1
|
Maravi JSM, Leszczynski EC, Schwartz CS, Dev PK, Barber JL, Reasons RJ, Pearce RW, McPhaul MJ, Konrad RJ, Robbins JM, Gerszten RE, Collier TS, Bouchard C, Rohatgi A, Sarzynski MA. Associations of an HDL apolipoproteomic index with cardiometabolic risk factors before and after exercise training in the HERITAGE Family Study. Atherosclerosis 2024; 395:117587. [PMID: 38823353 PMCID: PMC11254543 DOI: 10.1016/j.atherosclerosis.2024.117587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND AND AIMS Previous studies have derived and validated an HDL apolipoproteomic score (pCAD) that predicts coronary artery disease (CAD) risk. However, the associations between pCAD and markers of cardiometabolic health in healthy adults are not known, nor are the effects of regular exercise on pCAD. METHODS A total of 641 physically inactive adults free of cardiovascular disease from the HERITAGE Family Study completed 20 weeks of exercise training. The pCAD index (range 0-100) was calculated using measurements of apolipoproteins A-I, C-I, C-II, C-III, and C-IV from ApoA-I-tagged serum (higher index = higher CAD risk). The associations between pCAD index and cardiometabolic traits at baseline and their training responses were assessed with Spearman correlation and general linear models. A Bonferroni correction of p < 8.9 × 10-04 was used to determine statistical significance. RESULTS The mean ± SD baseline pCAD index was 29 ± 32, with 106 (16.5 %) participants classified as high CAD risk. At baseline, pCAD index was positively associated with blood pressure, systemic inflammation, and body composition. HDL size, VO2max, and HDL-C were negatively associated with pCAD index at baseline. Of those classified as high CAD risk at baseline, 52 (49 %) were reclassified as normal risk after training. Following training, pCAD index changes were inversely correlated (p < 1.4 × 10-04) with changes in HDL-C, HDL size, and LDL size. CONCLUSIONS A higher pCAD index was associated with a worse cardiometabolic profile at baseline but improved with regular exercise. The results from this study highlight the potential role of HDL apolipoproteins as therapeutic targets for lifestyle interventions, particularly in high-risk individuals.
Collapse
Affiliation(s)
| | | | | | - Prasun K. Dev
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Jacob L. Barber
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, MA
| | - Riley J. Reasons
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Ryan W. Pearce
- Quest Diagnostics Cardiometabolic Center of Excellence at Cleveland HeartLab, Cleveland, OH
| | - Michael J. McPhaul
- Quest Diagnostics Cardiometabolic Center of Excellence at Cleveland HeartLab, Cleveland, OH
| | - Robert J. Konrad
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Jeremy M. Robbins
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, MA
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Robert E. Gerszten
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, MA
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Timothy S. Collier
- Quest Diagnostics Cardiometabolic Center of Excellence at Cleveland HeartLab, Cleveland, OH
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Anand Rohatgi
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Mark A. Sarzynski
- Department of Exercise Science, University of South Carolina, Columbia, SC
| |
Collapse
|
2
|
Pugh P, Hemingway P, Christian M, Higginbottom G. Key stakeholders' perspectives on the development of an early dietary phosphate self-management strategy for children and young people with chronic kidney disease stages 1-3: A modified Delphi consensus process. J Hum Nutr Diet 2024; 37:952-967. [PMID: 38739861 DOI: 10.1111/jhn.13308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/29/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND An early dietary phosphate intervention (EPI) can provide vital medical benefits supporting self-management of chronic kidney disease (CKD) in childhood. OBJECTIVE To utilise expert consensus to provide early modelling for an EPI to guide clinical practice across a paediatric renal network. METHODS Forty-eight statements across six domains were constructed following a systematic review and semi-structured interviews with children and young people (CYP), parents and healthcare professionals (HCP). A three-round online Delphi survey with parents and paediatric renal multi-disciplinary healthcare experts was undertaken. RESULTS Twenty-one experts agreed on 56 statements over three Delphi rounds. Statements were accepted in all six domains: definition of an EPI (2), rationale (12), intended users (3), delivery (14) (when [1], where [3], who [2], how [8]), other considerations (16) and potential concerns (9). CONCLUSIONS Consensus was reached on a definition and a set of guiding principles, providing some early modelling for implementation and future research on the development of an EPI strategy for CYP with CKD.
Collapse
Affiliation(s)
- Pearl Pugh
- School of Health Sciences, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham Children's Hospital, Nottingham, UK
| | - Pippa Hemingway
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Martin Christian
- Nottingham University Hospitals NHS Trust, Nottingham Children's Hospital, Nottingham, UK
| | | |
Collapse
|
3
|
Sharp T, Slattery K, Coutts AJ, van Gogh M, Ralph L, Wallace L. Solving the High-Intensity Multimodal Training Prescription Puzzle: A Systematic Mapping Review. SPORTS MEDICINE - OPEN 2024; 10:82. [PMID: 39039351 PMCID: PMC11263329 DOI: 10.1186/s40798-024-00747-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/26/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND High-Intensity Multimodal Training (HIMT) refers to all styles of high-intensity combined aerobic, resistance and/or bodyweight exercise. Previous heterogeneity in exercise prescription and reporting in HIMT reduces the understanding of which factors should be considered when prescribing HIMT (e.g., exercise volume, intensity, duration). Previous studies have demonstrated positive effects of HIMT on health and performance outcomes. However, methodological disparities limit comparisons between findings. The objective of this systematic mapping review was to examine which prescriptive considerations and health and performance outcomes have been reported on in HIMT. This review also examined the quantity and trends of research conducted on HIMT. METHODS A systematic literature search was conducted using Ovid Medline, SPORTDiscus and Cochrane Library databases and additional sources to identify studies up until February 2023. A total of 37,090 records were retrieved, of which 220 were included for review. 246 individual HIMT protocols were included for categorical analysis against the Consensus on Exercise Reporting Template (CERT) and Applied Research Model for the Sport Sciences (ARMSS). RESULTS A total of 85 unique terms were used to describe HIMT. Included studies most commonly prescribed HIMT using a consistent exercise selection and circuit format. Exercise intensity was inconsistently reported on and a large proportion of studies prescribed 'high-intensity' exercise at a level lower than the American College of Sports Medicine criteria for high-intensity (i.e., < 77% heart rate maximum). Participation location, supervision and participation format were the most commonly reported non-training variables. The most frequently reported outcomes were cardiovascular health, perceptual outcomes, body composition and biochemical outcomes. A large proportion of previous HIMT research was experimental in design. CONCLUSIONS Previous HIMT research demonstrates a lack of standardisation in reporting. Future studies should seek to follow guidelines (i.e., CERT) to improve reporting rigour. Additionally, forthcoming research should attempt to actively involve practitioners in implementation studies to improve ecological validity among interventions. Finally, future outcome measures should be accessible in practice and reflect common training goals of participants. REGISTRATION This review adhered to PRISMA-ScR guidelines. PREREGISTRATION osf.io/yknq4.
Collapse
Affiliation(s)
- Tijana Sharp
- Faculty of Health, School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia.
| | - Katie Slattery
- Faculty of Health, School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - Aaron J Coutts
- Faculty of Health, School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - Mikah van Gogh
- Australian College of Physical Education, 10 Parkview Dr, Sydney Olympic Park, Sydney, Australia
| | - Lara Ralph
- Faculty of Health, School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - Lee Wallace
- Faculty of Health, School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| |
Collapse
|
4
|
Desai I, Wewege MA, Jones MD, Clifford BK, Pandit A, Kaakoush NO, Simar D, Hagstrom AD. The Effect of Creatine Supplementation on Resistance Training-Based Changes to Body Composition: A Systematic Review and Meta-analysis. J Strength Cond Res 2024:00124278-990000000-00483. [PMID: 39074168 DOI: 10.1519/jsc.0000000000004862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
ABSTRACT Desai, I, Wewege, MA, Jones, MD, Clifford, BK, Pandit, A, Kaakoush, NO, Simar, D, and Hagstrom, AD. The effect of creatine supplementation on resistance training-based changes to body composition: A systematic review and meta-analysis. J Strength Cond Res XX(X): 000-000, 2024-The purpose of this review was to determine the added effect of creatine supplementation on changes in body composition with resistance training in adults younger than 50 years. The review protocol was preregistered on the Open Science Framework (osf.io/x48a6/). Our primary outcome was lean body mass (LBM); secondary outcomes were body fat percentage (%) and body fat mass (kg). We performed a random-effects meta-analysis in R using the metafor package. Subgroup analyses were conducted to examine the effects of training status and use of a carbohydrate drink with creatine. We conducted a meta-regression to examine the moderating effect of total training volume. Statistical significance was set at p < 0.05. One thousand six hundred ninety-four records were screened, and 67 full-text articles were assessed for eligibility. Twelve studies were included in the meta-analysis. Fifty-two percentages of the studies had low risk, 41% some concerns, and 7% high risk of bias. Compared with resistance training (RT) alone, creatine supplementation increased LBM by 1.14 kg (95% CI 0.69 to 1.59), and reduced body fat percentage by -0.88% (95% CI -1.66 to -0.11) and body fat mass by -0.73 kg (95% CI -1.34 to -0.11). There were no differences between training status or carbohydrate subgroups. Training volume was not associated with effect size in all outcomes; 7 g or 0.3 g/kg of body mass of creatine per day is likely to increase LBM by 1 kg and reduce fat mass by 0.7 kg more than RT alone. Concurrent carbohydrate ingestion did not enhance the hypertrophy benefits of creatine.
Collapse
Affiliation(s)
- Imtiaz Desai
- School of Health Sciences, University of New South Wales, Sydney, Australia
| | - Michael A Wewege
- School of Health Sciences, University of New South Wales, Sydney, Australia
- Center for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia; and
| | - Matthew D Jones
- School of Health Sciences, University of New South Wales, Sydney, Australia
- Center for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia; and
| | - Briana K Clifford
- School of Health Sciences, University of New South Wales, Sydney, Australia
| | - Anurag Pandit
- School of Health Sciences, University of New South Wales, Sydney, Australia
| | - Nadeem O Kaakoush
- School of Biomedical Sciences, University of New South Wales, Sydney, Australia
| | - David Simar
- School of Health Sciences, University of New South Wales, Sydney, Australia
| | - Amanda D Hagstrom
- School of Health Sciences, University of New South Wales, Sydney, Australia
| |
Collapse
|
5
|
Fernández-Morales C, Espejo-Antúnez L, Cardero-Durán MDLÁ, Falla D, Moreno-Vázquez JM, Albornoz-Cabello M. Psychophysiological responses to a multimodal physiotherapy program in fighter pilots with flight-related neck pain: A pilot trial. PLoS One 2024; 19:e0306708. [PMID: 38968243 PMCID: PMC11226082 DOI: 10.1371/journal.pone.0306708] [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: 03/01/2024] [Accepted: 06/20/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND The physical and cognitive demands of combat flying may influence the development and persistence of flight-related neck pain (FRNP). The aim of this pilot study was to analyse the effect of a multimodal physiotherapy program which combined supervised exercise with laser-guided feedback and interferential current therapy on psychophysiological variables in fighter pilots with FRNP. METHODS Thirty-one fighter pilots were randomly assigned to two groups (Intervention Group: n = 14; Control Group: n = 17). The intervention consisted of 8 treatment sessions (twice per week) delivered over 4 weeks. The following primary outcomes were assessed: perceived pain intensity (Numeric Pain Rating Scale-NPRS) and Heart Rate Variability (HRV; time-domain, frequency-domain and non-linear variables). A number of secondary outcomes were also assessed: myoelectric activity of the upper trapezius and sternocleidomastoid, pain catastrophizing (Pain Catastrophizing Scale-PCS) and kinesiophobia (TSK-11). RESULTS Statistically significant differences (p≤0.05) within and between groups were observed for all outcomes except for frequency domain and non-linear HRV variables. A significant time*group effect (one-way ANOVA) in favour of the intervention group was found for all variables (p<0.001). Effect sizes were large (d≥0.6). CONCLUSIONS The use of a multimodal physiotherapy program consisting of supervised exercise with laser-guided feedback and interferential current appears to show clinical benefit in fighter pilots with FRNP. TRIAL REGISTRATION ClinicalTrials.gov: NCT05541848.
Collapse
Affiliation(s)
- Carlos Fernández-Morales
- Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, University of Extremadura, Badajoz, Spain
| | - Luis Espejo-Antúnez
- Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, University of Extremadura, Badajoz, Spain
| | | | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), College of Life and Environmental Sciences, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | | | - Manuel Albornoz-Cabello
- Department of Physiology, Faculty of Medicine and Health Sciences, University of Extremadura, Badajoz, Spain
| |
Collapse
|
6
|
Baena-Raya A, Martínez-Rosales E, Ruiz-González D, Hernández-Martínez A, López-Sánchez L, Ferrer-Márquez M, Rodríguez-Pérez MA, Soriano-Maldonado A. Exercise interventions following bariatric surgery are poorly reported: A systematic review and a call for action. Obes Rev 2024; 25:e13758. [PMID: 38741478 DOI: 10.1111/obr.13758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 04/03/2024] [Accepted: 04/07/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES This study assessed the transparency and replicability of exercise-based interventions following bariatric surgery by evaluating the content reporting of exercise-based clinical trials. DESIGN The study design of the present article is a systematic review. DATA SOURCES PubMed, Scopus, Web of Sciences, PsycINFO, and Cochrane were searched from their inception to May 2023. ELIGIBILITY CRITERIA Eligible studies were clinical trials including exercise interventions in participants following bariatric surgery. There were 28 unique exercise interventions. Two independent reviewers applied the exercise prescription components of Frequency, Intensity, Time, and Type (FITT; four items) and the Consensus on Exercise Reporting Template (CERT; 19 items). Exercise interventions were organized into four major exercise components: aerobic training, resistance training, concurrent training, and "others." RESULTS The FITT assessment revealed that 53% of the trials did not report the training intensity, whereas 25% did not indicate the duration of the major exercise component within the training session. The mean CERT score was 5 out of a possible score of 19. No studies reached CERT score >10, while 13 out of the total 19 CERT items were not adequately reported by ≥75% of the studies. CONCLUSION This study highlights that the exercise interventions following bariatric surgery are poorly reported, non-transparent, and generally not replicable. This precludes understanding the dose-response association of exercise and health-related effects and requires action to improve this scientific field.
Collapse
Affiliation(s)
- Andrés Baena-Raya
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
| | - Elena Martínez-Rosales
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
| | - David Ruiz-González
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
| | - Alba Hernández-Martínez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
| | - Laura López-Sánchez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
| | - Manuel Ferrer-Márquez
- Bariatric Surgery Department, Torrecárdenas University Hospital, Almería, Spain
- Obesidad Almería, Almería, Spain
| | - Manuel A Rodríguez-Pérez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
| |
Collapse
|
7
|
Jorge CH, Bø K, Chiazuto Catai C, Oliveira Brito LG, Driusso P, Kolberg Tennfjord M. Pelvic floor muscle training as treatment for female sexual dysfunction: a systematic review and meta-analysis. Am J Obstet Gynecol 2024; 231:51-66.e1. [PMID: 38191016 DOI: 10.1016/j.ajog.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
OBJECTIVE This study aimed to investigate the efficacy of pelvic floor muscle training in treating female sexual dysfunction. DATA SOURCES A systematic review of databases, including PubMed, Ovid Medline, CINAHL, Embase, BVSalud, Scopus, and Cochrane Library, was performed in July 2021 and updated in May 2023. STUDY ELIGIBILITY CRITERIA Full-text articles of randomized controlled trials comparing pelvic floor muscle training with no intervention or another conservative treatment were included. At least 1 arm of these trials aimed to improve women's sexual function or treat sexual dysfunction. METHODS The data for this review were extracted and analyzed by 2 independent reviewers. Data on the characteristics of each intervention were extracted using the Consensus on Exercise Reporting Template. The risk of bias and certainty of evidence were assessed using the Physiotherapy Evidence Database (PEDro) scale and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria, respectively. A meta-analysis was conducted considering the posttreatment mean score difference in the Female Sexual Function Index between the control and treatment groups. RESULTS A total of 21 randomized controlled trials were included in this review. The Consensus on Exercise Reporting Template revealed varying quality of the pelvic floor muscle training protocols. Four studies were included in the meta-analysis showing that pelvic floor muscle training improved arousal (1.49; 95% confidence interval, 0.13-2.85), orgasm (1.55; 95% confidence interval, 0.13-2.96), satisfaction (1.46; 95% confidence interval, 0.14-2.77), pain (0.74; 95% confidence interval, 0.11-1.37), and the Female Sexual Function Index overall score (7.67; 95% confidence interval, 0.77-14.57). Very low certainty of evidence due to the data's high clinical and statistical heterogeneity was found according to the GRADE criteria. No side effects of the interventions were reported. CONCLUSION This systematic review and meta-analysis showed that pelvic floor muscle training improved female Female Sexual Function Index total score and several subscales; however, the certainty of the evidence is low.
