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Pérez-Porta I, Flórez-García MT, García-Pérez F, Fernández-Matías R, Pérez-Manzanero MÁ, Araujo-Narváez AM, Urraca-Gesto MA, Fernández-Lagarejos C, Plaza-Manzano G, Pérez-Fernández E, Velasco-Arribas M. Effects of a web application based on multimedia animations to support therapeutic exercise for rotator cuff-related shoulder pain: protocol for an open-label randomised controlled trial. BMJ Open 2024; 14:e085381. [PMID: 39038866 DOI: 10.1136/bmjopen-2024-085381] [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] [Indexed: 07/24/2024] Open
Abstract
INTRODUCTION Rotator cuff-related shoulder pain (RCRSP) is the most common cause of shoulder pain. Currently, exercise is proposed as the first-line treatment for patients suffering from RCRSP. However, adherence to therapeutic exercise programmes can be poor in the long term in a home setting. The aim of this study is to evaluate the effects of adding video animations to a traditional paper-based exercise programme. METHODS AND ANALYSIS A single-centre, randomised, open-labelled clinical trial will be conducted in a hospital in Spain. Adults aged between 18 and 80 years diagnosed with RCRSP who meet the eligibility criteria will be included. Patients (n=132) will be randomised into two groups, with both receiving paper-based exercises, and the experimental group will also be provided with video animations. The participants will receive seven face-to-face physical therapy sessions and will be asked to perform the exercises at home for 6 months. The primary outcome measure will be the Shoulder Pain and Disability Index, measured at baseline, 3 weeks, 3 months (primary analysis) and 6 months. Secondary outcomes will be the patient's pain intensity during the last week (rest, during movement and at night); expectations of improvement; satisfaction with treatment; impression of improvement; perceived usability, usefulness and satisfaction of multimedia animations; and adherence to exercises. Generalised least squares regression models with an autoregressive-moving average lag one correlation structure will be implemented, with an intention-to-treat analysis. ETHICS AND DISSEMINATION This study has been approved by the ethics committee of Hospital Universitario Fundación Alcorcón (Madrid, Spain), reference number CI18/16. All participants will sign an informed consent. The results will be published in a peer-reviewed scientific journal. TRIAL REGISTRATION ClinicalTrials.gov, NCT05770908.
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Affiliation(s)
- Irene Pérez-Porta
- Physical Therapy and Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcon, Madrid, Spain
- International Doctoral School, Universidad Rey Juan Carlos, Mostoles, Madrid, Spain
| | - Mariano Tomás Flórez-García
- Physical Therapy and Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcon, Madrid, Spain
| | - Fernando García-Pérez
- Physical Therapy and Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcon, Madrid, Spain
| | - Rubén Fernández-Matías
- Research Unit, Hospital Universitario Fundacion Alcorcon, Alcorcon, Madrid, Spain
- Doctoral School, Department of Physical Therapy, Universitat de Valencia, Valencia, Comunitat Valenciana, Spain
| | - M Ángeles Pérez-Manzanero
- Physical Therapy and Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcon, Madrid, Spain
| | - Aurora María Araujo-Narváez
- Physical Therapy and Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcon, Madrid, Spain
| | - M Alicia Urraca-Gesto
- Physical Therapy and Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcon, Madrid, Spain
- Department of Physical Therapy, Occupational Therapy, and Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Mostoles, Madrid, Spain
| | - César Fernández-Lagarejos
- Physical Therapy and Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcon, Madrid, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation, and Physical Therapy, Universidad Complutense de Madrid, Madrid, Spain
- Fisioterapia Contemporánea (InPhysio) Research Group, Health Research Institute, Hospital Clínico San Carlos, Madrid, Comunidad de Madrid, Spain
| | - Elia Pérez-Fernández
- Research Unit, Hospital Universitario Fundacion Alcorcon, Alcorcon, Madrid, Spain
| | - María Velasco-Arribas
- Research Unit, Hospital Universitario Fundacion Alcorcon, Alcorcon, Madrid, Spain
- Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Mostoles, Madrid, Spain
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2
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Mahmood A, Nayak P, Deshmukh A, English C, N M, Solomon M J, B U. Measurement, determinants, barriers, and interventions for exercise adherence: A scoping review. J Bodyw Mov Ther 2023; 33:95-105. [PMID: 36775533 DOI: 10.1016/j.jbmt.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 05/21/2022] [Accepted: 09/18/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Adherence to exercise interventions is the cornerstone of a successful rehabilitation program. However, there is limited evidence on multifaceted components of exercise adherence. Therefore, we aimed to summarize the existing literature on measurement, determinants, barriers, theoretical frameworks, and evidence-based interventions that support exercise adherence. METHODS We conducted a scoping review based on the PRISMA extension for scoping reviews guidelines and searched the literature in PubMed, Cochrane Databases of Systematic Reviews, ScienceDirect, and Web of Science. Two reviewers independently screened articles. The included articles were subjected to data extraction and qualitative synthesis. RESULTS A total of 72 articles were included for this review. Data synthesis showed that there are no gold standard methods of measuring exercise adherence; however, questionnaires and daily logs are commonly used tools. The determinants of adherence are personal, disease-related, therapy-related, provider-related, and health system-related. The common barriers to adherence are the absence of a caregiver, low health literacy, poor communication by healthcare providers, cost, and lack of access to health facilities. Few evidence-based interventions used for supporting adherence are behavioral strategies, improving self-efficacy, motivational therapy, and mHealth or multimedia. CONCLUSION Non-adherence to exercises is a challenge for healthcare providers. There are no standard guidelines for the evaluation and management of non-adherence to exercises. Future studies should aim at developing objective measures of exercise adherence and investigate the long-term effects of adherence strategies in different disease populations. It is an under-researched area and requires multipronged strategies to improve adherence levels among patients.
