St-Cyr
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Kadia Saint-Onge
- Social and Preventive Medicine Department, School of Public Health, Université de Montréal, Montreal, QC, Canada.
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR CHUM), Montreal, QC, Canada.
| | - Isabelle Doré
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR CHUM), Montreal, QC, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Lise Gauvin
- Social and Preventive Medicine Department, School of Public Health, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR CHUM), Montreal, QC, Canada
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Al-Walah MA, Donnelly M, Cunningham C, Heron N. Which behaviour change techniques are associated with interventions that increase physical activity in pre-school children? A systematic review. BMC Public Health 2023; 23:2013. [PMID: 37845721 PMCID: PMC10580560 DOI: 10.1186/s12889-023-16885-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Insufficient physical activity (PA) is a significant risk factor that contributes to several health problems and there is a need to improve our understanding of how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between behaviour change techniques (BCTs) and interventions that increased PA among pre-school children aged < 6 years old. METHODS Systematic searches of six databases were undertaken from inception to July 2022, updated in December 2022, to locate studies that evaluated interventions and reported a positive change in PA levels in children aged < 6 years old. RESULTS A total of 5,304 studies were screened, and 28 studies involving 10,605 subjects aged 2.5 to 5.9 years met the eligibility criteria. Each eligible study (n = 28) was independently appraised by two researchers using the Cochrane risk of bias tool. The BCT Taxonomy v1 and the Template for Intervention Description and Replication (TIDieR) guided the extraction and analysis of data, and this process led to the identification of 27 BCTs. CONCLUSIONS Potentially promising BCTs for increasing PA among young children included 'shaping knowledge,' 'antecedents,' 'goals and planning,' and 'comparison of behaviour.' Future PA interventions that target young children should consider integrating these promising BCTs into their programmes. However, such consideration needs to be tempered by the fact that most of the reviewed studies were deemed to have a high or unclear risk of bias and/or were limited with respect to the populations that they targeted. Further research using rigorous methodologies is required to establish a higher standard that addresses the needs of young children who are expected to have insufficient levels of physical activity.
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Affiliation(s)
- Mosfer A Al-Walah
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK.
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, 21974, Taif, Saudi Arabia.
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK
| | - Conor Cunningham
- School of Health Science, Ulster University, Northern Ireland, UK
| | - Neil Heron
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK
- School of Medicine, Keele University, England, UK
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27
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Hao L, Goetze S, Alessa T, Hawley MS. Effectiveness of Computer-Tailored Health Communication in Increasing Physical Activity in People With or at Risk of Long-Term Conditions: Systematic Review and Meta-Analysis. J Med Internet Res 2023; 25:e46622. [PMID: 37792469 PMCID: PMC10585448 DOI: 10.2196/46622] [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: 02/24/2023] [Revised: 08/06/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Regular physical activity (PA) is beneficial for enhancing and sustaining both physical and mental well-being as well as for the management of preexisting conditions. Computer-tailored health communication (CTHC) has been shown to be effective in increasing PA and many other health behavior changes in the general population. However, individuals with or at risk of long-term conditions face unique barriers that may limit the applicability of CTHC interventions to this population. Few studies have focused on this cohort, providing limited evidence for the effectiveness of CTHC in promoting PA. OBJECTIVE This systematic review and meta-analysis aims to assess the effectiveness of CTHC in increasing PA in individuals with or at risk of long-term conditions. METHODS A systematic review and meta-analysis were conducted to evaluate the effect of CTHC in increasing PA in people with or at risk of long-term conditions. Hedges g was used to calculate the mean effect size. The total effect size was pooled and weighted using inverse variance. When possible, potential moderator variables were synthesized, and their effectiveness was evaluated by subgroups analysis with Q test for between-group heterogeneity Qb. Potential moderator variables included behavior change theories and models providing the fundamental logic for CTHC design, behavior change techniques and tailoring strategies to compose messages, and computer algorithms to achieve tailoring. Several methods were used to examine potential publication bias in the results, including the funnel plot, Egger test, Begg test, fail-safe N test, and trim-and-fill method. RESULTS In total, 24 studies were included in the systematic review for qualitative analysis and 18 studies were included in the meta-analysis. Significant small to medium effect size values were found when comparing CTHC to general health information (Hedges g=0.16; P<.001) and to no information sent to participants (Hedges g=0.29; P<.001). Half of the included studies had a low to moderate risk of bias, and the remaining studies had a moderate to high risk of bias. Although the results of the meta-analysis indicated no evidence of publication bias, caution is required when drawing definitive conclusions due to the limited number of studies in each subgroup (N≤10). Message-tailoring strategies, implementation strategies, behavior change theories and models, and behavior change techniques were synthesized from the 24 studies. No strong evidence was found from subgroup analyses on the effectiveness of using particular behavior change theories and models or from using particular message-tailoring and implementation strategies. CONCLUSIONS This study demonstrates that CTHC is effective in increasing PA for people with or at risk of long-term conditions, with significant small to medium effects compared with general health information or no information. Further studies are needed to guide design decisions for maximizing the effectiveness of CTHC.
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Affiliation(s)
- Longdan Hao
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Stefan Goetze
- Department of Computer Science, University of Sheffield, Sheffield, United Kingdom
| | - Tourkiah Alessa
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mark S Hawley
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Cooper K, Alexander L, Brandie D, Brown VT, Greig L, Harrison I, MacLean C, Mitchell L, Morrissey D, Moss RA, Parkinson E, Pavlova AV, Shim J, Swinton PA. Exercise therapy for tendinopathy: a mixed-methods evidence synthesis exploring feasibility, acceptability and effectiveness. Health Technol Assess 2023; 27:1-389. [PMID: 37929629 PMCID: PMC10641714 DOI: 10.3310/tfws2748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Background Tendinopathy is a common, painful and functionally limiting condition, primarily managed conservatively using exercise therapy. Review questions (i) What exercise interventions have been reported in the literature for which tendinopathies? (ii) What outcomes have been reported in studies investigating exercise interventions for tendinopathy? (iii) Which exercise interventions are most effective across all tendinopathies? (iv) Does type/location of tendinopathy or other specific covariates affect which are the most effective exercise therapies? (v) How feasible and acceptable are exercise interventions for tendinopathies? Methods A scoping review mapped exercise interventions for tendinopathies and outcomes reported to date (questions i and ii). Thereafter, two contingent systematic review workstreams were conducted. The first investigated a large number of studies and was split into three efficacy reviews that quantified and compared efficacy across different interventions (question iii), and investigated the influence of a range of potential moderators (question iv). The second was a convergent segregated mixed-method review (question v). Searches for studies published from 1998 were conducted in library databases (n = 9), trial registries (n = 6), grey literature databases (n = 5) and Google Scholar. Scoping review searches were completed on 28 April 2020 with efficacy and mixed-method search updates conducted on 19 January 2021 and 29 March 2021. Results Scoping review - 555 included studies identified a range of exercise interventions and outcomes across a range of tendinopathies, most commonly Achilles, patellar, lateral elbow and rotator cuff-related shoulder pain. Strengthening exercise was most common, with flexibility exercise used primarily in the upper limb. Disability was the most common outcome measured in Achilles, patellar and rotator cuff-related shoulder pain; physical function capacity was most common in lateral elbow tendinopathy. Efficacy reviews - 204 studies provided evidence that exercise therapy is safe and beneficial, and that patients are generally satisfied with treatment outcome and perceive the improvement to be substantial. In the context of generally low and very low-quality evidence, results identified that: (1) the shoulder may benefit more from flexibility (effect sizeResistance:Flexibility = 0.18 [95% CrI 0.07 to 0.29]) and proprioception (effect sizeResistance:Proprioception = 0.16 [95% CrI -1.8 to 0.32]); (2) when performing