1
|
Dawson JK, Ede A, Phan M, Sequeira A, Teng HL, Donlin A. Feasibility and Acceptability of a Mobile Health Exercise Intervention for Inactive Adults: 3-Arm Randomized Controlled Pilot Trial. JMIR Form Res 2024; 8:e52428. [PMID: 39120078 PMCID: PMC11346126 DOI: 10.2196/52428] [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: 09/03/2023] [Revised: 02/01/2024] [Accepted: 04/11/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Objective monitoring of self-directed physical activity (PA) is a common approach used in both fitness and health settings to promote exercise behavior, but adherence has been poor. Newer mobile health (mHealth) technologies could be a cost-effective approach to broadening accessibility and providing support for PA behavior change; yet, the optimal method of delivery of such interventions is still unclear. OBJECTIVE This study aimed to determine the feasibility and acceptability of an mHealth exercise intervention delivered in combination with objective monitoring in 3 ways: health education emails, asynchronous exercise videos, or synchronous videoconference exercise classes. METHODS Physically inactive (<30 min/wk) adults (cisgender women aged 31.5, SD 11.3 years, cisgender men aged 34.1, SD 28.9 years, and nonbinary individuals aged 22.0, SD 0 years) were randomized (1:1:1) to 8 weeks of increasing PA behavioral support: level 1 (health education+objective monitoring, n=26), level 2 (asynchronous contact, level 1+prerecorded exercise videos, n=30), or level 3 (synchronous contact, level 1+videoconference group exercise, n=28). Participants used a heart rate monitor during exercise and a mobile app for interaction. Primary outcomes were feasibility (accrual, retention, and adherence) and acceptability (user experience survey). Secondary outcomes assessed at baseline and 8 weeks included resting heart rate, self-reported PA, and quality of life. The exercise dose was evaluated throughout the intervention. RESULTS Between August 2020 and August 2021, 204 adults were screened for eligibility. Out of 135 eligible participants, 84 (62%) enrolled in the study. Retention was 50% (13/26) in level 1, 60% (18/30) in level 2 and 82% (23/28) in level 3, while adherence was 31% (8/26) in level 1, 40% (12/30) in level 2 and 75% (21/28) in level 3. A total of 83% (70/84) of the study sample completed the intervention, but low response rates (64%, 54/84) were observed postintervention at week-8 assessments. Program satisfaction was highest in participants receiving exercise videos (level 2, 80%, 8/10) or exercise classes (level 3, 80%, 12/15), while only 63% (5/8) of level 1 reported the program as enjoyable. Level 3 was most likely to recommend the program (87%, 13/15), compared to 80% (8/10) in level 2 and 46% (5/8) in level 1. Self-reported PA significantly increased from baseline to intervention in level 3 (P<.001) and level 2 (P=.003), with no change in level 1. Level 3 appeared to exercise at higher doses throughout the intervention. CONCLUSIONS Only the videoconference exercise class intervention met feasibility criteria, although postintervention response rates were low across all groups. Both videoconference and prerecorded videos had good acceptability, while objective monitoring and health education alone were not feasible or acceptable. Future studies are needed to examine the effectiveness of videoconference exercise interventions on health-related outcomes during nonpandemic times and how asynchronous interventions might maximize adherence. TRIAL REGISTRATION ClinicalTrials.gov NCT05192421; https://clinicaltrials.gov/study/NCT05192421.
Collapse
Affiliation(s)
- Jacqueline Kiwata Dawson
- Department of Physical Therapy, California State University, Long Beach, Long Beach, CA, United States
| | - Alison Ede
- Department of Kinesiology, California State University, Long Beach, Long Beach, CA, United States
| | - Madeleine Phan
- Department of Chemistry and Biochemistry, California State University, Long Beach, Long Beach, CA, United States
| | - Alec Sequeira
- Department of Kinesiology, California State University, Long Beach, Long Beach, CA, United States
| | - Hsiang-Ling Teng
- Department of Physical Therapy, California State University, Long Beach, Long Beach, CA, United States
| | - Ayla Donlin
- LifeFit Center, Department of Kinesiology, California State University, Long Beach, Long Beach, CA, United States
| |
Collapse
|
2
|
Sadek AT, Djerdjour L, Reyes RA, Adams GP, Logan CH, Smith MA, Biddle SG, Wiles TS, Urrea-Mendoza E, McConnell TM, Revilla FJ, Trilk JL. The Feasibility and Efficacy of a Virtual Reality Tandem Cycling Program for Persons with Parkinson's Disease and Their Care Partners. Neurol Ther 2024; 13:1237-1257. [PMID: 38878129 PMCID: PMC11263444 DOI: 10.1007/s40120-024-00636-3] [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: 03/30/2024] [Accepted: 05/30/2024] [Indexed: 07/23/2024] Open
Abstract
INTRODUCTION Persons with Parkinson's disease (PwPD) suffer from motor and non-motor symptoms which significantly affect their quality of life (QoL), and the QoL of their care partners (CP). Tandem cycling reduces PwPD motor symptoms; however, no studies have examined other benefits or included PwPD CP. We conducted an 8-week community virtual reality (VR) tandem cycling intervention to assess the feasibility and efficacy for PwPD and their CP (i.e., PD dyads). We hypothesized that dyadic tandem cycling would improve (1) PwPD motor and non-motor symptoms and (2) dimensions of PD dyads' QoL and physiologic health. METHODS Ten PD dyads were recruited to complete 8 weeks of progressive intensity, bi-weekly tandem cycling. At pre- and post-testing, PwPD were assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS-III), functional gait assessment (FGA), and 10-m gait speed test. PD dyads also completed emotional and cognitive status questionnaires [e.g., Geriatric Depression Scale-Short Form (GDS-SF)], and wore BodyGuard 2 heart rate (HR) monitors for 48 h to assess surrogate measures of heart rate variability. Statistical analyses were conducted using Student's t tests with significance set at p ≤ 0.05. RESULTS Eight PD dyads and one PwPD completed the intervention. Retention of PwPD (90%) and CP (80%) was adequate, and PD dyad adherence ranged from 91.67 to 97.91%. PwPD demonstrated significant clinical improvements in MDS-UPDRS-III scores (- 7.38, p < 0.01), FGA scores (+ 3.50, p < 0.01), and 10-m gait speed times (+ 0.27 m/s, p < 0.01), in addition to significant self-reported improvements in mobility (- 13.61, p = 0.02), fatigue (- 5.99, p = 0.02), and social participation (+ 4.69, p < 0.01). CP depressive symptoms significantly decreased (- 0.88, p = 0.02), and PD dyads shared a significant increase in root mean square of the successive differences (RMSSD; p = 0.04). CONCLUSION Our pilot study demonstrated feasibility and multiple areas of efficacy supporting further investigation of community VR tandem cycling as a therapeutic intervention for PD dyads.
Collapse
Affiliation(s)
- Alia T Sadek
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA.
| | - Leila Djerdjour
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Ryan A Reyes
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Greggory P Adams
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Cara H Logan
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Margaret A Smith
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Sara G Biddle
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | | | - Enrique Urrea-Mendoza
- Department of Clinical Science/TMH Physicians Partners, Medical School, Florida State University, Tallahassee, FL, USA
| | - Tracie M McConnell
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
- Neuroscience Associates, Prisma Health-Upstate, Greenville, SC, USA
| | - Fredy J Revilla
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
- Neuroscience Associates, Prisma Health-Upstate, Greenville, SC, USA
| | - Jennifer L Trilk
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| |
Collapse
|
3
|
Mildner S, Hotz I, Kübler F, Rausch L, Stampfer-Kountchev M, Panzl J, Brenneis C, Seebacher B. Effects of activity-oriented physiotherapy with and without eye movement training on dynamic balance, functional mobility, and eye movements in patients with Parkinson's disease: An assessor-blinded randomised controlled pilot trial. PLoS One 2024; 19:e0304788. [PMID: 38875243 PMCID: PMC11178185 DOI: 10.1371/journal.pone.0304788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 05/16/2024] [Indexed: 06/16/2024] Open
Abstract
OBJECTIVES To describe changes in balance, walking speed, functional mobility, and eye movements following an activity-oriented physiotherapy (AOPT) or its combination with eye movement training (AOPT-E) in patients with Parkinson's disease (PD). To explore the feasibility of a full-scale randomised controlled trial (RCT). METHODS Using an assessor-blinded pilot RCT, 25 patients with PD were allocated to either AOPT or AOPT-E. Supervised interventions were performed 30 minutes, 4x/weekly, for 4 weeks, alongside inpatient rehabilitation. Outcomes were assessed at baseline and post-intervention, including dynamic balance, walking speed, functional and dual-task mobility, ability to safely balance, health-related quality of life (HRQoL), depression, and eye movements (number/duration of fixations) using a mobile eye tracker. Freezing of gait (FOG), and falls-related self-efficacy were assessed at baseline, post-intervention, and 4-week follow-up. Effect sizes of 0.10 were considered weak, 0.30 moderate, and ≥0.50 strong. Feasibility was assessed using predefined criteria: recruitment, retention and adherence rates, adverse events, falls, and post-intervention acceptability using qualitative interviews. RESULTS Improvements were observed in dynamic balance (effect size r = 0.216-0.427), walking speed (r = 0.165), functional and dual-task mobility (r = 0.306-0.413), ability to safely balance (r = 0.247), HRQoL (r = 0.024-0.650), and depression (r = 0.403). Falls-related self-efficacy (r = 0.621) and FOG (r = 0.248) showed varied improvements, partly sustained at follow-up. Eye movement improvements were observed after AOPT-E only. Feasibility analysis revealed that recruitment was below target, with less than two patients recruited per month due to COVID-19 restrictions. Feasibility targets were met, with a retention rate of 96% (95% confidence interval [CI]: 77.68-99.79) and a 98.18% (95% CI: 96.12-99.20) adherence rate, exceeding the targets of 80% and 75%, respectively. One adverse event unrelated to the study intervention confirmed intervention safety, and interview data indicated high intervention acceptability. CONCLUSIONS AOPT-E and AOPT appeared to be effective in patients with PD. Feasibility of a larger RCT was confirmed and is needed to validate results.
Collapse
Affiliation(s)
- Sarah Mildner
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
| | - Isabella Hotz
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
| | - Franziska Kübler
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
| | - Linda Rausch
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Johanna Panzl
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
| | - Christian Brenneis
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
- Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research, Münster, Austria
| | - Barbara Seebacher
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
- Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research, Münster, Austria
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
4
|
Tsekoura M, Matzaroglou C, Xergia S, Dionyssiotis Y, Tsepis E, Sakellari V, Billis E. The Feasibilty of the Motor Control Home Ergonomics Elderlies' Prevention of Falls (McHeELP) Programme in Patients with Sarcopenia: A Pilot Study. J Frailty Sarcopenia Falls 2024; 9:89-95. [PMID: 38835618 PMCID: PMC11145092 DOI: 10.22540/jfsf-09-089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 06/06/2024] Open
Abstract
Objectives The objective of this pilot study was to investigate the feasibility of a three month 'Motor control Home ergonomics Elderlies' Prevention of falls' (McHeELP) programme on muscle mass, muscle strength, functionality, balance and fear of falling among older adults with sarcopenia. Methods A feasibility study of the McHeELP programme was performed in patients with sarcopenia. Primary outcome measures included number of participants; number of participants that showed engagement with the programme; adherence rates; data loss in questionnaires and secondary outcome measures; any adverse events, related or not to the intervention programme. All participants received a home-based motor control exercise programme combined with an ergonomic home modification for 12 weeks. Secondary outcome measures included Hand Grip Strength, Bioimpendance Analysis, Muscle Mass, Functionality and Fear of Falling. Results Twelve participants, (74.9±5 years), completed the pilot study. Significant differences were recorded before and after the programme on participants' functionality (p < 0.001), balance (p < 0.05) and fear of falling (p < 0.001). Conclusions The present study revealed that the McHeELP programme is fesasible and that it is possible to implement the programme in clinical practice. The McHeELP programme positively affects functionality, balance and fear of falling. Thus, it seems feasible to conduct a full-scale randomised controlled trial.
Collapse
Affiliation(s)
- Maria Tsekoura
- Physiotherapy department, School of Health Rehabilitation Sciences, University of Patras, Greece
| | - Charalampos Matzaroglou
- Physiotherapy department, School of Health Rehabilitation Sciences, University of Patras, Greece
| | - Sofia Xergia
- Physiotherapy department, School of Health Rehabilitation Sciences, University of Patras, Greece
| | - Yannis Dionyssiotis
- 2 Physical Medicine and Rehabilitation Department, National Rehabilitation Center EKA, Athens, Greece
| | - Elias Tsepis
- Physiotherapy department, School of Health Rehabilitation Sciences, University of Patras, Greece
| | - Vassiliki Sakellari
- Physiotherapy department, Faculty of Health and Care Sciences, University of Western Attica, Greece
| | - Evdokia Billis
- Physiotherapy department, School of Health Rehabilitation Sciences, University of Patras, Greece
| |
Collapse
|
5
|
Woods CB, O’Regan A, Doyle C, Hayes G, Clifford A, Donnelly AE, Gillespie P, Glynn L, Murphy AW, Sheikhi A, Bengoechea EG. Move for Life an intervention for inactive adults aged 50 years and older: a cluster randomised feasibility trial. Front Public Health 2024; 12:1348110. [PMID: 38813401 PMCID: PMC11133700 DOI: 10.3389/fpubh.2024.1348110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/25/2024] [Indexed: 05/31/2024] Open
Abstract
Background Move for Life (MFL) is a theory-informed intervention that was developed to augment established physical activity (PA) programmes and enable inactive adults aged 50 years and older to be more active. This study examined the feasibility of MFL and sought to provide evidence of its potential for improving PA and associated health outcomes. Methods A 3-arm cluster randomised feasibility trial compared MFL intervention, usual provision (UP) and control (CON) groups at baseline (T0), post-intervention (T1, at 8, 10 or 12- weeks) and 6-month follow up (T2). We used purposive sampling strategies to recruit participants according to characteristics of interest. Feasibility outcomes assessed recruitment, fidelity, adherence, retention and data completion rates based on pre-set criteria. Primary outcomes were accelerometer-based moderate-to-vigorous intensity PA (MVPA) and self-reported compliance with physical activity guidelines (PAGL). Secondary outcomes included light intensity PA (LiPA), standing time, sedentary time, body composition (adiposity), physical function and psychological well-being. We used linear mixed models (continuous outcomes) or generalized estimated equations (categorical outcomes) to estimate group differences over time in the study outcomes. Results Progression criteria for feasibility outcomes were met, and 733 individuals were recruited. Considering a 6-month period (T0-T2), while self-reported compliance with PAGL increased in MFL relative to UP and CON and in UP relative to CON, standing time decreased in MFL relative to CON and sedentary time increased in the latter compared to UP. Waist circumference decreased in MFL relative to UP and CON. MFL outperformed UP in the Timed Up and Go Test while MFL and UP increased the distance covered in the Six-Minute Walk Test compared to CON. Psychological well-being increased in MFL relative to CON (all p < 0.05). Conclusion Findings show that MFL is feasible, while data are promising with regards to the potential of improving community PA programmes for adults aged 50 or more years. Clinical trial registration https://www.isrctn.com/Registration#ISRCTN11235176.