Collapse
Affiliation(s)
- Cristine Homsi Jorge
- Pelvic Floor Muscle Function Laboratory, Health Science Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sports Sciences and Department of Obstetrics and Gynecology, Akershus University Hospital, Nordbyhagen, Norway
| | - Camila Chiazuto Catai
- Pelvic Floor Muscle Function Laboratory, Health Science Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Patricia Driusso
- Women's Health Research Laboratory, Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Merete Kolberg Tennfjord
- Department of Health and Exercise, School of Health Sciences, Kristiania University College, Oslo, Norway
| |
Collapse
|
8
|
Hug S, Cavalheri V, Lawson-Smith H, Gucciardi DF, Hill K. Interventions with a clear focus on achieving behaviour change are important for maintaining training-related gains in people with chronic obstructive pulmonary disease: a systematic review. J Physiother 2024; 70:193-207. [PMID: 38918084 DOI: 10.1016/j.jphys.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/09/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
QUESTIONS In people with chronic obstructive pulmonary disease (COPD) who complete an exercise training program (ETP) offered at a sufficient dose to result in training-related gains, to what extent are these gains maintained 12 months after program completion? Do variables such as the application of behaviour change techniques moderate the maintenance of these training-related gains? DESIGN Systematic review, meta-analysis and meta-regression of randomised controlled trials. PARTICIPANTS People with stable COPD. INTERVENTION Trials were included if they applied ≥ 4 weeks of a whole-body ETP and reported outcome data immediately following program completion and 12 months after initial program completion. The control group received usual care that did not include a formal exercise training component. OUTCOME MEASURES Exercise tolerance, health-related quality of life and dyspnoea during activities of daily living. DATA SOURCES EMBASE, PEDro, PubMed and the Cochrane Library. RESULTS Nineteen randomised trials with 2,103 participants were found, of which 12 had a sufficiently similar design to be meta-analysed. At 12 months after ETP completion, compared with the control group, the experimental group demonstrated better exercise tolerance (SMD 0.48, 95% CI 0.19 to 0.77) and quality of life (SMD 0.22, 95% CI 0.03 to 0.41) with no clear effect on dyspnoea. Meta-regression using data from all 19 trials demonstrated that the magnitude of between-group differences at the 12-month follow-up was moderated by: behaviour change being a core aim of the strategies implemented following completion of the ETP; the experimental group receiving more behaviour change techniques during the program; and the magnitude of between-group change achieved from the program. CONCLUSION At 12 months after completion of an ETP of ≥ 4 weeks, small gains were maintained in exercise tolerance and health-related quality of life. Applying behaviour change techniques with a clear focus on participants integrating exercise into daily life beyond initial program completion is important to maintain training-related gains. REGISTRATION CRD42020193833.
Collapse
Affiliation(s)
- Sarah Hug
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Physiotherapy Department, Royal Perth Hospital, Perth, Australia.
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Allied Health, South Metropolitan Health Service, Perth, Australia; Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
| | - Hollie Lawson-Smith
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Daniel F Gucciardi
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Kylie Hill
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Australia
| |
Collapse
|
9
|
Pires D, Duarte S, Rodrigues AM, Caeiro C, Canhão H, Branco J, Alves J, Marques M, Aguiar P, Fernandes R, Sousa RD, Cruz EB. MyBack - effectiveness and implementation of a behavior change informed exercise programme to prevent low back pain recurrences: a hybrid effectiveness-implementation randomized controlled study protocol. BMC Musculoskelet Disord 2024; 25:440. [PMID: 38840084 PMCID: PMC11151631 DOI: 10.1186/s12891-024-07542-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Low back pain (LBP) is a common health condition and the leading cause of years lived with disability worldwide. Most LBP episodes have a favourable prognosis, but recurrences within a year are common. Despite the individual and societal impact related to LBP recurrences, there is limited evidence on effective strategies for secondary prevention of LBP and successful implementation of intervention programmes in a real-world context. The aim of this study is to analyse the effectiveness of a tailored exercise and behavioural change programme (MyBack programme) in the secondary prevention of LBP; and evaluate acceptability, feasibility and determinants of implementation by the different stakeholders, as well as the implementation strategy of the MyBack programme in real context. METHODS This protocol describes a hybrid type I, randomized controlled trial to evaluate the effectiveness and implementation of MyBack programme in the context of primary health care. The Behaviour Change Wheel framework and FITT-VP principles will inform the development of the behaviour change and exercise component of MyBack programme, respectively. Patients who have recently recovered from an episode of non-specific LBP will be randomly assigned to MyBack and usual care group or usual care group. The primary outcome will be the risk of LBP recurrence. The secondary outcomes will include disability, pain intensity, musculoskeletal health, and health-related quality of life. Participants will be followed monthly for 1 year. Costs data related to health care use and the MyBack programme will be also collected. Implementation outcomes will be assessed in parallel with the effectiveness study using qualitative methods (focus groups with participants and health providers) and quantitative data (study enrolment and participation data; participants adherence). DISCUSSION To our knowledge, this is the first study assessing the effectiveness and implementation of a tailored exercise and behaviour change programme for prevention of LBP recurrences. Despite challenges related to hybrid design, it is expected that data on the effectiveness, cost-effectiveness, and implementation of the MyBack programme may contribute to improve health care in patients at risk of LBP recurrences, contributing to direct and indirect costs reduction for patients and the health system. TRIAL REGISTRATION NUMBER NCT05841732.
Collapse
Affiliation(s)
- Diogo Pires
- Instituto Politécnico de Setúbal, Escola Superior de Saúde, Setúbal, Portugal.
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal.
| | - Susana Duarte
- Instituto Politécnico de Setúbal, Escola Superior de Saúde, Setúbal, Portugal
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisboa, Portugal
| | - Ana Maria Rodrigues
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
- EpiDoC Unit, NOVA Medical School, NOVA University of Lisbon, Lisboa, Portugal
- Unidade de Reumatologia, Hospital dos Lusíadas, Lisboa, Portugal
| | - Carmen Caeiro
- Instituto Politécnico de Setúbal, Escola Superior de Saúde, Setúbal, Portugal
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Helena Canhão
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
- EpiDoC Unit, NOVA Medical School, NOVA University of Lisbon, Lisboa, Portugal
- Unidade de Reumatologia, CHULC Hospital Santo António dos Capuchos, Lisboa, Portugal
| | - Jaime Branco
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
- EpiDoC Unit, NOVA Medical School, NOVA University of Lisbon, Lisboa, Portugal
- Serviço de Reumatologia do Hospital Egas Moniz-Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - Joana Alves
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisboa, Portugal
| | - Marta Marques
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Pedro Aguiar
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisboa, Portugal
| | - Rita Fernandes
- Instituto Politécnico de Setúbal, Escola Superior de Saúde, Setúbal, Portugal
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
- LBMF, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Dafundo, Portugal
| | - Rute Dinis Sousa
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Eduardo B Cruz
- Instituto Politécnico de Setúbal, Escola Superior de Saúde, Setúbal, Portugal
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| |
Collapse
|
10
|
Tan GA, Peiris CL, Dennett AM. Cancer survivors maintain health benefits 6 to 12 months after exercise-based rehabilitation: a systematic review and meta-analysis. J Cancer Surviv 2024; 18:651-672. [PMID: 36547801 DOI: 10.1007/s11764-022-01322-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To determine if the effects of exercise-based cancer rehabilitation on physical functioning, activity (including physical activity) and participation (including quality of life) are maintained at 6 to 12 months. METHODS Electronic databases CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched from the earliest available time to August 2021. Randomised controlled trials examining the long-term effects (≥ 6 months post-intervention) of exercise-based rehabilitation were eligible for inclusion. Outcome data (e.g. fitness, physical activity, walking capacity, fatigue, depression, quality of life) were extracted and the methodological quality assessed using PEDro. Meta-analyses using standardised mean differences were used to synthesise data and Grades of Recommendation, Assessment, Development and Evaluation criteria were applied. RESULTS Nineteen randomised controlled trials including 2974 participants were included. Participants who underwent exercise-based rehabilitation had improved physical activity (SMD 0.30, 95% CI 0.09 to 0.51, I2 = 0%), cardiorespiratory fitness (SMD 2.00 ml/kg/min, 95% CI 0.56 to 3.45, I2 = 0%), walking capacity (SMD 0.62, 95% CI 0.33 to 0.92, I2 = 0%), depression (SMD 0.71, 95% 0.05 to 1.37, I2 = 90%), quality of life (physical functioning component SMD 0.56, 95% CI 0.11 to 1.01, I2 = 62%) and sleep (MD 0.69 points, 95% 0.46 to 0.92, I2 = 0%) at 6 to 12 months follow-up. There was no data available on cancer-related mortality or recurrence. CONCLUSION Health outcomes of cancer survivors after exercise-based rehabilitation can be maintained after rehabilitation completion. IMPLICATIONS FOR CANCER SURVIVORS Cancer survivors can maintain health benefits achieved through exercise-based rehabilitation.
Collapse
Affiliation(s)
- Germaine A Tan
- Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia.
- School of Allied Health, La Trobe University, Melbourne, VIC, Australia.
| | - Casey L Peiris
- Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia
- School of Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - Amy M Dennett
- Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia
- School of Allied Health, La Trobe University, Melbourne, VIC, Australia
| |
Collapse
|
11
|
Dawson R, Suen J, Sherrington C, Kwok W, Pinheiro MB, Haynes A, McLennan C, Sutcliffe K, Kneale D, Dyer S. Effective fall prevention exercise in residential aged care: an intervention component analysis from an updated systematic review. Br J Sports Med 2024; 58:641-648. [PMID: 38658135 PMCID: PMC11187368 DOI: 10.1136/bjsports-2023-107505] [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] [Accepted: 04/06/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The effect of fall prevention exercise programmes in residential aged care (RAC) is uncertain. This paper reports on an intervention component analysis (ICA) of randomised controlled trials (RCTs), from an update of a Cochrane review, to develop a theory of features of successful fall prevention exercise in RAC. METHODS Trial characteristics were extracted from RCTs testing exercise interventions in RAC identified from an update of a Cochrane review to December 2022 (n=32). Eligible trials included RCTs or cluster RCTs in RAC, focusing on participants aged 65 or older, assessing fall outcomes with stand-alone exercise interventions. ICA was conducted on trials with >30 participants per treatment arm compared with control (n=17). Two authors coded trialists' perceptions on intervention features that may have contributed to the observed effect on falls. Inductive thematic analysis was used to identify the key differences between the trials which might account for positive and negative outcomes. RESULTS 32 RCTs involving 3960 residents including people with cognitive (57%) and mobility (41%) impairments were included. ICA on the 17 eligible RCTs informed the development of a theory that (1) effective fall prevention exercise delivers the right exercise by specifically targeting balance and strength, tailored to the individual and delivered simply at a moderate intensity and (2) successful implementation needs to be sufficiently resourced to deliver structured and supervised exercise at an adequate dose. CONCLUSIONS This analysis suggests that delivering the right exercise, sufficiently resourced, is important for preventing falls in RAC. This clinical guidance requires confirmation in larger trials.
Collapse
Affiliation(s)
- Rik Dawson
- Sydney Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Jenni Suen
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Wing Kwok
- Sydney Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Marina B Pinheiro
- Sydney Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Abby Haynes
- Sydney Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Charlotte McLennan
- Sydney Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Katy Sutcliffe
- Social Research Institute, University College London, London, UK
| | - Dylan Kneale
- Social Research Institute, University College London, London, UK
| | - Suzanne Dyer
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
12
|
O'Neil J, Dionne N, Marchand S, Cardinal D, Handrigan G, Savard J. Reach, Adoption, and Implementation Strategies of a Telehealth Fall Prevention Program: Perspectives From Francophone Communities Across Canada. Health Promot Pract 2024:15248399241252807. [PMID: 38757965 DOI: 10.1177/15248399241252807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Introduction. A fall may impact a person's physical, emotional, and psychological well-being. Fall prevention programs are being implemented to reduce these negative outcomes. However, linguistic barriers in health services may reduce access to such prevention programs. A telehealth fall prevention program was designed to increase access to such programs in French for Francophone minority communities in Canada. This capacity-building project aimed to support community partners to deliver this telehealth program and document strategies used to reach, adopt, and implement the program within various Francophone and Acadian Minority Communities. Methods. A sequential explanatory mixed methodology was used to document reach, adoption, and implementation strategies and describe the lived experiences of program facilitators and organization representatives. Reach, adoption, and implementation were documented and analyzed descriptively, while lived experiences were analyzed using content analysis following the Consortium Framework for Implementation Research. Results. Twelve organization representatives or program facilitators from eight organizations operating in four different provinces participated in the study. Three themes emerged from the qualitative data on reach and adoption: external context, internal context, and capacity building. Four themes were identified as barriers and facilitators to implementation: level of preparation and time management, interpersonal relations and telepresence, exercise facilitation and safety, and technological problem-solving. Conclusion. Using tailored reach and adoption strategies such as prioritizing provinces with higher proportions of needs and training local community program facilitators may lead to the successful implementation of a new telehealth fall prevention program. Results from this study could potentially inform other primary prevention programs or telehealth program implementation.
Collapse
Affiliation(s)
- Jennifer O'Neil
- Université d'Ottawa, Ottawa, ON, Canada
- Institut de Recherche Bruyère, Ottawa, Ontario, Canada
| | | | | | - Dominique Cardinal
- Université d'Ottawa, Ottawa, ON, Canada
- CNFS-Volet Université d'Ottawa, Ottawa, Ontario, Canada
| | | | | |
Collapse
|
13
|
Poretti K, Ghoddosi N, Martin J, Eddo O, Cortes N, Clark NC. The Nature of Rehabilitation Programs to Improve Musculoskeletal, Biomechanical, Functional, and Patient-Reported Outcomes in Athletes With ACL Reconstruction: A Scoping Review. Sports Health 2024; 16:390-395. [PMID: 36929850 PMCID: PMC11025522 DOI: 10.1177/19417381231158327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
CONTEXT After anterior cruciate ligament (ACL) reconstruction (ACLR), athletes commonly undergo prolonged rehabilitation (eg, 9-12 months), but few actually return to preinjury sports activities. The nature (composition, configuration) of an ACL rehabilitation program (ACL-RP) is an important factor in determining rehabilitation outcomes; however, details about the nature of ACL-RPs are reported inconsistently in research studies. To guide future research reporting to support clinical translation and implementation of ACL-RPs, it is necessary to describe the nature, reporting, and outcomes of ACL-RPs in the current literature. OBJECTIVE The purpose of this scoping review was to understand the nature and reporting of various ACL-RPs that address musculoskeletal, biomechanical, functional, or patient-reported outcome measures in adult and pediatric athletes with ACLR. DATA SOURCES Articles were selected from searches in 5 electronic databases (PubMed, EbscoHost [MEDLINE, SportDiscus, CINAHL Plus], PROQuest, Cochrane, and Embase). STUDY SELECTION Studies were included if they evaluated a post-ACL-RP that implemented strength, balance, plyometric, change of direction running, and/or agility running and included self-reported physical function, quality of life, or pain outcomes. STUDY DESIGN Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines. LEVEL OF EVIDENCE Level 4. DATA EXTRACTION Data were extracted and synthesized to evaluate the reporting of acute program variables (APVs) and exercise descriptors (EDs); 17 studies were included in the final synthesis. RESULTS Studies reported between 0% and 67% of the APVs and EDs combined. Only 2 studies were considered to have adequate reporting of both APVs and EDs. CONCLUSION Inadequate reporting of APVs and EDs in past studies restricts the translation and implementation of existing research-based ACL-RPs to present-day clinical contexts.
