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Ahmad AM, Mohamed Awad Allah SA, Abd Elhaseeb GA, Elsharawy DE, Ahmed HS, Mohamed Abdelwahab MA. Effects of conventional versus virtual reality-simulated treadmill exercise on fatigue, cognitive function, and participant satisfaction in post-COVID-19 subjects. A randomized trial. J Exerc Sci Fit 2024; 22:316-321. [PMID: 38765321 PMCID: PMC11098941 DOI: 10.1016/j.jesf.2024.04.003] [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: 11/14/2023] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/22/2024] Open
Abstract
Background/objective Post-COVID-19 subjects typically experience symptoms of fatigue, cognitive impairment, and sleep difficulty, which can be relieved by conventional aerobic exercise. Virtual Reality (VR) technology to support conventional exercise has recently gained much attention. Therefore, this study aimed to assess the effects of traditional treadmill exercise compared to virtual reality-simulated treadmill exercise on fatigue, cognitive function, sleep quality, and participant satisfaction with the exercise program in post-COVID-19 subjects. Methods This single-centered, randomized, parallel-group intervention study was conducted between December 2021 and March 2022. Sixteen of twenty post-COVID-19 subjects completed this study (n1 = 8, n2 = 8). Inclusion criteria were persistent dyspnea/fatigue, mild cognitive problems, and age from 30-60 years. Exclusion criteria were previous severe COVID-19 infection and ICU admission, concomitant respiratory or cardiovascular disease, and musculoskeletal or neurological disease. Eligible subjects were assigned randomly to two groups: a non-VR group that received traditional treadmill aerobic exercise only and a VR group that received treadmill exercise with non-immersive VR. Both groups received moderate-intensity exercise on a treadmill at [50-60 % (peak HR-resting HR) + resting HR] for 30-45 min, three times per week, and for four weeks. The outcome measures were the Chalder Fatigue Scale, Montreal Cognitive Assessment (MoCA) questionnaire, Pittsburgh Sleep Quality Index (PSQI), and participant satisfaction with the exercise program rated on a 5-point Likert scale. Results Both groups showed significant improvements in the Chalder Fatigue Scale, the MoCA questionnaire, and the PSQI scores after training compared to baseline (p < 0.05), without significant differences between them (p > 0.05). However, participant satisfaction with the exercise program was significantly higher in the VR group than in the non-VR group (p = 0.037). Conclusion A moderate-intensity 4-week treadmill exercise program with and without non-immersive VR may improve fatigue, cognitive function, and sleep quality to the same extent in COVID-19 survivors. However, participant satisfaction with the exercise program could be greater after conventional treadmill training assisted by non-immersive VR than after conventional treadmill training alone in this cohort. Trial registration Pan African Clinical Trials Registry, PACTR202311561948428, retrospectively registered.
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Affiliation(s)
- Ahmad Mahdi Ahmad
- Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Sara Ali Mohamed Awad Allah
- Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Gehad Ali Abd Elhaseeb
- Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | | | - Hend Salem Ahmed
- Physical Therapy Department, National Heart Institute, Giza, Egypt
| | - Mona Ahmed Mohamed Abdelwahab
- Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Wen P, Sun L, Shen T, Wang Z. Factors impeding physical activity in older hospitalised patients: A qualitative meta-synthesis. J Clin Nurs 2024; 33:3273-3282. [PMID: 38572996 DOI: 10.1111/jocn.17158] [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: 01/13/2024] [Revised: 02/25/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Older hospitalised patients have low levels of physical activity and multiple impairing factors. AIMS To systematically evaluate the perceived barriers to physical activity among older patients during hospitalisation, and provide reference for future intervention programs. DESIGN Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. METHODS An exhaustive exploration was conducted across the CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Embase, Cochrane Library and Web of Science from their inception until August, 2023 to identify qualitative research on obstacles to physical activity among older hospital patients. The quality of the literature was evaluated using the Joanna Briggs Institute's critical appraisal tool for qualitative research. Meta-synthesis method was used to integrate the results. RESULTS In total, 8 literatures were included, 43 themes were extracted, and analogous research results were amalgamated to generate 10 categories and 3 syntheses: individual level, interpersonal influencing factors and hospital environment and resources level. CONCLUSION Older inpatients are faced with multiple barriers to physical activity. Medical staff should pay attention to changes in physical activity during hospitalisation, identify barriers to physical activity in older inpatients and provide references for promoting physical activity programs for the older. NO PATIENT OR PUBLIC CONTRIBUTION This study is a meta-synthesis and does not require relevant contributions from patients or the public. WHAT IS ALREADY KNOWN Older patients are at low physical activity levels during hospitalisation. Older inpatients are faced with multiple barriers to physical activity. WHAT THIS PAPER ADDS Factors of physical activity impairment in hospitalised older patients should be considered in the context of health status, psychological factors, motivation and social support. Disease-induced psychological fallout has a greater impact on physical activity in the older.
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Affiliation(s)
- Peiting Wen
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Lili Sun
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - TianTian Shen
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhaodi Wang
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Maier L, Benzinger P, Abel B, Roigk P, Bongartz M, Wirth I, Cuvelier I, Schölch S, Büchele G, Deuster O, Bauer J, Rapp K, Ullrich C, Wensing M, Roth C. The role of patient-related factors in the implementation of a multimodal home-based rehabilitation intervention after discharge from inpatient geriatric rehabilitation (GeRas): a qualitative process evaluation. Eur Geriatr Med 2024:10.1007/s41999-024-01027-5. [PMID: 39085750 DOI: 10.1007/s41999-024-01027-5] [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: 05/16/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Structured aftercare programs are implemented to facilitate the transition from rehabilitation centers to patients' home environments. Taking the program GeRas as an example, this paper aims to evaluate the influence of patient-related factors on the implementation of the geriatric aftercare program GeRas from patients' and providers' perspectives. METHODS To capture patients' and providers' perspectives, qualitative interviews were conducted using a semi-structured interview guide. The analysis was inductive-deductive and based on the thematic analysis by Braun and Clarke and guided by Domain IV of the CFIR. RESULTS 16 participants (10 patients, 4 providers, 2 family members) were interviewed from May 2023 to November 2023. Patient-related factors were perceived as an important aspect during the implementation of the GeRas program. The results were allocated to the four Constructs of Domain IV of the CFIR (Motivation, Opportunity, Capability, Needs). Especially patients' intrinsic motivation, social environment, and physical capabilities seemed to be crucial for successful implementation. While extrinsic motivation can mitigate missing personal capabilities, it cannot replace the presence of intrinsic motivation and capabilities. The results showed that patient-related factors are interlinked. DISCUSSION/CONCLUSION The relevance of patient-related factors during the implementation of the GeRas program shows that such programs must consider these factors during intervention planning.
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Affiliation(s)
- Leonie Maier
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany.
| | - Petra Benzinger
- Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Bastian Abel
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Patrick Roigk
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Martin Bongartz
- Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Isabel Wirth
- Geriatric Center Karlsruhe, ViDia Christian Clinics Karlsruhe, Karlsruhe, Germany
| | - Ingeborg Cuvelier
- Geriatric Center Karlsruhe, ViDia Christian Clinics Karlsruhe, Karlsruhe, Germany
| | - Sabine Schölch
- Department of Telemedicine, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Gisela Büchele
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Oliver Deuster
- Interdisciplinary Centre for Clinical Trials (IZKS) at the University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jürgen Bauer
- Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Kilian Rapp
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Charlotte Ullrich
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Catharina Roth
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
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Herold F, Theobald P, Gronwald T, Kaushal N, Zou L, de Bruin ED, Bherer L, Müller NG. The Best of Two Worlds to Promote Healthy Cognitive Aging: Definition and Classification Approach of Hybrid Physical Training Interventions. JMIR Aging 2024; 7:e56433. [PMID: 39083334 DOI: 10.2196/56433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 08/02/2024] Open
Abstract
A healthy lifestyle can be an important prerequisite to prevent or at least delay the onset of dementia. However, the large number of physically inactive adults underscores the need for developing and evaluating intervention approaches aimed at improving adherence to a physically active lifestyle. In this regard, hybrid physical training, which usually combines center- and home-based physical exercise sessions and has proven successful in rehabilitative settings, could offer a promising approach to preserving cognitive health in the aging population. Despite its potential, research in this area is limited as hybrid physical training interventions have been underused in promoting healthy cognitive aging. Furthermore, the absence of a universally accepted definition or a classification framework for hybrid physical training interventions poses a challenge to future progress in this direction. To address this gap, this article informs the reader about hybrid physical training by providing a definition and classification approach of different types, discussing their specific advantages and disadvantages, and offering recommendations for future research. Specifically, we focus on applying digital technologies to deliver home-based exercises, as their use holds significant potential for reaching underserved and marginalized groups, such as older adults with mobility impairments living in rural areas.
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Affiliation(s)
- Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Paula Theobald
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Hamburg, Germany
| | - Navin Kaushal
- Department of Health Sciences, School of Health & Human Sciences, Indiana University, Indianapolis, IN, United States
| | - Liye Zou
- Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen, China
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zürich, Switzerland
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St Gallen, Switzerland
| | - Louis Bherer
- Montreal Heart Institute, Montreal, QC, Canada
- Department of Medicine, Université de Montreal, Montreal, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Geriatrie de Montreal, Montreal, QC, Canada
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
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Rihova M, Jandova T, Vetrovsky T, Machacova K, Kramperova V, Steffl M, Hospodkova P, Marchelek-Myśliwiec M, Holmerova I. Adherence and Retention Rates to Home-Based Video Exercise Programs in Older Adults-Systematic Review and Meta-Analysis. Telemed J E Health 2024. [PMID: 39072676 DOI: 10.1089/tmj.2024.0100] [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: 07/30/2024] Open
Abstract
Introduction: This systematic review and meta-analysis aimed to investigate adherence and retention rates to home-based video exercise programs and identify key factors associated with these rates in older adults to understand the effectiveness of home-based video exercise interventions. Methods: We searched PubMed, Web of Science, and Scopus for articles addressing adherence to and retention of home-based video exercise programs. The study was conducted following PRISMA recommendations. Results: A total of 26 articles, including 1,292 participants older than 65, were included in the final qualitative and quantitative syntheses. The weighted mean of the retention rate was 91.1, and of the attendance rate was 85.0, with low I2 = 3.5, not significant p = 0.409 heterogeneity. The generalized regression models showed a positive effect of session duration on the attendance rate (%), where the possible change from <20 min to >60 min duration could decrease the attendance rate (%) B = -24.390 (p <0.001). The delivery method had a significant effect, where the absence of live contact with the coach in web-based or DVD-delivered interventions could decrease the attendance rate (%) compared to the online sessions B = -11.482 (p = 0.010). The lockdown during the COVID-19 pandemic had a positive effect on both the attendance rate (%) B = 10.321 (p = 0.019) and retention rate (%) B = 9.577 (p = 0.032). Conclusions: This systematic review and meta-analysis indicate that supervised home-based video exercise programs lasting less than 60 min might be a suitable and sustainable exercise mode to keep older adults active, especially in times resembling feelings of confinement.
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Affiliation(s)
- Marcela Rihova
- Longevity Studies, Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Tereza Jandova
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Katerina Machacova
- Longevity Studies, Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Veronika Kramperova
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Michal Steffl
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Petra Hospodkova
- Department of Biomedical Technology, Faculty Biomedical Engineering, Czech Technical University, Kladno, Czech Republic
| | | | - Iva Holmerova
- Longevity Studies, Faculty of Humanities, Charles University, Prague, Czech Republic
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Tsou HK, Chen HY, Shih KC, Lin YC. Para table tennis improves psychological/mental and cardiovascular health in individuals with spinal cord injury. NeuroRehabilitation 2024:NRE240083. [PMID: 39058455 DOI: 10.3233/nre-240083] [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: 07/28/2024]
Abstract
BACKGROUND Although rehabilitation exercise is known to be beneficial for cardiovascular and mental health, it remains a daunting challenge for patients with spinal cord injury (SCI) who rely on wheelchairs for mobility. OBJECTIVE This study aimed to examine the effectiveness of a 4-week para table tennis program in enhancing self-efficacy and health outcomes in adults with SCI. METHODS A total of 39 SCI patients were included and divided into the experimental group (n = 18, a 4-week para table tennis training program) and the control group (n = 21). Frequency domain indices of heart rate variability (HRV) were used to evaluate the function of the autonomic nervous system. RESULTS Following para table tennis training, there was a significant reduction in the physical stress index (PSI, P < 0.001), accompanied by shifts in autonomic regulation of vagal dominance. Additionally, the para table tennis training led to significant improvements in vessel state, differential pulse wave index, atrial elasticity, eccentric constriction power, remaining blood volume, and self-efficacy (all P < 0.05). CONCLUSION Para table tennis training results in favorable changes in sympathetic tone, enhanced self-efficacy, improved cardiovascular well-being, and an overall positive transformation in HRV.
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Affiliation(s)
- Hsi-Kai Tsou
- Functional Neurosurgery Division, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli County, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- College of Health, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Hsiao-Yu Chen
- Department of Nursing, National Taichung University of Science and Technology, Taiwan
| | | | - Yueh-Chiang Lin
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
- National Taichung University of Science and Technology, Taichung, Taiwan
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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.
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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
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Pabla P, Jones E, Piasecki M, Phillips B. Skeletal muscle dysfunction with advancing age. Clin Sci (Lond) 2024; 138:863-882. [PMID: 38994723 PMCID: PMC11250095 DOI: 10.1042/cs20231197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/15/2024] [Accepted: 06/20/2024] [Indexed: 07/13/2024]
Abstract
As a result of advances in medical treatments and associated policy over the last century, life expectancy has risen substantially and continues to increase globally. However, the disconnect between lifespan and 'health span' (the length of time spent in a healthy, disease-free state) has also increased, with skeletal muscle being a substantial contributor to this. Biological ageing is accompanied by declines in both skeletal muscle mass and function, termed sarcopenia. The mechanisms underpinning sarcopenia are multifactorial and are known to include marked alterations in muscle protein turnover and adaptations to the neural input to muscle. However, to date, the relative contribution of each factor remains largely unexplored. Specifically, muscle protein synthetic responses to key anabolic stimuli are blunted with advancing age, whilst alterations to neural components, spanning from the motor cortex and motoneuron excitability to the neuromuscular junction, may explain the greater magnitude of function losses when compared with mass. The consequences of these losses can be devastating for individuals, their support networks, and healthcare services; with clear detrimental impacts on both clinical (e.g., mortality, frailty, and post-treatment complications) and societal (e.g., independence maintenance) outcomes. Whether declines in muscle quantity and quality are an inevitable component of ageing remains to be completely understood. Nevertheless, strategies to mitigate these declines are of vital importance to improve the health span of older adults. This review aims to provide an overview of the declines in skeletal muscle mass and function with advancing age, describes the wide-ranging implications of these declines, and finally suggests strategies to mitigate them, including the merits of emerging pharmaceutical agents.