Collapse
Affiliation(s)
- Catherine B. Woods
- Physical Activity for Health Research Centre, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Andrew O’Regan
- Physical Activity for Health Research Centre, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Ciaran Doyle
- Physical Activity for Health Research Centre, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Grainne Hayes
- Physical Activity for Health Research Centre, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Amanda Clifford
- Health Research Institute, University of Limerick, Limerick, Ireland
- Ageing Research Center, School of Allied Health, University of Limerick, Limerick, Ireland
| | - Alan E. Donnelly
- Physical Activity for Health Research Centre, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Paddy Gillespie
- Centre for Research in Medical Devices (Cúram) and Health Economics and Policy Analysis Centre, NUI Galway, Galway, Ireland
| | - Liam Glynn
- Health Research Institute, University of Limerick, Limerick, Ireland
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Andrew W. Murphy
- HRB Primary Care Clinical Trials Network, Discipline of General Practice, NUI Galway, Galway, Ireland
| | - Ali Sheikhi
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Enrique García Bengoechea
- Physical Activity for Health Research Centre, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| |
Collapse
|
6
|
Oliva FM, Tarasconi M, Malovini A, Zappa M, Visca D, Zampogna E. Evaluation of physical activity before and after respiratory rehabilitation in normal weight individuals with asthma: a feasibility study. Front Sports Act Living 2024; 6:1372048. [PMID: 38783863 PMCID: PMC11111960 DOI: 10.3389/fspor.2024.1372048] [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: 01/17/2024] [Accepted: 04/12/2024] [Indexed: 05/25/2024] Open
Abstract
Background Individuals with asthma spend less time engaging in physical activity compared to the general population. Increasing physical activity has become a patient-centered goal for the treatment of treatable traits of individuals with asthma. There are data showing the possible effects of a pulmonary rehabilitation program on physical activity in obese individuals with asthma but not in normal-weight asthmatics. The objective of this feasibility study is to estimate the number of daily steps and time spent on activity in normal-weight individuals with asthma, measured before and after a pulmonary rehabilitation program. Methods Normal-weight individuals with moderate to severe asthma were evaluated. The individuals measured their daily steps with an accelerometer for 5 days before and after a pulmonary rehabilitation program. The study was registered on ClinicalTrials.gov: NCT05486689. Results In total, 17 participants were enrolled; one dropout and data on the time in activity of two individuals are missing due to a software error during the download. Data from 16 patients were analyzed. The median number of steps/day at baseline was 5,578 (25th, 75th percentiles = 4,874, 9,685) while the median activity time was 214 min (25th, 75th percentiles = 165, 239). After the rehabilitation program, the number of daily steps increased by a median value of 472 (p-value = 0.561) and the time in activity reduced by 17 min (p-value = 0.357). We also found a significant difference in quality of life, muscle strength, and exercise capacity. Conclusions The results of this study make it possible to calculate the sample size of future studies whose main outcome is daily steps in normal-weight individuals with asthma. The difficulties encountered in downloading time in activity data do not allow the same for this outcome. Clinical Trial Registration ClinicalTrials.gov, identifier NCT05486689.
Collapse
Affiliation(s)
- Federico Mattia Oliva
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Tarasconi
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - Alberto Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Martina Zappa
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Dina Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Elisabetta Zampogna
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| |
Collapse
|
7
|
Wadden KP, Hollohan N, Furneaux T, Maher R, Barrett CM, Fuller D, Basset F, Murphy D, Murphy S, Healey S, McGowan E, Twells LK. PRO-FIT-CARE study: the feasibility assessment of a pilot online exercise intervention for persons living with obesity and female infertility. Front Sports Act Living 2024; 6:1332376. [PMID: 38774277 PMCID: PMC11107087 DOI: 10.3389/fspor.2024.1332376] [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: 11/06/2023] [Accepted: 04/10/2024] [Indexed: 05/24/2024] Open
Abstract
Introduction Moderate-to-high physical activity participation is associated with a reduced risk of infertility. Yet, exercise interventions that target cardiorespiratory fitness, independent of weight loss, are lacking in obesity and female fertility research. Purpose The primary objective of the PRO-FIT-CARE (PROmoting FITness for CArdiometabolic & REproductive Health) study was to assess the feasibility of a moderate-to-high-intensity online exercise program for persons with obesity and female infertility. Methods Feasibility, safety, acceptability, and efficacy were assessed by examining: (1) recruitment and consent rate, (2) study retention, (3) adverse events, (4) participant satisfaction, (5) adherence, and (6) cardiorespiratory fitness. Results Eleven of thirty-two women contacted agreed to participate in the program (34.4% consent rate). Eight participants (72.7%) completed the study. One musculoskeletal injury was reported. There was a 30% adherence rate based on prescribed exercise intensity (60%-80% of heart rate maximum). One of eleven participants attended 80% of the exercise intervention. Based on a weekly satisfaction survey, the program had an overall high level of satisfaction. Compared to sex and age normative data, post-intervention, two of eight participants improved their cardiorespiratory fitness percentile rank. Conclusion The study highlights challenges with adherence to an online exercise program. While the program was safe and participants reported high levels of program satisfaction, approaches to improve adherence must be incorporated.
Collapse
Affiliation(s)
- K. P. Wadden
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - N. Hollohan
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - T. Furneaux
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - R. Maher
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - C. M. Barrett
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - D. Fuller
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - F. Basset
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - D. Murphy
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada
- Discipline of Obstetrics and Gynecology, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - S. Murphy
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada
- Discipline of Obstetrics and Gynecology, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - S. Healey
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada
- Discipline of Obstetrics and Gynecology, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - E. McGowan
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - L. K. Twells
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada
| |
Collapse
|
8
|
Punnoose A, Claydon-Mueller L, Rushton A, Khanduja V. PREHAB FAI- Prehabilitation for patients undergoing arthroscopic hip surgery for Femoroacetabular Impingement Syndrome -Protocol for an assessor blinded randomised controlled feasibility study. PLoS One 2024; 19:e0301194. [PMID: 38603694 PMCID: PMC11008823 DOI: 10.1371/journal.pone.0301194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The past decade has seen an exponential growth of minimally invasive surgical procedures. Procedures such as hip arthroscopy have rapidly grown and become the standard of care for patients with Femoroacetabular Impingement Syndrome (FAIS). Although, the results of such procedures are encouraging, a large proportion of patients do not achieve optimal outcomes due to chronicity and deconditioning as a result of delay in diagnosis and increased waiting times amongst other factors. In a recent systematic review and meta-analysis of randomised control trials, moderate certainty evidence supported prehabilitation over standard care in optimising several domains including muscle strength, pain and health related quality of life in patients undergoing orthopaedic surgical interventions. However, the role of prehabilitation in patients with FAI syndrome undergoing hip arthroscopy has received little attention. AIM To evaluate the feasibility, suitability, acceptability and safety of a prehabilitation programme for FAI to inform a future definitive randomised control trial to assess effectiveness. METHODS A systematically developed prehabilitation intervention based on a literature review and international consensus will be utilised in this study. A mixed methodology encompassing a two-arm randomised parallel study alongside an embedded qualitative component will be used to answer the study objectives. Patients will be recruited from a tertiary referral NHS centre for young adult hip pathology in the UK. Patient reported outcomes such as iHOT-12, Brief Pain Inventory Scale (Short form), Hospital Anxiety and Depression Scale and Patient Global Impression of Change score will be obtained alongside objective measurements such as Muscle Strength and Star Excursion Balance Test at various time points. Outcome measures will be obtained at baseline (prior to prehabilitation intervention), after prehabilitation before surgery, and at 6 weeks+/- 4 weeks and 6 months +/- 4 weeks (planned primary endpoint for definitive RCT) postoperatively when participants attend the research site for clinical care and remotely at 12 months +/- 4 weeks postoperatively. Mean change and 95% CI, and effect size of outcome measures will be used to determine the sample size for a future RCT. For the qualitative component, in depth face-to-face semi-structured interviews with physiotherapists and focus groups with participants will be conducted to assess the feasibility, suitability, and acceptability of the prehabilitation intervention using a predetermined success criteria. All qualitative data will be recorded, transcribed verbatim and thematically analysed. DISCUSSION This study will be first of its kind to evaluate a systematically developed prehabilitation intervention for patients with FAIS undergoing hip arthroscopy. This study will provide important preliminary data to inform feasibility of a definitive RCT in the future to evaluate effectiveness of a prehabilitation intervention. TRIAL REGISTRATION ISRCTN 15371248, 09/03/2023. TRIAL PROTOCOL Version 2.3, 26th June 2023.
Collapse
Affiliation(s)
- Anuj Punnoose
- Young Adult Hip Service & Physiotherapy Department, Addenbrooke’s- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- School of Allied Health, Anglia Ruskin University, Cambridge, United Kingdom
| | | | - Alison Rushton
- Faculty of Health Sciences, School of Physical Therapy, Western University, London, Canada
| | - Vikas Khanduja
- Department of Trauma and Orthopaedics, Young Adult Hip Service, Addenbrooke’s – Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
| |
Collapse
|
9
|
Giuliani-Dewig HK, Gerstner GR, Register-Mihalik JK, Blackburn JT, Padua DA, Staley JA, Ryan ED. The feasibility of workload monitoring among law enforcement officers: A multi-methodological approach. APPLIED ERGONOMICS 2024; 116:104212. [PMID: 38154228 DOI: 10.1016/j.apergo.2023.104212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 12/30/2023]
Abstract
This study examined the feasibility of workload monitoring to assess internal workload in law enforcement officers (LEO) using a multi-methodological approach. Fifty front-line LEO completed workload surveys on workdays for eight weeks. Retention and adherence were assessed across the survey period. LEO completed usability and likelihood to continue questionnaires, while departmental administrators (n = 8) received workload reports and completed utility and sustainability questionnaires. A subsample of LEO and administrators participated in semi-structured interviews, following consensual qualitative research design. LEO retention (96%), survey adherence (94%), and usability scores (88.3/100) were high, with a moderate likelihood to continue to use the survey. Administration reported high utility and sustainability. The high adherence rates and usability scores, coupled with strong administrative support, suggest that workload monitoring may be a feasible strategy among LEO to monitor occupational workloads. The LEO and administration feedback highlight areas of improvement (e.g., data transparency, departmental collaboration) to inform future implementation.
Collapse
Affiliation(s)
- Hayden K Giuliani-Dewig
- Human Performance Innovation Center, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA; MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gena R Gerstner
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Healthy Work Design and Worker Well-Being, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Johna K Register-Mihalik
- Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Matthew Gfeller Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; STAR Heel Performance Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J Troy Blackburn
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Darin A Padua
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John A Staley
- Carolina Center for Healthy Work Design and Worker Well-Being, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; North Carolina Occupational Safety and Health Education and Research Center, Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric D Ryan
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Healthy Work Design and Worker Well-Being, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| |
Collapse
|
10
|
Swales B, Ryde GC, Whittaker AC. A Mixed Methods Feasibility Study of Machine-Based Resistance Training With Prefrail Older Adults in Residential Care: The Keeping Active in Residential Elderly Trial II. J Aging Phys Act 2024; 32:244-263. [PMID: 38262397 DOI: 10.1123/japa.2022-0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/21/2023] [Accepted: 09/20/2023] [Indexed: 01/25/2024]
Abstract
Physical activity is an effective, proactive intervention to reduce or reverse frailty and functional decline. However, uncertainty exists about the feasibility and impact of resistance training on multidimensional health in prefrail older adults in residential care. This mixed methods feasibility study assessed practicability with limited efficacy testing on health and functional outcomes. Eleven prefrail older adults participated in a 6-week progressive resistance training protocol three times per week. The intervention and measures were found to be appropriate and acceptable by those who completed the trial, with participants self-reporting improved well-being, mood, and function. Analysis identified several barriers to recruitment, including prior commitments, seasonal impact, and session timing, and offered potential solutions with further recommendations for program refinement prior to a definitive randomized controlled trial. These findings add to our understanding of prefrail older adults' preferences regarding participation in physical activity research and the perceived benefits of resistance training. This trial was registered with ClinicalTrials.gov: NCT03141879.
Collapse
Affiliation(s)
- Bridgitte Swales
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Gemma C Ryde
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Anna C Whittaker
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| |
Collapse
|
11
|
Whale R, Hasani F, Haines T, Munteanu SE, Ellis K, Patel S, Buchholtz K, Warne J, Vallance P, Malliaras P. Assessing calf exercise fidelity among people with Achilles tendinopathy using videos recorded via Zoom®: an observational study. Disabil Rehabil 2024; 46:697-704. [PMID: 36755434 DOI: 10.1080/09638288.2023.2174604] [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: 07/04/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE Exercise fidelity is a fundamental aspect of exercise prescription by physiotherapists. Assessing exercise fidelity via telehealth (videoconference) is potentially useful but its reproducibility has not been assessed. The objective was to evaluate agreement (reproducibility) of video rating of calf exercise fidelity within (over four weeks) and between telehealth raters and compared with live rating. METHODS Nineteen videos of participants with AT undertaking calf exercises were rated by physiotherapists in person (live) and by watching pre-recorded videos (replicating telehealth). Three forms of agreement were assessed: (i) between live assessment and recorded video (telehealth) assessment; (ii) between telehealth raters (inter-rater); (iii) agreement within telehealth raters over four weeks (intra-rater). RESULTS There was weak to almost perfect agreement (Kappa = 0.65 to 1.00, rater 1, Kappa = 0.57 to 1.00, rater 2) between the telehealth and live raters. There was moderate to almost perfect agreement (Kappa = 0.65 to 1.00) when assessing intra-rater reliability, aside from one of the six criteria (quality of movement). CONCLUSION Assessing calf exercise fidelity via videos recorded on Zoom® appears to demonstrate weak or greater agreement versus live rating and over time. Inter-rater agreement was lower, suggesting that the criteria developed may be better suited to use by individual raters over time.Implications for rehabilitationTelehealth assessment (when compared with live, in person assessment) shows a moderate or greater agreement for the majority of assessment criteria when assessing calf exercise fidelity.The calf exercise fidelity criteria developed can be used as an adjunct to assessment and management of people with Achilles Tendinopathy.Intra-rater assessment was shown to be moderately or more consistent over a four-week period when assessing calf exercise fidelity.
Collapse
Affiliation(s)
- Rhiannon Whale
- Physiotherapy Department, Monash University, Melbourne, Victoria, Australia
| | - Fatmah Hasani
- Physiotherapy Department, Monash University, Melbourne, Victoria, Australia
- Physiotherapy Department, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Terry Haines
- School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building G, Peninsula Campus, Monash University, Frankston, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Kirsten Ellis
- Faculty of Information Technology, Monash University, Melbourne, Victoria, Australia
| | - Shalin Patel
- Back in Motion Physiotherapy, Melbourne, Victoria, Australia
| | - Kim Buchholtz
- Department of Physiotherapy, LUNEX University, Differdange, Luxembourg
| | - Jonathan Warne
- Physiotherapy department, Brunel University London, London, UK
| | - Patrick Vallance
- Physiotherapy Department, Monash University, Melbourne, Victoria, Australia
| | - Peter Malliaras
- Physiotherapy Department, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
12
|
Ghahfarrokhi MM, Shirvani H, Rahimi M, Bazgir B, Shamsadini A, Sobhani V. Feasibility and preliminary efficacy of different intensities of functional training in elderly type 2 diabetes patients with cognitive impairment: a pilot randomised controlled trial. BMC Geriatr 2024; 24:71. [PMID: 38238647 PMCID: PMC10797744 DOI: 10.1186/s12877-024-04698-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Aging and type-2 diabetes (T2D) are the most important risk factors for cognitive impairment and Alzheimer's disease. Exercise training is an effective, safe, and practical intervention in improving glucose metabolism, physical function, and cognitive disorders. This pilot study investigated the feasibility and preliminary efficacy of high-intensity low-volume (HIFT) vs. low-intensity high-volume (LIFT) functional training in elderly T2D patients with cognitive impairment. METHODS Forty-eight elderly T2D patients (31 female, 17 male, age 67.5 ± 5.8 years, MMSE score 18.8 ± 2.6, FBG 209.5 ± 37.9) were randomly assigned to HIFT, LIFT and control groups. Cognitive impairment was diagnosed with MMSE ≤ 23 based Iranian society. The SDMT, CVLT-II, BVMT-R, and Stroop tests were used to evaluated processing speed, learning, memory and attention respectively. Physical fitness tests include: tandem stance and walk test; TUG; 6MWT, 10MWT; SSST; 5TSTS; and hand grip was used to evaluated static and dynamic balance, agility, walking endurance, gait speed, lower limb function and lower and upper body strength respectively. As well as, Biochemical (FBG, insulin, HOMA-IR, HbA1c) and physiological outcomes (SBP, and DBP) were assessed. The HIFT group performed six weeks of functional training (three sessions per week) with 120-125% of the lactate threshold. The LIFT group performed six weeks of functional training (five sessions per week) with a 70-75% lactate threshold. Feasibility, safety, and acceptability of exercise programs were assessed at the end of the study. RESULT HIFT showed a higher adherence rate (91% vs. 87.5%), safety, and acceptability compared to LIFT. MMSE and Stroop scores, 6MWT, FBG, insulin, HOMA-IR, HbA1c, SBP, and DBP significantly improved in HIFT (all, P ≤ 0.004) and LIFT (all, P ≤ 0.023). Changes in 6MWT, FBG, insulin, HOMA-IR, and HbA1c in HIFT (all, P ≤ 0.001) and LIFT (all, P ≤ 0.008) were significant compared to the control group. Changes in Stroop scores were significant only in the HIFT group compared to the control group (P = 0.013). SDMT, CVLT-II, BVMT-R, balance test, 10MWT, SSST, TUG and hang grip significantly improved only in HIFT (all, P ≤ 0.038). CONCLUSION HIFT vs. LIFT is a safe, feasible, and effective approach for improving some aspects of physical, biochemical, and cognitive function in elderly T2D patients with cognitive impairment. This pilot study provides initial proof-of-concept data for the design and implementation of an appropriately powered randomised controlled trial (RCT) of HIFT vs. LIFT in a larger sample of elderly T2D patients with cognitive impairment. TRIAL REGISTRATION Randomized controlled trial (RCT) (Iranian Registry of Clinical Trials, trial registration number: IRCT20230502058055N1. Date of registration: 11/06/2023.