Collapse
Affiliation(s)
- Kelly Poretti
- School of Kinesiology, George Mason University, Manassas, Virginia
| | - Navid Ghoddosi
- School of Kinesiology, George Mason University, Manassas, Virginia
| | - Joel Martin
- School of Kinesiology, George Mason University, Manassas, Virginia
- Sports Medicine Assessment Research and Testing (SMART) Laboratory, George Mason University, Virginia
| | - Oladipo Eddo
- School of Kinesiology, George Mason University, Manassas, Virginia
- Sports Medicine Assessment Research and Testing (SMART) Laboratory, George Mason University, Virginia
| | - Nelson Cortes
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, Essex, UK
- Department of Bioengineering, George Mason University, Fairfax, Virginia
| | - Nicholas C. Clark
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, Essex, UK
| |
Collapse
|
14
|
Myers AM, Barlow RC, Baldini G, Campbell AM, Carli F, Carr EJ, Collyer T, Danjoux G, Davis JF, Denehy L, Durrand J, Gillis C, Greenfield DM, Griffiths SP, Grocott M, Humphreys L, Jack S, Keen C, Levett DZH, Merchant Z, Moore J, Moug S, Ricketts W, Santa Mina D, Saxton JM, Shaw CE, Tew GA, Thelwell M, West MA, Copeland RJ. International consensus is needed on a core outcome set to advance the evidence of best practice in cancer prehabilitation services and research. Br J Anaesth 2024; 132:851-856. [PMID: 38522964 DOI: 10.1016/j.bja.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/31/2024] [Accepted: 02/23/2024] [Indexed: 03/26/2024] Open
Abstract
Prehabilitation aims to optimise patients' physical and psychological status before treatment. The types of outcomes measured to assess the impact of prehabilitation interventions vary across clinical research and service evaluation, limiting the ability to compare between studies and services and to pool data. An international workshop involving academic and clinical experts in cancer prehabilitation was convened in May 2022 at Sheffield Hallam University's Advanced Wellbeing Research Centre, England. The workshop substantiated calls for a core outcome set to advance knowledge and understanding of best practice in cancer prehabilitation and to develop national and international databases to assess outcomes at a population level.
Collapse
Affiliation(s)
- Anna M Myers
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Rachael C Barlow
- Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Gabriele Baldini
- Anaesthesiology and Intensive Care Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, Florence, Italy
| | | | - Franco Carli
- Department of Anaesthesia, McGill University Health Center, Glen Site, Royal Victoria Hospital, Montreal, QC, Canada
| | - Esther J Carr
- South Tees NHS Foundation Trust, James Cook University Hospital, Middlesbrough, UK
| | - Tom Collyer
- Anaesthetic Department, Harrogate and District NHS Foundation Trust, Harrogate, UK
| | - Gerard Danjoux
- North Yorkshire Academic Alliance of Perioperative Medicine, James Cook University Hospital, Middlesbrough, UK
| | - June F Davis
- Macmillan Cancer Support, London, UK; Allied Health Solutions, Hadlow, Kent, UK
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia; Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - James Durrand
- Department of Anaesthesia and Perioperative Medicine, James Cook University Hospital, Middlesbrough, UK
| | - Chelsia Gillis
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Diana M Greenfield
- Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Mike Grocott
- Faculty of Medicine, University of Southampton, Southampton, UK; Acute Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Trust, University of Southampton, Southampton, UK
| | - Liam Humphreys
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Sandy Jack
- Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Biomedical Research Centre, University Hospital Southampton NHS Trusts, Southampton, UK
| | - Carol Keen
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Denny Z H Levett
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Trust, University of Southampton, Southampton, UK; Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Zoe Merchant
- Greater Manchester Cancer Alliance, Manchester, UK
| | - John Moore
- Department of Anaesthesia and Peri-operative Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - Susan Moug
- Departments of Colorectal Surgery, Royal Alexandra Hospital, Paisley, Scotland, UK
| | - William Ricketts
- Respiratory Medicine, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; Department of Anaesthesiology and Pain Management, University Health Network, Toronto, ON, Canada
| | - John M Saxton
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, UK
| | - Clare E Shaw
- NIHR Biomedical Research Centre at The Royal Marsden and the Institute of Cancer Research, London, UK
| | | | - Michael Thelwell
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Malcolm A West
- University of Southampton, Faculty of Medicine, Cancer Sciences, University Surgery, Southampton University Hospital NHS Foundation Trust, Southampton, UK
| | - Robert J Copeland
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| |
Collapse
|
15
|
Curtin M, Cruice M, Morgan G, Herman R. Assessing parent-child interaction with deaf and hard of hearing infants aged 0-3 years: An international multi-professional e-Delphi. PLoS One 2024; 19:e0301722. [PMID: 38683866 PMCID: PMC11057743 DOI: 10.1371/journal.pone.0301722] [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: 12/29/2023] [Accepted: 03/21/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION Most deaf babies are born to hearing families who do not yet have the skills to communicate effectively with their child. Adaptations to communication are important because the quality of parent-child interaction (PCI) predicts how a deaf child develops language. Teachers of Deaf children and Speech and Language Therapists support families with communication in the home. Currently, there are no assessments that appraise how a parent interacts with their deaf baby. Previous research has identified which parent behaviours and approaches are used in PCI assessments in research and practice. The current paper forms consensus on the core content and best practices of a new PCI tool for deaf children aged 0-3 years. METHODS An international sample of expert academics and practitioners (n = 83) were recruited to take part in a two-round modified electronic Delphi study. Participants were presented with 69 statements focusing on (i) which parent behaviours were important in assessment (ii) the methods to be used in PCI assessment. Participants rated the extent to which they agreed or disagreed with each statement on a five-point Likert scale and gave comments to support their response. Consensus was defined as >80% of participants rating the statement as a (4) 'highly important' or a (5) 'essential'. If consensus was not reached, participant comments were used to generate new statements which were rated in the second round. This project involved a patient and public involvement (PPI) group of hearing and deaf parents and professionals to design and guide the study. RESULTS Consensus was achieved on 52 statements and ranged from 80-99%. A further six statements were additionally included. Within the 58 statements included, 36 were parent behaviours which centred on the parent's observation of, and response to, their child's behaviour and/or language. The remaining 22 statements focused on methods used in the assessment such as parents having their PCI filmed, parents having the opportunity to review the video and assess themselves alongside a professional, and parents being involved in subsequent goal setting. CONCLUSIONS This e-Delphi presented the parent behaviours and methods of assessment to be included in a new PCI tool for deaf children. Future co-production work and acceptability and feasibility testing are discussed.
Collapse
Affiliation(s)
- Martina Curtin
- Speech and Language Therapy (Paediatrics, Community), Homerton Healthcare NHS Foundation Trust, London, United Kingdom
- Language and Communication Science, City, University of London, London, United Kingdom
| | - Madeline Cruice
- Language and Communication Science, City, University of London, London, United Kingdom
| | - Gary Morgan
- Universitat Oberta de Catalunya, Psychology and Education Sciences, Barcelona, Spain
| | - Rosalind Herman
- Language and Communication Science, City, University of London, London, United Kingdom
| |
Collapse
|
16
|
Karatrantou K, Gerodimos V. A Comprehensive Workplace Exercise Intervention to Reduce Musculoskeletal Pain and Improve Functional Capacity in Office Workers: A Randomized Controlled Study. Healthcare (Basel) 2024; 12:915. [PMID: 38727472 PMCID: PMC11083576 DOI: 10.3390/healthcare12090915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
The high levels of musculoskeletal pain, in conjunction with the low levels of functional capacity, may negatively affect workers' health, efficiency, and productivity. This randomized controlled study investigated the efficacy of a 6-month comprehensive workplace exercise program on musculoskeletal pain and functional capacity in office workers. Seventy male and female office workers with musculoskeletal pain in any body area were randomly assigned to either an intervention (IG; n = 35) or a control group (CG; n = 35). The IG participated every working day (during working hours) in a 6-month supervised combined (flexibility, strength, and balance) exercise program (120 training sessions; five times/week) for the total body. The CG did not participate in any intervention. Musculoskeletal pains in nine body areas and functional capacity (flexibility, balance, and strength) of the lower and upper body were measured before and following the intervention. The IG significantly reduced duration and intensity of pain (43.1-70%; p = 0.000) as well as days of work absenteeism (84.6%; p = 0.000), while improving work capacity (87.1%; p = 0.000). Furthermore, the IG significantly increased cervical, handgrip, back, and leg maximal strength (10.3-27.1%; p = 0.000) and flexibility and balance (12.3-73.7%; p = 0.000). In CG, all musculoskeletal pain and functional capacity indices remained unchanged. In conclusion, this program may be effectively used to reduce musculoskeletal pain and improve functional capacity.
Collapse
Affiliation(s)
- Konstantina Karatrantou
- Department of Physical Education and Sports Science, University of Thessaly, 42100 Trikala, Greece;
| | | |
Collapse
|
17
|
Short CE, Rawstorn JC, Jones TL, Edbrooke L, Hayes SC, Maddison R, Nightingale S, Ismail H, De Boer R, Hegi-Johnson F, Sverdlov AL, Bell R, Halligan I, Denehy L. Evaluating a Remotely Delivered Cardio-Oncology Rehabilitation Intervention for Patients With Breast Cancer (REMOTE-COR-B): Protocol for a Single-Arm Feasibility Trial. JMIR Res Protoc 2024; 13:e53301. [PMID: 38578682 PMCID: PMC11031702 DOI: 10.2196/53301] [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: 10/02/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Exercise rehabilitation is a promising strategy for reducing cardiovascular disease risk among patients with breast cancer. However, the evidence is primarily derived from programs based at exercise centers with in-person supervised delivery. Conversely, most patients report a preference for home-based rehabilitation. As such, there is a clear need to explore strategies that can provide real-time supervision and coaching while addressing consumer preferences. Evidence from cardiac rehabilitation has demonstrated the noninferiority of a smartphone-based telerehabilitation approach (REMOTE-CR) to improve cardiorespiratory fitness in people with cardiovascular disease compared to a center-based program. OBJECTIVE This study aims to assess the feasibility, safety, and preliminary efficacy of the REMOTE-CR program adapted for patients with breast cancer at risk of cardiotoxicity (REMOTE-COR-B). We will also assess the satisfaction and usability of REMOTE-COR-B. METHODS We will conduct a single-arm feasibility study of the REMOTE-COR-B program among patients with stage I-III breast cancer who are at risk of cardiotoxicity (taking treatment type and dose, as well as other common cardiovascular disease risk factors into account) and who are within 24 months of completing primary definitive treatment. Participants (target sample size of 40) will receive an 8-week smartphone-based telerehabilitation exercise program involving remotely delivered real-time supervision and behavior change support. The platform comprises a smartphone and wearable heart rate monitor, as well as a custom-built smartphone app and web application. Participants will be able to attend remotely monitored exercise sessions during set operating hours each week, scheduled in both the morning and evening. Adherence is the primary outcome of the trial, assessed through the number of remotely monitored exercise sessions attended compared to the trial target (ie, 3 sessions per week). Secondary outcomes include additional trial feasibility indicators (eg, recruitment and retention), safety, satisfaction, and usability, and objective and patient-reported efficacy outcomes (cardiovascular fitness, quality of life, fatigue, self-reported exercise, self-efficacy, habit strength, and motivation). Adherence, feasibility, and safety outcomes will be assessed during the intervention period; intervention satisfaction and usability will be assessed post intervention; and objective and patient-reported efficacy outcomes will be assessed at baseline, post intervention (2-month postbaseline assessment), and at follow-up (5-month postbaseline assessment). RESULTS Recruitment for this trial commenced in March 2023, and 7 participants had been recruited as of the submission of the manuscript. The estimated completion date for the project is October 2024, with results expected to be published in mid-2025. CONCLUSIONS The REMOTE-COR-B intervention is a novel and promising approach to providing exercise therapy to patients with breast cancer at risk of cardiotoxicity who have unique needs and heightened safety risks. This project will provide important information on the extent to which this approach is satisfactory to patients with breast cancer, safe, and potentially effective, which is necessary before larger-scale research or clinical projects. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12621001557820; www.anzctr.org.au/ACTRN12621001557820.aspx. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53301.
Collapse
Affiliation(s)
- Camille E Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Jonathan C Rawstorn
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Tamara L Jones
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Lara Edbrooke
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Sophie Nightingale
- Department of Surgical Oncology, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Hilmy Ismail
- Department of Anaesthesia, Pain and Perioperative Medicine, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Richard De Boer
- Department of Surgical Oncology, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Fiona Hegi-Johnson
- Department of Radiation Oncology, The Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - Aaron L Sverdlov
- Newcastle Centre of Excellence in Cardio-Oncology, The University of Newcastle, Hunter Medical Research Institute, Calvary Mater Newcastle, Newcastle, Australia
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, Australia
| | - Robyn Bell
- Consumer representative, Melbourne, Australia
| | | | - Linda Denehy
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, Australia
| |
Collapse
|
18
|
McGarrigle L, Norman G, Hurst H, Todd C. Rehabilitation interventions to modify physical frailty in adults before lung transplantation: a systematic review protocol. BMJ Open 2024; 14:e078561. [PMID: 38569690 PMCID: PMC11146394 DOI: 10.1136/bmjopen-2023-078561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/30/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Lung transplantation is the gold-standard treatment for end-stage lung disease for a small group of patients meeting strict acceptance criteria after optimal medical management has failed. Physical frailty is prevalent in lung transplant candidates and has been linked to worse outcomes both on the waiting list and postoperatively. Exercise has been proven to be beneficial in optimising exercise capacity and quality of life in lung transplant candidates, but its impact on physical frailty is unknown. This review aims to assess the effectiveness of exercise interventions in modifying physical frailty for adults awaiting lung transplantation. METHODS AND ANALYSIS This protocol was prospectively registered on the PROSPERO database. We will search four databases plus trial registries to identify primary studies of adult candidates for lung transplantation undertaking exercise interventions and assessing outcomes pertaining to physical frailty. Studies must include at least 10 participants. Article screening will be performed by two researchers independently at each stage. Extraction will be performed by one reviewer and checked by a second. The risk of bias in studies will be assessed by two independent reviewers using tools appropriate for the research design of each study; where appropriate, we will use Cochrane Risk of Bias 2 or ROBINS-I. At each stage of the review process, discrepancies will be resolved through a consensus or consultation with a third reviewer. Meta-analyses of frailty outcomes will be performed if possible and appropriate as will prespecified subgroup and sensitivity analyses. Where we are unable to perform meta-analysis, we will conduct narrative synthesis following Synthesis without Meta-analysis guidance. The review will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. ETHICS AND DISSEMINATION No ethical issues are predicted due to the nature of this study. Dissemination will occur via conference abstracts, professional networks, peer-reviewed journals and patient support groups. PROSPERO REGISTRATION NUMBER CRD42022363730.
Collapse
Affiliation(s)
- Laura McGarrigle
- Cardiothoracic Transplantation, Manchester University NHS Foundation Trust, Manchester, UK
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester, Greater Manchester, UK
| | - Gill Norman
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester, Greater Manchester, UK
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
| | - Helen Hurst
- School of Health and Society, University of Salford, Salford, UK
- Renal, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Chris Todd
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester, Greater Manchester, UK
- School of Health Sciences, University of Manchester, Manchester, UK
| |
Collapse
|
19
|
Peebles KC, Jacobs C, Makaroff L, Pacey V. The use and effectiveness of exercise for managing postural orthostatic tachycardia syndrome in young adults with joint hypermobility and related conditions: A scoping review. Auton Neurosci 2024; 252:103156. [PMID: 38401460 DOI: 10.1016/j.autneu.2024.103156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/06/2024] [Accepted: 02/10/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia. It may occur in isolation, but frequently co-exists in individuals with hypermobile variants of Ehlers-Danlos Syndrome (EDS) and related conditions (chronic fatigue syndrome [CFS] and fibromyalgia). Exercise is recommended for non-pharmacological POTS management but needs to be individualised. This scoping review explores the current literature on use and effectiveness of exercise-based management for POTS, with specific focus on individuals with joint hypermobility and related conditions who experience hypermobility, and/or pain, and/or fatigue. METHODS A systematic search, to January 2023, of Medline, EMBASE, AMED, CINAHL and the Cochrane library was conducted. Studies that reported on adolescents and adults who had been diagnosed with POTS using standard criteria and underwent an exercise-based training intervention were included. RESULTS Following full-text screening, 10 articles were identified (2 randomised control trials, 4 comparative studies and 4 case reports). One comparative study reported a small subset of participants with EDS and one case report included an individual diagnosed with CFS; the remainder investigated a wider POTS population. Overall, 3 months of endurance followed by resistance exercise, graduating from the horizontal-to-upright position reduced POTS symptoms and improved quality-of-life. CONCLUSION The findings highlight a paucity of higher-level studies documenting exercise for POTS management in people with joint hypermobility and related conditions. Results from the wider POTS population demonstrate exercise is safe and effective. Large, well-designed clinical studies exploring exercise for POTS management adapting to meet the complex musculoskeletal and non-musculoskeletal features of symptomatic joint hypermobility are needed.