strengthening exercise it may be most beneficial to combine concentric and eccentric modes (effect sizeEccentricOnly:Concentric+Eccentric = 0.48 [95% CrI -0.13 to 1.1]; and (3) exercise may be most beneficial when combined with another conservative modality (e.g. injection or electro-therapy increasing effect size by ≈0.1 to 0.3). Mixed-method review - 94 studies (11 qualitative) provided evidence that exercise interventions for tendinopathy can largely be considered feasible and acceptable, and that several important factors should be considered when prescribing exercise for tendinopathy, including an awareness of potential barriers to and facilitators of engaging with exercise, patients' and providers' prior experience and beliefs, and the importance of patient education, self-management and the patient-healthcare professional relationship. Limitations Despite a large body of literature on exercise for tendinopathy, there are methodological and reporting limitations that influenced the recommendations that could be made. Conclusion The findings provide some support for the use of exercise combined with another conservative modality; flexibility and proprioception exercise for the shoulder; and a combination of eccentric and concentric strengthening exercise across tendinopathies. However, the findings must be interpreted within the context of the quality of the available evidence. Future work There is an urgent need for high-quality efficacy, effectiveness, cost-effectiveness and qualitative research that is adequately reported, using common terminology, definitions and outcomes. Study registration This project is registered as DOI: 10.11124/JBIES-20-00175 (scoping review); PROSPERO CRD 42020168187 (efficacy reviews); https://osf.io/preprints/sportrxiv/y7sk6/ (efficacy review 1); https://osf.io/preprints/sportrxiv/eyxgk/ (efficacy review 2); https://osf.io/preprints/sportrxiv/mx5pv/ (efficacy review 3); PROSPERO CRD42020164641 (mixed-method review). Funding This project was funded by the National Institute for Health and Care Research (NIHR) HTA programme and will be published in full in HTA Journal; Vol. 27, No. 24. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Kay Cooper
- School of Health Sciences, Robert Gordon University, Garthdee Road, Aberdeen, UK
| | - Lyndsay Alexander
- School of Health Sciences, Robert Gordon University, Garthdee Road, Aberdeen, UK
| | - David Brandie
- Sportscotland Institute of Sport, Airthrey Road, Stirling, UK
| | | | - Leon Greig
- School of Health Sciences, Robert Gordon University, Garthdee Road, Aberdeen, UK
| | - Isabelle Harrison
- School of Health Sciences, Robert Gordon University, Garthdee Road, Aberdeen, UK
| | - Colin MacLean
- Library Services, Robert Gordon University, Garthdee Road, Aberdeen, UK
| | - Laura Mitchell
- NHS Grampian, Physiotherapy Department, Ellon Health Centre, Schoolhill, Ellon, Aberdeenshire, UK
| | - Dylan Morrissey
- William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, Bancroft Road, London, UK
| | - Rachel Ann Moss
- School of Health Sciences, Robert Gordon University, Garthdee Road, Aberdeen, UK
| | - Eva Parkinson
- School of Health Sciences, Robert Gordon University, Garthdee Road, Aberdeen, UK
| | | | - Joanna Shim
- School of Health Sciences, Robert Gordon University, Garthdee Road, Aberdeen, UK
| | - Paul Alan Swinton
- School of Health Sciences, Robert Gordon University, Garthdee Road, Aberdeen, UK
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Ribeiro AKPDL, Carvalho JPR, Bento-Torres NVO. Physical exercise as treatment for adults with type 2 diabetes: a rapid review. Front Endocrinol (Lausanne) 2023; 14:1233906. [PMID: 37842305 PMCID: PMC10569299 DOI: 10.3389/fendo.2023.1233906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/01/2023] [Indexed: 10/17/2023] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is a leading cause of disability-adjusted life years (DALY). Physical exercise is an effective non-pharmacological intervention to promote glycaemic control in T2DM. However, the optimal exercise parameters for glycemic control in individuals with T2DM remain unclear. Objective This study aimed to analyze the relationship between physical training variables - frequency, intensity, type, duration, volume, and progression - and glycemic control in individuals with T2DM. Methods A rapid systematic literature review was conducted on PubMed and LILACS databases. The PICOT strategy was employed to define the inclusion criteria. Eligible studies had to assess the impact of exercise parameters (frequency, intensity, type, duration, volume, and progression) on glycemic control indicators, primarily glycosylated hemoglobin (HbA1c). Randomized and non-randomized clinical trials were included in the review. The methodological quality of each study was assessed using the PEDro scale (PROSPERO - CRD 42021262614). Results Out of 1188 papers initially identified, 18 reports met the inclusion criteria and were included in the analysis. A total of 1,228 participants with T2DM (1086 in exercise groups) were included in the selected studies. Among these studies, 16 (88.9%) were RCTs and 2 (11.1%) were nRCTs. The age of participants ranged from 43.1 and 68.9 years, and the average intervention duration was 16.8 weeks. Data on adherence to the intervention, adverse events, detailed intervention protocol, and its impacts on glycaemic control, lipid profile, blood pressure, anthropometric measures, medication, body composition, and physical fitness are reported. Conclusion The evidence supports the safety and effectiveness of physical exercises as non-pharmacological interventions for glycemic control. Aerobic, resistance and combined training interventions were associated with reductions in HbA1c and fasting glucose. The diversity of the physical exercise intervention protocols investigated in the studies included in this review is an important limitation to generalizing evidence-based practice. The call for action is mandatory to implement large-scale education programs on the prevention of diabetes and public health policies aimed to include well-planned and supervised exercise programs as an essential part of the primary prevention of type 2 diabetes. Systematic Review Registration PROSPERO, identifier (CRD42021262614).
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Affiliation(s)
- Andressa Karoline Pinto de Lima Ribeiro
- Graduate Program in Attention and Clinical Study in Diabetes, Institute of Medical Sciences, Federal University of Pará, Belém, Pará, Brazil
- Neurodegeneration and Infection Research Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Pará, Brazil
| | - Josilayne Patrícia Ramos Carvalho
- Neurodegeneration and Infection Research Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Pará, Brazil
- Graduate Program in Human Movement Sciences, Institute of Health Sciences, Federal University of Pará, Belém, Brazil
| | - Natáli Valim Oliver Bento-Torres
- Graduate Program in Attention and Clinical Study in Diabetes, Institute of Medical Sciences, Federal University of Pará, Belém, Pará, Brazil
- Neurodegeneration and Infection Research Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Pará, Brazil
- Graduate Program in Human Movement Sciences, Institute of Health Sciences, Federal University of Pará, Belém, Brazil
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Litchfield I, Barrett T, Hamilton-Shield J, Moore T, Narendran P, Redwood S, Searle A, Uday S, Wheeler J, Greenfield S. Current evidence for designing self-management support for underserved populations: an integrative review using the example of diabetes. Int J Equity Health 2023; 22:188. [PMID: 37697302 PMCID: PMC10496394 DOI: 10.1186/s12939-023-01976-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/26/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS With numerous and continuing attempts at adapting diabetes self-management support programmes to better account for underserved populations, its important that the lessons being learned are understood and shared. The work we present here reviews the latest evidence and best practice in designing and embedding culturally and socially sensitive, self-management support programmes. METHODS We explored the literature with regard to four key design considerations of diabetes self-management support programmes: Composition - the design and content of written materials and digital tools and interfaces; Structure - the combination of individual and group sessions, their frequency, and the overall duration of programmes; Facilitators - the combination of individuals used to deliver the programme; and Context - the influence and mitigation of a range of individual, socio-cultural, and environmental factors. RESULTS We found useful and recent examples of design innovation within a variety of countries and models of health care delivery including Brazil, Mexico, Netherlands, Spain, United Kingdom, and United States of America. Within Composition we confirmed the importance of retaining best practice in creating readily understood written information and intuitive digital interfaces; Structure the need to offer group, individual, and remote learning options in programmes of flexible duration and frequency; Facilitators where the benefits of using culturally concordant peers and community-based providers were described; and finally in Context the need to integrate self-management support programmes within existing health systems, and tailor their various constituent elements according to the language, resources, and beliefs of individuals and their communities. CONCLUSIONS A number of design principles across the four design considerations were identified that together offer a promising means of creating the next generation of self-management support programme more readily accessible for underserved communities. Ultimately, we recommend that the precise configuration should be co-produced by all relevant service and patient stakeholders and its delivery embedded in local health systems.