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Affiliation(s)
- Pardeep Pabla
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
| | - Eleanor J. Jones
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
| | - Mathew Piasecki
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), U.K
- NIHR Nottingham Biomedical Research Centre (BRC), U.K
| | - Bethan E. Phillips
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), U.K
- NIHR Nottingham Biomedical Research Centre (BRC), U.K
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He S, Meng D, Wei M, Guo H, Yang G, Wang Z. Proposal and validation of a new approach in tele-rehabilitation with 3D human posture estimation: a randomized controlled trial in older individuals with sarcopenia. BMC Geriatr 2024; 24:586. [PMID: 38977995 PMCID: PMC11232209 DOI: 10.1186/s12877-024-05188-7] [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: 12/22/2023] [Accepted: 07/01/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVE Through a randomized controlled trial on older adults with sarcopenia, this study compared the training effects of an AI-based remote training group using deep learning-based 3D human pose estimation technology with those of a face-to-face traditional training group and a general remote training group. METHODS Seventy five older adults with sarcopenia aged 60-75 from community organizations in Changchun city were randomly divided into a face-to-face traditional training group (TRHG), a general remote training group (GTHG), and an AI-based remote training group (AITHG). All groups underwent a 3-month program consisting of 24-form Taichi exercises, with a frequency of 3 sessions per week and each session lasting 40 min. The participants underwent Appendicular Skeletal Muscle Mass Index (ASMI), grip strength, 6-meter walking pace, Timed Up and Go test (TUGT), and quality of life score (QoL) tests before the experiment, during the mid-term, and after the experiment. This study used SPSS26.0 software to perform one-way ANOVA and repeated measures ANOVA tests to compare the differences among the three groups. A significance level of p < 0.05 was defined as having significant difference, while p < 0.01 was defined as having a highly significant difference. RESULTS (1) The comparison between the mid-term and pre-term indicators showed that TRHG experienced significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05); GTHG experienced extremely significant improvements in 6-meter walking pace and QoL (p < 0.01); AITHG experienced extremely significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05). (2) The comparison between the post-term and pre-term indicators showed that TRHG experienced extremely significant improvements in TUGT timing test (p < 0.01); GTHG experienced significant improvements in ASMI and TUGT timing test (p < 0.05); and AITHG experienced extremely significant improvements in TUGT timing test (p < 0.01). (3) During the mid-term, there was no significant difference among the groups in all tests (p > 0.05). The same was in post-term tests (p > 0.05). CONCLUSION Compared to the pre-experiment, there was no significant difference at the post- experiment in the recovery effects on the muscle quality, physical activity ability, and life quality of patients with sarcopenia between the AI-based remote training group and the face-to-face traditional training group. 3D pose estimation is equally as effective as traditional rehabilitation methods in enhancing muscle quality, functionality and life quality in older adults with sarcopenia. TRIAL REGISTRATION The trial was registered in ClinicalTrials.gov (NCT05767710).
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Affiliation(s)
- Shichun He
- 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
| | - Meiqi Wei
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Hongzhi Guo
- AI Group, Intelligent Lancet LLC, Sacramento, CA, 95816, USA
- Graduate School of Human Sciences, Waseda University, Tokorozawa, 3591192, Aitama, Japan
| | - 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, CA, 95816, USA.
- Advanced Research Center for Human Sciences, Waseda University, Tokorozawa, 3591192, Aitama, Japan.
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Aumaitre A, Gagnayre R, Foucaut AM. Determinants and factors of physical activity and sedentary behaviors among post-treatment breast, colorectal, lung, and prostate cancer survivors living in France: Results from the DEFACTO study first phase. PATIENT EDUCATION AND COUNSELING 2024; 124:108273. [PMID: 38598865 DOI: 10.1016/j.pec.2024.108273] [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: 08/08/2023] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE This study aimed to investigate the facilitators and barriers to adopting an active lifestyle among post-treatment cancer survivors in France. METHODS Breast, colorectal, lung, and prostate cancer survivors were recruited. Participants completed a questionnaire covering sociodemographic and clinical factors, physical activity (PA) experiences, variables from the Transtheoretical model, types of motivation, knowledge of PA benefits, barriers to PA, and quality of life. We categorized participants into 4 profiles combining PA level and sedentary behaviors. RESULTS One hundred and seventy-five participants were included. Ordinal logistic regression revealed that the active lifestyle of cancer survivors is influenced by their professional situation (OR, 3.99; 95%CI, 1.76-9.10 and OR, 3.14; 95%CI, 1.45-6.77), the use of self-liberation (OR, 0.41; 95%CI, 0.20-0.82), helping relationships processes of change (OR, 2.45; 95%CI, 1.20-5.00), and quality of life (OR, 1.11; 95%CI, 1.04-1.18). CONCLUSIONS Identifying the factors associated with PA and sedentary behavior among cancer survivors in France will facilitate the adaptation of programs according to a whole-person approach. Semi-structured interviews will further enhance insights in this mixed-methods study. PRACTICE IMPLICATIONS Interventions aimed at promoting an active lifestyle among cancer survivors should be customized based on professional situation, the utilization of experiential behavior change processes, and perceived quality of life.
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Affiliation(s)
- Albane Aumaitre
- Sorbonne Paris North University, Health Educations and Promotion Laboratory, LEPS, UR 3412, F-93430 Villetaneuse, France.
| | - Rémi Gagnayre
- Sorbonne Paris North University, Health Educations and Promotion Laboratory, LEPS, UR 3412, F-93430 Villetaneuse, France
| | - Aude-Marie Foucaut
- Sorbonne Paris North University, Health Educations and Promotion Laboratory, LEPS, UR 3412, F-93430 Villetaneuse, France; Sports Science department, Sorbonne Paris North University, Bobigny, France
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11
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Letton ME, Trần TB, Flower S, Wewege MA, Wang AY, Sandler CX, Sen S, Arnold R. Digital Physical Activity and Exercise Interventions for People Living with Chronic Kidney Disease: A Systematic Review of Health Outcomes and Feasibility. J Med Syst 2024; 48:63. [PMID: 38951385 PMCID: PMC11217122 DOI: 10.1007/s10916-024-02081-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
Physical activity is essential to interrupt the cycle of deconditioning associated with chronic kidney disease (CKD). However, access to targeted physical activity interventions remain under-supported due to limited funding and specialised staff. Digital interventions may address some of these factors. This systematic review sought to examine the evidence base of digital interventions focused on promoting physical activity or exercise and their effect on health outcomes for people living with CKD. Electronic databases (PubMed, CINAHL, Embase, Cochrane) were searched from 1 January 2000 to 1 December 2023. Interventions (smartphone applications, activity trackers, websites) for adults with CKD (any stage, including transplant) which promoted physical activity or exercise were included. Study quality was assessed, and a narrative synthesis was conducted. Of the 4057 records identified, eight studies (five randomised controlled trials, three single-arm studies) were included, comprising 550 participants. Duration ranged from 12-weeks to 1-year. The findings indicated acceptability and feasibility were high, with small cohort numbers and high risk of bias. There were inconsistent measures of physical activity levels, self-efficacy, body composition, physical function, and psychological outcomes which resulted in no apparent effects of digital interventions on these domains. Data were insufficient for meta-analysis. The evidence for digital interventions to promote physical activity and exercise for people living with CKD is limited. Despite popularity, there is little evidence that current digital interventions yield the effects expected from traditional face-to-face interventions. However, 14 registered trials were identified which may strengthen the evidence-base.
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Affiliation(s)
- Meg E Letton
- School of Medical, Indigenous & Health Sciences, University of Wollongong, Wollongong, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Thái Bình Trần
- School of Medical, Indigenous & Health Sciences, University of Wollongong, Wollongong, NSW, Australia
- School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
- Department of Renal Medicine, Concord Repatriation and General Hospital, Sydney, NSW, Australia
| | - Shanae Flower
- School of Medical, Indigenous & Health Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Michael A Wewege
- School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Amanda Ying Wang
- Department of Renal Medicine, Concord Repatriation and General Hospital, Sydney, NSW, Australia
- Concord Clinical School, University of Sydney, Sydney, NSW, Australia
- Renal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- The Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Carolina X Sandler
- School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Shaundeep Sen
- Department of Renal Medicine, Concord Repatriation and General Hospital, Sydney, NSW, Australia
- Concord Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Ria Arnold
- School of Medical, Indigenous & Health Sciences, University of Wollongong, Wollongong, NSW, Australia.
- School of Health Sciences, University of New South Wales, Sydney, NSW, Australia.
- Department of Renal Medicine, Concord Repatriation and General Hospital, Sydney, NSW, Australia.
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Gómez-Redondo P, Valenzuela PL, Morales JS, Ara I, Mañas A. Supervised Versus Unsupervised Exercise for the Improvement of Physical Function and Well-Being Outcomes in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Med 2024; 54:1877-1906. [PMID: 38647999 PMCID: PMC11258164 DOI: 10.1007/s40279-024-02024-1] [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] [Accepted: 03/19/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Unsupervised exercise intervention (UNSUP) appears to be a practical and beneficial strategy for older adults, although its feasibility and effectiveness compared to supervised exercise intervention (SUP) remains unknown. We aimed to compare the safety, attendance/adherence rates, and effectiveness of SUP versus UNSUP on physical function and well-being outcomes in older adults. METHODS A systematic search was conducted in PubMed, Web of Science, CINAHL, SPORTDiscus, and APA PsycINFO up to September 2022 for randomized controlled trials comparing SUP versus UNSUP in older adults (≥ 60 years). Safety and attendance/adherence rates were registered as indicators of feasibility, and meta-analyses were performed for physical function and well-being outcomes. Sub-analyses were performed for those studies that applied a similar intervention in both groups and for those studies where participants performed ≥ 66% of the sessions in the assigned condition. RESULTS Thirty-four studies were included (n = 2830). No serious adverse events were reported, with similar attendance rates (81%) for both SUP and UNSUP. Compared with UNSUP, SUP induced significant higher benefits on knee extension strength (standardized mean difference (SMD) = 0.18, p = 0.002), sit-to-stand test (STS, SMD = 0.25, p = 0.050), timed-up-and-go test (TUG, SMD = 0.21, p = 0.035), usual gait speed (SMD = 0.29, p = 0.026), lean mass (mean difference = 1.05 kg, p < 0.001) and health-related quality of life (HRQoL, SMD = 0.21, p = 0.035), albeit only knee extension strength remained significant in sensitivity analyses. Sub-analyses revealed superior benefits of SUP on knee extension strength when only considering those studies that applied a similar intervention in both SUP and UNSUP groups. However, no significant benefits were found for the remaining outcomes. Beneficial effects of SUP over UNSUP were also observed for knee extension strength, STS, functional reach test, TUG, usual gait speed, lean mass, and HRQoL when separately analyzing those studies in which participants performed ≥ 66% of the sessions in the assigned condition. CONCLUSIONS Current evidence suggests that both SUP and UNSUP programs are safe and could exert benefits on physical function and HRQoL. However, despite being associated with similar attendance rates, SUP might offer some additional benefits, although further high-quality research (i.e., accounting for confounding factors such as presence of supervised sessions in UNSUP or vice versa, as well as equating the exercise dose) is necessary to confirm these findings. PROSPERO REGISTRATION NUMBER CRD42022326420.
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Affiliation(s)
- Paola Gómez-Redondo
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain
- CIBER On Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital, 12 de Octubre (imas12), Madrid, Spain
- Biology Systems Department, University of Alcalá, Madrid, Spain
| | - Javier S Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerto Real University Hospital, University of Cadiz, Cadiz, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain
- CIBER On Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Asier Mañas
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.
- CIBER On Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain.
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain.
- Center UCM-ISCIII for Human Evolution and Behavior, 28029, Madrid, Spain.
- Faculty of Education, Complutense University of Madrid, 28040, Madrid, Spain.
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García-Vigara A, Fernandez-Garrido J, Carbonell-Asíns JA, Sánchez-Sánchez ML, Monllor-Tormos A, García-Pérez MÁ, Tarín JJ, Cano A. Physical activity to reduce the burden of frailty after menopause: effectiveness and adherence rate of a resource saving exercise plan. Menopause 2024; 31:634-640. [PMID: 38743912 DOI: 10.1097/gme.0000000000002372] [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: 05/16/2024]
Abstract
OBJECTIVE Frailty may be increased by menopause. Physical activity has been proposed to reduce frailty, but poor adherence and cost limit effectiveness. We aimed to investigate both the effectiveness against the frailty burden and the adherence rate of a multicomponent physical activity scheme partially managed by the participating women themselves. METHODS Prospective controlled study consisting of a twice-weekly group physical activity scheme divided into two consecutive periods, one supervised by a health professional (12 wk) and the other supervised by the women themselves (36 wk). Group cohesion and mutual support during the patient-only period were aided by social networking via smartphones. Community-dwelling postmenopausal women were divided into a physical activity group (PAG = 126) and a usual activity control group (UAG = 126), both assessed at baseline and at the end of the study. Participants self-assigned to one of the two study arms. RESULTS Overall, women in the PAG were more likely to improve their frailty status (60.2% vs 42.6%, P < 0.05). The frailty reversal rate from prefrail to robust was significantly higher in the PAG than in the UAG (34.04 vs 8.00%, P < 0.05). Logistic regression confirmed that women in the PAG were more likely to improve their frailty phenotype (odds ratio [OR], 9.12; 95% confidence interval [CI], 3.45-31.52; P < 0.001). Adherence, defined by participants attending 75% of sessions, was attained by 56.35% of women at 48 wk. CONCLUSION A physical activity scheme implemented to improve frailty proved effective and attained acceptable adherence. Conditions in the peer-supervised 36-wk phase may increase sustainability.