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Affiliation(s)
- Amreen Mahmood
- Department of Health Professions, Manchester Metropolitan University, Birley Fields Campus, Bonsall Street, M15 6GX, Manchester, United Kingdom.
| | - Pradeepa Nayak
- Department of Health Professions, Manchester Metropolitan University, Birley Fields Campus, Bonsall Street, M15 6GX, Manchester, United Kingdom.
| | - Anagha Deshmukh
- Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
| | - Coralie English
- School of Health Sciences and Priority Research, Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia.
| | - Manikandan N
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
| | - John Solomon M
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
| | - Unnikrishnan B
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
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Mavragani A, Schoonman GG, Maat B, Habibović M, Krahmer E, Pauws S. Patients Managing Their Medical Data in Personal Electronic Health Records: Scoping Review. J Med Internet Res 2022; 24:e37783. [PMID: 36574275 PMCID: PMC9832357 DOI: 10.2196/37783] [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: 03/07/2022] [Accepted: 07/31/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Personal electronic health records (PEHRs) allow patients to view, generate, and manage their personal and medical data that are relevant across illness episodes, such as their medications, allergies, immunizations, and their medical, social, and family health history. Thus, patients can actively participate in the management of their health care by ensuring that their health care providers have an updated and accurate overview of the patients' medical records. However, the uptake of PEHRs remains low, especially in terms of patients entering and managing their personal and medical data in their PEHR. OBJECTIVE This scoping review aimed to explore the barriers and facilitators that patients face when deciding to review, enter, update, or modify their personal and medical data in their PEHR. This review also explores the extent to which patient-generated and -managed data affect the quality and safety of care, patient engagement, patient satisfaction, and patients' health and health care services. METHODS We searched the MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Web of Science, and Google Scholar web-based databases, as well as reference lists of all primary and review articles using a predefined search query. RESULTS Of the 182 eligible papers, 37 (20%) provided sufficient information about patients' data management activities. The results showed that patients tend to use their PEHRs passively rather than actively. Patients refrain from generating and managing their medical data in a PEHR, especially when these data are complex and sensitive. The reasons for patients' passive data management behavior were related to their concerns about the validity, applicability, and confidentiality of patient-generated data. Our synthesis also showed that patient-generated and -managed health data ensures that the medical record is complete and up to date and is positively associated with patient engagement and patient satisfaction. CONCLUSIONS The findings of this study suggest recommendations for implementing design features within the PEHR and the construal of a dedicated policy to inform both clinical staff and patients about the added value of patient-generated data. Moreover, clinicians should be involved as important ambassadors in informing, reminding, and encouraging patients to manage the data in their PEHR.
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Affiliation(s)
| | - Guus G Schoonman
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands.,Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
| | - Barbara Maat
- Department of Pharmacy, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
| | - Mirela Habibović
- Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Emiel Krahmer
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands
| | - Steffen Pauws
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands.,Department of Remote Patient Management & Connected Care, Philips Research, Eindhoven, Netherlands
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Greenberg E, Greenberg E, Lawrence JT, Ganley T. Understanding Youth Athlete Motivation, Training, and Activity Progression During and After the COVID-19 Sports Interruption. Int J Sports Phys Ther 2022; 17:1396-1403. [PMID: 36518827 PMCID: PMC9718718 DOI: 10.26603/001c.40372] [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: 02/04/2022] [Accepted: 09/11/2022] [Indexed: 11/12/2023] Open
Abstract
Background COVID-19 restrictions created a period of disrupted sports participation for youth athletes. The physical conditioning, sports training habits, and patterns of sports activity resumption upon returning to normal sports activity are currently unknown. Purpose/Hypothesis This study aimed to determine the extent to which youth athletes maintained their training levels during the early stages of the COVID-19 pandemic and understand the strategies that enhanced motivation and adherence to a training regimen while in isolation. A secondary aim was to analyze how youth athletes returned to activity and identify injuries associated with prolonged sports interruption. Study Design Observational / Survey Study. Methods A survey designed to determine activity changes, type of organized instruction, and athlete preferences for training support were distributed by email using snowball sampling methodology to athletes 14-21 years old who were involved in competitive sports when pandemic restrictions were enacted. As sports activities resumed, a follow-up survey was distributed to the same respondents to identify feelings of preparedness, training habits, and injuries. Results Of the155 subjects (mean age 16.1 ± 2 years, 64.5% female) that completed the initial survey, 98% reported a stoppage of in-person sports participation and 70% decreased their exercise/training volume, with 41% (n=63) reporting > 50% reduction. Most athletes (86%) received instruction from coaches, with written workouts (70%) being most common; however, most athletes (70%) preferred instructor-led, group training sessions. Of the 43 subjects that completed the follow-up survey (34% response rate), there was an increase in athletic exposures compared to mid-pandemic levels, and 25% reported sustaining a sports-related injury shortly after resuming sports activities. Conclusions Pandemic-related sports restrictions resulted in a significant reduction in youth athlete training and conditioning. Coaches attempted to maintain training via the use of written workouts; however, athletes preferred instructor-led, group training sessions. There was a rapid resumption of sports activities, which may have contributed to the high rate of injuries in this study. Level of Evidence 3.