Collapse
Affiliation(s)
- Karen C Peebles
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
| | - Charl Jacobs
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Logan Makaroff
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Verity Pacey
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| |
Collapse
|
20
|
Holm PM, Blankholm AD, Nielsen JL, Bandholm T, Wirth W, Wisser A, Kemnitz J, Eckstein F, Schrøder HM, Wernbom M, Skou ST. Effects of neuromuscular control and strengthening exercises on MRI-measured thigh tissue composition and muscle properties in people with knee osteoarthritis - an exploratory secondary analysis from a randomized controlled trial. Semin Arthritis Rheum 2024; 65:152390. [PMID: 38340609 DOI: 10.1016/j.semarthrit.2024.152390] [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: 10/05/2023] [Revised: 12/19/2023] [Accepted: 01/18/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To investigate the effects of adding strength training to neuromuscular control exercises on thigh tissue composition and muscle properties in people with radiographic-symptomatic knee osteoarthritis (KOA). METHODS In this exploratory secondary analysis of a randomized controlled trial, using a complete-case approach, participants performed 12 weeks of twice-weekly neuromuscular control exercise and patient education (NEMEX, n = 34) or NEMEX plus quadriceps strength training (NEMEX+ST, n = 29). Outcomes were MRI-measured inter- and intramuscular adipose tissue (InterMAT, IntraMAT), quadriceps muscle cross-sectional area (CSA), knee-extensor strength, specific strength (strength/lean CSA) and 30 s chair-stands. Between-group effects were compared using a mixed model analysis of variance. RESULTS At 12 weeks, responses to NEMEX+ST overlapped with NEMEX for all outcomes. Both groups reduced InterMAT (NEMEX+ST=25 %, NEMEX=21 %); between-group difference: 0.8cm2 (95 % CI: -0.1, 1.7). NEMEX+ST decreased IntraMAT (2 %) and NEMEX increased IntraMAT (4 %); between-group difference 0.1 %-points (-0.3, 0.5). Both groups increased quadriceps CSA and lean CSA (CSA minus IntraMAT), improved knee-extensor strength and specific strength, and improved chair-stand performance with a trend towards greater effects in NEMEX+ST. CONCLUSION Adding strength training to 12 weeks of neuromuscular control exercises provided largely similar effects to neuromuscular control exercises alone in decreasing InterMAT and IntraMAT, in improving knee-extensor strength, CSA and in improving performance-based function in KOA persons, with a trend towards greater effects with additional strength training. Notably, both groups substantially reduced InterMAT and improved specific strength (an index of muscle quality). Our hypothesis-generating work warrants exploration of the roles played by InterMAT and IntraMAT in exercise effects in KOA.
Collapse
Affiliation(s)
- Pætur M Holm
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands.
| | | | - Jakob L Nielsen
- Research Unit for Muscle Physiology and Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Thomas Bandholm
- Department of Orthopaedic Surgery & Department of Clinical Research, Copenhagen University Hospital - Amager and Hvidovre, Denmark; Physical Medicine & Rehabilitation Research Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital - Amager and Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Wolfgang Wirth
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute of Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany
| | - Anna Wisser
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute of Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany
| | - Jana Kemnitz
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute of Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria
| | - Felix Eckstein
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute of Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany
| | - Henrik M Schrøder
- Department of Orthopedic Surgery, Næstved-Slagelse-Ringsted Hospitals, Næstved, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Mathias Wernbom
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Søren T Skou
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
21
|
He S, Wei M, Meng D, Wang Z, Yang G, Wang Z. Self-determined sequence exercise program for elderly with sarcopenia: A Randomized controlled trial with clinical assistance from explainable artificial intelligence. Arch Gerontol Geriatr 2024; 119:105317. [PMID: 38176122 DOI: 10.1016/j.archger.2023.105317] [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: 07/18/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/06/2024]
Abstract
To improve and even reverse sarcopenia in elderly people, this study developed a self-determined sequence exercise program consisting of strength training exercise, Yijinjing exercise (a traditional Chinese exercise), and hybrid strength training with Yijinjing exercise. Ninety-four community-dwelling older adults screened for sarcopenia using the Asian Working Group for Sarcopenia criteria were randomly assigned to 24 weeks of a control group (CG, n = 30), self-determined sequence exercise program group (SDSG, n = 34) or strength training group (STG, n = 30). The study examined the effects of three interventions on participantsL3 skeletal muscle fat density, L3 skeletal muscle fat area, L3 skeletal muscle density, L3 skeletal muscle area, muscle fat infiltration, relative skeletal muscle mass index, and grip strength using a repeated-measures ANOVA to evaluate the experimental data. To evaluate the real effect of this model in reversing sarcopenia after the intervention, nine classification models were trained. Significant interaction effects were observed with grip strength, RSMI, L3 SMD, and L3 SMA. At the 24th week, participants' grip strength, L3 SMFA, L3 SMA, and RSMI were improved significantly in the SDSG and STG. The SDSG achieved significantly greater RSMI and grip strength than the STG and CG after the intervention. The self-determined sequence exercise program exhibited better performance than the single type of exercise modality in reversing sarcopenia and improving older adults' skeletal muscle area. Consequently, the stacking model is feasible to make a prediction as to whether or not sarcopenia may be reversed in older adults.
Collapse
Affiliation(s)
- Shichun He
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Meiqi Wei
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Deyu Meng
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Ziyi Wang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Guang Yang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Ziheng Wang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China; AI group, Intelligent Lancet LLC, Sacramento, California, 95816 CA, United States of America; Graduate School of Human Sciences, Waseda University, Tokorozawa, 3591192, Saitama, Japan.
| |
Collapse
|
22
|
Kucksdorf JJ, Bartley J, Rhon DI, Young JL. Reproducibility of Exercise Interventions in Randomized Controlled Trials for the Treatment of Rotator Cuff-Related Shoulder Pain: A Systematic Review. Arch Phys Med Rehabil 2024; 105:770-780. [PMID: 37741486 DOI: 10.1016/j.apmr.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/25/2023] [Accepted: 09/15/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVE To determine the reproducibility of exercise therapy interventions in randomized controlled trials for rotator cuff-related shoulder pain (RCRSP). DATA SOURCES Data sources included Medline, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, and SPORTDiscus from studies published from database inception to April 23, 2022. STUDY SELECTION Randomized controlled trials studying the use of exercise therapy for RCRSP. DATA EXTRACTION Two reviewers extracted exercise reporting details from all studies using the Template for Intervention Description and Replication (TIDieR) and the modified Consensus on Exercise Reporting Template (CERT). The same 2 reviewers assessed risk of bias of all studies using Cochrane Risk of Bias Tool version 2.0. DATA SYNTHESIS For 104 studies meeting inclusion criteria, the average number of items reported on the TIDieR was 5.27 (SD 2.50, range 1-12 out of 12) and 5.09 (SD 4.01, range 0-16 out of 16) on the CERT. Improved reporting over time was seen on both the TIDieR and CERT dating back to 1993 and through April 23, 2022. When comparing groups of studies published before and after the TIDieR (2014) and CERT (2016) were established, a statistically significant increase in median scores was noted on the TIDieR (P=.02) but not the CERT (P=.31). Quality of exercise therapy reporting was highest in studies with "low risk" of bias, and lowest in studies with "high risk" of bias on the RoB-2. CONCLUSION Overall exercise reporting in trials for RCRSP is incomplete despite the development of the TIDieR and CERT checklists. This has implications for translating evidence into practice.
Collapse
Affiliation(s)
- Joseph J Kucksdorf
- Bellin College, Green Bay, WI; Sports Medicine and Orthopedics, Bellin Health, Green Bay, WI.
| | - Jason Bartley
- Bellin College, Green Bay, WI; Multicare Health System, Tacoma, WA; Augustana University, Sioux Falls, SD
| | - Daniel I Rhon
- Bellin College, Green Bay, WI; Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
| | | |
Collapse
|
23
|
Preobrazenski N, McCaig A, Turner A, Kushner M, Pacitti L, Mendolia P, MacDonald B, Storoschuk K, Bouck T, Zaza Y, Lu S, Gurd BJ. Risk of bias in exercise science: A systematic review of 340 studies. iScience 2024; 27:109010. [PMID: 38405604 PMCID: PMC10884506 DOI: 10.1016/j.isci.2024.109010] [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: 10/04/2023] [Revised: 12/19/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
Risk of bias can contribute to irreproducible science and mislead decision making. Analyses of smaller subsections of the exercise science literature suggest many exercise science studies have unclear or high risk of bias. The current review (osf.io/jznv8) assesses whether this unclear or high risk of bias is more widespread in the exercise science literature and whether this bias has decreased since the publication of the 1996 Consolidated Standards of Reporting Trials (CONSORT) guidelines. We report significant reductions in selection, performance, detection, and reporting biases in 2020 compared with 1995 in the 340 of 5,451 studies assessed using the Cochrane Risk of Bias tool. Despite these improvements, most 2020 studies still had unclear or high risks of bias. These results underscore the need for methodological vigilance, adherence to reporting standards, and education on experimental bias. Factors contributing to these improvements, such advancements in education and journal requirements, remain uncertain.
Collapse
Affiliation(s)
| | - Abby McCaig
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Anna Turner
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Maddy Kushner
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Lauren Pacitti
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Peter Mendolia
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Ben MacDonald
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Kristi Storoschuk
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Tori Bouck
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Youssef Zaza
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Stephanie Lu
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Brendon J. Gurd
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| |
Collapse
|
24
|
Arora NK, Donath L, Owen PJ, Miller CT, Saueressig T, Winter F, Hambloch M, Neason C, Karner V, Belavy DL. The Impact of Exercise Prescription Variables on Intervention Outcomes in Musculoskeletal Pain: An Umbrella Review of Systematic Reviews. Sports Med 2024; 54:711-725. [PMID: 38093145 PMCID: PMC10978700 DOI: 10.1007/s40279-023-01966-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 04/01/2024]
Abstract
BACKGROUND Musculoskeletal pain conditions are the largest contributors to disability and healthcare burden globally. Exercise interventions improve physical function and quality of life in individuals with musculoskeletal pain, yet optimal exercise prescription variables (e.g. duration, frequency, intensity) are unclear. OBJECTIVE We aimed to examine evidence gaps, methodological quality and exercise prescription recommendations in systematic reviews of exercise for musculoskeletal pain. METHODS In our prospectively registered umbrella review, PubMed, SPORTDiscus, Cochrane Database of Systematic Reviews, EMBASE, and CINAHL were searched from inception to 14 February 2023. Backward citation tracking was performed. We included peer-reviewed, English language, systematic reviews and meta-analyses of randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared exercise with conservative treatment, placebo or other exercise interventions in adults with musculoskeletal pain. Data were extracted from the following groups of reviews based on their reporting of exercise prescription data and analysis of the relationship between prescription variables and outcomes: (1) those that did not report any exercise prescription data, (2) those that reported exercise prescription data but did not perform a quantitative analysis and (3) those that performed a quantitative analysis of the relationship between exercise prescription variables and outcomes. Outcome measures were physical function, pain, mental health, adverse effects and adherence to treatment. AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews) was used to assess methodological quality. RESULTS From 6757 records, 274 systematic reviews were included. 6.6% of reviews did not report any exercise prescription data, and only 10.9% quantitatively analyzed the relationship between prescription variables and the outcome(s). The overall methodological quality was critically low in 85% of reviews. CONCLUSION High methodological quality evidence is lacking for optimal exercise training prescription variables in individuals with musculoskeletal pain. To better inform practice and evidence gaps, future systematic reviews should (1) identify optimum exercise prescription variables, for example, via dose-response (network) meta-analysis, (2) perform high-quality reviews per AMSTAR-2 criteria and (3) include outcomes of mental health, adverse events and exercise adherence. PROSPERO REGISTRATION NUMBER CRD42021287440 ( https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287440 ).
Collapse
Affiliation(s)
- Nitin Kumar Arora
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Clint T Miller
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Tobias Saueressig
- Science and Research, Physio Meets Science GmbH, Leimen, Baden-Württemberg, Germany
| | - Felicitas Winter
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Marina Hambloch
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Christopher Neason
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Vera Karner
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Daniel L Belavy
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany.
| |
Collapse
|
25
|
Mansfield L, Daykin N, O'Connell NE, Bailey D, Forde L, Smith R, Gifford J, Ashdown‐Franks G. A mixed methods systematic review on the effects of arts interventions for children and young people at-risk of offending, or who have offended on behavioural, psychosocial, cognitive and offending outcomes: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1377. [PMID: 38188229 PMCID: PMC10765125 DOI: 10.1002/cl2.1377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Young people who enter the justice system experience complex health and social needs, and offending behaviour is increasingly recognised as a public health problem. Arts interventions can be used with the aim of preventing or reducing offending or reoffending. Objectives 1. To evaluate evidence on the effectiveness and impact of arts interventions on keeping children and young people safe from involvement in violence and crime. 2. To explore factors impacting the implementation of arts interventions, and barriers and facilitators to participation and achievement of intended outcomes. 3. To develop a logic model of the processes by which arts interventions might work in preventing offending behaviours. Search Methods We searched AMED, Academic Search Complete; APA PsycInfo; CINAHL Plus; ERIC; SocIndex; SportDiscus, Medline, CENTRAL, Web of Science, Scopus, PTSDPubs and Performing Arts Periodicals Database, Sage, the US National Criminal Justice Reference Service, the Global Policing and British Library EThOS databases, and the National Police Library from inception to January 2023 without language restrictions. Selection Criteria We included randomised and non-randomised controlled trials and quasi-experimental study designs. We included qualitative studies conducted alongside intervention trials investigating experiences and perceptions of participants, and offering insight into the barriers and facilitators to delivering and receiving arts interventions. We included qualitative and mixed methods studies focused on delivery of arts interventions. We included studies from any global setting. We included studies with CYP (8-25 years) who were identified as at-risk of offending behaviour (secondary populations) or already in the criminal justice system (tertiary populations). We included studies of interventions involving arts participation as an intervention on its own or alongside other interventions. Primary outcomes were: (i) offending behaviour and (ii) anti-pro-social behaviours. Secondary outcomes were: participation/attendance at arts interventions, educational attainment, school attendance and engagement and exclusions, workplace engagement, wellbeing, costs and associated economic outcomes and adverse events. Data Collection and Analysis We included 43 studies (3 quantitative, 38 qualitative and 2 mixed methods). We used standard methodological procedures expected by The Campbell Collaboration. We used GRADE and GRADE CERQual to assess the certainty of and confidence in the evidence for quantitative and qualitative data respectively. Main Results We found insufficient evidence from quantitative studies to support or refute the effectiveness of arts interventions for CYP at-risk of or who have offended for any outcome. Qualitative evidence suggested that arts interventions may lead to positive emotions, the development of a sense of self, successful engagement in creative practices, and development of positive personal relationships. Arts interventions may need accessible and flexible delivery and are likely to be engaging if they have support from staff, family and community members, are delivered by professional artists, involve culturally relevant activity, a youth focus, regularity and a sustainable strategy. We found limited evidence that a lack of advocacy, low funding, insufficient wider support from key personnel in adjacent services could act as barriers to success. Methodological limitations resulted in a judgement of very low confidence in these findings. Authors' Conclusions We found insufficient evidence from quantitative studies to support or refute the effectiveness of arts interventions for CYP at-risk of offending or who have offended for any outcome. We report very low confidence about the evidence for understanding the processes influencing the successful design and delivery of arts interventions in this population of CYP and their impact on behavioural, psychosocial, cognitive and offending outcomes.