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Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Tim Barrett
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
- Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, B4 6NH, UK
| | - Julian Hamilton-Shield
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 2NT, UK
- The Royal Hospital for Children in Bristol, Bristol, BS2 8BJ, UK
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol and Weston Foundation Trust, Bristol, B52 8AE, UK
| | - Theresa Moore
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Parth Narendran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
- Queen Elizabeth Hospital, Birmingham, B15 2GW, UK
| | - Sabi Redwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Aidan Searle
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol and Weston Foundation Trust, Bristol, B52 8AE, UK
| | - Suma Uday
- Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, B4 6NH, UK
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Jess Wheeler
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
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Vetrovsky T, Siranec M, Frybova T, Gant I, Semerad M, Miklikova M, Bunc V, Vesely J, Stastny J, Griva M, Precek J, Pelouch R, Parenica J, Jarkovsky J, Belohlavek J. Statistical analysis plan for a randomized controlled trial examining pedometer-based walking intervention in patients with heart failure with reduced ejection fraction: the WATCHFUL trial. Trials 2023; 24:539. [PMID: 37587489 PMCID: PMC10433657 DOI: 10.1186/s13063-023-07516-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 07/13/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Physical activity is an effective management strategy for heart failure with reduced ejection fraction, but patients' compliance is challenging. Walking is a suitable form of physical activity due to its convenience and sustainability, and it can potentially improve functional capacity in heart failure patients. OBJECTIVES The WATCHFUL trial aims to determine whether a pedometer-based walking intervention combined with face-to-face sessions and regular telephone contact improves functional capacity in heart failure patients. METHODS The WATCHFUL trial is a 6-month multicenter, parallel-group, randomized, controlled, superiority trial with a 6-month follow-up. A total of 202 patients were recruited for the trial. The primary analysis will evaluate the change in distance walked during the 6-min walk test from baseline to 6 months based on the intention-to-treat population; the analysis will be performed using a linear mixed-effect model adjusted for baseline values. Missing data will be imputed using multiple imputations, and the impact of missing data will be assessed using a sensitivity analysis. Adverse events are monitored and recorded throughout the trial period. DISCUSSION The trial has been designed as a pragmatic trial with a scalable intervention that could be easily translated into routine clinical care. The trial has been affected by the COVID-19 pandemic, which slowed patients' recruitment and impacted their physical activity patterns. CONCLUSIONS The present publication provides details of the planned statistical analyses for the WATCHFUL trial to reduce the risks of reporting bias and erroneous data-driven results. TRIAL REGISTRATION ClinicalTrials.gov (identifier: NCT03041610, registered: 3/2/2017).
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Affiliation(s)
- Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.
| | - Michal Siranec
- 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Tereza Frybova
- 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Iulian Gant
- 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Miroslav Semerad
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Marie Miklikova
- Cardiology Department, University Hospital Brno and Medical Faculty of the Masaryk University, Brno, Czech Republic
| | - Vaclav Bunc
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Jiri Vesely
- Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic
- Edumed S.R.O, Broumov, Czech Republic
| | - Jiri Stastny
- Department of Cardiology, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Martin Griva
- Department of Cardiology, Tomas Bata Regional Hospital, Zlin, Czech Republic
- Innere Medizin I - Abteilung Für Kardiologie Und Internistische Intensivmedizin, Landesklinikum Mistelbach, Mistelbach, Austria
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
| | - Radek Pelouch
- 1st Department of Internal Medicine - Cardioangiology, Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic
- University Hospital Hradec Kralove, Hradec Králové, Czech Republic
| | - Jiri Parenica
- Cardiology Department, University Hospital Brno and Medical Faculty of the Masaryk University, Brno, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jan Belohlavek
- 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Liu X, Soh KG, Omar Dev RD. Effect of Latin dance on physical and mental health: a systematic review. BMC Public Health 2023; 23:1332. [PMID: 37434149 PMCID: PMC10337058 DOI: 10.1186/s12889-023-16221-6] [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] [Received: 04/04/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Latin dance is a well-liked physical activity. It has gained increasing attention as an exercise intervention for improving physical and mental health outcomes. This systematic review examines the effects of Latin dance on physical and mental health. METHODS Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) were used to report the data for this review. To gather research from the literature, we used recognized academic and scientific databases such SportsDiscus with Full Text, PsycINFO, Cochrane, Scopus, PubMed, and Web of Science. The systematic review only included 22 studies out of the 1,463 that matched all inclusion criteria. The PEDro scale was used to rate each study's quality. 22 research received scores between 3 and 7. RESULTS Latin dance has been demonstrated to promote physical health by helping people lose weight, improve cardiovascular health, increase muscle strength and tone, and improve flexibility and balance. Furthermore, Latin dance can benefit mental health by reducing stress, improving mood, social connection, and cognitive function. CONCLUSIONS Finding from this systematic review provide substantial evidence that Latin dance has effect on physical and mental health. Latin dance has the potential to be a powerful and pleasurable public health intervention. SYSTEMATIC REVIEW REGISTRATION CRD42023387851, https://www.crd.york.ac.uk/prospero .
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Affiliation(s)
- Xutao Liu
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Roxana Dev Omar Dev
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
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Naja F, Khaleel S, Alhajeri ME, Ajlan BY, Abulfateh NM, Alawadhi AG, Bowah MHJ, Al-Jawaldeh A. The Bahraini food based dietary guidelines: a holistic perspective to health and wellbeing. Front Public Health 2023; 11:1182075. [PMID: 37377553 PMCID: PMC10291616 DOI: 10.3389/fpubh.2023.1182075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/15/2023] [Indexed: 06/29/2023] Open
Abstract
The impact of food consumption extends well beyond the physical aspect of health to affect the mind, the society, and the environment. The biopsycho-ecological (BSE) theory recognizes the interplay between these factors and emphasizes the need for a holistic perspective to dietary recommendations. This manuscript presents a situation analysis of food consumption and diet-related diseases in Bahrain and describes the themes of the Bahraini Food based dietary guidelines (FBDG) and their alignment with the BSE constructs. Available data revealed low fruit and vegetable intake and excessive consumption of processed meat and sugary drinks in the country. These dietary habits are accompanied by a high burden of non-communicable diseases and their risk factors, anemia, and vitamin D deficiency. The Bahraini FBDG consisted of 11 context-specific themes and key messages that addressed the four dimensions of health depicted by the BSE theory, as follows: diet, physical activity, and food safety (body), physical activity, mindful eating and mental health (mind); family relations and cultural heritage (society), and food waste and environmental footprints of dietary intake (environment). The Bahraini FBDG present a model of dietary guidelines that adopted a holistic perspective to address health as they promote the role of food and dietary habits in maintaining the health of the body and that of the mind, the society, and the environment.