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Affiliation(s)
- Elliot Greenberg
- Sports Medicine and Performance Center Children's Hospital of Philadelphia
| | - Eric Greenberg
- Department of Physical Therapy New York Institute of Technology
| | - J Todd Lawrence
- Sports Medicine and Performance Center Children's Hospital of Philadelphia
- Division of Orthopaedic Surgery Children's Hospital of Philadelphia
| | - Theodore Ganley
- Sports Medicine and Performance Center Children's Hospital of Philadelphia
- Department of Orthopaedic Surgery University of Pennsylvania
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Kang DW, Wilson RL, Gonzalo-Encabo P, Norris MK, Hans M, Tahbaz M, Dawson J, Nguyen D, Normann AJ, Yunker AG, Sami N, Uno H, Ligibel JA, Mittelman SD, Dieli-Conwright CM. Targeting Adiposity and Inflammation With Movement to Improve Prognosis in Breast Cancer Survivors (The AIM Trial): Rationale, Design, and Methods. Front Oncol 2022; 12:896995. [PMID: 35795051 PMCID: PMC9251632 DOI: 10.3389/fonc.2022.896995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background Obesity is a significant contributor to breast cancer recurrence and mortality. A central mechanism by which obesity stimulates cancer progression is through chronic, low-grade inflammation in adipose tissue. Exercise interventions to target chronic inflammation has a potential to improve obesity- and breast cancer-related outcomes; however, no studies have investigated the roles of exercise in modulating adipose tissue inflammation in breast cancer survivors. Also, it is unclear which exercise prescription would be optimal to maximize the outcomes. Therefore, we designed a randomized controlled trial (Taking AIM at Breast Cancer: Targeting Adiposity and Inflammation with Movement to Improve Prognosis in Breast Cancer Survivors [AIM] Trial) to examine the mechanisms by which different modalities of exercise impact chronic inflammation as a biomarker of breast cancer prognosis. Methods The AIM trial is a prospective, three-armed, phase II randomized controlled trial investigating the effects of a 16-week supervised circuit aerobic and resistance exercise (CARE) program versus a traditional aerobic and resistance exercise (TARE) program and attention control (AC) on adipose tissue inflammation in breast cancer survivors. 276 patients who are diagnosed with stage 0-III breast cancer, post-treatment, sedentary, and centrally obese are randomized to one of the three groups. The CARE and TARE groups participate in thrice-weekly supervised exercise sessions for 16 weeks. The AC group are offered the CARE program after the intervention period. The primary endpoint is adipose tissue inflammation assessed by core biopsy and blood draw. The secondary and tertiary endpoints are sarcopenic obesity, physical fitness and function, and patient reported outcomes. The exploratory outcomes are long-term breast cancer outcomes. Discussion This is the first randomized controlled trial examining the effects of exercise on adipose tissue inflammation in obese, breast cancer survivors. Our findings are anticipated to contribute to a better understanding of exercise modalities and mechanisms on adipose tissue inflammation that can potentially improve breast cancer prognosis. Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT03091842 identifier [NCT#03091842].
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Affiliation(s)
- Dong-Woo Kang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Rebekah L. Wilson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Paola Gonzalo-Encabo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Mary K. Norris
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Marybeth Hans
- Division of Breast Surgery, Brigham and Women’s Hospital, Boston, MA, United States
| | - Meghan Tahbaz
- Department of Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Jackie Dawson
- Department of Physical Therapy, California State University, Long Beach, Long Beach, CA, United States
| | - Danny Nguyen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Amber J. Normann
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Health Sciences, Boston University, Boston, MA, United States
| | - Alexandra G. Yunker
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Nathalie Sami
- Department of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Hajime Uno
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Jennifer A. Ligibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Steven D. Mittelman
- Children’s Discovery and Innovations Institute, University of California, Los Angeles, Los Angeles, CA, United States
| | - Christina M. Dieli-Conwright
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
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Wilson R, Kang DW, Tahbaz M, Norris M, Uno H, Ligibel J, Guenette J, Christopher C, Dieli-Conwright C. Improving cognitive function through high-intensity interval training in breast cancer patients undergoing chemotherapy – the CLARITY Trial: Protocol for a randomized study. (Preprint). JMIR Res Protoc 2022; 12:e39740. [PMID: 37027186 PMCID: PMC10132015 DOI: 10.2196/39740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND More than 75% of patients with breast cancer treated with chemotherapy experience cognitive impairments (eg, memory and attention problems), commonly known as chemo-brain. Exercise, especially aerobic high-intensity interval training (HIIT), is associated with better cognitive function in healthy populations. However, clinical trials testing the impact of exercise interventions on chemotherapy-induced cognitive decline in patients with cancer are lacking, and the mechanisms through which exercise could improve cognitive function are unclear. OBJECTIVE The objective of the Improving Cognitive Function Through High-Intensity Interval Training in Breast Cancer Patients Undergoing Chemotherapy trial is to examine the effects of HIIT on cognitive function in patients with breast cancer undergoing chemotherapy. METHODS This 2-arm, single-center, pilot randomized controlled trial will randomize 50 patients with breast cancer undergoing chemotherapy to HIIT or attention control. The HIIT group will perform a supervised 16-week, thrice-weekly intervention, with each session including a 5-minute warm-up at 10% maximal power output (POmax), 10 sets of alternating 1-minute high-intensity (90% POmax) and 1-minute recovery (10% POmax) intervals, and a 5-minute cooldown (10% POmax). The attention control group will receive a stretching program with no exercise components and be asked to maintain their exercise levels for 16 weeks. The primary outcomes of the study are executive function and memory measured using the National Institutes of Health toolbox and resting-state connectivity and diffusion tensor imaging microstructure evaluated using magnetic resonance imaging. The secondary and tertiary outcomes include cardiorespiratory fitness, body composition, physical fitness, and psychosocial health. The study has been approved by the institutional review board of the Dana-Farber Cancer Institute (20-222). RESULTS The trial was funded in January 2019, with recruitment started in June 2021. As of May 2022, a total of 4 patients have consented and been randomized (n=2, 50% to exercise; n=1, 25% to control; and n=1, 25% nonrandomized). Trial completion is expected in January 2024. CONCLUSIONS This first-of-its-kind study incorporates a novel exercise intervention (ie, HIIT) and comprehensive cognitive measures. If positive, our findings will establish the pilot efficacy of HIIT on chemotherapy-induced cognitive function in patients with breast cancer, providing the foundation for future larger phase-II and phase-III trials to confirm the findings and potentially establish HIIT as a standard of care for women undergoing chemotherapy for breast cancer. TRIAL REGISTRATION ClinicalTrials.gov NCT04724499; https://clinicaltrials.gov/ct2/show/NCT04724499. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39740.