Collapse
Affiliation(s)
| | | | - Neil E. O'Connell
- Department of Health Sciences, Centre for Health and Wellbeing Across the LifecourseBrunel University LondonUxbridgeUK
| | | | - Louise Forde
- Brunel Law SchoolBrunel University LondonUxbridgeUK
| | - Robyn Smith
- Life SciencesBrunel University LondonLondonUK
| | - Jake Gifford
- Department of Life SciencesBrunel University LondonUxbridgeUK
| | | |
Collapse
|
26
|
Phillips R, Hilton C, Sousa Filho LF, Farlie M, Morrissey D, Malliaras P. Behaviour change and rehabilitation adherence in adults with tendinopathy: a scoping review. Disabil Rehabil 2024:1-13. [PMID: 38420953 DOI: 10.1080/09638288.2024.2320832] [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: 10/30/2023] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE This scoping review aimed to identify behaviour change strategies influencing rehabilitation adherence in adults with tendinopathy, a common musculoskeletal condition requiring prolonged rehabilitation with poor adherence and variable outcomes. METHODS Following the Joanna Briggs Institute (JBI) methodology, seven databases were searched until April 2023. Records included reviews, intervention, and qualitative studies published in English. Behaviour change strategies were deductively coded and mapped to the capability, opportunity, and motivation model of behaviour (COM-B). RESULTS Eighty-six articles were retained. The primary behaviour change strategies in tendinopathy rehabilitation reports addressed Psychological Capability; from knowledge through education, instruction, and self-monitoring using exercise diaries. Also, Social Opportunity involves demonstration and monitoring of rehabilitation behaviour, and Physical Opportunity focuses on time-efficient programs with access to equipment and health professionals. Few reports addressed Automatic Motivation (positive reinforcement and habit formation). Barriers identified in the reports were Reflective Motivation (negative beliefs and fears), Physical Opportunity (time-constraints), and Physical Capability (pain and comorbidities). CONCLUSIONS Further research should explore the impact of education on beliefs, fears, and pain-management, as well as the effectiveness of teaching habit formation for improved time-management. Implementing these behaviour change strategies may enhance tendinopathy rehabilitation adherence, improving clinical trial efficacy, guiding clinical practice, and impacting patient outcomes.
Collapse
Affiliation(s)
- Rebecca Phillips
- Physiotherapy Department, Monash University, Melbourne, Australia
| | | | | | - Melanie Farlie
- Physiotherapy Department, Monash University, Melbourne, Australia
| | - Dylan Morrissey
- Physiotherapy Department, Barts Health NHS Trust, London, UK
- Sport and Exercise Medicine, Queen Mary University of London, London, UK
| | - Peter Malliaras
- Physiotherapy Department, Monash University, Melbourne, Australia
| |
Collapse
|
27
|
Hoffmann WG, Chen YQ, Schwartz CS, Barber JL, Dev PK, Reasons RJ, Miranda Maravi JS, Armstrong B, Gerszten RE, Silbernagel G, Konrad RJ, Bouchard C, Sarzynski MA. Effects of exercise training on ANGPTL3/8 and ANGPTL4/8 and their associations with cardiometabolic traits. J Lipid Res 2024; 65:100495. [PMID: 38160757 PMCID: PMC10832466 DOI: 10.1016/j.jlr.2023.100495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/03/2024] Open
Abstract
Angiopoietin-like protein (ANGPTL) complexes 3/8 and 4/8 are established inhibitors of LPL and novel therapeutic targets for dyslipidemia. However, the effects of regular exercise on ANGPTL3/8 and ANGPTL4/8 are unknown. We characterized ANGPTL3/8 and ANGPTL4/8 and their relationship with in vivo measurements of lipase activities and cardiometabolic traits before and after a 5-month endurance exercise training intervention in 642 adults from the HERITAGE (HEalth, RIsk factors, exercise Training And GEnetics) Family Study. At baseline, higher levels of both ANGPTL3/8 and ANGPTL4/8 were associated with a worse lipid, lipoprotein, and cardiometabolic profile, with only ANGPTL3/8 associated with postheparin LPL and HL activities. ANGPTL3/8 significantly decreased with exercise training, which corresponded with increases in LPL activity and decreases in HL activity, plasma triglycerides, apoB, visceral fat, and fasting insulin (all P < 5.1 × 10-4). Exercise-induced changes in ANGPTL4/8 were directly correlated to concomitant changes in total cholesterol, LDL-C, apoB, and HDL-triglycerides and inversely related to change in insulin sensitivity index (all P < 7.0 × 10-4). In conclusion, exercise-induced decreases in ANGPTL3/8 and ANGPTL4/8 were related to concomitant improvements in lipase activity, lipid profile, and cardiometabolic risk factors. These findings reveal the ANGPTL3-4-8 model as a potential molecular mechanism contributing to adaptations in lipid metabolism in response to exercise training.
Collapse
Affiliation(s)
| | - Yan Q Chen
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Charles S Schwartz
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Jacob L Barber
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA; Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Prasun K Dev
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Riley J Reasons
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | | | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Robert E Gerszten
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Günther Silbernagel
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Robert J Konrad
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Mark A Sarzynski
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA.
| |
Collapse
|
28
|
Weiß M, Mende E, Schaller N, Krusemark H, Spanier B, Zelger O, Bischof J, Haller B, Halle M, Siegrist M. Adherence and potential factors of adherence to a resistance, coordination and endurance training in older retirement home residents over 6 months. Scand J Med Sci Sports 2024; 34:e14576. [PMID: 38339790 DOI: 10.1111/sms.14576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/19/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION High exercise adherence is a key factor for effective exercise programmes. However, little is known about predictors of exercise adherence to a multimodal machine-based training in older retirement home residents. AIMS To assess exercise adherence and potential predictors of adherence. Furthermore, to evaluate user acceptance of the multimodal training and the change in exercise self-efficacy. METHODS In this sub-analysis of the bestform-F study, a total of 77 retirement home residents ≥65 years (mean age: 85.6 ± 6.6 years, 77.9% female) participated in a 6-month machine-based resistance, coordination and endurance training. Attendance to the training was documented for each training session. To identify potential predictors a multiple linear regression model was fitted to the data. Analyzed predictors included age, sex, body mass index (BMI), physical function, exercise self-efficacy, and physical activity history. Different domains of user acceptance (e.g. safety aspects, infrastructure) and exercise self-efficacy were assessed by a questionnaire and the exercise self-efficacy scale (ESES), respectively. RESULTS Mean exercise adherence was 67.2% (median: 74.4%). The regression model (R2 = 0.225, p = 0.033) revealed that the 6-minute walk test (6-MWT) at baseline significantly predicted exercise adherence (β: 0.074, 95% confidence interval (CI): 0.006-0.142, p = 0.033). Different user domains were rated at least as good by 83.9%-96.9% of participants, reflecting high acceptance. No statistically significant change was found for exercise self-efficacy over 6 months (mean change: 0.47 ± 3.08 points, p = 0.156). CONCLUSION Retirement home residents attended more than two thirds of offered training sessions and physical function at baseline was the key factor for predicting adherence. User acceptance of the training devices was highly rated. These findings indicate good potential for implementation of the exercise programme.
Collapse
Affiliation(s)
- Michael Weiß
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Esther Mende
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nina Schaller
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Helge Krusemark
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Bianca Spanier
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Otto Zelger
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan Bischof
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Martin Halle
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- DZHK (German Center for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany
| | - Monika Siegrist
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| |
Collapse
|
29
|
Rocha P, Baixinho CL, Marques A, Henriques MA. Safety-promoting interventions for the older person with hip fracture on returning home: A systematic review. Int J Orthop Trauma Nurs 2024; 52:101063. [PMID: 37956633 DOI: 10.1016/j.ijotn.2023.101063] [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: 08/11/2023] [Revised: 10/14/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Older adults with a prior history of falls that results in hip fractures have difficulties in regaining pre-fracture functional capacity. Scientific evidence has shown benefits of the implementation of multidimensional rehabilitation programs, but this evidence is not systematized with regard to continuity of care after hospital discharge. OBJECTIVE To identify interventions that promote safety and functional recovery of older adults with hip fractures after hospital discharge. METHOD A systematic review was carried out according to Cochrane methodology. The research strategy was predefined for the MEDLINE and CINAHL databases. The identified articles were screened according to the eligibility criteria by two independent reviewers. The articles included in the bibliographic sample were evaluated for risk of bias. RESULTS Of the 10,036 articles found, 10 were included in this systematic review. The safety-promoting interventions identified were: exercise training, occupational therapy/activities of daily living training, transfer and gait training, strengthening exercises, education on assistive device use, fall prevention education, nutritional assessment, environmental modifications/adjustments at home, use of an app, medication, self-care education, and support and counseling. CONCLUSIONS In eight studies analyzed, exercise training emerged as the most effective intervention for promoting the safety of older adults after hip fractures on returning home. Three studies associated two or more interventions, which focused on exercise training, occupational therapy/training of activities of daily living, and conventional postoperative rehabilitation with transfer and gait training, strengthening exercises, education on assistive device use and discharge planning, aiming to achieve muscle strengthening and safe gait, associated with the performance of activities of daily living.
Collapse
Affiliation(s)
- Paula Rocha
- Higher School of Health of Viseu; Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), 1900-160, Lisboa, Portugal; Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), 1600-190, Lisboa, Portugal.
| | - Cristina Lavareda Baixinho
- Nursing School of Lisbon, 1900-160, Lisboa, Portugal; Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), 1600-190, Lisboa, Portugal; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2411-901, Leiria, Portugal.
| | - Andrea Marques
- Nursing School of Coimbra, Health Sciences Research Unit: Nursing (UICISA:E), 3000-232, Coimbra, Portugal; Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, 3000-071, Coimbra, Portugal.
| | - Maria Adriana Henriques
- Nursing School of Lisbon, 1900-160, Lisboa, Portugal; Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), 1600-190, Lisboa, Portugal.
| |
Collapse
|
30
|
Pamukoff DN, Holmes SC, Heredia CE, Shumski EJ, Garcia SA, Montgomery MM. Cartilage deformation following a walking bout in individuals with anterior cruciate ligament reconstruction. J Orthop Res 2024; 42:349-359. [PMID: 37772457 DOI: 10.1002/jor.25694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/16/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023]
Abstract
The purpose was to (1) compare the effect of a walking bout on femoral cartilage deformation between limbs with and without anterior cruciate ligament reconstruction (ACLR) and (2) examine the association between gait kinetics and the magnitude of cartilage deformation. A total of 30 individuals with primary unilateral ACLR completed this study [14 male, 16 female; age = 22.57 (3.78) years; body mass index (BMI) = 25.88 (5.68) kg/m2 ; time since ACLR = 61.00 (16.43) months]. Overground walking biomechanics were assessed on day 1, and a 30-min walking bout or 30-min resting bout (control) were completed on days 2 and 3 (counterbalanced order). Femoral cartilage thickness was measured using ultrasound before, immediately following, and 30-min following each intervention. Linear mixed effects models compared the effect of walking on cartilage thickness between the ACLR and contralateral limbs after adjusting for sex, BMI, speed, and the number of steps. Stepwise regression examined the association between the external knee flexion and adduction moments and cartilage deformation following walking. There was a significant limb × time interaction for medial cartilage thickness. Post hoc analyses indicated that cartilage thickness decreased immediately following walking in the contralateral but not ACLR limb. Main effects of limb were observed for medial, central, and lateral cartilage thickness indicating thicker cartilage in the ACLR compared with contralateral limb. A higher knee adduction moment was associated with greater cartilage deformation in the ACLR limb. Femoral cartilage in the ACLR limb exhibited a less dynamic response to walking than the uninvolved limb, which may be due to habitual underloading during gait.
Collapse
Affiliation(s)
- Derek N Pamukoff
- School of Kinesiology, Western University, London, Ontario, Canada
| | - Skylar C Holmes
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | | | - Eric J Shumski
- Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Steven A Garcia
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Melissa M Montgomery
- Department of Kinesiology, California State University, Fullerton, Fullerton, California, USA
| |
Collapse
|
31
|
Di Bonaventura S, Fernández Carnero J, Ferrer-Peña R. Can a specific biobehavioral-based therapeutic education program lead to changes in pain perception and brain plasticity biomarkers in chronic pain patients? A study protocol for a randomized clinical trial. PLoS One 2024; 19:e0289430. [PMID: 38241249 PMCID: PMC10798500 DOI: 10.1371/journal.pone.0289430] [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: 07/27/2023] [Accepted: 12/01/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Chronic pain conditions are complex multifactorial disorders with physical, psychological, and environmental factors contributing to their onset and persistence. Among these conditions, the role of brain-derived neurotrophic factor (BDNF) and the impact of a specific therapeutic education (TE) on pain management have emerged as important areas of research. OBJECTIVE This study aims to investigate the effects of a specific type of therapeutic education on pain levels and BDNF concentrations. METHODS In this single-blind, randomized clinical trial, patients will be randomly assigned to one of two groups: one will receive exercise with TE and the other without TE. Assessments will be made at baseline, mid-treatment, post-intervention, and at one and eight months. OUTCOMES This study will shed light on the effectiveness of a therapeutic education (TE) program in pain management. Additionally, it will provide information on its effects on BDNF levels, a biomarker of brain plasticity, as well as on various psychosocial variables that can influence pain experience. CONCLUSION By comprehensively addressing the need to quantify brain changes more precisely in individuals with chronic pain during interventions like TE and recognizing the importance of establishing a more structured and comprehensive protocol, this study lays a solid and replicable foundation for future evidence-based treatment developments.
Collapse
Affiliation(s)
- Silvia Di Bonaventura
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Josué Fernández Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, Madrid, Spain
| | - Raúl Ferrer-Peña
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, Madrid, Spain
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, CSEU La Salle, Universidad Autonóma de Madrid, Madrid, Spain
| |
Collapse
|
32
|
Sigg S, Zeidler K, Fankhauser CD. Is It Worth the Sweat? Prehabilitation in Uro-oncology: A Mini Review. Eur Urol Focus 2024; 10:29-31. [PMID: 37940390 DOI: 10.1016/j.euf.2023.10.022] [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: 10/19/2023] [Accepted: 10/28/2023] [Indexed: 11/10/2023]
Abstract
In several surgical specialities, exercise as part of a prehabilitation program enhances recovery. However, for uro-oncological patients, evidence up to 2020 did not demonstrate significant benefits in terms of postoperative complications or hospital length of stay (LOS). We reviewed the literature from 2020 to 2023 and screened 205 reports, of which four full texts were included. Two retrospective cohort studies, despite having potential confounding risks, indicated that preoperative exercise might reduce LOS. One of these studies also suggested a lower likelihood of complications. Present evidence hints at the potential benefits of embedding exercise in prehabilitation for uro-oncological patients, particularly for short-term functional results. However, evidence on a direct effect on postoperative complications and LOS is still inconclusive. Future research should prioritise identification of specific exercises (eg, anaerobic vs aerobic, strength training, endurance, or respiratory exercises) that yield the most cost-effective benefits. PATIENT SUMMARY: Recent studies suggest that exercising before surgery might help people with urological cancers to improve their short-term fitness. More research is needed to see if exercise before surgery shortens hospital stays or reduces complications.