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Affiliation(s)
- Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Sharfa Khaleel
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | | | | | | | | | | | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo, Egypt
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López-Ruiz I, Lozano F, Masia MD, González-Gálvez N. Multicomponent Training and Optimal Dosing Strategies for Adults with Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Sports (Basel) 2023; 11:115. [PMID: 37368565 DOI: 10.3390/sports11060115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 05/26/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: Non-pharmacological interventions have demonstrated efficacy in the prevention, management, and control of hypertension. Multicomponent training confers a host of benefits to the general populace. The aim of this research was to assess the impact of multicomponent training on the blood pressure of adults with hypertension and ascertain the nature of the dose-response relationship. (2) Methods: This systematic review adhered to the PRISMA guidelines and was registered in PROSPERO. Eight studies were included, following a literature search across PubMed, Web of Science, Cochrane, and EBSCO. Randomized controlled trials implementing multicomponent training interventions on adults with hypertension were considered for inclusion. A quality assessment was performed using the PEDro scale, with a random-effects model utilized for all analyses. (3) Results: Multicomponent training yielded a significant reduction in systolic (MD = -10.40, p < 0.001) and diastolic (MD = -5.97, p < 0.001) blood pressure relative to the control group. Interventions lasting over 14 weeks with a minimum frequency of three sessions per week, each lasting 60 min, were deemed most effective. (4) Conclusion: An optimal training intensity was achieved with 30 min of aerobic exercise at 75% of the heart rate reserve, whereas sets of 10 repetitions at 75% of one repetition maximum produced the best outcomes in strength training.
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Affiliation(s)
- Isabel López-Ruiz
- Facultad del Deporte UCAM, Universidad Católica de Murcia, 30107 Murcia, Spain
| | - Fernando Lozano
- General University Hospital of Ciudad Real, 13005 Ciudad Real, Spain
| | - María Dolores Masia
- Faculty of Health Sciences, University Hospital San Juan de Alicante, 03550 Alicante, Spain
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Stockton MB, Ward KD, McClanahan BS, Vander Weg MW, Coday M, Wilson N, Relyea G, Read MC, Connelly S, Johnson KC. The Efficacy of Individualized, Community-Based Physical Activity to Aid Smoking Cessation: A Randomized Controlled Trial. J Smok Cessat 2023; 2023:5535832. [PMID: 37273658 PMCID: PMC10238145 DOI: 10.1155/2023/5535832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/14/2023] [Accepted: 05/10/2023] [Indexed: 06/06/2023] Open
Abstract
Objective The efficacy of individualized, community-based physical activity as an adjunctive smoking cessation treatment to enhance long-term smoking cessation rates was evaluated for the Lifestyle Enhancement Program (LEAP). Methods The study was a two-arm, parallel-group, randomized controlled trial. All participants (n = 392) received cessation counseling and a nicotine patch and were randomized to physical activity (n = 199; YMCA membership and personalized exercise programming from a health coach) or an equal contact frequency wellness curriculum (n = 193). Physical activity treatment was individualized and flexible (with each participant selecting types of activities and intensity levels and being encouraged to exercise at the YMCA and at home, as well as to use "lifestyle" activity). The primary outcome (biochemically verified prolonged abstinence at 7-weeks (end of treatment) and 6- and 12-months postcessation) and secondary outcomes (7-day point prevalent tobacco abstinence (PPA), total minutes per week of leisure time physical activity and strength training) were assessed at baseline, 7 weeks, 6 months, and 12 months. Results Prolonged abstinence in the physical activity and wellness groups was 19.6% and 25.4%, respectively, at 7-weeks, 15.1% and 16.6% at 6-months, and 14.1% and 17.1% at 12 months (all between-group P values >0.18). Similarly, PPA rates did not differ significantly between groups at any follow-up. Change from baseline leisure-time activity plus strength training increased significantly in the physical activity group at 7 weeks (P = 0.04). Across treatment groups, an increase in the number of minutes per week in strength training from baseline to 7 weeks predicted prolonged abstinence at 12 months (P ≤ 0.001). Further analyses revealed that social support, fewer years smoked, and less temptation to smoke were associated with prolonged abstinence over 12 months in both groups. Conclusions Community-based physical activity programming, delivered as adjunctive treatment with behavioral/pharmacological cessation treatment, did not improve long-term quit rates compared to adjunctive wellness counseling plus behavioral/pharmacological cessation treatment. This trial is registered with https://beta.clinicaltrials.gov/study/NCT00403312, registration no. NCT00403312.
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Affiliation(s)
| | - Kenneth D. Ward
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | | | - Mark W. Vander Weg
- Departments of Community and Behavioral Health, Internal Medicine, and Psychological and Brain Sciences, University of Iowa, Iowa City, IA and Iowa City VA Health Care System, Iowa City, IA, USA
| | - Mace Coday
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Nancy Wilson
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | - George Relyea
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Mary C. Read
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | | | - Karen C. Johnson
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
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Cody R, Kreppke JN, Fischer X, Faude O, Beck J, Brand S, Hatzinger M, Imboden C, Kügerl N, Lang UE, Mans S, Maurer R, Mikoteit T, Oswald A, Rhodius LS, Schweinfurth N, Wechsler L, Gerber M. An implementation evaluation of the physical activity counseling for in-patients with major depressive disorder (PACINPAT) intervention: a randomized controlled trial. BMC Psychiatry 2023; 23:316. [PMID: 37143013 PMCID: PMC10161407 DOI: 10.1186/s12888-023-04834-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 04/28/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The physical activity counseling for in-patients with major depression (PACINPAT) randomized controlled trial was launched to tackle physical inactivity for in-patients with major depressive disorder. Evidence shows that despite potential treatment effects, physical inactivity is prevalent in this population. To contribute to the assessment of how this in-person and remote, theory-based, individually tailored intervention was designed, received and effected behavior, the aim of this study was to evaluate its implementation. METHODS This implementation evaluation was conducted within a multi-center randomized controlled trial according to the Process Evaluation Framework by the Medical Research Council including the analysis of reach, dose, fidelity and adaptation. Data were collected from the implementers and the participants randomized to the intervention group of the trial. RESULTS The study sample comprised 95 physically inactive in-patients (mean age: 42 years, 53% women) with diagnosed major depressive disorder. The intervention reached the intended population (N = 95 in-patients enrolled in the study). The intervention dose varied between early dropouts (counseling sessions, M = 1.67) and study completers with some participants receiving a low dose (counseling sessions, M = 10.05) and high dose (counseling sessions, M = 25.37). Differences in the attendance groups were recognizable in the first two counseling sessions (duration of counseling session about 45 min in early dropouts versus 60 min for study completers). Fidelity of the in-person counseling content was partly achieved and adapted, whereas that of the remote counseling content was well achieved. Participants (86% at follow up) reported satisfaction with the implementers of the intervention. Adaptations were made to content, delivery mode and dose. CONCLUSION The PACINPAT trial was implemented in the intended population, in varying doses and with adaptations made to in-person counseling content and remote counseling dose. These findings are key to understanding outcome analyses within the PACINPAT trial, further developing interventions and contributing to implementation research among in-patients with depressive disorders. TRIAL REGISTRATION ISRCTN, ISRCTN10469580 , registered on 3rd September 2018.