Collapse
Affiliation(s)
| | - Hossein Shirvani
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Mostafa Rahimi
- Department of Sport Science, Shahrekord University, Shahrekord, Iran
| | - Behzad Bazgir
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alireza Shamsadini
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Vahid Sobhani
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| |
Collapse
|
13
|
Fisher SR, Villasante-Tezanos A, Allen LM, Pappadis MR, Kilic G. Comparative effectiveness of pelvic floor muscle training, mirabegron, and trospium among older women with urgency urinary incontinence and high fall risk: a feasibility randomized clinical study. Pilot Feasibility Stud 2024; 10:1. [PMID: 38178267 PMCID: PMC10765875 DOI: 10.1186/s40814-023-01440-w] [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: 06/23/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Untreated, urgency urinary incontinence (UUI) and overactive bladder (OAB) can precipitate a vicious cycle of decreasing physical activity, social isolation, fear of falling, and falls. Structured behavioral interventions and medications are common initial treatment options, but they elicit their effects through very different mechanisms of action that may influence fall-related outcomes differently. This study will determine the feasibility of conducting a comparative effectiveness, three-arm, mixed methods, randomized clinical trial of a behaviorally based pelvic floor muscle training (PFMT) intervention versus two recent drug options in older women with UUI or OAB who are also at increased risk of falling. METHODS Forty-eight women 60 years and older with UUI or OAB who screen positive for increased fall risk will be recruited through the urogynacology and pelvic health clinics of our university health system. Participants will be randomly assigned to one of three 12-week treatment arms: (1) a course of behavioral and pelvic floor muscle training (PFMT) provided by physical therapists; (2) the beta-3 agonist, mirabegron; and (3) the antimuscarinic, trospium chloride. Study feasibility will be established through objective metrics of evaluability, adherence to the interventions, and attrition. We will also assess relevant measures of OAB symptom severity, quality of life, physical activity, incident falls, and concern about falling. DISCUSSION The proposed research seeks to ultimately determine if linkages between reduction in UI symptoms through treatment also reduce the risk of falling in this patient population. TRIAL REGISTRATION NCT05880862. Registered on 30 May 2023.
Collapse
Affiliation(s)
- Steve R Fisher
- Department of Physical Therapy, University of Texas Medical Branch at Galveston, Galveston, USA.
| | | | - Lindsay M Allen
- Department of Physical Therapy, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Monique R Pappadis
- Department of Population Health and Health Disparities, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Gokhan Kilic
- Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, USA
| |
Collapse
|
14
|
Voskuil VR, Emmanuel J, Magnuson C, Guidone M. Feasibility and Preliminary Effectiveness of the INSPIRE Pilot Study for Adolescent Girls. J Pediatr Health Care 2024; 38:74-85. [PMID: 37747387 DOI: 10.1016/j.pedhc.2023.09.001] [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: 07/07/2023] [Revised: 07/18/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION This pilot study evaluated the feasibility and preliminary effectiveness of the Intervention to Support Physical Activity Independence and Routine Everyday program. METHOD This quasi-experimental single-group pretest/posttest study included adolescent girls (n = 15) who received a Fitbit Inspire 2 wearable activity tracker and participated in the seven-week Intervention to Support Physical Activity Independence and Routine Everyday program on a college campus in the Midwest. Feasibility outcomes included intervention participation, fidelity, and satisfaction. Preliminary effectiveness outcomes included moderate-to-vigorous physical activity, cardiorespiratory fitness, and resting heart rate. RESULTS For intervention sessions, the mean attendance rate was 83.42%, the mean minutes of moderate-to-vigorous physical activity was 62.03, and the mean satisfaction score was 28.90. Moderate-to-vigorous physical activity and resting heart rate improved significantly from baseline to postintervention, but cardiorespiratory fitness did not. DISCUSSION Results suggest the need for a pilot randomized controlled trial to improve cardiorespiratory fitness and incorporating an objective measure of moderate-to-vigorous physical activity.
Collapse
|
15
|
Arevalo WM, Caicedo BI, Urizar GG, Schroeder J. Active Moms: a feasibility study of a community-based and home-based physical activity intervention for low-income, ethnic-minority mothers. Pilot Feasibility Stud 2023; 9:187. [PMID: 37978576 PMCID: PMC10655306 DOI: 10.1186/s40814-023-01378-z] [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: 09/26/2022] [Accepted: 07/18/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Despite the health benefits of physical activity, increasing regular physical activity levels among low-income, ethnic-minority mothers has remained a significant challenge. Yet, few studies have examined the feasibility of implementing interventions to address physical activity barriers often experienced by this population. METHODS The current mixed-methods pilot study assessed the feasibility, impact, and acceptability of a 3-month community-based (CBI) and a home-based intervention (HBI) designed to improve physical activity and fitness levels, as well as psychosocial outcomes (self-efficacy and social support), among low-income, ethnic minority mothers. Mothers were randomized to either a 3-month CBI or HBI and completed pre- and post-intervention assessments of physical activity, fitness, self-efficacy, and social support. Intervention feasibility was assessed by tracking recruitment, retention, and adverse event rates, whereas intervention acceptability was assessed through post-intervention focus groups. RESULTS Although participant recruitment was lower than expected (30 vs. target of 52 mothers), retention and adverse event feasibility goals were met (> 60% retention rate, 0% adverse events). Mothers in both groups (CBI and HBI) showed significant improvements in their physical activity and fitness levels and short-term improvements in receiving social support for physical activity. However, only mothers in the CBI group showed improvements in their self-efficacy for physical activity. Mothers also reported both types of interventions (CBI and HBI) to be acceptable with minor modifications highlighted, including the potential for graduates of these programs to serve as group facilitators. CONCLUSIONS Overall, the study protocol was feasible, impactful, and acceptable to low-income, ethnic minority mothers with modifications required before large-scale evaluation. (TRN: NCT05540509; 9/12/22; retrospectively registered; ClinicalTrials.org).
Collapse
Affiliation(s)
- Wendy Miranda Arevalo
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Urban Planning, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
| | - Brianna Isabel Caicedo
- Department of Psychology, California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA, 90840-0901, USA
| | - Guido G Urizar
- Department of Psychology, California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA, 90840-0901, USA.
| | - Jan Schroeder
- Department of Kinesiology, California State University, Long Beach, Long Beach, CA, USA
| |
Collapse
|
16
|
Johnson RW, White BK, Gibson N, Gucciardi DF, Williams SA. A Mixed-Methods Feasibility Study of a Gamified Therapy Prescription App for Children with Neurodisability. Phys Occup Ther Pediatr 2023; 44:586-603. [PMID: 37814984 DOI: 10.1080/01942638.2023.2263576] [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: 01/16/2023] [Accepted: 09/12/2023] [Indexed: 10/11/2023]
Abstract
AIM Determine the feasibility of a gamified therapy (occupational therapy, physiotherapy, speech pathology) prescription app developed for children with neurodisability for delivering school and home therapy programs (the Zingo app). METHOD A mixed-methods feasibility study was conducted with children (and their parents, therapists, and teachers) with neurodisability (n = 8, female= 5) who were prescribed a 4-week individualized therapy program by their usual treating therapist using Zingo. Primary outcome measures were program adherence, engagement, app quality, and user experience, collected with quantitative and qualitative methods. RESULTS Mean adherence to the program was 58.0% (SD 27.2). Our combined Engagement Index (EI) score was 74.4% (SD 11.7). App quality measured using Mobile Application Rating Scale- User version was 4.6/5 (SD 0.7, n = 6) for parents, 4.6/5 (SD 0.5, n = 5) for teachers, and 4.4/5 (SD 0.6, n = 6) for therapists. Thematic analysis of semi-structured interviews yielded a primary theme of "app as motivator" for therapy. CONCLUSIONS Adherence findings were affected by COVID-19 outbreak however remain comparable with other studies in this cohort. EI findings compared favorably with other studies. The findings are supportive of the feasibility of Zingo for delivering home and school therapy programs for children with neurodisability and was found to motivate therapy program completion.
Collapse
Affiliation(s)
- Rowan W Johnson
- Curtin School of Allied Health, Curtin University, Perth, Australia
- Therapy Services, Ability WA, Perth, Australia
| | - Becky K White
- Curtin School of Population Health, Curtin University, Perth, Australia
- Reach Health Promotion Innovations, Perth, Australia
| | - Noula Gibson
- Curtin School of Allied Health, Curtin University, Perth, Australia
- Department of Physiotherapy, Perth Children's Hospital, Perth, Australia
| | - Daniel F Gucciardi
- Curtin School of Allied Health, Curtin University, Perth, Australia
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Sîan A Williams
- Curtin School of Allied Health, Curtin University, Perth, Australia
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
17
|
Charles C, Bardet A, Ibrahimi N, Aromatario O, Cambon L, Imbert A, Pons M, Raynard B, Sauveplane D, Pouchepadass C, Baudinet C, Lambotte O, Marabelle A, Dauchy S. Delivering adapted physical activity by videoconference to patients with fatigue under immune checkpoint inhibitors: Lessons learned from the PACTIMe-FEAS feasibility study. J Telemed Telecare 2023; 29:716-724. [PMID: 34137641 DOI: 10.1177/1357633x211021743] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Fatigue is one of the most frequent symptoms in anti-cancer immune therapy. Physical activity has been proven effective in reducing fatigue, but unmet needs remain regarding the provision and access to adapted programmes, which efficiently addresses the main barriers to PA. METHODS The PACTIMe-FEAS study primarily aimed at primarily to evaluate the feasibility and the acceptability of a videoconference-based 6-month programme promoting physical activity, and secondarily to assess its potential post-immediate and short-term effectiveness in reducing fatigue in cancer patients under immune therapy. Numeric self-reported questionnaires (Visual Analogue Scale-fatigue, Multidimensional Fatigue Inventory, International Physical Activity Questionnaire, Échelle de Motivation envers l'Activité Physique en contexte de Santé, Medical Outcomes Study 36-Item Short Form Health Survey, Hospital Anxiety and Depression Scale and Insomnia Severity Index) were completed by participants through an online secure platform at three time points: just before (T1), and after (T2) the programme, and 3 months later (T3). RESULTS Sixteen participants (50% male, 50% female, mean age 54 years, 69% melanoma, 31% overweight), with moderate-to-severe fatigue, entered the internet-delivered intervention; 14 completed it, with an average completion rate of physical activity supervised sessions of 75%. Satisfaction was high, confirming a demand for group format, personalised approach, professional guidance and home-based device, to support the practice of regular physical activity. A decrease in fatigue was observed at the end of the programme. DISCUSSION The recruitment process did prove to be challenging, with a relatively small eligible population, and will need to be reconsidered to envision a larger scale trial. But here and now, this feasibility study provides the first promising foundations to develop further research on the effectiveness of an original remote programme.
Collapse
Affiliation(s)
- Cécile Charles
- Gustave Roussy, Université Paris-Saclay, France
- Bordeaux Population Health Research Center (BPH- INSERM U1219), Methods for Intervention Research in Population Health (MéRISP), Bordeaux University, France
| | | | | | - Olivier Aromatario
- Bordeaux Population Health Research Center (BPH- INSERM U1219), Methods for Intervention Research in Population Health (MéRISP), Bordeaux University, France
| | - Linda Cambon
- Bordeaux Population Health Research Center (BPH- INSERM U1219), Methods for Intervention Research in Population Health (MéRISP), Bordeaux University, France
| | | | - Magali Pons
- Gustave Roussy, Université Paris-Saclay, France
| | | | | | | | - Cédric Baudinet
- Mooven SAS, Research and Development Unit, Montpellier University, France
| | - Olivier Lambotte
- Clinical Immunology Department, AP-HP, Université Paris-Saclay, Hôpital Bicêtre, France
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Université Paris-Saclay, INSERM, CEA, France
| | - Aurélien Marabelle
- Drug Development Department, Gustave Roussy, Université Paris-Saclay, France
| | | |
Collapse
|
18
|
Ha DM, Comer A, Dollar B, Bedoy R, Ford M, Gozansky WS, Zeng C, Arch JJ, Leach HJ, Malhotra A, Prochazka AV, Keith RL, Boxer RS. Telemedicine-based inspiratory muscle training and walking promotion with lung cancer survivors following curative intent therapy: a parallel-group pilot randomized trial. Support Care Cancer 2023; 31:546. [PMID: 37656252 PMCID: PMC10474183 DOI: 10.1007/s00520-023-07999-7] [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: 04/19/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE Following curative-intent therapy of lung cancer, many survivors experience dyspnea and physical inactivity. We investigated the feasibility, acceptability, safety, and potential efficacy of inspiratory muscle training (IMT) and walking promotion to disrupt a postulated "dyspnea-inactivity" spiral. METHODS Between January and December 2022, we recruited lung cancer survivors from Kaiser Permanente Colorado who completed curative-intent therapy within 1-6 months into a phase-IIb, parallel-group, pilot randomized trial (1:1 allocation). The 12-week intervention, delivered via telemedicine, consisted of exercise training (IMT + walking), education, and behavior change support. Control participants received educational materials on general exercise. We determined feasibility a priori: enrollment of ≥ 20% eligible patients, ≥ 75% retention, study measure completion, and adherence. We assessed acceptability using the Telemedicine-Satisfaction-and-Usefulness-Questionnaire and safety events that included emergency department visits or hospitalizations. Patient-centered outcome measures (PCOMs) included dyspnea (University-of-California-San-Diego-Shortness-of-Breath-Questionnaire), physical activity (activPAL™ steps/day), functional exercise capacity (mobile-based-six-minute-walk-test), and health-related quality of life (HRQL, St.-George's-Respiratory-Questionnaire). We used linear mixed-effects models to assess potential efficacy. RESULTS We screened 751 patients, identified 124 eligible, and consented 31 (25%) participants. Among 28 participants randomized (14/group), 22 (11/group) completed the study (79% retention). Intervention participants returned > 90% of self-reported activity logs, completed > 90% of PCOMs, and attended > 90% of tele-visits; 75% of participants performed IMT at the recommended dose. Participants had high satisfaction with tele-visits and found the intervention useful. There was no statistically significant difference in safety events between groups. Compared to control participants from baseline to follow-up, intervention participants had statistically significant and clinically meaningful improved HRQL (SGRQ total, symptom, and impact scores) (standardized effect size: -1.03 to -1.30). CONCLUSIONS Among lung cancer survivors following curative-intent therapy, telemedicine-based IMT + walking was feasible, acceptable, safe, and had potential to disrupt the "dyspnea-inactivity" spiral. Future efficacy/effectiveness trials are warranted and should incorporate IMT and walking promotion to improve HRQL. TRIAL REGISTRATION ClinicalTrials.gov NCT05059132.
Collapse
Affiliation(s)
- Duc M Ha
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA.
- Section of Pulmonary and Critical Care, Medical & Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA.