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Affiliation(s)
| | | | | | - M Luz Sánchez-Sánchez
- Multi-specialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Aitana Monllor-Tormos
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario-INCLIVA, Valencia, Spain
| | - Miguel-Ángel García-Pérez
- Department of Genetics, Faculty of Biological Sciences, University of Valencia, Burjassot, and INCLIVA, Valencia, Spain
| | - Juan J Tarín
- Department of Cellular Biology, Functional Biology, and Physical Anthropology, Faculty of Biological Sciences, University of Valencia, Valencia, Spain
| | - Antonio Cano
- Department of Pediatrics, Obstetrics, and Gynecology, University of Valencia-INCLIVA, Valencia, Spain
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Godoy-Izquierdo D, de Teresa C, Mendoza N. Exercise for peri- and postmenopausal women: Recommendations from synergistic alliances of women's medicine and health psychology for the promotion of an active lifestyle. Maturitas 2024; 185:107924. [PMID: 38599003 DOI: 10.1016/j.maturitas.2024.107924] [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: 08/05/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 04/12/2024]
Abstract
Adopting healthy behaviors is a multifaceted and complex process that poses significant challenges for individuals. Despite awareness of the detrimental effects of certain behaviors on health, many individuals continue to engage in risky practices. Traditional medical advice and prescriptions, while well intentioned, often fall short in fostering lasting lifestyle changes. Although individuals may also have good intentions, solely relying on doctor's counsel does not ensure successful lifestyle adjustments. One primary reason for this limitation is the lack of specialized expertise in behavioral modification among gynecologists and healthcare providers. Health psychologists are specialized professionals capable of effectively guiding and assisting individuals in modifying health-related behaviors. Their expertise in behavior change strategies and psychological interventions proves invaluable in empowering individuals to embrace healthier lifestyles and contributes to people's well-being. This paper emphasizes the importance of collaborative efforts between medical professionals, such as gynecologists, and health psychologists to promote healthy behaviors among peri- and postmenopausal women and enhance women's health. By forging integrative alliances, they can develop comprehensive and tailored interventions. By bridging the gap between medical advice and behavior modification, this collaborative effort has the potential to ensure a more effective intervention process. This holistic approach not only addresses women's specific health needs but also fosters sustainable behavior change when promoting healthy behaviors among middle-aged women. The ultimate goal of such a synergy is to improve women's health outcomes and contribute to a healthier society overall.
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Affiliation(s)
- Débora Godoy-Izquierdo
- Health Psychology & Behavioral Medicine Research Group (CTS-267), University Research Institute of Women and Gender Studies, University of Granada, Rector López Argueta w/n, 18071 Granada, Spain; Department of Personality and Psychological Assessment & Treatment, Faculty of Psychology, University of Granada, C.U. Cartuja w/n, 18071 Granada, Spain.
| | - Carlos de Teresa
- Andalusian Center of Sports Medicine (CAMD), Ed. IMUDS, Parque Tecnológico Ciencias de la Salud, Avda. del Conocimiento w/n, 18007 Granada, Spain
| | - Nicolás Mendoza
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of Granada, Avda. de la Investigación 11, 18071 Granada Spain.
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15
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Jacobsen JS, Evans R, Morgan K, Thorborg K, Oestergaard LG, Sørensen D. An exercise and patient education intervention to reduce pain and physical limitations in adults with acetabular dysplasia: study protocol for a process evaluation integrated within a randomised controlled trial (the MovetheHip trial). Trials 2024; 25:411. [PMID: 38915128 PMCID: PMC11197205 DOI: 10.1186/s13063-024-08262-y] [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: 07/14/2023] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND The Movethehip trial investigates the effectiveness of an exercise and patient education intervention for adults with acetabular dysplasia. The intervention involves eight tailored one-to-one sessions with trained providers who employ supportive feedback tools. The present protocol reports a planned process evaluation, which aims to determine how the intervention functions by examining the implementation of the intervention (process, dose and reach), its acceptability, mechanisms of change and the influence of contextual factors. METHODS Two hundred trial participants aged 18-50 years will be recruited from a University Hospital in Denmark and randomised to the intervention or control group. Approximately ten providers will deliver the intervention. The process evaluation adopts a concurrent mixed-methods design. The implementation will be assessed using self-report questionnaires (at baseline and 6-month follow-up), training records and semi-structured focus group interviews with intervention providers (n = 10) and healthcare managers (n = 4-6). The mechanisms of change will be explored through semi-structured one-to-one interviews (at baseline and 6-month follow-up) with 15-20 purposefully sampled participants and by measuring changes in health outcomes (self-reported pain, physical functioning and quality of life completed at baseline and at 3- and 6-month follow-up). Additionally, change will be measured through an explorative examination of associations between dose and change in health outcomes, applying simple linear regression models. The acceptability of the intervention and the influence of contextual factors will be explored through one-to-one participant interviews and focus group interviews with 4-6 healthcare managers. The interviews will focus on expectations, experiences, events, personal understandings and interaction with interpersonal and organisational aspects. Interview data will be analysed using theoretical thematic analyses, and findings will be merged with quantitative data and reported jointly on a theme-by-theme basis. DISCUSSION The process evaluation conducted as part of the MovetheHip trial will illuminate how the intervention functions, and if the intervention is proven effective, the findings of the evaluation will contribute to pinpoint how the intervention may be optimised to facilitate future up-scaling and implementation. TRIAL REGISTRATION The MovetheHip protocol was approved by the Committee on Health Research Ethics in the Central Denmark Region. ClinicalTrials, NCT04795843. Registered on 20 March 2021.
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Affiliation(s)
- Julie S Jacobsen
- Research Centre for Rehabilitation, VIA University College, Hedeager 2, Aarhus N, 8200, Denmark.
- Research Unit for General Practice, Bartholins Allé 2, 8000, Aarhus, Denmark.
| | - Rhiannon Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, SPARK, Cardiff University, Maindy Road, Cardiff, UK
| | - Kelly Morgan
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, SPARK, Cardiff University, Maindy Road, Cardiff, UK
| | - Kristian Thorborg
- Department of Orthopaedic Surgery, Sports Orthopaedic Research Center-Copenhagen (SORC-C), Copenhagen University Hospital, Amager-Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark
- Department of Physical and Occupational Therapy, Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Copenhagen University Hospital, Amager-Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark
| | - Lisa G Oestergaard
- DEFACTUM, Central Denmark Region, P.P. Ørums Gade 11, 8000, Aarhus C, Denmark
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus, Denmark
| | - Dorthe Sørensen
- Research Centre for Rehabilitation, VIA University College, Hedeager 2, Aarhus N, 8200, Denmark
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Orange ST, Roebuck J, Marshall P, Madden LA, Vince RV, Bell BT. 'I'm a failure again, I can't do it': Attitudes towards, and experiences of, exercise participation in adults with class III obesity. Br J Health Psychol 2024. [PMID: 38923753 DOI: 10.1111/bjhp.12739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES Living within a larger body brings unique challenges to exercise participation, which are poorly understood. This qualitative study explored the attitudes towards, and experiences of, exercise participation in adults with class III obesity. DESIGN Individual semi-structured qualitative interviews. METHODS We recruited 30 adults with class III obesity (body mass index: 45.8 ± 8.6 kg/m2) from a specialist multidisciplinary weight management service. Participants took part in semi-structured interviews while participating in a 6-month home-based aerobic and resistance exercise intervention. Open-ended questions were used flexibly to explore their views and experiences of exercise, encompassing barriers, motives and perceived benefits. Transcripts were analysed using reflexive thematic analysis. RESULTS Three themes were developed: (1) a web of barriers; (2) tailored exercise facilitates positive experiences; and (3) a desire to live a normal life. People with class III obesity perceived that they were unable to do exercise; a view that was attributed to perceived judgement, low physical function, pain during everyday activities and failed weight loss attempts. These complex physical and psychosocial barriers to exercise were described as contributing to exercise avoidance. High value was placed on tailored exercise that accommodates the unique needs of moving in a larger body. A desire to carry out everyday tasks underpinned motivations for exercise. CONCLUSIONS Our findings suggest that multi-component obesity interventions should move away from generic exercise prescriptions designed to maximize energy expenditure, and instead move towards addressing the unique physical and psychosocial needs of people who have class III obesity with tailored person-centred and weight-neutral exercise prescriptions.
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Affiliation(s)
- Samuel T Orange
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
- School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- School of Sport, Exercise and Rehabilitation Sciences, Faculty of Health Sciences, University of Hull, Kingston upon Hull, UK
| | - Jessica Roebuck
- School of Sport, Exercise and Rehabilitation Sciences, Faculty of Health Sciences, University of Hull, Kingston upon Hull, UK
| | - Phil Marshall
- School of Sport, Exercise and Rehabilitation Sciences, Faculty of Health Sciences, University of Hull, Kingston upon Hull, UK
| | - Leigh A Madden
- Centre for Biomedicine, Faculty of Health Sciences, University of Hull, Kingston upon Hull, UK
| | - Rebecca V Vince
- School of Sport, Exercise and Rehabilitation Sciences, Faculty of Health Sciences, University of Hull, Kingston upon Hull, UK
| | - Beth T Bell
- Department of Education, University of York, York, UK
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Da Silva-Grigoletto ME, Pereira-Monteiro MR, Aragão-Santos JC, Vasconcelos ABS, Marcos-Pardo PJ, Fortes LDS. Brain functional training: a perspective article. FRONTIERS IN AGING 2024; 5:1368878. [PMID: 38974345 PMCID: PMC11224132 DOI: 10.3389/fragi.2024.1368878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/27/2024] [Indexed: 07/09/2024]
Abstract
Introduction: Physical exercise (PE) positively affects the nervous system, impacting morphology and physiology. It increases brain gray and white matter, improves cerebral blood flow, and stimulates neurogenesis, synaptogenesis, and angiogenesis, promoting brain function. Although exercise already affects cognition, some training modalities place greater demands on the cognitive aspects of physical exercise, such as perceptual-motor and visual-motor training. This type of approach aims to emphasize the cognitive adaptations that occur chronically. Specifically for older people, functional training, a multi-component approach, is a promising exercise modality that stimulates functionality using multi-joint, multi-planar exercises mirroring daily activities. However, applying a greater focus on cognitive adaptations in line with the functional training proposal for maximal benefits remains underexplored. Aim: Thus, this perspective article initially explores different exercise approaches emphasizing cognitive adaptations and proposes Brain Functional Training to improve older adult's functionality. Methods: Furthermore, we explain how brain functional training can be explored to emphasize cognitive aspects based on increasing complexity to stimulate the executive function and its subdomains. Conclusion: This proposal is one alternative to combining motor and cognitive stimuli to promote autonomy and health in older people.
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Affiliation(s)
- Marzo Edir Da Silva-Grigoletto
- Department of Physical Education, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Graduate Program in Physiological Sciences (PROCFIS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Graduate Program in Health Sciences (PPGCS), Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - José Carlos Aragão-Santos
- Graduate Program in Health Sciences (PPGCS), Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Alan Bruno Silva Vasconcelos
- Graduate Program in Physiological Sciences (PROCFIS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Department of Health Education, Federal Univesity of Sergipe, Lagarto, Sergipe, Brazil
| | | | - Leonardo de Sousa Fortes
- Associate Graduate Program of Physical Education, Federal University of Paraíba, João Pessoa, Brazil
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18
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Mørtvedt AI. Exploring usability in exercise interventions: from conceptualisation to measurement and application (PhD Academy Award). Br J Sports Med 2024:bjsports-2024-108426. [PMID: 38904120 DOI: 10.1136/bjsports-2024-108426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 06/22/2024]
Affiliation(s)
- Anne Inger Mørtvedt
- Department of Cognitive and Learning Sciences, Michigan Technological University, Houghton, Michigan, USA
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Laakso J, Kopra J, Koivumaa-Honkanen H, Sirola J, Honkanen R, Kröger H, Rikkonen T. Physical and mental health predicts better adherence to exercise intervention in older women: A post-hoc analysis. Heliyon 2024; 10:e32128. [PMID: 38882273 PMCID: PMC11180318 DOI: 10.1016/j.heliyon.2024.e32128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/18/2024] Open
Abstract
Background Adherence to exercise is crucial for promoting health and maintaining functioning. Aims To investigate predictors of adherence to exercise in the initially free supervised fall prevention RCT and its low-cost, self-sustained continuation among elderly women. Methods In the 2-year Kuopio Fall Prevention Study RCT, 457 women (aged 71-84) were offered a free initial 6-month supervised weekly training program (gym, Tai Chi) in the municipal facilities. Women's adherence during this period was categorized into high (≥80 %) and low (<80 %). In the next six months, their free access to the premises continued without supervision. For the second year, low-cost access was offered with unsupervised independent training in these facilities. The second-year adherence was based on purchasing(yes/no) a gym card to continue exercising. Information on baseline health, functioning, and lifestyle was obtained by mailed questionnaires and physical tests. Results For the first six months, over 60 % of the women had high adherence. Only 26 % continued into the second year. For both follow-up years, active training history was related to better adherence. Initial predictors were related to mental health i.e. having less often fear of falls limiting one's mobility, ability to cope with external, not internal hostility, and being in a loving relationship. In the second year, predictors were related to younger age, having less frequent fear of falls, better functional capacity i.e. better strengths (grip and leg extension) and faster Timed "Up and Go" -test. Conclusion Better mental and physical health, better functional capacity and active training background were associated with higher adherence to exercise intervention in older women.
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Affiliation(s)
- J Laakso
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
| | - J Kopra
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
- School of Computing, University of Eastern Finland, Kuopio, Finland
| | - H Koivumaa-Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
- Institute of Clinical Medicine, Psychiatry, University of Eastern Finland (UEF), Kuopio, Finland
- Mental Health and Wellbeing Center, Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - J Sirola
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
- Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - R Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
| | - H Kröger
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
- Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - T Rikkonen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
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20
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Jinakote M, Jeeratantorn P, Surapolchai L, Dornbunlon P, Yoysungnoen B, Kasiyaphat A. Effects of brisk walking with or without music on body composition, standing balance, cardiovascular parameters, and salivary biomarkers in older women. J Exerc Rehabil 2024; 20:100-111. [PMID: 38973979 PMCID: PMC11222065 DOI: 10.12965/jer.2448154.077] [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: 03/20/2024] [Revised: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 07/09/2024] Open
Abstract
This study aimed to assess and compare changes in body composition, standing balance, cardiovascular parameters, and salivary biomarkers, particularly salivary antioxidant status, after brisk walking training with or without music in older women. Twenty-four subjects were randomly assigned to brisk walking groups: with music (BWM) (n=12) or without music (BW) (n=12). Eighteen subjects completed the exercise training (9 in each group), and their data were used for analysis. The research protocols were classified into three phases: pretraining phase, training phase, and posttraining phase, while the data collection was divided into four sessions: resting condition, during treadmill exercise testing, immediately posttreadmill exercise testing, and 5-min posttreadmill exercise testing defined as after the cool-down session. The results showed that 8 weeks of home-based brisk walking with or without music did not improve standing balance, blood pressure, salivary biomarkers including total protein concentration, and antioxidant status but maintained or prevented the decline of these parameters. Only the BWM group reduced fat mass relative to increasing fat-free mass (P<0.05) and improved recovery heart rate (P<0.05) by modifying cardiac autonomic control in posttreadmill exercise testing. Therefore, brisk walking with preferred music can be a tool to delay the progression of cardiovascular dysfunction in older women. A longer duration of the exercise program and larger groups of participants are needed for further investigation of brisk walking with or without music on physiological and biochemical changes.