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Affiliation(s)
- Robyn Cody
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland.
| | - Jan-Niklas Kreppke
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Xenia Fischer
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Oliver Faude
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | | | - Serge Brand
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, 6719851115, Iran
- Substance Use Prevention Research Center and Sleep Disorder Research Center, Kermanshah, University of Medical Sciences (KUMS), Kermanshah, 6715847141, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | | | - Nadine Kügerl
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Undine E Lang
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, Münchenbuchsee, Switzerland
| | - Reto Maurer
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | | | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, Riehen, Switzerland
| | - Lilja-Sophie Rhodius
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Nina Schweinfurth
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Laura Wechsler
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Markus Gerber
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
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Supportive Care Needs Survey: A reliability generalization meta-analysis. Palliat Support Care 2023:1-13. [PMID: 36779271 DOI: 10.1017/s1478951522001791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVES The purpose of this study is to investigate the reliability generalization of 2 forms of the Supportive Care Needs Survey (SCNS), the questionnaires commonly used to assess the unmet needs of cancer patients. METHODS Reviewed articles were retrieved through databases including PubMed, Ovid, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, Scopus, and ProQuest. The inclusion criteria were quantitative studies that assessed the unmet needs of cancer patients using the SCNS and presented reliability coefficients with sample size. Two independent reviewers examined the studies according to inclusion criteria and quality. The final studies included in the meta-analysis were determined by consensus. A random effects model was adopted for the analysis. To estimate reliability coefficients, the alpha coefficients for each study were transformed into the Z statistic for normalization and back to alpha. The values were weighted by the inverse of the studies' variance. The Higgins I2 statistic was used to test for heterogeneity, and the Egger's test and funnel plot were performed to evaluate publication bias. RESULTS Out of 12,522 studies, 26 studies were included in the meta-analysis. The overall mean weighted effect size of the SCNS long-form (LF) was 0.90 and the subdomains ranged from 0.90 to 0.97. The overall alpha for the SCNS short-form (SF) was 0.92, and the alphas for the subdomains were between 0.81 and 0.92. The estimated reliability coefficients in both LF and SF were highest in psychological and health information needs and lowest in sexuality. No publication bias was indicated in this study. SIGNIFICANCE OF RESULTS In this study, the overall reliability of SCNS was presented and the factors affecting the reliability of SCNS were identified. The results of this study may help clinicians or researchers make decisions about selecting tools to measure unmet needs of cancer patients.
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Li Q, Cai W, Li Y, Zhang R, Zeng C, Ma X, Barka CK, Zhang C, Sun T, Xie H. Effects of a theory-based exercise intervention on physical activity levels and health-related outcomes in older people with chronic diseases. Geriatr Gerontol Int 2023; 23:78-84. [PMID: 36573456 DOI: 10.1111/ggi.14520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/31/2022] [Accepted: 11/18/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND The benefits of physical activity are well-documented, and the prevalence of physical inactivity is high in older patients with chronic diseases. This study aimed to investigate the impact of an aerobic exercise intervention based on the capacity, opportunity, motivation-behavior (COM-B) model on physical activity and health-related outcomes in this population. METHODS Thirty-five participants were randomly assigned to the intervention group (IG) for an exercise intervention based on the COM-B model, and 33 were assigned to the control group (CG) for usual care. Physical activity levels, daily steps and bone mineral density T-value, body mass index, waist-hip ratio, subendocardial myocardial viability rate, central arterial pressure, growth index, brachial-ankle pulse wave velocity, ankle-arm index were measured at baseline, during the 12-week intervention, and after the 12-week follow-up. RESULTS Compared with the CG and pre-intervention, total physical activity in the IG increased significantly (P < 0.05); however, after the 12-week follow-up, total physical activity decreased. At the same time, the average daily steps of the elderly in both groups increased. Compared with the CG, at the 12-week follow-up, the bone mineral density T-value in the IG was significantly improved (P < 0.05). Compared with the pre-intervention values, during the 12-week intervention, bone mineral density T-value, body mass index, waist-hip ratio, subendocardial myocardial viability rate and central arterial pressure were significantly improved (P < 0.05); after the 12-week follow-up, brachial-ankle pulse wave velocity and ankle-arm index were significantly improved (P < 0.05). No statistically significant changes in the growth index were detected, independent of the group and time. CONCLUSION Theory-based exercise interventions can change the physical inactivity behavior of older people with chronic diseases, effectively promoting physical activity and improves bone mineral density T-value, controls body weight, and reduces cardiovascular risk and physiological indicators related to atherosclerosis. Geriatr Gerontol Int 2023; 23: 78-84.
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Affiliation(s)
- Qiyu Li
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Weiwei Cai
- Department of Nursing, Bengbu Third People's Hospital, Bengbu, China
| | - Yanling Li
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Ruixin Zhang
- Thyroid and mammary disease area of general surgery department, Fuyang People's Hospital, Fuyang, China
| | - Chunlu Zeng
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Xiaoqing Ma
- School of Nursing, Bengbu Medical College, Bengbu, China
| | | | - Chu Zhang
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Ting Sun
- School of Nursing, Bengbu Medical College, Bengbu, China
| | - Hui Xie
- School of Nursing, Bengbu Medical College, Bengbu, China
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Ramos JS, Chakraborty R, Dalleck LC, Sarunic K, Khadka J, Haslam T, Nassaris O. A retrospective evaluation of the Brain and Body Fitness Studio service on functional capacity and quality of life in people with neurological disorders. Front Neurol 2023; 13:1006221. [PMID: 36742042 PMCID: PMC9895383 DOI: 10.3389/fneur.2022.1006221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/21/2022] [Indexed: 01/22/2023] Open
Abstract
Background People with neurological disorders (ND) are less physically active than the general population due to physical, sensory, and/or cognitive impairments. These individuals often feel intimidated to join mainstream health and wellness centers due to lack of specialized support for people with ND. The Brain and Body Fitness Studio (BBFS) is one of the first Accredited Exercise Physiologist-led interprofessional services in Adelaide South Australia to provide individualized evidence-based multimodal exercise prescription and social support for this population. This comprehensive retrospective study evaluated the impact of BBFS on functional capacity (FC) determined as the 6-min walk distance (6 MWD) achieved during a 6-min walk test (6 MWT), of its members with ND. Methods Sixty-two BBFS members (age, 66 ± 10 years; 60% male) with ND (85% Parkinson's Disease; average time since diagnosis, 4 years [IQR, 2 to 12 years]) and complete pre- and post-6-month clinical assessment of the primary outcome of the study, the 6 MWD, were included in this retrospective analysis. A series of sub-analyses were also performed to investigate the effects of adherence to the recommended prescription of at least twice a week in the program (≥80 vs. < 80% adherence), and disease stage (time since diagnosis; ≥6 vs. < 6 years) on FC. Results Although there was no statistically significant change in 6 MWD from pre- to post-6-month BBFS program (+15 ± 90 m, p = 0.19), a clinically meaningful improvement of >14 m was evident. Improvement in 6 MWD was significantly greater in members who attended at least 80% of the recommended visits (≥80% visits, +37 ± 58 m; ≤ 80% visits,-1 ± 105 m, p = 0.046). We also found a 6 MWD improvement from pre- to post-6 months in those in the early years of their ND (< 6 years since diagnosis, +39 ± 76 m), but not in those in the later years of their ND (≥6 years since diagnosis, -36 ± 123 m, between group difference, p = 0.029). Conclusion A clinically meaningful 6 MWD improvement may be elicited by services provided by BBFS in people with ND. Overall, the benefits appear to be more evident in members who attended the BBFS for at least 80% of the recommended visits and those who were in the early stage of their ND diagnosis.