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Angela Comer
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Blythe Dollar
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Ruth Bedoy
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Morgan Ford
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Wendolyn S Gozansky
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Chan Zeng
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Joanna J Arch
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
- Cancer Prevention and Control, University of Colorado Cancer Center, Aurora, CO, USA
| | - Heather J Leach
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Atul Malhotra
- Division of Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California San Diego, San Diego, CA, USA
| | - Allan V Prochazka
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Robert L Keith
- Section of Pulmonary and Critical Care, Medical & Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Rebecca S Boxer
- Division of Geriatrics, Hospice and Palliative Care Medicine, University of California Davis, Sacramento, CA, USA
| |
Collapse
|
19
|
Danielsen KK, Cabral D, Sveaas SH. "Students Moving Together", Tailored Exercise for Students Facing Mental Health Challenges-A Pilot Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6639. [PMID: 37681779 PMCID: PMC10487833 DOI: 10.3390/ijerph20176639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
An increasing number of university students are facing mental health challenges. The primary aim of this study was to determine the feasibility of 10 weeks of supervised tailored group exercise for 60 min twice a week delivered by the student health service for students facing mental health challenges. Secondary aims were to explore changes in mental health and physical fitness from pre- to post-test. Feasibility was assessed in terms of recruitment, drop-outs, attendance, and adverse events. The secondary outcomes included symptoms of depression and anxiety, wellbeing, satisfaction with life, cardiorespiratory fitness, and muscular endurance/strength. A total of 13 university students with self-reported mental health challenges, aged 20-39 years, were recruited during a four-week period. Ten (77%) of these completed the intervention and post-test as planned, and no adverse events occurred. There was a significant average reduction of 20% in symptoms of depression and anxiety (p = 0.008), and non-significant improvements of 21% in well-being and 16% in satisfaction with life were found. On average, cardiorespiratory fitness (p = 0.01) and muscular strength (push-ups test, p = 0.01, and sit-ups test, p = 0.02) increased. In conclusion, a 10-week tailored exercise intervention delivered by the student mental health service was found to be feasible, and beneficial for mental health and physical fitness in students facing mental health challenges.
Collapse
Affiliation(s)
- Kjersti Karoline Danielsen
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University in Agder, 4604 Kristiansand, Norway;
| | | | - Silje Halvorsen Sveaas
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University in Agder, 4604 Kristiansand, Norway;
| |
Collapse
|
20
|
Choukou MA, He E, Moslenko K. Feasibility of a Virtual-Reality-Enabled At-Home Telerehabilitation Program for Stroke Survivors: A Case Study. J Pers Med 2023; 13:1230. [PMID: 37623481 PMCID: PMC10455082 DOI: 10.3390/jpm13081230] [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: 05/03/2023] [Revised: 07/12/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
Stroke rehabilitation is a lengthy procedure that is necessary for stroke recovery. However, stroke rehabilitation may not be readily available for patients who live rurally due to barriers such as transportation and expenses. This shortage in wearable technology, in turn, causes health disparity among the rural population, which was exacerbated by the COVID-19 pandemic restrictions. Telerehabilitation (TR) is a potential solution for stroke rehabilitation in rural areas. This one-case study aimed to examine the feasibility and safety of a technology-enabled at-home TR program for stroke survivors living in a rural area in Canada. A VR setup was installed successfully in the home of our participant. A tablet was also supplied for the TR program. Each program consisted of 24 sessions to be completed over a 12-week period. Our participant was assessed on day one using the Fugl-Meyer assessment, the Modified Ashworth Scale, the 10 m walk test, and the Mini-Mental State Exam. Three questionnaires were also completed, including the Motor Activity Log (MAL), the Stroke Index Scale (SIS), and the Treatment Self-Regulation Questionnaire. These assessments were completed thrice, on day 1, at week 6, and at week 12. The participant found the tablet and its accompanying exercises easy to use, with a few limitations. The participant found the VR system more challenging to manage independently as a lack of comfortability, the visual contrast during the first trials, and certain technical aspects of the technology created several functional barriers. Although some limitations with the technology were noted, this case study indicates that telerehabilitation is feasible under certain circumstances when used in conjunction with traditional rehabilitation services.
Collapse
Affiliation(s)
- Mohamed-Amine Choukou
- Department of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada; (E.H.); (K.M.)
- Centre on Aging, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Elizabeth He
- Department of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada; (E.H.); (K.M.)
| | - Kelly Moslenko
- Department of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada; (E.H.); (K.M.)
| |
Collapse
|
21
|
Valaas LJV, Soberg HL, Rasmussen MS, Steenstrup SE, Andelic N, Kleffelgård I. Sub-symptom threshold aerobic exercise for patients with persisting post-concussion symptoms and exercise intolerance after mild traumatic brain injury - a study protocol with a nested feasibility study for a randomized controlled trial. BMC Neurol 2023; 23:179. [PMID: 37138202 PMCID: PMC10155435 DOI: 10.1186/s12883-023-03221-7] [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: 04/03/2023] [Accepted: 04/20/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Persistent post-concussion symptoms (PPCS) affect between 34 and 46% after a mild traumatic brain injury (mTBI). Many also experience exercise intolerance. Sub-symptom threshold aerobic exercise, SSTAE (exercise at an intensity level that does not increase symptoms) is proposed as a treatment to both reduce the symptom burden and increase the exercise tolerance after the injury. It is unclear if this also applies in a more chronic phase after mTBI. MAIN PURPOSE The main purpose of this study is to evaluate whether SSTAE in addition to ordinary rehabilitation will lead to clinically meaningful improvement of symptom burden, normalize exercise tolerance, increase physical activity, improve health-related quality of life, and reduce patient-specific activity limitations compared to a control group that only receives ordinary rehabilitation. DESIGN Randomized, controlled, single-blind parallel-group study with three measurement times; T0 at baseline, T1 after the intervention and T2 six months after T1. METHODS Patients between the ages of 18 and 60 with exercise intolerance and persistent PPCS (> 3 months) will be recruited to the study and randomized to two groups. All patients will receive follow-up at the outpatient TBI clinic. The intervention group will in addition receive SSTAE for 12 weeks with exercise diaries and a retest every 3 weeks for optimal dosage and progression. The Rivermead post-concussion symptoms questionnaire will be the main outcome measure. The secondary outcome measure will be a test of exercise tolerance-the Buffalo Concussion Treadmill Test. Other outcome measures include the patient-specific functional scale that measures patient-specific activity limitations, as well as outcome measures for diagnosis-specific health-related quality of life, anxiety and depression, specific symptoms such as dizziness, headache and fatigue, and physical activity. DISCUSSION This study will add knowledge about the effect of SSTAE and whether it should be implemented in rehabilitation for the adult population with persistent PPCS after mTBI. The nested feasibility trial showed that the SSTAE intervention was safe and that the study procedures and delivery of the intervention overall were feasible. However, minor amendments to the study protocol were made prior to the commencement of the RCT. TRIAL REGISTRATION Clinical Trials.gov, NCT05086419. Registered on September 5th, 2021.
Collapse
Affiliation(s)
- Lars-Johan V Valaas
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.
- Center for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Helene L Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Mari S Rasmussen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Sophie E Steenstrup
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Center for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ingerid Kleffelgård
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
22
|
Machado P, Pimenta S, Garcia AL, Nogueira T, Silva S, Oliveiros B, Martins RA, Cruz J. Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility Trial. J Clin Med 2023; 12:jcm12082971. [PMID: 37109307 PMCID: PMC10146369 DOI: 10.3390/jcm12082971] [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: 02/23/2023] [Revised: 03/16/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Clinical guidelines recommend prehabilitation with exercise training to optimize recovery after lung cancer surgery. However, the lack of access to facility-based exercise programs is a major barrier to routine participation. This study aimed to assess the feasibility of a home-based exercise intervention before lung cancer resection. METHODS We conducted a prospective, two-site feasibility study, including patients scheduled for lung cancer surgery. Exercise prescription involved aerobic and resistance training with telephone-based supervision. The primary endpoint was overall feasibility (recruitment rate, retention rate, intervention adherence and acceptability). Secondary endpoints included safety and effects on health-related quality of life (HRQOL) and physical performance, evaluated at baseline, after the exercise intervention and 4-5 weeks after surgery. RESULTS Over three months, 15 patients were eligible, and all agreed to participate (recruitment rate: 100%). A total of 14 patients completed the exercise intervention, and 12 patients were evaluated postoperatively (retention rate: 80%). The median length of the exercise intervention was 3 weeks. Patients performed an aerobic and resistance training volume higher than prescribed (median adherence rates of 104% and 111%, respectively). A total of nine adverse events occurred during the intervention (Grade 1, n = 8; Grade 2, n = 1), the most common being shoulder pain. After the exercise intervention, significant improvements were observed in the HRQOL summary score (mean difference, 2.9; 95% confidence interval [CI], from 0.9 to 4.8; p = 0.049) and the five-times sit-to-stand test score (median difference, -1.5; 95% CI, from -2.1 to -0.9; p = 0.001). After surgery, no significant effects on HRQOL and physical performance were observed. CONCLUSION A short-term preoperative home-based exercise intervention is feasible before lung cancer resection and may enhance accessibility to prehabilitation. Clinical effectiveness should be investigated in future studies.
Collapse
Affiliation(s)
- Pedro Machado
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal
- Univ Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal
- Physioclem, Physical Therapy Clinics, 2460-042 Alcobaça, Portugal
| | - Sara Pimenta
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal
| | - Ana Luís Garcia
- Thoracic Surgery Unit, Portuguese Oncology Institute of Coimbra, 3000-075 Coimbra, Portugal
| | - Tiago Nogueira
- Thoracic Surgery Unit, Portuguese Oncology Institute of Coimbra, 3000-075 Coimbra, Portugal
| | - Sónia Silva
- Pulmonology Department, Leiria Hospital Center, 2410-197 Leiria, Portugal
| | - Bárbara Oliveiros
- Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Raul A Martins
- Univ Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal
| | - Joana Cruz
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal
| |
Collapse
|
23
|
O'Brien KK, Ibáñez-Carrasco F, Carusone SC, Bayoumi AM, Tang A, McDuff K, Jiancaro T, Da Silva G, Torres B, Loutfy MR, Islam S, Lindsay J, Price C, Zobeiry M, Pandovski Z, Illic I, Ahluwalia P, Brown DA, Avery L, Solomon P. Piloting an online telecoaching community-based exercise intervention with adults living with HIV: protocol for a mixed-methods implementation science study. BMJ Open 2023; 13:e067703. [PMID: 36997255 PMCID: PMC10069544 DOI: 10.1136/bmjopen-2022-067703] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Our aim is to evaluate the implementation of an online telecoaching community-based exercise (CBE) intervention with the goal of reducing disability and enhancing physical activity and health among adults living with HIV. METHODS AND ANALYSIS We will conduct a prospective longitudinal mixed-methods two-phased intervention study to pilot the implementation of an online CBE intervention with ~30 adults (≥18 years) living with HIV who consider themselves safe to participate in exercise. In the intervention phase (0-6 months), participants will take part in an online CBE intervention involving thrice weekly exercise (aerobic, resistance, balance and flexibility), with supervised biweekly personal training sessions with a fitness instructor, YMCA membership providing access to online exercise classes, wireless physical activity monitor to track physical activity and monthly online educational sessions on topics related to HIV, physical activity and health. In the follow-up phase (6-12 months), participants will be encouraged to continue independent exercise thrice weekly. Quantitative assessment: Bimonthly, we will assess cardiopulmonary fitness, strength, weight, body composition and flexibility, followed by administering self-reported questionnaires to assess disability, contextual factor outcomes (mastery, engagement in care, stigma, social support), implementation factors (cost, feasibility, technology), health status and self-reported physical activity. We will conduct a segmented regression analyses to describe the change in level and trend between the intervention and follow-up phases. Qualitative assessment: We will conduct online interviews with a subsample of ~10 participants and 5 CBE stakeholders at baseline (month 0), postintervention (month 6) and end of follow-up (month 12) to explore experiences, impact and implementation factors for online CBE. Interviews will be audiorecorded and analysed using content analytical techniques. ETHICS AND DISSEMINATION Protocol approved by the University of Toronto Research Ethics Board (Protocol # 40410). Knowledge translation will occur in the form of presentations and publications in open-access peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05006391.
Collapse
Affiliation(s)
- Kelly K O'Brien
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada
| | | | - Soo Chan Carusone
- McMaster Collaborative for Health and Aging, McMaster University, Hamilton, Ontario, Canada
| | - Ahmed M Bayoumi
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of General Internal Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Ada Tang
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kiera McDuff
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tizneem Jiancaro
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - George Da Silva
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Brittany Torres
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mona R Loutfy
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Maple Leaf Medical Clinic, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Shaz Islam
- Canada-International HIV and Rehabilitation Research Collaborative (CIHRRC), Toronto, Ontario, Canada
| | - Joanne Lindsay
- Canada-International HIV and Rehabilitation Research Collaborative (CIHRRC), Toronto, Ontario, Canada
| | - Colleen Price
- Canada-International HIV and Rehabilitation Research Collaborative (CIHRRC), Ottawa, Ontario, Canada
| | - Mehdi Zobeiry
- YMCA of Greater Toronto, YMCA Canada, Toronto, Ontario, Canada
| | - Zoran Pandovski
- YMCA of Greater Toronto, YMCA Canada, Toronto, Ontario, Canada
| | - Ivan Illic
- YMCA of Greater Toronto, YMCA Canada, Toronto, Ontario, Canada
| | | | - Darren A Brown
- Therapies Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Lisa Avery
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Biostatistics Department, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Patricia Solomon
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
24
|
Wurz A, McLaughlin E, Hughes K, Ellis K, Chen A, Cowley L, Molina H, Duchek D, Eisele M, Culos-Reed SN. Exploring feasibility, perceptions of acceptability, and potential benefits of an 8-week yoga intervention delivered by videoconference for young adults affected by cancer: a single-arm hybrid effectiveness-implementation pilot study. Pilot Feasibility Stud 2023; 9:37. [PMID: 36899410 PMCID: PMC9999078 DOI: 10.1186/s40814-023-01244-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 01/12/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Young adults affected by cancer face physical and psychological challenges and desire online supportive care. Yoga can be delivered online and may improve physical and psychological outcomes. Yet, yoga has rarely been studied with young adults affected by cancer. To address this, an 8-week yoga intervention was developed, and a pilot study was deemed necessary to explore feasibility, acceptability, implementation, and potential benefits. METHODS A mixed-methods, single-arm hybrid effectiveness-implementation pilot study evaluating the yoga intervention was conducted. Feasibility was assessed by tracking enrollment, retention, attendance, completeness of data, and adverse events. Acceptability was explored through interviews. Implementation metrics included training time, delivery resources, and fidelity. Potential effectiveness was evaluated by exploring changes in physical (i.e., balance, flexibility, range of motion, functional mobility) and psychological (i.e., quality of life, fatigue, resilience, posttraumatic growth, body image, mindfulness, perceived stress) outcomes at pre- (week 0), post- (week 8), and follow-up (week 16) time points. Data were analyzed with descriptive statistics, repeated measures analysis of variance, and content analysis. RESULTS Thirty young adults participated in this study (recruitment rate = 33%). Retention to study procedures was 70%, and attendance ranged from 38 to 100%. There were little missing data (< 5%) and no adverse events. Though most participants were satisfied with the yoga intervention, recommendations for improvement were shared. Sixty study-specific training hours and > 240 delivery and assessment hours were accrued and fidelity was high. Functional mobility, flexibility, quality of life (energy/fatigue, social well-being), body image (appearance evaluation), mindfulness (non-reactivity), and perceived stress improved significantly over time (all p< 0.050; [Formula: see text]). No other significant changes were observed (all p> 0.050; [Formula: see text]). CONCLUSIONS The yoga intervention may confer physical and psychological benefits, though intervention and study-specific modifications are required to improve feasibility and acceptability. Requiring study participation and providing greater scheduling flexibility could enhance recruitment and retention. Increasing the frequency of classes offered each week and offering more opportunities for participant interaction could improve satisfaction. This study highlights the value of doing pilot work and provides data that has directly informed intervention and study modifications. Findings could also be used by others offering yoga or supportive care by videoconference to young adults affected by cancer. TRIAL REGISTRATION Not available-not registered.