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Affiliation(s)
- Rebekah Wilson
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Meghan Tahbaz
- Department of Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Mary Norris
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Hajime Uno
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Jennifer Ligibel
- Harvard Medical School, Boston, MA, United States
- Division of Breast Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Jeffrey Guenette
- Division of Neuroradiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Cameron Christopher
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Christina Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Komaris DS, Tarfali G, O'Flynn B, Tedesco S. Unsupervised IMU-based evaluation of at-home exercise programmes: a feasibility study. BMC Sports Sci Med Rehabil 2022; 14:28. [PMID: 35183244 PMCID: PMC8857882 DOI: 10.1186/s13102-022-00417-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 02/04/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The benefits to be obtained from home-based physical therapy programmes are dependent on the proper execution of physiotherapy exercises during unsupervised treatment. Wearable sensors and appropriate movement-related metrics may be used to determine at-home exercise performance and compliance to a physical therapy program. METHODS A total of thirty healthy volunteers (mean age of 31 years) had their movements captured using wearable inertial measurement units (IMUs), after video recordings of five different exercises with varying levels of complexity were demonstrated to them. Participants were then given wearable sensors to enable a second unsupervised data capture at home. Movement performance between the participants' recordings was assessed with metrics of movement smoothness, intensity, consistency and control. RESULTS In general, subjects executed all exercises similarly when recording at home and as compared with their performance in the lab. However, participants executed all movements faster compared to the physiotherapist's demonstrations, indicating the need of a wearable system with user feedback that will set the pace of movement. CONCLUSION In light of the Covid-19 pandemic and the imperative transition towards remote consultation and tele-rehabilitation, this work aims to promote new tools and methods for the assessment of adherence to home-based physical therapy programmes. The studied IMU-derived features have shown adequate sensitivity to evaluate home-based programmes in an unsupervised manner. Cost-effective wearables, such as the one presented in this study, can support therapeutic exercises that ought to be performed with appropriate speed, intensity, smoothness and range of motion.
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Affiliation(s)
- Dimitrios-Sokratis Komaris
- Tyndall National Institute, University College Cork, Lee Maltings Complex Dyke Parade, Cork, T12 R5CP, Ireland.
| | - Georgia Tarfali
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Brendan O'Flynn
- Tyndall National Institute, University College Cork, Lee Maltings Complex Dyke Parade, Cork, T12 R5CP, Ireland
| | - Salvatore Tedesco
- Tyndall National Institute, University College Cork, Lee Maltings Complex Dyke Parade, Cork, T12 R5CP, Ireland
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Bientzle M, Minje J, Cress U, Kimmerle J. Therapeutic Touch in Exercise Videos: A Randomized Experiment of the Impact on the Evaluation of Therapists' Competence and Viewers' Self-Reliance. Front Sports Act Living 2019; 1:35. [PMID: 33344958 PMCID: PMC7739565 DOI: 10.3389/fspor.2019.00035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/10/2019] [Indexed: 01/21/2023] Open
Abstract
From a psychological health perspective, being physically touched is highly relevant throughout people's lives. Touch plays an important role in many contexts, such as in instructing movement exercises. Exercise videos have become a well-accepted format to support therapists in instructing movement exercises. In the study presented here we examined the impact of the use of therapeutic touch in exercise videos on people's evaluation of physiotherapists' competence and on their own self-reliance. In a between-group randomized experiment, 125 participants watched one of three videos that showed a physiotherapist who instructed a movement exercise to a patient. The physiotherapist touched the patient during the treatment (therapist-touch, TT), instructed the patient to use self-touch (ST), or provided only exercise instruction without physical touch (no-touch, NT). In the TT condition, the participants' perception was that the physiotherapist exhibited more professional competence. However, participants considered the movement exercise in this TT condition to have less potential for fostering their autonomy. Finally, participants in the ST condition had the biggest increase in perceived self-efficacy. The way of touching a patient in an exercise video influences the perception of the treatment. We conclude that therapeutic touch should be applied in exercise videos in a goal-oriented way: It seems appropriate to use ST if the aim is to strengthen viewers' self-reliance and to use TT to arouse trust in the competence of the therapist.
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Affiliation(s)
- Martina Bientzle
- Leibniz-Institut fuer Wissensmedien, Knowledge Media Research Center, Tübingen, Germany.,PT Academy Tübingen, Tübingen, Germany
| | | | - Ulrike Cress
- Leibniz-Institut fuer Wissensmedien, Knowledge Media Research Center, Tübingen, Germany.,Department of Psychology, University of Tübingen, Tübingen, Germany
| | - Joachim Kimmerle
- Leibniz-Institut fuer Wissensmedien, Knowledge Media Research Center, Tübingen, Germany.,Department of Psychology, University of Tübingen, Tübingen, Germany
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9
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Tomas-Carus P, Garrido M, Branco JC, Castaño MY, Gómez MÁ, Biehl-Printes C. Non-supervised breathing exercise regimen in women with fibromyalgia: A quasi-experimental exploratory study. Complement Ther Clin Pract 2019; 35:170-176. [PMID: 31003653 DOI: 10.1016/j.ctcp.2019.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/04/2019] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To know the effectiveness and safety of non-supervised breathing exercise regimen by promoting patients' self-management, and to investigate if non-supervised breathing exercise regimen shows similar benefits to supervised regimen in improving pain and fibromyalgia (FM) impact on daily life. MATERIAL AND METHODS Fifty-one women with FM were assigned to: supervised breathing exercise regimen group, non-supervised breathing exercise regimen group, and control group. Pain thresholds tolerance on tender points and FM impact on daily life were evaluated. RESULTS After 12-weeks of breathing exercises statistical differences were not found between supervised and non-supervised regimen. However, supervised regimen showed additional improvements in pain thresholds tolerance and in pain-FIQ subscale. CONCLUSION Our results suggest that performing a non-supervised breathing exercise program could be as safe and effective as the supervised regimen. However, it was observed that there could be a tendency of supervised exercise regimen to show additional benefits in terms of pain.