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Affiliation(s)
- Metee Jinakote
- School of Human Kinetics and Health, Faculty of Health Science Technology, Chulabhorn Royal Academy, Bangkok,
Thailand
| | - Punika Jeeratantorn
- School of Human Kinetics and Health, Faculty of Health Science Technology, Chulabhorn Royal Academy, Bangkok,
Thailand
| | - Lapol Surapolchai
- School of Human Kinetics and Health, Faculty of Health Science Technology, Chulabhorn Royal Academy, Bangkok,
Thailand
| | - Punkorn Dornbunlon
- School of Human Kinetics and Health, Faculty of Health Science Technology, Chulabhorn Royal Academy, Bangkok,
Thailand
| | - Bhornprom Yoysungnoen
- Division of Physiology, Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathum Thani,
Thailand
| | - Atchareeya Kasiyaphat
- School of Human Kinetics and Health, Faculty of Health Science Technology, Chulabhorn Royal Academy, Bangkok,
Thailand
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21
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Guijo JA, do Prado WL, de Araújo RC, Dos Santos EEP, Malik N, Lofrano-Prado MC, Botero JP. Adherence and dropout in exercise-based interventions in childhood obesity: A systematic review of randomized trials. Obes Rev 2024; 25:e13721. [PMID: 38359911 DOI: 10.1111/obr.13721] [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: 03/15/2023] [Revised: 11/21/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024]
Abstract
Our objective was to systematically examine the characteristics of exercise interventions on adherence and dropout in children and adolescents with obesity. PubMed, Embase, PsycINFO, Lilacs, Scielo, and The Cochrane Central Register of Controlled Trials and reference lists of relevant articles were searched. We included randomized controlled trials with exercise interventions for pediatric patients with obesity presenting data on dropout and/or adherence. Two reviewers screened the records independently for eligibility with disagreements being resolved by a third reviewer. Twenty-seven studies with 1268 participants were included. Because of high heterogeneity and poor reporting of adherence, it was not possible to perform a meta-analysis. Dropout prevalence was calculated, and subgroup analyses comparing different types of exercise and a meta-regression with potential moderators were performed. We found a dropout rate of 13%. Subgroup analyses did not identify significant differences. The duration of the exercise presented a moderating effect on dropout, suggesting that longer exercise sessions may lead to higher dropout in children and adolescents with obesity. Because of the poor adherence data, it is not clear which exercise characteristics may moderate adherence. To improve the quality of childhood obesity care, it is mandatory that future studies present adherence data. Systematic review registration: PROSPERO CRD42021290700.
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Affiliation(s)
- Jaddy Antunes Guijo
- Post-Graduate Program in Human Movement Sciences and Rehabilitation, Federal University of São Paulo (UNIFESP) Campus Baixada Santista, Santos, Brazil
| | - Wagner Luiz do Prado
- Department of Kinesiology, California State University San Bernardino, San Bernardino, California, USA
| | | | - Ellem Eduarda Pinheiro Dos Santos
- Post-Graduate Program in Human Movement Sciences and Rehabilitation, Federal University of São Paulo (UNIFESP) Campus Baixada Santista, Santos, Brazil
| | - Neal Malik
- Department of Health Science and Human Ecology, California State University San Bernardino, San Bernardino, California, USA
| | - Mara C Lofrano-Prado
- Department of Kinesiology, California State University San Bernardino, San Bernardino, California, USA
| | - Joao Paulo Botero
- Department of Human Movement Sciences and Rehabilitation, Federal University of São Paulo (UNIFESP) Campus Baixada Santista, Santos, Brazil
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22
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Thakar V, Kamalakannan S, Prakash V. Effectiveness of m-health technology-enabled physical activity program on physical activity adoption and adherence in people with hypertension in India: A randomized controlled trial protocol. Chronic Dis Transl Med 2024; 10:92-101. [PMID: 38872762 PMCID: PMC11166682 DOI: 10.1002/cdt3.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/09/2023] [Accepted: 10/24/2023] [Indexed: 06/15/2024] Open
Abstract
Background Exercise and medication have similar benefits in reducing blood pressure (BP); however, hypertension management initiatives primarily focus on medicines. This is due to scarce research on the effectiveness of implementation strategies for optimal exercise adoption and adherence. Smartphones were found to be effective in delivering hypertension care and increase exercise adherence. Despite this, only a small number of research projects in India have used smartphones as a strategy for managing hypertension. Methods We hypothesized that smartphone application-based care would lead to higher exercise adherence among adults (30-79 years) with hypertension compared to those who receive usual care. It will be a multicentric, randomized controlled, parallel-design, superiority clinical trial. The outcome assessor and data analyst will be blinded to group allocation. Participants in the intervention group will receive mobile application-based care for 6 weeks. Participants in the usual care group will receive a standard intervention. Both groups will receive the same number of follow-ups. Results The primary outcome is the difference in the proportion of people adherent to the recommended level of physical activity evaluated using an exercise adherence rating scale in the intervention group and the control group. Exercise adoption will be measured as the percentage of eligible participants in each study setting willing to initiate the exercise program. The secondary outcome includes differences in systolic and diastolic BP and self-management (evaluated using the Hypertension Self-Care Profile). The trial outcome will be accompanied by a process evaluation. Conclusions This research will inform about the comparative effectiveness of conventional and m-health interventions for exercise adoption and adherence in people with hypertension in resource-constrained settings.
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Affiliation(s)
- Vidhi Thakar
- Ashok & Rita Patel Institute of PhysiotherapyCharotar University of Science and TechnologyChanga, AnandGujaratIndia
| | - Sureshkumar Kamalakannan
- Department of Social Work, Education and Community‐ WellbeingNorthumbria UniversityNewcastle upon TyneUK
| | - V. Prakash
- Ashok & Rita Patel Institute of PhysiotherapyCharotar University of Science and TechnologyChanga, AnandGujaratIndia
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23
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Marriott KA, Hall M, Maciukiewicz JM, Almaw RD, Wiebenga EG, Ivanochko NK, Rinaldi D, Tung EV, Bennell KL, Maly MR. Are the Effects of Resistance Exercise on Pain and Function in Knee and Hip Osteoarthritis Dependent on Exercise Volume, Duration, and Adherence? A Systematic Review and Meta-Analysis. Arthritis Care Res (Hoboken) 2024; 76:821-830. [PMID: 38317328 DOI: 10.1002/acr.25313] [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: 10/20/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE The purpose of this study was to determine dose parameters for resistance exercise associated with improvements in pain and physical function in knee and hip osteoarthritis (OA) and whether these improvements were related to adherence. METHODS We searched six databases, from inception to January 28, 2023, for randomized controlled trials comparing land-based, resistance exercise-only interventions with no intervention, or any other intervention. There were four subgroups of intervention duration: 0 to <3 months, 3 to 6 months, >6 to <12 months, ≥12 months. The between-group effect was calculated for immediate postintervention pain and physical function (activities of daily living [ADL] and sports/recreation [SPORT]). RESULTS For both knee and hip, data from 280 studies showed moderate benefit for pain, physical function ADL, and physical function SPORT in favor of interventions 3 to 6 months. For the knee, there was also a moderate benefit for physical function ADL in favor of interventions >6 to <12 months. From 151 knee and hip studies that provided total exercise volume data (frequency, time, duration), there was no association between volume with the effect size for pain and physical function. A total of 74 studies (69 knee, 5 hip) reported usable adherence data. There was no association between adherence with the effect size for pain and physical function. CONCLUSION In knee and hip OA, resistance exercise interventions 3 to 6 months (and for the knee >6 to <12 months) duration improve pain and physical function. Improvements do not depend on exercise volume or adherence, suggesting exercise does not require rigid adherence to a specific dose.
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Affiliation(s)
| | - Michelle Hall
- The University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | | | | | - Emma V Tung
- The University of Waterloo, Waterloo, Ontario, Canada
| | - Kim L Bennell
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Monica R Maly
- The University of Waterloo, Waterloo, Ontario, Canada
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24
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Weng WH, Wang YH, Yeh NC, Yang YR, Wang RY. Effects of physical training on depression and related quality of life in pre-frail and frail older adults: a systematic review and meta-analysis. J Nutr Health Aging 2024; 28:100237. [PMID: 38643610 DOI: 10.1016/j.jnha.2024.100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/11/2024] [Accepted: 04/12/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES To investigate the effects of physical training on depression and related quality of life in pre-frail and frail individuals. DESIGN A systematic review and meta-analysis. PARTICIPANTS Pre-frail and frail older adults. METHODS Five electronic databases, including PubMed, Cochrane, Medline, CINAHL, and Wiley were searched through December 2023. Randomized controlled trials (RCT) comparing physical training with usual care, health education, or light-intensity exercise were included. Outcomes included depression and depression-related quality of life. The quality of the included studies was assessed using Physiotherapy Evidence Database (PEDro) score, and the Cochrane Risk of Bias Tool was used to assess the risk of bias. Meta-analysis was performed using the RevMan5.4. The certainty of the evidence was evaluated by The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS Ten articles with 589 participants met the inclusion criteria and were included. The pooled analysis indicated that depression (SMD = -0.55, 95%CI = -0.92, -0.17, p = 0.004) and mental health status in life (SMD = 1.05, 95%CI = 0.59, 1.50, p < 0.00001) improved significantly in the experimental group. The results of subgroup analysis revealed that the beneficial effects of physical training were significant only in frail older adults but not in pre-frail older adults. CONCLUSION This meta-analysis showed that the positive effects of physical training on depression and related quality of life were evident for people with frailty. However, no positive results were observed in pre-frail older adults, indicating the need for further investigation in this subgroup.
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Affiliation(s)
- Wei-Han Weng
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yin-Hsiang Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Nai-Chen Yeh
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yea-Ru Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ray-Yau Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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25
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André N, Grousset M, Audiffren M. A Behavioral Perspective for Improving Exercise Adherence. SPORTS MEDICINE - OPEN 2024; 10:56. [PMID: 38763991 PMCID: PMC11102891 DOI: 10.1186/s40798-024-00714-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/01/2024] [Indexed: 05/21/2024]
Abstract
Adherence to exercise is a crucial aspect of behavioral changes related to exercise. However, current models fail to predict behavioral change, and exercise programs struggle to foster adherence. In this Current Opinion article, we defined adherence as a process linking behavior and attitude. More specifically, exercise adherence is the process by which people's behaviors conform to their attitudes and vice versa. Behavioral change theories should be able to predict changes, transformations, and modifications of behaviors; however, this is not currently the case. Prediction models of behavior are mainly focused on how to predict behavioral changes by affecting attitudes; however, these models have not considered the target behavior as a facilitator of adherence. Herein, a behavioral perspective is considered in three directions: first, exercise is a therapeutic modality that has the potential to improve motivation; second, chronic exercise helps sustain effort over time and increase executive functions and willpower; and third, exercise is an active behavior that has the potential to facilitate attitude change.
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Affiliation(s)
- Nathalie André
- Research Centre on Cognition and Learning, CNRS, University of Poitiers, Poitiers, France.
- Maison des Sciences de l'Homme et de la Société, CNRS, University of Poitiers, Poitiers, France.
| | - Marine Grousset
- Research Centre on Cognition and Learning, CNRS, University of Poitiers, Poitiers, France
- Richelieu Centre, French Red Cross Association, La Rochelle, France
| | - Michel Audiffren
- Research Centre on Cognition and Learning, CNRS, University of Poitiers, Poitiers, France
- Maison des Sciences de l'Homme et de la Société, CNRS, University of Poitiers, Poitiers, France
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26
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Garcia-Roca ME, Catalá-Vilaplana I, Hernando C, Baliño P, Salas-Medina P, Suarez-Alcazar P, Folch-Ayora A, Collado Boira E. Effect of a Long-Term Online Home-Based Supervised Exercise Program on Physical Fitness and Adherence in Breast Cancer Patients: A Randomized Clinical Trial. Cancers (Basel) 2024; 16:1912. [PMID: 38791989 PMCID: PMC11120144 DOI: 10.3390/cancers16101912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/18/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
The purpose of the present study was to analyze the effect of a synchronous-supervised online home-based exercise program (HBG) during 24 weeks on body composition, physical fitness and adherence compared to an exercise recommendation group (ERG) without supervision with patients undergoing breast cancer treatment. Fifty-nine female breast cancer patients (31 in HBG and 28 in the ERG) undergoing cancer treatments participated in the present randomized clinical trial. The exercise program consisted of a 60 min combined resistance and aerobic supervised exercise session (6-8 points on Borg Scale CR-10, moderate intensity), twice a week during 24 weeks. The exercise recommendation group only received general recommendations to comply with the current ACSM guidelines. Body composition and physical fitness were assessed at baseline, 12 weeks and 24 weeks of the program. Adherence to the intervention was measured according to the minutes of exercise completed per session during each week. A general linear model of two-way repeated measures showed significant improvements (p < 0.05) in physical fitness that were observed in the home-based exercise group at the baseline, 12-week and 24-week assessments compared to the exercise recommendation group. Adherence was also higher in the home-based exercise group. However, no changes (p > 0.05) in body composition between groups and moments were observed. In this sense, supervised home-based exercise interventions can be an interesting strategy to improve physical fitness and adherence rates in breast cancer patients undergoing treatment.
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Affiliation(s)
- María Elena Garcia-Roca
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, 12071 Castellon, Spain; (M.E.G.-R.); (P.S.-M.); (P.S.-A.); (A.F.-A.); (E.C.B.)
| | - Ignacio Catalá-Vilaplana
- Department of Physical Education and Sports Sciences, University of Valencia, 46010 Valencia, Spain
| | - Carlos Hernando
- Sport Service, Department of Education and Specifics Didactics, Jaume I University, 12071 Castellon, Spain;
| | - Pablo Baliño
- Faculty of Health Sciences, Pre-Department of Medicine, Jaume I University, 12071 Castellon, Spain;
| | - Pablo Salas-Medina
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, 12071 Castellon, Spain; (M.E.G.-R.); (P.S.-M.); (P.S.-A.); (A.F.-A.); (E.C.B.)
| | - Pilar Suarez-Alcazar
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, 12071 Castellon, Spain; (M.E.G.-R.); (P.S.-M.); (P.S.-A.); (A.F.-A.); (E.C.B.)
| | - Ana Folch-Ayora
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, 12071 Castellon, Spain; (M.E.G.-R.); (P.S.-M.); (P.S.-A.); (A.F.-A.); (E.C.B.)
| | - Eladio Collado Boira
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, 12071 Castellon, Spain; (M.E.G.-R.); (P.S.-M.); (P.S.-A.); (A.F.-A.); (E.C.B.)