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Affiliation(s)
- Joyce S. Ramos
- Clinical Exercise Physiology, College of Nursing and Health Sciences, SHAPE Research Centre, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Ranjay Chakraborty
- Clinical Exercise Physiology, College of Nursing and Health Sciences, SHAPE Research Centre, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Lance C. Dalleck
- Clinical Exercise Physiology, College of Nursing and Health Sciences, SHAPE Research Centre, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
- Recreation, Exercise and Sport, Western Colorado University, Gunnison, CO, United States
| | - Kristina Sarunic
- Clinical Exercise Physiology, College of Nursing and Health Sciences, SHAPE Research Centre, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Jyoti Khadka
- Clinical Exercise Physiology, College of Nursing and Health Sciences, SHAPE Research Centre, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Tayla Haslam
- Brain and Body Fitness Studio, The Hospital Research Foundation Parkinson's, Adelaide, SA, Australia
| | - Olivia Nassaris
- Clinical Exercise Physiology, College of Nursing and Health Sciences, SHAPE Research Centre, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
- Brain and Body Fitness Studio, The Hospital Research Foundation Parkinson's, Adelaide, SA, Australia
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El Haddad L, Peiris CL, Taylor NF, McLean S. Determinants of Non-Adherence to Exercise or Physical Activity in People with Metabolic Syndrome: A Mixed Methods Review. Patient Prefer Adherence 2023; 17:311-329. [PMID: 36760232 PMCID: PMC9904214 DOI: 10.2147/ppa.s383482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/18/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Long-term adherence to exercise or physical activity (EPA) is necessary for effective first-line management of metabolic syndrome (MetS). Little is known about the determinants of adherence in this population. This systematic review aims to identify the determinants of adherence to EPA in people with MetS. METHODS Six databases (MEDLINE, CINAHL Complete, PubMed, PsycINFO, SPORTDiscus, and Cochrane Central Register of Controlled Trials (CENTRAL)) were searched for studies published before April 26, 2021. Primary research studies investigating factors affecting EPA adherence in adults with MetS in outpatient settings were included. Risk of bias was assessed using the QUIPS (Quality in Prognostic Factor Studies) and CASP (Critical Appraisal Skills Program) tools, for quantitative and qualitative methodologies, respectively. RESULTS Four quantitative studies (n = 766) and one qualitative (n = 21) study were included in the review, evaluating 34 determinants of adherence to EPA in MetS. Limited evidence was found for an association between ten determinants and non-adherence to EPA: lower self-rated health, lower baseline EPA, lower high-density lipoprotein cholesterol (HDL-C), fewer walk-friendly routes within 1 km, less consciousness raising, lower self-re-evaluation, lower self-liberation, reporting more arguments against EPA (cons), lower social support, and fewer positive psychological constructs. There was limited evidence of no association or conflicting evidence for the remaining 24 determinants. CONCLUSION A small number of included studies, most of low methodological quality, resulted in limited confidence in the findings for all determinants. The identified determinants associated with non-adherence are all potentially modifiable, thus further high-quality studies are required to increase confidence in the determinants of EPA in people with MetS, and test interventions.
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Affiliation(s)
- Laila El Haddad
- Department of Allied Health Professions, Sheffield Hallam University, Sheffield, UK
| | - Casey L Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Nicholas F Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Victoria, Australia
| | - Sionnadh McLean
- Department of Allied Health Professions, Sheffield Hallam University, Sheffield, UK
- Correspondence: Sionnadh McLean, Collegiate Campus, Sheffield Hallam University, L108, 36 Collegiate Crescent, Sheffield, S10 2BP, UK, Tel +447342 092 340, Email
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Keawtep P, Kamnardsiri T, Boripuntakul S, Wichayanrat W, Worakul P, Sungkarat S. Feasibility of Internet-Based Physical-Cognitive Exercise for Health Benefits of Middle-Aged Obese Women. J Prim Care Community Health 2023; 14:21501319231189961. [PMID: 37522590 PMCID: PMC10392207 DOI: 10.1177/21501319231189961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Obesity in middle-aged women markedly increases the risk for non-communicable diseases, neurodegenerative diseases, and physical and cognitive problems. Exercise, particularly combined physical-cognitive exercise, has been demonstrated to have beneficial effects on both physical and cognitive health. However, middle-aged women often face barriers to engaging in exercise, which include time constraints, lack of motivation, and enjoyment. Incorporating an exercise program into a technology-based intervention in the home environment may help overcome these barriers and promote health benefits. Therefore, this study aimed to assess the feasibility of home-based, physical-cognitive internet-based exercise for middle-aged obese women. METHODS A total of 33 middle-aged obese women were enrolled in the study. Participants performed an intervention for 60 min/day, 3 days/week for 3 months. Feasibility outcomes (adherence, adverse events, physical performances, obesity parameters, and enjoyment of the program) were measured. RESULTS Average exercise adherence was 91.67%, and no adverse events were reported in this feasibility study. At the end of the training period, body weight and BMI were significantly decreased compared to baseline. As for physical performances, both cardiorespiratory fitness and lower limb muscle power were significantly improved at post-training when compared to baseline. Furthermore, the participants experienced a high level of exercise enjoyment, and it was maintained over the 3-month training period. CONCLUSION These findings suggest that home-based, internet-based physical-cognitive exercise was safe and feasible for reducing obesity parameters, improving physical function, maintaining enjoyment over the course of training, and facilitating adherence to exercise in middle-aged obese women.
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Shams F, Tai AM, Kim J, Boyd M, Meyer M, Kazemi A, Krausz RM. Adherence to e-health interventions for substance use and the factors influencing it: Systematic Review, meta-analysis, and meta-regression. Digit Health 2023; 9:20552076231203876. [PMID: 37780062 PMCID: PMC10540609 DOI: 10.1177/20552076231203876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/08/2023] [Indexed: 10/03/2023] Open
Abstract
Background Substance use disorders affect 36 million people globally, but only a small proportion of them receive the necessary treatment. E-health interventions have been developed to address this issue by improving access to substance use treatment. However, concerns about participant engagement and adherence to these interventions remain. This review aimed to evaluate adherence to e-health interventions targeting substance use and identify hypothesized predictors of adherence. Methods A systematic review of literature published between 2009 and 2020 was conducted, and data on adherence measures and hypothesized predictors were extracted. Meta-analysis and meta-regression were used to analyze the data. The two adherence measures were (a) the mean proportion of modules completed across the intervention groups and (b) the proportion of participants that completed all modules. Four meta-regression models assessed each covariate including guidance, blended treatment, intervention duration and recruitment strategy. Results The overall pooled adherence rate was 0.60 (95%-CI: 0.52-0.67) for the mean proportion of modules completed across 30 intervention arms and 0.47 (95%-CI: 0.35-0.59) for the proportion of participants that completed all modules across 9 intervention arms. Guidance, blended treatment, and recruitment were significant predictors of adherence, while treatment duration was not. Conclusion The study suggests that more research is needed to identify predictors of adherence, in order to determine specific aspects that contribute to better exposure to intervention content. Reporting adherence and predictors in future studies can lead to improved meta-analyses and the development of more engaging interventions. Identifying predictors can aid in designing effective interventions for substance use disorders, with important implications for e-health interventions targeting substance use.
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Affiliation(s)
- Farhud Shams
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Andy M.Y. Tai
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jane Kim
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Marisha Boyd
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Maximilian Meyer
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, University of Basel Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Alireza Kazemi
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Reinhard Michael Krausz
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Tummers SCMW, Hommersom A, Lechner L, Bemelmans R, Bolman CAW. Determinants of physical activity behaviour change in (online) interventions, and gender-specific differences: a Bayesian network model. Int J Behav Nutr Phys Act 2022; 19:155. [PMID: 36536443 PMCID: PMC9762063 DOI: 10.1186/s12966-022-01381-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Physical activity (PA) is known to be beneficial for health, but adherence to international PA guidelines is low across different subpopulations. Interventions have been designed to stimulate PA of different target groups by influencing relevant psycho-social determinants, essentially based on a combination of the Integrated Model for Change, the Theory of Planned Behaviour, its successor the Reasoned Action Approach and the self-determination theory. The current study investigates the pathways through which interventions influence PA. Further, gender differences in pathways of change are studied. METHODS An integrated dataset of five different randomised controlled trial intervention studies is analysed by estimating a Bayesian network. The data include measurements, at baseline and at 3, 6 (short-term), and 12 (long-term) months after the baseline, of important socio-cognitive determinants of PA, demographic factors, and PA outcomes. A fragment is extracted from the Bayesian network consisting of paths between the intervention variable, determinants, and short- and long-term PA outcomes. For each relationship between variables, a stability indicator and its mutual information are computed. Such a model is estimated for the full dataset, and in addition such a model is estimated based only on male and female participants' data to investigate gender differences. RESULTS The general model (for the full dataset) shows complex paths, indicating that the intervention affects short-term PA via the direct determinants of intention and habit and that self-efficacy, attitude, intrinsic motivation, social influence concepts, planning and commitment have an indirect influence. The model also shows how effects are maintained in the long-term and that previous PA behaviour, intention and attitude pros are direct determinants of long-term PA. The gender-specific models show similarities as well as important differences between the structures of paths for the male- and female subpopulations. For both subpopulations, intention and habit play an important role for short-term effects and maintenance of effects in the long-term. Differences are found in the role of self-efficacy in paths of behaviour change and in the fact that attitude is relevant for males, whereas planning plays a crucial role for females. The average of these differences in subpopulation mechanisms appears to be presented in the general model. CONCLUSIONS While previous research provided limited insight into how interventions influence PA through relevant determinants, the Bayesian network analyses show the relevance of determinants mentioned by the theoretical framework. The model clarifies the role that different determinants play, especially in interaction with each other. The Bayesian network provides new knowledge about the complex working mechanism of interventions to change PA by giving an insightful overview of influencing paths. Furthermore, by presenting subpopulation-specific networks, the difference between the influence structure of males and females is illustrated. These new insights can be used to improve interventions in order to enhance their effects. To accomplish this, we have developed a new methodology based on a Bayesian network analysis which may be applicable in various other studies.