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Affiliation(s)
- Pablo Tomas-Carus
- Departamento de Desporto e Saúde, Escola de Ciência e Tecnologia, Universidade de Évora, Portugal; Comprehensive Health Research Centre (CHRC), University of Évora, Portugal.
| | - María Garrido
- Neuroimmunophysiology and Chrononutrition Research Group (Department of Physiology), Faculty of Science, University of Extremadura, Spain
| | - Jaime C Branco
- CEDOC, NOVA Medical School, Faculdade Ciências Médicas, Universidade Nova de Lisboa, Serviço de Reumatologia, CHLO, EPE-Hospital Egas Moniz, Portugal
| | - María Yolanda Castaño
- Neuroimmunophysiology and Chrononutrition Research Group (Department of Physiology), Faculty of Science, University of Extremadura, Spain
| | - María Ángeles Gómez
- Departamento de Fisiología, Facultad de Medicina, Universidad de Extremadura, Spain
| | - Clarissa Biehl-Printes
- Instituto de Geriatria e Gerontologia - IGG, Pontifícia Universidade Católica Do Rio, Grande Do Sul - PUCRS, Brazil
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Franklin RC, King JC, Riggs M. A Systematic Review of Large Agriculture Vehicles Use and Crash Incidents on Public Roads. J Agromedicine 2019; 25:14-27. [PMID: 30879394 DOI: 10.1080/1059924x.2019.1593275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Agricultural vehicles are a common sight on rural public roads. However, due to their larger mass (height, width, length, and weight), there are concerns about safety. The aim of this paper is to explore crash incidents on public roads of agricultural vehicles to determine the size of the problem, risk factors, and potential prevention strategies.Methods: A systematic review using the PRISMA guidelines was undertaken of peer-reviewed literature from Medline, Agricola, Scopus, PsycInfo, Science Direct, Web of Science, and SafetyLit. Crash incident rates, risk factors, and prevention strategies were extracted from the articles, and a review of quality was undertaken using McMasters guidelines.Results: Included in the review were 30 articles, with the majority from the United States. Crash risk rates, where reported, were low relative to agricultural vehicle use and when compared to overall road crash numbers. Crash risk factors included weather and visibility, age, personal and driving characteristics, road conditions, and event characteristics. Prevention strategies proposed were targeted at drivers and operators, vehicles, road design, driving behavior, and surveillance, policy, and technology.Conclusions: Overall, reported crash numbers involving large agricultural vehicles were low. Currently, there is limited capacity to calculate exposure rates compounded by the difficulties in identifying road incidents that involve agriculture vehicles. Better surveillance systems are required to improve our understanding of exposure and crash incident rates. Future research into the multiplicity of interrelated factors involved in agriculture vehicle crashes on roads, exposure rates, and evidence for the effectiveness of the prevention strategies is required.
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Affiliation(s)
- Richard C Franklin
- World Safety Organisation Collaborating Center for Injury Prevention and Safety Promotion, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Jemma C King
- World Safety Organisation Collaborating Center for Injury Prevention and Safety Promotion, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Matthew Riggs
- World Safety Organisation Collaborating Center for Injury Prevention and Safety Promotion, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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Flórez MT, Almodóvar R, García Pérez F, Rodríguez Cambrón AB, Carmona L, Pérez Manzanero MÁ, Aboitiz Cantalapiedra J, Urruticoechea-Arana A, Rodríguez Lozano CJ, Castro C, Fernández-Carballido C, de Miguel E, Galíndez E, Álvarez Vega JL, Torre Alonso JC, Linares LF, Moreno M, Navarro-Compán V, Juanola X, Zarco P. The EJES-3D tool for personalized prescription of exercise in axial spondyloarthritis through multimedia animations: pilot study. Rheumatol Int 2018; 38:1277-1284. [PMID: 29786781 DOI: 10.1007/s00296-018-4049-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/10/2018] [Indexed: 10/16/2022]
Abstract
To develop and evaluate a web application based on multimedia animations, combined with a training program, to improve the prescription of exercises in spondyloarthritis (SpA). After a review of exercises included in the main clinical trials and recommendations of international societies, a multidisciplinary team-rehabilitators, rheumatologists, physiotherapists, computer scientists and graphic designers-developed a web application for the prescription of exercises (EJES-3D). Once completed, this was presented to 12 pairs of rehabilitators-rheumatologists from the same hospital in a workshop. Knowledge about exercise was tested in rheumatologists before and 6 months after the workshop, when they also evaluated the application. The EJES-3D application includes 38 multimedia videos and allows prescribing predesigned programs or customizing them. A patient can consult the prescribed exercises at any time from a device with internet connection (mobile, tablet, or computer). The vast majority of the evaluators (89%) were satisfied or very satisfied and considered that their expectations regarding the usefulness of the web application had been met. They highlighted the ability to tailor exercises adapted to the different stages of the disease and the quality and variety of the videos. They also indicated some limitations of the application and operational problems. The EJES-3D tool was positively evaluated by experts in SpA, potentially the most demanding group of users with the most critical capacity. This allows a preliminary validation of the contents, usefulness, and ease of use. Analyzing and correcting the errors and limitations detected is allowing us to improve the EJES-3D tool.