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27
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Rierola-Fochs S, Terradas-Monllor M, Varela-Vasquez LA, Ochandorena-Acha M, Minobes-Molina E, Merchán Baeza JA. Feasibility study of a home-based graded motor imagery intervention (GraMI protocol) for amputees with phantom limb pain. Physiother Theory Pract 2024:1-11. [PMID: 38708842 DOI: 10.1080/09593985.2024.2349759] [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: 12/30/2023] [Accepted: 04/20/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Phantom limb pain affects 64% of amputees. Graded Motor Imagery comprises three consecutive application techniques designed to reorganize maladaptive changes that have occurred after the amputation. OBJECTIVE To assess the feasibility of a home-based Graded Motor Imagery intervention, the GraMI protocol, for amputee people with phantom limb pain. METHODS Twenty individuals over 18 years of age with upper or lower limb amputation, experiencing phantom limb pain, who were pharmacologically stable, and had been discharged from the hospital were recruited. The experimental group followed the GraMI protocol. Primary outcomes included study processes, such as recruitment time and rate, adherence, compliance, and the acceptability of digital technologies as a treatment tool. Secondary outcomes assessed the impact on phantom limb pain, quality of life, functionality, and depressive symptoms. RESULTS On average, seven participants were recruited monthly over a three-month period. No losses were recorded throughout the nine weeks of intervention. Treatment adherence averaged 89.32%, and all participants demonstrated familiarity with the usability of digital technologies. No significant differences were observed between groups (p = .054). However, within the experimental group, intragroup analysis revealed a significant (p = .005) and clinically relevant reduction (>2 points) with a large effect size (0.89) in phantom limb pain. CONCLUSION Conducting a multicenter study with a home-based intervention using the GraMI protocol is feasible. Future clinical trials are needed to verify its effectiveness in managing phantom limb pain.
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Affiliation(s)
- Sandra Rierola-Fochs
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Marc Terradas-Monllor
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
- Pain Medicine Section, Anaesthesiology Dept, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Luz Adriana Varela-Vasquez
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
- Tecnocampus Mataró-Maresme, Universitat Pompeu Fabra, Mataró, Spain
| | - Mirari Ochandorena-Acha
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
- Spanish Society of Geriatrics and Gerontology, Madrid, Spain
| | - Jose Antonio Merchán Baeza
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
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28
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Fleck JI, Patel P, Riley E, Ferri CV. Mindset matters: contributions from grit and growth mindsets to successful aging. Aging Ment Health 2024; 28:819-827. [PMID: 37970946 DOI: 10.1080/13607863.2023.2280626] [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: 03/14/2023] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Though we all age, some age more successfully than others. Health and social connections have been identified as cornerstones to successful aging, yet the contributions from psychological factors are less clear. Our goal was to examine the influence of grit and growth mindset in successful aging in middle and older age. We also assessed whether grit or growth mindset mediated the lifestyle-successful aging relationship. METHOD We used a telephone questionnaire to measure grit and growth mindset, successful aging, and lifestyle for 263 adults, ages 40-80 years. RESULTS Higher grit-effort and growth mindset predicted more successful aging in younger (40-64 years) and older groups (65-80 years). Additionally, exercise frequency predicted successful aging for the combined sample and partially mediated the relationship between growth mindset and successful aging. CONCLUSIONS Our findings reveal grit-effort and a growth mindset as important contributors to successful aging in middle and older adulthood. Because psychological constructs are malleable, continued study of grit and growth mindsets is essential to enable their eventual application in changing the aging process.
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Affiliation(s)
- Jessica I Fleck
- School of Social and Behavioral Sciences, Stockton University, Galloway, NJ, USA
| | - Poorva Patel
- School of Social and Behavioral Sciences, Stockton University, Galloway, NJ, USA
| | - Emma Riley
- School of Social and Behavioral Sciences, Stockton University, Galloway, NJ, USA
| | - Christine V Ferri
- School of Social and Behavioral Sciences, Stockton University, Galloway, NJ, USA
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29
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Cabral DF, Fried PJ, Bigliassi M, Cahalin LP, Gomes-Osman J. Determinants of exercise adherence in sedentary middle-aged and older adults. Psychophysiology 2024:e14591. [PMID: 38629783 DOI: 10.1111/psyp.14591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/21/2024] [Accepted: 04/02/2024] [Indexed: 05/01/2024]
Abstract
Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle-aged and older adults. Thirty-one participants underwent an evaluation of cortico-motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor-evoked potentials following intermittent theta-burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise-related behavioral factors were also assessed. The participants engaged in a 2-month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate-to-vigorous intensity. They were divided into Completers (n = 19), who attended all sessions, and Dropouts (n = 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico-motor plasticity was associated with better exercise adherence (r = -.53, corrected p = .019). Exploratory hypothesis-generating regression analysis suggested that post-iTBS changes (β = -7.78, p = .013) and self-efficacy (β = -.51, p = .019) may predict exercise adherence (adjusted-R2 = .44). In conclusion, this study highlights the significance of TMS/iTBS cortico-motor plasticity, self-efficacy, and cardiovascular health in exercise adherence. Given the well-established cognitive benefits of exercise, addressing sedentary behavior and enhancing self-efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs.
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Affiliation(s)
- Danylo F Cabral
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Marcelo Bigliassi
- Department of Teaching and Learning, Florida International University, Miami, Florida, USA
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA
| | - Joyce Gomes-Osman
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
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Brañas F, Díaz-Álvarez J, Fernández-Luna J, Vásquez-Brolen BD, García-Molina R, Moreno E, Ryan P, Martínez-Sanz J, Luna L, Martínez M, Dronda F, Sánchez-Conde M. A 12-week multicomponent exercise program enhances frailty by increasing robustness, improves physical performance, and preserves muscle mass in older adults with HIV: MOVIhNG study. Front Public Health 2024; 12:1373910. [PMID: 38694984 PMCID: PMC11062244 DOI: 10.3389/fpubh.2024.1373910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/06/2024] [Indexed: 05/04/2024] Open
Abstract
Background Our aim was to analyze the effects of a multicomponent exercise program (MEP) on frailty and physical performance in older adults with HIV (OAWH) since exercise can reverse frailty in the older population overall, but there is no data for OAWH. Methods A prospective longitudinal study with intervention and control group was designed. Sedentary adults 50 or over with and without HIV were included. The intervention was a 12-week home-based MEP. Dependent variables were frailty (frailty phenotype), physical performance (Senior Fitness Test), muscle mass (ASMI) by bioimpedance. Pre- and postintervention measurements were analyzed using McNemar's test for categorical variables and the Wilcoxon signed-rank test for quantitative variables. Results 40 OAWH and 20 OA without HIV. The median age was 56.5 years. 23.3% were women. The prevalence of frailty was 6.6% with no frail HIV-negative participants. Three of the four frail HIV-participants transitioned two (50%) from frail to prefrail and one (25%) to robust after the MEP. In participants with an adherence ≥50%, physical performance was significantly improved [basal vs. 12 week]: upper extremity strength [13 (13-15) vs. 16 (15-19), p = 0.0001], lower extremity strength [13 (11-16) vs. 15 (13-16), p = 0.004], aerobic endurance [62 (55-71) vs. 66 (58-80), p = 0.005]. Participants with low adherence experienced a significant worsening in ASMI [8.35 (7.44-9.26) vs. 7.09 (6.08-8.62), p = 0.03]. Conclusion A 12-week MEP enhances frailty by increasing robustness in OAWH, and improves physical performance, and preserves muscle mass in older adults with good adherence to the MEP independently of HIV status. Clinical trial number NCT 05435521
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Affiliation(s)
- Fátima Brañas
- Geriatrics Department, Hospital Universitario Infanta Leonor, Madrid, Spain
- FIIB H.U Infanta Leonor y H.U. Sureste, Madrid, Spain
- Medicine Department, Universidad Complutense, Madrid, Spain
| | - Jorge Díaz-Álvarez
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, Spain
| | | | | | - Rafael García-Molina
- Geriatrics Department, Hospital Nuestra Señora del Perpetuo Socorro, Albacete, Spain
- CIBER de Envejecimiento y Fragilidad (CIBERFES), ISCIII, Madrid, Spain
| | - Elena Moreno
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC). ISCIIII, Madrid, Spain
| | - Pablo Ryan
- FIIB H.U Infanta Leonor y H.U. Sureste, Madrid, Spain
- Medicine Department, Universidad Complutense, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC). ISCIIII, Madrid, Spain
- HIV Clinic, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Javier Martínez-Sanz
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC). ISCIIII, Madrid, Spain
| | - Laura Luna
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC). ISCIIII, Madrid, Spain
| | - Marta Martínez
- Geriatrics Department, Hospital Universitario Infanta Leonor, Madrid, Spain
- Medicine Department, Universidad Complutense, Madrid, Spain
| | - Fernando Dronda
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, Spain
| | - Matilde Sánchez-Conde
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC). ISCIIII, Madrid, Spain
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Gilanyi YL, Shah B, Cashin AG, Gibbs MT, Bellamy J, Day R, McAuley JH, Jones MD. Barriers and enablers to exercise adherence in people with nonspecific chronic low back pain: a systematic review of qualitative evidence. Pain 2024:00006396-990000000-00578. [PMID: 38635470 DOI: 10.1097/j.pain.0000000000003234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/25/2024] [Indexed: 04/20/2024]
Abstract
ABSTRACT Exercise is a first-line treatment for chronic low back pain (CLBP), reducing pain and disability in the short term. However, exercise benefits decrease over time, with a lack of long-term exercise adherence a potential reason for this. This study aimed to synthesize the perceptions and beliefs of individuals with CLBP and identify their barriers and enablers to exercise adherence. We searched CENTRAL, Embase, CINAHL, SPORTDiscus, PubMed, PsycINFO, and Scopus databases from inception to February 28, 2023, for qualitative studies that explored the factors influencing exercise adherence for people with CLBP. A hybrid approach combining thematic synthesis with the Theoretical Domains Framework was used to analyze data. We assessed methodological quality using the Critical Appraisal Skills Programme checklist and the level of confidence of the themes generated using the Confidence in the Evidence from Reviews of Qualitative Studies. Twenty-three papers (n = 21 studies) were included (n = 677 participants). Four main themes affected exercise adherence: (1) exercise, pain, and the body, (2) psychological factors, (3) social factors, and (4) external factors. These themes contained 16 subthemes that were predominantly both barriers and enablers to exercise adherence. The individual's experiences of barriers and enablers were most appropriately represented across a spectrum, where influencing factors could be a barrier or enabler to exercise adherence, and these could be specific to pre-exercise, during-exercise, and post-exercise situations. These findings may be used to improve exercise adherence and ultimately treatment outcomes in people with CLBP.
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Affiliation(s)
- Yannick L Gilanyi
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Brishna Shah
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Aidan G Cashin
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Mitchell T Gibbs
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Jessica Bellamy
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Richard Day
- St Vincent's Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - James H McAuley
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Matthew D Jones
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
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Vieira MC, Mendes FDSNS, da Silva PS, da Silva GMS, Mazzoli-Rocha F, de Sousa AS, Saraiva RM, de Holanda MT, Kasal DAB, Costa HS, Borges JP, Reis MS, Rodrigues Junior LF, Hasslocher-Moreno AM, do Brasil PEAA, Mediano MFF. Effect of an exercise-based cardiac rehabilitation program on quality of life of patients with chronic Chagas cardiomyopathy: results from the PEACH randomized clinical trial. Sci Rep 2024; 14:8208. [PMID: 38589582 PMCID: PMC11001987 DOI: 10.1038/s41598-024-58776-3] [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: 06/21/2023] [Accepted: 04/03/2024] [Indexed: 04/10/2024] Open
Abstract
To investigate the effect of an exercise-based cardiac rehabilitation program on the quality of life (QoL) of patients with chronic Chagas cardiomyopathy (CCC). PEACH study was a single-center, superiority randomized clinical trial of exercise training versus no exercise (control). The sample comprised Chagas disease patients with CCC, left ventricular ejection fraction < 45%, without or with HF symptoms (CCC stages B2 or C, respectively). QoL was assessed at baseline, after three months, and at the end of six months of follow-up using the SF-36 questionnaire. Patients randomized for the exercise group (n = 15) performed exercise training (aerobic, strength and stretching exercises) for 60 min, three times a week, during six months. Patients in the control group (n = 15) were not provided with a formal exercise prescription. Both groups received identical nutritional and pharmaceutical counseling during the study. Longitudinal analysis of the effects of exercise training on QoL, considering the interaction term (group × time) to estimate the rate of changes between groups in the outcomes (represented as beta coefficient), was performed using linear mixed models. Models were fitted adjusting for each respective baseline QoL value. There were significant improvements in physical functioning (β = + 10.7; p = 0.02), role limitations due to physical problems (β = + 25.0; p = 0.01), and social functioning (β = + 19.2; p < 0.01) scales during the first three months in the exercise compared to the control group. No significant differences were observed between groups after six months. Exercise-based cardiac rehabilitation provided short-term improvements in the physical and mental aspects of QoL of patients with CCC.Trial registration: ClinicalTrials.gov Identifier: NCT02517632; August 7, 2015.