Collapse
Affiliation(s)
- Silvan Sigg
- Department of Urology, Luzerner Kantonsspital, University of Lucerne, Lucerne, Switzerland
| | - Kristin Zeidler
- Department of Oncology, Luzerner Kantonsspital, University of Lucerne, Lucerne, Switzerland
| | - Christian Daniel Fankhauser
- Department of Urology, Luzerner Kantonsspital, University of Lucerne, Lucerne, Switzerland; University of Lucerne, Lucerne, Switzerland; University of Zurich, Zurich, Switzerland.
| |
Collapse
|
33
|
Delgado A, Amorim MM, Oliveira ADAP, Souza Amorim KC, Selva MW, Silva YE, Lemos A, Katz L. Active pelvic movements on a Swiss ball reduced labour duration, pain, fatigue and anxiety in parturient women: a randomised trial. J Physiother 2024; 70:25-32. [PMID: 38036399 DOI: 10.1016/j.jphys.2023.11.001] [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: 07/07/2022] [Revised: 08/30/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Abstract
QUESTION How much do active pelvic movements on a Swiss ball during labour affect maternal and neonatal outcomes? METHOD A randomised trial with concealed allocation, blinded assessors and intention-to-treat analysis. PARTICIPANTS Two-hundred parturient women. INTERVENTION The experimental group performed pelvic anteversion and retroversion, lateral pelvic tilts and circular hip movements according to individual obstetric evaluation (foetal station and position, cervical dilatation and the presence of early pushing urge) on a Swiss ball. The control group received usual care. Both groups were permitted to walk and shower. OUTCOME MEASURES The primary outcome was the duration of the first stage of labour. The secondary outcomes were the duration of the second stage of labour, pain intensity, delivery mode, medication use, local swelling, fatigue, anxiety, satisfaction and neonatal outcomes. RESULTS The experimental intervention reduced the duration of labour by 179 minutes (95% CI 146 to 213) in stage one and 19 minutes (95% CI 13 to 25) in stage two. It decreased pain by approximately 2 points (95% CI 2 to 2) on a 0-to-10 scale at 30, 60 and 90 minutes. It reduced the risk of a caesarean section (ARR 0.14, 95% CI 0.03 to 0.25; NNT 7, 95% CI 4 to 32) and vulvar swelling (ARR 0.11, 95% CI 0.03 to 0.19; NNT 9, 95% CI 5 to 31). It reduced fatigue by 18 points (95% CI 16 to 21) on a 15-to-75-point scale and anxiety by 9 points (95% CI 8 to 11) on an 18-to-72-point scale. Other effects were negligible or unclear. CONCLUSION Active pelvic movements on a Swiss ball during labour reduced the duration of labour, pain intensity, and maternal fatigue and anxiety; they also lowered the risk of caesarean section and vulvar swelling. Several effects exceeded the smallest worthwhile effect. REGISTRATION NCT04124835.
Collapse
Affiliation(s)
- Alexandre Delgado
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil.
| | - Melania M Amorim
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil; Medical Academic Unit, Federal University of Campina Grande, Campina Grande, Brazil
| | | | | | | | | | - Andrea Lemos
- Physical Therapy Department, Universidade Federal de Pernambuco, Recife, Brazil
| | - Leila Katz
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil
| |
Collapse
|
34
|
Groen LC, van Gestel T, Daams F, van den Heuvel B, Taveirne A, Bruns ER, Schreurs HW. Community-based prehabilitation in older patients and high-risk patients undergoing colorectal cancer surgery. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107293. [PMID: 38039905 DOI: 10.1016/j.ejso.2023.107293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/21/2023] [Accepted: 11/17/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION Prehabilitation before colorectal cancer (CRC) surgery is promising to prevent complications and to enhance recovery, especially in patients aged 70 or older or in patients with an American Society of Anaesthesiologist (ASA) physical classification score 3-4, for whom surgery is associated with higher postoperative complications and long-lasting adverse effects on functional performance. MATERIALS AND METHODS A cohort study was conducted in a large teaching hospital in Alkmaar, the Netherlands. Fifty CRC patients (≥70 years or ASA 3-4) underwent multimodal prehabilitation between September 2020 and July 2021. The reference group comprised 50 patients (≥70 years or ASA 3-4) from a historical cohort receiving CRC surgery without prehabilitation (March 2020-August 2020). The primary outcome was 90-day postoperative complication rate. Secondary outcomes were length of stay, 90-day readmission and mortality rates and functional outcome in the prehabilitation group. RESULTS One patient in the prehabilitation group decided not to undergo surgery. Of the remaining 49 patients, 48 (98.0 %) received prehabilitation for at least 3 weeks. Of these patients, 32.7 % developed postoperative complications, compared to 58 % in the reference group (p = 0.015), and none were readmitted, in contrast to 6 reference group patients (12.0 %, p = 0.012). Length of stay and mortality did not differ significantly. Six weeks postoperatively, all functional outcomes in the prehabilitation group were significantly higher than at baseline. CONCLUSIONS Prehabilitation reduced postoperative complications and improved short-term functional outcomes in older and high-risk patients receiving CRC surgery. Further research should investigate the maintenance of long-term enhanced lifestyle and the effects of tailor-made programs.
Collapse
Affiliation(s)
- Lennaert Cb Groen
- Department of Surgery, Northwest Clinics, Alkmaar, NL, the Netherlands.
| | - Tess van Gestel
- Department of Surgery, Northwest Clinics, Alkmaar, NL, the Netherlands
| | - Freek Daams
- Department of Surgery, Academic University Medical Center, Location VU, Amsterdam, NL, the Netherlands; Cancer Center Amsterdam, Amsterdam, NL, the Netherlands
| | - Baukje van den Heuvel
- Department of Operational Theaters, Radboud University Medical Center, Nijmegen, NL, the Netherlands
| | - Ann Taveirne
- Physiotherapy for Oncology Patients, Heiloo, NL, the Netherlands
| | - Emma Rj Bruns
- Department of Surgery, Academic University Medical Center, Location VU, Amsterdam, NL, the Netherlands
| | | |
Collapse
|
35
|
Lakicevic N, Ficarra S, Ortega-Gómez S, Jiménez-Pavón D, Asimakopoulou Z, Vantarakis A, Tavares P, Vaz V, Thaller J, Papakonstantinou S, Kirkar M, Glorioso F, Palma A, Bianco A. One more rep! The case for resistance training in young cancer survivors. Front Oncol 2023; 13:1284052. [PMID: 38111526 PMCID: PMC10726118 DOI: 10.3389/fonc.2023.1284052] [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: 08/27/2023] [Accepted: 11/06/2023] [Indexed: 12/20/2023] Open
Abstract
Resistance training is now seen as a powerful tool to improve the health and functionality of cancer survivors. Literature shows that it can be implemented both during and after cancer treatment, with the intent of preserving muscle mass in the former and increasing muscle mass in the latter case. However, currently available data on this matter are predominantly derived from adult cancer survivors (ACS), and it is questionable whether the exact same raining regimen should be implemented in young cancer survivors (YCS) given the unique challenges they experience throughout their disease trajectory. Therefore, the goal of this work is to distill the existing evidence on resistance training (RT) interventions in ACS and facilitate discussion on whether the same patterns of RT can be applied in YCS.
Collapse
Affiliation(s)
- Nemanja Lakicevic
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Salvatore Ficarra
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Sonia Ortega-Gómez
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cadiz, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cadiz, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Zoi Asimakopoulou
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Apostolos Vantarakis
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Paula Tavares
- Faculty of Sport Sciences and Physical Education and ICBR Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Vasco Vaz
- Faculty of Sport Sciences and Physical Education and ICBR Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Joshua Thaller
- Department of Health Consulting, Research and Science, Outdoor Against Cancer, Munich, Germany
| | | | - Musa Kirkar
- Centro Internazionale per la Promozione dell’educazione e lo Sviluppo (CEIPES), Palermo, Italy
| | - Francesca Glorioso
- Lega Italiana per la lotta Contro i Tumori (LILT Palermo), Palermo, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| |
Collapse
|
36
|
Lawrason SVC, Shaw RB, Turnnidge J, Côté J. Characteristics of transformational leadership development programs: A scoping review. EVALUATION AND PROGRAM PLANNING 2023; 101:102354. [PMID: 37611362 DOI: 10.1016/j.evalprogplan.2023.102354] [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: 04/29/2021] [Revised: 07/05/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
Abstract
The effectiveness of transformational leadership (TFL) on various outcomes is well known. Accordingly, researchers have developed training programs to enhance TFL behaviours of leaders. Yet, no reviews summarizing the characteristics of TFL training programs exist. The purpose of this review was to examine the characteristics, reporting, and application of TFL-informed programs. A search of six databases yielded 4032 articles, 31 of which met the inclusion criteria. Program characteristics were analyzed using the Template for Intervention Description and Replication (TIDieR) checklist tool, while outcomes were analyzed according to the Kirkpatrick model of evaluation. The most common context for TFL program implementation was healthcare (n = 9). Programs were tailored and often delivered using group workshops and individual feedback. Studies reported variation in the dose of programs, rarely evaluated outcomes multiple times post-baseline, and typically employed Level 3a (subjective ratings of behaviour) evaluation measures. Reporting on program location, modifications, and fidelity was poor. Varying conceptualizations of TFL in different contexts lead to disparities in programs and protocols. Evaluation specialists should consider using tools like the TIDiER checklist to ensure that program characteristics are reported appropriately. Program planners should develop common approaches for planning and evaluating TFL programs to improve transparency and replicability of programs.
Collapse
Affiliation(s)
- Sarah V C Lawrason
- University of British Columbia Okanagan School of Health & Exercise Sciences, 1147 Research Rd., Kelowna, BC V1V 1V7, Canada.
| | - Robert B Shaw
- University of British Columbia Okanagan School of Health & Exercise Sciences, 1147 Research Rd., Kelowna, BC V1V 1V7, Canada
| | - Jennifer Turnnidge
- Queen's University, School of Kinesiology & Health Studies, 28 Division St., Kingston, ON K7L 3N6, Canada
| | - Jean Côté
- Queen's University, School of Kinesiology & Health Studies, 28 Division St., Kingston, ON K7L 3N6, Canada
| |
Collapse
|
37
|
Meneses-Echavez JF, Loaiza-Betancur AF, Díaz-López V, Echavarría-Rodríguez AM, Triana-Reina HR. Prehabilitation programs for individuals with cancer: a systematic review of randomized-controlled trials. Syst Rev 2023; 12:219. [PMID: 37978411 PMCID: PMC10655304 DOI: 10.1186/s13643-023-02373-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/24/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Prehabilitation programs focusing on exercise training as the main component are known as a promising alternative for improving patients' outcomes before cancer surgery. This systematic review determined the benefits and harms of prehabilitation programs compared with usual care for individuals with cancer. METHODS We searched CENTRAL, MEDLINE, and EMBASE from inception to June 2022, and hand searched clinical trial registries. We included randomized-controlled trials (RCTs) in adults, survivors of any type of cancer, that compared prehabilitation programs that had exercise training as the major component with usual care or other active interventions. Outcome measures were health-related quality of life (HRQL), muscular strength, postoperative complications, average length of stay (ALOS), handgrip strength, and physical activity levels. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias and the certainty of the evidence. RESULTS Twenty-five RCTs (2682 participants) published between 2010 and 2022 met our inclusion criteria. Colorectal and lung cancers were the most common diagnoses. The studies had methodological concerns regarding outcome measurement, selective reporting, and attrition. Five prehabilitation programs were compared to usual care (rehabilitation): combined training, aerobic training, respiratory muscle training plus aerobic training, respiratory muscle training plus resistance training, and pelvic floor training. The studies provided no clear evidence of an effect between groups. We assessed the overall certainty of the evidence as very low, downgraded due to serious study limitations and imprecision. CONCLUSION Prehabilitation programs focusing on exercise training may have an effect on adults with cancer, but the evidence is very uncertain. We have very little confidence in the results and the true effect is likely to be substantially different from these. Further research is needed before we can draw a more certain conclusion. SYSTEMATIC REVIEW REGISTRATION CRD42019125658.
Collapse
Affiliation(s)
- Jose F Meneses-Echavez
- Division for Health Services, Norwegian Institute of Public Health, Sandakerveien 24C, Building D11, Oslo, Norway.
- Facultad de Cultura Física, Deporte y Recreación. GICAEDS, Universidad Santo Tomás, Bogotá, Colombia.
| | - Andrés F Loaiza-Betancur
- Universidad de Antioquia. Instituto Universitario de Educación Física, Medellín, Colombia
- Grupo de Investigación en Entrenamiento Deportivo y Actividad Física Para La Salud (GIEDAF), Universidad Santo Tomás, Tunja, Colombia
| | - Víctor Díaz-López
- Universidad de Antioquia. Instituto Universitario de Educación Física, Medellín, Colombia
| | | | | |
Collapse
|
38
|
Dawson R, Pinheiro M, Nagathan V, Taylor M, Delbaere K, Olivera J, Haynes A, Rayner J, Hassett L, Sherrington C. Physiotherapy-led telehealth and exercise intervention to improve mobility in older people receiving aged care services (TOP UP): protocol for a randomised controlled type 1 hybrid effectiveness-implementation trial. BMJ Nutr Prev Health 2023; 6:273-281. [PMID: 38618537 PMCID: PMC11009537 DOI: 10.1136/bmjnph-2022-000606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 10/30/2023] [Indexed: 04/16/2024] Open
Abstract
Introduction Deteriorating mobility and falls reduce independence and quality of life for older people receiving aged care services. This trial aims to establish effectiveness on the mobility of older people, and explore cost-effectiveness and implementation of a telehealth physiotherapy programme. Method and analysis This type 1 hybrid effectiveness-implementation randomised controlled trial will involve 240 people aged 65+ years receiving aged care services in community or residential settings. Participants will be randomised to either: (1) the Telehealth Physiotherapy for Older People (TOP UP) Program or (2) a wait-list control group. The 6-month intervention includes 10 physiotherapy sessions delivered by videocall (Zoom). The intervention will include the local support of an aged care worker and online exercise resources. Primary outcome is mobility at 6 months post randomisation measured by the Short Physical Performance Battery. Secondary outcomes include rate of falls, sit-to-stand, quality of life, and goal attainment at 6 months after randomisation. Regression models will assess the effect of group allocation on mobility and the other continuously scored secondary outcomes, adjusting for baseline scores. The number of falls per person over 6 months will be analysed using negative binomial regression models to estimate between-group differences. An economic analysis will explore the cost-effectiveness of the TOP UP programme compared with usual care. Implementation outcomes and determinants relating to the intervention's reach, fidelity, exercise dose delivered, adoption, feasibility, acceptability, barriers and facilitators will be explored using mixed methods. Conclusion This is the first trial to investigate the effectiveness, cost-effectiveness and implementation of a physiotherapy intervention in aged care delivered solely by telehealth internationally. The study has strong aged care co-design and governance and is guided by steering and advisory committees that include staff from aged care service providers and end-users. Trial results will be disseminated via peer-reviewed articles, conference presentations and lay summaries. Trial registration number The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12621000734864).