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Affiliation(s)
- Mariano Tomás Flórez
- Unidad de Rehabilitación, Hospital Universitario Fundación Alcorcón, Calle Budapest, 1, 28922, Alcorcón, Madrid, Spain.
| | - Raquel Almodóvar
- Unidad de Reumatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Fernando García Pérez
- Unidad de Rehabilitación, Hospital Universitario Fundación Alcorcón, Calle Budapest, 1, 28922, Alcorcón, Madrid, Spain
| | | | - Loreto Carmona
- Instituto de Salud Musculoesquelética (InMusc), Madrid, Spain
| | - María Ángeles Pérez Manzanero
- Unidad de Rehabilitación, Hospital Universitario Fundación Alcorcón, Calle Budapest, 1, 28922, Alcorcón, Madrid, Spain
| | - Juan Aboitiz Cantalapiedra
- Unidad de Rehabilitación, Hospital Universitario Fundación Alcorcón, Calle Budapest, 1, 28922, Alcorcón, Madrid, Spain
| | | | | | - Carmen Castro
- Servicio de Reumatología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | | | - Eugenio de Miguel
- Servicio de Reumatología, Hospital Universitario La Paz, Madrid, Spain
| | - Eva Galíndez
- Servicio de Reumatología, Hospital Universitario de Basurto, Bilbao, Spain
| | - José Luis Álvarez Vega
- Servicio de Reumatología, Hospital Regional Universitario Infanta Cristina, Badajoz, Spain
| | | | - Luis F Linares
- Servicio de Reumatología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Mireia Moreno
- Servicio de Reumatología, Corporació Sanitària Parc Taulí, Barcelona, Spain
| | | | - Xavier Juanola
- Servicio de Reumatología, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Pedro Zarco
- Unidad de Reumatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
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van Kasteren Y, Freyne J, Hussain MS. Total Knee Replacement and the Effect of Technology on Cocreation for Improved Outcomes and Delivery: Qualitative Multi-Stakeholder Study. J Med Internet Res 2018; 20:e95. [PMID: 29559424 PMCID: PMC5883076 DOI: 10.2196/jmir.7541] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 08/27/2017] [Accepted: 11/18/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The growth in patient-centered care delivery combined with the rising costs of health care have perhaps not unsurprisingly been matched by a proliferation of patient-centered technology. This paper takes a multistakeholder approach to explore how digital technology can support the cocreation of value between patients and their care teams in the delivery of total knee replacement (TKR) surgery, an increasingly common procedure to return mobility and relieve pain for people suffering from osteoarthritis. OBJECTIVE The aim of this study was to investigate communications and interactions between patients and care teams in the delivery of TKR to identify opportunities for digital technology to add value to TKR health care service by enhancing the cocreation of value. METHODS A multistakeholder qualitative study of user needs was conducted with Australian stakeholders (N=34): surgeons (n=12), physiotherapists (n=3), patients (n=11), and general practitioners (n=8). Data from focus groups and interviews were recorded, transcribed, and analyzed using thematic analysis. RESULTS Encounters between patients and their care teams are information-rich but time-poor. Results showed seven different stages of the TKR journey that starts with referral to a surgeon and ends with a postoperative review at 12 months. Each stage of the journey has different information and communication challenges that can be enhanced by digital technology. Opportunities for digital technology include improved waiting list management, supporting and reinforcing patient retention and recall of information, motivating and supporting rehabilitation, improving patient preparation for hospital stay, and reducing risks and anxiety associated with postoperative wound care. CONCLUSIONS Digital technology can add value to patients' care team communications by enhancing information flow, assisting patient recall and retention of information, improving accessibility and portability of information, tailoring information to individual needs, and by providing patients with tools to engage in their own health care management. For care teams, digital technology can add value through early detection of postoperative complications, proactive surveillance of health data for postoperative patients and patients on waiting lists, higher compliance with rehabilitation programs, and reduced length of stay. Digital technology has the potential to improve patient satisfaction and outcomes, as well as potentially reduce hospital length of stay and the burden of disease associated with postoperative morbidity.
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Affiliation(s)
- Yasmin van Kasteren
- Adaptive Social and Economic Systems, Land and Water, Commonwealth Scientific and Industrial Research Organization, Dutton Park, QLD, Australia
| | - Jill Freyne
- Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organization, Epping, NSW, Australia
| | - M Sazzad Hussain
- Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organization, Epping, NSW, Australia
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Chen KM, Li CH, Huang HT, Cheng YY. Feasible modalities and long-term effects of elastic band exercises in nursing home older adults in wheelchairs: A cluster randomized controlled trial. Int J Nurs Stud 2015; 55:4-14. [PMID: 26655368 DOI: 10.1016/j.ijnurstu.2015.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 11/19/2015] [Accepted: 11/22/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Physical activity holds promise for mobility-impaired older adults to prevent further disabilities and improve their health. However, staffing constraints have made it challenging to promote physical activity in long-term care facilities. OBJECTIVES To test the feasibility and effects of 12 months Wheelchair-bound Senior Elastic Band (WSEB) group-exercises that were led by volunteers for the first six months followed by the DVD-guided for another six months on functional fitness, activities of daily living (ADL), and sleep quality of nursing home older adults in wheelchairs. DESIGN Cluster randomized controlled trial with two groups, pre-test and post-tests. SETTINGS Ten nursing homes, Taiwan. PARTICIPANTS 127 participants participated voluntarily; 107 of them completed the study. INCLUSION CRITERIA (1) aged 65 years and over, (2) using wheelchairs for mobility, (3) living in facility for at least three months, (4) cognitively intact, and (5) heavy or moderate dependency in ADL. Majority of participants were middle-old older adults (75-84 years old, 53.2%), female (51.4%), and had chronic illnesses (98.1%). METHODS Participants were randomly assigned by facility to either the experimental (five nursing homes, n=56) or control group (five nursing homes, n=51). The WSEB program was conducted three times per week and 40 min per session in two stages: volunteer-led for the first six months (stage I) followed by the DVD-guided modality for another six months (stage II). The primary outcomes (functional fitness: lung capacity, body flexibility, range of joint motion, and muscle strength and endurance) and the secondary outcomes (ADL measured by the Barthel Index; sleep quality measured by the Pittsburgh Sleep Quality Index) of the participants were measured at three time points: pre-test, at the six-month interval, and at the end of 12 months of the study. No blinding was applied. RESULTS All of the functional fitness indicators of the experimental group participants improved significantly (p<.05), and were all better than the control group at six-month and 12-month of the study (p<.05). No symptoms of discomfort occurred during interventions. CONCLUSIONS Nursing home older adults in wheelchairs who received WSEB exercise training had better functional fitness, ADL, and sleep quality than those who did not. It was a feasible way of carrying out this exercise program by using the volunteer-led followed by the DVD-guided modalities. The program can be applied in institutional settings routinely.