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Affiliation(s)
- Marcelo Carvalho Vieira
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
- Center for Cardiology and Exercise, Aloysio de Castro State Institute of Cardiology, Rio de Janeiro, RJ, Brazil.
| | | | - Paula Simplício da Silva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | | | - Flavia Mazzoli-Rocha
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Andrea Silvestre de Sousa
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Marcelo Teixeira de Holanda
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Daniel Arthur Barata Kasal
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil
- Internal Medicine Department, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Henrique Silveira Costa
- Department of Physical Therapy, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, MG, Brazil
| | - Juliana Pereira Borges
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil
| | - Michel Silva Reis
- Faculty of Physical Therapy, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luiz Fernando Rodrigues Junior
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil
- Department of Physiological Sciences, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - Mauro Felippe Felix Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil
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Sun T, Xu X, Ding Z, Xie H, Ma L, Zhang J, Xia Y, Zhang G, Ma Z. Development of a Health Behavioral Digital Intervention for Patients With Hypertension Based on an Intelligent Health Promotion System and WeChat: Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e53006. [PMID: 38578692 PMCID: PMC11031705 DOI: 10.2196/53006] [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: 12/22/2023] [Accepted: 02/26/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The effectiveness of timely medication, physical activity (PA), a healthy diet, and blood pressure (BP) monitoring for promoting health outcomes and behavioral changes among patients with hypertension is supported by a substantial amount of literature, with "adherence" playing a pivotal role. Nevertheless, there is a lack of consistent evidence regarding whether digital interventions can improve adherence to healthy behaviors among individuals with hypertension. OBJECTIVE The aim was to develop a health behavioral digital intervention for hypertensive patients (HBDIHP) based on an intelligent health promotion system and WeChat following the behavior change wheel (BCW) theory and digital micro-intervention care (DMIC) model and assess its efficacy in controlling BP and improving healthy behavior adherence. METHODS A 2-arm, randomized trial design was used. We randomly assigned 68 individuals aged >60 years with hypertension in a 1:1 ratio to either the control or experimental group. The digital intervention was established through the following steps: (1) developing digital health education materials focused on adherence to exercise prescriptions, Dietary Approaches to Stop Hypertension (DASH), prescribed medication, and monitoring of BP; (2) using the BCW theory to select behavior change techniques; (3) constructing the intervention's logic following the guidelines of the DMIC model; (4) creating an intervention manual including the aforementioned elements. Prior to the experiment, participants underwent physical examinations at the community health service center's intelligent health cabin and received intelligent personalized health recommendations. The experimental group underwent a 12-week behavior intervention via WeChat, while the control group received routine health education and a self-management manual. The primary outcomes included BP and adherence indicators. Data analysis was performed using SPSS, with independent sample t tests, chi-square tests, paired t tests, and McNemar tests. A P value <.05 was considered statistically significant. RESULTS The final analysis included 54 participants with a mean age of 67.24 (SD 4.19) years (n=23 experimental group, n=31 control group). The experimental group had improvements in systolic BP (-7.36 mm Hg, P=.002), exercise time (856.35 metabolic equivalent [MET]-min/week, P<.001), medication adherence (0.56, P=.001), BP monitoring frequency (P=.02), and learning performance (3.23, P<.001). Both groups experienced weight reduction (experimental: 1.2 kg, P=.002; control: 1.11 kg, P=.009) after the intervention. The diet types and quantities for both groups (P<.001) as well as the subendocardial viability ratio (0.16, P=.01) showed significant improvement. However, there were no statistically significant changes in other health outcomes. CONCLUSIONS The observations suggest our program may have enhanced specific health outcomes and adherence to health behaviors in older adults with hypertension. However, a longer-term, larger-scale trial is necessary to validate the effectiveness. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2200062643; https://www.chictr.org.cn/showprojEN.html?proj=172782. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/46883.
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Affiliation(s)
- Ting Sun
- Graduate School, University of Science and Technology of China, Hefei, China
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- School of Nursing, Bengbu Medical University, Bengbu, China
| | - Xuejie Xu
- School of Nursing, Bengbu Medical University, Bengbu, China
| | - Zenghui Ding
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Hui Xie
- School of Nursing, Bengbu Medical University, Bengbu, China
| | - Linlin Ma
- School of Nursing, Bengbu Medical University, Bengbu, China
| | - Jing Zhang
- School of Nursing, Bengbu Medical University, Bengbu, China
| | - Yuxin Xia
- School of Nursing, Bengbu Medical University, Bengbu, China
| | - Guoli Zhang
- School of Nursing, Bengbu Medical University, Bengbu, China
| | - Zuchang Ma
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
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Alt A, Luomajoki H, Roese K, Luedtke K. How do non-specific back pain patients think about their adherence to physiotherapy, and what strategies do physiotherapists use to facilitate adherence? A focus group interview study. J Man Manip Ther 2024; 32:150-158. [PMID: 37725067 PMCID: PMC10956927 DOI: 10.1080/10669817.2023.2258699] [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: 04/17/2023] [Accepted: 09/09/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Long-term effectiveness of physiotherapy (PT) for low back pain (LBP) depends on the adherence of patients. Objectives: (1) Identify aspects associated with the adherence of patients with LBP to physiotherapy, and (2) identify factors to facilitate adherence of patients with LBP to PT. METHOD Focus group interviews were conducted with 10 patients with LBP (n = 10, 5 women) and 11 physiotherapists (5 women) from Germany and Switzerland, treating patients with LBP. Data analysis was based on structured content analysis. Deductive and inductive categories were identified and coded. RESULTS Patients with LBP requested more and effective home programs, long-term rehabilitation management, and individualized therapy to achieve a higher level of adherence. Physiotherapists requested more time for patient education. Communication, quality of the therapist-patient relationship, and individualized therapy were identified as essential factors by both representatives. CONCLUSION Patients and physiotherapists identified aspects contributing to adherence. These may guide the development of multidimensional measurement tools for adherence. In addition, this information can be used to develop PT approaches to facilitate the level of adherence.
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Affiliation(s)
- A Alt
- Department of Physiotherapy, Universität zu Lübeck, Institute of Health Sciences, Lübeck, Germany
| | - H Luomajoki
- Institute of physiotherapy, Zürich University of applied Sciences ZHAW, Winterthur, Switzerland
| | - K Roese
- Department of Occupational Therapy, Universität zu Lübeck, Institute of Health Sciences, Lübeck, Germany
| | - K Luedtke
- Department of Physiotherapy, Universität zu Lübeck, Institute of Health Sciences, Lübeck, Germany
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Dawson R, Oliveira JS, Kwok WS, Bratland M, Rajendran IM, Srinivasan A, Chu CY, Pinheiro MB, Hassett L, Sherrington C. Exercise Interventions Delivered Through Telehealth to Improve Physical Functioning for Older Adults with Frailty, Cognitive, or Mobility Disability: A Systematic Review and Meta-Analysis. Telemed J E Health 2024; 30:940-950. [PMID: 37975811 PMCID: PMC11035924 DOI: 10.1089/tmj.2023.0177] [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: 04/06/2023] [Revised: 08/17/2023] [Accepted: 09/01/2023] [Indexed: 11/19/2023] Open
Abstract
Introductions: This study assessed the effects of telehealth-delivered exercise interventions on physical functioning for older adults and explored implementation measures related to program delivery. Methods: We conducted a systematic review of studies investigating effects of exercise interventions delivered through telehealth in adults 60+ years of age with frailty, mobility, or cognitive disability on mobility, strength, balance, falls, and quality of life (QoL). Electronic databases (MEDLINE, CINAHL, SPORTSDiscus, and Physiotherapy Evidence Database) were searched from inception until May 2022. Evidence certainty was assessed with Grading of Recommendations, Assessment, Development, and Evaluation and meta-analysis summarized study effects. Results: A total of 11 studies were included, 5 randomized controlled trials, 2 pilot studies, and 4 feasibility studies. The overall certainty of evidence was rated as "low" or "very low." Pooled between-group differences were not statistically significant, but effect sizes suggested that telehealth produced a moderate improvement on mobility (n = 5 studies; standardized mean difference [SMD] = 0.63; 95% confidence interval [CI] = -0.25 to 1.51; p = 0.000, I2 = 86%) and strength (n = 4; SMD = 0.73; 95% CI = -0.10 to 1.56; p = 0.000, I2 = 84%), a small improvement on balance (n = 3; SMD = 0.40; 95% CI = -035 to 1.15; p = 0.012, I2 = 78%), and no effect on QoL. Analysis of implementation measures suggested telehealth to be feasible in this population, given high rates of acceptability and adherence with minimal safety concerns. Discussion: Telehealth may provide small to moderate benefits on a range of physical outcomes and appears to be well received in aged care populations.
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Affiliation(s)
- Rik Dawson
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Juliana S. Oliveira
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Wing S. Kwok
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Marte Bratland
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, Australia
| | - Ian Matthew Rajendran
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, Australia
| | - Ajith Srinivasan
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, Australia
| | - Chun Yin Chu
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, Australia
| | - Marina B. Pinheiro
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Leanne Hassett
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
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Lorenzo-Villarreal D, Monforte J, Úbeda-Colomer J, Albiñana N, Pérez-Samaniego V. "I needed something to hook me." A narrative study on adherence to Pilates. J Bodyw Mov Ther 2024; 38:534-540. [PMID: 38763604 DOI: 10.1016/j.jbmt.2024.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/18/2023] [Accepted: 03/15/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Exercise adherence is necessary for achieving long-term benefits. Along with other elements, stories and narratives can play a role in understanding and promoting adherence. The aim of the present study was to explore how stories and narratives may affect adherence to Pilates. METHOD 8 Pilates practitioners who had been participating in a Pilates program for 6 or more years were interviewed. Data obtained were analysed using thematic narrative analysis, (focusing on the whats of stories) and holistic narrative analysis (examining how narratives acted on adherence). RESULTS AND DISCUSSION Results highlight pain, Pilates as a health-related method, and the social relations as characters, plots and scenarios of stories enhancing long-term participation in Pilates. Exercise is medicine and eudaimonic well-being are presented as narratives articulating the coherence to practitioners' adherence. They act for participants subjectivizing their Pilates practice into a serious commitment to health. CONCLUSION Stories and narratives are relevant to give meaning and sense to the adherence to Pilates. A focus on stories can be added as a strategy to promote adherence to Pilates.
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Chandran G, Tang N, Ngo ELP, Huang S, Tong SI, Ong JX, Chew E. Comparing the efficacy of a multi-dimensional breast cancer rehabilitation programme versus a home-based exercise programme during adjuvant cancer treatment. BMC Cancer 2024; 24:361. [PMID: 38509471 PMCID: PMC10956284 DOI: 10.1186/s12885-024-12080-5] [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: 10/04/2023] [Accepted: 03/04/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Breast cancer is the most common female malignancy worldwide and a major cause of morbidity and mortality. Exercise during adjuvant treatment improves function and relieves symptoms in breast cancer survivors. However, it is unclear if an unsupervised exercise programme may be as effective as a supervised multimodal group. We investigated the feasibility and efficacy of a centre-based multidimensional rehabilitation (MDR) programme for breast cancer survivors undergoing adjuvant treatment and compared it to an unsupervised home-based exercise (HE) programme. METHODS Participants were self-allocated to either MDR or HE group. MDR participants underwent 24 supervised exercise classes and 10 education classes over 12 weeks. HE participants were instructed on a home exercise regime. Outcome measures, including the 6-min walk test (6MWT) and Frenchay Activities Index (FAI), FACT-Cognitive Function scale, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, were conducted at baseline (W0), post-intervention (W12) and 6-months post-intervention (M6). Variance between time points and the 2 groups were analysed using a linear mixed model (unstructured covariance matrix) and adjusted with Bonferroni. RESULT Twenty-five participants attended at least half of the MDR interventions, while 21 completed the HE interventions. The former showed significant improvement in 6MWT, from 406.88 m (W0) to 443.34 m (W12) to 452.81 m (M6), while the improvement in the HE group was not significant (407.67 m (W0) to 433.14 m (W12) to 430.96 m (M6)). Both groups showed a significant improvement in FAI, with earlier significant improvement noted at W12 in the MDR group (22.71 (W0) to 27.65 (W12) to 28.81 (M6)) compared to the HE group (23.16 (W0) to 26.47 (W12) to 29.85 (M6)). Dropout rate was 16% in the MDR group and 34% in HE group. Overall satisfaction with the MDR programme was high. CONCLUSION Both MDR and HE programmes were feasible. MDR was superior in improving endurance and earlier return to instrumental activities for those who completed at least half of the sessions. Future studies could explore use of technology to improve adherence to exercise. TRIAL REGISTRATION The study was registered with ClinicalTrial.gov on 01/04/2022 with the registration number NCT05306808.
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Affiliation(s)
- Gobinathan Chandran
- Department of Medicine, Division of Rehabilitation Medicine, National University Hospital, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597, Singapore
| | - Ning Tang
- Department of Medicine, Division of Rehabilitation Medicine, National University Hospital, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Ednajoy Lay Poh Ngo
- Division of Oncology Nursing, National University Cancer Institute, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Serene Huang
- Department of Medicine, Division of Rehabilitation Medicine, National University Hospital, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Shuk In Tong
- Department of Rehabilitation, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Jie Xin Ong
- Department of Rehabilitation, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Effie Chew
- Department of Medicine, Division of Rehabilitation Medicine, National University Hospital, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597, Singapore.
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Gómez-Redondo P, Valenzuela PL, Martínez-de-Quel Ó, Sánchez-Martín C, Cerezo-Arroyo M, Moreno-Manzanaro D, Alegre LM, Guadalupe-Grau A, Ara I, Mañas A. The role of supervision and motivation during exercise on physical and mental health in older adults: a study protocol for a randomized controlled trial (PRO-Training project). BMC Geriatr 2024; 24:274. [PMID: 38509514 PMCID: PMC10953175 DOI: 10.1186/s12877-024-04868-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/04/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Although supervised exercise is frequently recommended for older adults, its superiority over unsupervised exercise remains uncertain. Furthermore, whether motivational techniques could help to enhance the effectiveness of the latter remains to be elucidated. The present randomized controlled trial aims to determine the role of supervision and motivational strategies on the safety, adherence, efficacy, and cost-effectiveness of different exercise programs for improving physical and mental health in older adults. METHODS Participants (n = 120, aged 60-75 years) will be randomly allocated into five groups: 1-Control (CON), 2-Supervised exercise without motivational intervention (SUP), 3- Supervised exercise with motivational intervention (SUP +), 4- Unsupervised exercise without motivational intervention (UNSUP) and 5- Unsupervised exercise with motivational intervention (UNSUP +). Over 24 weeks, all exercise groups will participate in a multicomponent exercise program three times/week (performed in group classes at a center for SUP and SUP + , or home without supervision but with the help of a mobile app for UNSUP and UNSUP +), while the CON group will maintain their usual lifestyle. The motivational intervention (for SUP + and UNSUP + groups) will be based on the self-determination theory, including strategies such as phone calls, interactive workshops, motivational messages, informative infographics and videos. Primary outcomes will include safety, adherence, costs, and lower-body muscular function using a leg press machine. Secondary outcomes will include upper-body muscular function, physical and cardiorespiratory function, blood pressure and heart rate, body composition, health-related quality of life, cognitive performance, anxiety, depression, physical activity levels, sleep and sedentarism, biochemical markers, motivators and barriers to exercise. Assessments will be conducted at baseline, mid-intervention (i.e., week 13), at the end of the intervention (i.e., week 25), and 24 weeks later (i.e., week 49). DISCUSSION The findings of this trial might provide valuable insights into the role of supervision and motivational strategies on the effectiveness of exercise programs for older adults. Additionally, the study could contribute to developing cost-effective interventions, supporting the design of future public policies for healthy aging. TRIAL REGISTRATION NCT05619250. Registered 16 November 2022.