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Affiliation(s)
| | - Arjen Hommersom
- grid.36120.360000 0004 0501 5439Open University of the Netherlands, Heerlen, The Netherlands ,grid.5590.90000000122931605Radboud University, Nijmegen, The Netherlands
| | - Lilian Lechner
- grid.36120.360000 0004 0501 5439Open University of the Netherlands, Heerlen, The Netherlands
| | - Roger Bemelmans
- grid.413098.70000 0004 0429 9708Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Van Wasshenova E, Boardley D, Geers A, Tull M, Steiner V. A Brief Value-based Randomized Intervention to Promote Physical Activity in Patients Attending Cardiac Rehabilitation. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2142334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Petrusevski C, Morgan A, MacDermid J, Wilson M, Richardson J. Framing physical literacy for aging adults: an integrative review. Disabil Rehabil 2022; 44:8149-8160. [PMID: 34913771 DOI: 10.1080/09638288.2021.2012841] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE Physical literacy is an important component for improving functional health for adults. However, little is known how physical literacy can be framed to support the rehabilitation needs of aging adults. METHODS An integrative review was conducted to understand what components are used to frame physical literacy for adults. Electronic databases were searched from 2000-2021 for eligibility criteria including: 1) adults ≥45 years of age, 2) addressed physical literacy OR physical literacy components AND referred to outcomes assessing either mobility, physical function, rehabilitation, health promotion, health prevention, public health, or physical activity. RESULTS A total of 22 articles met the inclusion criteria. The varied methodological quality, including grey literature (50%) to systematic reviews (14%), indicates that physical literacy for adults is a novel topic. When defining physical literacy for adults, 13 new constructs emerged with purposeful activities, knowledge of age-related changes and social interaction as the top three. Physical literacy interventions demonstrated improvements in self-efficacy, physical function, and exercise behaviour. CONCLUSION Findings from the current literature indicate that engagement in purposeful, social, and diverse activities, obtaining knowledge of age-related changes and being able to self-adapt to mobility fluctuations is the foundation to becoming a physically literate adult.Implications for RehabilitationPhysical literacy is emerging as a promising health strategy for adults and older adults.Reconceptualization of the physical literacy construct to include rehabilitation approaches is needed to address the mobility challenges associated with aging.The foundation to becoming a physically literate adult involves monitoring one's ability for movement and having the knowledge to identify and remediate changes in function while engaging in purposeful movements.Physical literacy programs for adults and older adults have potential to positively impact important health outcomes equitably for all individuals.
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Affiliation(s)
| | - Ashley Morgan
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Joy MacDermid
- School of Rehabilitation Science, McMaster University, Hamilton, Canada.,Department of Health Evidence & Impact, McMaster University, Hamilton, Canada.,Physical Therapy and Surgery, Western University, London, Canada.,Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Canada
| | - Michael Wilson
- Department of Health Evidence & Impact, McMaster University, Hamilton, Canada.,McMaster Health Forum, McMaster University, Hamilton, Canada.,Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, Canada.,Department of Health Evidence & Impact, McMaster University, Hamilton, Canada
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Experiencias de los pacientes con diabetes sobre la promoción de la actividad física durante las consultas enfermeras en Cataluña. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Mukherji AB, Lu D, Qin F, Hedlin H, Johannsen NM, Chung S, Kobayashi Y, Haddad F, Lamendola C, Basina M, Talamoa R, Myers J, Palaniappan L. Effectiveness of a Community-Based Structured Physical Activity Program for Adults With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2247858. [PMID: 36542382 PMCID: PMC9857601 DOI: 10.1001/jamanetworkopen.2022.47858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE The efficacy of physical activity interventions among individuals with type 2 diabetes has been established; however, practical approaches to translate and extend these findings into community settings have not been well explored. OBJECTIVE To test the effectiveness of providing varying frequencies of weekly structured exercise sessions to improve diabetes control. DESIGN, SETTING, AND PARTICIPANTS The IMPACT (Initiate and Maintain Physical Activity in Communities Trial) study was a controlled randomized clinical trial (randomization occurred from October 2016 to April 2019) that included a 6-month, structured exercise intervention either once or thrice weekly vs usual care (UC; advice only). The exercise intervention was conducted at community-based fitness centers. Follow-up visits were conducted in a university research clinic. Participants included adults with type 2 diabetes (hemoglobin A1c [HbA1c] 6.5%-13.0%, not taking insulin, and no precluding health issues). Data analysis was performed from January to April 2022. INTERVENTIONS A once-weekly structured exercise group, a thrice-weekly structured exercise group, or UC. MAIN OUTCOMES AND MEASURES The primary outcome was HbA1c at 6 months. RESULTS A total of 357 participants (143 women [40.1%]) with a mean (SD) age of 57.4 (11.1) years were randomized (119 each to the UC, once-weekly exercise, and thrice-weekly exercise groups). There was no significant difference in HbA1c change by study group in the intention-to-treat analysis at 6 months. Specifically, HbA1c changed by -0.23% (95% CI, -0.48% to 0.01%) in the thrice-weekly exercise group and by -0.16% (95% CI, -0.41% to 0.09%) in the once-weekly exercise group. A total of 62 participants (52.1%) in the once-weekly exercise group and 56 participants (47.1%) in the thrice-weekly exercise group were at least 50% adherent to the assigned structured exercise regimen and were included in the per-protocol analysis. Per-protocol analysis showed that HbA1c changed by -0.35% (95% CI, -0.60% to -0.10%; P = .005) at 3 months and by -0.38% (95% CI, -0.65% to -0.12%; P = .005) at 6 months in the thrice-weekly exercise group compared with UC. There was no significant decrease in HbA1c in the once-weekly exercise group. The exercise intervention was effective in improving self-reported minutes of metabolic equivalent tasks per week for participants in the thrice-weekly exercise group (both overall and per protocol). CONCLUSIONS AND RELEVANCE Although the intervention was not effective in the intention-to-treat analysis, participants in the thrice-weekly exercise group who attended at least 50% of the sessions during the 6-month exercise intervention program improved HbA1c levels at 6 months. Future efforts should focus on improving adherence to thrice-weekly structured exercise programs to meet exercise guidelines. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02061579.