Collapse
Affiliation(s)
- Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada. .,Faculty of Kinesiology, University of Calgary, Calgary, Canada.
| | - Emma McLaughlin
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kimberly Hughes
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kelsey Ellis
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Amy Chen
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | | | | | - Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | | | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, Canada
| |
Collapse
|
25
|
Zhou W, Reddy RM, Lavoie Smith EM, Veliz PT, Chen W, Webster K, Larson JL. Objectively measured physical activity in patients with lung cancer after surgey: Feasibility and acceptability of a longitudinal approach. J Geriatr Oncol 2023; 14:101467. [PMID: 36907109 DOI: 10.1016/j.jgo.2023.101467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/12/2023] [Accepted: 02/24/2023] [Indexed: 03/12/2023]
Affiliation(s)
- Weijiao Zhou
- School of Nursing, University of Michigan, Ann Abor, MI, United States; School of Nursing, Peking University, Beijing, China.
| | - Rishindra M Reddy
- Department of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, MI, United States
| | - Ellen M Lavoie Smith
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Philip T Veliz
- School of Nursing, University of Michigan, Ann Abor, MI, United States
| | - Weiyun Chen
- School of Kinesiology, University of Michigan, Ann Abor, MI, United States
| | - Katelyn Webster
- School of Nursing, Indiana University, Indianapolis, IN, United States
| | - Janet L Larson
- School of Nursing, University of Michigan, Ann Abor, MI, United States
| |
Collapse
|
26
|
Sharp P, Caperchione CM, Brown GA, Stadnyk A, Marin E, Hulin B, Wade J, Mott B, Gabriel M, Impellizzeri F, Fullagar HHK. A pragmatic strength and conditioning intervention for firefighters: Feasibility of the Tactical Athlete Resilience Program (TARP). Health Promot J Austr 2023; 34:60-69. [PMID: 36054639 PMCID: PMC10091986 DOI: 10.1002/hpja.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/04/2022] [Accepted: 08/28/2022] [Indexed: 01/27/2023] Open
Abstract
ISSUE ADDRESSED Firefighting is physically and mentally taxing and recruits are expected to have optimal health and fitness. However, physical fitness tends to decline following initial training, placing firefighters at an increased risk for stress and injury. Efforts are needed to engage and support firefighters in maintaining adequate health and fitness to withstand the rigorous demands of their occupation. This study examined the feasibility of TARP, a pragmatic strength and conditioning intervention for metropolitan-based firefighters, delivered in collaboration with a professional National Rugby League club. METHODS A mixed-methods approach was utilised to examine program implementation, recruitment and sample characteristics, intervention satisfaction and acceptability, and participants' response to the intervention. Evaluation measures included field notes taken during steering committee meetings, participant flow data, baseline and follow-up outcome measures, self-report questionnaires, and telephone interviews with a sample of participants. RESULTS Participants (N = 113) were predominantly men (82%) with a mean age of 43 ± 9.3 years and BMI of 26.6 ± 2.9 kg/m2 . Program satisfaction was high (95% very satisfied or somewhat satisfied) among program completers (42% retention). Key strengths of the program included delivery through the professional sports club, quality of facilities and equipment, and scheduling flexibility. Future programs should consider incorporating education or training to support behaviour change maintenance and strategies to retain participants at follow-up. CONCLUSIONS Results provide valuable insights into the design and delivery of interventions for firefighters and demonstrate the importance of strong partnerships between community stakeholders.
Collapse
Affiliation(s)
- Paul Sharp
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia.,School of Nursing, University of British Columbia, Vancouver, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Cristina M Caperchione
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Georgia A Brown
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Antony Stadnyk
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Elizabeth Marin
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Billy Hulin
- South Sydney Rabbitohs Rugby League Football Club, Sydney, New South Wales, Australia
| | - Jarrod Wade
- South Sydney Rabbitohs Rugby League Football Club, Sydney, New South Wales, Australia
| | - Brendan Mott
- Fire and Rescue NSW, Sydney, New South Wales, Australia
| | - Mark Gabriel
- Fire and Rescue NSW, Sydney, New South Wales, Australia
| | - Franco Impellizzeri
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Hugh H K Fullagar
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
27
|
Herold M, Kempe M, Ruf L, Guevara L, Meyer T. Shortcomings of applying data science to improve professional football performance: Takeaways from a pilot intervention study. Front Sports Act Living 2022; 4:1019990. [PMID: 36311212 PMCID: PMC9597494 DOI: 10.3389/fspor.2022.1019990] [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: 08/15/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
Positional tracking data allows football practitioners to derive features that describe patterns of player behavior and quantify performance. Existing research using tracking data has mostly focused on what occurred on the pitch, such as the determinants of effective passing. There have yet to be studies attempting to use findings from data science to improve performance. Therefore, 24 professional players (mean age = 21.6 years, SD = 5.7) were divided into a control team and an intervention team which competed against each other in a pre-test match. Metrics were gathered via notational analysis (number of passes, penalty box entries, shots on goal), and positional tracking data including pass length, pass velocity, defensive disruption (D-Def), and the number of outplayed opponents (NOO). D-Def and NOO were used to extract video clips from the pre-test that were shown to the intervention team as a teaching tool for 2 weeks prior to the post-test match. The results in the post-test showed no significant improvements from the pre-test between the Intervention Team and the Control Team for D-Def (F = 1.100, p = 0.308, η2 = 0.058) or NOO (F = 0.347, p = 0.563, η2 = 0.019). However, the Intervention Team made greater numerical increases for number of passes, penalty box entries, and shots on goal in the post-test match. Despite a positive tendency from the intervention, results indicate the transfer of knowledge from data science to performance was lacking. Future studies should aim to include coaches' input and use the metrics to design training exercises that encourage the desired behavior.
Collapse
Affiliation(s)
- Mat Herold
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany,Deutscher Fußball-Bund, Frankfurt am Main, Germany,*Correspondence: Mat Herold
| | - Matthias Kempe
- Center for Human Movement Sciences, University Medical Center Groningen (UMCG), University of Groningen, Groningen, Netherlands
| | - Ludwig Ruf
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany,TSG ResearchLab gGmbH, Zuzenhausen, Germany
| | | | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany,Deutscher Fußball-Bund, Frankfurt am Main, Germany
| |
Collapse
|
28
|
McQuinn S, Belton S, Staines A, Sweeney MR. Feasibility of a peer-led, after-school physical activity intervention for disadvantaged adolescent females during the COVID-19 pandemic: results from the Girls Active Project (GAP). Pilot Feasibility Stud 2022; 8:194. [PMID: 36042503 PMCID: PMC9425823 DOI: 10.1186/s40814-022-01149-2] [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: 01/18/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction There is a critical need for interventions that can be feasibly implemented and are effective in successfully engaging adolescent females in physical activity (PA). A theory-based, peer-led, after-school PA intervention, the Girls Active Project (GAP), was codesigned with adolescent females. This study aimed to assess the feasibility of implementing and evaluating the GAP programme. Setting One single-sex, female-only, designated disadvantaged postprimary school (students aged 12–18) in Dublin, Ireland. Methods Mixed methods were applied with multiple stakeholders over a 12-week trial (March to May 2021). A single-arm study design was used to examine intervention: reach, dose, fidelity, acceptability, compatibility and context. Feasibility of using proposed self-reported outcome measures (moderate-to-vigorous PA levels, self-rated health, life satisfaction, PA self-efficacy and PA enjoyment) was also explored. Due to school closure resulting from the COVID-19 pandemic, the intervention was delivered both online and in person in the school setting. Results Eight exercise classes were peer delivered by project leaders (n = 6, students aged 15–17) to intervention recipients (students aged 13-14). Recruitment was low (n = 8, 10% of eligible students, mean age: 13.3 SD: 0.46), yet retention was high (n = 7/8, 88%). Attendance rates were satisfactory (68%), and the intervention was implemented with high fidelity (87%). Data completion rates suggested proposed self-reported outcome measures were deemed appropriate (≥ 95%), except for weight (50%) and height data (80%). Despite COVID-19 hindering intervention implementation, both quantitative and qualitative data suggested that stakeholders were satisfied and perceived the in-person delivered intervention to be compatible with the school setting. Recommended refinements included extending class duration, introducing different rewards, and boosting programme awareness. Conclusions Further thought must be given on how to increase recruitment. Overall, the in-person delivered after-school PA programme was well-received by stakeholders and shows promise as an intervention that can be feasibly implemented and evaluated. Suggested improvements to the GAP intervention programme are recommended, before continuing to a more robust evaluation. Trial registration 10.17605/OSF.IO/75HWJ (prospectively registered, date of registration: 9th December 2020) Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01149-2.
Collapse
Affiliation(s)
- Sara McQuinn
- School of Nursing, Psychotherapy and Community Health, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland.
| | - Sarahjane Belton
- School of Health and Human Performance, Faculty of Science and Health, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Anthony Staines
- School of Nursing, Psychotherapy and Community Health, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland
| | - Mary Rose Sweeney
- School of Nursing, Psychotherapy and Community Health, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland
| |
Collapse
|
29
|
Manettas AI, Tsaklis P, Kohlbrenner D, Mokkink LB. A Scoping Review on Outcomes and Outcome Measurement Instruments in Rehabilitative Interventions for Patients with Haematological Malignancies Treated with Allogeneic Stem Cell Transplantation. Curr Oncol 2022; 29:4998-5025. [PMID: 35877257 PMCID: PMC9322392 DOI: 10.3390/curroncol29070397] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
Rationale: Allogeneic hematopoietic stem cell transplantation (HSCT) is associated with increased treatment-related mortality, loss of physical vitality, and impaired quality of life. Future research will investigate the effects of multidisciplinary rehabilitative interventions in alleviating these problems. Nevertheless, published studies in this field show considerable heterogeneity in selected outcomes and the outcome measurement instruments used. The purpose of this scoping review is to provide an overview of the outcomes and outcome measurement instruments used in studies examining the effects of rehabilitative interventions for patients treated with allogeneic HSCT. Methods: We conducted a scoping review that included randomized controlled trials, pilot studies, and feasibility studies published up to 28 February 2022. Results: We included n = 39 studies, in which n = 84 different outcomes were used 227 times and n = 125 different instruments were used for the measurements. Conclusions: Research in the field of rehabilitation for patients with haematological malignancies treated with allogeneic HSCT is hampered by the excess outcomes used, the inconsistent outcome terminology, and the inconsistent use of measurement instruments in terms of setting and timing. Researchers in this field should reach a consensus with regard to the use of a common terminology for the outcomes of interest and a homogeneity when selecting measurement instruments and measurement timing methods.
Collapse
Affiliation(s)
- Anastasios I. Manettas
- Department of Physiotherapy and Occupational Therapy, University Hospital Zurich, 8091 Zurich, Switzerland;
- Biomechanics and Ergonomics, ErgoMech Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Panagiotis Tsaklis
- Biomechanics and Ergonomics, ErgoMech Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
- Department of Molecular Medicine and Surgery, Growth and Metabolism, Karolinska Institute, 17176 Stockholm, Sweden
- Correspondence:
| | - Dario Kohlbrenner
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland;
- Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Lidwine B. Mokkink
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007MB Amsterdam, The Netherlands;
| |
Collapse
|
30
|
Bloeckl J, Raps S, Weineck M, Kob R, Bertsch T, Kemmler W, Schoene D. Feasibility and Safety of Whole-Body Electromyostimulation in Frail Older People—A Pilot Trial. Front Physiol 2022; 13:856681. [PMID: 35812334 PMCID: PMC9263209 DOI: 10.3389/fphys.2022.856681] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/30/2022] [Indexed: 01/04/2023] Open
Abstract
Whole-body electromyostimulation (WB-EMS) induces high-intense stimuli to skeletal muscles with low strain on joints and the autonomic nervous system and may thus be suitable for frail, older people. However, if trained at very high intensities, WB-EMS may damage muscles and kidneys (rhabdomyolysis). This study aimed at investigating the feasibility, safety and preliminary efficacy of WB-EMS in frail, older people. Seven frail (81.3 ± 3.5 years), 11 robust (79.5 ± 3.6 years), 10 young (29.1 ± 6.4 years) participants completed an eight-week WB-EMS training (week 1–4: 1x/week; week 5–8: 1.5x/week) consisting of functional exercises addressing lower extremity strength and balance. Feasibility was assessed using recruitment, adherence, retention, and dropout rates. The satisfaction with WB-EMS was measured using the Physical Activity Enjoyment Scale for older adults (PACES-8). In week 1, 3, and 8 creatine kinase (CK) was assessed immediately before, 48 and 72 h after WB-EMS. Symptoms of rhabdomyolysis (muscle pain, muscle weakness, myoglobinuria) and adverse events were recorded. Functional capacity was assessed at baseline and after 8 weeks using the Short Physical Performance Battery (SPPB), Timed Up-and-Go Test (TUG), Choice Stepping Reaction Time Test (CSRT), 30-second Chair-Stand Test (30-STS), maximum isometric leg strength and handgrip strength. The recruitment rate of frail individuals was 46.2%, adherence 88.3% and the dropout rate 16.7%. All groups indicated a high satisfaction with WB-EMS. CK activity was more pronounced in young individuals with significant changes over time. Within older people CK increased borderline-significantly in the frail group from baseline to week 1 but not afterwards. In robust individuals CK increased significantly from baseline to week 1 and 3. No participant reached CK elevations close to the threshold of ≥5,000 U/l and no symptoms of rhabdomyolysis were observed. With the exception of the TUG (p = 0.173), frail individuals improved in all tests of functional capacity. Compared to the young and robust groups, frail individuals showed the greater improvements in the SPPB, handgrip strength, maximum isokinetic hip-/knee extension and flexion strength. WB-EMS is feasible for frail older people. There were no clinical signs of exertional rhabdomyolysis. WB-EMS proved to be sufficiently intense to induce meaningful changes in functional capacity with frail individuals showing greater improvements for several measures.
Collapse
Affiliation(s)
- Joerg Bloeckl
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- *Correspondence: Joerg Bloeckl,
| | - Sebastian Raps
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Weineck
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Robert Kob
- Institute for Biomedicine of Aging, Friedrich-Alexander University Erlangen-Nürnberg, Nuremberg, Germany
| | - Thomas Bertsch
- Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Wolfgang Kemmler
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Institute of Exercise and Public Health, University of Leipzig, Leipzig, Germany
| |
Collapse
|
31
|
Intensive physical therapy after emergency laparotomy: Pilot phase of the Incidence of Complications following Emergency Abdominal surgery Get Exercising randomized controlled trial. J Trauma Acute Care Surg 2022; 92:1020-1030. [PMID: 35609291 DOI: 10.1097/ta.0000000000003542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Postoperative pneumonia and delayed physical recovery are significant problems after emergency laparotomy. No randomized controlled trial has assessed the feasibility, safety, or effectiveness of intensive postoperative physical therapy in this high-risk acute population. METHODS The internal pilot phase of the Incidence of Complications after Emergency Abdominal Surgery: Get Exercising (ICEAGE) trial was a prospective, randomized controlled trial that evaluated the feasibility, safety, and clinical trial processes of providing intensive physical therapy immediately following emergency laparotomy. Fifty consecutive patients were recruited at the principal participating hospital and randomly assigned to standard-care or intensive physical therapy of twice daily coached breathing exercises for 2 days and 30 minutes of daily supervised rehabilitation over the first 5 postoperative days. RESULTS Interventions were provided exactly as per protocol in 35% (78 of 221 patients) of planned treatment sessions. Main barriers to protocol delivery were physical therapist unavailability on weekends (59 of 221 patients [27%]), awaiting patient consent (18 of 99 patients [18%]), and patient fatigue (26 of 221 patients [12%]). Despite inhibitors to treatment delivery, the intervention group still received twice as many breathing exercise sessions and four times the amount of physical therapy over the first 5 postoperative days (23 minutes [interquartile range, 12-29 minutes] vs. 86 minutes [interquartile range, 53-121 minutes]; p < 0.001). One adverse event was reported from 78 rehabilitation sessions (1.3%), which resolved fully on cessation of activity without escalation of medical care. CONCLUSION Intensive postoperative physical therapy can be delivered safely and successfully to patients in the first week after emergency laparotomy. The ICEAGE trial protocol resulted in intervention group participants receiving more coached breathing exercises and spending significantly more time physically active over the first 5 days after surgery compared with standard care. It was therefore recommended to progress into the multicenter phase of ICEAGE to definitively test the effect of intensive physical therapy to prevent pneumonia and improve physical recovery after emergency laparotomy. LEVEL OF EVIDENCE Therapeutic/Care Management; Level II.