Collapse
Affiliation(s)
- Rik Dawson
- Sydney Musculoskeletal Health, Faculty of Health and Medicine, School of Public Health, The University of Sydney Institute for Musculoskeletal Health, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Marina Pinheiro
- Sydney Musculoskeletal Health, Faculty of Health and Medicine, School of Public Health, The University of Sydney Institute for Musculoskeletal Health, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Vasikaran Nagathan
- Faculty of Health and Medicine, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Geriatric Medicine, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Morag Taylor
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Juliana Olivera
- Sydney Musculoskeletal Health, Faculty of Health and Medicine, School of Public Health, The University of Sydney Institute for Musculoskeletal Health, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Abby Haynes
- Sydney Musculoskeletal Health, Faculty of Health and Medicine, School of Public Health, The University of Sydney Institute for Musculoskeletal Health, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Jenny Rayner
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Leanne Hassett
- Sydney Musculoskeletal Health, Faculty of Health and Medicine, School of Public Health, The University of Sydney Institute for Musculoskeletal Health, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, Faculty of Health and Medicine, School of Public Health, The University of Sydney Institute for Musculoskeletal Health, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
| |
Collapse
|
39
|
Tsironikos GI, Potamianos P, Zakynthinos GE, Tsolaki V, Tatsioni A, Bargiota A. Effectiveness of Lifestyle Interventions during Pregnancy on Preventing Gestational Diabetes Mellitus in High-Risk Women: A Systematic Review and Meta-Analyses of Published RCTs. J Clin Med 2023; 12:7038. [PMID: 38002654 PMCID: PMC10672732 DOI: 10.3390/jcm12227038] [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: 10/07/2023] [Revised: 11/01/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Until now, it is uncertain whether lifestyle interventions during pregnancy can prevent gestational diabetes mellites (GDM) in high-risk pregnant women. OBJECTIVE This study aims at investigating the effectiveness of dietary interventions and/or exercise interventions during pregnancy for preventing GDM in high-risk pregnant women. MATERIALS AND METHODS Eligible randomized controlled trials (RCTs) were selected after a search in CENTRAL, Scopus, and PubMed. Synthesis was performed for the outcome of GDM in women with any identified GDM risk factor. Separate meta-analyses (MA) were performed to assess the efficacy of either nutrition or physical activity (PA) interventions or both combined compared with standard prenatal care for preventing GDM. Subgroup and sensitivity analyses, as well as meta-regressions against OR, were performed to assess potentional heterogeneity. Overall quality, the quality of RCTs, and publication bias were also evaluated. RESULTS A total of 13,524 participants comprising high-risk pregnant women in 41 eligible RCTs were analyzed for GDM. Women receiving only a nutrition intervention during pregnancy were less likely to experience GDM compared with women following standard prenatal care. Among 3109 high-risk pregnant women undergoing only dietary intervention for preventing GDM, 553 (17.8%) developed GDM; however, the result of the MA was marginally not significant (OR 0.73, 95%CI 0.51, 1.03; p-value 0.07), (Q 21.29, p-value 0.01; I2 58% (95%CI 10, 78%)). Subgroup analyses demonstrated an effect for studies that were conducted in Great Britain (OR 0.65, 95%CI 0.49, 0.81; p-value 0.003), and in Spain (OR 0.50, 95%CI 0.27, 0.94; p-value 0.03), for studies with forms of the Mediterranean diet as the intervention's component (OR 0.61; 95%CI 0.46, 0.81; p-value 0.0005), and for studies including a motivation arm in the intervention (OR 0.71, 95%CI 0.58, 0.87; p-value 0.0008). Among 2742 high-risk pregnant women being analyzed for GDM outcome after receiving only an exercise intervention, 461 (16.8%) were diagnosed with GDM. Women after receiving PA intervention were less likely to develop GDM (OR 0.64, 95%CI 0.51, 0.80; p-value < 0.0001), (Q 11.27, p-value 0.51; I2 0% (95%CI 0, 99%)). Finally, 1308 (17%) cases of GDM were diagnosed among 7673 high-risk pregnant women undergoing both diet and PA intervention. Women in the group of mixed lifestyle intervention had a significant reduction in incidence of GDM (OR 0.70, 95%CI 0.55, 0.90; p-value 0.005), (Q 50.32, p-value < 0.0001, I2 66%, (95% CI 44, 79%)). CONCLUSIONS The results of this study support the efficacy of lifestyle interventions during pregnancy for preventing GDM in high-risk women if an exercise component is included in the intervention arm, either alone, or combined with diet. A combined lifestyle intervention including physical exercise and a Mediterranean diet accompanied by motivation support may be considered the most effective way to prevent GDM among high-risk women during pregnancy. Future research is needed to strengthen these findings.
Collapse
Affiliation(s)
- Georgios I. Tsironikos
- Department of Medicine, University of Ioannina, University Campus, 45110 Ioannina, Greece;
| | - Petros Potamianos
- Department of Gastroenterology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo, 41335 Larissa, Greece;
| | - George E. Zakynthinos
- 3rd Department of Cardiology, “Sotiria” Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Vasiliki Tsolaki
- Department of Critical Care, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo, 41335 Larissa, Greece
| | - Athina Tatsioni
- Department of Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, University of Ioannina, University Campus, 45110 Ioannina, Greece;
| | - Alexandra Bargiota
- Department of Internal Medicine-Endocrinology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo, 41335 Larissa, Greece;
| |
Collapse
|
40
|
Dalgas U, Riemenschneider M, Gold SM, Kalron A, Beckerman H, de Groot V, Dennett R, Edwards T, Pilutti LA, Freeman J. The MoXFo initiative - study design: Considerations related to study design and methodology in exercise research for people with multiple sclerosis. Mult Scler 2023; 29:1561-1568. [PMID: 37880962 DOI: 10.1177/13524585231204456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
BACKGROUND Exercise as a subset of physical activity is a cornerstone in the management of multiple sclerosis (MS) based on its pleiotropic effects, but continued progression of the field requires better future designs and methodologies. OBJECTIVES This paper outlines the work of the 'Study design and methodology' group of the MoXFo (moving exercise research forward) initiative, and addresses critical aspects and future directions when defining the research question of interest, and subsequently, designing the study and exercise intervention in MS patients. METHODS The work is based on the formation of an international expert panel formed within the MoXFo initiative. We provide a structured and concise synthesis of exercise-specific MS research challenges and considerations when designing randomized controlled trials (RCTs). RESULTS Challenges and considerations are presented using the Patient population, Intervention, Comparator, Outcomes, Timing, Setting (PICOTS) framework, thereby forming a new and specific MS exercise PICOTS framework. CONCLUSION We propose that researchers should carefully consider and align all elements of this MS exercise PICOTS framework when developing future research questions and study designs, ultimately improving the quality of new exercise studies in people with MS.
Collapse
Affiliation(s)
- Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | | | - Stefan M Gold
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Section of Psychosomatic Medicine, Medical Department, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Alon Kalron
- Department of Physical Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neurosciences, Tel Aviv University, Tel Aviv, Israel
- Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Heleen Beckerman
- Amsterdam UMC location Vrije Universiteit, Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam, The Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Vincent de Groot
- Amsterdam UMC location Vrije Universiteit, Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam, The Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Rachel Dennett
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Thomas Edwards
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Jenny Freeman
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| |
Collapse
|
41
|
Hota M, Barber JL, Ruiz-Ramie JJ, Schwartz CS, Lam DTUH, Rao P, Mi MY, Katz DH, Robbins JM, Clish CB, Gerszten RE, Sarzynski MA, Ghosh S, Bouchard C. Omics-driven investigation of the biology underlying intrinsic submaximal working capacity and its trainability. Physiol Genomics 2023; 55:517-543. [PMID: 37661925 PMCID: PMC11178266 DOI: 10.1152/physiolgenomics.00163.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 07/21/2023] [Accepted: 08/31/2023] [Indexed: 09/05/2023] Open
Abstract
Submaximal exercise capacity is an indicator of cardiorespiratory fitness with clinical and public health implications. Submaximal exercise capacity and its response to exercise programs are characterized by heritability levels of about 40%. Using physical working capacity (power output) at a heart rate of 150 beats/min (PWC150) as an indicator of submaximal exercise capacity in subjects of the HERITAGE Family Study, we have undertaken multi-omics and in silico explorations of the underlying biology of PWC150 and its response to 20 wk of endurance training. Our goal was to illuminate the biological processes and identify panels of genes associated with human variability in intrinsic PWC150 (iPWC150) and its trainability (dPWC150). Our bioinformatics approach was based on a combination of genome-wide association, skeletal muscle gene expression, and plasma proteomics and metabolomics experiments. Genes, proteins, and metabolites showing significant associations with iPWC150 or dPWC150 were further queried for the enrichment of biological pathways. We compared genotype-phenotype associations of emerging candidate genes with reported functional consequences of gene knockouts in mouse models. We investigated the associations between DNA variants and multiple muscle and cardiovascular phenotypes measured in HERITAGE subjects. Two panels of prioritized genes of biological relevance to iPWC150 (13 genes) and dPWC150 (6 genes) were identified, supporting the hypothesis that genes and pathways associated with iPWC150 are different from those underlying dPWC150. Finally, the functions of these genes and pathways suggested that human variation in submaximal exercise capacity is mainly driven by skeletal muscle morphology and metabolism and red blood cell oxygen-carrying capacity.NEW & NOTEWORTHY Multi-omics and in silico explorations of the genes and underlying biology of submaximal exercise capacity and its response to 20 wk of endurance training were undertaken. Prioritized genes were identified: 13 genes for variation in submaximal exercise capacity in the sedentary state and 5 genes for the response level to endurance training, with no overlap between them. Genes and pathways associated with submaximal exercise capacity in the sedentary state are different from those underlying trainability.
Collapse
Affiliation(s)
- Monalisa Hota
- Centre for Computational Biology, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Jacob L Barber
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Jonathan J Ruiz-Ramie
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
- Department of Kinesiology, Augusta University, Augusta, Georgia, United States
| | - Charles S Schwartz
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Do Thuy Uyen Ha Lam
- Centre for Computational Biology, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Prashant Rao
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
| | - Michael Y Mi
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
| | - Daniel H Katz
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
| | - Jeremy M Robbins
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
| | - Clary B Clish
- Metabolomics Platform, Broad Institute, Boston, Massachusetts, United States
| | - Robert E Gerszten
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
| | - Mark A Sarzynski
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Sujoy Ghosh
- Centre for Computational Biology, Duke-National University of Singapore Medical School, Singapore, Singapore
- Bioinformatics Section, Human Genomics Core, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States
- Program in Cardiovascular and Metabolic Disorders, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States
| |
Collapse
|
42
|
Fernández-Matías R, García-Pérez F, Requejo-Salinas N, Gavín-González C, Martínez-Martín J, García-Valencia H, Flórez-García MT. Content reporting and effectiveness of therapeutic exercise in the management of massive rotator cuff tears: A systematic review with 490 patients. Shoulder Elbow 2023; 15:92-107. [PMID: 37974611 PMCID: PMC10649485 DOI: 10.1177/17585732221140113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2023]
Abstract
Background Massive rotator cuff tears (MRCT) account for a substantial fraction of tears above the age of 60 years. However, there are no clear criteria for prescription parameters within therapeutic exercise treatments. The aim of this study was to evaluate the effects and characteristics of therapeutic exercise treatments in patients with MRCT. Methods A systematic search was conducted in MEDLINE/PubMed, Web of Science, SPORTDiscus, SciELO, Scopus and EMBASE from inception to August 2022. Studies were included if they evaluated the effects of exercise on patients with MRCT. The risk of bias was evaluated and the Consensus on Exercise Reporting Template (CERT) was also used. A narrative synthesis without meta-analysis was performed. Results One randomized controlled trial, two non-randomized studies, six non-controlled studies, one case series and four retrospective studies were included. They ranged from serious to moderate risk of bias. The CERT reflected a poor description of the exercise programmes. Studies showed a pattern of improvements in most patient-reported outcome measures (PROM) surpassing the MCID, and active elevation range of motion. Conclusions There is limited evidence that exercise and co-interventions are effective in the management of some patients with MRCT, based on a systematic review without meta-analysis. Future research should improve content reporting. Level of evidence IV.
Collapse
Affiliation(s)
- Rubén Fernández-Matías
- Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
- Physiotherapy and Rehabilitation Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain
| | - Fernando García-Pérez
- Physiotherapy and Rehabilitation Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain
| | - Néstor Requejo-Salinas
- Department of Physical Therapy, Superior Center for University Studies La Salle, Autonomous University of Madrid, Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV). Superior Center for University Studies La Salle. Autonomous University of Madrid, Madrid, Spain
| | - Carlos Gavín-González
- Orthopedic Surgery and Traumatology Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain
| | - Javier Martínez-Martín
- Orthopedic Surgery and Traumatology Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain
| | - Homero García-Valencia
- Orthopedic Surgery and Traumatology Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain
| | | |
Collapse
|
43
|
Smith MD, Vuvan V, Collins NJ, Hunter DJ, Costa N, Smith MMF, Vicenzino B. Protocol for a randomised feasibility trial comparing a combined program of education and exercise versus general advice for ankle osteoarthritis. J Foot Ankle Res 2023; 16:72. [PMID: 37858226 PMCID: PMC10588035 DOI: 10.1186/s13047-023-00669-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Ankle osteoarthritis (OA) is a serious problem with high associated pain and disability. While education and exercise are recommended for the initial management of OA, this has not been investigated in ankle OA. The primary aim of this study is to establish the feasibility of running a full-scale randomised controlled trial (RCT) investigating a combined education and exercise program compared to a general advice program for people with ankle OA. The secondary aims are to collect preliminary data which will inform sample size calculations, and understand the perspectives of people with ankle OA on their participation in the trial. METHODS Thirty individuals aged 35 years or older with symptomatic radiographic ankle OA will be recruited from the community and randomised to receive either a combined education and exercise program or a general advice program, both of which will be delivered by a physiotherapist in a group setting. Primary outcomes of feasibility include responses to study advertisements, number of eligible participants, recruitment rate, adherence with the intervention, fidelity of the intervention, adverse events, drop-out rate, and credibility and expectancy of the intervention. Secondary participant-reported outcomes will include global rating of change, patient acceptable symptom state, severity of ankle pain and stiffness, self-reported function, quality of life, satisfaction with treatment, and use of co-interventions. Follow up will be at 8 weeks and 3 months. Physical measures of 40 m walking speed, timed stairs descent, heel raise endurance and ankle dorsiflexion range of motion will be collected at baseline and 8 weeks. Primary feasibility outcomes will be reported descriptively, and estimates of the variability of secondary participant-reported and physical outcomes will be calculated. Semi-structured interviews will be conducted with participants to understand perspectives about the intervention and participation in the trial, with data analyzed thematically. DISCUSSION Study findings will establish the feasibility of running a full-scale RCT to investigate a combined education and exercise program compared to a general advice program for people with ankle OA. This study is a necessary first step to advance the international research agenda of evaluating the efficacy of exercise in the management of ankle OA. TRIAL REGISTRATION ACTRN12623000017628. Registered 10 January 2023, https://www.anzctr.org.au/ACTRN12623000017628.aspx .
Collapse
Affiliation(s)
- Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia.
| | - Viana Vuvan
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Natalie J Collins
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - David J Hunter
- Sydney Musculoskeletal Health, Kolling Institute, Rheumatology Department, The University of Sydney, Royal North Shore Hospital, Sydney, Australia
| | - Nathalia Costa
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
- Sydney School of Health Sciences, The University of Sydney, Physiotherapy, Sydney, NSW, Australia
| | - Melinda M Franettovich Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| |
Collapse
|
44
|
Øiestad BE, Årøen A, Røtterud JH, Østerås N, Jarstad E, Grotle M, Risberg MA. The efficacy of strength or aerobic exercise on quality of life and knee function in patients with knee osteoarthritis. A multi-arm randomized controlled trial with 1-year follow-up. BMC Musculoskelet Disord 2023; 24:714. [PMID: 37684597 PMCID: PMC10485991 DOI: 10.1186/s12891-023-06831-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy of strength exercise or aerobic exercise compared to usual care on knee-related quality of life (QoL) and knee function at 4 months and 1 year in individuals with knee osteoarthritis. METHODS A three-arm randomized controlled trial (RCT) compared 12 weeks of strength exercise or aerobic exercise (stationary cycling) to usual care supervised by physiotherapists in primary care. We recruited 168 participants aged 35-70 years with symptomatic knee osteoarthritis. The primary outcome was The Knee Injury and Osteoarthritis Outcome Score (KOOS) QoL at 1 year. Secondary outcomes were self-reported function, pain, and self-efficacy, muscle strength and maximal oxygen uptake (VO2max) at 4 months and 1 year. RESULTS There were no differences between strength exercise and usual care on KOOS QoL (6.5, 95% CI -0.9 to 14), or for aerobic exercise and usual care (5.0, 95% CI -2.7 to 12.8), at 1 year. The two exercise groups showed better quadriceps muscle strength, and VO2max at 4 months, compared to usual care. CONCLUSION This trial found no statistically significant effects of two exercise programs compared to usual care on KOOS QoL at 1 year in individuals with symptomatic and radiographic knee osteoarthritis, but an underpowered sample size may explain lack of efficacy between the intervention groups and the usual care group. CLINICALTRIALS GOV IDENTIFIER NCT01682980.