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Affiliation(s)
- Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan.
| | - Chun-Huw Li
- Department of Nursing, Yuhing Junior College of Health Care and Management, No. 15, Lane 420, Dachang 2nd Rd., Sanmin District, Kaohsiung 80776, Taiwan.
| | - Hsin-Ting Huang
- College of Nursing, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan.
| | - Yin-Yin Cheng
- College of Nursing, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan.
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Moran L, Francis-Coad J, Patman S, Hill AM. Using a personalized DVD to prescribe an exercise program to older people post-hip fracture enhances adherence to the exercises – A feasibility study. Geriatr Nurs 2015; 36:273-80. [DOI: 10.1016/j.gerinurse.2015.02.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 02/19/2015] [Accepted: 02/23/2015] [Indexed: 10/23/2022]
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Kingston GA, Williams G, Judd J, Gray MA. Hand therapy services for rural and remote residents: Results of a survey of Australian occupational therapists and physiotherapists. Aust J Rural Health 2015; 23:112-21. [DOI: 10.1111/ajr.12141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2014] [Indexed: 11/26/2022] Open
Affiliation(s)
- Gail A. Kingston
- School of Public Health; Tropical Medicine and Rehabilitation Sciences; Anton Breinl Centre for Health Systems Strengthening James; Cook University; Townsville Queensland Australia
- The Townsville Hospital; Townsville Queensland Australia
| | - Gary Williams
- School of Public Health; Tropical Medicine and Rehabilitation Sciences; Anton Breinl Centre for Health Systems Strengthening James; Cook University; Townsville Queensland Australia
| | - Jenni Judd
- Faculty of Medicine, Health and Molecular Sciences; Anton Breinl Centre for Health Systems Strengthening James; Cook University; Townsville Queensland Australia
| | - Marion A. Gray
- Occupational Therapy; School of Health and Sport Sciences; University of Sunshine Coast; Sunshine Coast Queensland Australia
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Roia A, Paviotti E, Ferluga V, Montico M, Monasta L, Ronfani L, Tamburlini G. Promoting effective child development practices in the first year of life: does timing make a difference? BMC Pediatr 2014; 14:222. [PMID: 25193490 PMCID: PMC4177066 DOI: 10.1186/1471-2431-14-222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 06/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an increasing need for parenting programs aimed at promoting parent-child interaction. A variety of interventions have been proposed. The use of audiovisual materials for parents has been shown to be effective but limited information is available on the optimal timing for its use, particularly for new parents during the first year of life of their children. The aim of this study is to compare the effectiveness of a video administered at two different times to first-time parents in modifying parental knowledge, attitudes and intentions with regards to effective care practices. METHODS Open randomized controlled trial carried out in a referral mother and child hospital. Eligible parents were randomly assigned to receive a video at one month (early intervention) or at seven months (late intervention) of age of their child. The video addressed four specific activities related to early child development: reading aloud to the baby, early exposure to music, promotion of early socialization for parents and for children. The primary outcome was the proportion of parents who declared that their knowledge, attitudes and intentions changed after having seen the video at one or seven months of age of the child. RESULTS One hundred and five families were randomly allocated either to the early (53) or to the late (52) intervention group. For 99 families (52 in the early and 47 in the late group) a complete outcome evaluation was available. Parents included in the early administration group more frequently reported modifications in their knowledge of the suggested practices while parents in the late group more frequently reported a change in their attitudes. This finding was consistent across all four practices. The video was found to influence parental intentions in the great majority of interviewed parents with no significant difference between groups (82.7% and 87.2% in the early and late intervention group, respectively). CONCLUSIONS Audiovisual materials can be an effective complementary tool in programs aimed at supporting parents, particularly those dealing with their first baby. The results provide some useful insights into the differential benefits of using audiovisual aids at different times during the first year of life of the baby. TRIAL REGISTRATION ClinicalTrials.gov NCT02120430.
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Affiliation(s)
| | | | | | | | | | - Luca Ronfani
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137 Trieste, Italy.
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van Het Reve E, Silveira P, Daniel F, Casati F, de Bruin ED. Tablet-based strength-balance training to motivate and improve adherence to exercise in independently living older people: part 2 of a phase II preclinical exploratory trial. J Med Internet Res 2014; 16:e159. [PMID: 24966165 PMCID: PMC4090377 DOI: 10.2196/jmir.3055] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 03/19/2014] [Accepted: 05/31/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Home-based exercise programs can improve physical functioning and health status of elderly people. Successful implementation of exercise interventions for older people presents major challenges and supporting elderly people properly while doing their home-based exercises is essential for training success. We developed a tablet-based system-ActiveLifestyle-that offers older adults a home-based strength-balance training program with incorporated motivation strategies and support features. OBJECTIVE The goal was to compare 3 different home-based training programs with respect to their effect on measures of gait quality and physical performance through planned comparisons between (1) tablet-based and brochure-based interventions, (2) individual and social motivation strategies, and (3) active and inactive participants. METHODS A total of 44 autonomous-living elderly people (mean 75, SD 6 years) were assigned to 3 training groups: social (tablet guided, n=14), individual (tablet guided, n=13), and brochure (brochure guided, n=17). All groups joined a 12-week progressive home-based strength-balance training program. Outcome measures were gait performance under single and dual task conditions, dual task costs of walking, falls efficacy, and physical performance as measured by the Short Physical Performance Battery (SPPB). Furthermore, active (≥75% program compliance) and inactive (<75% program compliance) individuals were compared based on their characteristics and outcome measures. RESULTS The tablet groups showed significant improvements in single and dual task walking, whereas there were no significant changes observable in the brochure group. Between-groups comparisons revealed significant differences for gait velocity (U=138.5; P=.03, r=.33) and cadence (U=138.5, P=.03 r=.34) during dual task walking at preferred speed in favor of the tablet groups. The brochure group had more inactive participants, but this did not reach statistical significance (U=167, P=.06, r=.29). The active participants outperformed the inactive participants in single and dual task walking, dual task costs of walking, and SPPB scores. Significant between-groups differences were seen between the tablet groups and the brochure group, in favor of the tablet groups. CONCLUSIONS A tablet-based strength-balance training program that allows monitoring and assisting autonomous-living older adults while training at home was more effective in improving gait and physical performance when compared to a brochure-based program. Social or individual motivation strategies were equally effective. The most prominent differences were observed between active and inactive participants. These findings suggest that in older adults a tablet-based intervention enhances training compliance; hence, it is an effective way to improve gait.