Collapse
|
32
|
Brennan L, Sadeghi F, O’Neill L, Guinan E, Smyth L, Sheill G, Smyth E, Doyle SL, Timon CM, Connolly D, O’Sullivan J, Reynolds JV, Hussey J. Telehealth Delivery of a Multi-Disciplinary Rehabilitation Programme for Upper Gastro-Intestinal Cancer: ReStOre@Home Feasibility Study. Cancers (Basel) 2022; 14:2707. [PMID: 35681687 PMCID: PMC9179413 DOI: 10.3390/cancers14112707] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Telehealth has enabled access to rehabilitation throughout the pandemic. We assessed the feasibility of delivering a multi-disciplinary, multi-component rehabilitation programme (ReStOre@Home) to cancer survivors via telehealth. METHODS This single-arm mixed methods feasibility study recruited participants who had completed curative treatment for oesophago-gastric cancer for a 12-week telehealth rehabilitation programme, involving group resistance training, remotely monitored aerobic training, one-to-one dietetic counselling, one-to-one support calls and group education. The primary outcome was feasibility, measured by recruitment rates, attendance, retention, incidents, acceptability, Telehealth Usability Questionnaire (TUQ) and analysis of semi-structured interviews. RESULTS Characteristics of the twelve participants were: 65.42 ± 7.24 years; 11 male; 10.8 ± 3.9 months post-op; BMI 25.61 ± 4.37; received neoadjuvant chemotherapy 7/12; received adjuvant chemotherapy 4/12; hospital length of stay 16 days (median). Recruitment rate was 32.4%, and retention rate was 75%. Mean attendance was: education 90%; dietetics 90%; support calls 84%; resistance training 78%. Mean TUQ score was 4.69/5. Adaptations to the planned resistance training programme were required. Participants reported that ReStOre@Home enhanced physical and psychological wellbeing, and online delivery was convenient. Some reported a preference for in-person contact but felt that the online group sessions provided adequate peer support. CONCLUSION Telehealth delivery of ReStOre@Home was most feasible in individuals with moderate to high levels of digital skills. Low level of digitals skills was a barrier to recruitment and retention. Participants reported high levels of programme adherence and participant satisfaction. Adaptations to future programmes, including introducing elements of in-person contact, are required.
Collapse
Affiliation(s)
- Louise Brennan
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland; (F.S.); (L.O.); (L.S.); (E.S.); (J.H.)
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
| | - Fatemeh Sadeghi
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland; (F.S.); (L.O.); (L.S.); (E.S.); (J.H.)
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
| | - Linda O’Neill
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland; (F.S.); (L.O.); (L.S.); (E.S.); (J.H.)
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
| | - Emer Guinan
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
- School of Medicine, Trinity College, D08 W9RT Dublin, Ireland
| | - Laura Smyth
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland; (F.S.); (L.O.); (L.S.); (E.S.); (J.H.)
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
| | - Grainne Sheill
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
- Physiotherapy Department, St. James Hospital, D08 NHY1 Dublin, Ireland
| | - Emily Smyth
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland; (F.S.); (L.O.); (L.S.); (E.S.); (J.H.)
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
| | - Suzanne L. Doyle
- School of Biological and Health Sciences, Technological University Dublin, D07 ADY7 Dublin, Ireland;
| | - Claire M. Timon
- Centre for eIntegrated Care, School of Nursing, Psychotherapy and Community Health, Dublin City University, D09 X984 Dublin, Ireland;
| | - Deirdre Connolly
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
- Discipline of Occupational Therapy, Trinity College, D08 W9RT Dublin, Ireland
| | - Jacintha O’Sullivan
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
- Department of Surgery, Trinity Translational Medicine Institute, Trinity College Dublin, St James’s Hospital Dublin, D08 W9RT Dublin, Ireland
| | - John V. Reynolds
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
- Department of Surgery, Trinity Translational Medicine Institute, Trinity College Dublin, St James’s Hospital Dublin, D08 W9RT Dublin, Ireland
| | - Juliette Hussey
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland; (F.S.); (L.O.); (L.S.); (E.S.); (J.H.)
- Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland; (E.G.); (G.S.); (D.C.); (J.O.); (J.V.R.)
| |
Collapse
|
33
|
Signore AK, Jung ME, Semenchuk B, Kullman SM, Tefft O, Webber S, Ferguson LJ, Kowalski K, Fortier M, McGavock J, Ahmed R, Orr M, Strachan S. A pilot and feasibility study of a randomized clinical trial testing a self-compassion intervention aimed to increase physical activity behaviour among people with prediabetes. Pilot Feasibility Stud 2022; 8:111. [PMID: 35624519 PMCID: PMC9135984 DOI: 10.1186/s40814-022-01072-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes. METHODS This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical activity, and low self-compassion) were randomized to a self-compassion (Mage = 60.22 years) or control condition (Mage = 56.13 years). All participants received behaviour change education (e.g. SMART goals, action-coping planning) and either other health knowledge (control condition: e.g. sleep, benefits of water) or self-compassion training (intervention condition: practising mindfulness, writing a letter to themselves offering the same support that they would offer to a friend). The primary outcome was to determine the feasibility and acceptability of the trial. To be considered feasible, our outcomes needed to meet or surpass our pre-determined criteria (e.g. time for group formation: 14-20 participants per month). Feasibility was assessed by examining the recruitment rates, retention, adherence, fidelity, and capacity. Semi-structured interviews were conducted with participants to determine trial acceptability. As a secondary purpose, we examined the means on key study variables (secondary and exploratory variables; see Table 1) at all planned time points (baseline, intervention-end, 6- and 12-week follow-up) to identify if they are suitable to include in the efficacy trial (see Additional Table 3). RESULTS Eighteen participants were screened and randomized to one of two conditions. Retention, instructor fidelity, safety, capacity, adherence to most of the study aspects, and acceptability by participants and facilitators all met the criteria for feasibility. Recruitment rate, process time, and adherence to home practice were below our criteria, and we offer ways to address these shortcomings for the efficacy trial. CONCLUSION The results from this study suggest that it should be feasible to deliver our intervention while highlighting the alterations to components that may be altered when delivering the efficacy trial. We outline our changes which should improve and enhance the feasibility and acceptability of our planned intervention. Funding for this study was from the Canadian Institutes of Health Research (CIHR). TRIAL REGISTRATION ClinicalTrials.gov, NCT04402710 . Registered on 09 April 2020.
Collapse
Affiliation(s)
- Alana K Signore
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, V1V 1V7, Canada
| | - Brittany Semenchuk
- Applied Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Sasha M Kullman
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Olivia Tefft
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Sandra Webber
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Leah J Ferguson
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, S7N 5B2, Canada
| | - Kent Kowalski
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, S7N 5B2, Canada
| | - Michelle Fortier
- School of Human Kinetics, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Jon McGavock
- Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 3P5, Canada
| | - Rashid Ahmed
- College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, 58202, USA
| | - Marion Orr
- Inner Compass Counselling, Winnipeg, MB, R3G 2X6, Canada
| | - Shaelyn Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| |
Collapse
|
34
|
MacPherson M, Merry K, Locke S, Jung M. Developing Mobile Health Interventions With Implementation in Mind: Application of the Multiphase Optimization Strategy (MOST) Preparation Phase to Diabetes Prevention Programming. JMIR Form Res 2022; 6:e36143. [PMID: 35471473 PMCID: PMC9092234 DOI: 10.2196/36143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/03/2022] [Accepted: 03/17/2022] [Indexed: 12/15/2022] Open
Abstract
With thousands of mobile health (mHealth) solutions on the market, patients and health care providers struggle to identify which solution to use and prescribe. The lack of evidence-based mHealth solutions may be because of limited research on intervention development and the continued use of traditional research methods for mHealth evaluation. The Multiphase Optimization Strategy (MOST) is a framework that aids in developing interventions that produce the best-expected outcomes (ie, effectiveness), given constraints imposed on affordability, scalability, and efficiency (also known as achieving intervention EASE). The preparation phase of the MOST highlights the importance of formative intervention development-a stage often overlooked and rarely published. The aim of the preparation phase of the MOST is to identify candidate intervention components, create a conceptual model, and define the optimization objective. Although the MOST sets these 3 targets, no guidance is provided on how to conduct quality research within the preparation phase and what specific steps can be taken to identify potential intervention components, develop the conceptual model, and achieve intervention EASE with the implementation context in mind. To advance the applicability of the MOST within the field of implementation science, this study provides an account of the methods used to develop an mHealth intervention using the MOST. Specifically, we provide an example of how to achieve the goals of the preparation phase by outlining the formative development of an mHealth-prompting intervention within a diabetes prevention program. In addition, recommendations are proposed for future researchers to consider when conducting formative research on mHealth interventions with implementation in mind. Given its considerable reach, mHealth has the potential to positively affect public health by decreasing implementation costs and improving accessibility. The MOST is well-suited for the efficient development and optimization of mHealth interventions. By using an implementation-focused lens and outlining the steps in developing an mHealth intervention using the preparation phase of the MOST, this study may guide future intervention developers toward maximizing the impact of mHealth outside academia.
Collapse
Affiliation(s)
- Megan MacPherson
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Kohle Merry
- School of Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Sean Locke
- Faculty of Kinesiology, Brock University, St Catherines, ON, Canada
| | - Mary Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| |
Collapse
|
35
|
Lawson DO, Mellor K, Eddy S, Lee C, Kim KH, Kim K, Mbuagbaw L, Thabane L. Pilot and Feasibility Studies in Rehabilitation Research: A Review and Educational Primer for the Physiatrist Researcher. Am J Phys Med Rehabil 2022; 101:372-383. [PMID: 34091466 DOI: 10.1097/phm.0000000000001797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Pilot and feasibility studies are conducted early in the clinical research pathway to evaluate whether a future, definitive study can or should be done and, if so, how. Poor planning and reporting of pilot and feasibility studies can compromise subsequent research efforts. Inappropriate labeling of studies as pilots also compromises education. In this review, first, a systematic survey of the current state of pilot and feasibility studies in rehabilitation research was performed, and second, recommendations were made for improvements to their design and reporting. In a random sample of 100 studies, half (49.5%) were randomized trials. Thirty (30.0%) and three (3.0%) studies used "pilot" and "feasibility" in the study title, respectively. Only one third (34.0%) of studies provided a primary objective related to feasibility. Most studies (92.0%) stated an intent for hypothesis testing. Although many studies (70.0%) mentioned outcomes related to feasibility in the methods, a third (30.0%) reported additional outcomes in the results and discussion only or commented on feasibility anecdotally. The reporting of progression plans to a main study (21.0%) and progression criteria (4.0%) was infrequent. Based on these findings, it is recommended that researchers correctly label studies as a pilot or feasibility design based on accepted definitions, explicitly state feasibility objectives, outcomes, and criteria for determining success of feasibility, justify the sample size, and appropriately interpret and report the implications of feasibility findings for the main future study.
Collapse
Affiliation(s)
- Daeria O Lawson
- From the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (DOL, LM, LT); Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom (KM); Institute of Population Health Sciences, Queen Mary University of London, London, United Kingdom (SE); Department of Medicine, McMaster University, Hamilton, Ontario, Canada (CL, KHK, KK); and Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada (LM, LT)
| | | | | | | | | | | | | | | |
Collapse
|
36
|
McGibbon C, Jarrett P, Handrigan G, Bouchard D, Tranchant CC, Sexton AM, Yetman L, Robinson B, Crapoulet S, Chamard-Witkowski L, Liu-Ambrose T, Middleton LE, Almeida QJ, Bherer L, Lim A, Speechley M, Kamkar N, Montero Odasso M. Protocol for SYNchronising Exercises, Remedies in GaIt and Cognition at Home (SYNERGIC@Home): feasibility of a home-based double-blind randomised controlled trial to improve gait and cognition in individuals at risk for dementia. BMJ Open 2022; 12:e059988. [PMID: 35361653 PMCID: PMC8971768 DOI: 10.1136/bmjopen-2021-059988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Physical exercise and cognitive training have the potential to enhance cognitive function and mobility in older adults at risk of Alzheimer's disease and related dementia (ADRD), but little is known about the feasibility of delivering multidomain interventions in home settings of older adults at risk of ADRD. This study aims to assess the feasibility of home-based delivery of exercise and cognitive interventions, and to evaluate the relationship between participants' intervention preferences and their subsequent adherence. Secondary objectives include the effect of the interventions on ADRD risk factors, including frailty, mobility, sleep, diet and psychological health. METHODS AND ANALYSIS The SYNchronising Exercises, Remedies in GaIt and Cognition at Home (SYNERGIC@Home) feasibility trial is a randomised control trial that follows a 2×2 factorial design, with a 16-week home-based intervention programme (3 sessions per week) of physical exercises and cognitive training. Participants will be randomised in blocks of four to one of the following four arms: (1) combined exercise (aerobic and resistance)+cognitive training (NEUROPEAK); (2) combined exercise+control cognitive training (web searching); (3) control exercise (balance and toning)+cognitive training; and (4) control exercise+control cognitive training. SYNERGIC@Home will be implemented through video conferencing. Baseline and post-intervention assessments at 4-month and 10-month follow-up will include measures of cognition, frailty, mobility, sleep, diet and psychological health. Primary feasibility outcome is adherence to the interventions. Primary analytic outcome is the relationship between pre-allocation preference for a given intervention and subsequent adherence to the allocated intervention. A series of secondary analytic outcomes examining the potential effect of the individual and combined interventions on cognitive, mobility and general well-being will be measured at baseline and follow-up. ETHICS AND DISSEMINATION Ethics approval was granted by the relevant research ethics boards. Findings of the study will be presented to stakeholders and published in peer-reviewed journals and at provincial, national and international conferences. TRIAL REGISTRATION NUMBER NCT04997681, Pre-results.
Collapse
Affiliation(s)
- Chris McGibbon
- Faculty of Kinesiology, University of New Brunswick Fredericton, Fredericton, New Brunswick, Canada
- Institute of Biomedical Engineering, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Pam Jarrett
- Department of Geriatric Medicine, Horizon Health Network, Saint John, New Brunswick, Canada
- Faculty of Medicine, Deptartment of Internal Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Grant Handrigan
- Faculty of Health Sciences and Community Services, School of Kinesiology and Recreation, Universite de Moncton, Moncton, New Brunswick, Canada
| | - Danielle Bouchard
- Faculty of Kinesiology, University of New Brunswick Fredericton, Fredericton, New Brunswick, Canada
| | - Carole C Tranchant
- Faculty of Health Sciences and Community Services, School of Food Science, Nutrition and Family Studies, Universite de Moncton, Moncton, New Brunswick, Canada
| | - Andrew M Sexton
- Institute of Biomedical Engineering, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Linda Yetman
- Research Services, Horizon Health Network, Saint John, New Brunswick, Canada
| | - Bryn Robinson
- Research Services, Horizon Health Network, Saint John, New Brunswick, Canada
| | | | - Ludivine Chamard-Witkowski
- Department of Neuroscience, Dr Georges-L-Dumont University Hospital Centre, Moncton, New Brunswick, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Quincy J Almeida
- Faculty of Science, Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Louis Bherer
- Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Andrew Lim
- Neurology Division, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mark Speechley
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
| | - Nellie Kamkar
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
| | - Manuel Montero Odasso
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
- Department of Medicine (Geriatrics), Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
37
|
Saini M, Kaur J. Effect of subjective tool based aerobic exercise on pulmonary functions in patients with type 2 diabetes mellitus – a feasibility RCT. COMPARATIVE EXERCISE PHYSIOLOGY 2022. [DOI: 10.3920/cep210049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Literature has proved the benefit of exercise on pulmonary functions among the patients with type 2 diabetes mellitus (T2DM). However, objective tools of exercise intensity prescription have been used in previous trials. The trials to explore the effectiveness of subjective tools-based exercise on pulmonary functions among these patients are scarce. The purpose of this study was to explore the feasibility of subjective tools-based exercise among patients with T2DM. Another objective was to see the effectiveness of this kind of exercise on pulmonary functions among patients with T2DM. 49 patients were randomly allotted to three groups, talk test group (TTG, n=16); rating of perceived exertion group (RPEG, n=16); and control group (CG, n=17). Subjects were evaluated for five progression criteria. The intervention period for the groups was 8 weeks. Recruitment and retention rate was 62.82 and 75.5%, respectively. Adherence rate was 67.34% and 58.91% for supervised and unsupervised sessions, respectively. 78.38% of the patients were available for post-intervention outcome evaluation. A significant increase in pulmonary functions in both the experimental groups (P=0.00) was found after 8 weeks of training. This study provides evidence that a trial of this nature is feasible with a few amendments in methodology. Additionally, the study also concluded that the subjective tool based aerobic exercise may be effective in improving pulmonary functions among patients with T2DM. Trial registration at Clinical Trial Registry-India: CTRI/2019/02/017531.