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Affiliation(s)
- Paola Gómez-Redondo
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital, 12 de Octubre (imas12), Madrid, Spain
- Department of Systems Biology, University of Alcalá, Madrid, Spain
| | - Óscar Martínez-de-Quel
- Didactics of Languages, Arts and Physical Education Department, Faculty of Education, Complutense University of Madrid, 28040, Madrid, Spain
- Faculty of Sciences for Physical Activity and Sport (INEF), Polytechnic University of Madrid, 28040, Madrid, Spain
| | - Coral Sánchez-Martín
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Mónica Cerezo-Arroyo
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - David Moreno-Manzanaro
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Luis M Alegre
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Amelia Guadalupe-Grau
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Asier Mañas
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain.
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain.
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain.
- Didactics of Languages, Arts and Physical Education Department, Faculty of Education, Complutense University of Madrid, 28040, Madrid, Spain.
- Center UCM-ISCIII for Human Evolution and Behavior, 28029, Madrid, Spain.
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De Coninck L, Declercq A, Bouckaert L, Döpp C, Graff MJL, Aertgeerts B. Promoting meaningful activities by occupational therapy in elderly care in Belgium: the ProMOTE intervention. BMC Geriatr 2024; 24:275. [PMID: 38509458 PMCID: PMC10953191 DOI: 10.1186/s12877-024-04797-6] [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: 03/21/2023] [Accepted: 02/08/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Older people want to age in place. Despite advancing functional limitations and their desire of aging in place, they are not always faithful to therapy that maintains independence and promotes safety. Occupational therapists can facilitate aging in place. Occupational therapy is defined as the therapeutic use of everyday life occupations with persons, groups, or populations for the purpose of enhancing or enabling participation. AIM To describe the content a high-adherence-to-therapy and evidence-based occupational therapy intervention to optimize functional performance and social participation of home-based physically frail older adults and wellbeing of their informal caregiver, and the research activities undertaken to design this intervention. METHODS A roadmap was created to develop the occupational therapy intervention. This roadmap is based on the Medical Research Council (MRC) framework and is supplemented with elements of the Intervention Mapping approach. The TIDieR checklist is applied to describe the intervention in detail. A systematic review and two qualitative studies substantiated the content of the intervention scientifically. RESULTS The application of the first two phases of the MRC framework resulted in the ProMOTE intervention (Promoting Meaningful activities by Occupational Therapy in Elderly). The ProMOTE intervention is a high-adherence-to-therapy occupational therapy intervention that consists of six steps and describes in detail the evidence-based components that are required to obtain an operational intervention for occupational therapy practice. CONCLUSION This study transparently reflects on the process of a high-quality occupational therapy intervention to optimize the functional performance and social participation of the home-based physically frail older adult and describes the ProMOTE intervention in detail. The ProMOTE intervention contributes to safely aging in place and to maintaining social participation. The designed intervention goes beyond a description of the 'what'. The added value lies in the interweaving of the 'why' and 'how'. By describing the 'how', our study makes the concept of 'therapeutic use-of-self' operational throughout the six steps of the occupational therapy intervention. A further rigorous study of the effect of the ProMOTE intervention on adherence, functional performance and social participation is recommended based to facilitate the implementation of this intervention on a national level in Belgium.
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Affiliation(s)
- Leen De Coninck
- Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 7, Leuven, 3000, Belgium.
- CEBAM Belgian Center for Evidence-based Medicine vzw, Kapucijnenvoer 7, Leuven, 3000, Belgium.
| | - Anja Declercq
- LUCAS Center for Care Research and Consultancy & CESO Center for Sociological Research, KU Leuven, Minderbroedersstraat 8, Leuven, 3000, Belgium
| | - Leen Bouckaert
- Department of Occupational Therapy, Artevelde University of Applied Sciences, Voetweg 66, Ghent, 9000, Belgium
| | - Carola Döpp
- Scientific Institute for Quality of Health Care, Department of Rehabilitation, Radboudumc Research Institute, Radboud University Medical Center, Houtlaan 4, Nijmegen, 6525 XZ, The Netherlands
| | - Maud J L Graff
- Scientific Institute for Quality of Health Care, Department of Rehabilitation, Radboudumc Research Institute, Radboud University Medical Center, Houtlaan 4, Nijmegen, 6525 XZ, The Netherlands
| | - Bert Aertgeerts
- Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 7, Leuven, 3000, Belgium.
- CEBAM Belgian Center for Evidence-based Medicine vzw, Kapucijnenvoer 7, Leuven, 3000, Belgium.
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Gao D, Su Y, Zhang X, Li H, Luo H. The application of virtual reality meditation and mind-body exercises among older adults. Front Psychol 2024; 15:1303880. [PMID: 38566950 PMCID: PMC10985321 DOI: 10.3389/fpsyg.2024.1303880] [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: 09/29/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Virtual reality (VR)-based mindfulness is a promising method to improve the health of older adults. Therefore, many attempts have been made to explore the application of VR-based mindfulness, such as VR meditation and mind-body exercises, in older adults. Generally, current studies indicate the heavy reliance on apparatus for implementing VR-based mindfulness interventions. In VR meditation, the crucial apparatus is VR headsets. In VR mind-body exercises, three essential components are required: motion capture sensors, main consoles, and display screens. In the aspect of health promotion, VR meditation is an effective method for improving mental health, pain, and quality of life in older adults. VR mind-body exercises contribute to increasing the mental health and physical function of older adults. Furthermore, VR mind-body exercises may be combined with other forms of exercise as a mixed method to promote the health of older adults. VR-based mindfulness interventions enhance the meditation and mind-body exercises experience for older adults while improving accessibility. However, their implementation still encounters a series of challenges, such as cost, technical anxiety, and apparatus-related issues. Additionally, we recommend future research to examine the optimal exercise dose for VR mind-body exercises to maximize their health benefits.
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Affiliation(s)
- Dong Gao
- College of Physical Education, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Yuqin Su
- Institute of Sports Science, College of Physical Education, Southwest University, Chongqing, China
| | - Xing Zhang
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Hansen Li
- Institute of Sports Science, College of Physical Education, Southwest University, Chongqing, China
| | - Hongcheng Luo
- School of Physical Education, Xichang University, Xichang, China
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Moro T, Casolo A, Bordignon V, Sampieri A, Schiavinotto G, Vigo L, Ghisi M, Paoli A, Cerea S. Keep calm and keep rowing: the psychophysical effects of dragon boat program in breast cancer survivors. Support Care Cancer 2024; 32:218. [PMID: 38456933 PMCID: PMC10924022 DOI: 10.1007/s00520-024-08420-7] [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: 09/29/2023] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE Dragon Boat discipline has become a popular type of physical exercise among women with breast cancer. The present study aims to investigate the effects of Dragon Boat activity on body composition, physical function, and psychosocial aspects (i.e., body appreciation and quality of life [QoL]) in women operated for breast cancer. METHODS Thirty-one women (age, 57.88 ± 7.88 years; BMI, 27.86 ± 6.38 kg·m-2) with a previous breast removal surgery were recruited and randomized into two groups: Dragon Boat group (DB, N = 18) or a home-based non-supervised training program (home exercise group; HG, N = 13). All participants underwent body composition, handgrip test, 30-s chair stand test (30CST), 6-min walking test (6MWT), and shoulder mobility measurements at baseline and after 12 weeks of intervention. Participants also filled out the Body Appreciation Scale-2 (BAS-2) and the Short Form Health Survey-12 (SF-12) self-report questionnaires. RESULTS Dragon Boat activity significantly improved the 30CST (+ 6%, p = .011) and 6MWT performance (+ 30%, p = .011) compared to a home-based non-supervised training program. Moreover, 20% (3/15 women) of women in the DB group obtained a reliable change from pre- to post-intervention in the BAS-2 and in the mental QoL component of the SF-12 (vs 15% and 0% of the HC group). No reliable change emerged for the physical component of the SF-12. CONCLUSION Dragon Boat activity is efficient to improve lower limb strength in women operated for breast cancer. Furthermore, Dragon Boat activity emerged to improve body appreciation and mental QoL in some of the women assigned to this activity. Importantly, no adverse events were documented during the intervention. TRIAL REGISTRATION NCT05206526 (10/02/2022).
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Affiliation(s)
- Tatiana Moro
- Department of Biomedical Sciences, Istituto Di Fisiologia, University of Padova, Via Marzolo 3, 35131, Padua, Italy
| | - Andrea Casolo
- Department of Biomedical Sciences, Istituto Di Fisiologia, University of Padova, Via Marzolo 3, 35131, Padua, Italy.
| | - Veronica Bordignon
- Department of Biomedical Sciences, Istituto Di Fisiologia, University of Padova, Via Marzolo 3, 35131, Padua, Italy
| | - Alessandro Sampieri
- Department of Biomedical Sciences, Istituto Di Fisiologia, University of Padova, Via Marzolo 3, 35131, Padua, Italy
| | - Giorgia Schiavinotto
- Department of Biomedical Sciences, Istituto Di Fisiologia, University of Padova, Via Marzolo 3, 35131, Padua, Italy
| | - Lisa Vigo
- Department of Biomedical Sciences, Istituto Di Fisiologia, University of Padova, Via Marzolo 3, 35131, Padua, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padova, Padua, Italy
- Unità Operativa Complessa (UOC) Hospital Psychology, University-Hospital of Padova, Padua, Italy
| | - Antonio Paoli
- Department of Biomedical Sciences, Istituto Di Fisiologia, University of Padova, Via Marzolo 3, 35131, Padua, Italy
| | - Silvia Cerea
- Department of Biomedical Sciences, Istituto Di Fisiologia, University of Padova, Via Marzolo 3, 35131, Padua, Italy
- Department of General Psychology, University of Padova, Padua, Italy
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Vahedian-Azimi A, Sanjari MJ, Rahimi-Bashar F, Gohari-Mogadam K, Ouahrani A, Mustafa EMM, Ait Hssain A, Sahebkar A. Cardiac Rehabilitation Using the Family-Centered Empowerment Model is Effective in Improving Long-term Mortality in Patients with Myocardial Infarction: A 10-year Follow-Up Randomized Clinical Trial. High Blood Press Cardiovasc Prev 2024; 31:189-204. [PMID: 38564167 DOI: 10.1007/s40292-024-00636-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Cardiac rehabilitation (CR) play a critical role in reducing the risk of future cardiovascular events and enhancing the quality of life for individuals who have survived a heart attack. AIM To assess the mortality rates and stability of the effects in myocardial infarction (MI) survivors after implementing a Family-Centered Empowerment Model (FCEM)-focused hybrid cardiac rehabilitation program. METHODS This double-blind randomized controlled clinical trial, conducted at Shariati Hospital, an academic teaching hospital in Tehran, Iran (2012-2023), involved 70 MI patients and their families. Participants were randomly assigned to an FCEM intervention group or standard CR control group. The intervention commenced after the MI patient's safe discharge from the CCU and continued for the entire 10-year follow-up period. Various questionnaires were utilized to collect data on mortality rates and health-related quality of life (HRQoL). RESULTS The 10-year follow-up period revealed lower mortality rates in the intervention group (5.7%, 11.4%, and 17.1% at 5, 7, and 10 years, respectively) compared to the control group (20%, 37.1%, and 48.9%). After adjusting for age, gender, and BMI, the control group had a four times higher mortality risk (HR: 4.346, 95% CI 1.671-7.307, P = 0.003). The FCEM-focused program demonstrated a significant and sustained positive impact on participants' quality of life for 48 months, with greater improvement compared to the control group. CONCLUSION This study highlights the effectiveness of FCEM-based hybrid CR programs in enhancing long-term patient outcomes and reducing mortality rates among MI survivors. Further research is needed to explore the potential benefits in larger samples and diverse populations. TRIAL REGISTRATION This study (Identifier: NCT02402582) was registered in the ClinicalTrials.gov on 03/30/2015.
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Affiliation(s)
- Amir Vahedian-Azimi
- Trauma research center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Sanjari
- Trauma research center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Keivan Gohari-Mogadam
- Medical ICU and Pulmonary Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ayoub Ouahrani
- Department of Anesthesiology and Intensive Care, Dijon University Hospital, Dijon, France
| | | | - Ali Ait Hssain
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar.
- Department of Medicine, Weill Cornell Medical College, Doha, Qatar.
| | - Amirhossein Sahebkar
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
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Letton ME, Macdonald ER, Thom JM, Ward RE. Classical Ballet for Women Aged Over 50 Years: Investigating Balance, Strength, and Range of Motion. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:171-182. [PMID: 37036402 DOI: 10.1080/02701367.2023.2169236] [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: 02/28/2022] [Accepted: 01/11/2023] [Indexed: 06/19/2023]
Abstract
Background: Regular exercise can mitigate the loss of strength, balance, and flexibility that contribute to age-related decline in physical function and mobility. However, traditional exercise interventions often report poor adherence rates. There is growing interest in classical ballet as an enjoyable exercise modality for adults in middle to late age. Classical ballet requires muscular strength, coordination, and flexibility. The current study investigated a classical ballet intervention on the balance, physical function, and range of motion of women aged over 50 years. Methods: Twenty-two healthy female participants (aged 56.2 (4.5) years (mean (SD)) completed a 10-week ballet intervention. Results: This single-arm study showed significant improvements (p<.05) in lower limb strength (measured by 5 times sit-to-stand and forward leap) and high adherence rates (95% adherence for participants who completed the intervention). No adverse events were reported. Improvements in balance were reported in the left leg only (as measured by center of pressure ellipse area in the parallel retiré condition). Conclusions: These results allude to the positive effects of ballet training on strength and balance in adults aged 50 years and over. High adherence rates suggest that ballet training was enjoyed and may thus be a long-term exercise modality for this population. Although this study was a single-arm design, it suggests promising results for future research wishing to evaluate the effectiveness of classical ballet training using randomized controlled trial designs.