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Affiliation(s)
- Eva van Het Reve
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
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Chan C, Driscoll T, Ackermann B. Exercise DVD effect on musculoskeletal disorders in professional orchestral musicians. Occup Med (Lond) 2013; 64:23-30. [DOI: 10.1093/occmed/kqt117] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Kingston GA, Williams G, Gray MA, Judd J. Does a DVD improve compliance with home exercise programs for people who have sustained a traumatic hand injury? Results of a feasibility study. Disabil Rehabil Assist Technol 2013; 9:188-94. [PMID: 23789615 DOI: 10.3109/17483107.2013.806600] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This feasibility study sought to determine if compliance and understanding of a home exercise program following a traumatic hand injury is improved when patients are provided with a DVD and a brochure when compared to using brochures only. METHOD Patients who presented with a traumatic hand injury and commenced on a hand therapy protocol were randomly assigned into two groups. The control group received brochures while the experimental group were provided with exercise instructions on DVD as well as brochures. Compliance was measured through the use of exercise diaries, clinic attendance, a checklist to measure correctness and understanding of exercises and a follow-up survey. RESULTS No significant improvement was found in the mean exercise compliance score (p = 0.344) between the intervention and control groups. From the survey results almost half of all participants reported that pain interfered in their ability to perform their home exercises and a third acknowledged that time limited their ability to perform their exercises. CONCLUSION Findings demonstrate the multidimensional nature of compliance. The provision of DVD technology, while not shown to cause a statistically significant change in overall compliance, did help improve understanding of exercises; as such DVDs could be utilised as part of a program that facilitates the patient--therapist relationship. IMPLICATIONS FOR REHABILITATION Limited time and level of pain are highlighted as reasons for non compliance with exercise and treatment programs. The use of DVDs can improve understanding and execution of exercises and can be part of a treatment program that facilitates increased patient therapist contact for rural and remote clients.
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Affiliation(s)
- Gail A Kingston
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University , Townsville , Australia
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An exercise-based physical therapy program for patients with patellar tendinopathy after platelet-rich plasma injection. Phys Ther Sport 2012; 14:124-30. [PMID: 23010772 DOI: 10.1016/j.ptsp.2012.05.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 04/12/2012] [Accepted: 05/11/2012] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To describe a post platelet-rich plasma (PRP) injection, exercise-based physical therapy program, investigate feasibility and report the first results of patellar tendinopathy patients treated with PRP injection combined with the physical therapy program. STUDY DESIGN Case-series. SETTING A PRP injection followed by a physical therapy program seems promising for the treatment of patellar tendinopathy. However, descriptions of physical therapy programs are often limited and incomplete. PARTICIPANTS Five patellar tendinopathy patients (six tendons) in the degenerative phase. MAIN OUTCOME MEASURE VISA-P score. RESULTS Muscle strength, endurance, power and retraining sport-specific function form the basis for the physical therapy program aiming to improve the load capacity of the knee. The program is characterised by gradually increasing intensity and difficulty of exercises. Five of the six tendons showed an improvement of at least 30 points on the VISA-P after 26 weeks. CONCLUSIONS This study extensively describes, based on current knowledge, a physical therapy program after PRP injection for patellar tendinopathy patients. The combination treatment reported in this study is feasible and seems to be promising for patients in the late/degenerative phase of patellar tendinopathy.
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Adherence to use of a home-based exercise DVD in people with Huntington disease: participants' perspectives. Phys Ther 2012; 92:69-82. [PMID: 21960468 DOI: 10.2522/ptj.20100438] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Individualized exercise instruction on a regular basis may be desirable for people with Huntington disease (HD). Sustained interventions, however, may not be the most feasible for lifelong disease management. It is critical, therefore, for physical therapists to find ways to facilitate engagement in independent exercise programs. The capabilities of DVD technology can make the DVD a useful format to facilitate engagement for people with HD who have motivational and cognitive problems. OBJECTIVE The purpose of this study was to explore how people with HD used a home-based exercise DVD and how it was perceived by the participants and their caregivers. DESIGN An exploratory, mixed-method design was used in this study. METHODS Fifteen participants with HD were provided with an exercise DVD, developed by the authors, to support their engagement in a home-based exercise program. Exercise diaries were used to record adherence rates. Semistructured interviews were conducted to explore what factors affected the usability of the DVD. Conversations were audio recorded and fully transcribed. Content analysis approach was used to analyze the interviews. RESULTS Most of the participants (11/15, 73.3%) adhered well to the use of the DVD. Participants felt that the exercises were suitable. Commitment of the caregiver as a key to the success of the program was the main theme that emerged from the data. Participants identified barriers and facilitators that affected adherence to using the exercise DVD and described management strategies that helped promote adherence to the exercise program. CONCLUSIONS The DVD was perceived to be suitable and supportive. The DVD could be appropriate for use in supporting people with HD to engage in exercise at home, either outside of therapy sessions or upon completion of a therapy program.
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Lemoncello R, Sohlberg MM, Fickas S, Albin R, Harn BE. Phase I evaluation of the television assisted prompting system to increase completion of home exercises among stroke survivors. Disabil Rehabil Assist Technol 2010; 6:440-52. [DOI: 10.3109/17483107.2010.542571] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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