Collapse
Affiliation(s)
- M. Saini
- Mother Teresa Saket College of Physiotherapy, Department of Physiotherapy, 134107 Panchkula, Haryana, India
| | - J. Kaur
- Guru Jambheshwar University of Science and Technology, Department of Physiotherapy, Hisar 125001, India
| |
Collapse
|
38
|
Development and feasibility testing of a physical activity intervention for youth with anxiety and depression: a study protocol. Pilot Feasibility Stud 2022; 8:48. [PMID: 35236419 PMCID: PMC8889653 DOI: 10.1186/s40814-022-01010-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Anxiety and depressive disorders in children and adolescents are highly prevalent and account for more than half of all youth psychiatric disorders. Left untreated, anxiety, and depression lead to numerous detrimental outcomes, including reduced quality of life, psychiatric, and somatic comorbidity and even reduced lifespan. This puts a large strain on child and adolescent mental healthcare services (CAMHS) to provide effective treatments. However, even when provided the best evidence-based treatment, between 40–50% of patients continue to report significant symptom burdens. Thus, there is an immediate need for supplemental and/or new treatment approaches. Physical activity as a supplementary treatment may be such an approach. However, research investigating this approach within this population is scant. This protocol paper describes the development and feasibility trial of a physical activity-based intervention targeting anxiety and depressive symptoms in youth treated in CAMHS. Methods/design The study is based on the UK Medical Council Research Framework (MRC) for developing and evaluating complex interventions. Feasibility and acceptability of the physical activity intervention (confident, active, and happy youth) will be evaluated in an uncontrolled open-label trial using qualitative and quantitative data. Twenty youths with anxiety and/or depressive symptoms will be recruited. Acceptability of assessment procedures, the intervention, and perceived benefits and barriers to participation will be assessed, and qualitative interviews with participants, caregivers, and referring specialists will explore contextual and practical factors associated with intervention delivery. Physical activity will be measured using the Actigraph GT3X+ monitor at baseline, and post-intervention and change in anxiety and depression will be assessed. Discussion This study will contribute to the development of supplementary physical treatment interventions for youth with anxiety and depression in contact with CAMHS. The goal is to examine new avenues of treatment that ultimately may improve upon current treatment outcomes of anxiety and depression. This work will be in preparation for a future definitive randomized controlled trial (RCT) of this approach, in line with the MRC Framework. Trial registration ClnicalTrials.gov, NCT05049759. Registered on August 19, 2021. Retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01010-6.
Collapse
|
39
|
Wytsma-Fisher K, Ester M, Mustata S, Cowan T, Culos-Reed SN. Results From a Physical Activity Intervention Feasibility Study With Kidney Inpatients. Can J Kidney Health Dis 2022; 9:20543581221079958. [PMID: 35237444 PMCID: PMC8883299 DOI: 10.1177/20543581221079958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Individuals with end-stage kidney disease requiring dialysis are often physically inactive, resulting in reduced physical functioning, increased frailty, and reduced quality of life. Furthermore, extended hospital stays and frequent readmissions are common, exacerbating health care costs. Physical activity may improve physical functioning, disability, and frailty but is not part of standard care of patients requiring dialysis. Research is required to determine the feasibility of implementing physical function assessments and physical activity programs in kidney inpatients requiring dialysis. Objective: To assess the feasibility and preliminary efficacy of an early-physical activity intervention (Move More study) in the care of kidney inpatients requiring dialysis. It was hypothesized that the intervention would be feasible with regards to administration and participation, meeting a priori feasibility criteria, and that kidney inpatients would benefit from participating. Design: Pilot study. Setting: Patient Unit 37, Foothills Medical Center, Calgary, AB, Canada. Patients: Kidney in-patients receiving dialysis. Measurements: Feasibility data were collected for recruitment, participation, assessment completion, physical activity completion, and adverse events. Participant and healthcare practitioner (HCP) satisfaction with the intervention was assessed using a questionnaire. Frailty and physical function were assessed by the kinesiologist at baseline and postintervention prior to hospital discharge. Methods: The study was a single-arm pilot intervention examining feasibility and preliminary efficacy. Kidney inpatients requiring dialysis were recruited to an individualized in-hospital physical activity intervention for the duration of their hospital stay. The intervention was led by a kinesiologist and supported by the clinical care team, including physiotherapists and nurse clinicians. Individualized exercise programs were created for patients to perform daily during their stay. These programs focused on strength, mobility, balance, and general movement and were tailored to each patient’s needs. Results: Thirty-six percent of eligible patients (n = 23/64) consented to participate in the Move More study, of whom 78% (n = 18/23) completed the intervention. The a priori level for consent to participate in the intervention was set at 60%. In addition, the a priori level for completion of assessments pre and postintervention was 50%. Ninety-five percent (n = 22/23) of preintervention assessments were completed compared to 65% of postintervention assessments. All participants who completed the survey (100%, n = 14/14) and most of the staff (77%, n = 24/31) reported being satisfied or very satisfied with the program. There were no adverse events related to the intervention. On average, Move More patients demonstrated improvements in frailty status and specific subsets of quality of life. Limitations: Firstly, as a feasibility study, the research was not powered to address the effectiveness of the intervention and lacked a comparison group to definitively link observed changes to the intervention itself. The voluntary nature of recruitment may have been biased toward ESKD inpatients with above-average motivation and baseline function. Furthermore, the small sample size from a single site limits the generalizability of findings. An additional limitation was the fact that postassessments were missed on a large number of patients, due to them being discharged prior to research staff knowing and being able to complete the assessments. Finally, studying the length of stay across the institution, as opposed to just the individual ward, would provide insight into hospitalization impact for these patients. Conclusions: The administration of and participation in a physical activity intervention for kidney inpatients requiring dialysis was initially not feasible primarily due to low recruitment and adherence challenges. The study was modified by including a research team member on the unit to increase recruitment efforts and support exercise adherence. The intervention impact includes potentially benefits on frailty and quality of life.
Collapse
|
40
|
Feldman PH, McDonald MV, Onorato N, Stein J, Williams O. Feasibility of deploying peer coaches to mentor frontline home health aides and promote mobility among individuals recovering from a stroke: pilot test of a randomized controlled trial. Pilot Feasibility Stud 2022; 8:22. [PMID: 35101133 PMCID: PMC8801561 DOI: 10.1186/s40814-022-00979-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 01/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Each year, approximately 100,000 individuals receive home health services after a stroke. Evidence has shown the benefits of home-based stroke rehabilitation, but little is known about resource-efficient ways to enhance its effectiveness, nor has anyone explored the value of leveraging low-cost home health aides (HHAs) to reinforce repetitive task training, a key component of home-based rehabilitation. We developed and piloted a Stroke Homehealth Aide Recovery Program (SHARP) that deployed specially trained HHAs as "peer coaches" to mentor frontline aides and help individuals recovering from stroke increase their mobility through greater adherence to repetitive exercise regimens. We assessed the feasibility of SHARP and its readiness for a full-scale randomized controlled trial (RCT). Specifically, we examined (1) the practicability of recruitment and randomization procedures, (2) program acceptability, (3) intervention fidelity, and (4) the performance of outcome measures. METHODS This was a feasibility study including a pilot RCT. Target enrollment was 60 individuals receiving post-stroke home health services, who were randomized to SHARP + usual home care or usual care only. The protocol specified a 30-day intervention with four planned in-home coach visits, including one joint coach/physical therapist visit. The primary participant outcome was 60-day change in mobility, using the performance-based Timed Up and Go and 4-Meter Walk Gait Speed tests. Interviews with participants, coaches, physical therapists, and frontline aides provided acceptability data. Enrollment figures, visit tracking reports, and audio recordings provided intervention fidelity data. Mixed methods included thematic analysis of qualitative data and quantitative analysis of structured data to examine the intervention feasibility and performance of outcome measures. RESULTS Achieving the 60-participant enrollment target required modifying participant eligibility criteria to accommodate a decline in the receipt of HHA services among individuals receiving home care after a stroke. This modification entailed intervention redesign. Acceptability was high among coaches and participants but lower among therapists and frontline aides. Intervention fidelity was mixed: 87% of intervention participants received all four planned coach visits; however, no joint coach/therapist visits occurred. Sixty-day follow-up retention was 78%. However, baseline and follow-up performance-based primary outcome mobility assessments could be completed for only 55% of participants. CONCLUSIONS The trial was not feasible in its current form. Before progressing to a definitive trial, significant program redesign would be required to address issues affecting enrollment, coach/HHA/therapist coordination, and implementation of performance-based outcome measures. TRIAL REGISTRATION ClinicalTrials.gov, NCT04840407 . Retrospectively registered on 9 April 2021.
Collapse
Affiliation(s)
- Penny H Feldman
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, 220 East 42nd Street, New York, NY, 10017, USA
| | - Margaret V McDonald
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, 220 East 42nd Street, New York, NY, 10017, USA.
| | - Nicole Onorato
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, 220 East 42nd Street, New York, NY, 10017, USA
| | - Joel Stein
- Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, Department of Rehabilitation Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, 180 Ft. Washington Ave., Harkness Pavilion Room 1-165, New York, NY, 10032, USA
| | - Olajide Williams
- Department of Neurology, Columbia University, 710 West 168th Street, New York, NY, 10032, USA
| |
Collapse
|
41
|
Tincopa MA, Lyden A, Wong J, Jackson EA, Richardson C, Lok AS. Impact of a Pilot Structured Mobile Technology Based Lifestyle Intervention for Patients with Nonalcoholic Fatty Liver Disease. Dig Dis Sci 2022; 67:481-491. [PMID: 33939147 PMCID: PMC8090923 DOI: 10.1007/s10620-021-06922-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/23/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIMS Lifestyle modification is the main treatment for nonalcoholic fatty liver disease (NAFLD), but remains challenging to implement. The aim of this pilot was to assess the acceptability and feasibility of a mobile-technology based lifestyle program for NAFLD patients. METHODS We enrolled adult patients with NAFLD in a 6-month mobile-technology based program where participants received a FitBit with weekly tailored step count goals and nutritional assessments. Anthropometrics, hepatic and metabolic parameters, Fibroscan, physical function and activity, and health-related quality of life measures were obtained at enrollment and month 6. Semi-structured exit interviews were conducted to assess patient's experience with the program. RESULTS 40 (63%) eligible patients were enrolled. Median age was 52.5 with 53% males, 93% whites, 43% with diabetes and median BMI 33.9. On baseline Fibroscan, 59% had F0-2 fibrosis and 70% had moderate-severe steatosis. 33 patients completed the study. Median percentage of days with valid FitBit data collection was 91. 4 patients increased and maintained, 19 maintained, and 8 increased but subsequently returned to baseline weekly step count. 59% of patients reported Fitbit was easy to use and 66% felt step count feedback motivated them to increase their activity. Roughly 50% of patients had reduction in weight, triglycerides and Fibroscan liver stiffness, and 75% had improvement in controlled attenuation parameter and physical function. CONCLUSIONS A 6-month mobile-technology based pilot lifestyle intervention was feasible and acceptable to NAFLD patients. The program promoted physical activity and was associated with improvement in clinical parameters in some patients.
Collapse
Affiliation(s)
- Monica A. Tincopa
- grid.214458.e0000000086837370Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, 3912 Taubman Center, 1500 East Medical Center Drive, SPC 5362, Ann Arbor, MI 48109 USA
| | - Angela Lyden
- grid.214458.e0000000086837370Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI USA
| | - Jane Wong
- grid.214458.e0000000086837370Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, 3912 Taubman Center, 1500 East Medical Center Drive, SPC 5362, Ann Arbor, MI 48109 USA
| | - Elizabeth A. Jackson
- grid.265892.20000000106344187Division of Cardiology, Department of Internal Medicine, University of Alabama, Birmingham, AL USA
| | - Caroline Richardson
- grid.214458.e0000000086837370Department of Family Medicine, University of Michigan, Ann Arbor, MI USA
| | - Anna S. Lok
- grid.214458.e0000000086837370Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, 3912 Taubman Center, 1500 East Medical Center Drive, SPC 5362, Ann Arbor, MI 48109 USA
| |
Collapse
|
42
|
Stephens S, Schneiderman JE, Finlayson M, Berenbaum T, Motl RW, Yeh EA. Feasibility of a theory-informed mobile app for changing physical activity in youth with multiple sclerosis. Mult Scler Relat Disord 2021; 58:103467. [PMID: 34954651 DOI: 10.1016/j.msard.2021.103467] [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: 09/21/2021] [Revised: 12/01/2021] [Accepted: 12/11/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Youth with multiple sclerosis (MS) have high levels of disease activity, depression and fatigue, and lower moderate to vigorous physical activity (PA). PA participation is associated with lower disease activity, depression and fatigue as well as higher self-efficacy, goal setting and decreased barriers. These latter constructs may be targeted by an intervention program for behavior change, and such intervention must account for disease rarity, geographical proximity and time constraints which limit the feasibility, accessibility, and sustainability of implementing a PA intervention in youth with MS. We have developed a theory-informed mobile-app based PA promotion program to address these barriers, Active Teens with Multiple Sclerosis (ATOMIC) and herein report the feasibility of delivering this intervention in youth with MS. OBJECTIVE To determine the feasibility of delivering the ATOMIC program to youth with MS. METHODS Fifteen youth with MS (13F, 16.6 ± 1.2 years) followed at the Hospital for Sick Children were enrolled in the ATOMIC intervention. Participants underwent a standard clinical evaluation; an exercise test to determine cardiorespiratory fitness; 7-day PA monitoring with an accelerometer; and completed standardized depression, fatigue questionnaires at baseline and post-intervention. Social cognitive scales related to self-efficacy, self-management, goal setting, perceived barriers, outcome expectancy, and social support were completed at baseline, six and 12-weeks. The 12-week mobile app PA intervention was informed by Social Cognitive Theory (SCT) and included: individualized PA coaching, PA self-monitoring (Fitbit), goal setting, social support and MS specific educational modules. Feasibility was defined as (1) meeting the recruitment target of 15 participants within a one-year period; (2) completion of ≥80% of study related questionnaires and testing; (3) a drop-out rate of less than 20%, and (4) adherence to the ATOMIC intervention program components of ≥80% (Fitbit wear, PA coaching calls, modules). RESULTS From March 2018 to April 2019, 53% of youth approached agreed to participate (15/28). 13/15 participants completed the intervention. 36 of the possible 39 coaching calls (92%: 3 possible phone calls per participant); 89% wear adherence to FitbitCharge2 data (mean = 75 ± 16.6 days of 84 days); and 5/12 (42%) of modules were completed. An average 8.4% (SD= 40%, range = -74.0 to 176%) increase in Fitbit steps above the first week of the intervention were observed. PA level from accelerometry at 12-weeks, aerobic fitness, depression and fatigue were unchanged. SCT scales indicated an increase in social support from friends (0.67-points, T = 2.7, pholm=0.04), and a decrease in outcome expectancy (-2.7, T = 3.0, pholm=0.03). There were no differences in self-efficacy, self-management or perceived barriers post intervention. CONCLUSIONS Our results indicate that the ATOMIC program is feasible for delivery in youth with MS. Future work is needed to understand how to best implement each element of SCT through added features in the mobile-app, and to evaluate how the individual components of SCT mediate change in PA behaviours of youth with MS.