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Affiliation(s)
| | | | - Jeanette M Thom
- University of New South Wales
- Neuroscience Research Australia (NeuRA)
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Lee A, Dionicio P, Farcas E, Godino J, Patrick K, Wyckoff E, Loh KJ, Gombatto S. Physical Therapists' Acceptance of a Wearable, Fabric-Based Sensor System (Motion Tape) for Use in Clinical Practice: Qualitative Focus Group Study. JMIR Hum Factors 2024; 11:e55246. [PMID: 38421708 PMCID: PMC10940997 DOI: 10.2196/55246] [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: 12/08/2023] [Revised: 01/13/2024] [Accepted: 01/17/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Low back pain (LBP) is a costly global health condition that affects individuals of all ages and genders. Physical therapy (PT) is a commonly used and effective intervention for the management of LBP and incorporates movement assessment and therapeutic exercise. A newly developed wearable, fabric-based sensor system, Motion Tape, uses novel sensing and data modeling to measure lumbar spine movements unobtrusively and thus offers potential benefits when used in conjunction with PT. However, physical therapists' acceptance of Motion Tape remains unexplored. OBJECTIVE The primary aim of this research study was to evaluate physical therapists' acceptance of Motion Tape to be used for the management of LBP. The secondary aim was to explore physical therapists' recommendations for future device development. METHODS Licensed physical therapists from the American Physical Therapy Association Academy of Leadership Technology Special Interest Group participated in this study. Overall, 2 focus groups (FGs; N=8) were conducted, in which participants were presented with Motion Tape samples and examples of app data output on a poster. Informed by the Technology Acceptance Model, we conducted semistructured FGs and explored the wearability, usefulness, and ease of use of and suggestions for improvements in Motion Tape for PT management of LBP. FG data were transcribed and analyzed using rapid qualitative analysis. RESULTS Regarding wearability, participants perceived that Motion Tape would be able to adhere for several days, with some variability owing to external factors. Feedback was positive for the low-profile and universal fit, but discomfort owing to wires and potential friction with clothing was of concern. Other concerns included difficulty with self-application and potential skin sensitivity. Regarding usefulness, participants expressed that Motion Tape would enhance the efficiency and specificity of assessments and treatment. Regarding ease of use, participants stated that the app would be easy, but data management and challenges with interpretation were of concern. Physical therapists provided several recommendations for future design improvements including having a wireless system or removable wires, customizable sizes for the tape, and output including range of motion data and summary graphs and adding app features that consider patient input and context. CONCLUSIONS Several themes related to Motion Tape's wearability, usefulness, and ease of use were identified. Overall, physical therapists expressed acceptance of Motion Tape's potential for assessing and monitoring low back posture and movement, both within and outside clinical settings. Participants expressed that Motion Tape would be a valuable tool for the personalized treatment of LBP but highlighted several future improvements needed for Motion Tape to be used in practice.
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Affiliation(s)
- Audrey Lee
- Department of Bioengineering, San Diego State University, San Diego, CA, United States
| | - Patricia Dionicio
- Joint Doctoral Program in Public Health, San Diego State University and University of California San Diego, San Diego, CA, United States
| | - Emilia Farcas
- Qualcomm Institute, University of California San Diego, La Jolla, CA, United States
| | - Job Godino
- Qualcomm Institute, University of California San Diego, La Jolla, CA, United States
| | - Kevin Patrick
- Qualcomm Institute, University of California San Diego, La Jolla, CA, United States
- School of Public Health, University of California San Diego, La Jolla, CA, United States
| | - Elijah Wyckoff
- Active, Responsive, Multifunctional, and Ordered-materials Research (ARMOR) Laboratory, Department of Structural Engineering, University of California San Diego, La Jolla, CA, United States
| | - Kenneth J Loh
- Active, Responsive, Multifunctional, and Ordered-materials Research (ARMOR) Laboratory, Department of Structural Engineering, University of California San Diego, La Jolla, CA, United States
| | - Sara Gombatto
- School of Exercise & Nutritional Sciences, College of Health & Human Services, San Diego State University, San Diego, CA, United States
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Platz K, Metzger M, Cavanagh C, Park L, Howie-Esquivel J. Initiating and Continuing Long-Term Exercise in Heart Failure: A Qualitative Analysis From the GEtting iNTo Light Exercise-Heart Failure Study. J Cardiovasc Nurs 2024:00005082-990000000-00170. [PMID: 38411493 DOI: 10.1097/jcn.0000000000001086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
BACKGROUND Exercise is a class 1A recommendation to improve the lives of patients with heart failure, yet less than one-third adhere to physical activity guidelines, and less than 3% attend cardiac rehabilitation. OBJECTIVE The aim of this study was to determine the effect of gentle nonaerobic exercise on initial and long-term adherence in patients with heart failure. METHODS We used a qualitative descriptive approach with qualitative content analysis to analyze previously recorded interview data collected as part of the 6-month GEtting iNTo Light Exercise-Heart Failure study and looked for trends in responses among our sample. Thematic statements, representing salient aspects of the participants' experiences, were created and supported by illustrative excerpts from the data. RESULTS Twenty-two interviews were analyzed. Eight participants had ≥80% adherence, and the remaining 14 participants were super-adherers (>100% adherence). Super-adherers tended to be male and 65 years or older, and have no exercise for 3 months before the study, a body mass index ≥ 30, and poor to good Kansas City Cardiomyopathy Questionnaire scores. Participants initially enrolled because they saw the program as an opportunity to improve a health issue and to exercise. Long-term adherence was facilitated by convenience, individualization, experiencing psychological and physical improvements, and peer fellowship. CONCLUSIONS The GEtting iNTo Light Exercise-Heart Failure study that used home-based gentle nonaerobic exercise had 64% of participants come more than was asked. It is imperative that clinicians incorporate what participants with heart failure have directly stated is important for their initiation and long-term adherence to exercise so that we can work toward bridging sedentary patients to the full exercise guidelines to reduce morbidity and mortality.
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Lim JY, Yu H, Kwon YE, Do JG, Hwang JH. Feasibility of digital technology-supported home exercise intervention for health promotion in community-dwelling older adults: A pilot randomized controlled trial. Heliyon 2024; 10:e24933. [PMID: 38333828 PMCID: PMC10850410 DOI: 10.1016/j.heliyon.2024.e24933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/10/2023] [Accepted: 01/17/2024] [Indexed: 02/10/2024] Open
Affiliation(s)
- Ji Young Lim
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Heeju Yu
- Department of Physical Therapy, Graduate School, Sahmyook University, Republic of Korea
| | - Yeah Eun Kwon
- Research Institute for Future Medicine, Samsung Medical Center, Republic of Korea
| | - Jong Geol Do
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea
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Straiton N, Moons P, Verstrael A, Liu M, Winter MM. Beyond Validation: Getting Wearable Activity Trackers into Cardiovascular Care - A Discussion Paper. Eur J Cardiovasc Nurs 2024:zvae019. [PMID: 38345842 DOI: 10.1093/eurjcn/zvae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 04/24/2024]
Abstract
This paper addresses the challenge of integrating wearable activity trackers into cardiovascular disease care. Despite evidence supporting the use of trackers for monitoring and promoting physical activity, implementation challenges persist in clinical settings. The paper emphasises the lack of systematic, evidence-based implementation approaches for integrating trackers. It underscores the urgent need for stakeholder collaboration between clinicians, patients, implementation scientists, researchers, health and technology partners, and the use of proven implementation science methodologies. This is crucial for bridging the gap and ensuring effective translation of wearable activity trackers into cardiovascular disease care, meeting the increasing demand from patients and clinicians.
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Affiliation(s)
- Nicola Straiton
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, New South Wales, Australia
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 7 PB7001, 3000 Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Klipfontein Rd, Rondebosch, 7700 Cape Town, South Africa
| | - Axel Verstrael
- ESC Patient's Platform, European Society of Cardiology, Sophia Antipolis Cedex, France
| | - Mark Liu
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney
| | - Michiel M Winter
- University of Amsterdam, Heart Center; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam, The Netherlands
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Ning H, Chen F, Li J, Du Y, Chen X, Wu S, Joseph A, Gao Y, Cao Z, Feng H. Effectiveness of a multicomponent exercise intervention in community-dwelling older Chinese people with cognitive frailty: protocol for a mixed-methods research. Front Aging Neurosci 2024; 16:1282263. [PMID: 38410748 PMCID: PMC10895061 DOI: 10.3389/fnagi.2024.1282263] [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: 08/23/2023] [Accepted: 01/15/2024] [Indexed: 02/28/2024] Open
Abstract
Aims To evaluate the effectiveness of a multicomponent exercise intervention and to clarify the underlying mechanisms of the program in community-dwelling older adults with cognitive frailty. Additionally, the perception of participants in the program will be explored. Design A mixed-methods design, including a randomized controlled trial and an exploratory qualitative study, was used. Methods Each group consists of 41 participants. The experimental group will undergo a 12-week multicomponent exercise intervention, including warm-up, exergaming aerobic exercise, elastic-band resistance exercise, and cool-down. This intervention was developed based on the Health Belief Model (HBM) and Self-Efficacy Model (SEM). The control group will not receive any intervention. Physical frailty and cognitive function will be considered as primary outcomes. Data will be collected both at baseline and at the end of the intervention period. Fisher's exact test, analysis of covariance, and generalized linear models will be conducted to compare mean changes between the two groups. Additionally, the mediation models will be used to examine whether any intervention effects are mediated through exercise self-efficacy. Discussion The findings of this study are anticipated to provide valuable insights for healthcare providers, enabling them to learn about effective strategies to enhance exercise adherence and promote improved functionality, independence, and quality of life for older adults with cognitive frailty.Clinical trial registration: [https://clinicaltrials.gov/], identifier [ChiCTR2200058850].
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Affiliation(s)
- Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Fenghui Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- Nursing School, Xinjiang Medical University, Urumqi, China
| | - Junxin Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Yan Du
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Xi Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Shuang Wu
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Abigael Joseph
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Yinyan Gao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Zeng Cao
- Department of Physical Medicine and Rehabilitation, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Waaler PN, Bongo LA, Rolandsen C, Lorem GF. An individually adjusted approach for communicating epidemiological results on health and lifestyle to patients. Sci Rep 2024; 14:3199. [PMID: 38331938 PMCID: PMC10853548 DOI: 10.1038/s41598-024-53275-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
If scientific research on modifiable risk factors was more accessible to the general population there is a potential to prevent disease and promote health. Mobile applications can automatically combine individual characteristics and statistical models of health to present scientific information as individually tailored visuals, and thus there is untapped potential in incorporating scientific research into apps aimed at promoting healthier lifestyles. As a proof-of-concept, we develop a statistical model of the relationship between Self-rated-health (SRH) and lifestyle-related factors, and a simple app for conveying its effects through a visualisation that sets the individual as the frame of reference. Using data from the 6th (n = 12 981, 53.4% women and 46.6% men) and 7th (n = 21 083, 52.5% women and 47.5% men) iteration of the Tromsø population survey, we fitted a mixed effects linear regression model that models mean SRH as a function of self-reported intensity and frequency of physical activity (PA), BMI, mental health symptoms (HSCL-10), smoking, support from friends, and HbA1c ≥ 6.5%. We adjusted for socioeconomic and demographic factors and comorbidity. We designed a simple proof-of-concept app to register relevant user information, and use the SRH-model to translate the present status of the user into suggestions for lifestyle changes along with predicted health effects. SRH was strongly related to modifiable health factors. The strongest modifiable predictors of SRH were mental health symptoms and PA. The mean adjusted difference in SRH between those with 10-HSCL index = 1.85 (threshold for mental distress) and HSCL-10 = 1 was 0.59 (CI 0.61-0.57). Vigorous physical activity (exercising to exhaustion ≥ 4 days/week relative to sedentary) was associated with an increase on the SRH scale of 0.64 (CI 0.56-0.73). Physical activity intensity and frequency interacted positively, with large PA-volume (frequency ⨯ intensity) being particularly predictive of high SRH. Incorporating statistical models of health into lifestyle apps have great potential for effectively communicating complex health research to a general audience. Such an approach could improve lifestyle apps by helping to make the recommendations more scientifically rigorous and personalised, and offer a more comprehensive overview of lifestyle factors and their importance.
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Affiliation(s)
- Per Niklas Waaler
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lars Ailo Bongo
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Christina Rolandsen
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
- Deloitte AS, Oslo, Norway
| | - Geir F Lorem
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway.
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Singh J, Jawhari K, Jaffé M, Imfeld L, Rabenschlag F, Moeller J, Nienaber A, Lang UE, Huber CG. Implementation of a Budo group therapy for psychiatric in- and outpatients: a feasibility study. Front Psychiatry 2024; 15:1338484. [PMID: 38370554 PMCID: PMC10873915 DOI: 10.3389/fpsyt.2024.1338484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/09/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction Physical exercise has been shown to have numerous health benefits on co-morbid somatic conditions in psychiatry and can also enhance mental health. Thus, it is not difficult to recommend physical training programs as part of an integrated and holistic treatment approach for mental health disorders. However, getting patients to participate and keeping them engaged is a major challenge. Programs based on martial arts training could be interventions improving physical and mental health with higher attachment rates. The structured discipline, holistic approach integrating physical and mental elements, and empowering activities, may explain higher participant attachment rates. Methods Thus, the main objective of this feasibility study is to describe a newly established group therapy program incorporating interventions from martial arts training with its physical and philosophical parts including mindfulness and breath work. Results During the 14-month study period from April 2021 to May 2022, a Budo group therapy was used by 215 individual persons with a total of 725 group therapy participations. Retention in the program was good across all settings and very good for persons who participated as outpatients. The mean age of the participants was 33.5 years with a range from 14 to 69 years of age, and about 41% of the participants were female. The therapy program was able to address patients over the whole spectrum of psychiatric diagnoses. Satisfaction and motivation were uniformly self-reported as very good. Patients self-reported improved mental and physical health after participating in a Budo session compared to pre-session. Discussion Budo group therapy thus can be seen as a feasible, well-accepted and promising new transdiagnostic treatment approach, combining physical activation with resilience enhancement. With minimal contraindications, a broad spectrum of individuals seeking mental health support can engage in this group therapy.
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Affiliation(s)
- Jasprit Singh
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Karl Jawhari
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Mariela Jaffé
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Lukas Imfeld
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Franziska Rabenschlag
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Julian Moeller
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - André Nienaber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Department for Public Mental Health, Zentralinstitut für Seelische Gesundheit, Mannheim, Germany
| | - Undine E. Lang
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Christian G. Huber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
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