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Affiliation(s)
- Aishee B. Mukherji
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
| | - Di Lu
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
| | - FeiFei Qin
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
| | - Haley Hedlin
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
| | - Neil M. Johannsen
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge
| | - Sukyung Chung
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
| | - Yukari Kobayashi
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Cardiovascular Institute, Stanford, California
| | - Francois Haddad
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Cardiovascular Institute, Stanford, California
| | - Cynthia Lamendola
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
| | - Marina Basina
- Division of Endocrinology, Stanford University School of Medicine, Stanford, California
| | - Ruth Talamoa
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
| | - Jonathan Myers
- Cardiology Division, VA Palo Alto Health Care System, Stanford University, Palo Alto, California
| | - Latha Palaniappan
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
- Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Stanford, California
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López Sánchez GF, Mendiola Olivares J, Torres Cantero AM. Association between Physical Activity and 32 Chronic Conditions among Spanish Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13596. [PMID: 36294177 PMCID: PMC9603751 DOI: 10.3390/ijerph192013596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/15/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
The objective was to analyse the association between physical activity and the risk of suffering from 32 chronic conditions using a large representative sample of Spanish adults. We utilised the dataset of the last edition of the Spanish National Health Survey, which was conducted in the year 2017. This dataset included a total of 23,089 adults between the ages of 15 and 103 years. The average age was 53.4 years (standard deviation 18.9 years). Regarding sex distribution, 54.1% of the participants were females. The instrument used to measure physical activity was the short form of the international physical activity questionnaire. The question used to evaluate if the participants suffered from chronic conditions was "Have you ever been diagnosed with chronic condition?". This question was asked for 32 different chronic conditions. The association between low levels of physical activity (exposure) and chronic conditions (outcome) was assessed with multivariable logistic regression analyses. The highest prevalence of chronic conditions was found in the group doing less than 600 MET (metabolic equivalent of task)-min/week of physical activity (in 28 of the 32 conditions analyzed). The lowest prevalence was in the group doing at least 1200 MET-min/week (in 30 of the 32). Adjusted multivariable logistic regression analyses showed that less than 600 MET-min/week of physical activity was significantly associated with a higher risk of 19 chronic conditions. All these significant associations, except for hypertension, were also maintained in those doing less than 1200 MET-min/week. In conclusion, higher physical activity is a protective factor against the risk of suffering from chronic conditions, with the lowest prevalence of chronic conditions in people doing more than 1200 MET-min/week. International physical activity guidelines should recommend at least 1200 MET-min/week to prevent the risk of chronic conditions.
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Jabardo-Camprubí G, Bort-Roig J, Donat-Roca R, Milà-Villarroel R, Sitjà-Rabert M, McKenna J, Puig-Ribera A. A socio-ecological approach to reduce the physical activity drop-out ratio in primary care-based patients with type 2 diabetes: the SENWI study protocol for a randomized control trial. Trials 2022; 23:842. [PMID: 36192800 PMCID: PMC9531392 DOI: 10.1186/s13063-022-06742-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Physical activity (PA) is a key behaviour for patients with type 2 diabetes (T2DM). However, healthcare professionals’ (HCP) recommendations (walking advice), which are short-term and individually focused, did not reduce the PA drop-out ratio in the long run. Using a socio-ecological model approach may contribute to reducing patient dropout and improving adherence to PA. The aim of this study is threefold: first, to evaluate the effectiveness of a theory-driven Nordic walking intervention using a socio-ecological approach with T2DM patients in Spain; second, to explore the feasibility on the PA adherence process in T2DM patients while participating in the SENWI programme; and third, to understand the HCPs’ opinion regarding its applicability within the Spanish healthcare system. Methods A three-arm randomized control trial (n = 48 each group) will assess the efficacy of two primary care-based PA interventions (Nordic walking vs. Nordic walking plus socio-ecological approach; two sessions per week for twelve weeks) compared to a control group (usual HCPs’ walking advice on PA). Inclusion criteria will include physically inactive patients with T2DM, older than 40 years and without health contraindications to do PA. PA levels and drop-out ratio, quality of life and metabolic and health outcomes will be assessed at baseline, post-intervention and at 9- and 21-month follow-ups. The effect of the different interventions will be assessed by a two-factor analysis of variance: treatment group vs time. Also, a two-factor ANOVA test will be performed with linear mixed models for repeated measures. A qualitative analysis using focus groups will explore the reasons for the (in)effectiveness of the new PA interventions. Qualitative outcomes will be assessed at post-intervention using thematic analysis. Discussion Compared with the general PA walking advice and Nordic walking prescriptions, integrating a socio-ecological approach into Spanish primary care visits could be an effective way to reduce the PA drop-out ratio and increase PA levels in patients with T2DM. Such interventions are necessary to understand the role that multiple socio-complex process in day-to-day PA behaviour has in patients with T2DM in the Spanish context. Trial registration ClinicalTrials.gov NCT05159089. Physical Activity Drop-out Ratio in Patients’ Living with Type 2 Diabetes. Prospectively registered on 15 December 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06742-7.
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Affiliation(s)
- Guillem Jabardo-Camprubí
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain.
| | - Judit Bort-Roig
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain
| | - Rafel Donat-Roca
- School of Health Science UManresa, Sport Exercise and Human Movement (SEaMH), University of Vic-Central University of Catalonia, Av. Universitaria 4-6, Manresa, Spain
| | - Raimon Milà-Villarroel
- School of Health Science Blanquerna, Ramon Llull University, Padilla, 326-332, Barcelona, Spain
| | - Mercè Sitjà-Rabert
- School of Health Science Blanquerna, Global Research on Wellbeing (GRoW) Research Group, Ramon Llull University, Padilla, 326-332, Barcelona, Spain
| | - Jim McKenna
- School of Sport, Leeds Becket University, Leeds, LS1 3HE, Leeds, England
| | - Anna Puig-Ribera
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain
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Fuente-Vidal A, Guerra-Balic M, Roda-Noguera O, Jerez-Roig J, Montane J. Adherence to eHealth-Delivered Exercise in Adults with no Specific Health Conditions: A Scoping Review on a Conceptual Challenge. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10214. [PMID: 36011856 PMCID: PMC9408657 DOI: 10.3390/ijerph191610214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
Adherence has emerged as a focal point and critical determinant of success for physical activity interventions. The term is used for both traditional and digital interventions, and for prescribed and nonprescribed activities. Many other terms for adherence are being used interchangeably, as there is no consensus on its precise conceptualization. This scoping review aimed to advance the definition of adherence to eHealth programs, specifically for the adult population with no specific health conditions. A total of 2983 papers, published between 1 January 2016 and 13 March 2022, were retrieved from different databases (including grey literature). Of those, 13 studies met the eligibility criteria and were included for review. The selected studies used a wide array of technologies and consisted mainly of exercise interventions. Most of the reviewed publications contemplated exercise adherence as a percentage of expected dose. Most (8 out of 13) studies neither assessed nor specified an expected use of the involved technology. Results suggest a need for homogeneity in the conceptualization of adherence to physical activity and exercise, including those interventions delivered digitally.
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Affiliation(s)
- Andrea Fuente-Vidal
- Research Group on Health, Physical Activity and Sport (SAFE), Blanquerna School of Psychology, Education and Sport Sciences, Universitat Ramon Llull, 08022 Barcelona, Spain
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
| | - Myriam Guerra-Balic
- Research Group on Health, Physical Activity and Sport (SAFE), Blanquerna School of Psychology, Education and Sport Sciences, Universitat Ramon Llull, 08022 Barcelona, Spain
| | | | - Javier Jerez-Roig
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
| | - Joel Montane
- Research Group on Health, Physical Activity and Sport (SAFE), Blanquerna School of Psychology, Education and Sport Sciences, Universitat Ramon Llull, 08022 Barcelona, Spain
- Blanquerna School of Health Science, Universitat Ramon Llull, 08025 Barcelona, Spain
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