Collapse
Affiliation(s)
- S Stephens
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Division of Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada.
| | - Jane E Schneiderman
- Clinical Research Services, Hospital for Sick Children, Toronto, Ontario, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.
| | - Marcia Finlayson
- Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
| | - Tara Berenbaum
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Division of Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada
| | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Chicago Illinois, Chicago, IL, USA.
| | - E Ann Yeh
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Division of Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada; Faculty of Medicine, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
43
|
Snowdon DA, Vincent P, Callisaya ML, Collyer TA, Wang YT, Taylor NF. Feasibility of allied health assistant management of people with acute hip fracture: protocol for a feasibility randomised controlled trial. BMJ Open 2021; 11:e054298. [PMID: 34815289 PMCID: PMC8611436 DOI: 10.1136/bmjopen-2021-054298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Guidelines for hip fracture care state that patients with hip fracture should be mobilised on the day after surgery and at least once a day thereafter. However, compliance with these guidelines is poor. One approach that would assist physiotherapists to meet mobility guidelines after hip fracture is to delegate the provision of daily mobilisation to allied health assistants under their supervision. Therefore, we plan to conduct a randomised controlled trial to determine the feasibility of an allied health assistant providing daily inpatient rehabilitation to patients with hip fracture. METHODS AND ANALYSIS Using a parallel group randomised controlled design with one-to-one allocation, participants will be randomly allocated to an experimental group (allied health assistant management) or a comparison group (physiotherapist management). Inclusion criteria are: adult with diagnosis of hip fracture; inpatient in acute hospital; walked independently pre-hip fracture and able to communicate in conversational English. The experimental group will receive routine physiotherapy rehabilitation, including daily mobilisation, from an allied health assistant following initial physiotherapist assessment. The comparison group will receive routine rehabilitation from a physiotherapist. The primary outcome will be the feasibility of allied health assistant management of patients with hip fracture. Feasibility will be determined using the following areas of focus in Bowen's feasibility framework: acceptability (patient satisfaction), demand (proportion of patients who participate), implementation (time allied health assistant/physiotherapist spends with participant, occasions of service) and practicality (cost, adverse events). Staff involved in the implementation of allied health assistant care will be interviewed to explore their perspectives on feasibility. Secondary outcomes include compliance with daily mobilisation guidelines, discharge destination, hospital readmission, falls, functional activity and length of stay. We aim to recruit 50 participants. Descriptive statistics will be used to describe feasibility and mobilisation rates will be calculated using Cox proportional hazards regression to compare compliance with mobilisation guidelines. ETHICS AND DISSEMINATION Ethics approval was obtained from the Peninsula Health human research ethics committee (HREC/63 005/PH-2020). The findings will be disseminated in peer-reviewed journals and conference presentations. TRAIL REGISTRATION NUMBER Australian and New Zealand Clinical Trial Registry; ACTRN12620000877987; Pre-results.
Collapse
Affiliation(s)
- David A Snowdon
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia
- Academic Unit, Peninsula Health, Frankston, Victoria, Australia
| | - Peggy Vincent
- Physiotherapy Department, Peninsula Health, Frankston, Victoria, Australia
| | - Michele L Callisaya
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia
- Academic Unit, Peninsula Health, Frankston, Victoria, Australia
| | - Taya A Collyer
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia
| | - Yi Tian Wang
- Physiotherapy Department, Peninsula Health, Frankston, Victoria, Australia
| | - Nicholas F Taylor
- College of Science Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Victoria, Australia
| |
Collapse
|
44
|
Mardaniyan Ghahfarrokhi M, Banitalebi E, Faramarzi M, Motl R. Feasibility and efficacy of home-based neurofunctional exercise vs. resistance exercise programs for ambulatory disability of multiple sclerosis patients with cognitive impairment. Mult Scler Relat Disord 2021; 58:103400. [DOI: 10.1016/j.msard.2021.103400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 01/26/2023]
|
45
|
Fricke M, Kruse A, Schwenk M, Jansen CP, Muehlbauer T, Gramann K, Wollesen B. Requirements of a cognitive-motor spatial orientation training for nursing home residents: an iterative feasibility study. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [PMCID: PMC8515784 DOI: 10.1007/s12662-021-00762-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A sedentary lifestyle in nursing home residents is often accompanied with reduced life space mobility and in turn affects satisfaction with life. One of the reasons for this may be limited ability to find one’s way around the care facility and its environment. However, spatial orientation exercises might reduce these problems if they are integrated into an adequate cognitive-motor training. Therefore, we integrated six novel and target group-specific spatial orientation exercises into an established multicomponent cognitive-motor group training for nursing home residents and evaluated its feasibility. Forty nursing home residents (mean age: 87.3 ± 7 years) participated in the spatial orientation cognitive motor training (45–60 min, twice a week over a period of 12 weeks). The main outcomes included the feasibility criteria (adherence, completion time, acceptance, instructions, motor performance, materials/set up, complexity) and first measurements of mobility and satisfaction with life (SPPB [Short Physical Performance Battery], SWLS [Satisfaction with Life Scale]). Adherence increased over time. The increase was associated with the adaptions and modifications of the spatial orientation exercises that were made to meet the participants’ requirements. A positive trend was discerned for mobility and life satisfaction, comparing pre- and posttraining data. In summary, the feasibility analysis revealed that future interventions should consider that (a) instructions of demanding spatial tasks should be accompanied by an example task, (b) trainers should be encouraged to adjust task complexity and materials on an individual basis, (c) acceptance of the training should be promoted among nursing staff, and (d) surroundings with as little disturbance as possible should be selected for training.
Collapse
Affiliation(s)
- Madeleine Fricke
- Department of Biological Psychology and Neuroergonomics, TU Berlin, Fasanenstr. 1, 10623 Berlin, Germany
| | - Adele Kruse
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Michael Schwenk
- Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Carl-Philipp Jansen
- Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
- Clinic for Geriatric Rehabilitation, Robert-Bosch-Krankenhaus Stuttgart, Stuttgart, Germany
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
| | - Klaus Gramann
- Department of Biological Psychology and Neuroergonomics, TU Berlin, Fasanenstr. 1, 10623 Berlin, Germany
| | - Bettina Wollesen
- Department of Biological Psychology and Neuroergonomics, TU Berlin, Fasanenstr. 1, 10623 Berlin, Germany
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| |
Collapse
|
46
|
Balart MT, Russell L, Narula N, Bajaj G, Chauhan U, Khan KJ, Marwaha AN, Ching E, Biro J, Halder S, Tse F, Marshall JK, Collins SM, Moayyedi P, Bercik P, Verdu EF, Leontiadis GI, Armstrong D, Pinto-Sanchez MI. Declining Use of Corticosteroids for Crohn's Disease Has Implications for Study Recruitment: Results of a Pilot Randomized Controlled Trial. J Can Assoc Gastroenterol 2021; 4:214-221. [PMID: 34617003 PMCID: PMC8489529 DOI: 10.1093/jcag/gwaa037] [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: 05/08/2020] [Accepted: 10/01/2020] [Indexed: 11/25/2022] Open
Abstract
Background Corticosteroids (CS) have been used extensively to induce remission in Crohn’s disease (CD); however, they are associated with severe side effects. We hypothesized that the administration of an exclusive enteral nutrition (EEN) formula to CS would lead to increased CD remission rates and to decreased CS-related adverse events. We proposed to undertake a pilot study comparing EEN and CS therapy to CS alone to assess decrease symptoms and inflammatory markers over 6 weeks. Aim The overall aim was to assess study feasibility based on recruitment rates and acceptability of treatment in arms involving EEN Methods The pilot study intended to recruit 100 adult patients with active CD who had been prescribed CS to induce remission as part of their care. The patients were randomized to one of three arms: (i) standard-dose CS; (ii) standard-dose CS plus EEN (Modulen 1.5 kcal); or (iii) short-course CS plus EEN. Results A total of 2009 CD patients attending gastroenterology clinics were screened from October 2018 to November 2019. Prednisone was prescribed to only 6.8% (27/399) of patients with active CD attending outpatient clinics. Of the remaining 372 patients with active CD, 34.8% (139/399) started or escalated immunosuppressant or biologics, 49.6% (198/399) underwent further investigation and 8.8% (35/399) were offered an alternative treatment (e.g., antibiotics, surgery or investigational agents in clinical trials). Only three patients were enrolled in the study (recruitment rate 11%; 3/27), and the study was terminated for poor recruitment. Conclusion The apparent decline in use of CS for treatment of CD has implications for CS use as an entry criterion for clinical trials.
Collapse
Affiliation(s)
- M T Balart
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada
| | - L Russell
- McMaster University Medical Centre, Hamilton, ON, Canada
| | - N Narula
- McMaster University Medical Centre, Hamilton, ON, Canada
| | - G Bajaj
- McMaster University Medical Centre, Hamilton, ON, Canada.,Brampton Endoscopy Centre, Brampton, ON, Canada
| | - U Chauhan
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada
| | - K J Khan
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada.,St. Joseph's Health Care Centre, Hamilton, ON, Canada
| | | | - E Ching
- GI Health Centre, Burlington, ON, Canada
| | - J Biro
- McMaster University Medical Centre, Hamilton, ON, Canada
| | - S Halder
- McMaster University Medical Centre, Hamilton, ON, Canada
| | - F Tse
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada
| | - J K Marshall
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada
| | - S M Collins
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada
| | - P Moayyedi
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada
| | - P Bercik
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada
| | - E F Verdu
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada
| | - G I Leontiadis
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada
| | - D Armstrong
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada
| | - M I Pinto-Sanchez
- Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada.,McMaster University Medical Centre, Hamilton, ON, Canada
| |
Collapse
|
47
|
Adherence is a key factor for interpreting the results of exercise interventions. Physiotherapy 2021; 113:8-11. [PMID: 34555674 DOI: 10.1016/j.physio.2021.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/04/2021] [Accepted: 05/21/2021] [Indexed: 12/30/2022]
Abstract
Adherence may be an important factor to consider when interpreting the results of an exercise intervention. This article will discuss the importance of measuring and reporting adherence to exercise interventions that are designed to improve targeted health outcomes. Additionally, we will propose and describe a universal method to measure and report adherence to exercise interventions.
Collapse
|
48
|
Weller S, Hart NH, Bolam KA, Mansfield S, Santa Mina D, Winters-Stone KM, Campbell A, Rosenberger F, Wiskemann J, Quist M, Cormie P, Goulart J, Campbell KL. Exercise for individuals with bone metastases: A systematic review. Crit Rev Oncol Hematol 2021; 166:103433. [PMID: 34358650 DOI: 10.1016/j.critrevonc.2021.103433] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/26/2021] [Accepted: 07/28/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Exercise has the potential to improve physical function and quality of life in individuals with bone metastases but is often avoided due to safety concerns. This systematic review summarizes the safety, feasibility and efficacy of exercise in controlled trials that include individuals with bone metastases. METHODS MEDLINE, Embase, Pubmed, CINAHL, PEDro and CENTRAL databases were searched up to July 16, 2020. RESULTS A total of 17 trials were included incorporating aerobic exercise, resistance exercise or soccer interventions. Few (n = 4, 0.5%) serious adverse events were attributed to exercise participation, with none related to bone metastases. Mixed efficacy results were found, with exercise eliciting positive changes or no change. The majority of trials included an element of supervised exercise instruction (n = 16, 94%) and were delivered by qualified exercise professionals (n = 13, 76%). CONCLUSIONS Exercise appears safe and feasible for individuals with bone metastases when it includes an element of supervised exercise instruction.
Collapse
Affiliation(s)
- Sarah Weller
- Provincial Programs, BC Cancer, 750 West Broadway, Vancouver, BC, V5Z 1H5, Canada. https://twitter.com/_sarahweller
| | - Nicolas H Hart
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, 191 Ipswich Rd, Woolloongabba, QLD, 4102, Australia; Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia; Institute for Health Research, University of Notre Dame Australia, 23 High Street, Freemantle, WA, 6160, Australia. https://twitter.com/DrNicolasHart
| | - Kate A Bolam
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Fack 23400, SE-141 83 Huddinge, Stockholm, Sweden. https://twitter.com/katebolam
| | - Sami Mansfield
- Cancer Wellness for Life, 8022 Reeder Street, Lenexa, KS, 66214, USA. https://twitter.com/bewellwithsami
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, 27 King's College Cir, Toronto, Ontario, ON M5S, Canada. https://twitter.com/DR_SantaMina
| | - Kerri M Winters-Stone
- Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. https://twitter.com/winters_stone
| | - Anna Campbell
- Department of Sport, Exercise and Health & Science, School of Applied Sciences, Edinburgh Napier University, Sighthill Court, Edinburgh, EH11 4BN, UK. https://twitter.com/CanRehab
| | - Friederike Rosenberger
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, Heidelberg, 69120, Germany
| | - Joachim Wiskemann
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, Heidelberg, 69120, Germany. https://twitter.com/exoncolgermany
| | - Morten Quist
- The University Hospitals Centre for Health Research, Rigshospitalet, Blegdamsvej 9, 2100, København, Denmark. https://twitter.com/QuistMorten
| | - Prue Cormie
- Mary MacKillop Institute for Health Research, Australian Catholic University, 5/215 Spring Street, Melbourne, VIC, 3000, Australia. https://twitter.com/PrueCormie
| | - Jennifer Goulart
- Department of Radiation Oncology, BC Cancer, 2410 Lee Avenue, Victoria, BC, V8R 6V5, Canada
| | - Kristin L Campbell
- Department of Physical Therapy, 212-2177 Wesbrook Mall, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
| |
Collapse
|
49
|
Determination of the Strongest Factor and Component in a Relationship between Lower-Extremity Assessment Protocol and Patient-Oriented Outcomes in Individuals with Anterior Cruciate Ligament Reconstruction: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158053. [PMID: 34360344 PMCID: PMC8345576 DOI: 10.3390/ijerph18158053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022]
Abstract
Although the Lower-Extremity Assessment Protocol (LEAP) assesses multidimensional aspects of a patient with anterior cruciate ligament (ACL) injury, there is a need to reduce the dimensionality of LEAP items to effectively assess patients. Therefore, the present study aimed to establish the validity of LEAP and to determine associated factors and components in a relationship between LEAP and the International Knee Documentation Committee (IKDC) questionnaire. Fifteen patients who had ACL reconstruction more than 1 year and less than 5 years earlier were recruited. Patients performed LEAP, including muscular strength, fatigue index, static balance, drop landing, and functional hopping assessment. They also completed the IKDC questionnaire and the Tegner Activity Score. Factor analysis and stepwise regression analysis were performed. The 14 components of LEAP were categorized into four factors (functional task, muscle strength, neuromuscular control, and fatigue), which accounted for 83.8% of the cumulative variance by factor analysis. In the stepwise regression analysis, the functional task (R2 = 0.43, p = 0.008) in factors and single-leg hop (R2 = 0.49, p = 0.004) in components were associated with patient-oriented outcomes, respectively. In conclusion, the functional task and single-leg hop may be used for providing valuable information about knee joints to patients and clinicians.
Collapse
|
50
|
Danicic JM, Inder WJ, Kotowicz MA. The impact of subclinical hypothyroidism on health-related quality of life: a narrative review. Intern Med J 2021; 51:1380-1387. [PMID: 34139046 DOI: 10.1111/imj.15431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 06/08/2021] [Accepted: 06/14/2021] [Indexed: 11/28/2022]
Abstract
A biochemical diagnosis of subclinical hypothyroidism is defined by an elevated serum thyroid-stimulating hormone (TSH) with a normal serum free thyroxine (FT4). This paper discusses SCH in the Australian population, the impact of SCH on health-related quality of life (HRQoL), and the evidence for thyroid hormone therapy as well as exercise therapy to improve HRQoL in SCH. The prevalence of SCH in Australia is approximately 4-5% and is higher in females and the elderly. Current evidence suggests thyroid hormone therapy is not associated with an improvement in HRQoL. However, there does appear to be a subgroup of those with SCH that experience an impairment in HRQoL who may potentially benefit from treatment. Because the majority of research to date has been done in elderly, largely asymptomatic individuals, this may not be representative of the entire SCH population. Additionally, alternative treatments such as exercise therapy have not been well explored in the literature, despite exercise therapy's effects on HRQoL in other populations. Further research is required to clearly define which individuals with SCH are likely to experience an impaired HRQoL, as well as explore the effects of thyroid hormone therapy and exercise therapy in these individuals. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Joseph M Danicic
- Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Australia
| | - Warrick J Inder
- Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Mark A Kotowicz
- School of Medicine, Deakin University, Geelong, Australia.,Department of Endocrinology and Diabetes, Barwon Health.,Department of Medicine, University of Melbourne, Melbourne
| |
Collapse
|