Collapse
Affiliation(s)
- Britt Elin Øiestad
- Department of Rehabilitation Sciences and Health Technology, Oslo Metropolitan University, Oslo, Norway.
| | - Asbjørn Årøen
- Orthopedic department, Akershus University Hospital, Lørenskog, Norway
| | | | - Nina Østerås
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | | | - Margreth Grotle
- Department of Rehabilitation Sciences and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - May Arna Risberg
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway
- Department of Sports Medicine, Norwegian of School Sport Sciences, Oslo, Norway
| |
Collapse
|
45
|
Tremblay R, Marcotte-Chénard A, Hamelin-Morrissette J, Poirier L, Perron PN, Durivage A, Mampuya WM, Huard G, Riesco E. The Effect of Exercise Modalities on Walking Capacity in Patients With Intermittent Claudication: A NETWORK META-ANALYSIS. J Cardiopulm Rehabil Prev 2023; 43:318-328. [PMID: 36880959 DOI: 10.1097/hcr.0000000000000780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
INTRODUCTION Despite extensive research on the effect of supervised exercise therapy on walking performance in patients with symptomatic peripheral arterial disease (PAD), it remains unclear which training modality provides the greatest improvement in walking capacity. The objective of this study was to compare the effect of different types of supervised exercise therapy on walking capacity in individuals with symptomatic PAD. METHODS A random-effect network meta-analysis was performed. The following databases were searched from January 1966 to April 2021: SPORTDiscus, CINAHL, MEDLINE, AMED, Academic Search Complete and, Scopus. Trials had to include at least one type of supervised exercise therapy for patients with symptomatic PAD, with an intervention lasting ≥2 wk with ≥5 training sessions, and an objective measure of walking capacity. RESULTS Eighteen studies were included for a total sample of 1135 participants. Interventions duration ranged from 6-24 wk and included aerobic exercise (treadmill walking, ergometer, and Nordic walking), resistance training (lower and/or upper body), a combination of both, and underwater exercise. Results showed that combined training improved treadmill walking capacity to a comparable extent to aerobic walking (+122.0 [24.2-219.8] m vs +106.8 [34.2-179.4] m), but with a larger effect size (1.20 [0.50-1.90] vs 0.67 [0.22-1.11]). Similar results were observed for the 6-min walk distance, with combined training being the most promising modality (+57.3 [16.2-98.5] m), followed by underwater training (+56.5 [22.4-90.5] m) and aerobic walking (+39.0 [12.8-65.1] m). CONCLUSION While not statistically superior to aerobic walking, combined exercise seems to be the most promising training modality. Aerobic walking and underwater training also improved walking capacity for patients with symptomatic PAD.
Collapse
Affiliation(s)
- Renaud Tremblay
- Faculty of Physical Activity Sciences (Messrs Tremblay and Marcotte-Chénard, Drs Hamelin-Morrissette and Riesco, and Ms Poirier) and Faculty of Medicine and Health Sciences (Drs Perron, Durivage, Mampuya, and Huard), University of Sherbrooke, Sherbrooke, Quebec, Canada; and Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada (Messrs Tremblay and Marcotte-Chénard, Drs Hamelin-Morrissette and Riesco, and Ms Poirier)
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Engel D, Testa GD, McIsaac DI, Carli F, Santa Mina D, Baldini G, Scheede-Bergdahl C, Chevalier S, Edgar L, Beilstein CM, Huber M, Fiore JF, Gillis C. Reporting quality of randomized controlled trials in prehabilitation: a scoping review. Perioper Med (Lond) 2023; 12:48. [PMID: 37653530 PMCID: PMC10472732 DOI: 10.1186/s13741-023-00338-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Inadequate study reporting precludes interpretation of findings, pooling of results in meta-analyses, and delays knowledge translation. While prehabilitation interventions aim to enhance candidacy for surgery, to our knowledge, a review of the quality of reporting in prehabilitation has yet to be conducted. Our objective was to determine the extent to which randomized controlled trials (RCTs) of prehabilitation are reported according to methodological and intervention reporting checklists. METHODS Eligibility criteria: RCTs of unimodal or multimodal prehabilitation interventions. SOURCES OF EVIDENCE search was conducted in March 2022 using MEDLINE, Embase, PsychINFO, Web of Science, CINAHL, and Cochrane. CHARTING METHODS identified studies were compared to CONSORT, CERT & Modified CERT, TIDieR, PRESENT, and CONSORT-SPI. An agreement ratio (AR) was defined to evaluate if applicable guideline items were correctly reported. Data were analyzed as frequency (n, %) and mean with standard deviation (SD). RESULTS We identified 935 unique articles and included 70 trials published from 1994 to 2022. Most prehabilitation programs comprised exercise-only interventions (n = 40, 57%) and were applied before oncologic surgery (n = 32, 46%). The overall mean AR was 57% (SD: 20.9%). The specific mean ARs were as follows: CONSORT: 71% (SD: 16.3%); TIDieR: 62% (SD:17.7%); CERT: 54% (SD: 16.6%); Modified-CERT: 40% (SD:17.8%); PRESENT: 78% (SD: 8.9); and CONSORT-SPI: 47% (SD: 22.1). CONCLUSION Altogether, existing prehabilitation trials report approximately half of the checklist items recommended by methodological and intervention reporting guidelines. Reporting practices may improve with the development of a reporting checklist specific to prehabilitation interventions.
Collapse
Affiliation(s)
- Dominique Engel
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Anesthesia, McGill University, Montréal, QC, Canada
| | - Giuseppe Dario Testa
- Department of Anesthesia, McGill University, Montréal, QC, Canada
- Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Daniel I McIsaac
- Clinical Epidemiology Program, Department of Anesthesiology and Pain Medicine, Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Francesco Carli
- Department of Anesthesia, McGill University, Montréal, QC, Canada
| | - Daniel Santa Mina
- Department of Anesthesia and Pain Management, Faculty of Medicine, Faculty of Kinesiology and Physical Education, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Gabriele Baldini
- Section of Anesthesiology, Intensive Care and Pain Medicine, Anesthesiology and Intensive Care Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Stéphanie Chevalier
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, Quebec, H9X 3V9, Canada
- Department of Medicine, Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Linda Edgar
- Prehabilitation Clinic, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Christian M Beilstein
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Markus Huber
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Julio F Fiore
- Department of Surgery, McGill University, Montreal, QC, H3G 1A4, Canada
| | - Chelsia Gillis
- Department of Anesthesia, McGill University, Montréal, QC, Canada.
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, Quebec, H9X 3V9, Canada.
- Department of Surgery, McGill University, Montreal, QC, H3G 1A4, Canada.
| |
Collapse
|
47
|
Siegrist M, Schaller N, Weiß M, Isaak J, Schmid V, Köppel E, Weichenberger M, Mende E, Haller B, Halle M. Study protocol of a cluster-randomised controlled trial assessing a multimodal machine-based exercise training programme in senior care facilities over 6 months - the bestform study (best function of range of motion). BMC Geriatr 2023; 23:505. [PMID: 37605110 PMCID: PMC10463394 DOI: 10.1186/s12877-023-04176-7] [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: 12/12/2022] [Accepted: 07/15/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Physical functioning is a crucial factor for independence and quality of life in old age. The aim of the "bestform-Best function of range of motion" trial is to investigate the effects of a 6 months multimodal machine-based strength, coordination and endurance training on physical function, risk of falls and health parameters in older adults. METHODS Bestform is a cluster-randomised trial including older adults ≥ 65 years living in senior care facilities in Southern Germany. Senior care facilities are randomly allocated to the control group with usual care (n ≥ 10 care facilities) and to the intervention group (n ≥ 10 care facilities), overall including ≥ 400 seniors. Residents belonging to the intervention group are offered a supervised machine-based exercise training programme twice weekly over 45-60 min over six months in small groups, while those in the usual care facilities will not receive active intervention. The primary outcome is the change in Short Physical Performance Battery over six months between groups. Secondary outcomes are change in risk of falling, fear of falling, number of falls and fall-related injuries, physical exercise capacity, handgrip strength, body composition, cardiac function, blood parameters, quality of life, risk of sarcopenia, activities of daily living, and cognition over three and six months. DISCUSSION The bestform study investigates the change in physical function between seniors performing exercise intervention versus usual care over six months. The results of the study will contribute to the development of effective physical activity concepts in senior care facilities. TRIAL REGISTRATION ClinicalTrials.gov: NCT04207307. Registered December 2019.
Collapse
Affiliation(s)
- M Siegrist
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital "Klinikum rechts der Isar", Technical University of Munich, Georg-Brauchle-Ring 56, Munich, 80992, Germany.
| | - N Schaller
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital "Klinikum rechts der Isar", Technical University of Munich, Georg-Brauchle-Ring 56, Munich, 80992, Germany
| | - M Weiß
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital "Klinikum rechts der Isar", Technical University of Munich, Georg-Brauchle-Ring 56, Munich, 80992, Germany
| | - J Isaak
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital "Klinikum rechts der Isar", Technical University of Munich, Georg-Brauchle-Ring 56, Munich, 80992, Germany
| | - V Schmid
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital "Klinikum rechts der Isar", Technical University of Munich, Georg-Brauchle-Ring 56, Munich, 80992, Germany
| | - E Köppel
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital "Klinikum rechts der Isar", Technical University of Munich, Georg-Brauchle-Ring 56, Munich, 80992, Germany
| | - M Weichenberger
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital "Klinikum rechts der Isar", Technical University of Munich, Georg-Brauchle-Ring 56, Munich, 80992, Germany
| | - E Mende
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital "Klinikum rechts der Isar", Technical University of Munich, Georg-Brauchle-Ring 56, Munich, 80992, Germany
| | - B Haller
- Institute of AI and Informatics in Medicine, University Hospital "Klinikum rechts der Isar", Technical University of Munich, Munich, Germany
| | - M Halle
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital "Klinikum rechts der Isar", Technical University of Munich, Georg-Brauchle-Ring 56, Munich, 80992, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| |
Collapse
|
48
|
Feller D, Pedri C, Gozzer P, Innocenti T, Trentin F. The Reporting of Somatic Sensory Training Interventions in Individuals After a Stroke Is Suboptimal: A Systematic Review and Meta-research Study. Am J Phys Med Rehabil 2023; 102:701-706. [PMID: 36757855 DOI: 10.1097/phm.0000000000002188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE The purpose of this systematic review is to assess adherence to the "template for intervention description and replication" checklist among all published randomized controlled trials of sensory retraining strategies for patients with a history of stroke. METHODS Medline, the Cochrane Register of Controlled Trials, and the Physiotherapy Evidence Database were investigated, without time restrictions, until September 1, 2021. In addition, a search for additional studies was carried out using the included studies' reference list. Only randomized controlled trials of adults with a history of stroke who aimed to improve sensation, via any type of intervention, were included. The template for intervention description and replication checklist was used to assess the completeness of reporting on each intervention. RESULTS A total of 61 trials were included. None of the included studies declared to have used the template for intervention description and replication checklist to report interventions. Overall, the median percentage of adherence to the 12 items of the template for intervention description and replication was 33% (interquartile range, 25%-50%). Only five of the single items were adequately described in more than 50% of the studies. None of the randomized controlled trials reported the entirety of the core intervention components, as described in items 3 to 9. CONCLUSIONS This systematic review demonstrates that interventions in sensory retraining strategy trials are described below desirable standards. Without this information, clinicians and researchers cannot reliably replicate interventions.
Collapse
Affiliation(s)
- Daniel Feller
- From the Provincial Agency for Health of the Autonomous Province of Trento, Trento, Italy (DF, PG, FT); Freelance, Trento, Italy (CP); Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands (TI); and GIMBE Foundation, Bologna, Italy (TI)
| | | | | | | | | |
Collapse
|
49
|
Becher B, Lozano-López C, Castro-Carletti EMD, Hoffmann M, Becher C, Mesa-Jimenez J, Fernandez-de-Las-Peñas C, Armijo-Olivo S. Effectiveness of therapeutic exercise for the management of cervicogenic headache: A systematic review. Musculoskelet Sci Pract 2023; 66:102822. [PMID: 37479561 DOI: 10.1016/j.msksp.2023.102822] [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: 05/16/2023] [Revised: 06/26/2023] [Accepted: 07/01/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVE The main aim of this systematic review is to evaluate the effectiveness of therapeutic exercise for managing pain and disability in patients with cervicogenic headache (CEH). METHODS A protocol for this systematic review was published in PROSPERO (CRD42019122703). PRISMA and AMSTAR2 standards were followed. Based on an extensive systematic search in five databases (EMBASE, MEDLINE, CINHAL, PsychInfo and SportDISCUS) and the CENTRAL trial register, two reviewers carefully and independently assessed, selected results, collected data, rated the risk of bias (RoB) of included studies with the Cochrane risk of bias tool, synthesized the available evidence, and rated it using GRADE methodology. RESULTS A total of 12 manuscripts, reporting on 11 studies were included. Most studies showed a high risk of bias (63,63%). Additionally, a great deal of heterogeneity was observed regarding interventions, comparisons, and outcomes and thus, results could not be synthesized in meta-analyses. The quality of the evidence was found to be from low to very low. Significant differences with large effect sizes were found when comparing multimodal exercise vs. control groups on headache outcomes (SMD = 0.73; 95%CI [0.31, 1.14] for headache intensity and SMD = 0.98; 95%CI [0.56, 1.41], for headache frequency). CONCLUSIONS Findings indicate that therapeutic exercise may be effective to achieve clinically relevant reductions in headache intensity and frequency as well as disability for patients suffering from cervicogenic headache. However, more high-quality research is needed to gain confidence in this finding and possibly determine optimal types and dosage of therapeutic exercise.
Collapse
Affiliation(s)
- Björn Becher
- University of Applied Sciences, Faculty of Business and Social Sciences, Osnabrück, Germany
| | | | | | | | | | | | - Cesar Fernandez-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Móstoles, Madrid, Spain
| | - Susan Armijo-Olivo
- University of Applied Sciences, Faculty of Business and Social Sciences, Osnabrück, Germany; Faculty of Rehabilitation Medicine, Department of Physical Therapy, Rehabilitation Research Center, University of Alberta, Edmonton, Canada.
| |
Collapse
|
50
|
Hughes T, O'Hara J, Burton A, London N, Emmonds S. Evaluating the impact of injury prevention interventions in child and adolescent sports using the RE-AIM framework and CERT: A systematic review. PLoS One 2023; 18:e0289065. [PMID: 37478075 PMCID: PMC10361493 DOI: 10.1371/journal.pone.0289065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/11/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Participation in sport is a popular pastime for children and adolescents that improves their physical health, mental health and motor skills. Musculoskeletal injuries are a relatively common downside of sports participation and can have negative long-term consequences. Injury prevention programmes have demonstrated effectiveness in child and adolescent sports, provided compliance is adequate. However, little is known about the factors which relate to their impact on the wider community and whether the prevention programmes have been adopted and maintained in the long-term. The objective of this review was to assess the current literature on exercise-based injury prevention interventions in child and adolescent sports (aged under 19 years) against the 'Reach', 'Effectiveness', 'Adoption', 'Implementation', 'Maintenance' (RE-AIM) framework and Consensus of Exercise Reporting Template (CERT), to ascertain level of reporting for the components which relate to external validity. METHODS Seven electronic databases; PubMed, Medline, SPORTDiscus, PsycINFO, CINAHL, Scopus and The Cochrane Library, were searched from date of inception to July 2022 using the themes of: 'Child and Adolescent', 'Sport', 'Injury' and 'Prevention'. Eligibility criteria included: Experimental trial design, exercise-based intervention programmes, primary outcome of injury incidence and participants aged under 19 years. Two reviewers assessed each trial independently against the RE-AIM model dimension items checklist (RE-AIM MDIC) and Consensus on Exercise Reporting Template (CERT) before reaching a consensus on reporting. RESULTS Forty-five unique trials met the eligibility criteria. Mean reporting level for all studies across the whole RE-AIM MDIC was 31% (SD ± 16.2%, Range 7-77%). The domain of 'effectiveness' was the most comprehensively reported (60%), followed by 'implementation' (48%), 'reach' (38%), 'adoption' (26%) and 'maintenance' (7%). The mean reporting score for the CERT was 50% (SD ± 20.8, range 0-81%). CONCLUSION Published data on injury prevention in child and adolescent sports is highly focussed on the effectiveness of the intervention, with little consideration given to how it will be adopted and maintained in the long-term. This has led to considerable gaps in knowledge regarding optimal programme implementation, with a lack of data on adoption and maintenance contributing to the gap between research and practice. Future research needs to place greater focus on external validity and consider incorporating the study of implementation and feasibility as part of effectiveness trial design. This approach should provide the data that will help narrow the considerable gap between science and practice. TRIAL REGISTRATION PROSPERO Registration number CRD42021272847.
Collapse
Affiliation(s)
- Thomas Hughes
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - John O'Hara
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Alan Burton
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Nick London
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
- The Yorkshire Knee Clinic, Nuffield Health Leeds Hospital, Leeds, United Kingdom
| | - Stacey Emmonds
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| |
Collapse
|